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HomeMy WebLinkAbout0100 LITTLE POND ROAD - Health 100 LITTLE POND ROAD Marstons Mills A= 064-002,,i,-Vb Li 0I6 S M AD No.2.153LY UPC 12OU amead.com . Made In USA t^� 0��.7V.71Ni1Vi06=E 0NMAnVE CeeiQodRbw$oufc" www ®rmur9 tl __ E r-o- � � )� �� � 1 �3 J� 0 �",,__ - - u. �� 1 is d X# 00o2—00� �. Commonwealth of Massachusetts 60 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments - ' Property Address h.�4 flame / Owner Owner's Name ;•; information is /_ / !` required for every z �s � page. Cit rowown State Zip Code Date of spection v 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:out f When A. Inspector Information fillip out forms on the computer, use only the tab �1f/ key to move your Name of Inspector _ cursor-do not use the retumi Company Name key. 7 ca Company Address Cityrrown State Zip/Code Telephone Number License Number B. Certification , - I certify that: 1 am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. A Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority � 4. ❑ Fails Inspector's Signature Date ' The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner,and copies sent to the buyer, if applicable, and the approving authority. Please note: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. t5insp.doc rev.7rAM18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 �0el ��r Commonwealth of Massachusetts _ Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 6 Property Address e Owner Owners Name ` information is required for every page. CityfTown State Zip Code Date of Inspectio C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 10 -777 pelf z2 1r® _ 1�,9� 2) System Conditionally Passes: �l/�f��t4a4®am*r—,. ❑ 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): s t5insp.doc-:rev.7/OM18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name information is ^ 1 ,/� 14* fs^ required for�every �, � !! page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7Q612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Addr ss Owner Owner's Name information is ��2_'1 �7� / `J 10"� required for every page. Cityrrown State Zip Code Date of In6pection C. Inspection Summary (cont.) ❑ 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 b. 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 coliforrn 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ W Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.70612018 Title 5 Official Inspection Fonn:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments c Property Ad Owner Owner's Name y �J information is �1®` A7'__ �— / ,//'/ required for every �"�! ` - (�! page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems:(cont.) Yes No ❑ FUf 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 ❑ 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 water supply ❑ well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000 gpd- 010,000 gpd. ❑ n 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. 5) 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 C. . Yes No P (. � ❑ ❑ 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 t5insp.doc•rev.7f28/2018 Tide 5 Official Irrspeclion Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of o Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments lea Property Addre pt Owner Owner's Name G information is required for-every page. cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No I ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 51, 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? ❑ ,9c Have large volumes of water been introduced to the system recently or as part of Y-� 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)] t5insp.doc•rev.7f26W18 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments C Property Ad ss V d Owner D A.1 ���) Owners Name informatior is required for every —� w page. City/I own State Zip Code Date of Ins ection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes D' No Does residence have a water treatment unit? ❑ Yes �z No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes .�rNo information in;this report.) U°' Laundry system inspected? XYes ❑ No Seasonaluse? ❑ Yes No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes No Last date of occupancy: /T Date t5insp-doc•rev_7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name informations is required for every page. Cityrrown State Zip Code Date of Inspect n D. System Information (cont.) 2. CommercialAndustrial 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? Yes ❑ No If yes, volume pumped: �� erJ� gallons How was quantity pumped determined?Reason for pumping: � ���� �•'`� t5insp.doc•rev.7r-16M18 Title 5 Official Inspection Forth:Subsurface Sew wage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address z�yr1 Owner Owner's Name information is required for every page. 471f�own � State Zip Code Date of InspecKn D. SystemInformation (cost.) 4. Type of System: FSeptic tank, di&##* ien-bar, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Altemative 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): Approximate age of all components, date installed if known and source of information: 9 p ( ) Were sewage odors detected when arriving at the site? ❑ Yes Vr No 5. Building Sewer(locate on site plan): /� rr Depth below grade: feet Material of construction: ❑cast iron IZ40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7,2612018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 18 I c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner OwneAite'6 ' information is required for every �1/f page. Cityffown State Zip Code Date of rnspecti D. System Information (cont.) 6. Septic Tank(locate on site plan): / Depth below grade: ! s feet Material of construction: (Lconcrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) Caana s/�� s '®0 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 'x Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle p Distance from bottom of scum to bottom of outlet tee or bafflei 4Whi �G. How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, struc ral integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): t5insp.doc•rev.7128M18 Title 5 official I nspection Form:Subsurface Sewage Disposal System•Page 10 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address T Owner Owner's Name / information is ` A. or (z required for every page. cifyfrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address tv r� Owner Owner's Name ' information is G requires"for everyA e �� � � page. ityfrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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.): i, Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. 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.): t5insp.doc•rev.7/2WO18 Title 5 Official Iru pection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Propel%Add,;eF Owner Owner's Name information iso �� required for every ) page. Ci !Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number. Ud leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7,26=18 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner owner's Name information is required for every � � I page. CILYI I own State Zip Code Date bfKspedioK D. System Information (cont.) 11. Soil Absorption System (SAS)(cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/28/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i< Property Address Owner Owner's Name information is required for every page. L;nyl I own State Zip Code Date ofrnspectiopr D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions I Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7128/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name information is ?�-�� required for every page. City own State Zip Code Date of I pecdion D. System Information (cont.) 14. 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 cawing attached separately IX Pr e- e 00A 14C 4DS .f /Y, 7 6 e-- 15- ' ? Einsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Nam6 information is required for every page. City own State Zip Code Date o Inspect' D. System Information (cont.) 15. Site Exam: 9"'C'heck Slope ❑ Surface water Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe howyou established the high ground water elevation: Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5insp.doc•rev.M2612016 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address ' ��� 4 Owner Owners /� information is required for every /2VP page. R wn State Zip Code Date of Insp ion E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: n A• Inspector Information: Complete all fields in this section. R B• Certification: Signed & Dated and 1, 2, 3, or checked C. Inspection Summary: 1, 2, 3,or 5 completed as appropriate 4(F ilure Criteria)and 6(Checklist)completed D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5msp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewag e Disposal System•Page 18 of 18 l Citizen Web Request Page I of 3 'Y T H� j'• ®F fir (� � ltFi�.,. .$ tAx i Monday,August 2018 Citizen Request Management Application`enter Logged In As: heal Logoff Route to Users Search Requests Create Requests Changes saved Request Information Request ID: 59646 Created: 8/3/2018 11:26:35 AM Status: Assigned To Staff Assigned To: Desmarais, Donald Health Office Anonymous: No Request Category: Title 5 : Section 353-7 Sewage edit Routine work: No Estimate: No edit Date scheduled: edit Estimated 8/17/2018 Change Estimated Jul August 2018 Sep Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 29 30 31 1 2 3 4 5 6 7 8 9 10 .11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 1 7 8 Created By: Soto, Kathryn Priority: Medium edit Health Office Citation Numbers: edit Requestor Information Requestor Request Parcel Number Real estate agent states Patrick Map: 664 Block: 002 Lot: 004 Tropeano installed a septic tank at property.There was no permit filed and Parcel Lookup they are not a licensed installer. Email: Edit Requestor Information http://itsqldb/CitizenRequest/WRequest.aspx?ID=59646 1 8/13/2018 Citizen Web Request Page 2 of 3 Track Request Progress Request Work History: Internal Note History: Entered on 8/13/2018 8:06:37 AM Entered on 8/3/2018 11:26:35 AM by Health by Soto, Kathryn Last modified on 8/3/2018 11:28:05 AM DD has spoken to both. Am going out on 8/13 to view that the septic tank has not been changed Real estate agent told me he installed a plastic and the realtor was mistaken. tank instead of concrete. She texted him to ask update delete what was going on and he said he was planning on coming in this afternoon to get permit. I explained to her it has to be done before work Entered on 8/13/2018 3:59:35 PM and he is not licensed. She says she has used him by Health before for properties in Mashpee. saw the old septic(concrete)tank with fluid System entry on 8/3/2018 11:26:35 AM: level where it should be. informed system Assigned to Desmarais, Donald inspector to redo report to show the tank was not leaking but had not been used in a long time and most probably evaporated.The conditional pass will be reversed and the system will pass. update delete Enter work progress: Enter internal note: (Viewed by everybody) (Viewed internally only) Ir v v Spell Check Spell Check Add document or image link: Brow1.se... * You can also type in a folder name to see everything in the folder , Current Links: Time worked on request: 1°5 Response time: 4.00 *Time entries are in hours. Examples of time entries: 1.25, 0.5, 0.75, 1, 3.5, 0.25, 0.10 • Response time: Measured from the creation date to your first actions on the request. * Do not include nights,weekends,and holidays in response time for most departments. O Save changes ❑ Check to notify town employee below to review this request. O Save changes and notify Health Office http://itsqldb/Citiz6nRe4uest/WRequest.as,, x?ID=59646 8/13/2018 Town of Barnstable Barnstable ° Regulatory Services Department MMmiftacf 1 1 � BARNSCAHLE, •' 9 63q. 10� Public Health Division m A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 0688 June 5, 2018 DEVELLIS, JOHN & JOAN G 100 LITTLE POND ROAD MARSTONS MILLS, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 100 Little Pond Road, Marstons Mills, MA was inspected on 05/18/2018 by Brett Hickey, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Septic tank is leaking and needs to be replaced. You,are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE OARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Lp.tters Mailing\Conditionally Passes Letters\100 Little Pond Road Marstons Mills.doc i A TKE ram, . Town of Barnstable � aizr�isrrr_ � � ' Regulatory Services Department `rEn Mlc+�` • Public Health Division 200 Main Street,Hyannis MA"02601 Offlce: 508-8624644 Richard ScA Dircctor FAX 508-790-6304 Thomas A-McKean,CEO Feb 6, 2007 Rev. 5111116 DEADLINES TO'REPAIR FAILED.SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) _ An` "marked in the ❑is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA { ❑Discharge or ponding of effluent to the surface of the ground ❑Pumping more than 4 times during the last year not due to clogged or obstructed pipe. a Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE(1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ' ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis.'(This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA q Single:Cesspool (k, 1ny"conditio'nally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components, etc) o Leaching pit or cesspool with high liquid level,<12"below inlet(per Town Code §360-9.1) ❑Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: - Q:\sEPTICVEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts boa W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments m E M 100 Little Pond Road Property Address M Joan DeVillis & Randy Katchis Owner Owner's Name 0 information is Marstons Mills Ma 02648 5-18-18 : required for every � page. City/Town State Zip Code Date of Inspection CY1 �t 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. filling out forms A. General Information �'� /i Oq filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Brett Hickey use the return Name of Inspector key. B&B Excavation raa Company Name 374 Route 130 Company Address a � Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 S113747 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 161 5-18-18 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 100 Little Pond Road _ Property Address Joan DeVillis & Randy Katchis _ Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Bit 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): The septic tank was only half full at the time of inspection. The liquid level was at the seam when viewed showing the tank is leaking. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection- B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (corl ❑ 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. Gityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier,.if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® Static liquid level in the distribution box above outlet invert due to an overloaded" or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 'I. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. An portion of a cesspool El ® y p sspoo or privy Is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is Marstons Mills Ma 02648 5-18-18 required for every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done..You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner,occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: 3 Number of bedrooms (design): Number of bedrooms (Actual) _3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 524/GPD t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts fo Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills - Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d See below 9 ( Y 9 (gP ))� Detail: 2016- 148,000gallons 2017-67,000gallons Sump pump? ❑ Yes ® No Last date of occupancy: 1 year agoDate Commercial/Industrial Flow Conditions: Type of Establishment: NA 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? I❑ Yes ❑ No Water meter readings, if available: - t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner-date of last pump is unknown Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth. of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °wM 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis _ Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspec-ion D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 10-16-1992 per COC Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Townfeet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 1 — feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) _l If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach-a copy of certificate) ❑ Yes ❑ No allons Dimensions: 1000g - Sludge depth: 6„ t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 30 Scum thickness 0 Distance from top of scum to top of outlet tee or baffle "Tank is leaking" Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The septic tank was only half full at the time of inspection showing the tank is leaking. Grease Trap (locate on site plan): Depth below grade: NA 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town .State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal Sy.5tem•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 11 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box is in working order at time of inspection with liquid level equal to outlet invert. D-box did not show signs of back up. 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.): NA If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System- g pForm Not for Voluntary Assessments °M 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of InspecVon D. System Information (cont.) Type: (1) 6'x6'® leaching pits number. — ❑ leaching chambers number: ❑ leaching galleries number: — ❑ leaching trenches number, length: — ❑ leachingfields 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.): Leaching was in working order at time of inspection with no sign of hydraulic failure. Leaching was dry when viewed with a stain line '/2 way up from the bottom. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA 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 ❑ N.o t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Little Pond Road M Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is Marstons Mills Ma 02648 5-18-18 required for every ' 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: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r - Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately E— 01 D AF-46611 AG-M1311 BE- 157 BF14111 B B •25 1 CG• 131 CH•45` CH•341 t5ins•3/13 Title 5 Official Inspecion Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 ,page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: No GW @ 144"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: 10-16-1992 Gate ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground wager elevation: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Dispcsal System•Page 16 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Little Pond Road Property Address Joan DeVillis & Randy Katchis Owner Owner's Name information is required for every Marstons Mills Ma 02648 5-18-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage.Disposal System•Page 17 of 17 ■ Complete items 1,2,and 3. 7BRec ign ur® Print your name and address on the reverse ❑Agent so that we can return the card to you. ❑Addressee m Attach this card to the back of the mailpiece, e y 02 Na —� C. Date of Delivery or on the front if space permits. 1. -- ——— D. Is d e ddress different from item 1? ❑Yes If YES,enter delivery address below: p No -DEVELLIS, JOHN & JOAN G 100 LITTLE POND ROAD I MARSTONS MILLS, MA 02648 II I�II�I I�I 101 I II II II I I( III'I I IIIIIIII III IN I I�) 11 Service Type ❑Priority Mail Express® ❑Adult Signature ❑Registered MaiITTM dull Signature Restricted Delivery ❑Registered Mail Restricted Certified Mail® Delivery 9590 9402 1933 6123 1777 46 Certified Mail Restricted Delivery Q�Retum Receipt for ❑Collect on Delivery `MMerchandise 2—e.+ e_n�.. ti rr ��-� ---- -� _ leliveryRestricted Delivery ❑Sighature.Confirrnationm ..17 3 0 0 0 0.1 i 4 9 8 8 P 6 8 8j '' i Signature Confirmation 7 015 1: . . , I ( + 1� t Restricted Delivery Restricted Delivery --- —over uu1 PS Form 3811,July 2015 PSN 7530-02-000-9053 omestic Return Receipt t ll uses= ►r +t First-Class Mail Postage&Fees Paid USPS - Permit-No.G-10 I 9590 9402 1933 6123 1777 46 United States •Sender: Please print your name,address,and ZIP+4®in this box* Postal Service Town of Barnstable ; \ti Health Division 200 Main Street i f Hyarulis,MA 02601 ' I I 1 Co •.CP o mat co Cert'rfied Mail Fee * v1-r Er $ q �� Extra Services&Fees(check bar,add fee as appropriate) �`L\1'" w,l ❑Return Receipt(hardcwpy) $ Q ❑Return Receipt(electronic) $ ";�+',•Postmark �..i O ❑Certified Mail Restricted Delivery $ p Here 0 ❑Adult Signature Required $. [:]Adult Signature Restricted Delivery$ 0 O Postage m $ Total Postage a DEVELLIS, JOHN & JOAN G �► Sr-qent To 100 LITTLE POND ROAD o s«QBfa�dApr.'MARSTONS MILLS, MA 02648 r` .......... pity;-Sfate,ZIP', Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail a A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the. n A record of delivery(including the recipients retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period, delivery to the addressee specified by name,or-3 Important Reminders: to the addressee's authorized agent. ?� -Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail',First-Class Package Services, available at retail). ^` or Priority Mails service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specifed m Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent- with Certified Mail service.However,the purchase (not available at retail). _ of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with,a proper this Certified Mail receipt,please present your ,j endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for c—, the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded pom4 n of delivery(including the recipient's signature). of this label,affix R to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version:For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTAM:Save this receipt for your records, Ps Form 38O0,April 2015(Reverse)PSN 7530-02-000.9047 Citizen Web Request Page 1 of 1 e 6h.'L\37AULF, + Citizen Request Management - Internal Use Request ID: 59646 Created: 8/3/2018 11:26:35 AM Status: Assigned To Staff Assigned To: Desmarais, Donald Health Office Anonymous: No Category: Title 5 Section 353-7 Sewage E.C. Date: 8/17/2018 Created By: Soto, Kathryn Citations: Health Office - ime Worked: 0.00 Response Time: 0.00 Requestor Details: Email: Request Location: 100 LITTLE POND ROAD Marstons Mills, Ma 02648 Parcel Number: Map: 064 Block: 002 Lot: 004 Request: Real estate agent states Patrick Tropeano installed a septic tank at property.There was no permit filed and they are not a licensed installer. Request Work History: Internal Note History: Entered on 8/3/2018 11:26:35 AM by Soto, Kathryn Last modified on 8/3/2018 11:28:05 AM Real estate agent told me he installed a plastic tank instead of concrete. She texted him to ask what was going on and he said he was planning on coming in this afternoon to get permit. I explained to her it has to be done before work and he is not licensed. She says she has used him tefore for properties in Mashpee. System entry on 8/3/2018 11:26:35 AM: Assigned to Desmarais, Donald ' http://itsqldb/CitizenRequest/WRequestPrint.aspx?ID=59646 8/7/2018 8/9/2018 Pinnacle Residential Properties Master Bath: Yes Master Bedroom First Floor Level: V. Bedroom 2 Level: Second Floor Bedroom 3 Level: Second Floor Dining Room Level: First Floor Living Room Level: First Floor Kitchen Level: First Floor Laundry Room First Floor 4 Level: I Other Room 1 Level: Second Floor ' Master Bedroom 19X14 _ Dimensions: "' m Bedroom 2 19X14 � Dimensions: Bedroom 3 17X15 Dimensions: Dining Room 16X11 JQ Dimensions: Kitchen 17X12 Dimensions: Living Room 19X16 Dimensions: '` Other Room 1 20X15 Dimensions: OPEN HOUSES �,� Start Time: End Time: Comments: 08-11-2018 10:00 AM 08-11-2018 Spacious 3 11:30 AM bedroom Cape on a beautiful Pond setting. 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This site was last updated on August 09,2018 08:29 AM Property Last Updated:August 07,2018 11:57 PM N. https://www.pinnaciehouses.com/properties/listing_sheet/57612022 2/3 8/9/2018 Pinnacle Residential Properties PROPERTIESPINNACLE RESIDENTIAL 100 Little Pond Rd, Marstons Mills, Barnstable, MA 02648 MLS#72375289 PROPERTY SUMMARY Property Type: Single Family - Attached t Property Status: New List Price: $599,000 ,Y Neighborhood: Marstons Mills , L_ E County: Barnstable Zip: 02648 Year Built: 1992 Assessed Value: $466 900 - Taxes: $5,239 , Tax Year: 2018 Style: Cape 47 1 Lot Size: 9 6 sft q x Acres: 1.1 - Living Area: 1,934 sqft Garage Spaces: 2 --- ►� Garage Description: Attached, Garage Door Opener, Side Entry Parking Spaces: 4 ti Parking Description: Improved Driveway ' Basement: Yes r , Rooms: 7 Bedrooms: 3 ' Full Baths: 2 ` — Half Baths: 1 Total Bathrooms: 3 https://www.pinnaclehouses.com/properties/listing_sheet/57612022 1/3 — TownsP"Operty 'Search Out: Reports Moo CNIA Info Vi CI C• s Our Teani TA ; .? �.. r �i, "•,,k. . W77 Contact an Agent qal®ting Email,a,Fricnd i oanCalculator° �ddwN'otesti • .c avoiit u: :, " Piat Details: r , `^ , .&y nd d Barn .' ,.. .. stab°1e A J�0O LittleP 264 $.5 9 9,°00,0' rY "VTranquil and:pfi�aie waterfronttou:11ittle P,ond`t ere you will findu`ttus spacious } w� Tbi dtoom Ca a The 3 beautiful a,.gardener's d elight dews ofFthe ,« p grounds are3just w +*� Pond.;and'gardens can be seen,- rom eve room TheifrontIo back master vrith t ritatebath,and vtalk indcloset fireplaeed living room with cafiiedral'ceiliags.and. . r atdittittgtoom;alllhar•e access to;the extrailarge��lec k through 3'sLders Tglie eat iu- kitchen is; to!icing-areaavuth�j%4da=of ont Arid backyards;access:to garage, .,sue . .; � - - laundry� Sf&a and'po der�room Second;ll vel feaiures 2 additional iargc+bedrooms a landrng tWith 3 pi_tctvvre inddWs a largeeUth,'Nith jkWighteand-a,btinus.rooml., y. above.the 2 carvgata a-POtlij'r features nclude,full'bouseiGenerato�rf'r'eshly-` - painted interior, tievasept ianl.~ great:ctosetc storage'spacz close^to'golf,'horse> ,ibaft ridittg�shopp "g aiid=Rt 6 - v -ff. 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OF BEDROOMS PRIVATE WELL OR PUBLIC WATER�y tBUILDER -OR`OWNER y DATE PERMIT ISSUED: (v�f �- DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No i Div ` , � g ID � - - N -` 7- FEs................�........... -a THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ................oF....'SCR,►.1�`T",�.�.1..�---------............-------- Appliration for Digpnaal 19orkii Tnnitrnrtiun Permit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: ..�....._.. . .LOT...I.�� 4.L1TI.�.:PQN.R...E* RTE1---- Location-Address Lot No. ARP..RI.GQRsAa.... EAT.... L5 .T.._... �-I.FT'LE_• !uD __ QAp ne Address ..•..... W -----------------b.a� A.G ......------------------•--------...._ 5AR9.5 AB (M ws..�n�.4) kt.... In ller Address Type of Building Size Lot46 fd_9__I._-..Sq. feet Dwelling—No. of Bedrooms....................................______..Expansion Attic (140) Garbage Grinder (No) a Other—T e of Building No. of persons............................ Showers — Cafeteria Otherfixtures ..--•---------------•--........---------•-----------------------------------------._.._...........-•-----------•----------......------•--••-----_.... W Design Flow..........r.�.......•................•__gallons per person per day. Total daily flow-__--��0.....__................_gallon. fe WSeptic Tank—Liquid capacityltOOO.gallons Length-W4...... Width4-1jP.._. Diameter---------------- Depth,5- e.... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......t............. Diameter....1.Q"------- Depth below inlet-ff,_G7.... Total leaching area.ZS7.....sq. ft. Z Other Distribution box (X ) Dosing tank ( ) °-' Percolation Test Results Performed by 4fmCPP S�tRYE4 Co�/SUGTAUTS-•--_ Date_.4-7�'8 W 7�- ii a Test Pit No. 1.... --------minutes per inch Depth of Test Plt..14 ..___.._ Depth to ground Ovate � ..........Pit.................... s.�,�. O ...................................... .. II �?�---6T-9P ZNm_--�$Go Description of Soil...-�..�?A?.....•. __.'. 4 �l l._ S__65.Q 1-•............................. .......ALLYN...... n' V _Z .p--(o0"_�314f3.- �"�1L_.... tt- ,� Qa �c�s WILSON �+ .FI.�ITC—�. L•------------------ +o.30216 W MjEDI!(JVl SANn e. '� -- Q U Nature of Repairs or Alterations—Answer when applicable.______............................................................. .e r�. 0.:AL��� Agreement: Gi v„ The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 3 the provisiot of"IT,TLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in opera ' til er ' of Complia a ha en iss d by,the boa 01 p&of health. Sin - - - -• •- ..... / Dat Application Approved By ----•-•• ........................................ -------6-'-----'- Date Application Disapproved for the f ollo ng reasons------------------------•----------------------------•--------- ----------------•----.......................... -------•--•---------------------------------•---....---------......---------------------•--•-•------------------•------------•-•----•••••---•-••••-•---•--••---••------•--•••--•------••••-••--••-•••--- Permit No ...................;?`1 .._.. Issued_ -� .9 au Date No........................ / t FE$ ...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C -4.J1�•l................OF.... R.'�,1-5TA:B.L .... Appliration for Ili,spuattt Works Tontrurtion rnmit Application is hereby made for a Permit to Construct (>(.) or Repair ( ) an Individual Sewage Disposal System at: 1.�.►Try. .. 'szl sa.Ro..-:.5A&a!5-rAaLF r AA.... _LQ-T....i.,.L.1.t1::LX---.£�?bAp... *:rA.M:r ---- --- Location-Address or Lot No. GAFx�,tC.QRJaI. „E:if jr T'tSZ"---------------_. -13T`�.. .. 1 ...R-oAp-........................................ Owner - Address W ------------------•-----. Installer Address Type of Building Size Lotn�0 .J_.---Sq. feet Dwelling—No. of Bedrooms..............,.........................Expansion Attic (Na) Garbage Grinder (t4a) WOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------••------------------------------••--•-----------••••-•-----.... W Design Flow..........16'_5............................gallons per person per day. Total daily flow-----330....................._ .gallons. WSeptic Tank—Liquid capacity1,OWI..gallons LengthB..6"... Width-/C.`.._ Diameter................ DepthS._.�'......... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......1............. Diameter----l0.�__..... Depth below inlet�6..�07.... Total leaching areaZ57.....sq. ft. Z Other Distribution box (x ) Dosing tank ( ) Percolation Test Results Performed b .'AF�Ew. QP.. �1� 4�_ ?t!($u4�T.fl�!�'`a..... Date..�'—. 7-:-. . Test Pit No. I...P.........minutes per inch Depth of Test Prt_14......... Depth to ground wate-. _ 4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wat ,�ti�'�....._..... a ••-----•---•................••-•-••••------------••-...•--•-•--•----•-•--•-----.....-----•--••-------•......-•--•-•----•......._ sue' STEPHE[�_. �G D Description of Soil-FF0L_n3T'..1.Z------ ?° �.�:!�.��..�Q.PEA.LL_ 5t.(�SQr�-------••-------•-•------------ � ALLYN x Z ....... <j A.c�_. �_�� _ �.ra_� U W ^- U Nature of Repairs or Alterations—Answer when applicable._____................................................................. ..�e�,7..._....�� OVAL Agreement: di The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed Dat`�- Application Approved By-•.. Iffollo ............ . �, ........ ......................................... •-----6 -0-- Date Application Disapproved for the ng reasons:------•-•-----•------------------------------- •--••--•-----•-------------•-•--•- ........................ ------------------------------------------------•---------------••-•----------•-------•----••--......---•-••-•••-•----------------•••-----------•-----------------..................................... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF............D.. 1• ....I.......................................... %rrtifiratr of Tontptiattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed Z)6 or Repaired ( ) by--•-....---•---•----•---••---••--•.....------•••------....-•-------------•-•---•...------------•••----•-•-----•-•......----••......•--....-------- ...------••---------•--•--•............-•-- nsta er i has been installed in accordance with the provisions of TIT E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No... ............... dated----------- ....._._.-_.-. THE ISSUANCE OF THIS C RTIF1 CATE SMALL NOT BE CONST D A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATH FAC'ORY. r.. DATE...........................................} I.. - Inspector = ----------.•-----------------------------•- — /J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH/ ...........................................OF......... ...........I` --?.'...... ......................._...._............ FEE .................... Disposal Works Tuontrurtion Vamit Permissionis hereby granted.............................................................................................................................................. to Construct ( or Repair ( ) an Individual Sekr ge Disposa Yd.tem) l at No....L.L>--.r............... �"---------�„d_..._-' ---------•- .s� ?�1 ��-�" �� Street as shown on the application for Disposal Works Construction Permit No.)52:3�... Dated.._ .'_ . ._ ................. -------------------�a,,\ ........................................ DATE......................................................................................... Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ' i 1i SOIL TEST PIT DATA: INDICATES INDICATES SEPTIC TANK DETAIL: 1 , 0 0 GiA L . DISTRIBUTION BOX DETAIL: LEACHING PIT_ DETAIL: REVISIONS: _ PERC. -S— OBSERVED NOT TO SCALE P 554 6 TEST - GROUNDWATER NOT TO SCALE NOT TOSCALE NO DATE 1 MANHOLE V LOAM 6 SEED _ NOTES. I. SEPTIC TANK SHALL BE STEEL 4. INLET AND OUTLET TEES TO BE CAST IRON, :rr NO. OF OUTLETS. -- COVER SE TP Lc)—I I Z TP TP TP REINFORCED CONCRETE. SCHED. 40 PVC OR CAST-IN-PLACE CONCRETE. TEES f-.3 BROUGHT TO FINISH GRADE OR PAVEMENT ��. GIRD. EL. GRD. EL. GIRD. EL. -I LOADING TO BE CENTERED UNDER ,MANHOL.E COVER. NOTES- 777 `%n�/ 1 ; GIRD. EL. 2. SEPTIC TANK TO WITHSTAND H 0 LO D G �_�__ �� UNLESS UNDER PAVEMENT DRIVES OR F I. DIST. BOX TO WITHSTAND H-10 LOADING 2O 1/ OF I/8' GW. EL.ND wa-r�... GW. EL. GW. EL. GW. EL. I I To ►�2•• .- TRAVELED WAYS,WHEREIN H-20 LOADING 1 I UNLESS UNDER PAVEMENT, DRIVES OR WASHED - 12r'MIN. FILL I TRAVELED WAYS WHEREIN H-20 LOADING T�PSOiL_ SHALL APPLY. U PRECAST F_ STONE j r'f I SHALL APPLY. 3. ALL PIPE CONNECTIONS AND CONCRETE MANHOLE COVER f DIST. I T FINISH GRADE I I I 1- U B S O i �-. , CONSTRUCTION TO BE WATERTIGHT. BROUGHT o -� BOX 2. PROVIDE INLET TEE OR BAFFLE WHERE SLOPE OF ¢ ti INLET PIPE EXCEEDS 0.08 FL/FT' OR IN PVC INLET PIPE o ca o 0 o cO CMc; ❑ 0,0 i PUMPED SYSTEM. a Qr ,. RA 51 2M �fi��fi L -- ----� o c GENERAL NOTES. C7 !� LT y I r--1 -` r� o d o c� Q o a NOTE: f r �� COVER- 3. FIRST TWO FEET OF PIPE OUT.OF GIST _' � . LA M ) BOX TO BE LAID EVE ►- 1 :A ° , ' LEACHING PIT TO i. THIS PLAN IS FOR DESIGN AND PLAN VIEW w p Q d cm a o a = C3 in o WITHSTAND H-10 LOADING CONSTRUCTION OF THE SEWAGE Cl ° 0 V ,. UNLESS UNDER DISPOSAL FACILITY ONLY. REMOVEABLE PRECAST .. . — I u -�0 PAVEMENT DRIVE Q __, . t• NORMAL WATER LEVEL n_� COVER w 3/4 TO L-If2 o cs"c� o c7 c� o o p , ' OR 2. ALL CONSTRUC"LION METHODS AND � t - �: >' •% TRAVELED WAY WHEREIN DOUBLE t rr .:• ►= 5.1p7�/ LEACHING PIT � - � -qo H-20 LOADING SHALLMATERIALS SHALL CONFORM TO MASS. w WASHED ❑ t= c� o cn C= ° APPLY. D.E.Q.E. TITLE 5 AND LOCAL BOARD P I I .•t PROVIDE >.. . . .... ......, o c❑ ❑ , INLET TEE t� STONE p rr I I WATERTIGHT 1 • r OF HEALTH REGULATIONS. (no f inee B _— i u JOINTS(tYR) w , p - PRECAST 1,. ♦ -o MIN. OUTLET - - _ i , a o t� tJ o ,a t1 a II D 3. ALL PIPES LOCATED UNDER PAVEMENT • 00 E NOTE 2 rl SEPTIC I�• . N LIOUW DEPTH TEE :,. �. - T ? -SEE .� � 1 �` ; , „� I I a� OR TRAVELED SHALL BE SCHEDULE � ._ TANK — I 4 '/0 -. 4 INLET I _i - �� f �/' , STRATIFIEI'i i I cki, I 4 OUTLET 1 � , ❑ c o ci o o p �' 40 OR EQUAL: E I Li l�• . l I,... i 2 a IVY !7 SAN 1r3 I ► .• .:. I - - - - - - - - - - - - - - - — ---I L--- --�� BOTTOM ON 6 DIA. of BOTTOM N LEVEL STABLE BABE O:o9u w p-p - I-iNE RAVEL _ e O 0 0 -,9 _ o u oo LEVEL STABLE D .PQ it r i nr�/riCROSS-SECTION /,dE//1 B,� /C� DIA. PLAN VIEW CROSS-SECTION VIEW NO ATER i 44 43.8CROSS-'�FrT`InN - - CONSTRUCTION NOTES: DATE: DATE: DATE: DATE: INVERT ELEVATIONS. I. IF ENCOUNTERED, Al.i. UNSui7'AE~Li= SOIL-, HA . REMOVED WITHIN A WILE TEST BY. TEST BY. TEST BY. TEST BY. SHALL E.. R ED H 1D S 4 INVERT AT BUILDING TI^J� Yy1L.�t',�h� `o1�E A'rn.QUN1} TF?,. LEACHING FACILITY (oO H AND SH.,LL F.c. >rAC,D WITH .CLEAN • WITNESSED BY: WITNESSED BY: WITNESSED BY: WITNESSED BY: _4 .INVERT AT SEPTIC TANK(In) S E � WITH TANK(out) �0 5 �:�. ;•.- .. .,AND Ar.�3 GnAVt.. IN ACCORDANCE 4 INVERT AT SEPTIC • <, fit. TITLE Y. PERC. RATE. PERC. RATE... PERC. RATE. PERC. RATE. r. �t•S i 4 INVERT AT DIST. BOX(In) 2 MIN./INCH MIN./INCH MIN./INCH MIN./INCH _ 4 INVERT AT DIST. BOX(out) �o .z_ DATUM. INVERTS AT LEACHING FACILITY: NOTES. PROPERTY UNES SHOWN HEREON WERE COMPILED VERTICAL DATUM. ASSUMED 7 u ;, , , _ DATE PRO ESS/ONAL ENGINEER - CIVIL FROM A PLAN RECORDED AT THE BARNSTABLE l��V�;.T A?" r; � 5 .JG REGISTRY OF DEEDS IN`PLAN BOOK 429 PAGE 58 , -o BENCH .MARK USED: SEE PLAN AND DOES NOT REPRESENT AN ACTUAL SURVEY ON :� THE GROUND. 'THIS TOPOGRAPHIC SURVEY WAS MADE ON `9 / 'THE GROUND BY TRANSIT AND STADIA METHOD � OBSERVED GROUNDWATER FRANK WHITING ON MAY, 1970 ELEVATION No. 2W3 CP �F�sr A`�ISt EAc© �, .3- G,- 6 7 DATE PROFESSIONAL LAND SURVEYOR R , . ` _ ,�, x . _ z -. _: { . w _ DESIGN_ . . ,. . . . _ ..v :., _ r RI_ T Ri \ _ , _ \ \ / D 'X. X � Z, 1 \ LOT ll DESIGN FLOW. \ \ \ r BEDROOMS AT O G.P.B./D .:� O G.P.D. '. o /oIp�t ,' `\. `y'{ \ ♦ \ SSA \ \ ♦� . �., .�.... .,. �n CAPRJCORN REAL�-y TRUST p \ \ \ rn S O \ \. \ ' � ,.j �� -- ��,.:.. 5q.ce� :�; The BSC Group S57.26 7 \ \ \ ,•� Q , •_ . � ; REQUIRED SEPTIC TANK. ZONE:RF Ir \ \ r ,r 0 ,% _ �" '� \ : ..,t_. ... .,._ .. -- GAL. SETBACKS J _ I 1 1 \ \ \ \ \ \ \ I i —. v, \ \ \ \ \ SEPTIC TANK PROVIDED: GAL. FRONT - 30' 1 r 1 W rn 1 1 \ \ \ \ �•- \ \ a U 1 cr \ 1 \ Cape Cod Survey Consultants SIDE J5 SIZE OF LEACHING FACILITY REQUIRED: rnm I 635 �, 1 - t .- \ \ REAR 15 1 rn 1 1 \ \ \ I \ U PL A IJO -1- 7 \_ ,F 1 /.G ._ \ 1 \ DESIGN PERC. RATE: � MINJNJCH ` _ \ \ 3261 Main Street -A Route 6A , \ i Barnstable Village MA \ ♦\ \ - \ 1 \ 02630 `.• \ \ \ \ LITTLE, - POND 617 362 8133 >~ \ \ 1 \ \ r-� � � ' \ ` \ \• \ , \ � \ \ •, \,cam . �` \ PROJECT TITLE. O � , G� • c� SIZE OF LEACHING FACILITY PROVIDED. /T � � ,1L TLE \ \ � \ ,6 \ \ � _. ., , POND rl SEWAGE DISPOSAL , t � ROAD \ � �--- --�- \ \ � \ . 3 �. \ t la ..��.�. �� ,.. � G- ,.�� .-._.._ \ \ \ . � .� SYSTEM.. DESIGN , c -� {.Of-'OSET� p)� \ �. ,;,,,, ;.; 25 . Fj. r \ \ , ram_ 501 WIDE E' .- \ � , y i..:....: �\ \ C+ ` r I �RIVATE WAY _ \ 1 -.__ - l ��— \; ioao r a , a FOR a- \� 1 \ 63.4 ,I.. .. \ \O \ \ � \ \ ♦ \ ,, , ram_ j a- - _ \� ZA \�,. LOT 12 h y \ \ \ IT i _` \ :\..,....._- \ \ !�'�i�,(. � �.. ,-�, \ \,� \ \ ,\ . � LITTLE POND \ \ \ J L 5 t3 \ O \ \ \ a \ ti �, \ 1 ,.. SCALE. l 2083 - \ .� \ ., , .._..,- \ \ :4 � z LOCUS PLAN. ESTATES c!I �. f \ x / \ r R \ B.M. EL. 100.00' C.B./D.H. AT N.W. -- _ \ \ \ �a -� � � ,.- BARNST ABLE, MA. COR.OF LOT `7. -- \ \/ \ \ \ \ \ + --- ' (MARSTONS MILLS) \ \ \ \ \ \ \ - \ \ \ \ PREPARED FOR: �I y *6 . 1 1 \ "� \ \ \ ,..\ 0 1 \ \ \ g,� / \ � � \ 1 . 1 1 � \ o -,--' LOCUS CAPR/CORN .REALTY , - FND 1 \ 1 \ 1 \ \ o \ 3 i 1 _1 63J 1 \ \ \ 1 .� \ � j TRUST \ i_ \ \ 379J0' 1 1 \ o LOT /3 \ _ . . \ ` \ \ \ IJTTLE POND \ �s / 1 / N59-56 45°W 1 1 \ \ RACE \ N/F 1 I C.B./D.H. \ \ LANE \ \, 1 h N/F \ "\� \ \ o N/F \, \ , \ CAPRIC ?N REALTY TRUST h 1 1 \ FND \ 1 0` c� \ BRIAN G.GALLO o \ 1 \ \ \ RICHARD F.PUSKIN I \ 1 DATE: FEBRUARY 27,1987 MYSTIC ( COMP/DESIGN. J . A ,Q C LAKE . \ \ ✓ CHECK- \ -- --- _ - \ ;� DRAWN: — _— - PLAN VIEW RL H SCALE: 1 = 2 FIELD: W B. B.M.EL. 63.8/ C.B./D.H. AT N.W. — --_.__--- --- -- - -- ; \ F►LE NO 3/38606SS,2D COR. OF PUSK/N LOT. ------ --- 1. DWG. NO. SHEET a ® I E1 2C �� FEET I24T lD JOB NO 3J386.06 I OF / r