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0114 LONG POND ROAD - Health
114 Long pond -Road Mrstons Mills -- A= 030-123 i 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. I'mpfilling out A. General Information filling out forms on the computer, Ilk use only the tab 1. Inspector: key tc move your 1 ® \ �\ cursor-do not Kevin Usilton J \ use tFe return key. Name of Inspector / �►/ � Wastewater Treatment Services VV Company Name 44 Commercial Street Company Address Raynham Ma 02767 Cityrrown State Zip Code 508-880-0233 SI 13528 Telephone Number License Number B. Certification 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 lu ion by the Local Approving Authority 3/18/15 Inspector Sign a 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 . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. Cityrrown 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. Comme-its: B) System Conditionally Passes: ❑ One or components mores stem as described in the "Conditional Pass" section need to be Y replaced or repaired. The system, upon completion of the replacement or repair, as app roved by the Board of Health, will pass. Check tl a 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 meta 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts F W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Long Pond Road Property Address David Shab Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 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 114 Long Pond Road Property Address David Shaby Owne. Owners Name information is required for every Marstons Ma 02648 3/18/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the 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•3M 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts _ v Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma' 02648 3/18/15 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 CM 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): 330gpd t5ins-313 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. City/Town State Zip Code Date of Inspection D. System Information Description: The system @ 114 Long Pond Road is designed for 330 gpd and is running under its daily design flow. The system consists of a 1500 gallon 2 compartment septic tank, the 2nd compartment has an I/A technology(FAST) system for treatment. The treated effluent flows by gravity to a distribution box were it is dosed to 2 32'x3'x2' deep trenches. Number of current residents: n/a 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)): 26gpd Detail: spoke with the water dept. and received the flows over the last 2 years verbally. They averaged 27.4gpd 2014-24.6gpd 2013 Sump pump? ❑ Yes ® No Last date of occupancy: n/aDate 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: l5ins•113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 \ Commonwealth of Massachusetts L v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: n/a t Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ® Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) 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 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 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: 3 years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3+ feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): All piping looks good, no signs of leakage and venting is good. Septic Tank(locate on site plan): Depth below grade: COTfeet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) The septic tank has a access cover to grade over the baffle wall and the I/A(FAST) system. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallon Sludge depth: 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 114 Long Pond Road Property Address David Shaby Owner Owner's Name requir required is Marstons Ma 02648 3/18/15 required for every 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 Scum thickness 0" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No signs of leakage or infiltration. The structural integrity of the septic tank and the baffle wall are in good condition. The inlet tee is in good condition with the outlet tee built into the FAST system. The liquid level is at operating level for a FAST system. The system is scheduled to be pumped on 5/27/15 and the pump out reciept will be attached to this report. 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•3113 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 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins•3il3 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 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 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 0" 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.): The distribution box is level with no signs of solids carryover. No evidence of leakage around the distribution box. There are flow equalizers installed in both of the 4"outlets to insure equal flow out of both pipes. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3113 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 Form - Not for Voluntary Assessments 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leachinggalleries number: ® leaching trenches number, length: (2)-32'x3'x2' ❑ 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.): No signs of hydraulic failure, the vegetation looks normal. No signs of ponding or damp soils. 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 ofconstruction Indication of groundwater inflow ❑ Yes ❑ No tEins•3113 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 ,w 114 Long Pond Road Property Address David Shaky Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. Cityffown 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: Dimens'ons Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3.'13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 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 t5ins•3/13 Title 5 Official Inspection 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 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 . 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: 4+. 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: 2012 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Established ground water from the design plan on record with the Board of Health. Test pits were performed by Arne H. Ojala, PE and witnessed by Don Desmarais,RS on march 28, 2012 and no ground water was encountered Before filing this Inspection Report, please see Report Completeness Ch ecklist on next page. t5ins•3i13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 114 Long Pond Road Property Address David Shaby Owner Owner's Name information is required for every Marstons Ma 02648 3/18/15 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems) completed E System Information— Estimated depth to high groundwater E 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 Al, y r ` �€ f •KV/jV'574 77 MP �• L%Jr4TR CT �.�" r >} t nii CAt1MG p�GS pJ �f k VE`R�I�FY�NG THE 'Ix '$Y a��-gr fit' •s ''t�,,yi et t t� t h 2 �( _}( pp yy y _!Y.3 Yn$ nlf 4--'.v �, s- �• �.:: •3Nr-, :7 a,{�, ,s r r+„•-s� r�� e .: .w y ,S:s,, t d `_ °R. ,a : ., ,3t •• - - __.n1\Y,UN�y -:;�^T tl: j ....:€,�. t ,.o ` SH ALL,gC .p ® r y 'X` ; ��,2,'g .� - x u ::Ys ' �1". •gPA t bi x-x `a a `F` n r r a RE j��.+.- �S � may.is]�y,a- (^` aa .�y� y�' �+Et�` F•�3 �05'"^'� {'�`�. .,r ; .sue�� � f• x - C.1 - �- a ai i y 12. �S�N xy 5 v =`ay 'k t •per s s d a y v' a ^a v rw �.w si 9 "''' c _ h % SAND. r 1,4N ov-�L s ^"a J•i*r ax,- r,z s?'=aS�,ia _ �+ + *"�T •4 '` •� =z � ° , b 41fPROVIDEA ���, y��. 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S. 4 � //�� �� s d �',#-•� �.F sr x=1 05-2 .72 rj 9�aw + - �r '=°rsa Tg 41Q5 6z t T , �i �� c 06 a x� � w`��>c �' � ��•sa"-w�} r�`�i"� ,r � s 31 � '' j rr.- "z' ;`f/ gg:,b. i a .'., � `E:. ..•�' �,,.�'^R s„ *t ze3•>y(•s'� � : �, -t } 'p � - • 44 Commercial Street Raynham, MA 02767 k Tel: (508) 880-0233 Fax: (508) 880-7232 INSPECTION AND TESTING AGREEMENT Agreement entered into by and between Wastewater Treatment Services,Inc. (herein called WTS)and the FAST®System OWNER(herein called OWNER)for thejnspection by WTS of certain equipment of OWNER which is described below. Upon acceptance of this agreement at WTS's office,WTS will render the following services only: Equipment will be inspected at least 2 times per year with the first inspections beginning These inspections will include: 1) Testing of the sludge depth in the septic tank. 2) Inspection, power testing and clean/replace intake filter of the air blower. 3) Inspection of the alarm system. 4) Inspect overall condition of FAST®System. 5) Notify OWNER of any problems encountered. 6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parts. WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 24 hours of a system failure or alarm event including corrective measures that have been taken. OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional labor time will be billed to the OWNER at current labor rates of$78.00 per hour. Emergency service between regular inspections will be provided at standard labor rates during normal business hours; at time and one-half after 5:00 PM and on Saturdays; and at double time on Sundays and holidays. Emergency service charges will include a minimum four(4)hours of labor, plus standard WTS charges for parts, plus mileage and travel charges. The annual rate includes routine maintenance,but does not include repairs required for damages caused by abuse,accident,theft, acts of third persons,forces of nature,or alterations made to the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes, labor disputes,non-cooperation by OWNER, or other factors beyond the control of WTS. OWNER understands and agrees that WTS is not responsible for special, incidental or consequential damages, including but not limited to loss of time, injury to person or property, or equipment failure. OWNER agrees that WTS may enter OWNER's property and have acceptable access to all areas deemed by WTS to be necessary or appropriate for WTS to perform its duties hereunder. Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS must receive the payment before expiration of the current contract year to assure continuous contract coverage. Failure to return payment may result in suspension of service, cancellation of the contract and/or nullification of warranties, at the election of WTS. OWNER may not assign this contract without the prior written consent of WTS. It will remain in force until a party cancels by written notice to the other at the address given herein. MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE PERMIT Bio-Microbics MicroFAST 0204933 Marstons Mills,MA $410.00 General Includes(2)Field Tests EQUIPMENT OWAX Wastewater Treatment Services,Inc. i *Signed by OWNER: �- o l_ David ShabYSigned.- � *Address: 114 Long Pond Road 44 Commercial Street Raynham,MA 02767 Tele: (508) 880-0233 *City: State:_Zip: Fax: (508) 880-7232 Marstons Mills MA 02648 Telephone ?F1'1?0_ 6V4�q Effective Date of Agreement E-mail address: OWNER understands that(1)ANNUAL RATE payment is for one year only commencing on the effective date set forth above and is non-refundable; and(2)Current DEP Regulations require OWNER to maintain a service agreement for the life of th FAST@ System. I VE READ AND UNDERSTAND THE FOREGOING. *Signed by OWNER: Field Testing Onsite testing performed twice per year will be used to demonstrate that the systems are operating at a secondary treatment standard of 30 mg/L of BODS and TSS. The following will be performed: 1) Visual examination of the effluent for color,turbidity and effluent solids. 2) Effluent pH to determine if the waste water is between 6 and 9 standard units. 3) Dissolved Oxygen,2mg/L or more,to ensure that the system is operating. 4) Turbidity, less than or equal to 40 NTU. If the effluent does not meet effluent quality standards, a grab sample will be collected for laboratory analysis. Results sent to state and local Agencies as well as the OWNER. OWNER is responsible for providing acceptable access to effluent for field testing and/or to enable a grab sample to be taken for laboratory testing performed. If such laboratory sample is required,OWNER will be responsible for charges incurred. IF REQUIRED,THE COST FOR THIS ADDITIONAL TESTING WILL BE$190.00/VISIT. Effluent Testing State requirements are two(2)grab samples per year for Nitrate,Nitrite, and TKN at a cost of$205.00/test. Water meter reading. *Approval for Testing / Owner's §ign re Operator assigned: Michael Moreau Telephone: (508)989-2744 44 Commercial Street Raynham, MA 02767 Tel: (508)880-0233 Fax: (508)880-7232 March 17, 2015 Mr. David Shaby 360A Pond Street Westwood,MA 02090 Reference: FAST®Wastewater Treatment System- Serial Number: 0204933 Dear Mr. Shaby: Attached please find the Field Inspection& Service Report and test results (as required) for services performed on 12/2/14 at your property located at 114 Long Pond Road, Marston Mills,MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures a 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsite(a)-biomicrobics.com, www.blomicrobics.com, 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home MST'System 22606 INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: 114 Long Pond Road Name:Wastewater Treatment Services,Inc. Marstons Mills,MA 02648 Owner Name:David Shaby Mail Address: 360A Pond Street Mail Address: 44 Commercial Street Westwood,MA 02090 Raynham,MA 02767 Phone: Fax: e-mail: Phone:(508)880-0233 Fax:(508)880-7232 a-mail: r INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 0204933 5/14/2012 EQUIPMENT NO.' MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating x Audio Alarm Operating x (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone 12" Aerobic Treatment Zone 12" EFFLUENT,(optional), LIMIT' RESULT Estimated Daily Flow 330 gpd pH(Standard Units) 6.50 Color Clear Temperature Odor Emily Comments: TECHMCIAIV':. SERVICE DATE Michael Oliveira 12/2/14 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 ®EP Approved Inspection and ®&M F'®Irm. for ` i le 6 I/A Treatment and Disposal Systems 22606 A. Installation David Shab Owner 114 Long Pond Road Facility Street Address Marstons Mills 02648 City Zip Mailing address of owner, if different: 360A Pond Street Street Address/PO Box: Westwood MA 02090 City State Zip Telephone Number 13. Authorized Service Provider Wastewater Treatment Services Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip 508-880-0233 Telephone Number Michael Oliveira 15621 Certified Operator Name Certification Number C. Facility/System Information 0204933 Bio-Microbics, Inc. MicroFAST.5 DEP ID Manufacturer ID Model Number 5/14/2012 5/14/2012 Installation Date Start of Operation Approval Type: [] General [] Provisional [] Piloting [] Remedial [x] General Denite Seasonal Residence—used less than 6 mo./year: []Yes [x] No D. Operating Information 12/2/14 Inspection Date Previous Inspection Date 12" Pumping Recommended []Yes [x] No Sludge Depth(to be checked yearly) 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 .. DEP Approved Inspection and OW Form for `title 5 VA `treatment and Disposal Systems 22606 F. Field Testing Field Inspection: Color: []gray [J brown [x]clear []turbid [] Other(specify): Odor: [] musty [x]earthy [] moldy [] offensive []turbid Effluent Solids: [x] no []some pH 6.50 SU DO 5.20 ma/L Turbidity 11.40 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: [] Influent [x] Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: 330 gpd Parameters sampled: Influent: []pH [] BOD [] CBOD. []TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform Effluent: [] pH [] BOD [] CBOD []TSS [x]TKN [x] Nitrate [x] Nitrite [J Phosphorus []Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter Checked Splash Recycle Notes and Comments: 2 Massachusetts Department of Environmental Protection Bureau.of Resource Protection -Title 5 ®EP Approved Inspection and ®&ICI Form for Title 6 I/A Treatment and Disposal Systems 22606 H. Certtificati®n certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the incnartinn i am a Maccachucatts certified operator in accordance with 257 CMR 2.00. 12/2/14 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 3 Environmental Chemistry Environmental Services Site Assessment _ Site Sampling Quality Assurance ServicesaVlCa1 i �al��Ce Data Auditing C O R 0 R r1 T 1 O N Mike Moreau CERTI)F'ICATE OF ANALYSIS Wastewater Treatment Services,Inc. REPORTED: 12/10/2014 44 Commercial Street Raynham, MA 02767 ORDER#: G1473145 COLLECTED BY: M. Oliveira SAMPLE DATE: 12/1/2014 TIME: 1.5:30 DATE RECEIVED: 12/2/2014 LOCATION: 114 Long Pond Marston Mills,MA SAMPLE ID: David Shaby Grab(0204933) DESCRIPTION: WATER RESULTS OF ANALYSIS Parameter � ��� Analyttcal �: Date x Units � ID`et �,,;° A „� mar : ' � Method Analyzedl t �Yn• �. � � rya' .rn .:..�.._. '� ,�. ':,r: '.. } �7r fir.%`: Test Parameters LAIR-IN: 1473145-01 Kjeldahl,Nitrogen EPA 351.2 12/05/2014 mg/L 0.50 5.10 Nitrate,Nitrogen 4110B SM 4110 B 12/02/2014 mg/L 0.50 8.53 Nitrite,Nitrogen 4110B SM 4110 B 12/02/2014 mg/L 0.25 0.46 NA=Not Applicable Timothy A. ND=Not Detected Begley `� Approved By: a o.a:muez+°rzxn 'G = Less Than Lab Manager / Date ' = Detection Limit Page 1 of 1 Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph:508-946-2225 r MAR/13/2015AE,D 06:58 AM COMM Water Dept FAX No, 5084283508 P. 001/001 1i-N(gR-15 12:03 FRONRENGPROD +15086807Z82 T-054 P.01/01 F-282 Fax 508-428-3508 To: COMM Water Department From: Sharon—Wastewater Treatment Services, Inc_ Date: March 17, 2015 Subject: Water motor readings for last 2 years 114 Long Pond Road, Marstons Mills To whom it may concern: We are In the process of performing a Title 5 inspection at the above referenced property, We need the water meter readings for the last 2 years to include in the submittal. Would you please fax them to my attention at 508-880-7232? Thank in advance for your assistance. Kind regards, Wa*ftwatp,r T'raatWe4"L 'SeX/6C-e*, . VWX Sharon Foster I 1490 Mar 2715 01:27p DeBarros Septic 508428411 PA BUJd1 � � L� DATE s Custom q �..•. ; T D PT R�� dQ�D� A?% Address: Resid ntial a.C�®mi�evc� al a End %tV� (S� post Office Box 97 Marst®ns Mills, MA 02640 508-428-1087 a FAX 500-428-1490 Phone; TOLL FREE 886-427-1087 TERMS KNIT PRICE TOTAL 1000 Gallon eV 1500 Galion ------------ 2000 Gallon 2500 Gallon Other Labor Snake Jetting Materials Tf�tal 1. Please send copies of your invoice. . _,____...:�N—i.o. AoTivary and soecificaifons shown above. 10�3i/(4 Cm New I/A System Fermat Summary Sheep (U: _ol Site Information 'ss4CH°5�� Town: Town Permit# �( Z Assessor Map/Parcel: Unique Town ID # Site Address: ( 14 C_ o Pe�c�� c± Owner Name: cA -f C_ [cea-�c� ,� 5�� l,3 Alternate Name: Home Phone: Mailing Address: Work Phone: Title 5 Information Building Type/Use: r� '� vv� Design Flow: 3 (gpd) Seasonal Use? Yes ❑ No ❑ Unknown's Bedrooms: 3 Title V N.S.A.? Yes' No ❑ Unknown ❑ Lot Size: ,1-4 q Non-standard components: Please list all components e.g. 1/A treatment unit, pump chamber,pre-and post equalization tanks, pressure distribution SAS, effluent filter, UV unit, etc., and maintenance schedule for each component e.g. quarterly, 2x/yr, annual, etc. C' P 1-s �s� (�� -v��i y,-� 2 ( e `1 U 5 F (y f " Q e� I/A Treatment Unit Make and Model # ,S DEP Permit Type: .General Pe ring i Beer-d Approval Date: `J i''Z � y COC Date: 5 I Lf 2- ❑ Provisional O & M Contract Entity: vv ( S ❑ Remedial Contract Start Date: SY 1-1 (Z Contract Duration: 2�v S El Pilot Unit Installation Date: Unit Startup Date: j /2_ DEP Permit ID#: Influent/Effluent Monitoring Requirements and Water Quality Limits Please indicate water quality parameters that must be monitored and any town mandated water quality limits;if no limits are shown, we will assume parameters and effluent limits specified in the system's DEP approval will apply. Effluent pH ❑ BOD5 ❑ CBOD ❑ TSS ❑ TN ❑ Nitrate- Nitrite Er, Organic N ❑ Ammonia ❑ TKN Fecal Coliform ❑ Total P ❑ Organic P ❑ TDS ❑ Oil/Grease ❑ Ccnductance ❑ Alkalinity ❑ Water Usage ❑ Temp. ❑ Monitoring Schedule: 4� Other Applicable Limits: Influent pH ❑ BOD5 ❑ CBOD ❑ TSS ❑ TN ❑ Nitrate ❑ Nitrite ❑ Organic N ❑ Ammonia ❑ TKN ❑ Fecal Coliform ❑ Total P ❑ Organic P ❑ TDS ❑ Oil/Grease ❑ Conductance ❑ Alkalinity ❑ Water Usage ❑ Temp. ❑ Monitoring Schedule: Other Applicable Limits: . BCDHE Tracking# Please return this sheet to: FAX: 508-362-2603 Email: bciatech@cape.com OU- rN2 �5 TOWN OF BARNSTABLE LOCATION jig LOn4 -Pena( Qd( SEWAGE# ZO)o? - JOS VILLAGE M. fy)11$ ASSESSOR'S MAP&PARCEL 30. /�13 INSTALLER'S NAME&PHONE NO. 13 d!I3 E'xeayc.4j D~ y77" OL53 SEPTIC TANK CAPACITY Sop 9c 1 Fx* s 4 gar%K LEACHING FACILITY.(type) 2-Trenc1%e5 (size) Zx3 it 37- NO.OF BEDROOMS 3 OWNER j d S K;rUct N PERMIT DATE: S'•Sl-j Z COMPLIANCE DATE: �-JS-•J;Z, 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 g�• Os ° AV 2Z No. Fee THE COMMONWEALTH O'F MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF.BARNSTABLE, MASSACHUSETTS YeS 01pplitatlon for Bisposal :Fppstrm Construction permit Application for a Permit to Construct( ) Repair(Upgrade("'� Abandon( ) ❑Complete System Individual Components Location Address or Lot No. 1111 Lon3PanD EU Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ©Z6 1 D-3 Iq Tet) S V_i rvo n rl7N �GQ1/Address an Tel Sa�'�17'�(�3 DIJOWf1 A�Q.�32'a Tel.net✓rin4 �.J Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 gpd Design flow provided gpd Plan Date 412'1/L Number of sheets Revision Date 5 ;L Title'fl+1f_ 5 1}e_Ptan Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) T s+n 0I T LA I L(' 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 o Health. Si a Date .6 (Li 12— Application Approved by Date Ap?lication Disapproved by Date for the following reasons Permit No. Date Issued . .-.-- ,_ _�.�'-vry +.-..+..J.�.+.-.�w.•w.r(n.a�.+ilrit +Y'n.n 'r- r1 r..r�..•1r�...y..l�' ... +-• .�-... - r r j l C No. / 1 Fee ` Entered in computer: THE COMMONWEALTH-OF- PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21pplicatioll for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(1X(Upgrade(1) Abandon( ) ❑Complete System individual Components Location Address or Lot No. 111 Long Non Q ( Owner's Name,Address,and Tel,No.Assessor's Map/Parcel 0 Min Ten 5 L i r vn n � �� 3 Inst4iler's N e,Address and Tel No. Designer's Name,Address,and Tel.No. I }-1 S4r— 17574 !u("1 5�� �i 17 C�C�53 Uc�v�r� cc,4�.X Type of Building: Dwelling No.of Bedrooms J Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 -3 gpd Design flow provided 1 gpd Plan Date '1 �I�i 2- 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) Tne i C-1(� rate 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 CDmpliance has been issued by this Board o Health. Signed Date -6 Application Approved by Date 5� Application Disapproved by Date for the following reasons Permit No. l Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO�CE,RTI�•FY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded •� ( ) Abandoned( )by .0 I G �- xu ,-Ira i i%n ti at jig `--U i 161 f-jU f l i) P—D has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. (,i/�'/:�Iated r Installer Igo �..� & �.�/J�I Designer U!#.%i ( '?.,G`' c @ 1 C- I i}t-,to.1/( � #bedrooms \3 Approved design flow 4 gpd The issuance of this permit/shof a strued as a guarantee that the syste will functio a d-sighe Date a Inspec or -- a No. 90J J / -Fee / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstrm Collstructioll Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at 09, L u f)&-) 'P(-)fl tD Q-0cy-4 �} �� }i;�1` ✓`'1 I 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. Provided:Construction must be completed'within three years of the date of this permit t. --- Date 5,11 / l '7�Y" Approved bye FROM :down cape engineering inc FAX NO. :15083629880 May. 15 2012 09:5BAM P1 ri Aez,:���?1"L•�1-H'' T Thom:';1". 4-ll(kr,�J<QJr�'%N::i.1�''t' (� �tatrJ�ti7'I.33T.F/�� ?-ldiffe, T11 P;a fth 6➢.Asion �: �'��ia�:.: 1'1nsr�rnda.Fa i`a�.fu:��ia�a�,�Pulrec�tcux' 200 Ma iuu 31h,re t,HvsuTnug, WA 02601 Offirx- Fax: 5,0$=/90 630'4 JaroeA�@l�en�_>�::�t'a.�e�,tn�.a° ¢;�.�auTa���uexkc di'o�'�na • Date: .arcei- '*0/ 1 1 t �• On._�'l L4 I ( wa.s is red a per..mit.to in^tall a s(rptic sy:',terrI at bJ--#''_ yLc.., C ,0 r)&;c.d on a degip_7.draWn by dated l5 I r_eli y llult the serfiu, sy"'Au a.rel:cz;ucc;ct ibcvc wgs ihis-ii lul. s-tabstat.all-y accurcl.iug ts, �.i�, Wbicli niay rnc'•lur.41, rr�;T,ur -,;pjxo-vcd c:banges sud:.:l ms latccal,relc.catiou of fhe di.,tribctlion box mid/or sc(ic:tack. L cer ify L 'it Ict Septic system i-L,feroncedl. Am, vans .lcf7taller_1 wl ll .Major. rhangn ginater than 10' la;iusl.r.-e ncatimi of the `iA:, or tarty vcatica.i.relc.r. dou.0f.9ily coT.l pollE'•r2t of tLc: septi.c. :ivStdsiu)bof iu a.ccom.Fince with SLaLm Local-'-eguhdiom,:. P1,9a aevisirm of ceitiiior a7".-built by du•:signcx 1c fbikm. DANIELA. y OJAI �S1Stc'3Lld)''3llT,llil LYI " CIVIL cn No.,i6502 a (T�r.:i1g11Ps''S ��3.( L1ti%LLLf ) (,A 1 i1:c L) si c?,r.°'a RiIrnF: E CT3.) PLEASE, ITiTt'i) t`r...Z'4V Ye,lial�3'lllD_LL�1`mr�ndRi; IF/1i_R,`9:11Q_ 1Dl!�!1lP.f.D:l°I. t�+L'sJt'9�rLd_: :[';._f71T C60iTf't';LAl�l�l%.it, VRL idii'i' "rot: iSkRUL •t1i'�TtE1 !it3't'}jt :r.' f;� flF�m cltelli .A`ro..kY T e� �,PSF . E'1 ilnalth/Grnli�Ji?:SiAULi OcirlifitmLim Pbilii 3 26 04-.d'or �.'' r 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 May 16, 2012 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Board of Health Agent Reference: Home FAST Treatment Serial Number: 0204933 Attached please find a copy of the Product Registration Report for the FAST Treatment System for the startup performed on 5/14/12 at the home of Ted Skirvan located at 114 Long Pond Road, Marstons Mills, MA. Also, attached is a copy of the fully executed Inspection & Effluent Testing Agreement. If you have any questions or require additional information please do not hesitate to call. Sincerely, Donna L. Callahan Enclosures q mV R,W s u 0 Rr � '8450 Cole Parkway 0 Shawnee, KS 66227 0 Phone 913-422-0707 0 Fax: 912-422-0808 e-mail: onsite@biomicrobics.com 0 www.biomicrobics.com 0 800-753-FAST(3278) . PRODUCT REGISTRATION REPORT Product Registration Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty. Date of Start-Ups j Date Shipped to End User 5/10/12 Serial# 0204933 OWNER NAME Ted Skirvan ADDRESS 114 Long Pond Road CITY/STATE/ZIP Marston Mills,MA 02648 PHONE/FAX B10=MI'CROBICS:DISTRIBUTOR' NAME J&R Sales and Service,Inc. ADDRESS 44 Commercial Street CITY/STATE/ZIP Raynham, MA 02767 PHONE/FAX 508-823-9566 FAX: 508-880-7232 INSTALLER;; NAME B&B Excavation ADDRESS 14 Teaberry Lane CITY/STATE/ZIP Forestdale,MA 02644, PHONE/FAX 508-477-0653 CONSULTING ENGINEER' if applicable) NAME Down Cape Engineering ADDRESS 939 Main Street CITY/STATE/ZIP Yarmouth,MA 02675 I PHONE/FAX 508-362-4541 Good Bad NA Good Bad NA ELECTRICAL PANEL(S) TREATMENT UNIT(S) Visual Alarm Operating �' Air vent clear [ Audio Alarm Operating Septic tank level 0 BLOWER(S) Septic tank meets min. size Wired for correct voltage 2f/ Q Septic tank filled to operating level Inlet/outlet piped correctly 0 Air Lift Operation ,Filter element installed 17 Recirculation tube in place Blower hood secure 0 Fasteners tight Blower works correctly. 0 WATER-TIGHT JOINTS Blower located within 100f of Treatment unit to septic tank treatment unit Air line clear Entrance tube to insert cover Air inlet screen clear Insert to insert cover [73 Blower hood vents clear Discharge line connection Factory Authorized Personnel Title: c� G Firm: Wastewater Treatment Services. Inc. Date: i Va&&va(,P^ 9Wtine2t1 Jov6 al, tj 44 Commercial Street Raynham, MA 02767 Tel: (508) 880.0233 INSPECTION AND TESTING AGREEMENT Fax: (508) 880.7232 Agreement entered into by and between Wastewater Treatment Services,Inc.(herein called WTS)and the FAST°System OWNER(herein called OWNER)for the inspection by WTS of certain equipment of OWNER which is described below. Upon acceptance of this agreement at WTS's office,WTS will render the following services only: - Equipment will be inspected at least 4 times per year for the first year with the first inspections beginning These inspections will include: 1) Testing of the sludge depth in the septic tank. 2) Inspection,power testing and clean/replace intake filter of the air blower. r 3) Inspection of the alarm system. 4) Inspect overall condition of FAST®System. 5) Notify OWNER of any problems encountered. 6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parts. WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 24 hours of a system failure or alarm event including corrective measures that have been taken. OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional labor time will be billed to the OWNER at current labor rates of$78.00 per hour. Emergency service between regular inspections will be provided at standard labor rates during normal business - hours; at time and one-half after 5:00 PM and on Saturdays;and at double time on Sundays and holidays. Emergency service charges will include a minimum four(4)hours of labor, plus standard WTS charges for parts, - plus mileage and travel charges. The annual rate includes routine maintenance,but does not include repairs required for damages caused by abuse,accident,theft,acts of third persons,forces of nature, or alterations made to the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes,labor disputes,non-cooperation by OWNER, or other factors beyond the control of WTS. OWNER understands and agrees that WTS is not responsible for special,incidental or consequential damages, including but not limited to loss of time,injury to person or property, or equipment failure. OWNER agrees that WTS may enter OWNER's property and have acceptable access to all areas deemed by _ WTS to be necessary or appropriate for WTS to perform its duties hereunder. Current WTS practice is to send OWNER approximately 10 days before expiration of the tern of the current contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS must receive the payment before expiration of the current contract year to assure continuous contract coverage. Failure to return payment may result in suspension of service; cancellation of the contract and/or nullification of warranties, at the election of WTS. OWNER may not assign this contract without the prior written consent of WTS. It will remain in force until a party cancels by written notice to the other at the address given herein. MANUFACTURER MODEL NO. SERIAL NO: LOCATION ANNUAL RATE PERMIT Bio-Microbics MicroFAST > 13 ' `; Marstons Mills,MA $720.00 General Includes(4)Field Tests EQUIPMENT OWNER /wastewater Treatment Services.Inc. * Signed by OWNER: Ted Skirvan / Signed: - *Address: A 114 Lon Pond Road S 44 Commercial Street Raynham,MA 02767 Tele: (508) 880-0233 *City: State:_Zip: Fax: (508) 880-7232 Marstons Mills MA_ 02648 Telephone S� 3�� _ �L Effective Date Agreement _ p _ E-mail address:� +� MIYI.VA0@ }44Q C6+� OWNER understands-that(1)ANNUAL RATE payment is for one year only commencing on the effective date set forth above and is non-refundable; and(2)Current DEP Regulations require OWNER to maintain a service agreement for the life of the FAS ®System. I HAVE READ AND UNDERSTAND THE FOREGOING. *Signed by OWNER: Field Testing Onsite testing performed quarterly for the first year will be used to demonstrate that the systems are operating at a secondary treatment standard of 30 mg/L of BOD5 and TSS. The following will be performed: 1) Visual examination of the effluent for color,turbidity and effluent solids. 2) Effluent pH to determine if the waste water is between 6 and 9 standard units. 3) Dissolved Oxygen,2mg/L or more,to ensure that the system is operating. 4) Turbidity, less than or equal to 40 NTU. If the effluent does not meet effluent quality standards,a grab sample will be collected for laboratory analysis. Results sent to state and local Agencies as well as the OWNER. OWNER is responsible for providing acceptable access to effluent for field testing and/or to enable a grab sample to be taken for laboratory testing performed. If such laboratory sample is required,OWNER will be responsible for charges incurred. IF REQUIRED,THE COST FOR THIS ADDITIONAL TESTING WILL BE $190.00/VISIT. Effluent Testing State requirements are four(4)grab sam s per year for the first year for Nitrate,Nitrite, and TKN at a cost of $205.00/test: *Approval for Testing Owner's Signature - Operator assigned: Michael Moreau Telephone: (508)989-2744 a n Ef1s 2+ 22 F°��r� AL 0�-�—1l 10 2 i�1L 2 c's� 'I� - .t,6 sa�'5 Notice of Alternative Sewage Disposal System M.G.L. c. 21A, § 13 and 310 CMR 15.0287(10) This Notice to be recorded and/or filed.for registration in the chain of title of the Property served by an Alternative ewa a Disposal System Alternative t 1; P y ( Sys em ).]. NAME(S) OF OWNER OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: Theodore J. Skirvan III and Christine G. Skirvan ADDRESS OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: 114 Long Pond Road, Barnstable (Marstons Mills) , MA TITLE.REFERENCE FOR PROPERTY SERVED BY*ALTERNATIVE SYSTEM [check.and complete each that applies]: X Deed recorded with theBarns t abl eRegistry of Deeds in Book .1 4 0 4 0,Page '2 7 0 _Certificate of Title No. issued by the Land Registration Office of the Registry District _Source'oftitle other than by deed [If Alternative System Owner(s)is other than Property Owner(s),complete the following:] Alternative System y tem Owner Name: Alternative System Owner Address: WHEREAS, Section 15:280 of Title 5 of the State Environmental Code("Approval of Alternative Systems"),provides for the Massachusetts Department of Environmental Protection(the "Department")to approve or certify,as appropriate, all proposals to construct,upgrade or replace on-site sewage disposal systems using alternative systems; WHEREAS,.owners and/or operators of approved or certified alternative systems are subject to general conditions,.as specified in Section 15.287 of Title 5 of the State Environmental Code, 310 CMR 15.287, and may be subject to special conditions, as specified in the Department's approvals or certifications; such general and special conditions potentially including, without limitation,requirements relating to the use of trained operators,periodic inspections,maintenance, sampling,reporting and/or r recordkeeping; WHEREAS, Section 15.287(10) of Title 5 of the State Environmental Code, 310 CMR . 15.287(10),requires that 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 and/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 [J"and WHEREAS, the Property is served by an alternative sewage disposal system. NOW, THEREFORE,Notice of an alternative sewage disposal system is hereby given for the above-referenced Property, as follows: 1. Existence. An alternative system has been installed as a new or upgraded alternative sewage disposal system, on or adjacent to the Property, and serves the Property. The trade name and model number(s) of the alternative system are as follows: Trade name of technology: MicroFAST Manufacturer Name: Bio-Microbics, Inc. Model number(s): MicroFAST 0 .5 Pagel of 2 I 2. A roval/Certification. On 12-2 9-2 010 �P [date],the Department,pursuant to its authority under the section of Title 5 as specified below, approved or certified the technology used in the above- referenced alternative system,under MassDEP Transmittal Number X2 3 2 8 31 [Transmittal Number of approval or certification]. [Check one of the following,as applicable:] _Approved for remedial use under 310 CMR 15.284 _Approved for piloting under 310 CMR 15185 _Provisionally approved under 310 CMR 15.286 X Certified for general use under 310 CMR 15.288 A copy of the Department's Approval/Certification is available from the Department in person or on- line at the Department's website: http://www.mass.jz6v/dep . WITNESS the execution hereof under seal this 16 day of MQ4 20 ['L,made by the above-named Alternative System Owner(s). y _I [A n e System Owner(s)] L Print Name(s):1ARO F J?/X194�/ f;S+ - COMMONWEALTH OF MASSACHUSETTS ss On this ]0 day of WLA ,20_13 before me,the undersigned notary public,personally appearedTheo j&Uu4 (name of document signer),proved to me through satisfactory evidence of identification,which were 'EX Very 1 gv%tom. ,to be the person whose name is signed on the preceding or attached d ent, and acknowledged to me that(he) (she) signed it voluntarily for its stated purpose. C` JOY JULIE M.MASTERSON (official 'gnature and seal of notary) " '+ Notary Public Commonwealth of Massachusetts ----------------------------------------- ------------ ------------------------------------ ?- y Q=njssioa Expires April 22,2016 [Complete the following Property Owner(s)Consent if Alternative System Owner(s)is other than the Property Owner(s):] CONSENTED TO: [Property Owner(s)] Print Name(s): Date: COMMONWEALTH OF MASSACHUSETTS ss On this day of ,20_,before me,the undersigned notary public,personally appeared (name of document signer),proved to me through satisfactory evidence of identification, which were ,to be the person whose name is signed on the preceding or attached document, and acknowledged to that(he) (she) signed it voluntarily for its stated purpose. (official signature and seal of notary) Upon recording, return to: [Name and address of Property Owner(s)] Page 2 of 2 TOWN OF BARNSTABLE .,.-LOCATION JJg [.pnq ppf-,,4 7Qd SEWAGE#;O/Q ' OR r,,,VILLAGE �. �;)f$ ASSESSOR'S MAP&PARCEL,?Q- 1,13 INSTALLER'S NAME&PHONE NO. 3 41 13 6XCo y,5j On 'q )'7-(nG:9 3 SEPTIC TANK CAPACITY t000 9c0 LEACHING FACILITY: (type) (Z) 'T"rtrlykc 5 (size) 2x3X NO.OF BEDROOMS 3 OWNER ' PERMIT DATE: N•,3. 2• COMPLIANCE DATE: - •1 Z 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 Al- �g V � 4 AZ, 2 � °. RfA R As A 13 Ay' s e' 3 3y- 5 ,�. vcn'� s ilk, Towu of Barustable P#_ �I RE rur ,v JDepartmoat of,Regulatory Services Public llee lath DivisioU Irate �/ �Z. L DARNBTAHL4 a 1 . 70-ka& 200 Pvlain Street,Hyanuis MA 02601 was� Date Scheduled_ o'� �! Time / Fee rd. Foil Szeii`ability Assessmlentfor ,fie c Disposal Pcrfonned By:__ 4Yilnessed By.; Location Address / 1 Ll / PO Owner's Name Address J Assessor's Map/Parcel; 3v ld3 Engineer's Name NEW CONSTRUCTION REPAIR � Telephone ll Laud Use. - _ Slopcs(1/0) Surface SLunes AVN Distance's From: Open'Water Body_/V /4-- ft Possible Wet.Area�f"+—It Drinking Water Well �F[ Dralha.ge Way t Property Line 21C9 ft Oilier Ft SKIl+,TIC]H, (Street name,dimensions of lot,exact locations of lest holes 8c pore tests, locale wetlunds'i f n pro)tintily to Boles) Uj co a! co cy i•^-•G ^O s Ie .} 4 - 1'urent maLeriai(geolog;icj-GT "``� �� S A`U 1�S Depth lq BeclroelL ^ � � o N Depth to Groundwater. Standing Water in 1-tote: -=�v yry `. ^Weepllig I'ronl I'it PHCB e. Estimated Seasonal High Oioundwater TT' DIETERAUNAT Off,FOR SEASONAL HIGH WATER TABLE IvIcthod Used: Depth Observed standing in obs.hole: In, Depth 10 5911 IIItJllI531. `� III, Depth to weeping;from side of obs.hole: — In. dYtlul]Jwuli .Adf uslnt nt„_� Ft. Indck Well Y i2cading Dale: 7rIndex Well laybllw_ry T r�ry�Arl_Lrfami, �_ AaJ,Ormindwmer Uvel JL�El[�.COLAJl1.0 V A�Jl S ADlllk `I<blic_ Observation Hole# �l Tinge tit 9" Depth of Perc %6 Tln'IG at 6" Slatl Pre-soak Tlme @ Time End Prc-soak 4 Rate Min./Inci'I �Z Site Sujlability Assessment; Site PB55rd_ Sih'Failed: Additional Tasting Needed(Y/N) Original; Public I-leallh Division Observation hIole Data To Be Completed on Back-----7f- - *"If percolation test is to be comiducted Y iffibi 1.00' of yveda'4nd, you must first Hotiry We Barnstable Consery;1tion Y)9v1s1011 alt least one (I) week prior to begilmiug. Q:\SCPTIC\PLRCPORM.DOC TOLE, LOG Deplh from Soil hiorizon 1rol?# Surface(in.) Soil Texture `Soil Color (USDA Soil --// ) (Mansell) 0 Mottling (Structure`hu 5tan,s'; Boulders, Con istc c ravel b�ZL/ � • 5 a y-12v S; L IvYr2 - DREP MISER VATION ROLE, LOG Depth from Soil Horizon Hole (USDA) �{ Surface(in.) Soil Texture 5ai1 Color Soil (Mansell) Mottlin Other g (Structum,Stones, 130 onsis enc r alders. _'.d� �-' C avel Depth Pram Soil S"i Soil ��®➢�' i rface(in.) Texture Soil Color. -'�— (USDA) Soil Other (MuosGll) Mottling (,structure,Stones,Boulders. C'.onsistency 9a Orwell Depth fi"om Soil Horizon �'0G, Hole # Surface(in.) Soil Texture Soil Color (USDA) Soll Other (Mansell) Mottling (Structure,Slone5; Boulders, Con Istenc_y o^�p�p�"ell ` II99®d Insurance Rate MnN Above 500 year flood boundary No Yes x IVIthin 500 year boundary No Yes. �...- Within 100 year flood boundary No� Death of PtTattnlrQilll'�/_ CCIRV ng Pqg v`lt�aterial Does at least four feat of naturally occurrin ervlou S p s material exist in all areas Observed throughout the area proposed for the soil absorption system? `�/ _ 1F not, "'hat is the depth of naturally occun-ing 1)ervious marm ihl? C�ea•tll$-- acat�o>ru • A cer'ti fy that on (date)I have passed the soil evaluator examination approved by the Department of I nvironmental.Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in �10 C1\4R 15.017. Signature �-.. . Date- " Q!1uHBTlC\PRRCr01ZM.DOC LOCATION SEWAGE PERMIT q0• VILLAGE yl& A �?S`To k") 2 INSTA LLER'S, NAME �& ADDRESS �o •J /i�o sS t-- XCAqPllq,-'7'/"� � U1-LDEQ OR OWNER " DA-T E PERMIT US t E0" 1§6 z D "AT" E COMPLIANCE ISSUED 6 L3a1f� _---- -- 4 9.�1 ' 37, iS 4 I �hrti✓� l.i��, I � , REMOTE SYSTEM PROFILE BLOWER ALL SY`�TEM COMPONENTS SHALL BE PROP. VENT NOTES LOCATION PER (NOT TO SCALE) MARKEC WITH MAGNETIC TAPE OR As el s OWNER 6" INSPECTION PORT/VENT COMPAFABLE MEANS FOR FUTURE LOCATION. 5 00l NOTE: PROVIDE RISER AND LOCKING FIBERGLASS COVER 1. DATUM IS APPROX. NGVD TOP FOUND. EL. 106.9' I PROP. TO GRADE OVER DBOX FOR TESTING PORT Ij 3" VENT PIPING (OR EQUAL ACCESS AS DIRECTED BY FAST) 2. MUNICIPAL WATER IS EXISTING �, 3 MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 105' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. z INSPECTION/PUMP- INSPECTION PORT TO WITHIN 3" OF FINAL GRADE OUT PORTS 4"mSCH40 PVC 4. DESIGN LOADING FOR ALL PROPOSED PRECAST TREATED WATER OUTLET PIPES LEVEL 1 ST 2' 2" PEASTCWE OR GEOTEXTILE UNITS TO BE AASHO H-14 5 gatµ fis �n PROP. TEE FILTER FMRIC OVER STONE 5. PIPE JOINTS TO BE MADE WATERTIGHT. 103.75' 103.5' o°o°o°°°o o°o°0°0°0°°0°0°°o°°o°n°o°°o°°0°00000000°°0°°0 °°o°°o°°o°°o°°o°°o° 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE ' °°o°O°o°° 0°O°o°O°O°0°0°O°o° °O°o°o°O°o°O°O°o°o o°o°o°o°o°o°o° ^ WASTE INLET (MIN. i S o000000 100.5 0000 000000000"000000000 000000o WITH 310 CMR 15.000 (TITLE 5.) J� 0 9 °o°o°o°o°o°o o°o°o°o°o o°o°o°o°o°o°o°o°o°u°o°o°o°o°o°o°o°o°° o°o°o°o°o°o°o° , J5 LOCU o p 3" ABOVE OUTLET) �_o0o�o 0 0_ o°o°o°o°o o°o°o°o°o°o°o°o°o°a°o°o°o°o°o°o°o°o° °o°o°o°o°o°o°o° 9$ 3j 7, THIS PLAN IS FOR PROPOSED WORK ONLY AND o �° 50" 1010.74' 100.57' 4" PVC SET AT .005'/' SLOPE NOT TO BE USED FOR LOT LINE STAKING OR ANY �akeb� R nd ON 6" DOUBLE WASHED 3/4" - 1 1/2" STONE OTHER PURPOSE. ood 6" MIN. SUMP .............a,.,e,.,.,.,q=06- 12" MIN INT. DIM. 2 - 32' x 3' x 2' DEEP TRENCHES 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. �40 .. ..... .. . . . . . . . . ... .. . 0 0 0 0 0 0 0 oe 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 . ................ a 6" DIAM. HOLE 0.5 MICROFAST WITHIN 6„ CRUSHED STONE OR MECHANICAL 9. COMPONENTS NOT TO BE BACKFILLED OR H-10 F.A.S.T. CHAMBER COMPACTION. (15.221 [2]) 47 + CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD ( 39 X SLOPE) ( 1 X SLOPE) EXISTING OF HEALTH. EXISTING LEACHING 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP FOUNDATION 18 F.A.S.T. TANK 7 D BOX FACILITY BOTTOM TH 1 & 2 EL. 95 CALLING DIGSAFE (1-888-344-7233) AND G-W ELEV. PER QUAD MAP = 51 t VERIFYING THE LOCATION OF ALL UNDERGROUND do NOT TO SCALE LATHE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ASSESSORS MAP 30 PARCEL 123 UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS WORK. PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. PROPOSED SAMPLING PORTS TO 12. EXISTING LEACHING FACILITY SHALL BE PUMPED BE PROVIDED FOR REQUIRED TESTING ACCORDING AND REMOVED OR PUMPED AND FILLED WITH CLEAN TO SAMPLING AND MAINTENANCE AGREEMENT 105.01 SAND. PROVIDED BY F.A.S.T. SYSTEM AND BARNSTABLE BOARD OF HEALTH REQUIREMtNTS. SITE IS WITHIN GP & ESTUARINE PROTECTION DISTRICTS OPERATIONS AND MAINTENANCE AGREEMENT x 105.50 UTILIZING MICROFAST 0.5 FOR NITROGEN CREDIT TO SHALL BE IN PLACE PRIOR TO ITS USE AND PROVIDE ALLOW 3 BEDROOM DWELLING ON 21,490 SF LOT SHALL BE FOR THE LIFE OF THE SYSTEM REMOTER BLOWER &xl It PRESENCE OF THE FAST UNIT MUST BE RECORDED ON d VENT WITH 104.26 THE DEED TO THE PROPERTY. 10 OWNER'S SYSTEM DESIGN: DIRECTION VENT 3 �h 99 INSTALLATION OF F.A.S.T. SYSTEM TO BE IN ACCORDANCE SHE 4.46 bb4.26 4.56 GARBAGE DISPOSER IS NOT ALLOWED WITH PLANS AND SPECIFICATIONS OF MANUFACTURER t .a / 105.17 04.7 / DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD CONC. BULKHEAD EL. 106.5 �x 04. / x 104.36 USE A 330 GPD DESIGN FLOW BENCH MARK - CORNER 6. 05.-6 t \ .00 / E)US71NG SAS AI4D O'BOX TO 4.44 \ / REMAIN .4 104.28 SEPTIC TANK: 330 GPD (2) = 660 � � \ L / (� 5.87 105.68 a�.y j\L / 104.48 O �I'fR H ✓.x 105.5G� x 104.80 104.67 USE MICROFAST 0.5 UNIT UNDER GENERAL DINITE PERMIT `AO U77tS L� 104.77 4.! \ PROP. 0.5 MI OFAST 104.80 104.64 LEACHING: k UNIT IN FAST TANK SIDES: 2[2 (32 + 3) 2 (.74)] = 207 GPD LOT 126 21,490t SF 9 of DIRT PLAYGROUND BOTTOM 2[32 x 3 (.74)] = 142 GPD TEST HOLE LOGS \ lOt, O 89 4 p`R �`04.64 / \ EXIST. ST 104.84 TOTAL: 472 S.F. 349 GPD 105.96 (REMOVE) C 105.84 ENGINEER: ARNE H. OJALA, PE, SE �N 106.14' '�'Z 105.45 104.90 USE (2) 32' LONG x 3' WIDE x 2' DEEP DON DESMARAIS,WITNESS: IRS \ ,�/ EXIST. DWELL. �Oo°ti 104.81 / LEACH TRENCHES OF PERF. SCH. 40 PVC PIPE AND STONE TOP FNDN. DATE: MARCH 28, 2012 ELEV. 106.9' 10� '' 0 105.3 / PERC. RATE _ < 2 MIN/INCH �0 \ 4 67 os 1 I�/ MA o. / CLASS I SOILS p# 13587 ?. \ 1 .08 APPROVED DATE BOARD OF HEALTH 105.12 / ELEV. ELEV. -o 05.18c' TITLE 5 SITE PLAN » 105.0' » Q 105.0' i 05.26 / Q OF A A Q x 105.79 \ x 105.72 O /,LS UNSUIT. / UNSUIT. x 105.57 SHELL DRIVE x�11b�.06 Q 114 LONG POND ROAD 6" 10YR 2/1 6" 10YR 2/1 0 \ / MARSTONS MILLS x 104.80 k 105.09 B B O \ x 105 36 10�.St / LS UNSUIT. LS UNSUIT. PREPARED FOR 24„ 10YR 5/S 24„ 10YR 5/8 \ 104.46 p B&B EXCAVATION/ c1 c, SHED l N°AMA "N�FM .f SKIRVAN T// AM UNSUIT. SILT/LOAM UNSUIT. I � yam ���j �S y` CANIELA APRIL 2, 2012 SIL �LO� � � � � � � � UAN EL <. „ 10YR 5/2 10YR 5/2 "`;'o A. i .(U OJAI :a REV. MAY 1, 2012 (ADD F.A.S.T.) 54 00.5 54 00.5 �'�� / <.` CIVIL REV. MAY 2, 2012 (DBOX NOTE) 9 6S x 10 39 No.4098 N 405 \ �S(9 '06e� �c 03 PERC S F� \ `ht \ ( off 508-362-4541 O fax 508-362-9880 C2 C2 \ 2��6ti / �o DAAIEL tiG�� DANIEsLA. cy�s downcape.com x 10 )0 Y� OJA!A dowel cope �n �Ilee�il! , Inc. CS CS 18.77' R���6 / ( OJAL.A �� . .� � P� Civil_ 8 g h; 120" 10YR 6/4 95.0' 120" 10YR 6/4 95.0' ` ,, ! °� s `0�'P �`�\ c.4o ��a �``� civil engineers Scale: 1 = 20 / ^ I �,© S e./ -� land surveyors �j 2 2 � oNat: E NO GROUNDWATER ENCOUNTERED - - 939 Main Street ( Rte 6A) zo 30 40 5o FEET DATE DANIEL A. OJALA, P. P.L.S. YARMOUTHPORT MA 02675 12_060 0 10