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Home My WebLink About0201 LAKESIDE DRIVE - Health 201 Lakeside Drive Marstons Mills P 102 171 TOWN OF BARNSTABLE LOCAT$ON SEWAGE_# - Ir VILLAGE ASSESSOR'S MAP Cz LOT U`2-'�� INSTALLER'S NAME & PHONE NO. 3` Cn1SS�ov e 1 oves-�o,•3 r � TSEACHING FACILITY:(type) `�- CAS (size) c�a lG A ` NO. OF BEDROOMS30A PRIVATE WELL OR UBLIC WATER BUILDER OR OWNER Nff'4-T�C-Z DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No /t v2�u fJ gly f VL -v,w,3�2- p o � v l � 6 J.P.MACOMBER & SON INC, r BOX 66 f CENTERVILLE,MA.02632 y k ' I I Hazardous Materials Inventory Sheet Checklist _(_/Date _Physical Street Address-Check database to ensure it exists Working Phone Number =Actual Amounts—(i.e.gas being used to fuel machines,thinner to /lean brushes all count as hazardous materials) 1/ Storage Information—location of storage,how long is storage for? If none,note that. �D'sposal Information—where and who? If none,note that. pplicant Signature—understand what is listed and noted. Staff Initial— any questions,know who to ask. ehicle Washing/Rinsing?—provide a vehicle washing policy and r explain it—note that it was given. Attach the Business Certificate with your sign-off and comments. **The Inventory form should explain what the business consists of and theprocedures they are doing. Notes need to be left to explain what you discussed with them. Date: OI//q / 0 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: &ro �P_OLAN mole ielcAofor ('Vla BUSINESS LOCATION: 1/OL �,OL S INVENTORY MAILING ADDRESS: ,9_07°Lo.uzQ_sic(e cey tar onsM'/Ls ./1///t)2,6(/,9 TOTAL AMOUNT: TELEPHONE NUMBER: ug_ 17- 1 r CONTACT PERSON: rA C,(-) EMERGENCY CONTACT TELE ONE NUMBER: / y /►� MSDS ON SITE? TYPE OF BUSINESS: i cPah P&WO W �a�wbo TCoc�r' INFORMATION/RECOMMENDATIONS: Fire District: m o,�te r"0 L S sto e01 e n V Cat.v-\ Waste Transportation: Last shipment of hazardous waste: Name of Hauler- Destination: Waste Product: r'62 m49-* ro s Licensed? Yes No NOTE: Under the provisions`of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or.more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) _ Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's `® Paints, varnishes, stains, dyes/s,:1Z&,1L _,,-,- Other chlorinated hydrocarbons, 1 ��(� Lacquer thinners P0 � ��t n� (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint & varnish removers, deglossers - ` ` (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may e toxiq or haz dous (please list): Laundry soil & stain removers (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS YOU WISH TO OPEN A BUSINESS? i For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office I' FL- 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at the Licensing counter. �- DATE: Fill in please: _ APPLICANT'S YOUR NAME: 401ri, �. BUSINE Y UR HOME ADDRESS: . _ La d J TELEPHONE # Home Telephone Number: 5-02 C/W ! y NAME OF NEW BUSINESS u✓t�a TYPE OF BUSINESStNS�LL IS THIS A HOME OCCUPATION? i/ YES NO Have you been given a hv.r�' c�nd' L ,rs Y g' approval from,the buil in division. YES NO ADDRESS OF BUSINES s MAP/PARCEL NUMBER 2S_ —63e,/ When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in. obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate.your business in this town. 1 . BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual en inf m of he$e mit requirements that pertain to this type of business. Authorized ignature**COMMENTS: UST COMPLY WITH ALL 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: L f Septic System Inspection Report i 201 Lakeside Drive Marston Mills, Massachusetts �] END SEP 18 2002 September 16, 2002 TOWN OF BARNSTABLE HEALTH DEPT. MAP Prepared For: PARCEL -j 1 Carlotta Walsh and Walter Walsh, Jr. LOT 18 Browning Drive Livingston,New Jersey 07039 Prepared By: William E. Robinson, Jr. —Septic System Inspections 43 Tomahawk Drive Centerville,Massachusetts 02632 COMMONNVEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ! v � ^'t TITLE 5 _g OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A j CERTIFICATION i Property Address: 201 Lakeside Drive,Marstons Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Owner's Address: 18 Browning Drive Livingston,New Jersey 07039 Date of Inspection: September 14,2002 j Name of Inspector: (please print) William E.Robinson,Jr. Company Name: William E.Robinson,Jr.Septic Inspections Mailing Address: 43 Tomahawk Drive Centerville,MA. 2632 Telephone Number: (508)775-7986 FI CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my j 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: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: / d� t The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or j DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments The septic system appeared to be in good functioning condition on the day of inspection. 1 ****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. Page 2 of 11 i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS -� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 201 Lakeside Drive,Marston Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system was found to be in good working condition on the day of inspection. V R System Conditionally Passes: N/A I 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. -d 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 distribution 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: Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 201 Lakeside Drive,Marstons Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 -+, C. Further Evaluation is Required by the Board of Health: N/A Conditions exist which require further evaluation by the Board of Health in order to determine if the system _I 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: ..I _ 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 i i 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. {I _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. J _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**.Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and 1 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. 4 3. Other: E I i Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 201 Lakeside Drive,Marstons Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of]inspection: September 14,2002 i D. System Failure Criteria applicable to all systems: ' You must indicate`yes"or"no"to each of the following for aIl inspections: ' Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or pondmg of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than%2 day flow _ X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of the SAS,cesspool or privy is below high ground water elevation. _ X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ' T X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia k 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.) No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described j 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. i E. Large Systems: N/A To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either`dyes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) t 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. i Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 201 Lakeside Drive,Marston Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 Check if the following have been done.You must indicate`yes"or"no"as to each of the following: x Yes No X - Pumping information was provided by the owner, occupant,or Board of Health(sewage Treatment Plant) X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? _ X Have large volumes of water been introduced to the system recently or as part of this inspection? i X Were as built plans of the system obtained and examined?(If they were not available note as N/A) N/A X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X Were all system components,excluding the SAS,located on site? i _ X Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition ! of the bales or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Does not apply X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: `3 Yes no X Existing information.For example,a plan at the Board of Health. k F X _ 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(3)(b)] p 9 • f Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION _j Property Address: 201 Lakeside Drive,Marston Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gad(assumed) Number of current residents:0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): N/A Seasonal use: (yes or no): No Water meter readings,if available(last 2 years usage(gpd): 2000-98K gals.(268 Epd),2001—I1K gals(30 gpd). ! Sump pump(yes or no): No Last date of occupancy: July 2002. COMMERCIAL/iNDUSTRIAL N/A Type of establishment: Design flow(based on 310 CMR 15.203): Rod Basis of design flow(seats/persons/sq ft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ i Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): I GENERAL INFORMATION J Pumping Records Source of information: Barnstable Sewage Treatment Plant(no information available) j Was system pumped as part of the inspection(yes or no): 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 i� _Overflow cesspool J —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 X Other(describe): Cesspool with overflow cesspool in line. Approximate age of all components,date installed(if known)and source of information: Approximately 31-years of age(assumed from when the house was first built—1971) Were sewage odors detected when arriving at the site(yes or no): No i Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 201 Lakeside Drive,Marstons Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 t BUILDING SEWER(locate on site plan) Depth below grade: 6" Materials of construction:_cast iron X 40 PVC—other(explain): Distance from private water supply well or suction line: N/A Comments(on condition of joints,venting,evidence of leakage,etc.): -, Building sewer leaves the building below the foundation. No evidence of leakage,all ioints appear to be in good condition on the day of inspection. SEPTIC TANK. N/A (locate on site plan) Depth below grade: _ Material of construction:—concrete_metal_fiberglass polyethylene _other(explain) If tank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Sludge depth Distance from top of sludge to bottom of outlet tee or baffle:— 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:_ ' How were dimensions determined:_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.):— GREASE TRAP: N/A (locate on site plan) Depth below grade:— Material of construction:—concrete----Metal fiberglass fiberglass—polyethylene—other (explain). Dimensions: Y 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: E Date of last pumping: J Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): J i Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 201 Lakeside Drive,Marstons Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 TIGHT or HOLDING TANK: N/A (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:NA(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:_ Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): t PUMP CHAMBER N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): J a i � Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM _., PART C SYSTEM INFORMATION(continued) Property Address: 201 Lakeside Drive,Marstons Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 -+ SOIL ABSORPTION SYSTEM(SAS):N/A(locate on site plan,excavation not required) 't If SAS not located explain why: r Type leaching pits,number: 1 leaching pit leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: + Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, i etc.): CESSPOOLS: X (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: 2 cesspools in line(one cesspool and one overflow cesspool) Depth—top of liquid to inlet invert: No liquid present Depth of solids layer: 6"in cesspool No. 1 Depth of scum layer: N/A Dimensions of cesspool: Each cesspool has an effective dimension of 61(diameter)x 5'(depth). Materials of construction: Concrete block construction Indication of groundwater inflow(yes or no): No Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Soil relatively dry,some residual wetness from percolating effluent at bottom of cesspool#l. No signs of hydraulic failure. No lush vegetation. { PRIVY: N/A (locate on site plan) f Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): E Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 201 Lakeside Drive,Marston Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 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. Please see attached sketch t I 7 t� 1 I J 1 J Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address. 201 Lakeside Drive,Marstons Mills Owner's Name: Carlotta Walsh and Walter Walsh,Jr. Date of Inspection: September 14,2002 -� SITE EXAM Slope: Mostly flat in cesspool area Surface water: Shubael Pond is across Lakeside Drive to the east Check cellar: No water Shallow wells: None in area Estimated depth to ground water 30 feet(below the ground surface at the cesspool) z Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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) X Accessed USGS database-explain: You must describe how you established the high ground water elevation: i Seasonal high groundwater was determined by comparing USGS/Cape Cod Commission groundwater data and Town of Barnstable GIS data to field measurements and installation as-built information. The surface of the site was estimated from the USGS topographic quadrangle map for the Hyannis Quadrangle(1972)to be elevation 70. The depth to groundwater was estimated to be at elevation 40 from the Barnstable GIS map showing groundwater level information at the Health Department (from July 1992). ! The bottom of the cesspool No. 2 (the deepest cesspool) was measured to be approximately 8' below the surface. Therefore,the bottom of cesspool No.2 is approximately 22'above the estimated groundwater level from 1992. {� Using the Cape Cod Commission method to estimate the seasonal high groundwater elevation,the site was found to be within the area of groundwater indicator well SDW-253 (Zone B). According to the data provided by the Town of Barnstable Health Department(from Cape Cod Commission records)the July 1992 adjustment for that well is 7' upward in Zone B. When subtracted from the separation between estimated groundwater and the bottom of cesspool No.2 the resultant separation is 15'from seasonal high groundwater J I `��:.d� !' Q a 1f,L6•. �5,,,r-; 'J ` , �_e c^��j� ., @yV-��' trn?{t3 v_ . •^. ,.. ��., Q�/ •- '!,� J`.✓ Stir- �.�1\ la„i 4'J �}�.+��2 _ �` �, r- � p��`fl`• •,;,� tL - N � � sQ'ae 1`jag,•r� .,�^�•._:.f` ��J�' A,`� r� T �Li! � p�� '•� +___� o•1 � Fri. � H�•\ 1, ` e a �.., b � t �fc, �t "-�o "fir,: 1.' f Ce f • aj/ 1 t ` 3 • ^�� / ! `�'\ ,• ua e � ��`�..r@ .,1�` •er/q/ V {` 1 /[•. wont ` ? t M' 00 100 •^4� i Lake -�j. :. % �/ �, q.cE, \� �'..h ` v ` D ° 44 r; C �•1 •y r \-I '7 • ";_""`� a NF anber ry Sk Ne Shubael l J @ a PO Hamblim Pond00 `� i� r�\�ft•'t ,p . ems,i r � 1t ` •.'• I * ic- IN_ rt ��..�f •4� ,S IQ� � �:! � It a,;f � i �1 �} f /•, •�� 0 fP CIE am • � • , rr� 4 � p� J b . " - G �y>s- � o :�/ � •� 7� \\� `,s 1. ( ,� �a�� ; � Name,SANDW ICH Location: 041°40'23.9" N 070°23'47.8" W Date:9116/2002 Caption: Locus Map Scale:1 inch equals 2000 feet 210 Lakeside Drive Marstons Mills, MA Copyright(C)1997,Maptech,Inc. Septic System Sketch .......................................... .......................................... .......................................... .......................................... .......................................... .......................................... .......................................... .......................................... .......................................... ra e Stairs i 47.6' 47.6' 18' Cesspool #2 Cesspool #1 Lakeside Drive _s [ Cross Section _i Ground Surface - Elevation 70 1211 16" 15' € Foundation Elevation 47 Adjusted Groundwater Estimated Groundwater Elevation 40 William E. Robinson Location: 201 Lakeside Drive Figure 2 Septic Inspections Marstons Mills, Massachusetts 43 Tomahawk Drive Not To Scale Centerville, MA. 02632 Date: September 14, 2002 Based on Visual Observations