HomeMy WebLinkAbout0161 JONES ROAD - Health 161 JONES ROAD,MARSTONS MILLS
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TOWN OF BARNSTABLE
LOCATION /tom[ 30's � 9£ �M'ar#
VILLAGE )1� ASSESSOR'S MAP&PARCEL
RiSTA- ER'S NAME&PHONE NO. tcc.'�r i Cle—06 it6t/
SEPTIC TANK CAPACITY 1;600
LEACHING FACILITY:(type) (size)
NO.OF BEDROOAmuo .
S
OWNER
PERMIT DATE: CONtE DATE:*::Ck .S 1 113
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
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Back Yard
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address ^
Robert McAnaw 0`1—7 0_
Owner Owner's Name.
information is MA 02632 May 20, 2013
required for ui11e '� �SC1��� ---- --� — -- --- - - —
every page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important: A. General Information
When filling out
forms on the
computer,use 1. Inspector: l
only the tab key l �j I � `
to move your Patrick M. O'Connell (/
cursor-do not Name of Inspector
use the return
key. Septic Inspection Services Co.
Company Name
116 PO Box 1487
--------------------------------------------
Company Address
Marstons Mills MA 02648
City/Town 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 15.3.340 of
Title 5 (310 CMR 15.000). The system: ca p
® Passes ❑ Conditionally Passes ❑ F;ai1sa
❑ Needs FurtherEvaluation by the Local Approving Authority
y
May 20, 2013 _ Job# 13-41
Inspector's Si nature Date M
l/1 �
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.
x***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.
IZ/0I�,3
I5ins•3/13 Title 5 ffic Inspection Form Subsurface Sewage Disposal System•Page 1 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Robert McAnaw --- --- --------- —----
Owner Owner's Name
information is required for Centerville MA 02632 May 20, 2013 '
—_..------------- -- --
every 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:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR '5.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
Recommend pumping tank, leaching system had 4-5" of standing water with no evidence of
surcharge.
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 inspectior if the existing tank is replaced with a complying septic t�.nk 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 indicat ng that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
l5ins•3113 1ale 5 otliciai Inspection Form Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA 02632 May 20, 2013
required for ------------— — -- ---- —-- y
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (Cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health ;n order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b) that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
w 161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name -------- -------------- ----- -- ----
information is Centerville MA 02632 May 20, 2013
required for ------...---- -._---- ---- --- y
every 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 fe_ 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_day flow
l5ins•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
w 161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is required for Centerville -MA—,-- 0_2632 _ May 20, 2013
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, 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 wa;:,r 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.
15ins-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
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name ------------------------ ---
information is Centerville MA_ 02632 May 20, 2013
required for _.__ _ Y
every page. City/Town State Zip Code Da!1 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): 3- - - Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): 330
15ins•3/13 Title 5 Official Inspection Form Subsurf t Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name -------- —-
information is Centerville _ _MA 02632 _Md 20, 2013
required for _ _ y
every page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 3
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:
Sump pump? ❑ Yes ® No
Last date of occupancy: CurrentlyOccupied.
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: ----- ----
15ins•3/13 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
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA 02632 May 20, 2013
required for ------------ ------------- ----_ ----- y
every page. City/Town Stale 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: Unknown
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 inspecti:n records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ - Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
C. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA_ 02632 May 20, 2013
required for _ _ y
every 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:
Leacihng system upgraded 5/12/08. Tank is original.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 1
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Septic Tank (locate on site plan):
Depth below grade: 8"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.
----
4"
Sludge depth: — - --
t5ins•3/13 Title 5 Official Inspection Form Subsur'��e Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
w 161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville
required for MA_ 02632 _ May 20, 2013
every page. City/Town 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 26
Scum thickness 3
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 10"
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.):
Observed solids in outlet tee, recommend pumping tank. Liquid level was found at bottom ofoutlet
invert and tees were intact.
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•3113 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
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA 02632 May 20, 2013
required for ---- -- —
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethy:--ne ❑ 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 Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA 02632 May 20 2013
required for _ Y
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 0
il
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.):
Observed a trace of solids carryover, no high stains present. Liquid level was at bottom of outlet pipe.
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:
l5ins•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA 02632 May 20, 2013
required for _ __. _ y
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number:
Three Infiltrators.
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology: -- -
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Interior of infiltrators were video inspected, observed 4-5"of standing water and no evidence of
surcharge.
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•3/13 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
161 Jones Road
Property Address
Robert McAnaw _
Owner Owner's Name
information is Centerville MA 02632 May 20, 2013
required for — y
every page. Citylrown State Zip Code Da:'of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction: ---- —
Dimensions
Depth of solids - —
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
15ins-3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
i
1 Subsurface Sewage Disposal System Form Not for Voluntary Assessments
j 161 Jones Road
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA 02632 M? 20, 2013
n
required for Cit �!--- —------- —
every page. y�own _ -- —_ State — Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
34
16
26
} , ` 41
Back Yard
.<rCommonwealth of Massachusetts
w. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road _
Property Address
Robert McAnaw
Owner Owner's Name
information is Centerville MA 02632 May 20, 2013
required for _ Y
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 20+feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health - explain:
❑ Checked with local excavators, installers - (attach documentation.)
❑ Accessed USGS database -explain:
You must describe how you established the high ground water elevation:
Low area of adjacent property with no surface water is considerablylower ower than SAS.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
15ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 16 of 17
'Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road _
Property Address
Robert McAnaw
Owner Owner's Name
information is
required for Centerville MA_ 02632 May 20, 2013
every 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 attach:,,d in separate file
l5ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 17 of 17
TOWN OF BARNSTABLE
LOCATION /G/ �OheS' {2o�t� SEWAGE # 2ao8� /8G
VI L.AGE 41.0.,15/`0l S GLIl/s ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. SD$-y?0-97Tg J,,Se - ,19,s z?Ow®l
SEPTIC TANK CAPACITY /d00 ~
LEACHING FACILITY: (type) ,3— 30Sds L.101 rS (size) .�SX /Z 4
NO. OF BEDROOMS /
BUILDER OR OWNER
PERMITDATE: S- DS COMPLIANCE DATE: / -OB
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching_ Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leachi g facility) Feet
Furnished by rutu^✓
+ JOHCS ROp[f
I �
d+9�
2 G,
17,
ZN9�EG1014
orr
•
No. �DO ' 1 Fee '
THE CbMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
0[ppYf cation for ;Mt!5po.5a1 ,pgtem Con5tructiou Permit
Application for a Permit to Construct(e),<'epair(• Upgrade O Abandon O ❑.Complete System ❑Individual Components
Location Address or Lot No.nw vlooe$ 4v"0► Owner's Name,Address;and Tel.No.
Assessor's Map/Parcel 0 g 1 1 O4!/ G
08-- g20 77s'2
Installer's Name,Address,and Tel.No.-s Designer's Name,Address and Tel.No.S®9'—
/ C .e-nt oeor/ rsro I/ pp, o>< 8/ F', ra.��/�d c oA s-s
Type of Building:Dwelling No.of Bedrooms 3 Lot Size oZ3 631 sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 30 gpd Design flow provided 3 3 I 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(Answerwhen applicable) Z/1,SPol/ 3 50S-0 Liq oli Irewnir-Y L/rJ/TS
tell T4 5' `Ined-4 19ryvs o /
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date S- 7`�
Application Approved by Date 7'0
Application Disapproved by: Date
for the following reasons
Permit No. ���a �8 Date Issued ��? _0
' .. -.^.+ti.•Y��y.lc t-....,.,,:'Y•1,..-.,.,. ..y wr.�,.a ��^.,.,., � r •"a.. .vyfy.y .e.P' T�-�c^erg .1L.....•'�^ :.w i .:,r- ..
4+�p,µ.# �.k,`: '
! � No. �DO e� YYYYY''' r Fee
� I
THE d MONWEALTH OF MASSAC USETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Application for i0tqozal �&pgtem Congtructton Permit
t Application for a Permit to Construct(Ai., epair(�de( ) Abandon( ) ❑.Complete System ❑Individual Components
Location Address or Lot No. I I vlorl.s5 a"qw Owner's Name,Address,and Tel.No.
M, 4 ,'I,(r
Assessor's Map/Parcel
odtogZ9-77Sa /y
Installer's Name,Address,and Tel.No. S Designer's Name,Address and Tel.No.
Type of Building: 2 ,
Dwelling No.of Bedrooms Lot Size 023 6 > sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) - gpd Design flow provided 3 3 y 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) 1"i9 5tsa�� 3 jos-O �y��fr�aTurS LIJI/1�S
i
wf r4 y `_Yrox-e �9rc�vh�
i
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed ,. Date S- 7-
Application Approved by ( Date 7
Application Disapproved by: Date
i`
for the following reasons
� y
Permit No. 9015 �S 6 Date Issued S"7 -00
--------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance �
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( e,4- RepairL,(k Upgraded ( )
Abandoned( )by o ,z
at 161 jAleo'G S /P02 NdAwm w r 0,f,1/c has been cons trt cte&in accordance J
with the provisions of Title 5 and the for Disposal System Construction Permit No. 02 00� 46 dated 5-7_Oa
Installer ,Adis Qi �IAY:"US Designer aae ,
�/-
#bedrooms _3 Approved design flow gpd
The issuance of this permit sha)1 not be construed as a guarantee that the system il,1715n ' ma a igned.
Date �($"�$ Inspector , j
No. a000 —��b --- Fee �� ---
THE COMMONWEALTH OF MASSACHUSETTS
F PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
1=i5po5al *p!gtem Construction Permit
Permission is hereby granted to Construct Repair ( 4.A` Upgrade ( ) Abandon ( )
System located at
i Y �G/ . ar/e���
i
r7�,or S rD r!S `LI�l�s
and as described in the above Application for Disposal System Construction Permit.The appl' ant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
F Provided: Construction must be completed within three years of the date of this permit.
Date — Loa Approved by
Town of Barnstable
�fTHE TQk, Regulatory Services
v ti
yP O�
_ Thomas F. Geiler,Director
'* BA"STABM
Public Health Division
ATfO►Yw'ta Thomas McKean;Director
200 Main Street,Hyannis,MA 02601
Office:. 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: Sewage Permit# uo R. a6 Assessor's Map\Parcel 4 7-0
Designer: }}-2-1�j� �e Installer: jl,.6es,W Ti
Address: . U P,0 CK- Address:
On .S-7 -g c�o �i ��,�i�rra 5 was issued a permit to install-a-
(date) (installer)
septic system at jG J®V,&S based on a design drawn by
n (address)
TA.We\ '"1. M dated
(designer) -
- I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the -
distribution box and/or septic tank. Stripout (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 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in.accordance with State & Local Regulations. Plarr-revision or
certified as-built by designer to follow. Stripout (if required nspected-arid the soils
were found satisfactory. VA of
0 R
(Installer's Signature) " E H
I 114.0
o+sr���o
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNI TABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Septic\Designer Certification Form Rev 03-09-06.doc
i
Tb1E Town of Barnstable Barnstable
�F T��
Regulatory Services Department ASAmedca M
1{ BARNSTABLE,
MASS 3 : Public Health Division
�p i6gq. �0 m
ATfD a"A�a 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
January 2, 2008
Michael Richmond Al
161 Jones Road
Marstons Mills, MA 02648
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 161 Jones Road, Marstons Mills MA was inspected on
September 26, 2007 by Robert Paolini, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system FAILED under the
guidelines of 1995 TITLE V (310 CMR 15.00) due to the following:
Static liquid level in the distribution box above outlet invert due to an overloaded or
clogged SAS or cesspool
You are ordered to repair or replace the septic system within One (1) year from the date
you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER OF THE ARD OF HEALTH
7007 0710 0005 5820 7533
T omas McKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Letters Septic Inspection Failures\161 Jones Road.doc
7007 0710 0005 5820 7533
t Commonwealth of Massachusetts Vk
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 161 Jones Road V o y \
Property Address I `r
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.
ImpoWhen filling A. General Information
When filling out
forms on the
computer,use 1. Inspector:
only the tab Frey
to move your Robert Paolini
cursor-do not Name of Inspector
use the return
key. -Capewide Enterprises,LLC
Company Name
!� P.O.Box 73
Company Address
Centerville Ma. 02632
City/Town State 'Zip Code
(508)428-4028 S 14454
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and thitt 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 orrsite
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 - i
❑ Needs Further Evaluation by the Local Approving Authority r„
A
9/26/2007
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system 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.
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Q�'
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every 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:
Leaching Pit was full at time of inspection.Upgrade of leaching is needed.
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.
Answer yes, no or not determined (Y, N, ND) in the ❑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.
ND Explain:
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced
❑ obstruction is removed
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for. Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ distr bution box is leveled or replaced
ND Explain:
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced
❑ obstruction is removed
ND Explain:
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
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 Nell.
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15
F
Commonwealth of Massachusetts
Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form - Not for Voluntay Assessments
�M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cont.):
❑ 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 ® 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
® El or
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 Y2 day flow
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.
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15
f
' Commonwealth of Massachusetts
ti, W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems (cont.):
Yes No
❑ ® 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.
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15
Commonwealth of Massachusetts
i
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
^M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is Marstons Mills Ma. 02648 9/26/2007
required for �
every 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?
® ❑ Y P
❑ ® 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)]
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
;M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
D. System Information
Residential Flow Conditions:
t. Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection requ[red] ❑ Yes ® No
Laundry system inspected? ® Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage 2006: 1,0000
g ( y g (gpd))' 2006:91,000
Sump pump? ❑ Yes '® No
Last date of occupancy: Date 007
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:
Last date of occupancy/use: Date
Other(describe):
161 jones rd.-08/03' Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is
required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
General Information
Pumping Records:
Source of information:
Was system pumped as part of the inspection? ❑ Yes ❑ No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed if known and source of information:
pp 9 P ( )
1978
Were sewage odors detected when arriving at the site? ❑ Yes ® No
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15
r
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page.. City[Town State Zip Code Date of Inspection
D. System Information (cont.)
Building Sewer(locate on site plan):
1'
Depth below grade: feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
20'+
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Joints appear tight.No evidence of Ieakage.System vented through the house vents.
Septic Tank (locate on site plan):
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: 8'6"x4'10"x57"
Sludge depth: 411
Distance from top of sludge to bottom of outlet tee or baffle
26"
2"
Scum thickness
71' -
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
12"
How were dimensions determined? Measured
161 Jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma: 02648 9/26/2007
every page. City/Town 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.):
Pump septic tank every 2-3 years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank
appears to be structurally sound.
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
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
_ a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
requiratifor Marstons Mills Ma. 02648 9/26/2007
required for
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Tight or Holding Tank(cont.)
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
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert yes
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Box is Ievel.Box has one ourlet Iateral.No evidence of solids carryover.No evidence of leakage into or
out of box.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
161 Jones rd.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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:
Type:
® leaching pits number: 1-1000
❑ 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.):
Sandy soil.Leaching pit was full at time of inspection.Leaching needs to be upgraded.
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
^M 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(Iodate 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.):
161 jones rd.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 161 Jones Road
Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills. Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties
to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet.
Locate where public water supply.enters the building.
tigGlc
y ,
161 jones rd.-08l06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.-Page 14 of 15
Commonwealth of Massachusetts
W Title, 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
161 Jones Road
M Property Address
Michael Richmond
Owner Owner's Name
information is required for Marstons Mills Ma. 02648 9/26/2007
every page. City/Town State Zip Code Date of Inspection .
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
❑ Shallow wells
Estimated depth to ground water: Bottom of leaching 60'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:
As-Built Card
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Used:Gaherty& Miller model 12/16/94 groung water elevations. Used:USGS Observation Well Data
June 1992. Used:Technical Bulletin 92-000-01 plate#2 Annual ranges of ground water elevations.
161 jones rd.-08rJ6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15
Town of Barnstable
INE Tp�
Regulatory Services
,,5,AB Thomas F. Geiler, Director
AIFo a
Public Health .Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
This septic system inspection report was completed by a private inspector who is certified
by the State of Massachusetts, Department of Environmental Protection.
Although the Town of Barnstable Health Division received the original/copy of this
report; this Division does not warranty the functionality of the septic system in the future
nor does this Division agree with any technical observation s and interpretations
contained within this report.
In addition, by receiving this report the Town of Barnstable Health Division does not
automatically approve the number of bedrooms listed within this report. The actual
number of bedrooms approved at a particular property would-be listed on the "Disposal
Work Construction Permit".
If you should have any questions regarding this report,please contact the certified Septic
System Inspector who conducted the inspection.
• a
� 17 0Z11/
D
PROPERTY ADDRESS:-16-1 joiaeaRpaj________
Marstons Mills
Mass . 02648
------
On the above date, I Inspected`the septic system at the above address.
This system consists of the following:
1 . 1-1000 gallon septic tank.
2. 1-Distribution box.
3. 1-1000 gallon leaching pit.
Based on my inspection, I certify the following conditions:
1 .This is a title five septic system. ( 78 Code )
2.Septic Tank must be pumped.
3. Leaching pit is dry.
4. Cover must br raised on the leaching pit.
5.. The septic system is in proper working order
at the present time:
SIGNATURE.-
Company: J.P_Macomber & Son INC.
--- �� 11
Address:
Box 66 d
Mas_ 6 2 �fCEIVEo ,�
; ��s� 3 �
Phone: 508-775-3338 OCTQCT � 1995
19
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR
•
JOSEPH..P. MACOMBER & SON, INC.
Tanks-Cesspools-Leachfields.
Pumped & Installed
Town Sewer Connections
P.O. Box 66 Centerville, MA 02632-0066
.775.3338 775-6412
•
I -
Commonwealth of Massachusetts
Executive Office of Environmental Affairs
IL
Department of
Environmental Protection
Wllllam F.'Weld
Gowma
Trudy Coxe e
S�cntuy,EOEA e '
David B.Struh:
Commiulomr
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Addlftss: 161 Jones Road Marstons Mills Address of Owner:
Date of Inspection: 1 0/1 7/95 (If different)
Name of Inspector: Joseph P.Maeomber Jr.
Company Name, Address and Telephone Number:
J.P.Macomber & Son Inc.
Box 66 Centerville,Mass . 026N2 508-775-3338.
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
XXPasses
Conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: Date: 10/17/95
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30)days of completing this
inspection. 'If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority.
INSPECTION SUMMARY:
Check A, B,C, or D:
�Zave
PASSES:
not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
Bj SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,
passes inspection.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not)
The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or.exfiltration, or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as
approved by the Board of Health. ty..�.
' .'.
(revised 8/15/95) 1 2 =�r
t
One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 9 Telephone(617)292-5500 n'�? r:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 161 Jones .Road Marstons Mills ,Mass .
Owner: H. Terrence Slack
Date of Inspection:10/17/9 5 1
B) SYSTEM CONDITIONALLY PASSES (continued)
AO Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s)(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health):
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled.or replaced
AD The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
inspection if(with approval of the Board of Health):
broken pipe(s) are replaced
obstruction is removed
CJ FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
A Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
AV Cesspool or privy is within 50 feet of a surface water
AM Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING 1N A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system nas a seutiL idnk aiiu �uii aLsorptiun.systen-. and IS within 100 feet to a surface water supply C::rIbutarj to a
surface water supply.
The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well.
t0 The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water
' supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is
free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5
PPm•
DI SYSTEM FAILS:
_ I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for this determination is identified below,. The Board of Health should be contacted to determine what will be necessary to correct
the failure.
Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool.
(revised 8/15/95) 2
�1
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 161 Jones Road Marstons Mills ,Mass.
Owner: H.Terrence Slack
Date of Inspection: 10/17/9 5
D] SYSTEM FAILS (continued):
Ab Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow.
Ab Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
AD Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
AAA Any portion of a cesspool or privy is within a Z,re I of.a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
E] LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria above:
The design flow of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety
and the environment because one or more of the following conditions exist:
`0 the system is within 400 feet of a surface drinking water supply
,O the system is within 200 feet of a,tributary to a surface drinking water supply
AM the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a
public water supply well;
The owner or opera_or of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 8/ls/95) 3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
opertyAddress: 161 Jones Road Marstons Mills,Mass .
,vner: H. Terrence Slack
ite of Inspection: 10/17/9 5 '
,eck if the following have been done:
Pumping information was requested of the owner, occupant, and Board of Health.
,;None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
4/As built plans have been obtained and examined. Note if they are not available with N/A.
i
The facility or dwelling was inspected for signs of sewage back-up.
46/The system does not receive non-sanitary or industrial waste flow
,,, The site was inspected for signs of breakout.
All system components, excluding the Soil Absorption System, have been located on the site.
_/he septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or
tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
-,,/The size and location of the Soil Absorption System on the site has been determined based on existing information or
ap roximated by non-intrusive methods.
The facility ov,ne.: tand occupants, if p different from owner) were provided with information on the proper maintenance of Sub..
Surface Disposal System.
Reccomendations
1 . Septic tank must be pumped.
3. Cover on leaching pit, must be raised.
Yf
sed 8/15/95) 4
�.J SUBSURFACE SEWAGE DISPOSAL�SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address:161 Jones Road Marstons Mi11s ,Mass.
Owner: H.Terrence Slack
Date of Inspection: 10/17/95
FLOW CONDITIONS
RESIDENTIAL: w,, ��� •
Design flow: }_gallons pdA
Number of bedrooms:,
Number of current residents:
Garbage grinder(yes or no):
Laundry connected to system (yes or no): °�
Seasonal use (yes or no):A& ,)
Water meter readings, if available: z 11 w') aA146Cz 1"9 9T
Last date of occupancy:a'Alk/
COMMERCIAUINDUSTRIAL•
Type of establish nt:-
Design flow: gallons/day
Grease trap present: (yes or no)
Industrial Waste Holding Tank present: (yes or no)AIN
n-sanitary waste discharged to the Title S system: yes or no).
11V4ter meter readings, if available: AJ14
Last date of occupancy:
OTHER: (Describe)
Last date of occupancy:
GENERAL INFORMATION
PUMPING R�9�DS�����of information: ;
System pumped as part of inspection: (yes or no)2
If yes, volume pumped. Rallons
Reason for pumping:
TYPE OF YSTEM
Septic tank/distribution box/soil absorption system
IM Single cesspool
Overflow cesspool '
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
Other(explain)
PROXIMAL AGko all coin Is
date
t installed (if known) and source of information: _/M- l7Y�J44c5 os
�(,7 ' Y �—
.,---,/age odors detected when arriving at the site: (yes or.no)Q� ,
(revised 6/15/95) S
t7)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART G
SYSTEM INFORMATION (continued)
Property Address: 161 Jones Road Marstons Mills ,Mass .
Owner: H.Terrence Slack
Date of Inspection: 10/17/9 5 0
SEPTIC TANK:1-1000 gallon tank.
(locate on site plan)
Depth below grade: 6 n
Material of construction:Uconcrete_metal _FRP_other(explain)
Dimensions: 11 T,ong 51711 High 411011 Wide
Sludge depth:
Distance from top of srudge to bottom of outlet tee or baffle:
Scum thickness:_p_
Distance from top of scum to top of outlet tee or baffle: 0
Distance from bottom of scum to bottom of outlet tee or baffle:_ 0
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.) — ear . Inlet andoutlet tees
are fine. 1 rt liquid levei to � outiet invert. beptic tank is s ruc ura
sound and has no suns o ea age. an musta pumpe . o o er
�eded at this time,
GREASE TRANNO
(locate on site plan)
Depth below grade: N%A
Material of construction: _concrete _metal _FRP_other(explain)
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle_
Distance from bottom ni From in bonom o) outlet tee or baftleu4L
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth-of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.) None
(revised 8/15/95) 6
SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 161 Jones Road Marstons Mills ,Mass.
Owner: H.Terrence Slack
Date of Inspection: 10/17/9 5
•
TIGHT OR HOLDING TANKA ��
(locate on site plan)
Depth below grade:ILA
Material of construction: —Nc nncrete _metal _FRP —other(explain)
Dimensions: N.1 A
Capacity:N/A T_gallons N/A
Design flow: NIA
Alarm level: N A
Comments:
(condition of inlet tee, condition of alarm and float switches, etc.)
None
DISTRIBUTION BOX:one 6-Hole Box
(locate on site plan)
Depth of liquid level above outlet invert: NQ_
Comments:
(note ii level and distribut-un, r,idence of solids carryover, evidence of leakage into or out of box, etc.)
Distribution box is level No evidence of leakage in or out of the box.
No repairs needed at this time
PUMP CHAMBER: N/A
(locate on site plan)
Pumps in working order.(yes or no)NIA
Comments:
(note condition of pump chamber, condition of NOR
umps and appurtenances, etc.)
(revised 8/15/95) 7
SUBSURFACE SEWAGE DISPOSAL,SVSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 161 Jones Road Marstons Mills Mass .
Owner: H.Terrence Slack
Date of Inspection:10/17/9 5
SOIL ABSORPTION SYSTEM (SAS):1—1 000 gallon leaching pit. ,
(locate on site plan, if possible; excavation not required,,but nlay be approximated by non-intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number: 1
leaching chambers, number:
leaching galleries, number:
leaching trenches, number,length: 0
leaching fields, number, dimensions:U
overflow cesspool, number:O
Comments:.(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.)
4andy � caravel soil,No signs of hvdrauj cgaij re,No signs of pon ing,
egg ati n normal. 1Vo— ep irs nee e a 1
CESSPOOLS:N/A
(locate on site plan)
Number and configuration: N/A
Depth-top of liquid to inlet invert: N A
Depth of solids layer: N/A
Depth of scum layer: N A
Dimensions.of cesspool: N/A
A
Materials of construction: N,/
Indication of groundwater: N/A
inflow(cesspool must be pumped as part of inspection) NIA
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
NONE
PRIVY:_ •:g
(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.)
(revised 8/15/95) 8 c4�'.
Ith
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued) ,
Property Address: 161 Jones Road. Marstons Mills ,Mass.
Owner: H. Terrence Slack
Date of Inspection: 10/17/9 5
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100' 74wj> WARA We,4,4 6 46 �6v Cm/TYtO
lcz—
Y N�
0p
O V�
DEPTH TO GROUNDWATER
Depth to groundwater: l �feet
methodof d terinationpmio :
(revised 6/15/95) 9'
=6-
f
IDIT OOft
' a .
6q•L I
per.bpX
----_�e, 40
9 � .:� ..�•�' , - ti �L �s��/.. �c. •�t't'� ��'_ '�7 �.. ���'.. •aS. �*1�!���!` ;�% yv.�[b1.. �y � -.�, y� • � ; - ` '
N, ../ 177�� .. �,�►it w1Y•J: r,' t_ -s:'s- y ,F;/.• h 3. Y r
ir
17ILO-atG�N �r+ALGI.iL.AT10T�S1 �.. 1 _:
W Z.
py
. ••k. ( r
4►u^.:•. _.�.?�! _ Nat'l � �•.. � �'�;; . .
�ING�► CAP.
•tom'—�.wiw�• ti�����,i � ��� ' _. � '�' , CF
zew
• 11
•rnnrwT-nl•r:+—''rrnrmr•nmr+s'n*Taenrs*+nvs+•+�sr►n+�*i*'m+'I nsrn�Tso�rrerrrn �'1*'rs's•-nrr.�r*�Irrr.r•'� .
II'OWN; OF Barn stahl P BOARD OF HEALTH
SUBSU11FACF SEWAGE pISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION
&'•'47M�T•;••.—T.11f.�•3TT1.TIrm T:T1"ITi1+SRfRTY1'T'�5'IT!IVf.17a1'RIQr•!'
-TYPE OR PRINT CI-EARLY-
PROPERTY INSPECTED
STREET ADDRESS 161 Jones Roar Marctans Mille Mass .
ASSESSORS MAP , BLOCK AND PARCEL # mniD parcel 41
OWNER' s NAME H. Terrerfce Slack
PART D - CERTIFICATION
NAME OF INSPECTOR Joseph P. Macomber Jr.
COMPANY NAME J P Macomber & Son Inc
COMPANY ADDRESS Box 6`� �. nteryj11P Maac 09632
Street Town or City State LIP
COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 ) 790 1578
R
11.
CER'fIFICATION .STATEMENT -
I certify that I . have . personally inspected the sewage disposa'l system at
this address and that the information reported is true, accurate, and
complete as of the time of ,inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems .
1
Check one: "
XXXXXXSystem PASSED
The inspection which I 'have conducted has not found any information
which indicates that: the system fails to adequately protect public
health or the. environment as defined in 310 CMR 15 . 303 . Any failure
criteria not evaluated : are as stated in the FAILURE CRITERIA section of
this form.
System FAILED*
The inspection which Ch'ave conducted has found that the system failjs to
Protect the public health and the environment in accordance with Title
5 , 310 CMR 15 . 393, and;,as specifically noted on PART C - FAILURE
CRITERIA of this inspection form .
Inspector Signatu Date 1018/95
._,/ One copy of this, certification must be provided to the OWNER, the BUYER
( where applicable ) and the DOAitD OF HEALTH.
.�..
* If the inspection FAILED, . th'a owner orap operator shall upgrade ' the eyetem>:.
within one year of the date ; of the inspection, unless allowed or requi'r,ec .;
otherwise as provided in 310.' CMR 15 . 305 . F.*
IiCC,T,1Tcnwec Cr 1/1CS�Cc� :SciiS
ExecuTNe Ct'sice yr .`.^vlfcrmeniC: ,',;c:'S
Department of
Environmental Protection
i Water Pollution Conrfol Tecnniccl Assocnce ana Training SecTions
Wlulam F.W"doy,G mr
Trudy Cosa
Socwwy.EGEA
Thomas & Pow«. ,
06/12/9'.)
ATTN: Joseph P. Macomber, ir.
Joseph Macomber and scm
PO Box 6 6
Centerville, MA 02632-
Dear Joseph P. Macomber, :14- . ,
I am pleased to inform you thae:,you have attended training, met
the experience qualificacions, 'and have passed the Title 5 System
Inspector exam, pursuant Lo 310 CMR 15. 340 . The passing grade for
the exam was 39/52 or 75% .
This is an official notification that you are a Certified Department
of Environmental Protection System Inspector pursuant to 310 CMR 15 . 340 .
You will receive a System Inspector certificate at a later date.
If you have any futher questions, please write to me at the following
address:
:<imball Simpson
D.E. P. Training Center
50 Route 20
Hillbury, MA 01527
Thank you very nnlet: -:o:' ;aar time and consideratioi' in this matter.
Sincerely,
l
Kimball T. S'mnson,
DEP Train:nq :r Direcccr
!'405)
Route Millbury, MA FAX 5w8-755.9253 0 •. m• 508-756.7^01
Y • }
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.�.. .ram. .••M•�rr•wr•�• w•.r•r,•r.•r w•r • •. •• .. ... •..• •. •••.•••••..•......-•. •n ,r ...� ''.
r
,.• Water
vation
Coris'er �.
• , .
SAME Tips
MEl • • •
F0
CHECK
• R LEAKS • � .
• Water loss Id-Gallons Due to Leaks
Leak
this loss Per Oay . ,loss For Month '
Size
• 0120 3,600
` 360 10,800
'693, 20,790
• " ' 1,200 36,000 .
.O 4y296 •' .128,980
® .• 6,640 . 199,20R
6,9.84 '• 20Q,520
8,424 ' 252,720
8,888•'' . 1296,640
.® '11.324 339,720
12,720 381.000
14,952 448,560
.1ii. .1 .
_ a3�3
TOWN OF BARNSTABLE
LOCATION J D NCB`5 iP,-z SEWAGE#
VILLAGE./ .4of 510 A/57 _M,t LL,S ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE_NO.
4
SEPTIC TANK CAPACITY
LEACHING FACEL=: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMU DATE: COMPLIANCE DATE:
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 44 A L 0 0
4
1`b
\
�h
O A \
LO_C*'T WN / / f SEWAGE PERMIT NO.
o#ES
VILLAGE
�nSz4 �
1 KSTA LLER'S NAME & ADDRESS
BURDER OR OWNER
0
I
DATE PERMIT ISSUED Q ��
DATE CO-MPLIANCE ISSUED
3 7 �
179
7 � - -
r'
No-----------.... Fps...
THE COMMONWEALTH OF MASSACHUSETT5
BOAR® OF HEALTH
TOWN OF........BARNSTABLE
...............................
Appliratilau for Disposal Workii Toustrurtiou Vrrutit
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
System at
Jones Road, Marston Mills Lot 456
................--......................................... .....- ------- ..........................................
�`� Location-Ad ress or Lot No.
�! �'-1-�.-..... �'�1� .t' .1�n`:s�1.....-4:aAlP-- -•---••------1 }i.h(1_s1_I:f.........................................................
O ner Address
............................ ..- �1 d. l'(......--•------------.................---- ----.................:�� 2.- ------•--•--------........................------.....----
Installer Address
d Type of Building C P.h/L -• SA I.P
-6 o) Size L�t....23.,.F.4.4.......Sq. feet
U Dwelling—No. of Bedrooms.........3.................................Expansion Attic ( ) Garbage Grinder
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures ..................................
W Design Flow............ ...........................gallons per person per day. Total daily flow..............3.3-0......................
04 Septic Tank—Liquid-capacitylQ.O.Q.gallons Lengt$_-_'._-6".... Width...'.-IQ T)iameter................ Depth.-`-_'---!°.
W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---------1.......... Diameter.....1.0......... Depth below inlet..... Total leaching area.....2.6.Z.....sq. ft.
Z Other Distribution box (x ) Dosing tank ( )
Percolation Test Results Performed by-Cafe...Cod...SurVe.y...C.Q.UZ_1t r1tl Date..A 1.1.--.2_
........ ,9_.7.8
Test Pit No. 1..... -___.__-_minutes per inch Depth of Test Pit......12........ Depth to ground water......none...--.
(� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....................
P+' ----•--••••---------------------•--•--------...........................................••...._•••--•............................... Sty of SDP
O Description of Soil........Q_-Q_._5_-WIQQd---10AM .__.1.-S-1x9...5Ub5.?-7,-1...... MeLdi . F. ........... .,1yc
v ............ x Y�.],,R .7.•Q-1 ..0----Qle.zm...5ADA.................................................... ......RnaERT... y�
D
U Nature of Repairs or Alterations—Answer when applicable.............................................................. "• -._ . .... r-a„
A .A IVo:-237410
--------------•--------•------.......--•---•-------•---------•--........._...........-•-•----...-----•--...........--••-•-•-•--•_.................-•-••-•--- FF-----------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in ac
the provisions of iITLZ 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 b the board of health.
ignd_., .`. --•--•-•-•--------------•------------- --------------------------------
Date
Application Approved By.... ..- ----- . . .. ... . .17 7
Date
Application Disapproved for the following reasons:-----•-------------------------•---------------------......---•----------------•---------........._........----
--••-•--••----•..............•--••-•-•--............---•-----......---•--------•----•------... -•-•......---•-•-•-•--------. ••-••••------------r------+-•-•----•--•-••------------------.••---
.._, n .......Date
Permit No.--•.....................•--• -- Issued-S. '..v..i
Date
iv�
Fzic............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN BARNSTABLE
. .........................I...................OF.............................................................I...................
Vpfiration for Bhipoiial Worka Tonstrurtion Prrutit
Application is hereby made for a:Permit to Construct (K ). or Repair an Individual Sewage Disposal
Y11drston Mills Lot 456
Jones Road,., K
............................................. ....................................................Ro..........................................
Von-9Xddfess_ or Lot
................... .. ..............
.........................................................
......................7—-----
Owner Address
................................................................................................ ..................................................................................................
.A
Installer Address
M
.!4 ,-I. Type of Building J-*,jil Size L7....21.544......Sq. feet
U
Dwelling No. of Bedrooms.........3................................Expansion Attic Garbage Grinder
a4 Other—Type of Building ............................ No. of persons.......................... Showers ;, ,,Cafeteria 7
Otherfixtures .........................................................................................................................................................
}i W`. Design Flow..........55 daily flow 330
e gn . , ............T.......................gallons per person per day. Total ....;. ...............w.....gal
lons�
-------------
04� Septic Tank—Liquid capacity l.0/1-00gallons LengthO 1-6-" -1..lb affieler................ Depth..5_!_':7.A"!
............. Width_.4_1 -6 i
clft-L�,No.-,...4............. Widths.................. Total Length.................... Total btal leaching area............D I Tren isposa ........sq.
Seepage Pit No.... ...1......... Dia, meter IQ.!------- Depth below inlet.....0............,T otalleaching area.....267
...sq. f t.
f
Z Other DistrPution box (X ) " Dosing tank n.
P cola nlT Perfo'med by.cap.f�..�ZQd...aurmey... 26
er tio est Results r ----------------------I 1V 8
01 Test Pit No. I..... ........minutesperinch De th of Test Pit.... ..Depth to ground water ._..nOrie
0;4 Test Pit No. 2.................minutes per inch Depth-of Test Pit.................... Depth to gjrouZ� ter, ........................
........................................................................................................................................... T
i '0 - 'Description of SOH........0S.0..5...wood....loAm.,....Q.J-1.5 sul�rsoil 7....0...medi.....
....... .. wood ..... ------------------------------------- ..... ... ...........
j gravel 7.0-12.0 clean sand
.......................... ........ .......... ........;.......................................................................................................
.................................................................................................. ...........F--------
-7------------- ,-------- -----------------
U :NatureDAYLag
of Repairs or Alterations—Answer when applicable. ...................... ................. .......
4 23
741
. .......... .....................
------------ ......--------------------------- ----------------------------------------------------------------44.
Agreement:
The undersigned agrees tto Install the aforedescribed Individual Sewage Disposal System in a c
the provisioiiisloi TIT I.: ,-5,of,-(he State Sanitary Code The undersigned furtl-ier-'agrees not to place the system in
operation until a Certificite of Compliance has'been issued by the board of health.
ign d.. 4.11
...................... ................................
Date
Application Approved By..... ....... . . ......................................
7
Date
Application Disapproved for the following reasons .......7 1
..........................0................................................................
..................................................................................................................... .................................................................................
Date
PermitNo.----- :"................ .................... .............................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............. . ......OF.............. .. .............................................
(9rdifirate 'of Toutplitturr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed- (.4ror Repaired
by.....:... �4%t, ................................................... ............................................ ..............................I .......T_ A.5._�t...........
e.. Installer
at ..........4.��.�t... ....... ..................
......................... . .........:r............... .-ilt _.........................................................
has been installed in accordance with the provisions of T 5 �p5 Code as described in the
e State Sanitary
application for Disposal Works Construe'tion Permit No._10.-.�----_-_-------J:!!� dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE-CONSTRUED AS A GUARANTEE THAT THE
I J SYSTEM WILL FUNCTION SATISFACTORY.
DATE............. ................................................................... Inspector....................................................................................
74 THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9f HEALTH
/T L
................. ..... A-2. 444--V7..................................... .......
...... OF.........
N 4
.................. FEE...
V
Disposal Works,: T-Lowitrurt' n Upprinit
I
Permission is hereby granted.............. -------j(j/
--- --- . ................................................................................................
to Construct or Repair an Individual Sewage Disposal System
.........................................
.at No.----............ ............ a.Aj A...........A.at................i�k
Street
y—
as shown on the application for Disposal Works Construction I ;P In i�tN . ..... I...... Dated.... . !
.
... .........
e"-
'Board of H,
DATE... -&............................................................. .....
FORM'
1255 HOBBS,& WARREN, INC., PUBLISHERS
k
LEGEND m �e``�s
BEf\JCH MARS" 99 �n �® °F BOR�
PAINT SPOT ON , \ 1 �-�1- PROPOSED CONTOUR
BULKHEAD CORI IEP. >: JQ ' � � �- � \� I 9® PROPOSED SPOT GRADE LA RACE �
ELEVATION = 10 3. 38
— 98 -- EXISTING CONTOUR 1600 x
BARNSTA.BLE GIS DATUM - w 0o "'
120 f; - �\\ \\ + 96.52 EXISTING SPOT GRADE DELLA
w
W— EXISTING WATER SERVICE �O ONF 9C�Q4� D ,
TEST PIT
, �\\ _ \\,_- QQ41 \\S ao a arcCZ
i � 99
O `
_ water servr� ��`A ASs y c� Q
Cr
�\ \\ i I I E LOCUS MAP N.T.S.
--r ---- • • l
Cr 140 GENERAL NOTES:
2:1 /r \ \\ MNITAR\Q'� p I. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
l/ n , I 1 \\ BOARD OF HEALTH AND THE DESIGN ENGINEER.
EXlStl 1 OOO gal g g I/ \ I �u t� 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
ll $ P tic Tank�� r ,� I 11 11 I OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS.
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
\ _O (�I II, TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
- \ I 1 j O DESIGN ENGINEER.
7 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
U) ( I j FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
n I ` } D J ENGINEER BEFORE CONSTRUCTION CONTINUES.
v \ \ ! I I < 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
^/tom 20 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
/ \ / �� ' / I
G HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
j/ 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
Existing Leach Pit 11 // TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
(Note 10) j I / I 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
O ° \ I / I I CONSTRUCTION.
OfV
p 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND FILLED
O� N ° \ I I \\ s I I / J 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY
AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
° 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING.
\ �T \�� \� ! ; T 14. NO WETLANDS WITHIN 150' OF PROPOSED LEACHING.
cop 12 c0Q �y� ,� I1o0 T�
" /6� t7;�C 7 \\ \\ 15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED)
r \\ I \\ 1
lu I
I
i LOT '' -556
! AREA = 23639 sf
' l i PROPOSED SEPTIC SYSTEM UPGRADE PLAN
l I i Q I
- ...............
161 JONES ROAD, M. MILLS, MA
Prepared for: Michael Richmond
7 g - / i/ MAP. 047 Engineering by: Surveying by: SCALE DRAWN JOB. NO.
SURVEY REFERENCE: 4 ft
R
MEYER,
RDARRENM.MEYE . .
LOT:04> Eco-Tech Environmental 1"=20' DMM
PLAN OF LAND BY EVERETT H. HINCKLEY. ---- — — / / / Po Box981 508 364-0894
LCP.Cent#164293 EASTSANDWICH,MA02537 DATE CHECKED SHEET NO.
DATED: FEBRUARY 8, 1974 102 1_-01-7< �---� 508-362-2922 04/24/08 DMM 1 Of 2
,
ELEV. TOP i
FOUNDATION F
(Existing)
= 104.06� F.G .EL: 102.5 F.G.EL: 102.25 F.G. EL: 102.25 FINISH GRADE= 102.0
MAINTAIN 2% MIN SLOPE OVER LEACHING AREA MAX. COVER OVER LEACHING = 3.0 FT.
a
COVERS TO WITHIN 6 OF GRADE 171 6" INSPECTION PORT
.� W/IN 6" OF FINISH GRADE
6" . 4" SCH 40 PVC 4" SCH 40 PVC ° ° ° ° ° ° ° ° ° ° ° °
@S=2% 10 I ® S= 1% MIN s" -
( -
14" ) � S 1% (MIN.
(MIN.) TEE'S ARE TO BE `
4" SCH 40 PVC INV.99.75
INV.100.72 ° ° ° ° ° ° ° ° ° ° °
GAS I INV.99.55
EXIST. OUTLET PROPOSED DB-3 ° °
BAFFLE H=10 DISTRIBUTION BOX
A
INV. 100.97 EXISTING 1 ,000 GALLON SEPTIC TANK INV. ELEV.= 99.00
' Frlror FABRI sat 9 MIN.
GAS BAFFLE TO BE INSTALLED ON NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING as 2•OF Jam•D -- A94ED STONE
OUTLET TEE AS MANUFACTURED BY PIPE INVERTS PRIOR TO CONSTRUCTION
�� PER TI TLE 5
TUF-TITE, ZABEL, OR EQUAL 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BREAKOUT EL. = 99.5
GRADE ON A MECHANICALL COMPACTED SIX INV. ELEV.= 99.00
INCH CRUSHED STONE BASE, AS SPECIFIED IN
310 CMR 15.221(2) J/+'- 1-1/2' 24" 30.5„
OOf1BLE WASHED STONE
3) REPLACE EXISTING 1,000 GALLON SEPTIC INVERT
TANK WITH 1500 GALLON SEPTIC TANK BOTTOM EL.= 97.00
IF FAILED, DAMAGED, OR,UNDERSIZED. 8» 50» 8»
4) INSTALL INLET & OUTLET TEES AS REQUIRED
SEPARATION 5.45 FT. I 146"SOIL LOGS SEPTIC SYSTEM PROFILE BOTTOM OF TH-1 EL: 91.55 SOIL ABSORPTION SYSTEM (SECTION)
N.T.S. DESIGN CRITERIA
DATE: APRIL 23, 2008
SOIL EVALUATOR: DARREN MEYER, R.S., CSE NUMBER OF BEDROOMS: 3 BEDROOOM DESIGN
WITNESS: DONALD DESMARAIS SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF)
HEALTH AGENT SIN Bth DESIGN PERCOLATION RATE: <2 MIN/IN
KI T BR DAILY FLOW: 110 G.P.D.
Elev.- TH-1 Depth Elev. TH-2 Depth 1 DESIGN FLOW: 330 G.P.D.
102.05 0" 102.25 0" , GARBAGE GRINDER: NO (not designed for garbage grinder)
A LOAMY SAND A LOAMY SANG FAM. RM 10YR 3/1 10YR 3/1 LI V RM SEPTIC TANK: 330 gpd x 2 = 660 gpd USE EXISTING 1,000 GALLON SEPTIC TANK
LOAMY SAND
101.72 B 4" 101.83 B LEACHING AREA REQUIRED:
5" (330) = 445.94 S.F.
LOAMY SAND .74
10YR 5/8 10YR 6/6 USE THREE (3) INFILTRATOR 3050 UNITS WITH 4 FT. STONE
99.38 C1 32" FIRST FLOOR ON THE SIDES & 1.3 FT. STONE ON ENDS: 25' L x 12.16' W x 2'D
MEDIUM 99.0 39"
BOTTOM AREA: 25 x 12.16 = 304 SF
SAND C1 SIDE AREA: (25 + 12.16) X 2 X 2 = 148.64 SF
PERC 0`3': 2.5Y 6/6
97 89 C2 50" BR BR B[/7 TOTAL SQUARE FEET PROVIDED = 452.6 vs. 445.94 REQ'D
MEDIUM DESIGN FLOW PROVIDED: 0.74(452.6 S.F.) = 334.95 G.P.D. vs. 330 G.P.D. req'd
MED - COARSE 5 Of
2Y6/6 MAS,r9�,
SAND open to below D PROPOSED SEPTIC SYSTEM UPGRADE PLAN
2.5Y7/4 -' 161 JONES ROAD, M. MILLS, MA
91.55 126" 92.0 123" � o. 140, Prepared for: Michael Richmond
PERC RATE <2 MIN/IN. ("C" HORIZON) PERC RATE <2 MIN/IN. ("C" HORIZON) SECOND FLOOR C� p� Engineering by: Surveying by: SCALE DRAWN JOB. NO.
NO GROUNDWATER OBSERVED NO GROUNDWATER OBSERVED S1E- DARRENM.MEYER,R.S. Boo-Tech Boviroamentel N.T.S. DMM
SANI TARP Po BOX981
(508) 364-0894
EAST SANDWICH,MA02537 DATE CHECKED SHEET N0.
508-362-2922 04/24/08 DMM 2 Of 2
_•-' - __' - �.--. _..... - � - _ - �-s - •�-'�'. .' _^"y!` .�„T .+r»� ter%+ raw .. .- �_.�.-..r. � .;,y w_..•v ..
• ^ 1.
S SOIL LOS
\)(IiAUI(.W\Vnrox- Marie/...c.4 �iwVn�A/i i_• /�'�
2'.PEASTONE LOAM 0 FILL,— 12"MAX, laoQD O." �-
- . T
° o
41�C.I• DI ST. ! e°• • °• ° °
BOX (e ° °°
+I e24°MIN.
/O MIN. 1000 1• °, •d .1000— GAL. �- 7-
GAL. I e ° PRECAST OR ° °41
°I
SEPTIC 6 1� o� BLOCK °° °
TAMK I, o .. SEEPAGE PIT
f • s�
20' MINIMUM °°°•� •° — — — — 10 ° of
` FOUNDATION I• ° i�9. S
1 1 % =WASHED STONE
ELEVATION SKETCH 101 Palle. RATS I 1/vPat a—w1 eNc
SCALE- 1" 4' TEST BY
ks7�,raY' r,./rr�- �i�G— TOWN INSPECTOR- p.+s•+ �sn��/id►*a"!'
BACKHOE OPERATOR :
TEST MADE ON
�9✓ .�/Y /�G i uaG �"/i�z.D .��.•Cc»•?'�a.✓f�•t+iG. 2��
��7$ .:•orn.%ta C'o�•/�f�di+scr 'TO 7"/,/C' L�,csNi/IIeS,
w3>I'—LolV,& •S 4010 T W146 70wn/ 0,4% Id.094el*Z'T.rt�A.E[/ AWWO grS.
I /� { • �• t jc.
�n p I T ...---� O - 4,11
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'
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�gfD�/A� IAA'' X2.5��►f5�/OAY¢4'7f.a Aft-fl.1�Y _.
i v w 5 �
P.
; 9¢ o If
40
�Q
¢�
EIEVATI ON 'SCHEDULE �PLj� ov�gs
_ PROPOSED 81T; PLAN / R08FRT
Kx � t
.b
fi
R08ER1 y� DAYLOR
1NV. Aj xjF4UN�DAT10p1 F. �
` r�� DAYLOR $E w A A'E 8 Y`S T E M D E S I G N No, 20l Oa
{{ t 2. I NV' I NT•Q TSE`PT I C TANK A ¢ Na 23741 'I N
3W I NV '.041T OF -.SEPTIC TANK ' 1P" F ST j`` L. t' •' w� tA �Cj�
.• . �' ✓�M'
114f' Z 'DISTRIBUTION BOX. ` ^� ' 5 .� SCALE I°; 19 P7,8
667
5. 1 NV. i OUT OF DISTRIBUTyIOfV
6. INV INTO SEEPAGE PIT CAPE COD SURVEY CO-NSULTANTS
ROUTE 132
7. BOTTOM OF PIT = HYANNIS,MASS. _.
+ A DIVISION BOSTON SURVEY CONSULTANTS,INC. y
B. BOTTOM OF STONE LAYER
f
A