HomeMy WebLinkAbout0307 LAKESIDE DRIVE - Health 307, LAKESIDE i' �
, �g4 MARS'TONS MILL0 TD s
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No. ✓� T Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplitatlon for Disposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair XUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 3o'7 Lj*-ao.9_ bAklk Owner's Name,Address,and Tel.No
p VA%rs�s V1;1 s �P Ch ri5ft tom,,, i-f er �otrs iy1'I, (�
Assessor's Ma /Parcel In s,
Installer's Name,Address,and Tel.No. �p$ ��-q'� Designer's Name,Address,and Tel.No. CID 7 oaf t 10 A
Hb'rs tt4 `fie 1 A
Type of Building: 833 _ (a L,"
Dwelling No.of Bedrooms Lot Size d i 2.1 sq.ft. Garbage Grinder( )
Other Type of Building e 5t MAh al No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) �J gpd Design flow provided gpd
Plan Date 5) `71 2 i�• Number of sheets ' Revision Date 9 2
Title ��S�C W CJ, �cYM�Lt
Size of Septic Tank �� U" // Type of S.A.S. ��` KW Lkat'htnfg
Description of Soil d
Nature of Repairs or Alterations(Answer when applicable) e « Cq 5LJ$-k04 WaL
N 01=0, C I A .5ePt Cu s W 5 .
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 He p
Signed _ Date ( Z
Uz i
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. 02121— 35 Date Issued 101412024
b.
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No. /mot/{s = E Fee ./]
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:_4e!!!
M PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSCHUSETTS Yes
A
Lo application for Misposal 6 stem Construction J3er,mit
application.for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 307 00 �1ib4. Owner's Name,Address,and Tel.No o"� �,.t t�s Id t p�
Assessor's Ma /Parcel !93 "!�r� 1 t1h#SST+ ' ee ' .��5 p,�
it p J�� 1K7a. .tr 1] G[9s ► e ��iA'.
Installer's Name,Address,and Tel.No. C� '�-]� Designer's Name,Address,and Tel.No.` RO ~ ®t*C b A
MA
?'P.i f"S f >7/ A4.M;leis
Type of Building: g$3 • bbOb-
. ' Dwelling No.of Bedrooms Lot Size 00201 sq.ft. Garbage Grinder( )
Other Type of Building 441t 511&tAll CA No.of Persons Showers( ) Cafeteria( ) '
Other Fixtures
Design low(min.required) 3 314 gpd Design flow provided gpd
-Plan 'Date �� �7� 'fir I Number of sheets Revision Date
cl18121
t TitleAS�W0. U'
Size of Septic Tank ' C Type of S.A.S. X� �g nth►nG
Description of Soil a j
p , �
r
Nature of Repairs or Alterations(Answer when applicable) t "YS'"rj q 54-s-km v jaL
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""'
igned Date -f f '_1 h I i
' Application Approved by Date
Application Disapproved by 4 Date k
for the following reasons
Permit No. A�1- 357 Date Issued I#q]Z -i
----------------------
a THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded O
Abandoned( )byat ,,`,'
S-ICAL)
� �%yVtVh IsAas been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit Not tl-,30 dated IV I y;I 2oZ)
Installer C {VW A) � Designer
#bedrooms NA- � Approved design flow IVA gpd
The issuance of this permit shall/not be construed as a guarantee that the system will f inctio as designed.
Date �d / ll Inspector _
+-----a---- -- ------------------ ------ ------ ------- ,.
No. 02, � Fee l-115"go'
THE COMMONWEALTH OF MASSACHUSETTS �»
f Rt C PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Disposal *pstem Construction permit
Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( )
System located at 3®*7 �..0►�2tSI fps rt trt a OS�Si�1 g� At
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
/ Title 5 and the following local provisions or special conditions.
K
Provided:Construction must be completed within three years of the date of this permit
Date Approved by
/10
y
Town of Barnstable
.� > Inspectional Services
Public Health Division
snnrrsrast.e.
°M Thomas McKean,Director
019. .�
ADNIA'tA 200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 10/21/2021 Sewage Permit# ZOZI - 357 Assessor's Map\Parcel 102/145
Designer: Joe Henderson, Horsley Witten Group, Inc. Installer• E.J2I c STTJrt15
Address: 90 Route 6A Address: fb. \36k -1 1
Sandwich, MA 02563 YVI WL5TO" M f Lt's WI Il--
OZ6 Y9
On /6/ /z/ G21 C- 5Te0ex S was issued a permit to install a
date) (installer)
septic system at 307 Lakeside Drive based on a design drawn by
(address)
Joe Henderson, Horsley Witten Group, Inc. dated May, 7 2021 revised 9/8/2021
(designer)
X 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. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State &Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
X I certify that the system referenced above was constructed ;- ^^—Van^""ith*hP terms of
the IAA approval letters (if applicable) � � OF,yt&
JOSEM �y
o MENDER
e s Si ature) `
,�
V k
(Desi er's ignature) (Affix D
PLEASE RETURN TO BARNS 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.
WoAdeptAHEALTHISEWER connecASEPTICOesiper Certification Form Rev 8-14-13.DOC
P
S�
Town of Barnstable
wtxsr�ece.
` , ' Board of Health
Mo+''
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 John Norman,Chairrman
FAX: 508-790-6304 Donald A.Guadagnoli,M.D.
F.P.(Thomas)Lee,P.E.
Daniel Luczkow,M.D.Alt
March 3, 2022
Mr. Joseph Henderson
Horsley Witten Group
90 Route 6A, Unit 1
Sandwich, MA 02563
RE: 307 Lakeside Drive, Marstons Mills A; 102-1457-� a
Dear Mr. Henderson,
You are granted permission on behalf of your client, Christopher Hagerty, to construct
and utilize a NitROE secondary treatment unit with advanced nitrogen reduction
technology at 307 Lakeside Drive, Marstons Mills, Massachusetts.
You are reminded the following requirements are provided within the MA Department of
Environmental Protection (DEP) Provisional Use Approval Renewal letter for this
particular technology, dated May 12, 2020:
(1) Thirty (30) days prior to submitting an application for a DSCP, the Company or its
representative shall provide to the Approving Authority a certification, signed by
the owner of record for the property to be served by the unit, stating that the
property owner: a) has been provided a copy of the Provisional Use Approval
and all attachments and agrees to comply with all terms and conditions; b) has
been informed of all the owner's costs associated with the operation including
power consumption, maintenance, sampling, recordkeeping, reporting, and
equipment replacement; KleanTu NitROE 2K Provisional Approval, May 2020
Page 11 of 15 Technology: NitROE® 2KS & 2KM WWTS c) understands the
requirement for a contract with a company approved operator and has been
provided a current list of all approved operators; d) agrees to fulfill his
responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10)
and the Approval; and e) agrees to fulfill his responsibilities to provide written
notification of the Approval conditions to any new owner, as required by 310
CMR 15.287(5).
(2) Prior to the issuance of a Certificate of Compliance by the Approving Authority: a)
In accordance with 310 CMR 15.021(3), the System Installer and Designer must
certify in writing that the System has been constructed in compliance with 310
Q:WP/Henderson 307 Lakeside Drive NAROE Approval August 2021.docx
• y
e
r�
CMR 15.000, the approved design plans, and all local requirements, including
any local approving authority site-specific requirements;
(3) Prior to issuance of the Certificate of Compliance and after recording and/or
registering the Deed Notice required by 310 CMR15.287(10), the System Owner
shall submit the following to the Local Approving Authority: (i) a certified Registry
copy of the Notice bearing the book and page/or document number; and (ii) if the
property is unregistered land, a Registry copy of the System Owner's deed to the
property, bearing a marginal reference on the System Owner's deed to the
property. The Notice to be recorded shall be in the form of the Notice provided by
the Department
(4) Prior to the use of the System, the System Owner shall enter into an O&M
Agreement with a qualified contractor and submit the Agreement to the
Approving Authority and the Company. The Agreement shall be at least for one
year.
(5) The wastewater effluent shall be sampled and analyzed/tested quarterly if this
facility is utilized year-round. Sampling shall include pH, BOD5, TSS and Total
Nitrogen, unless otherwise stated. Flow shall be recorded at each inspection.
[Note: a)Year-round facilities shall be inspected and effluent sampled quarterly; b) Seasonal properties shall
be inspected and effluent sampled a minimum of twice per year,with at least one annual sample taken 30 to
60 days after seasonal occupancy and a second sample taken no less than 2 months after the first sample;
and c) After 12 rounds of monitoring, sampling may be reduced to TN only quarterly. Reduced sampling
shall also include Field Testing of System wastewater when determined necessary by the operator, see DEP
Field Testing Protocol at http://www.mass.gov/eea/docs/dep/water/laws/i-thru-z/testsamp.pdf]
(6) A copy of the wastewater analyses, wastewater flow data, field testing results,
and System Operator O&M reports and inspection checklists shall be maintained
by the Company. It is recommended the System Owner also maintain copies of
these items.
The above list is not all inclusive; all of the other conditions listed in the MA Department
of Environmental Protection (DEP) Provisional Use Approval Renewal letter to KleanTu
LLC dated May 12, 2020 will need to be adhered to.
This permission is granted because the proposed plan appears to meet the maximum
feasible compliance provisions of the State Environmental Code, Title 5, and the Town
of Barnstable Board of Health Regulations. It also appears to meet the nitrogen loading
restrictions contained within the State and local regulations with no increase in sewage
flow requested at this property at this time.
Sinc rely urs,
yp
n Norman (�
hairman
Q:WP/Henderson 307 Lakeside Drive NitROE Approval August 2021.docx
DATE
4" $95.00 FEE*:
MAM��. Town of Barnstable REC.BY:
i639. �10�' Q�
Board of Health SCHED.DATE:
200 Main Street, Hyannis MA 02601 I
Office: 508-8624644
John T.Norman
FAX: 508-790-6304 Donald A.Guadagnoli,M.D.
Paul J.Canniff,D.M.D.
F.P.(Thomas)Lee,Alternate
VARIANCE REQUEST FORM
LOCATION
Property Address: 307 Lakeside Drive
Assessor's Map and Parcel Number: 102/145 Size of Lot: 0.21 ac
Wetlands Within 300 Ft. No Business Name:
Subdivision Name:
APPLICANT'S NAME: Joseph Henderson (Horsley Witten) Phone _ 508-833-6600
Did the owner of the property authorize you to represent him or her? Yes X No
PROPERTY OWNER'S NAME CONTACT PERSON
Name:
Christopher C Hagerty Name: Joseph Henderson (Horsley Witten Group)
Address: 307 Lakeside Drive, Marstons Mills Address: 90 Route 6A, Unit 1 Sandwich, MA 02563 .
Phone: Phone: 508-833-6600
EMAIL: ienderson@horsleywitten.com
VARIANCE FROM REGULATION(tacl.Reg.code a) REASON FOR VARIANCE(May attach separate sheet if more space needed)
—Installation of new I/A system with existing septic system.—
Wastewater Retrofit_
NATURE OF WORK: House Addition Li Humic Renovation Repair of Failed Septic System
Checklist (to be completed by office staff-person receiving variance request application)
Please submit first four on list as S collated packets
A. Five(5)copies of the completed variance request form
_ B. Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an I/A system or
secondary treatment unit(S.T.U.).
_ C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email:
health(@town.bamstable.ma.us *(Pool Plan—5 hard copies)
D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic
version.
A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or RS.
Signed letter stating that the property or business owner authorized you to represent him/her for this request
Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or
local sewage regulation variances only).
Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only).
Fee Submitted•$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New
owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair withou an
increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance").
_ Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED John T.Norman
NOT APPROVED Donald A.Guadagnoli,M.D.
REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D.
Q:\Application Forms\VARIREQ Rev Jan 1-2020.docx
MAIL-IN REQUESTS
Please mail the variance fee amount of $95.00 (if applicable), along with the documents listed
below, to the following address: Checks payable to: Town of Barnstable.
Town of Barnstable
Public Health Division
200 Main Street
Hyannis, MA 02601
For septic system variance requests, each of five packets must include:
1) Variance Request Form,
2) Letter for the Board with further information on the reason for the septic
variance request (Optional),
3) MA DEP Approval letters for proposed Innovative Alternative (I/A) septic
system or a proposed secondary treatment unit (S.T.U.)
4) Engineering plans,
5) Floor plans
In additional to the five septic packets above, include one copy of the seven (7) page checklist,
the authorization letter, copy of abutters notice, and fee, if applicable (see checklist below).
Please send one electronic submission using a PDF or .jpg of the engineering plan and floor
plans to email: health(cD-town.barnstable.ma.us. (Total email must be less than 10 megabytes.)
For grease trap variance requests, each of five packets must also include a full menu. (see
checklist below).
Checklist - Please submit first four on list as 5 collated packets.
A. Five(5)copies of the completed variance request form
B. Five(5)copies of MA DEP approval letters for Innovative Alternative septic system(when proposing an I/A or
secondary treatment unit(S.T.U.).
C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted
to email: health@barn stable.ma.us
D. Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and
one(1)electronic version submitted to email: health@town.bamstable.ma.us
A completed seven (1) page checklist, confirming all required items are on the engineered septic system plan
submitted by engineer or registered sanitarian.
Signed letter stating that the property or business owner authorized you to represent him/her for this request
Applicant must notify the abutters by certified mail at least ten days prior to meeting date at applicant's expense(for
Title V and/or local sewage regulation variances only).
Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only)
Fee Submitted*$95.00 for the following variances: 1)New construction,2)Septic repairs with increase in flows,3)
New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic
repair without an increase in flow and variances granted at the counter. 2) Monitoring Plans, and 3) Temporary
Food(this is not a variance).
Variance request submitted at least 15 days prior to meeting date.
For,further assistance on any item above, call (508) 862-4644
Email: healthO-town.barnstable.ma.us
Back to Main Public Health Division Page
l
e Commonwealth of Massachusetts
Executive Office of Energy &Environmental Affairs
IVOne Winter Street Boston, MA 02108.617-292-5500
Department of Environmental Protection
Charles D. Baker Kathleen A.Theoharides
Governor Secretary
Karyn E.Polito Martin Suuberg
Lieutenant Governor Commissioner
PROVISIONAL USE APPROVAL RENEWAL
Pursuant to Title 5, 310 CMR 15.000
Name and Address of Applicant:
K1eanTu LLC.
300 Old Pond Road, Ste#206
Bridgeville, PA 15017
Trade name of technology and models:
NitROE® Waste-Water Treatment System (NitROE® WWTS) with unit sizing for design flows up to
2000 gpd (NitROE® 2KS WWTS and NitROER 2KM WWTS) (hereinafter the `System' or the
`Technology'). Owner and Operator manuals, installation manual, schematic drawings illustrating the
System models and the technology inspection checklist are part of this Certification.
DEP Transmittal No.: X285590
Date of Issuance: May 12,2020,
Expiration date: May 12,2025
Authority for Issuance
Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000,the Department of Environmental
Protection (hereinafter "the Department") hereby issues this Provisional Approval to: KleanTu LLC,
located at 300 Old Pond Rd., Ste 206 in Bridgeville, PA (hereinafter "the Company"), NitROE® 2KS
WWTS and NitROE® 2KM WWTS (hereinafter "the Technology" or "System") for use in the
Commonwealth of Massachusetts subject to the conditions herein. Sale and use of the Technology is
subject to compliance by the Company, the Designer, the System Installer, the Operator, and the System
Owner with the terms and conditions herein. Any noncompliance with the terms or conditions of this
Certification constitutes a violation of 310 CMR 15.000.
_May 12, 2020
Marybeth Chubb, Section Chief Date
Wastewater Management Program
Bureau of Resource Protection
This information is available in alternate format.Contact Michelle Waters-Ekanem,Director of Diversity/Civil Rights at 617-292-5751.
TTY#MassRelay Service 1-800.439-2370
MassDEP Website:www.mass.gov/dep
Printed on Recycled Paper
' I
K1eanTu NitROE 2K Provisional Approval,May 2020 Page 2 of 15
Technology:NitROEO 2KS&2KM WWTS
I.PURPOSE
Subject to the conditions of this Approval and any other local requirements, the purpose of this Approval
is to allow installation and operation of at least 50 on-site sewage disposal systems utilizing the
technology in Massachusetts in order to conduct a performance evaluation of the capabilities of the
Technology during the first 3 years of operation of each system, in accordance with Title 5 — 310 CMR
15.286 (7),Provisional Approval of Alternative System.
The specific goal of the Performance Evaluation is to determine if the Technology is capable of
consistently meeting the concentration limits for total nitrogen (TN) of less than 11 milligrams per liter
(mg/L) for installations with design flows less than 2,000 GPD in the effluent discharged to the soil
absorption system. In areas subject to nitrogen leading limitations, increases in the discharge rate per acre
may be allowed when the nitrogen concentration discharged to the soil is reduced.
The Company is responsible for oversight and sampling of the systems during the Performance
Evaluation. The System Owner has responsibility for continued oversight and sampling of the system if
the property served was allowed to increase the discharge rate per acre above 440 gallons per day per acre
(gpda) in an area subject to Nitrogen Loading Limitations. The System Owner will be required to repair,
replace,modify or take any other action as required by the Department or the local approving authority, if
the Department or the local approving authority determines that the System is not capable of meeting the
required reduction in nitrogen in the effluent.
With the other applicable permits or approvals that may be required by Title 5, this Approval authorizes
the installation and use of the Alternative System in Massachusetts. All the provisions of Title 5,
including the General Conditions for all Alternative Systems (310 CMR 15.287), apply to the sale,
design, installation, and use of the System, except those provisions that specifically have been varied by
this Approval.
II.GENERAL DESCRIPTION OF THE'TECHNOLOGY
The NitROE ® 2KS or 2KM WWTS (the `System') is installed in series between a Title-5 system septic
tank and a soil absorption system constructed in accordance with 310 CMR 15.100 — 15.279, subject to
the provisions of this Approval to accommodate design flows of less than 2,000 GPD.
The System is comprised of two-unit processes which are sequentially performed in two different
chambers. The first chamber is aerated, via an external air pump and airline header/hose arrangement; to
achieve both organic carbon reduction along with the biological conversion of ammonia-N to nitrate-N.
From the Aeration Chamber, the wastewater then gravity flows into a Denitrification Chamber where, in
the presence of natural organics from wood chips, bacteria mediate the conversion of nitrate-N to inert N
gas that exits to the atmosphere via the Title 5 system vent piping. Depending on design flow and
availability of local tank structures, the sequential Aeration and Denitrification process steps can be
performed in the same single tank, which is NitROE® 2KS WWTS, or each process could be performed
in its own separate tank with the overall NitROE® WWTS comprised of multiple tank combinations,
which is NitROE®2KM WWTS.
The use of the Technology under this Approval requires:
• Disclosure Notice in the Deed to the property;
• Certifications by the Company,the Designer, and the Installer;
0 System Owner Acknowledgement of Responsibilities;
K1eanTu NitROE 2K Provisional Approval,May 2020 Page 3 of 15
Technology:NitROEO 2KS&2KM WWTS
• A certified operator under contract for periodic inspection and maintenance;
• Periodic sampling;
• Recordkeeping and reporting; and
• An external power supply
III. CONDITIONS OF APPROVAL
A. Basis for Conditions
1. The term "System" refers to the Technology in combination with any other components of an
on-site treatment and disposal system that may be required to serve a Facility in accordance
with 310 CMR 15.000.
2. The term "Approval" includes the Special Conditions, Standard Conditions, General Conditions
of 310 CMR 15.287, and the approved Attachments.
3. Items required by this Approval include:
a) Performance Evaluation Plan (PEP) with sampling and analysis requirements and
approved by the Department. The PEP must be submitted to the Department for review
and approval within 60 days of issuance of this Approval and meet the requirements of
the Department's Guidance for the Preparation of Performance Evaluation Plans
<2,000 GPD;
b) Minimum System installation requirements;
c) Company schematic drawings and specifications;
d) Owner's Manual, including information on substances that should not be discharged to
the System;
e) Operation and Maintenance manual, including but not limited to, operator qualification
requirements, inspection requirements, sampling and analysis requirements,
recordkeeping requirements, and/or reporting requirements; and
f) MassDEP Operation and Maintenance (O&M) checklist and I/A technology inspection
checklist.
B. Special Conditions
1. Department review and approval of the System, design and installation is not required unless
the Department determines on a case-by-case basis pursuant to its authority at 310 CMR
15.003(2)(e)that the proposed System requires Department review and approval.
2. System installations must meet the specific siting conditions for Provisional Use provided in
310 CMR 15.286(4) and the facility must meet the siting requirements of this Approval.
3. Any System for which a complete Disposal System Construction Permit Application is
submitted while this Approval is in effect,may be permitted, installed, and used in accordance
with this Approval unless the Department,the local approval authority, or a court requires the
System to be modified or removed or requires discharges to the System to cease.
4. The System Owner shall provide access to the site for purposes of sampling the System in
accordance with the Company's technology Performance Evaluation Plan approved by the
i
K1eanTu NitROE 2K Provisional Approval,May 2020 Page 4 of 15
Technology:NitROE®2KS&2KM WWTS
Department, in addition to providing access for performing inspections, maintenance, repairs,
and responding to alarm events.
5. The System Owner shall ensure that no permanent buildings or structures, other than the
System, are constructed in the area for the installation of all the components of a fully
conforming Title 5 system with a reserve area. The area for a fully conforming Title 5 system
with a reserve area shall not otherwise be disturbed by the System Owner in any manner that
will render it unusable for future installation of a fully conforming Title 5 system.
6. The Department has not determined that the performance of the System will provide a level of
protection to public health and safety and the environment that is at least equivalent to that of a
sanitary sewer system.
If it is feasible to connect a new or existing facility to the sewer, the Designer shall not
propose an Alternative System to serve the facility and the facility Owner shall not install or
use an Alternative System.
When a sanitary sewer connection becomes feasible after an Alternative System has been
installed,the System Owner shall connect the facility served by the System to the sewer within
60 days of such feasibility and the System shall be abandoned in compliance with 310 CNfR
15.354, unless a later time is allowed in writing by the Department or the Local Approving
Authority.
7. The control panel including alarms shall be mounted in a location accessible to the System
Operator.
8. For any System that does not flow by gravity to the SAS, the System shall be equipped with
sensors and high-level alarms to protect against high water due to pump failure, pump control
failure, loss of power, or system freeze up. The control panel including alarms and controls
shall be mounted in a location always accessible to the operator (or service contractor).
.Emergency storage capacity for wastewater above the high level alarm shall be provided equal
to the daily design flow of the System and the storage capacity shall include an additional
allowance for the volume of all drainage which may flow back into the System when pumping
has ceased.
Instead of providing emergency 24-hour storage, an independent standby power source may be
provided for operation during an interruption in power. With any interruption of the power
supply the source must be capable of automatically activating in addition to manual start up
capability. The standby power must be sufficient to handle peak flows for at least 24 hours and
sufficient to meet all power needs of the System including, but not limited to, pumping,
ventilation, and controls. Standby power installations must be inspected and exercised at least
annually and all automatic and manual start up controls must be tested. Standby power
installations must comply with all applicable state and local code requirements. Provided that a
standby power installation complies with these requirements, no variance is required to the
provisions of 310 CMR 15.231(2).
9. System unit malfunction and high water alarms shall be connected to circuits separate from the
circuits to the operating equipment and pumps.
10. All System control units,valve boxes, conveyance lines and other System appurtenances shall
be designed and installed to prevent freezing per the Company's recommendations.
K1eanTu NitROE 2K Provisional Approval,May 2020 Page 5 of 15
Technology:NitROE®2KS&2KM WWTS
11. Any System structures with exterior piping connections located within 12 inches or below the
Estimated Seasonal High Groundwater elevation shall have the connections made watertight
with neoprene seals or equivalent.
12. In compliance with 310 CMR 15.240(13), a minimum of one (1) inspection port shall be
provided within the SAS consisting of a perforated four inch pipe placed vertically down into
the stone to the naturally occurring soil or sand fill below the stone. The pipe shall be capped
with a screw type cap and accessible to within three inches of finish grade.
Operation and Maintenance
13. Inspection, operation and maintenance (O & M), sampling, and field testing of the System
required by this Approval shall be performed by a System Operator with the following
qualifications:
a) is an approved System Inspector in accordance with 310 CMR 15.340;
b) has been trained by the Company and whose name appears on the Company's current
list of qualified operators; and
c) has been certified at a minimum of Grade Level IV (four) by the Board of
Registration of Operators of Wastewater Treatment Facilities, in accordance with
Massachusetts regulations 257 CMR 2.00. The name of the Operator shall be
included in the O&M agreement required by paragraph B (14).
14. Prior to the use of the System, the System Owner shall enter into an O&M Agreement with.a
qualified contractor and submit the Agreement to the Approving Authority and the Company.
The Agreement shall be at least for one year and include the following provisions:
a) The name of the qualified Operator that appears on the Company's current list of Service
Contractors;
b) The System Operator must have the qualifications specified in paragraph B (13);
c) The System Operator must inspect the System in accordance with the Approval and
anytime there is an equipment failure, System failure, or other alarm event;
d) In the case of a System failure, an equipment failure, alarm event, components not
functioning as designed or in accordance with the Company specifications, or violations of
the Approval, procedures and responsibilities of the Operator and System Owner shall be
clearly defined for corrective measures to be taken immediately. The System Operator
shall agree to provide written notification within five days describing corrective measures
taken to the System Owner,the Company, and the local board of health;
e) The System Operator shall determine the cause of total nitrogen effluent limit violations if
they occur and take corrective actions in accordance with the approved O & M Manual;
.and
f) Procedures and responsibilities for recording quarterly or monthly wastewater flows must
be defined, see paragraph B (32)"Flow Metering".
15. At all times, the System Owner shall maintain an O&M Agreement that meets the
requirements of paragraph B (20).
16. The System Owner and the System Operator shall properly operate and maintain the system in
accordance with this Approval, the Designer's operation and maintenance requirements, and
the requirements of the local approving authority.
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17. Upon determining that the System has failed, as defined in 310 CMR 15.303, the System
Operator shall notify the System Owner immediately.
18. Upon determining that the System has failed, as defined in 310 CNIR 15.303, the System
Owner and the System Operator shall be responsible for the notification of the local approving
authority within 24 hours of such determination.
19. In the case of a System failure, an equipment failure, alarm event, components not functioning
as designed or in accordance with the Company specifications, or any violations of the
Approval, the System Owner and the System Operator shall be responsible for the written
notification of the local approving authority and the Company within five days describing
corrective measures taken.
20. Within 60 days of any site visit, the System Operator shall submit an O&M report and
inspection checklist to the System Owner and the Company. The O&M report and inspection
checklist shall include, at a minimum:
a) for a System failing, any corrective actions taken;
b) wastewater analyses, wastewater flow data, and field testing results;
c) any violations of the Approval;
d) any determinations that the System or its components are not functioning as designed or
in accordance with the Company specifications; and
e) any other corrective actions taken or recommended.
21. B September 30th of each ear, the System Owner and the Service Contractor shall be
Y P Y � Y
responsible for submitting to the local approving authority all monitoring results with all
O&M reports and inspection checklists completed by the System Operator during the previous
12 months.
22. By September 30th of each year, the Service Contractor shall be responsible for submitting to
the Company copies of all O&M reports including alarm event responses, all monitoring
results, violations of the Approval, inspection checklists completed by the Service Contractor,
notifications of system failures, and reports of equipment replacements with reasons during the
previous 12 months.
23. A copy of the wastewater analyses, wastewater flow data, field testing results, and System
Operator O&M reports and inspection checklists shall be maintained by the Company. It. is
recommended the System Owner also maintain copies of these items.
24. The System Owner shall notify the Approving Authority in writing within seven days of any l
cancellation, expiration or other change in the terms and/or conditions of the O&M Agreement
required by Paragraph B(14).
25. The System Owner and the Service Contractor shall maintain copies of the Service
Contractor's O&M reports, inspection checklists, and all reports and notifications to the LAA
for a minimum of five years.
26. The System may only be installed to serve facilities where a fully conforming Title 5 system
with a reserve area exists on-site or could be built on-site in compliance with the design
standards for new construction of 310 CMR 15.000, and for which a site evaluation in
I
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compliance with 310 CMR 15.000 has been approved by the Approving Authority. A fully
conforming Title 5 system may include other approved alternative technologies in accordance
with the conditions imposed on the alternative technologies.
27. Subject to the provisions of this Approval, the Technology shall be installed in a manner
which neither intrudes on, replaces a component of, or adversely affects the operation of all
other components of the System designed and constructed in accordance with the standards for
new construction of 310 CMR 15.200 - 15.279.
Effluent Limit and Monitoring_Requirements,
28. For the new construction, unless the facility meets a TN effluent limit of 11 mg/l or less, the
system shall not be designed to receive more than 440 gallons of design flow per day per acre
(gpda) in an area that is subject to the Nitrogen Loading Limitations of 310 CMR 15.214. If
the facility does not meet with the Nitrogen Loading Limitations pursuant to the aggregation
provisions of 310 CMR 15.216, the System Owner shall repair, replace, modify or take any
other action as required by the Department or the local approving authority to meet the total
nitrogen concentration limits in the effluent.
Violation of the TN concentration in the System effluent shall not require notifications as
required in paragraphs B (18)and(19).
29. Prior to Department approval of the Company's Performance Evaluation Plan, the Company
shall be responsible for the following monitoring requirements for all System installations that
are subject to a total nitrogen concentration limit in accordance with paragraph B (28).
Sampling shall include pH, BOD5, TSS and Total Nitrogen, unless otherwise stated. Flow
shall be recorded at each inspection, see"Flow Metering" section below.
a) Year-round facilities shall be inspected and effluent sampled quarterly;
b) Seasonal properties shall be inspected and effluent sampled a minimum of twice per year,
with at least one annual sample taken 30 to 60 days after seasonal occupancy and a second
sample taken no less than 2 months after the first sample; and
c) After 12 rounds of monitoring, sampling may be reduced to TN only quarterly. Reduced
sampling shall also include Field Testing of System wastewater when determined
necessary by the operator, see DEP Field Testing Protocol at
http://www.mass.govleealdocsldeplwaterllawsli-thru-zltestsamp.pdf.
Properties occupied at least 6 months per year are considered year-round properties.
Properties occupied less than 6 months per year are considered seasonal properties.
30. During the Performance Evaluation period, the Company shall follow the monitoring
requirements specified in the Performance Evaluation Plan for installed Systems.
31. After the three (3) year Performance Evaluation period by the Company and approval by the
Department, and until this Approval is modified, terminated, or superseded by a General Use
Certification, the System Owner shall comply with the following monitoring requirements if
the System is subject to a total nitrogen concentration limit in accordance with paragraph B?
(28)•
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a) Year-round properties shall be inspected and sampled for at least the TN parameter a
minimum of twice/year, at least 5 months apart and with at least one sample taken
between December 1 and March 1 of each year. Field testing shall be completed as
determined necessary by the System operator, see DEP Field Testing Protocol at
http://www.mass.govleealdocsldeplwaterl7awsli-thru-zltestsamp.pdf.
Water meter readings shall be recorded at each inspection, see"Flow Metering"below.
b) Seasonal properties shall be sampled for at least the TN parameter a minimum of
twice/year. At least one annual sample must be taken 30 to 60 days after each seasonal
occupancy. A second sample must be taken no less than 2 months after the first sample.
Field testing of the System shall be completed as determined necessary by the operator.
Water meter readings shall be recorded at each inspection, see"Flow Metering" below.
32. Flow Metering - At a minimum, for all systems installed prior to this Approval, water meter
flow data shall be recorded each time the system is inspected and sampled by the System
Operator. For systems installed after the effective date of this Approval, wastewater flow data
shall be recorded each time the system is inspected and sampled by the System Operator and
may be based on:
a) actual metering data of wastewater flow to the system; or
b) water meter data for the total facility with metered non-wastewater flows, if available,
subtracted from the total facility water usage.
' 33. Field Testing: Turbidity, pH and Apparent Color - Turbidity, pH, DO and apparent color shall
be measured and/or recorded in the field when when determined necessary by the operator.
See applicable sections of the Department's Field Testing Protocol at
http://www.mass.govleealdocsldeplwater/laws/i-thru-zltestsamp.Ddf.
34. At a minimum,the System Operator shall inspect the System:
a) two times per year;
b) in accordance with the approved O&M manual, the Designer's operation and maintenance
requirements, and the requirements of the local approving authority; and
c) any time there is an alarm event, equipment failure,,or system failure
35. The System Operator shall collect samples and obtain analysis results from an approved lab,
perform field testing required by the Approval and submit results within 60 days of the site
visit to the System Owner.
36. If the Company successfully demonstrates the effectiveness of the System to reduce nitrogen
loadings during the Performance Evaluation period, a minimum of three years, the System
Owner shall operate the System subject to the requirements of the General Use Certification, if
issued, for this technology.
C. Special Conditions Specific to the Company
1. The Approval shall only apply to model units with the same model designations specified in
this approval and meet the same specifications, operating requirements, and plans, as
provided by the manufacturer at the time of the application. Any proposed modifications of
the units shall be subject to the review of the Department for coverage under the Approval.
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2. Prior to submission of an application for a DSCP, the Company shall provide to the Designer
and the System Owner:
a) All design and installation specifications and requirements;
b) An operation and maintenance manual, including:
i) an inspection checklist;
ii) recommended inspection and maintenance schedule;
iii)monitoring(i.e. water use and power consumption)and sampling procedures, if any;
iv)alarm response procedures, if any, and troubleshooting procedures;
c) An owner's manual, including proper system use and alarm response procedures, if any;
d) Estimates of the Owner's costs associated with System operation including, when
applicable: power consumption, maintenance, sampling, recordkeeping, reporting, and
equipment replacement;
e) A copy of the Company's warranty; and
f) Lists of Designers,Installers, and Service Contractors.
3. The Company shall implement the Performance Evaluation Plan, as submitted and approved
by the Department, and shall be responsible for all data collection and submissions to the
Department until a final determination on the Performance Evaluation has been made by the
Department.
4. Until a final determination has been made by the Department on a completed Performance
Evaluation, the Company shall submit to the Department an annual report by.February 15th
of each year that includes the following:
a) a table of all sample data collected for all systems installed to date and all information
required by the Department as part of the approved Performance Evaluation Plan;
b) status of preparation of a Performance Evaluation Plan if not yet provided to MassDEP, or
any recommended changes to the approved Performance Evaluation Plan;
c) a list of pending applications for system installations which have been submitted to local
approving authorities;
d) identification of any System after start-up in violation of the Approval or not in
compliance with any performance criteria at the time of the annual report, the reasons for
the noncompliance and the status of any corrective actions that are needed; and
e) any recommendations and requests for changes to the system monitoring and reporting
plan or the performance criteria of the Approval.
The report shall be signed by a corporate officer, general partner or the Company
owner.
(Service Contractor records submitted to the Company should not be included with the
annual report to the Department, but shall be made available to the Department within
30 days of a request by the Department.)
5. The Company shall institute and maintain a program of Installer training and continuing
education that is at least offered annually. The Company shall maintain and annually update,
and make available the list of qualified Installers by February 15th of each year. The
Company shall certify that the Installers on the list have taken the training and passed the
Company's training qualifications.
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6. The Company shall institute and maintain a program of Designer training and continuing
education, as approved by the Department. The Company shall maintain and annually update,
and make available the list of qualified Designers by February 15th of each year. The
Company shall certify that the Designers on the list have taken the training and passed the
Company's training qualifications.
7. The Company shall institute and maintain a program of Operator training and continuing
education, as approved by the Department. The Company shall maintain and annually update,
and make available the list of qualified Operators by February 15th of each year. The
Company shall certify that the Operators on the list have taken the training and passed the
Company's training qualifications.
8. The Company shall not sell the Technology to an Installer unless the Installer is trained to
install the System by the Company.
9. Prior to its sale of any System that may be used in Massachusetts, the Company shall provide
the purchaser with a copy of the Approval with the System design, installation, O&M, and
Owner's manuals. In any contract for distribution or sale of the System, the Company shall
require the distributor or seller to provide the purchaser of a System for use in Massachusetts
with copies of these documents,prior to any sale of the System.
10. Within 60 days of issuance by the Department of a revised Approval, the Company shall
provide written notification of changes to the Approval to all Service Contractors servicing
existing installations of the Technology and all distributors and resellers of the Technology.
11. The Company shall provide written notification to the Department's Director of the
Wastewater Management Program at least 30 days in advance of the proposed transfer of
ownership of the Technology for which the Approval is issued. Said notification shall include
the name and address of the proposed owner containing a specific date of transfer of
ownership,responsibility, coverage and liability between them.
12. The Approval shall be binding on the Company and its officers, employees, agents,
contractors, successors, and assigns, including but not limited to dealers, distributors, and
resellers. Violation of the terms and conditions of the Approval by any of the foregoing
persons or entities, respectively, shall constitute violation of the Approval by the Company
unless the Department determines otherwise.
IV. CERTIFICATION AND NOTIFICATION REQUIREMENTS
1. Thirty (30) days prior to submitting an application for a DSCP, the Company or its
representative shall provide to the Approving Authority a certification, signed by the owner
of record for the property to be served by the unit, stating that the property owner:
a) has been provided a copy of the Provisional Use Approval and all attachments and
agrees to comply with all terms and conditions;
b) has been informed of all the owner's costs associated with the operation including power
consumption, maintenance, sampling, recordkeeping, reporting, and equipment
replacement;
I
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c) understands the requirement for a contract with a company approved operator and has
been provided a current list of all approved operators;
d) agrees to fulfill his responsibilities to provide a Deed Notice as required by 310 CMR
15.287(10)and the Approval; and
e) agrees to fulfill his responsibilities to provide written notification of the Approval
conditions to any new owner, as required by 310 CMR 15.287(5).
2. Upon submission of an application for a DSCP to the Approving Authority, the Company
shall submit to the Approving Authority, with a copy to the Designer and the System Owner,
a certification by the Company or its authorized agent that the design conforms to this
Approval and that the proposed use of the System is consistent with the unit's capabilities and
all Company requirements. The review shall include evaluation of the need for installation of
water meter(s) at each facility. An authorized agent of the Company responsible for the
design review shall have received technical training in the Company's products.
3. The System Designer shall be a Massachusetts Registered Professional Engineer, or a
Massachusetts Registered Sanitarian provided that such Sanitarian shall not design a system
with a discharge greater than 2,000 gallons per day.
4. Thirty (30) days prior to delivery of the treatment unit to the site for installation, the
Company shall provide to the Approving Authority a copy of a signed contract for a
minimum period of one year with a Company approved Operator and the initial
Owner/Occupant of the property.
5. Prior to the commencement of construction,the System Installer must certify in writing to the
Designer and the System Owner that (s)he has taken the Company's training, passed the
Company's training qualifications, and is listed on the Company's list of Installers.
6. Prior to the issuance of a Certificate of Compliance by the Approving Authority:
a) In accordance with 310 CMR 15.021(3), the System Installer and Designer must certify
in writing that the System has been constructed in compliance with 310 CMR 15.000,the
approved design plans, and all local requirements, including any local approving
authority site-specific requirements;
b) In accordance with 310 CMR 15.021(3), the Designer must certify in writing that any
changes to the design plans have been reflected on as-built plans which have been
submitted to the Approving Authority by the Designer;
c) As a condition of this Approval, the System Installer and Designer must certify to the
Approving Authority in writing that the System has been constructed in compliance with
the terms of this Approval;
d) An authorized agent of the Company must certify to the Approving Authority in writing
that the installation was done by a qualified Installer approved by the Company and the
installation conforms to this Approval. The authorized agent of the Company responsible
for the inspection of the installation shall have received technical training in the
Company's products; and
e Prior to signing an agreement to transfer an or all interest in the roe served b the
g g Y g Y property rh' Y
system, or any portion of the property, including any possessory interest, the System
Owner shall provide written notice, as required by 310 CMR 15.287(5) of all conditions
contained in the Approval to the transferee(s)..Any and all instruments of transfer and
any leases or rental agreements shall be included as an exhibit attached thereto and made
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a part thereof of a copy of the Approval for the System. The System Owner shall send a
copy of such written notification(s) to the Local Approving Authority within 10 days of
such notice to the transferee(s).
V. STANDARD CONDITIONS
1. The provisions of 310 CMR 15.000 are applicable to the design, installation, use and
operation of a System utilizing an approved or certified alternative technology, except those
provisions that specifically have been varied by the conditions of this Approval.
2. The design, installation, and use of the System must conform to the terms and conditions of
the Approval and the Department approved attachments.
3. The facility served by the System and the System itself shall be open to inspection and
sampling by the Department and the local approving authority at all reasonable times.
Standard Conditions Applicable to the System Owner.
4. This Approval shall be binding on the System Owner and on its agents, contractors,
successors, and assigns. Violation of the terms and conditions of this Approval by any of the
foregoing persons or entities, respectively, shall constitute violation of this Approval by the
System Owner unless the Department determines otherwise.
5. The System Owner shall obtain all necessary permits and approvals required by 310 CMR
15.000 prior to the installation and use of the System in Massachusetts.
6. The System is approved for the treatment and disposal of sanitary sewage only. The System
Owner shall not introduce any wastes that are not sanitary sewage into the System. The
System Owner shall dispose of wastes generated or used at the facility that are not sanitary
sewage by other lawful means.
7. Prior to issuance of the Certificate of Compliance and after recording and/or registering the
Deed Notice required by 310 CMR15.287(10), the System Owner shall submit the following
to the Local Approving Authority: (1)a certified Registry copy of the Notice bearing the book
and page/or document number; and(ii) if the property is unregistered land, a Registry copy of
the System Owner's deed to the property, bearing a marginal reference on the System
Owner's deed to the property. The Notice to be recorded shall be in the form of the Notice
provided by the Department.
8. The System Owner shall at all times have the installed System properly operated and
maintained in accordance with the most recent O&M provisions of this Approval for the
alternative technology and in accordance with any additional requirements of the Approving
Authority. The most recent O&M provisions of this Approval for the alternative technology
are available from the Department.
9. The System Owner shall furnish the Department any information that the Department
requests regarding the System,within 21 days of the date of receipt of that request.
Standard Conditions Applicable to the Designer
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10. The Designer shall be a Massachusetts Registered Professional Engineer or a Massachusetts
Registered Sanitarian, including when designing systems for repair, provided that such
Sanitarian shall not design a system to discharge more than 2,000 gallons per day.
11. Prior to the application for a DSCP,the Designer shall provide the System Owner with a copy
of this Approval.
Standard Conditions Applicable to the Company
12. This Approval shall be binding on the Company and its officers, employees, agents,
contractors, successors, and assigns. Violation of the terms and conditions of this Approval
by any of the foregoing persons or entities, respectively, shall constitute violation of this
Approval by the Company unless the Department determines otherwise.
13. The Company shall include copies of the Approval with each System that is sold. In any
contract executed by the Company for distribution or re-sale of the System, the Company
shall require all vendors, distributors, and resellers to provide each purchaser of the System
with copies of the Approval.
14. The Company shall make available, in printed and electronic format, the approved
Attachments and any approved updates associated with the Approval, to the System Owners,
Operators, Designers,Installers,vendors, resellers, and distributors of the System.
15. The Company shall submit to the Department for approval any proposed updates or changes
to the Attachments to the Approval.
16. The Company shall notify all System Owners, resellers, and distributors of changes to the
Approval within 60 days of issuance by the Department.
17. The Company shall notify the Department's Director of the Wastewater Management
Program at least 30 days in advance of the proposed transfer of ownership of the Technology
for which the Approval is issued. Said notification shall include the name and address of the
proposed owner containing a specific date of transfer of ownership, responsibility, coverage
and liability between them. All provisions of the Approval applicable to the Company shall
be applicable to successors and assigns of the Company, unless the Department determines
otherwise.
18. The Company shall furnish the Department any information that the Department requests
regarding the Technology within 21 days of the date of receipt of that request.
19. If the Company wishes to continue the Approval after its expiration date, the Company shall
apply for and obtain a renewal of the Approval. The Company shall submit a renewal
application at least 180 days before the expiration date of the Approval, unless written
permission for a later date has been granted in writing by the Department. Upon receipt of a
timely and complete renewal application, the Approval shall continue in force until the
Department has acted on the renewal application.
Reporting
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20. All notices and documents required to be submitted to the Department by the Approvalshall
be submitted to:
Director
Wastewater Management Program
Department of Environmental Protection
One Winter Street- 5th floor
Boston,Massachusetts 02108
Rights of the Department
21. The Department may suspend, modify or revoke the Approval for cause, including, but not
limited to, noncompliance with the terms of the Approval, non-payment of any annual
compliance assurance fee, for obtaining the Approval by misrepresentation or failure to
disclose fully all relevant facts or any change in or discovery of conditions that would
constitute grounds for discontinuance of the Approval, or as necessary for the protection of
public health, safety, welfare, or the environment, and as authorized by applicable law. The
Department reserves its rights to take any enforcement action authorized by law with respect
to the Approval and/or a System utilizing the Technology against the Company,the Designer,
the System Owner,the Installer, and/or the Operator of the System.
VI. GENERAL CONDITIONS
Title 5 Regulations 310 CMR 15.287: "General Conditions for Use of Alternative Systems Pursuant to
310 CMR 15.284 through 15.286"
"The following conditions shall apply to all uses of alternative systems pursuant to 310 CMR 15.284
through 15.286:
1. All plans and specifications shall be designed in accordance with 310 CMR 15.220.
2. Any required operation and maintenance, monitoring and testing plans shall be submitted to
the Department and approved prior to initiation of the use. Monitoring and sampling shall be
performed in accordance with a Department approved plan. Sample analysis shall be
conducted by an independent U.S. EPA or Commonwealth of Massachusetts approved testing
laboratory, or an approved independent university laboratory, unless otherwise provided in
the Department's written approval. It shall be a violation of 310 CMR 15.000 to omit from a
report or falsify any data collected pursuant to an approved testing plan.
3. The facility served by the alternative system and the system itself shall be open to inspection
and sampling by the Department and the Local Approving Authority at all reasonable times.
4. The Department and/or the Local Approving Authority may require the owner or operator of
the system to cease operation of the system and/or to take any other action necessary to
protect public health, safety,welfare and the environment.
5. The owner or operator shall provide written notice to any new owner or operator that the
system is an alternative system.Such notice shall include notice of the general conditions and
any special conditions applicable to the system and its owner.
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6. The owner or operator, or the proponent of the alternative system, shall obtain and provide
the Department with a determination from the board of certification of operators of
wastewater treatment facilities established pursuant to M.G.L. c. 21, § 34A as to whether a
certified operator is required for operation of the alternative system. The Department shall
waive this requirement if it has on file a determination for the alternative system, and shall
notify the owner, operator, or proponent of the determination.
7. It is a violation of 310 CMR 15.000 to install, construct, or operate an alternative system
except in full compliance with the written approval and 310 CMR 15.287.
8. The Department may require the issuance of a groundwater discharge permit pursuant to 314
CMR 5.00 (groundwater discharge program)for any alternative system.
9. The system owner shall maintain an operation and maintenance contract with a
Massachusetts certified operator where one is required by 257 CMR 2.00, or otherwise with a
person qualified to operate and maintain the system in accordance with the Department's
written approval.
10. Prior to obtaining a Certificate of Compliance for installation of a new or upgraded system,
the system owner shall record in the chain of title for the property served by the alternative
system in the Registry of Deeds or Land Registration Office, as applicable, a Notice
disclosing both the existence of the alternative on-site system and the Department's approval
of the system. The system owner shall also provide evidence of such recording to the Local
Approving Authority.
i
McKean, Thomas
From: Parziale, Jim
Sent: Wednesday, August 18, 2021 10:18 AM
To: McKean,Thomas
Subject: -'�07 lakeside dr
My issues were
Existing SAS is 2 chambers, Noted as 3
No basement floor plan -- �40 e-f
"bonus room" on second floor shown, although no door shown
Jim Parziale
Town of Barnstable
Public Health Division
a.
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SEPTIC TANK CAPACITY /000
LEACHING FACILITY:(type) 'S OV d9}6W4151"$(size)
NO.OF BEDROOMS _3
OWNER
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
k3 f
A
/� c .
' r J
No. ( 0 Fee j
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipplitation for Disposal *pstrm Construction jhrmit
Application for a Permit to Construct( ) Repair(,,�)—Upgrade(4<A bandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.3 o'7 /4kr.f h91 ,^ Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel/p /f/f�dy1 d' �� !!/� ✓�4cvl� y�ri��/`I
I taller's Name Address,and Tel.No j Ug'� V—97,3 Designer' Name,,A dress d Tel.No.$" 9—
Type of Building:
Dwelling No.of Bedrooms —3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 330 gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Ot
Nature of Repairs or Alterations(Answer when applicable) i" to r re>
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
Application Approved by r Date ~1'
Application Disapproved by Date
for the following reasons
Permit No. �� Date Issued
,201 -' �
j No. Fee
! ,f THE COMMONWEALTHOF MASSACHUSETTS Entered in computer. Yes
PUBLIC HEALTH DIVISION - TOWNOF BARNSTABLE, MASSACHUSETTS
x
applicatioti for ]Disposal *pstem Construction Permit
Application for a Permit to Construct( ) Repair(A)--Upgrade(,,-)"Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.3 O 7 44 A,5 f'l 1, oi' Ow er's Name,Address,and Tel.No.
Assessor'sMap/Parcel /O2�%f%4'Jled ���/� �/��'/�
Installer's Name,Address,and Tel.No.,U� ��v-q7 j E Designer's Name,•Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures',, _ ''ll
Design Flow(min.required) 3?j V gpd Design flow provided 3 2-- 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) 2h_5r*11 faC�J/" /�C/ 70
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 - 23—
Application Apprdved by ell, Date 7
Application Disapproved by Date
for the following reasons
Permit No. C) U Date Issued r--
I' ---------------- -----------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( G-)-- Upgraded(Abandoned( )by j�S Y�6� lae gx/,' zl_
at _5,rJ 7 ,/,W/1 /, j%, i k//^ AA/ /X////� has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No..03 V 001 dated 'r
If t
Installer _!n>�s-� � /,^.i;,�/J; Designer
#bedrooms / Approved design flo t� gpd
i
The issuance of t'is permit shall not be construed as a guarantee that the system will ,ctioas/designed.
Date �r Inspector
P _ \ 1
I' -------- -------`-------,--------------------------------------------------------------------------------------- •- --------
No. O ► Do l ( V"
Fee,,
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal *pstrm Construction Permit
Permission is hereby granted to Construct( ) Repair( L)- Upgrade( Z--�)- Abandon( )
System located atU7
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions. ,
. 1
Provided:Construction must be$afihpleted within three years of the date of this permit.
Date ' 7 Approved by
From: 01/10/2017 16:36 0508 P.001/001
Joy s0
Town of Barnstable
Regulatory Services
,P Richard V. Scali, Interim Director
(• 9ARNS SLE. •}
Public Health Division
'°TFarru►�° Thomas McKean, Director
200 Main Street,Hyannis, NIA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 1 Sewage Permit# ®�Assessor's tY'Ia}�1Parcel D�. )�S Qr�
Designer: G444- JOV%. !'n L Installer: 30S e-�3
T
Address: Do )3 U)l 0 Address: T
O-z-S'3�
On 1'1,3111 h►d J/f -1_bl og was issued a permit to install a
(date) (installer)septic system at ��7 1-�l< /�'� �K. M, 1'f q, )
l t 1S based on a design drawn by
(address) '
*IS /il dated 6 to
(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. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than W lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out (if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was construct e ' e with the tert�s
of the f A approval letters(if applicable)
0A
( taller's Signature) t t t
V'-\_1;M 1
(Designers Signature) (Aftis Designer amp-Here)
PLEASE RETURN TO BAR STABLE PUBLIC HEALTH DIVISION, CERTIFICATE
OF COMPLIA>NrCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Sepfic\Designer Certification Form Rev 3-14-13.doe
x
1
• Town of BL nstable. P#
Department of Regulatory Services
Public Health Division mate ho
s6jp ems$ 200 Main Street,Hyannis MA 02601 CIO
• .' /V► Fee Pd 0 C� 4
Date Scheduled i Time _ 01)
• � VI
Foil Suitability Assessment for Sewgge Disposal
Performed By "' ^+ t" ` Witnessed Br u
i
LOCATION
&GENERAL INFORMATION
Location Address .30 t mil.a iD �l F�- )
A � 1,1 15 Address J O,..* `f l� Iv
Assessor's Map/Ntcel: 1'0 l f'Sl 001 ` Engineer's Name M t�1 t/' �.*A S I n 0
NEW CONSTRUtt.nON REPAIR I Telephone# Sf0 g 36 b 3✓�
LandUse �,�s �(J�N/ t• � Slopes(46) -1b��: Surface Stones ``tOM-
Distances from: Open Water Body? R Possible Wet Area 2 ft Drinking Water Well, ft
Drainage Way t7 ft Propraty Line 4d ft Other ft
i
SKETCH:(Street name,dimensious'of lot,exact locatipns of test holes&pe c tests,locate wetlands in proximity to holes)
,Sec- let fi.c. �epat r'
GlA"
i
'Ann
Parent material(geologic)M UAA �U, I Depth to Bedrock
U.
Depth to GroundwaWr. Standing Water in Hole::/' i Weeping from Pit Face
Estimated Seasonal Thigh Groundwater
D TION FOR SEASONAL HIGH'WAT]CR TABLE
Method Used: In,
Depth Gybaerved standing obs.hole: in. Depth to soil mottles,
Depth toiweeping from side of obs.hole i in. Groundwater Adjustment
! WtOr••••.��. Adj.GtrwndwatcrLevel.—
Index Well
ReadingDat4 Index Well level•.��.�.... •�
i
PERCOLATION TEST Date T4W
Observation 75ine at 9" .._---.—
Hole#
Depth of Pere
S t Time at 6"
Start Pre-soak Time. 6
' . .� Time(9"•ti") _.-----
End Pre-soaks`
Rate MinJlnch
Site Suitability Assessment: Site Passed '� Site Failed; Additional Testing Needed(YIN)
original .Public lie><Ith Division Observation Hole Data'To Be Completed on Back
***If percolalipn test is to be conducted within 100' of wetland,,
be-You must
first notify the
Barnstable C41)tservation Di-vision at least one(1)we&prior to ginning-
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil ' Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency. Gravel)
.16
4 (4 'Iraq
'L' Sl' �l
DEEP,OBSERVATION HOLE LOG Hole,#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.1%Gravel)
t
1r 1 I,,pEtrn ►, 6 01v
DEEP OBSERVATION HOLE LOG Hole#.
Depth from' Soil Horizon Soil Texture Soil Color 3or1 ':� ,Other,q l
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones`,Boulders:
Conssten c. o Gravell
4.
I,-N S'
DEEP OBSERVATION HOLE LOG Hole# N
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
n ist n
t
Flood Insurance Rate Mati:
Above 500 year flood boundary No_ Yes __
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
`A
Depth of Naturally`Ucc�rrina Pervious Material
feet`of naturally g ea3 observed throughout the occurring erv'o terial exist.in all ar
Does at least p.
area proposed for the soil absorption system?
If not,what is the depth of naturally.occurring per ious material?
Certification q ,
I certify that on b \ (date)I have passed the soil evaluator,examination approved by the
Department of Enviro mental Protection and that the above analysis was perforrded by me consistent with
the required ' in ,expe rise and experience described in 3.10 CMR 15.01,
Signature A ,44 V Date
Q:ISEPTIC\PERCFORM.DOC
o _ 1,41 l
Commonwealth of Massachusetts
` Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray A
Owner Owner's Name
information is Barnstable Marston Mills Ma required for every 12/6/16 =C
page. Cityrrown State Zip Code Date of Inspection
m
111
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When A. General Information
filling out forms O 61# J 02 0 A P O
on the computer, J
use only the tab 1. Inspector:
key to move your a 4 4 `
cursor-do not Chad Hathaway �, L
use the returnsip
key. Name of Inspector
VQ H.P.S.
�, Company Name
P.O.Box 151
Company Address
Forestdale Ma 02644
Cityrrown State Zip Code
774-274-2581 12866 � '
Telephone Number, License Number 00
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. 1 am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 16.000).The system:
❑ Passes ❑ Conditionally Passes ® Fails
❑ Needs Further Evaluation by the Local Approving Authority
12/6/16
I ctor's Signa Date
The system inspector,sha t 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.
t5ins•3/13
Title 5 pFiaal Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Citylrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
❑ I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
' Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined,"please explain_
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Citylrown 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(cunt.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owners Name
information is
required for every Barnstable Marston Mills Ma 12/6/16
page. Cityfrown State Zip Code Date of inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
*"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure Criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes No
® ❑ Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ to 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•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
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owners Name
information is required for every Barnstable Marston Mills Ma 12/6/16
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 forma
❑ ❑ 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•3PI3 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
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. CitylTown 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
❑ ED 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-3113 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
upTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
precast leaching pit is overfull level is in the riser
Number of current residents: 4
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: current
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
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owners Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Citylrown 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: owner every 2-3 years
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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed(if known) and source of information:
1998
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: 10+
feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 12"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: 41'
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Cityrrown 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
30"
Scum thickness
3"
Distance from top of scum to top of outlet tee or baffle 3„
Distance from bottom of scum to bottom of outlet tee or baffle
18"
How were dimensions determined? tape and sludge judge
Comments on pumping recommendations inlet and outlet to or( p p e baffle condition structural integrity,
. g g tY,
liquid levels as related to outlet invert, evidence of leakage, etc.):
pump every 2-3 years as maint. to protect leaching. pump tank at time of new SAS
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
•'l 307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marstcn Mills Ma 12/6/16
page. City/Town State Zip Code Date of Inspection
D. System Information (cost.)
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 g-ade:
Material of construction:
❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins.3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
r 307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
overfull
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:
leach pit level is in riser
t5ins-3/13 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
lugTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
informrequired
Barnstable Marston Mills Ma 12/6/16
required for every
page_ City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number. 1
❑ 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.):
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
1
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6116
page. Cityrrown 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 117
�. Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Cityrrown 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
13
0
d9
I
�r l�eUj
t5ins-3113 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
r� 307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is required for every Barnstable Marston Mills Ma 12/6/16
page. Cityrrown 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:
GIS
You must describe how you established the high ground water elevation:
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 rifle 5 official Inspection Form:Subsurface Sawage Disposal System•Page 16 of 17
. Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
307 Lakeside Drive
Property Address
Griffen-Murray
Owner Owner's Name
information is Barnstable Marston Mills Ma
required for every 12/6/16
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary:A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•3113 Title 5 Official Ins
pection Form:Subsurface Sewage Disposal System•Page 17 of 17
CERTIFIED SEPTIC SYSTEM REPORT
LOCATION
307 LAKESIDE DR.
MARSTONS MILLS, MA
MAP 102 PARCEL 145. 001 LOT 136
PREPARED FOR 4� ✓0, �P�►f,�
L .bed
SELLER '9
MR. & MRS. RANDALL FROST
307 LAKESIDE DR. S
MARSTONS MILLS, MA
BUYER
MR. & MRS. JAMES GRIFFIN
720 PITCHERS WAY
HYANNIS, MA
PREPARED BY
HILLIARD HILLER, JR.
P .O. BOX 250
CENTERVILLE, MA 02632
508-778-1472
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Address of property
owner's name /Li9A�1Vh1 (_ F�PoS?
Date of Inspection 71jvf9.s
PART A
CHECKLIST
Check if .the following have been done:
c/ 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.
As built plans have been obtained and examined. Note if they are not
available with N/A.
(/ The facility .or dwelling was inspected for signs of sewage back-up.
c/ The site was inspected for signs of breakout.
All system components, awcluding the SAS, have been located on the
site.
The 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 SAS on the site has been determined based
on existing information or approximated by non-intrusive methods.
The facility owner (and occupants, if different from owner) were
provided with information on the proper maintenance of SSDS.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION
FLOW CONDITIONS
If residential
3 number of bedrooms
number of current residents
garbage grinder, yes or no
y-S laundry connected to system, yes or no
seasonal use, yes or no
If nonresidential, calculated flow:
Water meter readings, if available: /q�y Ca,00a C44
/y S 3 SJ'000 C.76
'd4A5,04-rLY Last date of occupancy
GENERAL INFORMATION
Pumping records and source of information:
4JoT ,l3"// Id!/�S►F,t4 . y6'yN4'/l '&.
At:;, System pumped as part of inspection, yes or no
if yes, volume pumped
Reason for pumping: . .
—ac.-"f1l Le dS &ry r To /"elf /T jQ~w'o .C3��'a?E Tie CLosi,�G
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)
Other (explain)
Approximate age of all components. Date installed, if known. Source of
informati
AogFT ��ir y�r ,�� -/n
k_ Sewage odors detected when arriving at the site, yes or no
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued.
SEPTIC TANK:_(
(locate on site plan)
depth below grade: /10
material of construction: concrete metal FRP other(explain)
dimensions:
sludge depth
a3" distance from top of sludge to bottom of outlet tee or baffle
scum thickness
S "' distance from top of scum to top of outlet tee or baffle
13' distance from bottom of scum to bottom of outlet tee or baffle
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, recommendations for repairs, etc. )
7-Y'UIr AeV %�6.5 L cif AW 6400 A a SIGN
DISTRIBUTION BOX:
(locate on site plan)
O— depth of liquid level above outlet invert
Comments:
(note if level and distribution is equal, evidence of solids carryover,
evidence of leakage into or out of box, recommendation for repairs, etc. )
/.Sox G�/-'Ca DULL
h0" fox Al fIf v
PUMP CHAMBER:
(locate on site plan)
pumps in working order, yes or no
Comments:
(note condition of pump chamber, condition of pumps and appurtenances,
recommendations for maintenance or repairs,etc. )
f '
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued,
SOIL ABSORPTION SYSTEM (SAS) : /
(locate on site plan, if possible; excavation not required, but may be
approximated by non-intrusive methods)
If not determined to- be present, . explain:
Type
leaching pits and number GflG /°lT
leaching chambers and number
. leaching-, galleries and number
leaching trenches, number, length
leaching fields, number, dimensions
overflow cesspool; number
Comments:
(note condition of soil , signs of hydraulic failure, level of ponding,
condition of vegetation, recommendations for maintenance or 'repairs,etc. )
y o` I?IMA� 11,-7o
ALA 'y/9 Y. �Pf��ost.�r a�,�a Pri ri.Qi�vG �vHzAl Files T �v.7•�ivG 7.9,vi, /�'.�vo
TWXAl F_4,1"y OTh',eA Tl,ti E 4P-r l? -FA f T.
CESSPOOLS (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 (cesspool must be pumped as
part of inspection)
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding,
condition of vegetation, recommendations for maintenance or repairs,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, recommendations for maintenance or repairs,etc. )
r
1;
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM 'INFORMATION continued
SKETCH OF SEWAGE DISPOSAL SYSTEM: 307 �h'�i�S/DL ,d/1 �l�i`/LSTvvS /Z-Z-s
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100 '
� fi o,tlT
I
a,,
t
DEPTH TO GROUNDWATER
Al.33' depth to groundwater
method of determination or approximation:
13�RNs r!�lSL G/S 5 howS THE FzGL-v�r-1 ,v i91 !//� rl' %O /3E 7C
5L'.Cdd0 Gig j,�1
T/93 .iv vl �`i� DQf�c�//v6 S NDGvs THE s9TCit Ti9/�G� is (� _ /17 V3;
,7N 5
t °
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
FAILURE CRITERIA
Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of
determination in all instances. If "not determined", explain why not)
Ne Backup of sewage into facility?
Po Discharge or ponding of effluent to the surface of the ground or
surface waters?
No ' Static liquid .level in the distribution box above outlet invert?
A Liquid depth in cesspool <6" below invert or available volume< 1/2 day
flow?
W Required pumping 4 times or more in the last year?
number of times pumped
No Septic tank is metal? cracked? structurally unsound? substantial
infiltration? substantial exfiltration? tank failure imminent?
Is any portion of the SAS , cesspool or privy:
__�O below the high groundwater elevation?
within 50 feet of a surface water?
Nd within. 100 feet of a surface water supply or tributary to a surface
water supply?
P within a Zone I of a public well?
_k within 50 feet of a bordering vegetated wetland or salt marsh
(cesspools and privies only, not the SAS) ?
A10 within 50 feet of a private water supply well?
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 analysi
for coliform bacteria , volatile organic compounds, ammonia nitrogen
and nitrate nitrogen.
TOWN OF &iWAl 5T�.6z-z BOARD OF HEALTH
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION
-TYPE OR PRINT CLEARLY-
PROPERTY INSPECTED
STREET ADDRESS u?o7 G.41,-/f51,af D/L -**y,044S-.
ASSESSORS MAP, BLOCK AND PARCEL # _/0.1 11y5-eal Z, r
OWNER' s NAME _Xi94V17t4 R_ A.u,O 1111AA1Y f,*..ST
PART D - CERTIFICATION
NAME OF INSPECTOR G//4 e.a 1f/LG,C1t rTif -
COMPANY NAME —
COMPANY ADDRESS /nb 13,-,-X cZ.SD GB,Vlf f4-1LG1z fy/q ey-CD
Street Town or City State ZIP
COMPANY TELEPHONE , ( fj'b� ) 77F - /V72 FAX
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system a
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 .
Check one :
System 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 I have conducted has found that the system fails tc
protect the public health and the environment in accordance with Title
5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form.
Inspector Signature 3��Z4 /! Date 7 zM yu,�
One copy of this certification must be provided to the OWNER, the BUYER
( where applicable ) and the BOARD OF HEALTH.
* If the inspection FAILED, the owner or operator shall upgrade the system
within one year of the date of the inspection, unless allowed or required
otherwise as provided in 310 CMR 15 . 305 .
partd.doc
t
e
KEY NUMBER <9920 >
NAME <FROST, RANDALL > B-C 1 B-C 2
B-C 3 B-C 4 ZOC
STREET 307 LAKESIDE DRIVE
CITY MARSTONS MILLS ST MA ZIP 02648-1922 REF 1 REF 2
PHONE ( ) - REF 3 REF 4
METER NO.< 9415> DATE READING CONS
STREET <LAKESIDE DR NO. 307> 06/30/95 444 35
CITI MM C L136 ST LOC 12/31/94 . 409 33
PHONE ( ) - 06/30/94 376 29�
12/31/93 347 179-
ROUTE NUMBER 03 06/30/93 318 29s?
SERVICE DATE 07/26/88 12/31/92 289 3�-
METER DACE 09/13/88 06/30/92 254 377.E
CAPACITY 7 12/31/91 217 39
STYLE T10
SIZE 1 RATE SCHEDULE
KEY PIT PLASTIC X
NOTE RR LEFT SIDE ADDITIONAL CONS 0
ALTERNATE MIN 0
f
l t� TOWN OF i3ARNSTABLL
LOJcATION_Lg_t1j46'L•�IQE.D L'��w/_�fSEWAGE
VILLAGE^Tac� ��..�rl _ ASSESSOR'S MAP Cz LOT_/
INSTALLER'S NAMt & PHONE NO.
� -* Q--
SEPTIC TANK CAPAC1TY�a00
� H
-Zts
IEAC'HING
No OF BEDROOMS _PRIVATE WELL OR PUBLIC WATER
BUlf DER OR OWNER_�ES�Meu��S�Lr&A-"
U.4.TE PERMIT ISSUED: �A5 --�-----
DATB COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes_ No y —
� .6L
0� ,SI
S'"Ooyam
� £ d�sodg
�� a
l�
TOWN OF BARNSTABLE
LOCATION SEWAGE #
ULAGE /"IfS%o.LS 11711-41 ASSESSOR'S MAP & LOT ba /y .mac!
toT i3�
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY lk=� 6i94
LEACHING FACILITY: (type) P17— (size) !cam Ci9[
NO.OF BEDROOMS 3
R OR OWNER 1-;,4 �il2s /�/9l�i9L L Sc oT
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility IY37 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 facili ) / Feet
Furnished by ° ,!>6�f�
ry � . ,
3 D
�� O �= 2
l � o
a
1
�,a
i
�I
No..--- Fizic .. .
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
�. ..r'- - ........
-.OF......����!!JS'/�✓��..�...�.................
4110ration for thip ml Workii Tomitrudion Frrutit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at
J
........`/.. <v ...-----' !�-`��.................................... ..............................•-. .......................................
.:........---......------•--•------.......---
Location-Ad ress or Lxo.
.lyO.l ..> �l d . — __ I�7 �1.•,.I'. :.../_�.1�.....
- Ll
er Q �T ddress ` /
Installer Address Type of Building Size Lot.... _,Z.0_5....__._...Sq. feet
U 'Dwelling—No. of Bedrooms........._..................................Expansion Attic ( ) Garbage Grinder �✓
4 Other—Type of Building No. of persons............................ Showers — Cafeteria
C4 yP g P ( ) ( )
Q' Other fixtures ..................................-
W Design Flow..__.__...._1____________________________gallons per per day. Total dall flow........_._._.._.7_7.._. ._..........g 1llons.
W, Septic Tank—Liquid capacity..�d�gallons Length�.9..._.. Width_.'._.__..... Diameter________________ Depths___ _.
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No......../________._ iameter.........1�.... Depth below inlet....... ......... Total leaching area--- ..sq. ft.
Other Distribution box ( Dosing to ), > /zS
aPercolation Test Results Z Performed by............ .__w1�.. ................. Date____.1<..._..... .�r
minutes per inch
h of Test Depth to ground water....
fi Test Pit No. 2.__.��minutes per inch Deptth of Test Pit..l S`..... Depth to ground water........................
.............69------------ --• .............................................. -------------46-------•-•---
O Description of Soil... .. ? �?Qa t �-----� 21-
-
51
U --------____ram.-. 8.. S�3so,�...................r--�•=/...�:y.. 'v.� o �� s: --�
W .........................................Y._...................._......__..___._.................._............._...___._.............................................................................
U Nature 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 TITLE 5 of the State Sanitary Code—T undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ued Y) th boar of health.
&Ww Signed...... ..�`/�........ ...... -+ ............................... /ZDate
Application Approved By.......- -• -- .... ---_-•••:........ ..... ......•-. .... ..-----� I.....................•
Application Disapproved for the following reasons_________ ________________�.:_...................... ......._._____
............................-...........................................................................................................................................................................
Permit No....�� Da
..wIl_ -. Issued---------•--------------------•---------- Date------
Date
i
No.............._.1.1 FEB :✓.. ......_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
l.... . ijj C
ApplirFatiun for Disposal Works Toustrurtiun Vamit �
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at: /
................_........................... - ----••14--------------- .............. .....-------•---•--------.............-----....-------•--•-------..........•-----.................
o�ation- Aress ..........................................................
or/ o.
... / . ...........- -.............................L.... -Y. Z../ pl...... �/ 7 . ..TvS`
L
Owner Addressgj /V 6-
c; ?�� e/ ......6�......��✓-...-----•---------------- - ?---.... ................ �. a ..r�
Installer Address
d Type of Building Size Lot... . .:..........Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder
'PL4_l Other—Type of Building No. of persons............................ Showers — Cafeteria
Otherfixtures �._._....... --------------------•--------------.----.----------------•-------------..-----••------------
W Desrgn Flow............................................gallons per p€ n per day. Total d�il flow.__...._........••----'............._.. gallons.,
Septic Tank—Liquid capacity.��e?gallons Length.���.._ ...... Width...:.'-._.. Diameter................ Depth•-C..f.`.....
W Disposal Trench—No..................... Width.................... Total Length......•..._........ Total leaching area....................sq. ft.
Seepage Pit No...... ........... Diameter.._.....��..... Depth below inlet......f�—.......... Total leaching area.............7...sq. ft.
Z Other Distribution box Dosing to )t ca J
.. ...........•• ---•--•••--•...•---
a Percolation Test Resin Performed by.................:...... . c '` Date....f......._.. ....._......._....;.
Test Pit No. 1................minutes per inch Depth of Test Pit._'`. ..`* ........ Depth to ground water............. .�.;.
Test Pit No. 2................minutes per inch Depth of Test Pit... ...=......... Depth to ground water.__........................
c oi l&%3 .% _ / . L.r---='------- -•• . -- ---................. --�"--••--........'...--•.......-•-.....-•--•----------------------.•2-.
D Description of Soil C G � sr� iS c,0 !e_J 77)f � 7v. ... �
. <
W
-----------------------------------------------------------------------------------•--•---------•-----------•--------------------------------------------•-•---...--•---------------.................
U Nature 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 TITLE 5 of the State Sanitary de—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has n iss t bard of health. ? / /
Signer •.-- •-�`� .......--••----•--•...........J •./.,l Q
_...
Application Approved BY-_. ,1,�11, ..... ... .... }
D
_... ....... ... � i:OJ
_•-- �
Application Disapproved for the following reasons:. Date
........"'."_--•------------- � ----------•-•----------•-•----------------
...--•.........................•----••---••--••-....••-••--•--•--••••-•••--•--•---..........••-------•----•---•••--•-••........_.....--•---•---•-•••••••••----••••-•-••--•-......---•••............•---
1> I r Date
Permit No..64-----�/! -•--------•-------- Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
!, / BOARD OF HEALTH
Tntifirat-P of TuutpliFanrr
THIS I TO CERT FY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
b �•-� 1
�l. S
`� Installer
at............
--- ----- ��6/� ; I f
has been installed in accordance w`iffi the provisions of TI 5 of Tie State Sanitary Code a d scribed1
application for Disposal Works Construction Permit No.__. _. . r' dated-._'....... .. /%� .c.� .....
,�/ /�
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARA TEE AT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector::............--••----•-•--••-••-••-•--••-•-----•---........-----------••.....--•-•-
THE COMMONWEALTH OF MASSACHUSETTS
/ BOARD OF HEALTH
� fiY ....OF......... .' f�c:t.��-' ...
Now ^�.lA. FEE......
Disposal Works 10.1unstrurtiun ranfit
Permission is hereby granted.._..._. = .�.��..
� ... ' ........•..................•-........•.....
to Construct ( or Repair ( ) ana'I"ndiv-ddua Sewag Misposal System
as shown on the application for Disposal Works Construction Permit
^1 � ----• Bof Dated
--_--
j1_ 451-
----•---••--•--•••-•------•------ .......................................--••--•-•.....
DATE-------------•--- -.!l...................................
_
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
LEGEND MARSTONS MILLS -
PROPOSED CONTOUR
® PROPOSED SPOT GRADE �o
EXISTING CONTOUR oc LAKES�pE DR._
� c a
z
+ 96.52 EXISTING SPOT GRADE
.P 0
�
o �0 `"m a
` W— EXISTING WATER SERVICE 0 03 cn
w
TEST PIT Q
i m
SCALE: 1"=20' ? Z D
BENCH ,) MARK LOCUS
74. -\` 73 TOP OF FOUNDATION 0 FLINT ST
79-129
72 ,
75- BARNSTABLF GIS DATU
LOCUS MAP
\\ 700
°° 71' LOCUS INFORMATION
EXIST. 1 OOOG 76,\' \
SEPTIC TANK `� �`��, PLAN REF: 138/25
70 TITLE REF: 9775/042
LOT I,3 e� PARCEL ID: MAP 102 PAR. 145/001
- ARENA, = 9300 sf+\-
`I PLAN BOI�K 138 PAGE 2 c\
i
77 1 ASSR MAP\1 02 PCL 1�5-1
XIST�NG �\ J
,0 /� SEPTIC SYSTEM
WELL/NC
REPAIR PLAN
c
78- ' -_ � _ OF �` ti` 71 LOCATED AT:
'o 307 LAKESIDE DRIVE
7 2 MARSTONS MILLS, MA
s�
79— � �PLP `� PREPARED FOR
cv
80_ / /����' I , ��/'�O- JAMES P. GRIFFIN
8 /7/ / 1 DECEMBER 30, 2016
/ / o
If)RIVEWAY /\ O I ) I 74 OF �1As
/ I 1 I
j t /DAg3 5
I 2
80 p \P0I I No. 114
78n7 aTS/DD `_e_eeF 7
cA,teNT
PLAN � MEYER &. SONS, INC.
SCALE: 1 in = 20 ft 4 P.O. BOX 981
0 20 40
EAST SANDWICH, MA. 02537
0 10 20 40 PH: (508)360-3311
FAX: (774)413-9468
{ meyerandsonstitle50gm oil.com
1
SHEET 1 OF 2 J 1826
NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GENERAL NOTES:
TOF SEPTIC TANK GRADE SHALL NOT BE < EL:74.65 FOR A DISTANCE
INSTALL RISERS & COVERS OVER INLET & PROPOSED D-BOX 15' AROUND THE PERIMETER OF THE S.A.S.
EL.=79.29t OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED S.A.S. I. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
INSTALL RISER & COVER BOARD OF HEALTH AND THE DESIGN ENGINEER.
INSTALL. LOCKING COVERS IF AT FINISH GRADE SET TO 6" OF GRADE INSTALL A RISER OVER ;ONE CHAMBER (MIIN) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
F.G. EL.=78.5t AND SET TO 3 OF F.G. VENT OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE
F.G. EL.=77.0f F.G. EL: 78.70t LOCAL RULES AND REGULATIONS, EXCEPT AS USTED BELOW:
- 310 CMR 15.405 (1) (8):
F.G. 'EL: 79.D(MAX.) 1) A 1.86 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING
TO BE 4.86 Fi (MAX) BELOW GRADE VS REO'D 3 FT. (H20/VENT PROVIDED)
U36*
COVER/re - 2) A 3.0 Ff. VARIANCE FROM 310CMR15.211 TO ALLOW LEACHING
X COVER L = 50' L = 20'(MAX) To .0 r. Fr (MAX) FROM DWELLING VS RTO'0 2O L® S=1% (MIN.) 75.81t ® S=1% (MIN.) ® S=1X (MIN.) 2" OF 3r.
4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC /8" DOUBLE WASHED 3/4" - 1-1/2" 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
STONE OR FILTER FABRIC TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
1O" 6
DOUBLE WASHED STONE DESIGN ENGINEER.
INV.=74.80 14 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
•r M'uou�D INV.=74.55 E3 ®®®® FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
L£VI-L PROPOSED E3. 0 E3 E3 ENGINEER BEFORE CONSTRUCTION CONTINUES.
®E3E3
GAS BAFFLE IN
T ®®®®®®®®®®® 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
D-80`+ JX INV.=73.85 ®®®®®®®®®®® 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
INV.=74.05 DB-5 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
EXISTING 1.000 GALLON SEPTIC TANK ) 4 2 X 8.5 4
7. DWELLING IS SERVICED BY MUNICIPAL WATER.
EXIST. SEWER OUTLET EFFECTIVE LENGTH = 25.0' $' ° IRDURING
P " NNJEANBNTORo ACONION AGREED ONBETWEE ORAND COAC
INV. ELEV.= 73.65 T 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE
LOCATION OF ALL UNDERGROUND UTILITIES. PRIOR TO STARTING WORK.
BREAKOUT 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5.
EL. 74.65 REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5.
NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING TOP CONC. ELEV.= 74.65
PIPE INVERTS PRIOR TO CONSTRUCTION IT. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION
2) D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 73.65 686.3
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY
fEia66El AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
GRADE ON A MECHANICALLY COMPACTED SIX ....3aaa 13. NO KNOWN PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING
INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM EL.= 71.65 a®6.B a 14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. )
310 CMR 15.221(2) 4 5 FT. J. 4 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW
3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK
WITH 1500 GALLON SEPTIC TANK IF FAILED, SEPARATION 5.05 FT: EFFECTIVE WIDTH = 13' FOR THE USE WI A GARBAGE GRINDER.
DAMAGED, NOT H2O LOADING, OR UNDERSIZED. SOIL ABSORPTION SYSTEM (SECTION)
16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING
4) INSTALL INLET & OUTLET TEES W/ SEPTIC SYSTEM PROFILE BOTTOM OF TESTHOLE EL: 66.60 17. SLEEVE 4" SOLIDS LINE, 10 FEET ON EITHER SIDE OF WATER LINE.
GAS BAFFLE AS REQUIRED (500 GALLON H2O LEACH CHAMBER)
N.T.S.
DESIGN CRITERIA SOIL LOGS P#:15237
NUMBER OF BEDROOMS: EXISTING 3 BEDROOOM
SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) DATE: DECEMBER 22, 2016
IN SOIL EVALUATOR: DARREN M. MEYER, RS, CSE
DESIGN PERCOLATION RATE: <2 MIN
/ WITNESS: DAVE STANTON, BARNSTABLE HEALTH �10 OF 41gss,
DAILY FLOW: 110 G.P.D. X 3 BR DESIGN FLOW: 330 G.P.D.
GARBAGE GRINDER: NO (not designed for garbage grinder) Elev. TP-1 Depth Elev. TP-2 Depth DAR E
M
SEPTIC TANK: 330 gpd x 200% = 660 gpd USE EXIST. 1,000G SEPTIC TANK 78'S0 A LOAMY SAND o" 77.so LOAMY SAND o" o. 1 0 "
LEACHING AREA REQUIRED: 330 0.74 = 445.94 S.F. 77.83 IDYR 3/2 8" 76.85 IOYR 3/2 9.
B LOAMY SAND B LOAMY SAND
USE TWO (2) 500 GALLON H2O PRECAST LEACH CHAMBERS 75.67 10YR 5/8 32" 10YR 5/8 '�NITAR�A�
W/ 4' STONE ON ENDS AND 4' ON SIDES:. 25' L x 13' W x 2' D C1 MEDIUM 74.85 C1 MEDIUM
►'7i 3d wb
SAND PERC TEST 2.5Y 7/4 2.SY SANG
BOTTOM AREA: 25 x 13 = 325 SF • 74.207/4
SIDE AREA: (25 + 13) X 2 X 2 = 152 SF
TOTAL SQUARE FEET PROVIDED = 477 vs. 445.94 REQ'D PROPOSED SEPTIC SYSTEM UPGRADE PLAN
DESIGN FLOW PROVIDED: 0.74(477 S.F.) = 352 G.P.D. vs. 330 G.P.D. req'd 67.50 132" ' 66.60 132"
PERC RATE <2
11,MIN/IN. ('Cl' HORIZON) 307 LAKESIDE DRIVE, MARSTONS MILLS, MA
NO GROUNDWATER OBSERVED Prepared for: Griffin
j System Design and Topography Plan by: SCALE DRAWN DATE
MEYER&SONS,INC. N.T.S. . DMM 12/30/16
• I, Darren M. Meyer. R.S.. CSE, hereby certify that 1 am cutTently approved by MADEP pursuant to 310 CMR 15.017 PO BOX981
to conduct soil evaluations and that the above analysis has been performed by me consistent with the E41STS4NDKICH,MA02537 REV DATE CHECKED SHEET NO.
requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October, 1999. -2922 DMM 2 Of 2
I "�> t � ' tom.,-� �r �a 'r�"•�. ',,,.
WASTEWATER NOTES
O 16. THE CONTRACTOR SHALL PROVIDE A DEWATEERING PROTOCOL PRIOR TO CONSTRUCTION
IN ACCORDANCE WITH CONSERVATION COMMIISSION ORDER OF CONDITIONS.
1. ELEVATION,PROPERTY LINE AND EXISTING CONDITIONS ON THIS PLAN ARE BASED ON A ,. °
SURVEY CONDUCTED BY THE HORSLEY WITTEN GROUP, INC.ON NOVEMBER 20,2020. 17. UNSUITABLE SOIL MUST BE REPLACED WITH TfITLE 5 SAND AS SPECIFIED IN 310 CMR
15.255(3). ANY ADDITIONAL AREAS THAT ARE FOUND TO HAVE UNSUITABLE MATERIAL
2. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE REPORTED TO THE ENGINEER.
UNDERGROUND ELECTRIC
SHALL BE IN ACCORDANCE WITH THE STATE ENVIRONMENTAL CODE AND THE RULES AND _
TO PUMP CHAMBER
REGULATIONS OF THE LOCAL BOARD OF HEALTH. G A ,. Ty,. b. 5
18. ALL SEPTIC COMPONENTS SHALL BE INSTALLED WITH MAGNETIC WARNING TAPE. " 4 e :� �. •c
PROPOSED AIR PUMPfn
Y a u
3. THIS PLAN I5 INTENDED TO ADEQUATELY PROVIDE THE INFORMATION NECESSARY TO S B APPLIED I DAMP PROOFING OR BITUMINOUS �� r •:� ,=a, : , � � -�.: � .. � _ � .. - ,�}... m
TO BE 19. ALL SEPTIC TANKS HALL E A P D WITH 2(COATS OF O I � .�:,;� ��r
FINAL LOCATION .,
LAYOUT AND CONSTRUCT THE PROPOSED SEWAGE DISPOSAL SYSTEM REPRESENTED ON .MATERIAL. ��� �.,, �:`� ' �� - ,f��� � 'x's �.� -, ❑
FIELD DETERMINED /
IT AND SHOULD NOT BE USED FOR ANY OTHER PURPOSES. �
20. THE CONTRACTOR SHALL RESTORE ALL SURFiACES EQUAL TO THEIR ORIGINAL CONDITION
4. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE ENGINEER AND/OR THE LOCAL
AFTER CONSTRUCTION IS COMPLETE. AREAS NOT DISTURBED BY CONSTRUCTION SHALL
BOARD OF HEALTH(BOH)STAFF. BE LEFT NATURAL.THE CONTRACTOR SHALL TI AKE CARE TO PREVENT DAMAGE TO
- - SHRUBS,TREES,OTHER LANDSCAPING AND/OIR NATURAL FEATURES. WHEREAS THE _ Q
O ,. .. ar
5. PRIOR TO CONSTRUCTION,THE CONTRACTOR SHALL COORDINATE WITH THE PROPERTY PLAN DO NOT SHOW ALL LANDSCAPE FEATUFRES EXISTING CONDITIONS MUST BE "' -" 16
n
EXISTING SEPTIC TANK TO REMAIN
OWNER AND ENGINEER ON THE CONSTRUCTION SITE ACCESS AND MATERIAL STOCK PILE VERIFIED BY THE CONTRACTOR IN ADVANCE OF THE WORK.. >
�,, �-,,�: ,. ' �r ..::' ,�.,; ���+ 4 za' ��; • I
AREAS..
INV. IN = 70.48
• 21. ALL UNPAVED AREAS DISTURBED BY THE WOFRK SHALL HAVE A MINIMUM OF 4-INCHES OF :•, ;- ��ae: , =�� ,,,
_ N To<�aaaA
INV OUT=70.23 ��tt.-•,� � f 6. TRENCH SAFETY SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR INCLUDING ANY �
,wy �c LOAM INSTALLED AND BE SEEDED WITH GRASS SEED ASSHOWN ON THE PLAN AND/OR
LOCAL AND/OR STATE PERMITS REQUIRED FOR THE TRENCH WORK, THIS WORK MAY BE ">s n'`° '` ��_.; ` ,; :• �,_
L C Q DIRECTED BY THE ENGINEER. THE CONTRACTfOR SHALL BE RESPONSIBLE FOR WATERING
REQUIRED TO TAKE PLACE OUTSIDE OF NORMAL HOURS OF OPERATION FOR THE ANY LOAM AND SEEDED AREAS UNTIL LAWN GROWTH IS ESTABLISHED AND APPROVED BY
72-- ...., ..a- """e O FACILITY.THE CONTRACTOR SHALL PLAN ACCORDINGLY. THE ENGINEER AND/OR OWNER. . .�.• �s C '+ � ��. �� •o =s w
-,
�`^;�„� :. . �• N JcYi
� 7. THE CONTRACTOR SHALL REPORT ANY DISCREPANCIES FOUND IN SITE CONDITIONS FROM �� .. .; . , + .•,, " �, � .;� ,, • ,., ,�, ,. { �
22. AN INNOVATIVE&ALTERNATIVE TREATMENT SYSTEM IS PROPOSED FOR THIS SITE. THE
O .THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER
SYSTEM MUST BE INSTALLED AND MAINTAINS®IN ACCORDANCE WITH THE DEPARTMENT
OF ENVIRONMENTAL PROTECTION(DEP)PROWISIONAL USE APPROVAL.
SEPTIC TANKS AND TREATMENT SYSTEM° I 8. FAILING TO PROPERLY INSPECT OR PUMP THE SE C T
EXISTING OVERHEAD OR CHANGES TO EFFLUENT FLOW,GRADING,OR LANDSCAPING, EITHER ON-SITE OR
'? d ELECTRIC, TELEPHONE CX7 m
O ADJACENT TO THE SITE,MAY RESULT IN IMPROPER FUNCTIONING OF THE SEPTIC AND V y
,<... 4" SCH 40 PVC C ,� � C w '
& CABLE SERVICE LEACHING SYSTEM(S). ,O
L=6.6', S=1.0°i° ... WASTEWATER INSTALLATION INSPECTION NOTES
9. CALL"DIGSAFE"AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 1. THE CONTRACTOR SHALL PROVIDE A MINIMUNN OF 24 HOURS ADVANCE NOTICE TO THE C ❑
7 ` ° m 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES TO FIELD VERIFY LOCATIONS OF ENGINEER AND LOCAL BOARD OF HEALTH FOIR ANY INSPECTION,
NITROE 2KS 2,000 10.2' f 307 LAKESIDE DRIVE T
EXISTING UTILITIES. to m
GALLON TANK y ONE STORY WOOD FRAME 2. ALL WASTEWATER COMPONENTS SHALL BE INSPECTED BY THE ENGINEER AND THE LOCAL L- = as z
INV, IN=70.16 1 '1 3 $ I 90. THIS ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED FOR USE WITH A BOH REPRESENTATIVE PRIOR TO BACKFILLING. AT A MINIMUM THE FOLLOWING ITEMS SHALL d I; w
BEDROOM DWELLING G� BE INSPECTED:
GARBAGE GRINDER. C v M �
INV. OUT=69.91 ,✓ f 2.1. SYSTEM COMPONENTS BASE AND INSTALLATION PRIOR TO BACKFILL (D p v� ❑
✓ 2.2. LEAKAGE TEST ON SEPTIC TANK(MIN.24'HR)
O 11. THE OWNER SHALL INSPECT AND PUMP THE SEPTIC TANK ONCE EVERY 2 YEARS. �1
2.3. START UP TEST OF SYSTEM WITH ALL COMPONENTS INSTALLED AND FUNCTIONING ASy-
r M DESIGNED ? W 5, Q Cc,
12. PROVIDE WATERTIGHT SEALS BY USE OF NON-SHRINK GROUT AT ALL POINTS WHERE y Q o ,� a
PIPES ENTER OR LEAVE ANY CONCRETE STRUCTURES. 2.4. FINAL INSPECTION OF BACKFILLED SYSTEM >+ N co(D to M N
N 3. THE CONTRACTOR SHALL BE RESPONSIBLE TO MAINTAIN UP-TO-DATE AS-BUILT DRAWINGS AND O M M
13. USE SCH.40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN.
EXISTING DISTRIBUTION BOX TO BE RESET � NOTES INDICATING THE i. w a ao �
� ALL PIPE SHALL BE PLACED ON A COMPACTED FIRM BASE. H _ M
/� COMPONENTS INSTALLED. THESE AS-BUILT DRAWINGS AND NOTES WILL BE UTILIZED BY THE G
��rs INV. IN EL. = 69.22_ ENGINEER FOR THE PREPARATION OF RECORD PLANS.
Z 14. ALL STONE TO BE DOUBLE-WASHED AND FREE OF DIRT, DUST,AND FINES. N
INV. OUT EL. -69.05 `�.
15. THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING OPERATIONS AND MAINTENANCE
° EXISTING LEACHING FACILITY TO REMAIN
c+� %s 3-500 GAL. LEACHING CHAMBERS WITH INFORMATION FOR THE SEPTIC SYSTEM TO THE ENGINEER, IF NECESSARY. J
�I Q
1 s7 4-FT STONE
S EXISTING LEACHING CAPACITY= 352 GPD ZONING & RESOURCE PROTECTION NOTES
PROPOSED LEACHING CAPACITY=336 GPD LLJ
s
4 SCH 40 PVC ` • 1 1. PARCEL ID:102/145 LOT SIZE:0.21 AC
I L=42.8', S=1.6% "` - - - - - - - - - 4"SCH40PVC
OWNER OF RECORD:CHRISTOPHER C HAGERTY ' ' t z
4" SCH 40 PVC I L=10.3', $=1.0% 2. (ADDRESS:307 LAKESIDE DRIVE,MARSTONS MILLS
SLEEVE PIPE 10' EITHER SIDE ` . ° - w vJ Q
L=4.5, 5=2.4/o � I � � 3. THE LOCUS IS IN LOCATED IN FLOOD ZONE X(A5 SHOWN ON F.1.R.M.MAP 25001 C0542J DATED JULY 16,2014).
-0F WATER SERVICE I J _17 Z
re - O 4. THE SITE IS LOCATED IN A WELLHEAD PROTECTION DISTRICT.
Ii � J (J <C
z
EXISTING LEACHING CHAMBER SIZING CALCULATION J
EX INV. IN=69.23 `� Q
PR INV. IN=68.94 - - - - - - - - - - --- iI U-1 '^ I-
F SIDEWALL CAPACITY Q U) V)
PROJECT BENCH (L+W)i(2 SIDES)(1.71'HIGH)(0.74 GPD/SF)
1 _ (25'+13')(2)(1.71')(0.74)=96.1 GPD '� Z Q LL
> MAG SET EL.=69.83 V J
C N71° 33'05"E BOTTOM AREA LLJ O O
r 78.36' - 90.59' (L x Wf)(0.74 GPD/SF)
(25'x1 S')(0.74)=240.5 GPD U J
TOTAL AREA
w EXISTI G GAS SERVICE (TYP.) C EXISTING WATER SERVICE
336 GIPD PROPOSED J M
W
Q 330 GPD REQUIRED .�
m oct
w � to W
Y GRAPHIC SCALE Z I-
10 0 5 10 20 40 G � Q
I,--
O G - G Q
G 0 W
co0 LAKESIDE DRIVE 1-
(in feet)
N 1 INCH = 10 FEET
Q
a CL
GENERAL NOTES:
153„
1. NITROE 2KS TANK TOP TO HAVE THREE-24",TWO-12"HOLES AND
TOTAL TANK LENGTH MULTIPLE 4"HOLES WITH RISERS AND COVERS FOR MAINTENANCE
0 OUTSIDE WALL TO OUTSIDE WALL OUTLET TROUGH(OT) AND SAMPLING:
2. FOR THE THE 24"HOLES;PROVIDE 24"DIA.ADS PIPE(CORRUGATED) N
WITH POLYLOK(OR EQUIVALENT)COVER(OR EQUIVALENT co
N TANK WALL a'' " ` ' 4 X w CONCRETE RISER AND COVER)TO 12"BELOW GROUND SURFACE
U THICKNESST F- AND SECURE TO TANK TOP.
AT TOP LL� 3. FOR THE 12"HOLES; USE ADS PIPE(CORRUGATED)AND POLYLOK co
C
.� 00
rn
N _ (3"TYP) O U (OR EQUIVALENT)COVERS TO 12"BELOW GROUND SURFACE AND p
MIDDLE 40 „ o O SECURE TO TANK TOP. V o 0
w INLET ROUGHFn J 4. PROVIDE FOUR 4"DIA.SAMPLING PORT(1"BELOW GROUND N Q �
V � TROUGH S RGED (MT) DENIT CAT( ¢ SURFACE)WITH 6"PLASTIC ROUND BOX AND COVER TO BE FLUSH o -p ,n < 00
❑ F EFFLUENT 0 WITH GROUND SURFACE. LL co p N ai �
FROM SEPTIC (IT) A N HAMB o p _.
O DC 5. FOR EXISTING SEPTIC TANK;PROVIDE 2"DIA.SAMPLING PIPE THAT m ca X
81 �" z O TANK C B ( ) IS CEMENTED OR ANCHORED TO THE TANK TOP AND EXTEND 2" CU 0 -t m 16 o
V ¢ � 0 SAC) BELOW THE TANK TOP AND BE POSITIONED 6-12"FROM THE EDGE 00 O L
QQ EFFLUENT OUT OF THE OUTLET END OF THE SEPTIC TANK OR IN THE SEPTIC TANK o m U °o a O [L
CONCRETE OUTLET COVER.ON THE TOP SIDE OF THE SEPTIC TANK,
U 0111 THE 2"DIA.SAMPLING PIPE SHOULD EXTEND TO 2"BELOW THE
m GROUND SURFACE AND HAVE A 6"DIA.PLASTIC ROUND BOX.AND
N _ COVER AT GROUND SURFACE.
t- O TANK WALL
THICKNESS
O AT BOTTOM
(4 112"TYP) d.., .. - . , . : :: . .. •:a
O
N
N
V s�
N Q
'p
6"PLASTIC BOX AND COVER WITH 4
SEE NOTES 3 AND 4(TYP) MONITORING PIPE;SEE NOTE 2 AND 4(TYP)
SEE NOTES 3 AND 4(TYP) c0 o N
SEE NOTE 2(TYP)
GROUND SURFACE TYP EL.73.90 24"ACCESS HOLE WITH COVER SEE NOTE 2(TYP).
m � NG CM7 Ch N
SEE NOTE 2(TYP) RISER
FINISH WITHIN
ED GRADE' o � o >
< OC) E
o
�, 5 1/2"TANK TOP(TYP) TO SOIL �/ �/ �/ �/� �/ EL.74.50 �(/-
CL CU a> 2 S o Z
ABSORPTION SYSTEM - -III-111=- i
-Q (SAS) 111:LOAMANDSEED-III- - - - s' p c o x
EL.71.08 _ _ - - EL.70.14 =m= U) = rn co DO a W 0
N �,•.. , � : I - CLEAN-- - - - - - - i
` •: 4. . s - - _ - - - - = I Registration:
O EFFLUENT FROM SEPTIC EFFLUENT I- -BACKFILL-_
O -TANK �. 48"STATIC WATER DEPTH -�� - ^- - - 11
A
O o - i FLOW
FLOWLL
�-
0w LL Z - - - - - - - 6"OF3/4"
❑ it a- _ SUBMERGED DENITRIFICATION CHAMBER _ 0 nw. ¢ nw _EL 68.55• - - - __ __ ..... - - - -_ _- COMPACTED
.L FL
0 z _ AERATION (DC) t w F- io- _ - CRUSHED _ .
- 0 C9 CHAMBER ❑ 0 > Z w z - I I I I I I STONE BASE
0u �-, � F= zw � w p
O = Z � ^ (SAC) � 0 0LL0 �
� � w -_ W
N a w Q
O z-' 0 NOTES:
�[ N 1. PROVIDE 3 OUTLET DISTRIBUTION BOX INSTALLED ON LEVEL
STABLE BASE.
O 2. BLOCK ONE OUTLET..
Project Number: Sheet
TANK BOTTOM 12 CRUSHED AGGREGATE OR APPROVED 3. INSTALL FIRST 2 FEET OF OUTLET PIPES LEVEL. 20112 1 Of
THICKNESS 4" MATERIAL.ON LEVEL,COMPACTED AND 4. INSTALL SPEED LEVELERS(OR EQUAL)ON OUTLET PIPES.
'
' TANK WALL THICKNESS AT BOTTOM(4") STABLE BASE
PROPOSED H-10 DISTRIBUTION BOX DETAIL Sheet Number:
O TANK WALL THICKNESS AT TOP(3") ACME PREICAST OR EQUIVALENT
E WROE 2KS 2,000 GALLON WASTEWATER TREATMENT SYSTEM (WWTS)
N-ASST20M-Hl0 NOT TO SCALE
WW - 1
t� NOT TO SCALE
-ws .:...,ee.� s.�urnm,� •--.. b..,a..�.w.n.:..s-Me_,.. :
1
`4;., ,� 7K
2,;
WASTEWATER NOTES INFORMATION FOR THE SEPTIC >n ,e # ,SYSTEM TO THE ENGINEER IF NECESSARY. � . � ,. ,,.,x p ,, x I
�`4"+.: S `C'Sv� �4p } ..
+'`,..;' u.,.,,,,: `::. y,..:. c,' ,..a,:.s '. �..> 'ors, ',; 'i ,, >,,. .,�'�„+.,`:- •_;.. E , I.
16. UNSUITABLE SOIL MUST BE F REPLACED VJVITH TITLE 5 SAND AS SPECIFIED x ,, ,, w .,>< {;
1. ELEVATION PROPERTY LINE AND EXISTING CONDITIONS ON DIN 310 CMR �,�_ � =ry ,., , . , �:, .,e,� . ' „ Wax __ , ..� � ,,, ., , E
. ,.- .. ,
THIS PLAN ARE BASED ON A 15.255 3 . ANY ` ` �= ,�'"` :'�.-•. •�`� `� +` �' h � :> � ,� „ o ,O ADDITIONAL AREAS THAT;ARE FOUND .•;.
SURVEY CONDUCTED BY THE HO TO HAVE UNSUITABLE MATERIAL _ s°`,.. � ���,_ w ��v „�, � `
H RSLEY WITTEN GROUP, INC.ON NOVEMBER 20 2020. �..>:: ,�w „ r,,,;�; "" ..,.,„� ��, � �� ,.,s, �s�,,. F �� �"
? gk U
SHALL BE REPORTED TO THE ENGINEER,.
.�, � 2. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION � �.< �-,_ � :.,,.�� _ �.� - :� � 00
�'. �°, . .�. �_'�
UNDERGROUND ELECTRIC TIIDN METHODS
17. ALL SEPTIC C � . v,"F" `� �, ,,. � -;� ;_ .,;, , �, � �r� �� < ' �.��OMPONENTS SHALL BE INSTALLED WITH MAGNETIC
SHALL BE IN ACCORDANCE WITH THE STATE EN ETIC WARNING TAPE. �M;,° 4 r,.x,,, ,•
ENVIRONMENTAL CODE AND THE RULES AND ., , ,,, .
TO PUMP CHAMBER _ ., .. CL
REGULATIONS OF THE LOCAL BOARD OF HEALTH. �:� ' .,�. � , m"�
.,.,�, 18: ALL SEPTIC TANKSBITUMINOUS
PROPOSED AIR PUMP
1 ALL BE APPLIED WYITH 2 COATS OF DAMP PROOFING OR � °�' -. -y � µ, � -:��, �� .,. ,,,�;. • . _; ._,� ,,, � t,,:-. c o
� A MATERIAL. �. � ,• � _, .� . . ,.,. '
3. THIS D T � rt ,. , �„ 'r
J PLAN IS INTENDED 0 ADEQUATELY PROVIDE THE INFORMATION NECESSARY T ar.•• " `" .,.: , >
FINAL LOCATION TO BE O ���� .,.� � �;� �,,,_ � ��,.;". �. 4� s � �� � :; �>
LAYOUT AND CONSTRUCT THE PROPOSED
/ / SEWAGE DISPOSAL SYSTEM REPRESENTED ON ,. ,ti•. .,..e...E ,
.� l ,.- 19. THE CONEQUAL
FIELD DETERMINED TRACTOR SHALL RESTORE ALL SURFACES TO
-; IT AND SHOULD NOT BE USED FOR ANY OTHER PURPOSES. THEIR ORIGINAL CONDITION �' ,�,_r ,;.��•R .,,.� �s,w, ,�;' � �� � _
AFTER CONSTRUCTION IS COMPLETE. AIREAS NOT DISTURBED BY CONSTRUCTION SH L � ,# x . ' � Z -
BE LE ;
FT NATURAL.THE
/ E CONTRACTOR SHALL TAKE , w a
® 4, ANY CHANGES TO THIS PLAN MUST BE APPROVED BY CARE TO PREVENT DAMAGE TO
THE ENGINEER AND/OR THE LOCAL _ . ,,, W�� � �_:, � �'�;,' `.�,� `�� ��°•; r �.`
SHRUBS TREES OTHER ... ...
LANDSCAPING AND/OR NATURAL FEATURES. WHEREAS THE
BOARD OF HEALTH(BOH)STAFF. ;�-"� '` � �*r` ' ` �w; ` `� 'x,.� �, _•,: �. °�,���. E, . .r �'`�` ,: Y
I PLANS DO NOT SHOW ALL LANDSCAPE FEATURES,
a\ TURES, EXISTING CONDITIONS MUST BEco
VERIFIED BY THE
CONTRACTOR IN ADVANCE OF ,. ,
I / 5. PRIOR TO CONSTRUCTION,THE CONTRACTOR SHALL COORDINATE WITH T THE WORK. ,�„ ,„ ��,, :' �„ �� ,• t,� ��., �
\ � HE PROPERTY r.* � �� -�: '. �:_ ' �� ���„ � .� ,, <, >• ._�. :.. ; �� �" `,.,.
OWNER AND ENGINEER ON THE CONSTRUCTION SITE ACCESS AND MATERIAL STOCK PILE _, o , , W
EXISTING SEPTIC TANK TO REMAIN 20. ALL UNPAVED ,:. fi ,,. ,..
AREAS DISTURBED BY THE WORK SHALL HAVE A MINIMUM OF 4-INCHES OF
���
.....J AREAS. „, � ' ,�� �.�`"' �:a' � ` �'�_+ `�, � � �. . N
INV. IN = 70.48 i LOAM INSTALLED AND BE SEEDED WITH(GRASS SEED AS SHOWN O
;' � ' N THE PLAN AND/OR
DIRECTED BY THE .. ..ENGINEER. THE CONT . .. .
RACTORSHALLBERESPONSIB ,
V OUT -70.23 � LE FOR WATERING N ,
IN � � , 6. TRENCH SAFETY SHALL BE THE RESPONSIBILITY OF THE'.CONTRACTOR INCLUDING ANY
ANY LOAM AND SEEDED AREA �,,, , �.. „�.� � ..:.. �„ �: . v }... ,... ��..,< ,.� , ��.- .<,„ .- ,
S UNTIL LAWN GROWTH IS ESTABLISHED s.,e , .,, . .. c� m. o
AND APPROVED BY Y ,, „�., k •.,.r R �-
' LOCAL AND/OR STATE PERMITS REQUIRED FOR THE TRENCH WORK. THIS " �"" � �-� � _.- .:. .: .'9 �� `''�ua� .�'`� .-* ,.� � a:a
THE ENGINEER AND/OR OWNER. �,,. ,
WORK MAY BE
I REQUIRED TO TAKE PLACE OUTSIDE OF NORMAL HOURS OF OPERATION FOR THE
- J FACILITY.THE CONTRACTOR S
72 0 HALL PLAN ACCORDINGLY.
21. AN INNOVATIVE&ALTERNATIVE TREATMENT SYSTEM IS PROPOSED
_.,. FOR THIS SITE. THE
- .
n
SYSTEM MUST BMAINTAINED ..E INSTALLED AND „.f,..IN ACCORDANCE � , ,_., � .., _,. , . _ :,RDANCE WITH THE .K. ,
., ��, .. >,n ._ �:. � ,_a _ �, ri� , . ,w _�.,._ ,,.
7. THE CONTRACTOR SHALL REPORT ,� , `�. .. LU
ANY DISCREPANCIES FOUND IN SITE CONDITIONS F � pry•,• . ����,. � � .,,.� ... r _.�,. , . ,� ,,,. .� ., o FROM OF ENVIRONMENTA P
.. E, �c
I L PROTECTION(DEP) PROVISIONAL USE APPROVAL.
THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER.
I
I
gg ,x '
AW
v
8. FAILING TO PROPERLY INSPECT OR PUMP THE SEPTIC TANKS AND TREATMENT SYSTEM `� t�. 4 � 1.• � � �'4a� ; � w�' ,:� �;_ � - �;; �_,.�.� . ,
I EXISTING OVERHEAD i I � .,. � � ,,,.". . .,.= �� ;• ., •`>� ,�� ,.. .,.,.. � .- s,„: .. '
OR CHANGES TO EFFLUENT FLOW GRADING,OR LANDSCAPING, EITHER ON-SITE_ OR �...::_..�. �,,a �•,. -,: ���� � . v. �. �; � ��' , -�. ,.�: � �_ ,,, ���, �mow,
> I ELECTRIC, TELEPHONE coi ADJACENT TO THE SITE,MAY RESULT IN IMPROPER FUNCTIONING OF THE SEPTIC AND
4" SCH 40 PVC I & CABLE SERVICE ' LEACHING SYSTEM(s). t� c m w
L=6.6', S=1.0% -' Q I WASTEWATER INSTALLATION INSPECTION NOTES C p 3
9. CALL"DIGSAFE"AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 1. THE CONTRACTOR SHALL PROVIDE A MUNIMUM OF 24 HOURS ADVANCE NOTICE TO THE ., o
307 LAKESIDE DRIVE EXISTING
AND ANY OTHER APPLICABLE AGENCIES TO FIELD VERIFY LOCATIONS OF ENGINEER AND LOCAL BOARD OF HEALTH FOR ANY INSPECTION.
NITRIDE 2KS 2,000
O y T
EXISTING UTILITIES.
10.2' ONE �'OEi� WOOS FRAME
GALLON TANK � � .1 � I 2. ALL WASTEWATER COMPONENTS SHALL..BE INSPECTED BY THE ENGINEER AND THE LOCAL L w m
INV. IN=70.16 3 .BEDROOM DWELLING 10. THIS ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED FOR USE WITH A BOH REPRESENTATIVE PRIOR TO BACKF?ILLING. AT A MINIMUM THE FOLLOWING ITEMS SHALL
INV. Ol1T-69.91 O I GARBAGE GRINDER. BE INSPECTED: O w
' 2.1. SYSTEM COMPONENTS BASE AND INISTALLATION PRIOR TO BACKFILL
O11. THE OWNER SHALL HAVE THE SYSTEM INSPECTED AND HAVE THE SEPTIC TANK PUMPED 2.2. LEAKAGE TEST ON PRECAST TANKS (MIN,24 HR) fl? p p c d
EVERY 3-8 YEARS. 2.3. START UP TEST OF SYSTEM WITH ALL COMPONENTS INSTALLED AND FUNCTIONING AS � O 'O
DESIGNED W Q w
/ n 12. PROVIDE WATERTIGHT SEALS BY USE OF NON-SHRINK GROUT AT ALL POINTS WHERE 2.4. FINAL INSPECTION OF BACKFILLED SYSTEM a1 Q p o
ES ENTER LEAVE ANY CONCRETE STRUCTURES, zo
� '� lo ego
_ PIP OR L TRUCT to y d N
3. THE CONTRACTOR SHALL BE RESPONSIBLE:TO MAINTAIN UP-TO-DATE AS-BUILT DRAWINGS AND p .,. .� ' �'
EXISTING DISTRIBUTION BOX TO BE RESET `r'
_ o CC> 13. USE SCH.40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN. NOTES INDICATING THE HORIZONTAL AND VERTICAL LOCATION WITH TWO TIES OF ALL SYSTEM U� o s� M M Q
INV. IN EL. = 69.22 i ALL PIPE SHALL BE PLACED ON A COMPACTED FIRM BASE. COMPONENTS INSTALLED. THESE AS-BUILT"DRAWINGS AND NOTES WILL BE UTILIZED BY THE H _ GGo CID
INV. OUT EL. =69.05 Z ENGINEER FOR THE PREPARATION OF RECORD PLANS. _ y � y O o
\. 14. ALL STONE TO BE DOUBLE-WASHED AND FREE OF DIRT,DUST,AND FINES. to
EXISTING LEACHING FACILITY TO REMAIN 15. THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING OPERATIONS AND MAINTENANCE
c+> 2 500 GAL. LEACHING CHAMBERS WITH
o _
4-FT STONE
o
g i I EXISTING LEACHING CAPACITY= 352 GPD
s \` I ZONING & RESOURCE PROTECTION NOTES E-
PROPOSED LEACHING CAPACITY=336 GPD
2: W
1
4" SCH 40 PVC I 4 SCH 40 PVC 1 1. PARCEL ID:102/145 LOT SIZE:0.21 AC
- -- - - - - -
OWNER OF RECORD:CHRISTOPHER C HAGERTY ❑
4"SCH 40 PVC ! - - - -- I L=10.3', S=1.0% 2. ADDRESS:307 LAKESIDE DRIVE,MARSTONS MILLS W
z
SLEEVE PIPE 10 EITHER SIDE _ °
L=4.5, S=2.4/o - ---- 3. THE LOCUS IS IN LOCATEDvJ IN FLOOD ZONE X AS SHOWN ON F.LR.M.MAP 2
RV ICE
( 5001 C0542J DATED JULY 16 2014 .
� OF WATER SE I � � -1 � � � W = Q i
U z 4. THE SITE IS LOCATED IN A WELLHEAD PROTECTION DISTRICT. _
rJ - J
EX INV. IN=69.23 - -- - EXISTING LEACHING CHAMBER SIZING CALCULATION J V J
PR INV. IN=68.94 j I Q Q_
rr^^
SIDEWALL CAPACITY W v,
PROJECT BENCH (L+VW)(2 SIDES)(1,71'HIGH)(0.74 GPD/SF) '^ /�
_ (25'+13')(2)(1.71')(0.74)=96.1 GPD
❑ VJ vJ
>� _
ET
�� I 416
-► / MAG S EL. 69.83 . •
- z <C LL
c,
I I
cc
N71 33 05 E 90. � �BOTTOM
cPDiSF) LL.I O G 0
I 78.36 - / 59 _
` I S71° 30' 19"VI/ (25'x13')(074)-240.5 GPD ^ W L.(_
W `� EXISTING GAS SERVICE(TYP I) ! I TOTAL
�T�Po PROPoso J W
Q EXISTING WATER SERVICE
jl- - 330 GPD REQUIRED
Q
z
w - o I-- �
Q GRAPHIC SCALE - ----- ,I c� (n W
J 40 z
10 0 5 10 20 - -- -�-.
------
1-
co
------- ----- - - ry ---f Q
m ry
w
� LAKESIDE I W
i N ,
(in feet)
� I
0 1 INCH = 10 FEET
Cq
c °'
�Q
>� GENERAL NOTES: a a
153" 1. NITRIDE 2KS TANK TOP TO HAVE THREE-24',TWO-12"HOLES AND
TOTAL TANK LENGTH MULTIPLE 4"HOLES WITH RISERS AND COVERS FOR MAINTENANCE
OUTSIDE WALL TO OUTSIDE WALL OUTLET TROUGH(OT) AND SAMPLING.
2. FOR THE 24"HOLE •PROVIDE i S O IDE 24"DIA.ADS PIPE
E(CORRU
GATED)
x .
a WITH POLYLOK(OR EQUIVALENT)COVER(OR EQUIVALENT )
fn Y w co
TANK WALL _" z a CONCRETE RISER AND COVER)TO 12"BELOW GROUND SURFACE
V THICKNESS I 1 ¢ a AND SECURE TO TANK TOP:
1
H
AT TOPT i ) u_ 3. FOR THE 12"HOLES;USE ADS PIPE(CORRUGATED)AND POLYLOK C
_J - U
� .� (3"TYP) G � O (OR EQUIVALENT)COVERS TO 12"BELOW GROUND SURFACE AND
Lo oo
N ¢ MIDDLE f 40 s„ o O SECURE TO TANK TOP.
a I
I
U co dam,
w INLET ROUGHS I - Sr 4. PROVIDE FOUR 4"DIA.SAMPLING PORT(1"BELOW GROUND N
- H - TROUGH SU8,4 RGED r ( ) I DENIT,RIFICATIC )WITH 6"PLASTIC ROUND BOX AND COVER TO BE FLUSH _ C> �
m Q
U = p MT � Q SURFACE I
EFFLUENT i, O WITH GROUND SURFACE.
- 1- (IT) AEIN CHAMBER I rR
FR
OM SEPTIC o ao
i co � o
� -"� DC I ! 5. FOR EXISTING SEPTIC TANK;PROVIDE 2"DIA.SAMPLING PIPE THAT " +-� .� c c� ,°i �n r Cn Y o TANK CIfAFBEiR f €, ( ) , v +_ -
IS CEMENTED OR ANCHORED TO THE TANK TOP AND EXTEND 2"
81 „ z O O E(S "C 0 6 1 a L CU 2 m c) BELOW THE TANK TOP AND BE POSITIONED 6-12"FROM THE EDGE c O O N
U J 1 � i is INFLUENT OUT c OF THE OUTLET END OF THE SEPTIC TANK OR IN THE SEPTIC TANK
CE t� U oo a_ O a
CONCRETE OUTLET COVER.ON THE TOP SIDE OF THE SEPTIC TANK,
o
O 0 w I� THE 2"DIA.SAMPLING PIPE SHOULD EXTEND TO 2"BELOW THE
100 I ( GROUND SURFACE AND HAVE A 6"DIA.PLASTIC ROUND BOX AND
CIO
N d I COVER AT GROUND SURFACE.
r- O TANK WALL dl Ci
r- THICKNESS
O AT BOTTOM I I E I li
;.
O �.
(4 1/2"TYP) 4 . :
'I N
O
N
N
I U
N Q
O 6"PLASTIC BOX AND COVER WITH 4" OO
SEE NOTES 3 AND 4 TYP I-
� MONITORING PIPE; NOTE 2 AND 4 TYP Ur
SEE NOTES 3 AND 4(TYP) (TYP)
/ Cfl � N
>+ -i-+ LO , r-
_ SEE NOTE 2(TYP) L
GROUND SURFACE TYP EL.73.90 24"ACCESS HOLE WITH COVER SEE NOTE 2(TYP).
SEE NOTE 2(TYP) Co .- � M a
5 1/2"TANK TOP TYP TO SOIL RISER TO WITHIN F `� EL.74.50 T ID
> cos o
FINISHED GRADE > <C o0
>% (TYP) ABiRPTION SYSTEM _ a (D o_ v o z
I I=i 1 1 �s I-
fir-- , �.,,,» , � t__: t � o
(SAS) ;° I h I :LOAM AND SEED _ i i o o 0
EL.71.08 _____ _ M c o'
N - - - - z o Co .r
�. i $ _ EL 70 94 - I I _.._ = O ca c m
.. 1 CLEAN m = w Cn s2 ii 0
ti EFFLUENT FROM SEPTIC FLUENT I I w. _ -
•48 STATIC WATER DEPTH li
-BACKFILL- -
- Registration:_ _. -
O `..r a _ I
� TANK H --•--- , I
I
O w FLOW
___-
o LL _ _ s FLOW - _ �0 0Fk
O
- a SUBMERGED DENITRIFICATION CHAMBER _ a Q w _ n _ _ ) - - 6"OF 3/4 6
W a = DC O a = a I _._ EL..68.55 _ ;
O + -~ AERATION ( ) D 1- a _ _ _ COMPACTED !�
dEE
� ¢ z O CHAMBER z w z u_fTh
>` 0 s t- - , CRUSHED
p O LL -► (SAC) _ i _ w _. $ "_ STONE BASE
r' _ W v Z
0
0
t r► -"" � ;°,. NOTES:
PROVID
E 3OUTLIET DISTRIBUTION BOX INSTALLED ON LEVEL m
O EL.65.33
STABLE BASE.
KleanTu LLC
t* j
� ) t js 77
2. BLOCK ONE OUTLET, Project Number: Sheet
TANK BOTTOM
1 ZUSHED AGGREGATE OR APPROVED 3. INSTALL FIRST 2 IFEET OF OUTLET PIPES LEVEL.
THICKNESS 4" MRIAL;ON LEVEL,COMPACTED AND 4. INSTALL SPEED LEVELERS(OR EQUAL)ON OUTLET PIPES. 20112 1 Of
TANK WALL THICKNESS AT BOTTOM(4") SIE BASE
O TANK WALL THICKNESS AT TOP(3") PROPOSED H-110 DISTRIBUTION BOX DETAIL
E NItROE 2KS 2,000 GALLON WASTEWATER TREATMENT SY�M (WWTS) ACME PRECAST OR EQUIVALENT sheet Number:
N-ASST20M-HIO NOT TO SCALE
cc NOT TO SCALE
WW 1
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