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Home My WebLink About0143 LONG POND ROAD - Health r 143 Long:Pond Road ..Marstons Mills" P L� i Fimim r '^' Owl THE COMMONWEALTH OF MASSACHUSETT BOARD OF HEALTH . 7.0 .M/. ..................OF.... .? j .. . {i 3 Applira#ilin for Disposal Worko Tanotrnr#inn Vrr-nti# Application is hereby made for a Permit to Construct (4 or Repair ( ) an Individual Sewage Disposal System at: ��JJ •,.,-/Location-Address �j . . V or Lot No.� yC!L c�•�` /! �-/--•-------------•--------------------- Installer Address Type of Build' Size Lot............................Sq. feet U Dwelling—No. of Bedrooms........... ............................Expansion Attic ( ) Garbage Grinder (�- p`�, Other—Type of Building ___—__-________---___ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures -------•------------------•----- - w Design Flow-----J-A..............................gallons per person per day. Total.daily�flow............. ------------------gallons. WSeptic Tank—Liquid capacity/QMD_gallons Length...... __.... Width.-- .... Diameter_______________ Depth___--______-__. x Disposal Trench—No--------._11 ....`width.................... Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No----/__4_0a_ _ ameter-------------------- Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box (V. i) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date------------------..................... Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water......._-__-.___._------ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground a _ �dSL-irUE' water___-_______-___________ -- x ---------------------------------- Description of Soil.........SO ® re- ' ...u� . . U -------------------------------------------------------------------------------- -7--------------------------------------------------------------------------------------------------- w VNature of Repairs or Alterations—Answer when applicable.-__---____________________________________________________________________________________. ----------------------------------------------------------------------------------------------•----------------_....-- ------------- ------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed ------------------------- --------------------------- Date Application Approved By...... -/ --=---------•••-----------------------•---•-----•-----------------....._•---- ---------------------------------------- Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------•-------------•------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date Permit No...... -------------•--------------------- Issued.---- r.., Dat r •.J• �.n T. . i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. . ........ ..... . .......................... .............. ppliration for Uiipoiial Works Tonstrnrtion Orrutit Application is hereby made for a Permit to Construct (.,4 or Repair ( ) an Individual Sewage Disposal System at: ,/ <_. 1 /_i ry - 1 -Y f.•.c� Y j/.�/Y ''✓^ .r. ?•"d.T ._. J ............. ........ ._„_..___..._va-... .. ,�.� - ____________......______.. Location-Address or Lot No .......... j .. ,✓� Y f- Ali _p/ ,l+t 'r� _______________________________ Owner e ' dress Installer -= 7 _-';--_Address Q Type of Buildi,n�$� Size Lot----------------------------Sq. feet Dwellingl No. of Bedrooms._____.___ "_____________________________Expansion Attic ( ) Garbage Grinder <; per, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) G., Other fixtures -------------------------------- -- W Design Flow.........�`!a...............................gallons per person per day. Total daily flow-------------- _____-_______.-_--gallons. WSeptic Tank—Liquid capacity -eZ.gallons •Length___,___'___ Width.- _`--.- Diameter____----------------- Depth---------------- x Disposal Trench—No..................... Width------------------ Total Length.................... Total leaching area--------------------sq. ft. 3 Seepage Pit No..... ......fAameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date---------------------------------------- ,� Test Pit No. 1................minutes per inch Depth of Test Pit____________________ Depth to ground water------------------------ CZ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P ----------------------------•--------------------------------------------------------------•--------......................................................... Description of Soil---------- _ i, !; r_LR W ----------------- . = ._.... V Nature of Repairs or Alterations—Answer when applicable-----—__-------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed r :. t. --------_.. - --------------- ---- Date ApplicationApproved By----- i..:.............•---------------------------------------------------------•............... ---------------------Date-------------------- Application Disapproved for the following reasons:................................................................................................................ •--------------•-------•---------•-------------=-----------•----•-•--•--------------------------------------------------•--•---------------------------------•-----.--...-----------------------__ .. Date Permit No.... ,w' ------__-__-•--•-•---------------- Issued---- Dat THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..i :. ....:+a..,•........................... Cnrdif iratr of Tontphaurr I . ` THIS IS TO CERTIFY, That the Individual Sewage Dispo'�al ystem cons ated ( ,,,j"or Repaired ( ) Installer �» , a � at- 1 f = G=- ----•----''`=`=-r: -: s-------------------------------------------•-•-•---•-•----•--- has been installed in accordance with the provisions of Article .XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........ __r;:-' __________________ dated..-.---:__:_ . _ "' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE . .., Inspector - i THE COMMONWEALTH OF MASSACHUSETTS BOARD:-OF HEALTH �t L...r. vl',/...... . . ............... OF..... No - �- 1V..... FEE _: . Permission is hereby grantedc�� f to Construct (.,y.,<or Repair ( ) an Individual Sewage Disposal' System at No - =' ,� ----_ F ,j Street ., as shown on the application for Disposal Works Construction P pit No v_:Y Dated--------- '" 2 >c= = ` Road otIeaPt� - f DATE.--=� ---v�--�----�r---*-%�- -��,-------------------------------------•-- i FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS b d DEPARTMENT OF ENVIRONMENTAL PROTECTION d v,Q 4 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION RECEIVE® Property Address: 143 Long Pond Rd.Marston Mills Owner's Name:Bill MCN#Para MAR 2 6 2002 Owner's Address: 37 Whitmare Road Marston Mills Date of Inspection: 3/5/02. TOWN OF BARNSTABLE HEALTH DEPT. Name of Inspector: (please print)Timothy Lovell Company Name:Accurate Inspections MV Mailing Address:550 Willow Street Hyannis Ma PARCEL : �4`5--- Telephone Number: 508-771-3700 LOT t CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _X_ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signatu t Date: 3/5/02 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) i Property Address: 143 Long pond Rd Owner: Bill McNemara Date of Inspection: 3/5/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _x_ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CUR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: _N/A_ One or more system components as described in the"Conditional Pass"section need to'be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. N/A 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. ND explain: N/A Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: N/A The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 143 Long pond Rd. Owner:Bill McNemara Date of Inspection: 3/5/02 C. Further Evaluation is Required by the Board of Health: N/A Conditions exist which require further evaluation by the Board of Health in order to determine if the system 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: _n/a_ Cesspool or privy is within 50 feet of a surface water _n/a Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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: _n/a 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. _n/a_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _n/a The system has a septic tank and SAS and the SAS is within 50 feet of a private water.supply well. n/a_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and 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: Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 143 Long pond Rd. Owner: Bill McNemara Date of Inspection: 3/5/02 D. System Failure Criteria applicable to all systems: You must indicate`yes"or"no"to each of the following for all inspections: Yes No _x_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _x_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _x Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _x_ Liquid depth in cesspool is less than 6"below invert or available volume is less than'/z day flow _x_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _x Any portion of the SAS,cesspool or privy is below high ground water elevation. _x_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _x_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _x Any portion of a cesspool or privy is within 50 feet of a private water supply well. _x_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is..equal.to or less than 5 ppm,provided that no.other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described 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• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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 H 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 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 143 Long pond Rd. Owner: Bill McNemara Date of Inspection: 3/5/02 Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes No x _ 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? _x_ Have large volumes of water been introduced to the system recently or as part of this inspection? x_ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _x _ Was the facility or dwelling inspected for signs of sewage back up? _x_ _ Was the site inspected for signs of break out? 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 bales or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _x _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no x _ 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(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 143 Long pond Rd. Owner:Bill McNemara Date of Inspection: 3/5/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4. DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):_440 Number of current residents:_1 Does residence have a garbage grinder(yes or no):_no_ Is laundry on a separate sewage system(yes or no):_no_ [if yes separate inspection required] Laundry system inspected(yes or no):_n/a Seasonal use:-(yes or no):_no_ Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no):_no_ Last date of occupancy:_current COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd- Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: owner Was system pumped as part of the inspection(yes or no):_ If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _x 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) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 143 Long pond Rd. Owner: Bill McNemara Date of Inspection: 3/5/02 BUILDING SEWER(locate on site plan) Depth below grade:—3' Materials of construction: cast iron x_40 PVC other(explain): Distance from private water supply well or.suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locate on site plan) Depth below grade:_2' Material of construction:_x concrete_metal_fiberglass polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: 1000 gal tank Sludge depth: 7" Distance from top of sludge to bottom of outlet tee or baffle:_20" Scum thickness:_4" Distance from top of scum to top of outlet tee or baffle: 12" Distance from bottom of scum to bottom of outlet tee or baffle: 13" How were dimensions determined: field measurments Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Recommended pumping system every 2 years GREASE TRAP:_(locate on site plan) Depth below grade:— 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): I I Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 143 Long pond Rd. Owner: Bill McNemara Date of Inspection: 3/5/02 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_n/a (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.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 143 Long pond Rd. Owner: Bill McNemara Date of Inspection: 3/5/02 SOIL ABSORPTION SYSTEM(SAS):_x (locate on site plan,excavation not required) If SAS not located explain why: Type _x_leaching pits,number:—I— leaching chambers,number: leaching galleries,number: leaching trenches,number,.length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil;condition of vegetation, etc.): Leaching pit is 1/3 full no sign of hydraulic failure CESSPOOLS: (cesspool must be pumped as part of inspection)(Iocate 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 or no): Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) I Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): I . Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 143 Long pond.Rd. Owner:Bill McNemara Date of Inspection: 315102 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building. 1_Fl d l= H'o rn �a Sy' 37' ` Page 11of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:.143 Long pond Rd. Owner: Bill McNemara Date of Inspection: 3/5/02 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth,to ground water_13'_feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain- Checked with.local excavators,installers-(attach documentation) _x Accessed USGS database-explain: at B.O.H. You must describe how you established the high ground water elevation: Use usga map and data TOWN OF BARNSTABLE LOCATION /`13 Lo.-/6 POI O ROAl'-) SEWAGE # ``i ILLAGE A,411 5SAI IAC ,5 ASSESSOR'S MAP & LOTQA 3 p D9�V:� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /Oav G,4 L j A A//t LEACHING FACILITY: (type) (size) x 7 NO. OF BEDROOMS BUILDER OR� ��i L /e1t I►I,�?6 *� PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility s' `� Feet Private Water Supply Well and Leaching Facility (If any wells exist _ on site or within 200 feet of leaching facility) 70w'U W/d/6Peet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet yy Furnished by __ ACk o= on��. ' � b - � � I _ i �C� ; a_ gig' 3 �' SZ � � -.�� Commonwealth of Massachusetts Executive Office of Envirolunental Affairs Dept. of Environmental Protection John Gil-ad One winter Street Boston Ma, 02108 ' D.P.P. Title V Septic Inspector P.O. Box 2119 Teaticket, MA 02536 WILLIAM F.WELD (508)564-6813 Governor ARGEO PAUL CELLUCCI Lt.Governor ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A !� RECw�O CERTIFICATION OCT 2 0 1997 �► Property Address: 143 Long Pond Rd.Marstons Mills LoM15 Address of Owner: iOWNOFBARNSTABLE Date of Inspection: 10/16/97 (If different) Name of Inspector: John Graci Micheal&Stacey Boudrot HEALTHDEPT. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) Company Name,Address and Telephone Number: g L 9 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: x Passes This Inspection Is based on criteria dented InT@Is V Conditionaly Passes code 310 CMR 16.303.My findings are of how the system is performing at the time of the Inspection.My inspection does — Need/Fuyher valuation By the Local Approving Authority not Imply any warranty or guarantee orthslongavityofthe Falls septic system and any of Its components useful life. Inspector's Signature: Date: 1o/16197 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A. B, C,or D: A] SYSTEM PASSES: x I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes,no, or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of CoMpliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised=7)97) One Winter Street a Boston,Massachusetts 02108 9 FAX(617)556-1049 • Telephone(617)292-5500 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 143 Long Pond Rd.Marstons Mills Lot115 Owner: Micheal&Stacey Boudrot Date of Inspection:10116197 _ Sew,acie backup or,breakout or high.static water level observed.in.the distribution box is due to a broken, or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced _The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed 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 the public health, safety and the environment. i) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone f of a public watersupply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method usedto determine distance (approximation not valid) 3)Other D] SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an 000aded 01 ciUggdd cesspool. SAS is in hydraulic failure. (revised OMP971 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 143 Long Pond Rd.Marstons Mills Lot115 Owner: Micheal&Stacey Boudrot Date of Inspection:10116197 DJ SYSTEM FAILS(continued) Yes No 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 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or,privy is below the high groundwater elevation. k , Any portion of a 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 0427)97I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 143 Long Pond Rd.Marstons Mills Lot115 Owner: Micheal B Stacey Boudrot Date of Inspection:10116197 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: _c_ — Pumping information was requested of the owner, occupant,and Board of Health. x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal — flow rates during that period. Large volumes of water have not been introduced Into the system recently or as part of this inspection. x — As built plans have been obtained and examined. Note if they are not available with N/A. x — The facility or dwelling was inspected for signs of sewage back-up. x — The system does not receive non-sanitary or industrial waste flow. _x_ — The site was inspected for signs of breakout. x All system components,excluding the Soil Absorption System, have been located on the site. x The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees,material of construction, dimensions, depth of liquid,depth of sludge,depth of scum. x The size and location of the Soil Absorption System on the site has been determined based on The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. x Existing information. Ex. Plan at B.O.H. x Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is — — unacceptable)[15.302(3)(b)] (revised 04117)87) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 143 Long Pond Rd.Marstons Mills Lot115 Owner: Micheal&Stacey Boudrot Date of Inspection:10116197 FLOW CONDITIONS RESIDENTIAL: Design flow: 440 g•p•d./bedroom for S.A.S. Number of bedrooms. 4 Number of current residents: 4 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings,if available:(last two(2)year usage(gpd): rda Sump Pump(yes or no): No [Last date of occupancy: nla ,COMMERCIAL/INDUSTRIAL: Type of establishment: NO Design flow:0 gallons/day Grease trap present: (yes or no) No Industrial Waste Holding Tank present:(yes or no) No Non-sanitary waste discharged to the Title 5 system:(yes or no) No Water meter readings,if available: Ma Last date of occupancy: nla OTHER:(Describe) rya Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System has not been pumped In the last year. System pumped as part of inspection: (yes or no)Yes If yes,volume pumped:2000 gallons Reason for pumping: Maintenance TYPE OF SYSTEM x Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes,attach previous inspection records, if any) I/A Technology etc.Copy of up to date contract? Other: APPROXIMATE AGE of all components,date Installed(if known)and source Information: 79tt6 Sewage odors detected when arriving at the site:(yes or no) No (revleed 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 143 Long Pond Rd.Marstons Mills Lot115 Owner: Micheal&Stacey Boudrot Date of Inspection:10116197 SEPTIC TANK: x (locate on site plan) Depth below grade: Z' Material of construction:x concreate metal FRP Polyethylene—other(explain) If tank is metal, list age o . Is age confirmed by Certificate of Compliance No (Yes/No) Dimensions: L6.6"H6'7^w4'10" Sludge depth:7" Distance from top of sludge to bottom of outlet tee or baffle: 20" Scum thickness:6" Distance from top of scum to top of outlet tee or baffle:6" Distance form bottom of scum to bottom of outlet tee or baffle: 13" How dimensions were determined: Measured Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Septic tank and all components are structurally sound.Recommend pumping system every year for maintenance. GREASE TRAP:_ (locate on site plan) Depth below grade: nla Material of construction: _concrete_metal_FRP_Polyethylene_other(explain} Dimensions: n!a Scum thickness:rda Distance from top of scum to top of outlet tee or baffle:rda Distance from bottom of scum to bottom of outlet tee or baffle: We Date of last pumping;,ra Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) nla BUILDING SEWER: (Locate on site plan) Depth below grade: 2-6" Material of construction:_cast iron x 40 PVC_other(explain) Distance from private water supply well or suction line?o- Diameter: 4"_ giimments: (conditions of joints,venting,evidence of leakage,etc.) (revised 04117)97► SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address; Pond Rd.Marstons Mills Lot115 143 Long Owner: Micheal B Stacey Soudrot Date of Inspection:1ei16!g7 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: rda Material of construction:_concrete_metal_FRP_Polyethylene_other(explain) Dimensions: nfe Capacity: nfa gallons Design flow: Na gallons/day Alarm level:_nfa Alarm in working order?_Yes_No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) rYa DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: n1a Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box etc.) rVa PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)No Alarms in working order(yes or no)_Yee Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) nfa r (revleed 04f27ST) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 143 Long Pond Rd.Marstons Mills Lot115 Owner: Micheal&Stacey Boudrot Date of Inspection:10116197 SOIL ABSORPTION SYSTEM (SAS):x (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Na Type: leaching pits, number: 1,OOO gallon leach pit leaching chambers,number:We leaching galleries,number: nla leaching trenches, number,length: rda leaching fields,number,dimensions:Na overflow cesspool,number:nle Alternate system: Na Name of Technology:_Na Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) The leach pit Is structurally sound and functloning properly.It had V of leaching left and some solid¢In @.Recommend pumping every year. CESSPOOLS:_ (locate on site plan) Number and configuration: Na Depth-top of liquid to inlet invert: Na Depth of solids layer: Na Depth of scum layer: Na Dimensions of cesspool: Na Materials of construction: nla Indication of groundwater: Na inflow(cesspool must be pumped as part of inspection) Na Comments: (note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation, etc.) Na PRIVY:_ (locate on site plan) Materials of construction: Na Dimensions: Na Depth of solids: Na Comments: (note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation, etc.) Ne (revised 04127197) I f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 143 Long Pond Rd.Marstons Mills Lott 15 Micheal&Stacey Boudrot 10/16/97 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) A �yy 0C a Dq (revised04)27197) Page ! of I0 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 143 Long Pond Rd.Marston Mills Loll 15 Micheal&Stacey Boudrot 10116/97 Depth of groundwater 12, Please indicate all the methods used to determine High Groundwater Elevation: Obtained from design plans on record. Observation of Site(Abutting property,observation hole, basement sump etc.) Determine it from local conditions Check with local Board of Health Check FEMA Maps Check pumping records Check local excavators, installers X Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS Maps and Charts (revlved04R7197) page 10 at 10 L0 CAT ION SEWAGE PERMIT NO. Laiug f� !fin IRA VILLAGE tom►. � � I 1 �,, INSTA LLER'S NAME A ADDRESS S U I l D E R OR OWN ER 13 DATE PERM T ISSUED r DAT E COMPLIANCE ISSUED 1� �� ti .x LC �� q0 6 No. ..................... r FEE.............................. THE M 4_ NWEALTH OF MASSACHUSETTS BOARD OF HEALTH .... ..............................OF...............Barns,t,ab*I,e------------------------------ ............ U U ff&,Ui_qj111sa1 Works Towitrurtion Vantic Application is hereby made for a Permit to Construct (X ) or Repair an Individual Sewage Disposal System at: Long Pond Rd. (Marston Mills)..... Lot 115 ... ........................................................... . ............................................... .......................................... Location-Address or Lot No. ... Custom.-jqaRgmt.u. ....................................... ............2...F s&u 1JW.-AY P_&.....Bmckton.........?a................ Owner Address ............................ ...... ............................................... .................................................................................................. Installer Address Type of Building Size Lot.....2-0,320........Sq. feet Dwelling-&No. of Bedrooms..._.___.U .........................Expansion Attic Garbage Grinder ( Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( Ga Other fixtures ------ ............................................................................................................................................... Design Flow.......55 ...................................gallons per person per day. Total daily flow.__....... 30 I I . ....................gallons. P4 Septic Tank—x Liquid capacity..Mq9gallons Length................ Width....!k__1.0_! Diameter................ Depth.....A W Width_....-_.....:....... Total Length..............._.... Total leaching area....................sq. ft. Disposal Trench—No..................... ......�Av Seepage Pit No-------------1------- Diameter. ........ Depth below inlet....... f Total leaching area.330..........sq. ft. Z Other Distribution box Dosing tank Date......k/!Q/`.a3.................. Percolation Test Results Performed by.... ward-Boynton&Williams, Inc. Test Pit No. I.........2 .......minutesperinch Depth of Test Pit......i4.......... Depth to grou tw,. ...not. enc. Test Pit No. 2................minutes per inch Depth of Test Pit...__........-_-.... Depth to gr ....... ......................................................................................."........ .... ... .. X' 0 A- -.j9&§..on attached plan SDP Description of Soil....... ...............................................n7.8-3------------------- U ................................................................................................................................................................. ---- -------------------------------------------------------------------------------------------------------------------------------------------------- Answer when applicable---------------------------------------------- U Nature of Repairs or Alterations ,Tat . ........ .....................................................................................................................................I......................... iift--- --- -.--------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI I TJ TIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance been issued by the board of health. Certificate of Compliance s been g g ned... ............................................................................. .. ........ ........... ..... ..... ........ Application Approved BY----- - Date Application Disapproved f the ollowing reasons:............................................................................................................... ............. ................ ................................................... .............7.............................................................................................................................. Date PermitNo......................................................... Issued...................t................................... Date iP No. .... ....... Flms......4V..... ............ THErCOM `7ONWEALTH OF MASSACHUSETTS BOARD OF -HEALTH .......... own.......................OF...............liarnatable Applirntilan for Dispas tl Works Tomitrnrtiun Vamit Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal System at: Long_Pond Rd,, (Mars ton_.N!;L10__.__. Lot 115 .... .........._........................................_. •----- ...... Location-Address or Lot No. Custom carpentr. ............2---Paulin._Aue......Br�acktom........._X&................ Ilep f 9 er Address W Installer Address Q Type of Building Size Lot.....2I1,320---------Sq. feet U Dwelling x ________________ _ _____Ex Expansion Attic Garba e Grinder—No. of Bedrooms._.•..._ . p ( ) g ( ) P4 Other—Type of Building ............................ No, of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -----•------------------------------------------•-•--......-------------------------------------------------------------------------------•-•••--•---. Q Design Flow.......5�................................gallons per,person per day. Total daily flow....... 3 .......................gallons. WSeptic Tank x Lignid capacity..1000gallons Length-.-..�........ Width....4V_10". Diameter---------------- Depth......4....... x Disposal Trench—No. .:='..x..: ......... Width.................. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.............. Diameter......1........... Depth below inlet......4........... Total leaching area33 .......... ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed ... Date.....C1101 1.................. Test Pit No. 1................minutes per inch Depth of Test Pit-----14.......... Depth to grou te---not. enc. f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to gr ��r A �+ ---------------- -------------------------•----••--------------....._......._....-----•---- ---••---------G. ................ ,........... D Description of Soil.._...See soil loss on attached._g141i.._SAP-__7_b .......................'. _, ALBFRI.A....._ _ ...... U •--------------••-•----•-------------•.......--...........-----...........•--•---•-•--•••••••••----------••--•----------••--------••----•-------------.= ....PFARSQN,-1R. --•--- -----------------------------------=------------------------------------------------- .............................................................. %1/7�� .-------- ...... Nature of Repairs or Alterations—Answer when applicable- --------- . . of Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance s been issued by the board of health. gned /.--••-------------•---•-----....-•--••..._.........------•........ ----------- ate i Application Approved By `i------•-----------•--•-•-------•-.......---•-•-------•-....•----- ... ./ ij/P_.�------------ llate Application Disapproved g reasons:.•----•--------------•-------•-------------......---•--•-----------------------•-----•-----------.........••---- ....................••......•----••-----••--•----- ----------------........-------__••... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................... :...........OF..................................................................................... Trrtifiratr of fanntpHaurr TH��"S TO CERTIFY, That the Individual Sewage DispdSal System constructed (�r Repaired ( ) by �,.�.' �'�L .l. ........... �_...... - _..._.....> .. . - - ! /. Imstad'ler j'� at.., fl =::._r'",.,tr....}1'' 7Z ----==�=� ---------------------------------=---------------- has been installed in accordance ith'the provisions of l I"' F 5 f The State Sanitary Cod as ,es 'bed in the application for Disposal VVo��k Construction Permit No.- '-_ `�................... dated-. -:.11---- �_-............_... THE ISSUgN F THIS CERTIFICATE SHALL NOT BE CONSTRUE® A GUARANTEE THAT THE SYSTEM VIAL FUit, TAON SATISFACTORY. DATE. / :i: ..� Inspect �----- -- ----------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH D ...........................................O F..................................-..........----.................................... f.No. •., �---.... FEE. .................... in �a, , 1 Works Cnnnntrnrtinn rrntit Permission is hereby granted- " ; _),.-- }� - •--•------------•-•..............................................•••... to Construct ( or, epair ( _) n=Individual ewa e Disposal System at No as shown on thZap lication fo Dispo ;` -------------- Street - = Street sal corks Construction Permit ........ Dated.........................................: ............... ...... -•-•------•- -----------.........................................- [' ................................................ Board of Health DATE..... ---....-..... ........ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS I , . 1 i /F. CONCRETE RETAINING WALLS ARE SHOWN ON THIS PLAN,THEYSHALL CONFIRMATION OF CONSTRUCTION iN ACCORDANCE WITH THIS PLAN IS REOU/RED. -24"DlA CONCRETE MANHOLE BE CONSTRUCTED WATERTIGHT,WITHOUT WEEPHaES OR OTHER PERVIOUS — TNISCFFICF_ SLALL SENOTIF/ED'PRIOfR T084CMLL 0FTHESYS7FMFOR0URNVSPECT0V — FRAME AND COVER BROUGHT _ TO FINISH GRADE/S REOU/RED /8"D/A.ACCESS MANHOLE CoNs T/oN•__%110UL D THE RESERVE AREA BE BU/L T IN TIE FUTURE,IT FINISH GRADE-� 7NAY REOU%RE THE EX TENS/GH/OF THESE RETAINING WALLS. (w0 ni rn r ,r nl r n rl hnnrrlr 1 ru r it ilk r�i r rr� / ' i iir tlrt rrrr 1` 4 4UNPERFORATED N Z 2„1/8"TO l/2" i UVPERFORATED PIPE = •- .. . PIPE _ WASHED ST-AE . LIQUID LEVEL — 4 3/4„r0!-//2" O I- 7 -1 o OO�o pppp pp WASIED STVAE 4"Sched.40 a 2OD0000000 PVC.PIPE 6 I _06 aio�.%ner O SAN. -- - TEE C a 8'0„ SAN o _.00000 0 0 0 0 _:000000000 ::000000000 ( /2" OF 414"- 1//2" oOcr .oca 1 "' - WASHED STONE TANK IS 4'l0'rWIDE IA OUTLETS _.._. IOOOREQUIRED GALLON SEPT/C /ANK o ,18 DISTRIBUTION t For proper performance,septic fork should be BOX GROUND WA7FR TABLE L� inspected annually and Wen the total depth of scum Q solids exceeds //3 the liquid depth of i the tank, the tank should be pumped. SEEPAGEPITAND LINER :.PROFILE � \ Lot ll All topsoil, subsoil and irgverviaus moterid4 ifony,mast be excovoted 8 removed below the leaching area and to a 4 ' OF 3/4"70 /-//2" distance of l0 feet from al/sides of the leaching area. WASHED S7O!'VE Excavate down to 6 below the surface of the natural V \ ,/ Lot ll5 l4'pl SEEPAGE PIT w/ 4' ti /8" permeable soil. Backfill as required with cean coarse Bond t \ UNPERt�RAIED ACCESS and gravel,free from fines,clay,organic matter and �0�� w^ `�`�a+ \ 6'�Pl CpVC. LINER 3'deep 6 i \:�p� \ 8 12'of score under(330s.f.) PIPE ,,• •,.MAN�7C£ large boulders. \ � 320 REGULATION 2.17 OF TITLE 5 t / ` ,4 j01 IT PIT ' i / _ REQUIRED o f (R y0 6'D/A. LINER � � 116 /000 gallon i Lot i <_::: SEPTIC TANK 9 �o SEEPAGE PIT AND LINER N ' - —�9 `: PROPOSED e ti DWELLING a tCr PLAN , - Lot ll4 Note The desgn of this system does not permit the use of garbage ` 1 disposal units. 98 DGJll7rY No permanent structures shall be constructed over the reserve area. ` '- h 98 I ELEVATION SCHEDULE t ELEVATION TOP OF FOUNDATION /00. 00 LEACHING AREA DES/GN ANALYSIS _ FIN/.SHED-BASEMENT FLOOR_ - -92. 5G� __� -_ _ _ UP 14 REQUIRED —se - ,!= .�,�, . FINISHED GARAGE FLOOR 99— — — s8x PA�EMEN 9T 87c—s 9sx 47 3 BEDROOMS AT 1/0 GPD/BR=�QGPO �.z: �:. ocr <� x 95 SEWEfr' INVERT AT FOUNDATION 95.00 s8 x04 ®. 98 x 39 f 50/o FOR GARAAGE GRINDER = GPD 99 x 41 98x 98 98 xl3 SE6vER INVERT INTO SEPTIC TANK 9 4.70 �I POI D 6 DESIGN: 330 GPD TOTAL EFFLUENT 99 x 49 LONG,G i 98x 9 *-' z „,�,ffi•. P SEWER/NVERTOUT OF SEPTIC TANK 94. 50 99xI3 ,.. .. 98 x 72 --.. Oct? DESIGN PERC. RATE 2 MIN. INCH - SEWER INVER TIN TO D/STR/BUT/ON BOX BOTTOM, AREA _ _L S.F. x 1. OD _ l54 GPD i SEWER INVERT OUT OFDISTR/BUT/ON BOX SIDE► ALL AREA = NSF. x �,50 = : 0 GPD g8� 3 TOTAL LEACHING ARE, 330 S-F. W/CAPAC/TY OF 4 GPD SEWER/NV£RT AT SEEPAGE P/TS 9 .00 �� B.M. — Nail m U.P, l3 ELEVAT/ON OF GROUND WATER TABLE not enc. 84.8 elev. 100.00asstxn�+d SOIL EXAM/NATION REPORT EXAM/NA1T/ON TAKEN BY AL` PEARSON N,P.E.ON 6110 19 83 AND W/TNESSED BY JOHN JACOBI BOARD OFHEALTH AGENT TEST PIT NO. l TEST PIT NO. TEST PIT NO. TEST PIT NO. TEST PIT NO. GROUND SURFACE EL. 98.8 GROUNp SURFACE EL. GROUND SURFACEEL. GROUND SURFACE EL. GROUND SURFACE EL. ° ° ° ° ° PL,4/V o Loom a Permit N- 2029 2 Subsoil 2 2 2 2 j REMARKS LEGEND THE SAN/TARYDISPOSAL FAC/LfrYSHALL BE CONSTRUCTED INACCORDANCE WITH THE 3 ) LOT HAS NOT BEEN STAKED. EX/STING CONTOURS /00 /00 REQUIREMENTS OF TITLE�`OF TNESTATEENV/RONMENTAL CODEANDNO VAR/A77GYUS TYPE OF HOUSE: CAPE PAOPOSED CONMURS l00 - - FROM THIS DESIGN SHALL BE ALLOWED WITHOUT PR/OR APPt,t7VAL OF rH/S OFF,CE. 4 Silty Fine 4 4 4 „4 DUE rOSOIL COAV17/OWS,WATER MBLEELEVArION AND ACCEPTABLE MATERIAL FOUND Sand EX/Sr/NG ELEVATION /OOX00 ASSESSORS PLAN NO. CAN VARY AND MUS r BE VERIFIED PRIOR TO THE TIME OF CONSTRUCTION. C/ay PROPOSED ELEVATION 100 PLOT NO. LOTNO. 115 �- 6 6 6 6 6 ZONING CLASS/F/CAT70N. FIN/SHED SURMCE GRADE FLOW - rEsrP/TLOCAr/oN - - CUSTOM •CARPENTRY 8 8 8 — 8 8 /CERTIFY THAT THESEWAGED/SF0SAL FACIL/TYSHOWNHEREON HAS BEEN 2 PAOL IN AVE BROCKTON, MA SS. Medium DES/GNEDINACCO?D4NCE WITH REGULATIONS OF THE LOCAL BOARD OFHEALrHAND r/TLEYOFTHE STATEENV/(,'ONMENTAL CODE.., ✓o Coarse /o /o to /o N _ T ON-S/TE SANI URY DISPOSAL SYSTEM SEPT 2, 1983 _ Sand - DATE PMOFESSIONAL ENGINEER Lot 115 Long Pond Rood /2 — 12 /2 /2 /2 r DESIGNED BY: A.F. 8. o l4 no water enc. 14 /4 /4 /4 _ . DRAWN BY C F. R. Mors to n Mills Barnstable Moss. Q CHECKED BY.A.A.P./J. .W. 4S ,.. : ..' APPROVED BY-A.A.P/J.B.W. HAYWARD-BOYNr0N8WILL1A4f5, INC. PERC. TEST PERC. TEST PERC. TEST PERC. TEST PERC. TEST ;F` " r.. - , *; oArE SEPT. t, 1985 ENGINEERS SURVEYORS TAKEN AT6-75 FEET TAKEN AT -'FEET TAKEN AT FEET TAKEN AT FEET TAKEN AT FEET! SCALE 1 40 SHEET :i s e 83 / OF / m <_. . .: REvisloNs 1 r� / 140 'SCHOOL :ST. BROCKTON MASS. o A = 2 / CH RATE= M/N.//NCH RATE= Mii✓./INCH RATF= —MIN RA MIN./INCH. �/lGu�'/�'. r, R rE —MiN/N 7 BROADWAY TAUNTON , MASS. �z S ri 78.3 i r. i r , n� L ocA TE5T Pt 7— � y � 30 �J c7 A { i i i y1 t a0! 'l 1 l .5 %REFr I f ' I SCALE DRAWN BY T y REV"SEA DA T E APPROVED BY DRAWING NUMBER �J�� ALAANENIF(rtl 1C 34e-