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HomeMy WebLinkAbout0275 LONG POND ROAD - Health �s"1Trti x 27.5L' urY 'Pc�rid Road Mar's'tons Mills A = 013 - 055 r S PSI EA e No.53LY UPC 12943 smeadcom Made In USA I 2q,05 ✓ bfruggiero@rjragonexom VICE PRESIDENT ERR J.FRUGGIERO CELL(508)951-5739 VIC FEr 1 [ RICHARD J. RRGONE COMPANY, INC.GENE �� � TORS NAPLES;I L-- BOURNE,MA (239)435-084 (508)743.9200 FAX 743-9120 III ij I I i r I _ TOWN OF BARNSTABLE LOCATION n� �`' SEWAGE# 2W-SS9� VILLAGE ASSESSOR'S MAP&PARCEL OS INSTALLERS NAME&PHONE NO. Cc-hcrca • 'Ro.Sr . Cam. sa8�7w3 920� SEPTIC TANK CAPACITY \Sb;:) LEACHING FACILITY:(type)���suset 5 (size) NO.OF BEDROOMS OWNER PERMIT DATE: \\ -Z3 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BYe— T3 O'S -S$' A,Z-Zo 6" A A3-C��' �� L A 5-1®6V . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments C M 275 Long pond rd r! Property Address Fred Hegg Owner Owner's Name information is M. M. required for every Marstons Mills Ma 02648 6/30/16 page. City/Town State Zip Code Date of Inspection •a Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your f / 76 cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain Company Name 8 Johns path Company Address S Yarmouth Ma 02664 City/Town State Zip Code 508-364-9587 S103522 _ Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7/5/16 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. q t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 l� Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 275 Long pond rd ` Property Address ` Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page.., CitylTown State Zip Code Date of Inspection A. B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not.found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310.CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System contains a 1,500 gl septic tank, a Distribution box as well as five chambers. System is functioning properly. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for.Voluntary Assessments M 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (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 M 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 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: II 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 El ® 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Long pond rd ,M Property Address Fred He 99 Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® .Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑. Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. City/Town State Zip Code Date of Inspection D. System Information Description: System contains a 1,500 gl septic tank, a Distribution box as well as five chambers. System is functioning properly. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 229 GPD .� ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy:' Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: 15ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M aft 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: None provided Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts - Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Built 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 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.): System vents through the roof Septic Tank (locate on site plan): Depth below grade: 1.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 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 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 24 3„ Scum thickness Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick How were dimensions determined? Tape Measure 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 evidence of Ieaking,Tees and or baffles in place at time of inspection. 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 um in p P 9 Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 o Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. Citylrown 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.): Tees are in place and levels are normal. 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M a 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. Cityfrown 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 Level and at normal level 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 ❑ 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 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Long pond rd Property Address Fired Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) j Type. - ❑ leaching pits number: ® leaching chambers number: 5 ❑ 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.): Soil at leaching is clean and dry Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. City/Town . 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.): No ponding no break out Privy (locate on site plan): Materials of construction: ` Dimensions Depth of solids Comments note condition of soil signs of hydraulic failure level of ponding, condition of vegetation, ( 9 Y P 9. 9 , etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments' ^M 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 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•3113 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 a 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 10+ ft feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 10/17/05 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: Test hole data on plan dated 10/17/05 Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 AsBuilt rage i ui L _ TOWN OF BARNSTABLE LOCATION L� o�1a`�ac�l t2, SEWAGE# ZW5593 VILLAGE 6Ao r4pr,% ^rl'lks ASSESSOR'S MAP&PARCEL -S INSTALLERS NAME&PHONE NO�icS�iacd S• a�o�2 Cu• y�rlcr C �1V3.9Loi SEPTIC TANK CAPACITY \f0�7 LEACHING FACILITY. (size) NO.OF.BEDROOMS , OWNER Oe' 01 PERMIT DATE: \\ -Z3 o COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility), Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED13Y^� crc-d1 B 1 -33'61 NOv.S� Caro, e 13 3-45'V A Z-Zd u A3. W L A9-�iy` 131L 11 httn:Hissa12/intranet/Droi)data/prebuilt.aspx?mappar=013055&seq=1 6/28/2016 f I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 275 Long pond rd Property Address Fred Hegg Owner Owner's Name information is required for every Marstons Mills Ma 02648 6/30/16 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information— Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Town of Barnstable �`� 39 Regulatory Services s Thomas F.Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 3/8/06 Sewage Permit# 2-(Y-)S S 9 3 Assessor's Map\parce113/55 Designer: Bennett Engineering,Inc. Installer: I�t C�1G - Address: PO BOX 297 Address: 25Fs mc,- ns SY. \ag C,- Sagamore Beach,MA 02562 �u,r n(Z-, M 0 V Z'5 7-s'Z On 19-ro was issued a permit to install a (date) (installer) septic system at 275 Long Pond Rd. based on a design drawn by (address) 1 Bennett Engineering,Inc. dated 10/17/2005 (designer) XI certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10'lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as built by designer to follow. H OF �Ss i r DONAW F. y� BRACKEN,JR. srn CML No.37071 � 9FC/STER� NAL ECG (Designer's Signature) 3�Of-0f (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUII.T CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc _ TOWN OF BARNSTABLE LOCATION. 2— �-0��, ` -c\ 'AZ, SEWAGE# L00-SS9 VILLAGE ox .6 l05 ASSESSOR'S MAP&PARCEL i INSTALLERS.NAME&PHONE NO, SEPTIC TANK CAPACITY 1ST CEO LEACHING FACILITY:.(type) (size) NO.OF BEDROOMS j OWNER PERMIT DATE: k0 -Z S LS COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY r�ncrsol J• 2rx��y":e� I I I�Z-2a ��� GC,role IR�3-f�45'6" B --76' ! AI-»'6" A 3-G3' ! z i ' qq Feer. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Migo9al 6p5tem Couotructtou 3permit Application for a Permit to Construct(7Re air O Upgrade O Abandon O ❑ Complete System ❑Individual Components PP P P Y P zs ' Location Address or Lot No. �rd�/ryJ��,i�4��� Owner's Name,Address,and Tel.No. Lt Assessor's Map/parcel � �>2�-�L P0e14ei� i OTC 0 2(-� Instal os Name,Address,=a-nde Designer's Name,Address and Tel.12)C,hWtrJ -T-, 0 ., .1. ✓� 13 �✓�T1 ;�UGi.0 r=JZ�NG Type of BjiUWg: Dwellin No.of Bedrooms Lot Sized sq.ft. Garbage Grinder ( ) Other Type of Building S 713!Z VL-—�yaN No.of Persons Showers(vj Cafeteria( ) Other Fixtures Design Flow(min.required) 0 gpd Design flow provided gpd Plan Date I �>'� O�S Number of sheets Revision Date Title V V 5,r:: Lam; !Di YPZ � s'Y5�`�Z/`� —,-9 Size of Septic Tank Type of S.A.S. Description of Soil �c7ls�Lt CLl�SS Nature of Repairs or Alterations(Answer when applicable) •— 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 al Signe t Date /f Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Date Issued a006 - _.,f Fee D �__1_\ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: , PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Rpplication for3hooal *pgtem Cony;truce on Permit `k"1 Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Z �t/� 1'ai�� CV/`p!� Owner's Name,Address,and Tel.No. _ Assessor's Map/Parcel,``',I"' (.>� r3 On 7 2 3 !LA74 O 2Gq l�st&N I�7ame,A7dress,an'd Tel"No b���� 3 Z Designer's Name,Address and Tel.No�� f� .'3 —'4� 12�Lrfio/t�� �—. 2�G o.✓� C.r�•�-�"�c, %,;.:,dv r-7 i �`.,vG�.v�,=v2�.�uC, 2SY s���v s>, i3�vr=�vt4 ri.� � f3ax 29�-- se�6���,�<�- �3%;,�•l � '. Type of Building: D 2S3 Z- a�?,(v 7 Dwellin ) No.of Bedrooms 5 Lot Size )? B sq.ft. Garbage Grinder ( ) Other Type of Building S?] VGY ZOO vNo.of Per9ns Showers Cafeteria( ) ;s Other Fixtures W Design Flow(min.required) )Dv gpd Design flow provided /, "Dc� gpd Plan Date Number of sheets Revision Date Title 67.0- 5,ram' s%�•��,� ,7,S��c,¢� SyS��'rr -! �S ,�� �.v,' /2ra�, Size of Septic Tank Type of S.A.S. 4/L C Description of Soil �7_` -71,,2 f C2,4<1 M7 Nature of Repairs or Alte at or ns(Answer when applicable) ! �7 ,,3,_ Date last inspected: t Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of alth. �-- f Signe l� ,� /I. Date Application Approved 6y Date Application Disapproved by: r v k Date for the following reasons 4 Permit No. Date Issued —————————-——————————————————— —— ——————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( __) Repaired ( ) Upgraded ( ) Abandoned( )by at � � �-f/1f/(a I�O.U�7 �r� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer 1�y�3s=,2.r 'l' . !=r2r�l(,Gir,2 C) — Designer #bedrooms �- Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system wi 1 function as''esi ed. Date ( Inspector _ --------------------------------------------- - No. Fee 93 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS P Q�3 1=igpo,qa16p.5temt Con6truction Permit Permission is hereby granted to Construct (,/Repair ( ) Upgrade ( ) Abandon ( ) System located at PaV0 4Dr¢,) [ L. C. 14� and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constructidn must a completed within three years of the date of s e it. t_ Date ) Approved by . APPLICATION FOR . PERCOLATION TEST AND OBSERVATION PITS 71 --CATION` /_0% l LO 4 -fj ILLAGE //`1/9.o770 4.7S' �`?!Le-S-� V DATE -7- 3 PPLICANT eegVA,' ��'/9G 7-r FEE TO S (Non-refundable) DDRESS TELEPHONE NO. (Non-re.f NGINEER C.VPE IV' :5 Uoey4e TELEPHO NO. ®- ATE SCHEDULED - - (Applicant' s signature). S SOIL OG UB-DIVISION NAME I-oA)4 c A)DI DATE /© L! G° 3 TIME t9.' XPANSION AREA: YES NO ENGINEER OWN WATER PRIVATE WELL BOARD OF HEALTH EXCAVATOR KETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) �. NOTES : ww 4t� Q! p� h /4 31, 0 ERCOLATION RATE: C �nio�h xt o EST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 2 S0J's> a141• 2 3 3 4 4 E� 5 _ � 5 7 7 - -- - --- ! 8 8 9 9 10 10 11 11 12 12 �! 13 14 14 15 15 16 16 UITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD %LEACHING PITS LEACHING TRENCHES ✓ NSUITABLE FOR SUB-SURFACE SEWAGE. REASONS:. OTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION RIGINAL: COMPLETED IN ENTIRETY BY P . E. AND RETURNED TO BOARD OF HEALTH OPY: RETAINED BY APPLICANT ---- ------ FeeA BOARD OF HEALTH TOWN OF BARNSTABLE 0[ppricationArVell Conotruction Permit i A plication is�ereby ma for a p it to Construct (V), Alter ( ), or{Repair ( )an ' divi ual Well at: - ,eat — --bil ------------------ Vocation — Address f Assessors Map and Parcel -------------------------------------------------------------------------------- Owne Address Installer — Driller — Address --- Type of Building Dwelling------- -�— --;------— Other - Type of Building-- -------- No. of Persons------------------------------------ Typeof Well ---- ----- Capacity--------- ___;------------------------------------------ Purpose of Well - — -—-- - ---------- -- - Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed — -_ _-- - -------- ------- g tJ— --- —— ® /data Application Approved By ----------- --- ------------ -- ` -f date Application Disapproved for the following reasons: date Permit No. Issued -- —— __—---— — -------- ------ -�--- -------------__ __ d-f date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, at t e Individual Well Constructed ( Altered ( ), or Repaired ( ) D� � �� by- l —- -- ---- - - -�;------------------------------------------------------- ---- --------- -- Installer at-- - has been installed in accordance with the provisions of the Town of Barnstable B``o,,��a��dppoff Healt rivate Well rote ion Regulation as described in the application for Well Construction Permit No.1�1�30f Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-——- - -- —__-- --- —---- Inspector--- ------------------------------------=------------------ No.----�-------------- � Fee-------------------- . - BOARD OF HEALTH TOWN - -OF BARNSTABLE 5.. Application-*rVeir Con!Wuct ion Permit Application is hereby mad for a permit to Constr_u ct ( , Alter ( ), or Repair ( )an individual Well at. t Location — Address Assessors Map and Paicel n ------- Own � � `Address J6r�[�/, f Q,• ----—------ —— — — —— — —_—__ —--- --— --— _— —--------- {� Installer — Driller Address Type of Building Dwelling — --- - — Other - Type of Building------------------- No. of Persons-- ----- -------------- Type of Well___— --- --- -- -------------- Capacity--------------- Purpose of Well --------- --- — ---- --- ` Agreement: • The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed d ------- _ — — date Application Approved By date Application Disapproved for the following reasons: ----------------------------------------------------------- --- ------ date Permit No.--- -- - -- - Issued----------------- �- "-�-— --- -——— date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f compliance THIS IS TO CERTIFY,Piat the Individual Well Constructed ( I/Altered ( ), or Repaired ( } _--__-- --- - --- -- -- ------ -------- j - TInstaller J1------- � ---- - 1 --------- has —-- ----___- been installed in accordance with the provisions of the Town of Barnstable Boa d of Health Private Well Protection Regulation as described in the application for Well Construction Permit No.W-90- '1�Dated— � �"�� T �- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------— —-- -- Inspector -- BOARD OF HEALTH TOWN OF BARNSTABLE t No.-V. Fee--------� --- � CD Permission is hereby granted - p to Construct IX,Alter ( or ep��air ( ))�a�ndivi ua Well at: No. -- —) ,_ — Street IJ — ——— ——— — —as shown on t e application for a Well Construction Permit No.---'fir=, `_�— ---—- ----- Dated Board offHealth DATE -—� D------------------------------- G/1ZSS - G 1 { le_ ' s _ be ig42 L ' t 'rvis� �� � � ilvs-s-� •�-to• i3tx- 9 , - t A. e tell ' om. nttwwna,:wwEw .......... w- _...... 1 4 •-mot, _ --- Fl AL . i 1 • r r — `X/ TVT .—... ray ._ ...__ ..- ---- --•— _ i--Tt• i—i j u,rrE'S t r . .v.wovec ow.wwa�fJ`. 340 3vLi _ cu �! U-0, i :_ a� 6 d�' I 771 ; p � � A• SCMA or: •__•-- -' -- - -- - - - ... , ..,ate �,.�;«,. ,.� . • f i - - b ,.ram• �r9 .0 0 - - r - ��rtSel—"D"stl Ir '„-77 Al 77 W. 1 t- � Za.•o - ". f + ��r---'-- - -- --- - . � - ,dam G• .. z412 Z_ - • ,o 1 � - - I .r f „ Fs 5'le e` L i 77 ...-.. - - __.._ I � � F , a r M W O �o� 1.4•'' O jj ------------------------- Iv - _ - � RNENp t O 1 ir 7-1 t •�.zs.+.zai 77 DATE 1.5 _ az Y . . �•.:'. fit+ '- � - 1 h 77.7 .. R E. REXF- 1+1 r-T - _ s _ an u v i� gHppg p c SO 777 n { x c _ r 't 1 1 7 4 rn i. k� a'. - �, r t r �� iyEsl-b _— i ! , t p a�rnrar�� r C - CM ; - _ a t . 2 m K, , fT EE jW �}}:.0 2 - � K� _i.,. �-- - `-� •_$'%.4a '& .'is. arc^ - - .-- �11-.E�"'�_ —_ - - _L : �,, ,1 : 21 x .: .. -. :. _ �.� a'�",�'���•+'s, . r—BcC-t� lA���— — w- �- 'Y k s � -; _�,-.-tea' —. nm`�: �--_ On s � � h -'+... '+v+••'�J'l lam- C,.. — �,� � 'a°sY �.YMM1�TC�XM�-��� .. - s .��� +�a-F- -.�k'`�,•\vim :.,sw94 r -.h .. -+.n` ..rr•J '-? r,a1- .,3 7, a k K - , ',-v' `:,,'s�'rd-- - -,wit ...- ---.. .-•---------- �-y airs• xt � �x w � �; ---t—M1'�- Y .. r /R DESIGN CALCULATIONS 11 5 BDRMS ® 110 Gal/Day N F / 550 GAL./ DAY ARE REQUIRED WILLI HOUSE #245 \ �AM f-1A1'WARD a� CAPACITY PROVIDED: SEPTIC TANK: _- 2 DESIGN FLOW = 5.io Gal/Day X 200% i --_-- SITE 6 REQUIRED SIZE = 1,1o0 Gol/Day SIZE PROVIDED 1,500 Gal/Day � --- LEACHING FACILITY: DESIGN PERCOLATION RATE: s2 MPI O SOIL TEXTURAL CLASS: CLASS I LONG TERM ACCEPTANCE RATE (LIAR): 0.74 GPD/SF 525.26 N F �kp y SIDE AREA: 2'[2(48.5')+2(1 o'-10")]= 237.32 SFF WILLIAM 1--1. AND 2� TOTAL AREA- 762.58 SF GalCARMELLA A. ECHOES LOCUS x LTA 56043 Gol/Doyy/SF �, TOTAL CAPACITY = 1-` SCALE: 1"=800'± I _ HOUSE #259 SYSTEM IS NQI DESIGNED FOR A GARBAGE GRINDER i LEGEND rn TP \ / i Q� DEEP OBSERVATION HOLE ^� BENCHMARK: PROPOSED GAS LINE /1o�i t PT \ CBDH FND. EL. =�,7 EXISTING SHED (APPROXIMATE LOCATION)I t 0 Q PERCOLATION TEST TO BE REMOVED �� t CBDH FND '�j x112.49 EXIST. SPOT GRADE CBDH FND L _ - I = - _..- -- \ O LO rn \ rni `I H E N '34'47"E 4 5 - - _ - - -- - - - - - - - I \ CBDH - -110- - EXIST. CONTOUR 9 - - - - 16' GRAVEL DRIVE, - FND \` 16' PROPOSED GRAVEL DRIVE PROPOSED WATER LINE (APPROXIMATE' LOCA_TION� - _ - - - - - W- - - - W --S -- --�- PROPOSED CONTOUR I \ / - sig, -� W - W W 1 O W 10' MIN. , I OH OHW 1oa.sx A oHw oHw oHw - o w-�-- oHW PROPOSED SPOT GRADE E E -��- E E -- OHW PROPOSED ELECTRIC LINE APPROXIMATE LOCATION / � / -W WATER LINE PROPOSED �r /101� \ - E - UNDERGROUND ELECTRIC UTILITY / \ �� • �O \ \ \ t /�� / POLE (TYP.) OHW \ OVERHEAD WIRES 1 �o #2 5 \ ' t \ \ W� O ORY �l qR t // oo ��\�� 6- G GAS LINE i \ \ \ RqM� qG / ��011 0 I, ` \ PROPOSED RESERVE / LOT 11 1 \ T.O1HOUF C= 101.0\ \ 1 � AREA / 171 ,798 SF f 0 � 00 1 \ \ \ Vo 553.51' \ \ 1� \ PR9POS tDIt g9� 100 \� CBDH c^ Z Ng,3.05 .. � `'�. ', \ `\ `\ \ \\ 1 ��/ POQL I PROPOSED � � 589.74.�.... � • \ \ 36 W � I � LFIACHING � ` 55 W 3' 30 S f _ -- I/2" HANDLE 4" SANITAR'Y \ ` �� TEE �s � � 1 \ � FLOOD ZONE.: - -�-- N T o ' �' " N/F ENTIRE SITE IS LOCATED IN FLOOD ZONE C ON MAUREEN E. GATTO FILTER i l 1 / FLOOD MAP 2500010015C • CARTR,DGE �. EFFECTIVE DATE: 8/19/1985 s9 PIPE EWER ( SH OF MOF ass CBDH FND -- N/F �s' DONALD F. 9sy T1AAOTHY HOUSE #2 91 I -- ---- - I DAViD P. BR BRACKEN, BENNM __.,� CPDH FND FILTER HOUSE #295 /--GASKET f NAL ZABEI_ A1800 RESIDENTIAL SEPTIC TANK GAS BAFFLE �� l�- d EXCAVATION NOTE. DATE _DESCRIP_TION - - INIT. EFFLUENT FILTEP, SPECIFICATIONS -� APPLICATION: SINGLE FAMILY HOMES, REVISIONS FLOW RATE: goo Gr�D. CONTRACTOR IS TO REMOVE ALL LOAM, SUBSOIL AND OTHER r25' WIDE) _ INSTALLATION- THE A1800 EFFLUENT FILTER \ -- ----- - -- "--` 0 20 40 60 UNSUITABLE MATERIAL TO C1 LAYER IN THE AREA BENEATH AND FOR 5FT. ON ALL SIDES OF - CARIRIDGE. WILT_ rlT ANY 4' SANITARY TEE AND ( ) V Y SEWAGE PIPE. USE AS A SEPTIC TANK OUTLET �...�-- -I�.J----L.�I---------------- -I I THE LEACHING FACILITY. EXCAVATED MATERIAL IS TO BE REPLACED WITH CLEAN BENCHMARK DESCRIPTION BAFFLE. EXTEND THE SEWAGE PIPE AT LEAST ---���'--�_ r --------------- METERS COARSE SAND FREE FROM CLAY, FINES, OR OTHER UNSUITABLE MATERIAL,' N/F ONE INCH 91:LOW THE UOI TOM OF THE FILTER - - ______.__________ - - F LET CARTRIDGE GASKET. IN ACCORDANCE WITH 310CMR 15.255(3). ROBERT H. AND CBDH - FOUND EL. _ 0 a0 80 120 160 QUEST!ONS: CALL 1-800-'2.21--5742 - -_-_-E---- GRAPHIC SCALE 1 " = 40' CAROL HAZELTON PLAN OF SEWAGE DISPOSAL SYSTEMJ� �f�OP.-TO NOTES AND SPECIFICATIONS _ TEST Pl INFORMATION DEED REFERENCE OF FOUND EPuoi�l, t:p-` - BRING RISER TO DEEP OBSERVATION HOLE LOG 1 DEEP OBSERVATION HOLE LOG 2 INSTALL RISER TO WITHIN 6"OF � CGVM FROM "'� � 50� no(S1R1'C W ERT # 149589 1 01.CI FINISHED GRADE WITHIN 6" OF SURFACE sou OTIIEA(SiRI1CTtIfI� - "-" -- 99_?� - FINISHED GRADE FINISHED GRADE 1. All risers are to be made watertight. SOIL TEXTURE COLOR SOIL soft. TEXTURE COLOR SOIL g FEEET INCHES SIpIES BJlN1EK' FEET INCHES STOIES BDJIDERS L i' HORIZON USDA (MUNSELL MOTTllNG �,�.•x pG1Q � HORIZON (USDA) (MUNSELL MOTTLING OOM�hIIC'4 x�� 2. All pipes to be Schec. 40 ore equivalent. EL- as. (USDA) TOP EL- sa.o FINISHED GRADE p p - - PLAN REFERENCE / 99.0 MIN. BRING RISER TO 3. All joints are to be made Watertight. 11 - 1 A SANDY 6-21' 81 S+WDY .5YR 5/8 7-20' Bt SYR 5/8 - WITHIN s" of 4. All stone Is to be double washed. LOAM LOAM -------- L.C.P. 37493-B ! - FINISHED GRADE FINISHED GRADE 99.8 MAX. 5. All components are to have a minimum of 9" and a maximum of 36" of cover. 2 21-35" 82 SILT, OYR 6/B 20-40" 82 SILT OYR 6/8 EL. = 98.0 �- 6. The contractor is to verify all elevations and utility locations prior to construction. Any differences 35 LOAN 3 LOAM _ __-__-------_.--.____.___._•__ ON OF shall be brought to the attention of the engineer. 0 4 PRoPo SOIL L= 10' FT. 3" MIN. 3" MIN. ABSOR TION t 1-E-v, S= 02 FT/I- r - - " - - L=48'-6" 7. There are no conflicts with Title V, Section 15.220(4)(k) - location of public and private water 5i, 5 sYsTEM CURRENT OWNER aC APPLICANT S= .00 FT/FT supplies. U_'; ,; � } 6" 12 + I L= 53' FT. FREDERICK A. HEGG - - 1 i 3 L S= 01 FT/FT -�-- TOP ELEV. = 96.8 are no own sources of waters , streams or drains within 100 of the proposed IL MA 0264COARSE _ --------------- S. There known supply,1 723 _r_� s P.O. BOX __ _ _ ._-_ �--2• ....... e p o 6 MARSTONS MILLS, - - - - -� --- __ 2, •�°•o ;°• 000 0 000 4.e3'X e.5' LEACHING CHAMBERS 000000 0 • ° ° ° 9yThere are no wetlands within0 ' f the proposed stem °-125 c / or1R 6/6 7 126 c �D oYR 6/8 c7ao oaa o00 ❑ao 7 2 0 o h p opose system, 8 SAND 8 \ I 14 * 6 :90 :. oaa a 0mo 5 REQ'D.) (SEE SECTION) ado 0 000 • °J MIN. f- - °' 10. A new 1,500 al. septic tank is to be installed. _--4'0" MIN. -. g h g 9 \ LIQUID DEPTH CORROSION 11. A Zabel Filter is to be installed at the outlet end of the tank. 10a 10 ON-SITE SEWAGE DISPOSAL SYSTEM = 86.58 Et_- 88.5 i RESISTANT D8 INLET INV. 111 11 GAS BAFFLE -� 96.2.2 48'-6" ; U< E ;,J,�E,���,, 275 LONG POND ROAD OUTLET INV. BOTTOM CHAMBEKS 2. 2 B 96.05 94.0 INSTALL TEES IN ACCORDANCE 1MTI-1 TITLE 5 NO �.w. FOUND N . . N MAP 13 PARCEL 55 / LANK INI t l INV. 5'-6" INVERT ELEV. (2% Min.) Finish Grade SOIL EXAMIINAnON PERFORMED BY THOMAS ROUX SOIL EXAMINATION PERFORMED BY :THOMAS ROUX { l rAr1K OUT-INV. 96.0 Compacted Earth Fill BARNSTABLE , MASS . P-.-- -------- - - ..�, 96.75 INVERT ELEV. --- -- ��� � T 12" Min. 96.0 MIN. OF 2" OF oo'ootfiv�°00 -- -- -- -= --- --- o p'p 0 0 0 4„ (0.25')NO GROUNDWATER DOWN TO 88.5 WASH TO W/2" °° WASHED STONE. o ° °° ° 24" PERCOLATION TEST DATA BENNETT ENGINEERING 00 0000 00 000 .000�00 00 00 N0. DATE ELEV. SATE NOTES LAND SURVEYING,ENGINEERING,&DEVELOPMEN'TSERMLS ----- - PROPOSED I `-I'J�:! GALLON PRECAST CONC. MIDI .._-_..-__.---..._.. 1 10 13 0 5 9 9 2 M P I PRECAST CONC. SEPTIC TANK DISTRIBUTION BOX SOIL ABSORPTION SYSTEM 3/4" TO 1-1/2" I I H-10 LOADING I 2 10 13 05 99 2 MPI PO BOX297 ---- FAx (�;0B) 888-48CD3 ' WASHED STONE. 3' - - 4.8' 3' SAGAMORE BEACH, MA 02562 FAX.(Ei0E3)88f3�1£3c�7 I DRAWN BY: TCR -DATE: 10/17/2005 SYSTEM PROFILE not to scale SECTION (not to scale) WITNESSED BY: DONALD DESMARAIS REVIEWED BY: DFB SHEET N0. w,_ Igot 1 ........... Q70-AAA W""FO Sol,;U � V7 0­izv� Liz . :n mot T P­ 0 oil" FT;� IN.*,,�iz'Flo Hh"0 SOIL SE ONO ""Con Nit S,CREW -ion L V OtACOLAT16W AATE,.."isrN. 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