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NlnXunlxm Adjustrl Grau>Ailwakec''b(ea tlacattprri oi'Xjr;sichtn l�aciltl;/ -�� -�
PrivaBcs'N'Jt�t r,du�ply V,!c;ll at�ci Y,caG�iiieg l7Actaaty, �r►Y�vr i9s t xEst 'pool
an eata awlthln lob teat.ok';l*Wfl�fArtU'(}�) �--
E .ge }f WOdAvirl mid Uachimg Fagi(Ify`.(xf wily wetWnds exist
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036 7
TOWN OF BARNSTABLVI10 o q -O 8,7
LOCATION Cliff Q SEWAGE#
'I,..
VILLAGE I` 2.►t-;�y.�(' Eli LL `ASSESSOR'S MAP&PARCEL o 4-7-16
INSTALLER'S NAME&PHONE NO. C 5ZE- 7-7 i-dt-011
SEPTIC TANK CAPACITY' 0k/S--f--i kW=1
LEACHING FACILITY.(type) "-IZA- Gad-- (size) 4� 1�-•�3 of
NO.OF BEDROOMS �' �O /2P°
OWNER L Lo Nt.tgh
PERMIT DATE: i 16 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -#- fe 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 ellP
O
3ry
3g'
i
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftphtation for 33isposal 6pstrm Construction 3permit
Application for a Permit to Construct( ) Repair* Upgrade Abandon( ) El Complete System .kC Individual Components
Location Address or Lot No. 2
55V Jp nes 'i�J . Owner's Name,Address,and Tel.No. 9/7
M4.r'5A,.r+s t4JJ J S Mar.n�L eo na. 11 NkK-__r- C;r-
Assessor's Map/Parcel r 87 ,' },c,rn (Apt v 0 8 a
Installer's Name,Address,and Tel.No.sO$-'M r 4 3 Ct Designer's Name,Address,and Tel.No. So 19
(or6leZt.4s' nS{rcrG��oE'�,SY1G• pr54�x Bey C' G^3+rUO2triV.57-r C °gar McUr% S�
AAA Data
Type of Building: 7
Dwelling No.of Bedrooms 3 Lot Size ,?0, sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) _33 0 gpd Design flow provided 3 Y 9 gpd
Plan DateALr,4 4 $� Des I- Number of sheets / Revision Date 4".f/(, o/&
Title
Size of Septic Tank e C" I Type of S.A.S. M 43 X
�-►crr�•ad,�j{y
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health. 7
Date (�
Application Approved by Date
0
Application Disapproved by Date
for the following reasons
Permit No. p`�� Date Issued
6 ''o
No. `rt Fee t'Ie
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION} TOWN OF BARNSTABLE, MASSACHUSETTS Yes
4plication for Disposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair(� Upgrade Abandon( ) Complete System Individual Components
Location Address or Lot No. 3 V ,lV nes t Owner's Name,Address,and Tel.No.
Mar5r5 r`4icl5 Mafin�C�onaarl ICE R."CkSer" Ci,-
Assessor's Map/Parcel 4/7 $rj k�---- _. t � ;�� MR O i q is x
Installer's Name,Address,and Tel.No.$0'9-rY7(- 9 3 Designer's Name,Address,and Tel.No.So I&
( it�rolvZ C'vnsfrc,c{�or�,Snc. PvC1vX 'Ivy C'ct�e ^.gineeeti -mac 93'-t It(ct�r. Sf-
Marsfo sm;/k ,MA 0;•4,gg Ctr rk M a S
Type of Building: 7
Dwelling No.of Bedrooms ✓ Lot Size c,70, 5 93 sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) -33 0 gpd Design flow provided gpd
Plan Date t-it�a n�- �, o1G IG Number of sheets •/ Revision Date (.t t,rr)_ !< 1/ , oZG/(o
Title
Size of Septic Tank e-Xi 4 inc )0004cc- Type of S.A.S. /a 43 X
Description of Soil ¢�. Q ra nQ, ��r�e P�r, If
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore.desc.611ribed-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.
Si :
d Date
Application Approved by \ Date
Application Disapproved by Date
for the following reasons
Permit No. r J Date Issued �5���•
----------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS T/O�CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(�) Upgraded( )
Abandoned( )byL X�r-k tL Cr)5fnr A:�/Tfon . ._t.n C-
at 35 L1 ao aas F"W• has been constructed in accordance �} ,✓ / ]
with the provisions of Title 5 and the for Disposal System Construction Permit NO�U b `�,a dated
Installer t.)Ur �a Cis SFfvc� lor, .,i y,c Designer k)�n`�<1p �»crnr-,Ef)nC ,Z»�
#bedrooms 3 Approved design flow gpd
The issuance of this pe : itI shall not be construed as a guarantee that the system will fu of n as/designed.
11 Date V Inspector I / f
----- c� -1----------------------------------------------- ------------------------------------------------- -------------------
- Fee No. -- ,lor)
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Misposal *pstem Construction Permit
Permission is hereby��gr -)anted to Construct( ) Repair( Upgrade( ) Abandon( )
System located at '35 7 -:y-0r1e-S pj n S 1Y,//S r
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
P Y
Title 5 and the following local provisions or special conditions.
Provided:Construction must .e completed 'within three years of the date of this permit t.
Date / Approved by�,
i
I�
I AUG-24-2E16 23:32 From: To:15097906304 Paee:1/1
FROM FAX No.
Aug, 24 2�116 09:41AM P1
ow7a 9i Barnqtable
Be stow Servieu,
Thomas F. €;oiler,1hrutor
a Pixblie Health DEVIS1 31
4a maa MdCvaimg Director
Q�1FDti 5r7!l-86�r4d644 Y�srx; S�tt740-6�04
]<Dad@: L? Sege Permitft 011b ,°� AAsa;3sor'3 Majvkpnitel
cjJ /0 'l1
kildress-
pro
ors (S t —+ t��? , wes iSnrx1 a p=L--t to bzb l d
> ) Miller)
septic system at (3JtY 0 nAO �,% � d based m a design dmwz by
L _ T ce161ty tw to septic syStu-M ae£etunLed above virds installed substnutidlly accu i4 to
` the ejes,�, which mazy 1-Icltil;ll:ada0f apprev'c�i.r�hattk;such Etc 1�I T.¢l reloval.an o't t.
di,stnb-ntl4-a box wn41a:srptic tank;.
I CeX ify i}dat the .;c rkir system rC�Jesenrerl Wj�,q ;1js18D.P(I 1lith D2ajoT cl mgass i.e.
-- pLeatet than 10' ldie e i m[oca lino ul tbv SAS ax mq voi ic�l,10.0cadot. ci£anp w,11P as�t
of the sephic,a )be t iu mmm.d=t:-with State& 'IAuaLFAn`t Wdou s. J,°ku v�Jjl&m Orr
CAI i1P t]11t Cl�BiQJJ er fU i00�v F.
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(1�15#sijjei'9TiCliyM� CIVIIL
No.46502
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TJa�3jgr>Pi 3 Stainr LIe� j
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Town of Barnstable Barnstable
. .�°� Regulatory Services Department ml-ftn,cac j
lARNSfABL&
AM
1` : ,� Public Health Division m
3
�Fa Ma�� 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL# 7015 1730 0001 4989 0281
July 20, 2016 _
Catherine Leonard
354 Jones Road
Marstons Mills, MA 02648
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 354 Jones Road, Marstons Mills, MA was inspected on
06/16/2016 by Shawn Mcelroy, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Leaching pit or cesspool with high liquid level,<12" below inlet(per Town
Code 360-9.1). You may request a hearing before the Board of Health if
written petition requesting same is received within 10 days.
You are ordered to repair or replace the septic system within two (2)years from the date
you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER OF THE BOARD OF HEALTH
s c ean, R.S., CHO
Agent of the Board of Health
QASEPTIC\Letters Septic Inspection Failures or Future Evl\354 Jones Road Marstons Mills.doc
Town of Barnstable
anxxsMnsr.e,
059. ,,�� Regulatory Services Department
'0rfa rub
Public Health Division
200 Main Street, Hyannis MA'02601
Office: 508-862-4644 Richard Scali,Director.
FAX: 508-790-6304 Thomas A.McKean,CHO
Feb 6, 2007
Rev. 5/11/16
DEADLINES TO REPAIR FAILED SYSTEMS
(Town Code §360-44 and Title V: 310 CMR 15.000) _
An"x"marked in the ❑ is the failure criteria and associated repair deadline
60 DAY DEADLINE CRITERIA
❑ Discharge or ponding of effluent to the surface of the ground
❑ Pumping more than 4 times during the last year not due to clogged or obstructed
pipe.
❑ Backup of sewag-. into the house due to an overloaded or clogged SAS or cesspool
ONE (1)YEAR DEADLINE CRITERIA
❑ Static liquid level in the distribution box above outlet invert due to an overloaded or
clogged SAS or cesspool
❑ Any portion of th-- SAS, cesspool, or privy below high groundwater elevation
❑ Any portion of the cesspool within a Zone 1 to a public well
❑ Any portion of a cesspool within 50 feet of a private water supply well with no
acceptable water quality analysis. (This system passes if the water analysis
indicates the well is free from pollution).
TWO (2)YEAR DEADLINE CRITERIA
❑ Single Cesspool
❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation
of a driveway due to H-10 components, etc)
eaching pit or cesspool with high liquid level, <12" below inlet(per Town Code
360-9.1)
❑ Leaching facility with standing liquid level at or above the invert pipe (per Town
Code §360-20 h)
OTHER
4.,
❑ 1
^n c lv v� r o �i6,2j
f rH \(
f / `
y
Repair deadline: dvn
Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc OVA re nGr1'
Commonwealth of Massachusetts '
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M y 354 Jones Rd MY l I-P M4gl
Property Address
Jack Leonard
Owner Owner's Name
information is Marstons Mills J
MA 02648 6-16-16
required for every
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
A. General Information
1. Inspector: S� '� I
Shawn Mcelroy
Name of Inspector
Upper Cape Septic Services
Company Name
P.O. Box 73
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
1-508-495-0905 S13971
Telephone Number License Number
B. Certification
I certify that 1 have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 15.000).The system:
❑ Passes ❑ Conditionally Passes ® Fails
;nsPector's
Need pproving Authority
6-16-16
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. 0 1 ,,p)
�be
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal Sys -Page 1 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
a a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
G M s 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
❑ I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health,will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined,"please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
+ �I
t5ins-3M3 Title 5 Official 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
M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town 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 in order to determine if
the system is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-3/13 Ttle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
Commonwealth of Massachusetts '
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
.'" 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is Marstons Mills MA 02648 6-16-16
required for every
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
ElThe s tic tank and SAS and the SAS is less than 100 feet but 50 feet or
system has a septic
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 m, provided that no other failure criteria are triggered.A co of the analysis must
PP P 99 PY
be attached to this form.
3. Other:
r
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
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts
. Title 5 official Inspection Form i om
p
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16,
page. City/Town 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 wel[water analysts, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
® ❑ The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•3/13 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
M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate "yes"or"no" as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
❑ _® Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions;depth of liquid, depth of sludge and depth of scum?
® ❑ 'Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
❑ ® Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual). 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 0
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: 2016
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form;Not for Voluntary Assessments
M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: N/A
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,. 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
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:
1980's
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 12"feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Good condition.
Septic Tank(locate on site plan):
Depth below grade: 4"feet
Material of construction: ,
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
1000 gal
Sludge depth: 12
n
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
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
20"
Scum thickness
1"
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
15"
How were dimensions determined? Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with outlet baffle broken and no sign of leakage.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•3/13 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
354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required fcr every Marstons Mills MA 02648 6-16-16
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.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
"Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town State Zip Code Date of Inspection
D. System Information (font.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert N/A
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.):
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:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
u r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
i
Type:
® leaching pits number
1-1000-gal
❑ leaching chambers number.
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leach pit was empty at inspection with dear stain lines above inlet invert.
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
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town State Zip Code Date 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.):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
ill
Commonwealth of Massachusetts
_ v Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
page. City/Town 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
tI
w-
- - - 236
,4 _O- 31 ' ( -0- 9 04, {
35
t5iris•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts '
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-16-16
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:
USGS and town maps show groundwater at greater than 20'.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
354 Jones Rd
Property Address
Jack Leonard
Owner Owner's Name
information is Marston Mills MA 02648 6-16-16
required for every �I
page, City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
i
t5ins•3M3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17
�6 Town of Barnstable P#
De artment of Health Safet and Ea onm`enaal Services. .
4 1 ,yblic ffMth D><V',iS>ton Datet 1-�6 �
z� 367 Ma0S'treet,Hyannis MA 0 01' `
0 ■ARNSTABIE.
rfd ct� Date Scheduled I I Time V� Fee Pd.
r+
r+
Soil Suatabluo Assessment for ,Sewage Disposal
c �.d.......... .........
-
Performed By: �CU • l R6 + Witnessed B�:,��
i isi%: i ''s i[>; s i'it#'ii i::•'y,'•.',.;..,::.�. .•..;•.,,,::::....' ?>:?ti
::.::.;: LI fiLR :;ITF.Q .:::'JCQ:N:.:;;:::;::.:::.:.:.>::::.;;.: ....:.........
..
Location Address 33-f J d/nQ� Owner's Name /
M. M �.G f Address,
Assessor's Map/Parcel: 71e 7. 6 vJ e
NEW CONSTRUCTION REPAIR - Telephone
Land Use e0✓ I Slopes(°/.) Surface-Stones
Distances from: Open Water Body �0,00+ft Possible Wet Area C.1-i� ft Drinking Water Well
r
Drainage Way liC/ ft Property Line _LC_.> ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
Clip
3yy�
Parent material(geologic) _ ` . t E-�' '��`�° Depth. Bedrock t
Depth to Groundwater: Standing Water in Hole: Weeping-from Pit Face
Estimated Seasonal High Groundwater_.
::.:..:..:.......:.::...:...:......:::::::.;.......:.:.:..::,:...;..::......;::.......::::.::�,..::...:..c.;;.;:...:.;.......:::.:,......;....:.::.,.;.........:..:;;.....,,...::...:..:,y.,i::::::?:':::::::>::>'::�::>:::
x(��( ,;.:�.yy�am�„yy'.y�:��r>; 1 ' ' . L
1'!I :l1.Lly:;C1.... ..............................................:::z:i:?''•�t: :'
Method Used: Ivt;
Depth Observed standing in obs.hole: in. Depth to soffmottles: < in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment •
Index Well#___•_•_ -Reading Date: Index Well level AdJO'factor -fk "`'-Adj'-Groundwati r Level_
EA.00I.�S.'L'.�+(�1'�::;7�.�t..�T.::::::::::::::::
Observation Tim SO!'
Hole#' �w. O!
Depth of Perc ( Time at"6"`
Start Pre-soak Time® Time(9"-6") j
End Pre-soak I(/, t y
Rate Min./inch
04
Site Suitability Assessment: Site'Passed•• ' +' n, *Site Failed:ems+ •• A iditional.Testing-Needed(YM) - +
Original: Public Health Division Observation Hole Data To Be,.& -leted on]back
Copy: Applicant
} �0#4 V S
wDepth from Soil Horizon Siiil Tettturetl! t tlisdiWolor 'I '` Soil
Oth
er
.Surface(in.) (,USDA) L. (Munsell) . Mottling (Structure,Stones,
Boulderes.
�tr' •
61
Depth from Soil Horizon, soil, exture Soil Color Soil Olher
�Suiface(in.) (USD;a,)` (Munsell) Mottling (Structure,Stones,Boulderes.
Consis tency,°oGravel)
Mz
nZ
Depth from Soil Horizon �(USDA)
re Soil Color Soil t ter
Surface(in.) (Munsell) Mottling (Structure,Stones,Boulderes.
o i nc °oGravel)
.::OBSE............. .'�)(.U :HBO:Ian:��.�G.;;:.;;:;::.;:<.::.::::.:::::::;:::.;:<::«.;:.:; .�;;.::.::.;:.;:.>:;:.:::::::.:.:.::..:.
Depth from Soil Horizon Soil Texture Soil Color Soil Otlter
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
onsi ency.°o Gravel)
]Flo'odInsurance
Above 500 year flood,boundary.a,Nol_ Yes
t->>. �Vithin,:500,year,boundaty Xo X Yes
wiihin f00yea`floods'yb'bVt dary No
i
tpth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervi us aterial exist in all areas observed throughout the
area proposed for the soil absorption system?
hf.not,what is the depth of-'naturally occurring pervious material?
Certification
II ertify-that.on (dhte)I liave passed the soil evaluator examination approved by the
,tit- ,'n-vi - f and,thatthe°above analysis was performed byeme consistent,with
Department of EnvtronmentalKProtectton_ Y
tithe required paining,expertise and experience described in 310 CMR 15.017.
Signature Date .
No._.af J,..... Fint .........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD PF H
2 ....7fz4,_i.. .......... ...OF_ �..............................
Appliratian for Biupvoal 19orks Toustrurtion Vamit
a e is Application is hereby ade for a Permit to Construct or Repair an Individual Sew, posal
Syste;n at---.IL.
...7.... . .. _ ..... &.............
atio.-n.-IL
dd, or Lot No.
...... . . ........ .................................... ......... 0 ...................................................
er C 46ddress
........Application
ler......................................... .............................................Address...........................................
U Type of Building,,- Size Lot............................Sq. feet
Dwelling—?No. of Bedrooms............................................Expansion Attic Garbage Grinder (
'4
P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria (
P4 Other fixtures
.. ---- --------------------------------------------*-----------------------------------------------------------------------Design Flow.........................LM..--....__gallons per person per day. Total daily flow...... ... ...............gallons.
� Septic Tank-I/Liquid capacity./A�_gallons Length................ Width-_--_-___-___-_- Diameter_.__-___________ Depth................
Disposal Trench—No. .....................Width....... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.... ............. DiameterXX&(............Depth below inlet.......(.a......... Total leaching area.,3Z�n.sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1.....:2=.minutes per inch Depth of Test Pit.................... Depth to ground water___________.__--__.-___.
�14 Test Pit No. 2................minutes per inch Depth of Test Pit......._..... Depth to ground water.._......._._._....___..
P4 .......... ------- ......
0 Description of Soil...............—..V.0 _.f..........................................................................
U .........................................................................................................................................................................................................
W
14 ---------------------------------------------------------------............. .......................................... ..........................................................................
U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------
........................................................................................................................................................................................................
Agreement: 0
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance witli
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
S* ed ....... ................ ...........
Date
79......Application Approved ...
12,By.. ......Le ..........
----------------- ate
Application Disapproved for the following reasons: . ............................................................................................
....................................................................................................................................................... .................................................
Date
PermitNo......................................................... Issued.�/// .................................
Dat
-------------- --------------- ------
No...- . .........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF, HEALT
.... OF...0
Xpli iratinn fur liapnial World Tlanitrurtinn funfit
Application is hereby made for a Permit to Construct ( ) or. Repair ( ) an Individual Sewage Disposal
Syst /at } f
.. 0.
-axl
atio..•Adds e .. ......................... .,...., -✓ ..... or Lot 1
.....................
O.ner d /J Address
f LC
nstaner Address
Q Type of Building Size Lot............................Sq. feet
U Dwelling--?No. of Bedrooms......4.....................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No, of persons...._..._..........I......... Showers ( ) — Cafeteria ( )
a' Other fixtures --•--•................••-•-•-- ... -
W Design Flow.................................._.gallons per person per day. Total daily flow......,t'Cc`"" ................gallons.
WSeptic Tank-6/Liquid capacity,/42d.gallons Length................ Width................ Diameter-----------..... Depth..............
x Disposal Trench—No..................... Width....... ,_ Total Length.................... Total leaching area.....................sq. ft.
Seepage Pit No.... _ Diameter `f....Depth below inlet.._..../ Total leaching area..- d.1.X_..s ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed.,by-=- •-------.------•------------•-•• . ............. Date........................................
Test Pit No. 1....._`2- ...minutes per inch Depth of* Test Pit.................... Depth-to ground water------------------------
4, Test Pit No. 2................minutes per inch Depth of Test Pit............ .... Depth to ground water.......................
----•---- ............................................
O Description of Soil---_--------- -P
W
UNature of Repairs or Alterations—Answer when applicable................................................................................................
----•------•--•--•------------------------•-•------•---------•--•-------------....--•-•----.......---------------•--........------------. ..............................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the-State Sanitary-Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Si ed
Date
Application Approved By--- 4 /.fit ------
aId to
Application Disapproved for the following reasons:----------------•--••-••••••••••••---•-••--•-••-...••-•-•-•-•-•-•-•-••-•-------•-----••--•------•-•--......--...
.................... ..------•------•••-••-••-••-
------------ ----------------------------------
- - •- - -•-•---------•----•----•--•---..... Date
Permit No............................................ ....... Issued---���.....
--7--- ....•--•-•--
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD ff HEAL.T
r�... ................O F......... .. ...:. . .............. ........................
Tertifiratr of Toutphatta
T IS I TO CERTI - at the Individual Sewaize Disposal System constructed ( or Repaired ( )
by
has been installed in acco- ance with the provisions"of article XI of The State Sanitary Code.as de ribed in the
application for Disposal Works Construction Permit No----------------------------------------- dated_... _ _�''............
THE 'ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST)RYED AS A GU AIdTEE THAT THE
SYSTEM WILL PUNCJ40N SATISFACTORY.
DATE.......�L.. .j Inspector..•--X--•--- -----. .....:..G ........ .......
,i.
THE ,COMMONWEALTH OF MASSACHUSETTS ,
B®ARV
F I-IEA H
~f'L...........OF..
411 .+
NO... ...�...: ...... FEE........................
• � �i��1i�� � _ � .� r 'jinn Prntt�
Permission s erebY granted.../J:.... .. ------
to Construct O o Repair ( a• In vidual Sewer posal S s m � `
at No....: i.�.. ..: f [G.-• � r� ... . .... ...........................
• Street
as shown on the application for Disposal Works Construction inlit No' ;...... ' Dated:._
�A. .....................
DATE................................................................................ ]3oa d f Health
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS -
SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE OR B�
i SHALL
NOTES
(NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION.
PROVIDE MIN. 20" DIAM. WATERTIGHT 1. DATUM IS NAVD 88 S
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE
\ TOP FOUND. EL. 103.4' FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING
/
0 I I 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 1 O2 W W \X
NOTE: 2" MIN. WALL 4. DESIGN LOADING FOR ALL PROPOSED PRECAST Rac
PRECAST H-10 BLOCKS OR P c Lane
RISERS (TYP.) THICKNESS REQUIRED UNITS TO BE AASHO H-10
2'* 4"0SCH40 PVC PRECAST RISERS 0 /�
•. 101.2' MORTAR ALL H-10 e� az c
r, s` MIN. SUMP PIPES LEVEL 1ST 2' �4. COMPONENTS 5. PIPE JOINTS TO BE MADE WATERTIGHT. P /� eat o/i6
12" MIN. INT. DIM. E DS [—SIDES4 G oaf
N IN A RDANCE o�o-o-.�a�o�o-..o� o = � CCOTYP10" 14. 1 EE.. o 99.03' 6 CONSTRUCTION DETAILS TO BE
TEE **EXISTING TEE , 0m®0 =mm rn�0M_O �m0� >oao°o°o° ( ) Locu ��
SEPTIC TANK \*99.8 °°°°°°°° o 0 0 0 o 0 0 0 o 0 0 0 WITH 310 CMR 15.000 TITLE 5. O 9��
° ° ° ° ° ° • WATERTEST D BOX ° ° ° ° aaaaaooao�a �ao�aaaoaao
° ° ° ° ° ° ° ° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND Rd
GAS BAFFLE °�°°°°°°°°°° >°°°°°°°° �O���D��O�C� ®OO�0®�����
° ° FOR LEVELNESS c� ° ° ° °
>00000000 ®��1�0������� �����1�����0 ; NOT TO BE USED FOR LOT LINE STAKING OR ANY -A Mystic
98.47' 98.3' oo;�o�o�0 96.2 OTHER PURPOSE. (P Lake
H-10 500 GAL LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. ooi
3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. So
ALL AROUND PRECAST STRUCTURES
(2) UNITS REQUIRED 9. COMPONENTS NOT TO BE BACK'FILLED OR
6" CRUSHED STONE OR IMECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' CONCEALED WITHOUT INSPECTION BY BOARD OF
COMPACTION. (15.221 [21) HEALTH AND PERMISSION OBTAINED FROM BOARD
OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR
CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP
89.5' BOTTOM TH-1 VERIFYING THE LOCATION OF ALL UNDERGROUND &
( 1 % SLOPE) ( 1 % SLOPE) NO GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF
WORK. NOT TO SCALE
FOUNDATION EXIST. SEPTIC TANK 100' D' BOX 12' LEACHING 11. ANY UNSUITABLE MATERIAL ENCOUNTERED
FACILITY SHALL BE REMOVED 5' BENEATH AND AROUND THE ASSESSORS MAP 47 PARCEL 87
PROPOSED LEACHING FACILITY.
*THE INSTALLER SHALL VERIFY THE �`
�� n 12. EXISTING LEACHING FACILITY SMALL BE PUMPED LOCUS IS WITHIN ZONE II
LOCATIONS OF ALL UTILITIES AND ALL 1 AND REMOVED.
L�� � � D BUILDING SEWER OUTLETS AND
ELEVATIONS PRIOR TO INSTALLING ANY ON
99— EXISTING CONTOUR
PORTION OF SEPTIC SYSTEM
\X 99 **INSTALLER SHALL CONFIRM MINIMUM SEPTIC
Exlsr. SPOT ELEV. TANK SIZE AT 1000 GALLONS AND ITS SUITABILITY 70 Q� T '02\�� SYSTEM DESIGN.
—[991— PROPOSED CONTOUR FOR RE—USE. REPLACE WITH 1500 GALLON
SEPTIC TANK APPROPRIATE TO SITE CONDITIONS IF �� lb
198•41 PROPOSED SPOT EL. NOT SUITABLE 0 4 �O GARBAGE DISPOSER IS NOT ALLOWED
TH1
TEST HOLE � o � `SOO,
EXISTING 3 BEDROOM DWELLING
DESIGN FLOW: 3 BEDROOMS @ 110 GPD = 330 GPD
2� SLOPE OF GROUND BENCHMARK: USE A 330 GPD DESIGN FLOW
urlLlrr POLE CBDH ELEVATION lb
=100.4 NAVD88 �a w/w C'o� SEPTIC TAN-K: 330 GPD (2) = 660
FIRE HYDRANT --� _ __1 y...
**RE-USE EXIST[NG-_10 O GAL: SEPTIC -TANK—
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING `'C w
LEACHING: '
SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD
TEST HOLE LOGS BOTTOM 25 x 12.83 (.74) = 237 GPD
TH1 j01 TOTAL: 472 S.F. 349 GPD
ENGINEER: CRAIG J. FERRARI, SE #13871 �� TH2 EXISTING goo
DAVID W. STANTON RS o`O 2 DWELLING �� USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
WITNESS: TOF = 103.4 WITH 4' STONE ALL AROUND
DATE: 7/1 1/16 g�
i 98
PERC. RATE _ < 2 MIN/INCH DECK
MA
CLASS I SOILS P# 15112 A- � PAVED DRIVE6 APPROVED DATE BOARD OF HEALTH
ELEV. ELEV.
p" 1 100.5' p" z 100.5'
A A \ }
LS LS
TITLE 5 SITE PLAN
7" 10YR 4/2 5" 10YR 4/2 + � % +
OF
B B 99
SL SL LOT 97 �� #354 JONES ROAD
28" 10YR 6/6 98 2, 30„ 10YR 6/6 98' 20,583_ S.F MARSTONS MILLS, MA
' PREPARED FOR
PERC
c C , 95 BORTOLOTTI CONSTRUCTION/
g6 LEONARD
CS CS g3 / DATE: AUGUST 8, 2016
REV. AUGUST 11, 2016 (MOVE SAS)
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