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HomeMy WebLinkAbout0291 LONG POND ROAD - Health 291 Long`Pond Road Marstons Mills A = 013 056001 i Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M < 291 Long Pond Rd Property Address P Maureen Gatto ' Owner Owner's Name information is rX Marstons Mills Ma 02648 5/8/2015 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any t way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information 16 K-7 on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. S.M.Jones Title V Septic Inspection Q Company Name 74 Beldan Ln. Centerville Ma 02632 City/Town State Zip Code 774-248-4850 smjonestitle5@gmail.com SI4522 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 5/8/2015 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information required for every Marstons Mills Ma 02648 5/8/2015 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The dwelling located at 291 Long Pond Marstons Mills is served by a Title V septic system consisting of a 1000 gallon septic tank, distribution box and 5 hi cap infiltrators. The system was found to be in proper working condition at the time of inspection. 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 p e e st g tank is replaced with a complying septic tank as approved b the Board of Y 9 PP Y Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M SVBy,a 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Cityrrown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year RIOT 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ Z 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? ® El 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? ® El Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 381 gpdprovided t5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Citylrown State Zip Code Date of Inspection D. System Information Description: 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 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Cityrrown 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: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 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: system repaired 11/19/03 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.5 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(cn condition of joints, venting, evidence of leakage, etc.): Joint were ok, no leaks, vented through the roof Septic Tank ;locate on site plan): Depth below grade: 1 feet Material of construction: ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: 6" 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 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 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 3" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? opened covers, took measurements Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank should be cleaned soon and again every 2 years for proper maintenance. Water level was even with outlet, tank was not leaking and was structurally sound. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 I Commonwealth of s Ma h sac usetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 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.): 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box was in good condition, no rot, water level was even with outlet invert. 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5 hi cap infiltrators ❑ 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.): s.a.s. consists of 5 hi cap infiltrators in a 11'x38'trench. Leaching facilty was observed to hav 3"of standing water in the observation port with no sign of past hydraulic overloading. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts — Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 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 t`h30.rs s1- J c a ('rO4 i 0 d v A ko si 2s Q+o s+ 3 G p Qio paox 'O V)40 Qioo bsery��►a� yy o��erv�itu„ I I i t5ins•3113 Title 5 Official Inspect;,;F-„rz Sewage Diyposai S _ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 N 291 Long Pond Rd Property Address Maureen Gatto Owner Owners Name information is required for every Marstons Mills Ma 02648 5/8/2015 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: 12'+feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. Design plan with test hole date of 3/15/1984 indicates that no groundwater was encountered at 12'. Bottom of s.a.s. is 6' below grade. 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M '< 291 Long Pond Rd Property Address Maureen Gatto Owner Owner's Name information is required for every Marstons Mills Ma 02648 5/8/2015 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BA�RNSTABLE � LO 'AUON �-I U./ A-1 �W SEWAGE # C�20411-3"� VILLAGE_ P1"�r15 �s A / i� ASSESSOR'S MAP & LOT Z/ f- -� INSTALLER'S NAME&PHONE NO. S C o 1-a-Wl k SEPTIC TANK CAPACITY Q V I t5"/ 16 O® �. f LEACHING FACILITY: (type) Tr-\V�HrKiU/ H.7® (size) NO,OF BEDROOMS BUILDER OR OWNER PERMIT DATE: 9 Ids/03 COMPLIANCE DATE: Separation Distance Between the: Trlaximum Adjusted Groundwater Table to the Bottom of Leaching Facility U Feet Private Water Supply Well and Leaching Facility (If any wells exist / on site or within 200 feet of leaching facility) / 7 Feet Edge of Wetland and Leaching Facility(If any wetlands exist �) widdn 300 feet of leaching facility) v� Feet Furnished by a Li p Pi6�C U Jens fr�2 r p: t No. 2V03 I( FEE COMMONWEALTH OF MASSAC14USETTS cc Board of Health, APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgrade(t<�bandon( ) - ❑Complete System Components Location Owner's Name /1n t k V 1 Z_ j 14 I Map/Parcel# Address ��j �G9�n 1—c/, 6 Lot# Telephone# Ir'staller's Name �A 1-\ Designer's Name \ yq v �e S u/V e dew S C Q Vl Address ` 4 Address �� v�cl�S� �� �yM�92C1' i j I5 Telephone# Telephone# Qj -s' S 5 Type of Building Lot Size 87 sq.ft. Dwelling-No.of Bedrooms Garbage grinder 0 r Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) l gpd Calculated design flow 3 d Design flow provided J I gpd Plan: Date Se 2T 2,00 3 Number of sheets Revision Date Title SE'lJ�t C_ ��q e ea.C�� (� r4 v✓ Description of Soil(s) �� Sc-e C Ate' / Soil Evaluator Form No. ®� Name of Soil Evaluator ^— Date of Evaluation 3 z//' y DESCRIPTION OF REPAIRS OR ALTERATIONS rip �Uy \ t The undersigned agrees to install.the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agr es to not to place the apom until a Certificate of oi}ipliance has been issued by the Board of Health. Signed Date V/ 0 y OV� S ZS 3 Irispecdons . FEE 5 �. 1 G ✓ Board of Health, _/"�1 S���7 Q MA. APPLICATION FOP, DISPOSAL SYST M CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgrade({'bandonO - ❑Complete System WArf6ividual Components Location a� G(a h �n /�a,,q� Owner's Name /h t �C V l L / N IV Map/Parcel# $. — f M Address i ate./ [�� :2 Lot# Telephone# + Installer's Name �..� Designer's Name 14 t+V klY' S eCAA-�G Cykl o Address ��_...��� NV� Address !eox, ir►c1••t� �.1''/�^dq/CC S „�;/� Telephone# Telephone# Qi-t- 4 66. Type of Building Lot Size 8-7 I sq.ft. Dwelling-No.of Bedrooms * Garbage grinder (f) r -1 l uwlf7. Other-Type'of Building ` No.of persons.` . Showers ( ),Cafeteria ( ) Other Fixtures -r f j' " Design Flow(min.required) � Q gpd Calculated design flow 3 3© Design flow provided gpd Plan: Date Sro G a,00 3 Number of sheets Revision Date Title Se Artt C.. �-'!��►/a a4 L�d�✓ i Description of Soil(s) ?S,J-e C` ti' ` Soil Evaluator Form N J o� Name of Soil Evaluator Date of Evaluation /r�� L� DESCRIPTION OF REPAIRS OR ALTERATIONS �iP00 Q1 The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agr es to not to place the s e opevatrion"until a Certificate of Co pliance has been issued by the Board of Health. Signed a Date Inspections No.L-W 3 FEE �0 Board of Health, �c3,/ S�1'a e' , MA. CERTIFICATE OF COMPLIANCE Description of Work: ®'individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired (ii`Upgraded ( ),Abandoned ( ) at o� ) n pc/K ( U d4 I 'i has been installed in actor�ante with the pr vision of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. Zt)03- fT dated '9 2 V 03 . Approved Design Flow 3a / (gpd) Installer M. /{ 1I e Designer: �4o'kt-f Su/tl dcr+1Sut AkJnspector: /^(l Date: t'/ tu3 The issuance of this permit sh not be construed as a guaran a that the system will function as designed. ^^ No.ZW✓- I /-( FEE J� COMMONWEALTH OF MASSACHUSETTS Board of Health, A 0,t U 5-k 6 f f' ' M. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair(t.-)'Upgrade( ) Abandon( ) an individual sewage disposal system at aal I G A ) as described in the application for Disposal System Construction Permit No. ZCO—�M dated 2 3 Provided: Construction shall be completed wit]h"in t,ree years of the date of this e.R mit. Al loc onditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date / Board of Health t TOWN OF BARNSTABLE. �L LOCATION SEWAGE # ASSESSOR'S MAP & LOT--- INSTALLER'S NA &PHONE NO. \S C o �-) sty+ E ro ME ll k, SEPTIC TANK CAPACITY �V; S-/ 1600 fj LEACHING FACILITY: (typ I H m4U r H,7 (size) NO.OF BEDROOMS BUILDER OR OWNER VOL V `CND N PERMIT DATE: 9I�`S�10.3 COMPLIANCE DATE r' Jzz�lw 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 / c on site or within 200 feet of leaching facility) �? Feet Edge of Wetland and Leaching Facility(If any wetlands exist . (�/�Q, Feet within 300 feet of leaching facility) Furnished by Q6x sp S\C00 , FrO4 F � �v QA- Q �J'a0X 3.S- G o�XNh�tctn �-k 0b ����6� yet 29 TOWN OF BARNSTABLE LOCATION- L ,�p�rl leA— SEWAGE VILLAGE ;Y�zvss dlI�<l� ASSESSOR'S MAP & LOT.�13•�-D� I INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY J C)o® LEACHING FACILITYAtype) (size) k NO. OF BEDROOMS PRIVATE WELL R PUBLIC.WATER - BUILDER OR OWNER DATE PERMIT ISSUED: l y DATE COMPLIANCE ISSUED: 2 VARIANCE GRANTED: RANTED: Yes No /1^ i n , °� c - 1 Barnstable Assessing Search Results Page 1 of 2 yyyy�,��yyyy y�+g�ry�q3 9 b Wd RNSZpR1Yx&��.0 sYv nd3��i•Y # •. `. Home: Departments:Assessors Division: Property Assessment Search Results 291 LONG POND ROAD - Owner: Property Sketch Legend GATTO, MAUREEN E Map/Parcel/Parcel Extension 013 /056/001 Mailing Address GATTO, MAUREEN E *r n 291 LONG POND RDi' " MARSTONS MILLS, MA.02648 ' fil A , Assessed Values: Appraised Value Assessed Value Building Value: $ 125,800 $ 125,800 Extra Features: $5,900 $5,900 Outbuildings: $ 12,200 $ 12,200 Land Value: $56,700 $56,700 Interactive Property Map: Ma requires Plug in: Totals:$200,600 $200,600 1 have visited the maps before :., Show Me The Map April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: GATTO, MAUREEN E 4/15/1991 C123060 $ 150,000 FANNING, EDWARD J 4/15/1984 C96047 $0 Tax Information: Tax Rates: (per$1,000 of valuation) Town Tax $ 1,885.64 Town Fire District Rates Other Rates 9.40 Barnstable 2.88 Land Bank 3%of Town Tax C.O.M.M. FD Tax $308.92 C.O.M.M. 1.54 Cotuit 1.88 Land Bank Tax $56.57 Hyannis 2.89 West Barnstable 1.96 http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/`... 6/16/2003 TOWN OF BARNSTABLE LOCATION Zcj— lW L2gs SEWAGE # 97q—00 VILLAGE ,�zy5 io5 ®JII((� ASSESSOR'S MAP & LOT �13 D5 o�,d'9j INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY J Q® LEACHING FACILITYAtype) (size) NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: y DATE COMPLIANCE ISSUED: 2�l F VARIANCE �G��//RArrNTED: , Yes X, No *J-CIA � �li� \ • ��i ♦. .fgl • ��T �Q�6, f'd►►e® �r� ,� N6... ..i.......(.` FEs......C-�.°............. i THE COMMONWEALTH OFIMASSACHUSET12a • BOAR® OF HEALTH , ................... ...................OF............................I..,.......................................................... Appliratilan for Disposal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ®�.. G= o-q wn.......... ••-----•-------------- ----------------------------•------ .�- �J-.----------------------------------------- LLo^=on- ss or It No. -. .1. v. a1/ �.. ..�?........ • � v� .. .... ... 1- o .�2.. .. ........-- O ner Address .....f........M...QJ3T=-1--.'.V........................................... --- .._._� �,. wt..s ... a ....................... 14 14 Installer Address � Type of Building Size Lot.......:__.2 .Aq-geet U Dwelling—No. of Bedrooms___-- -_ _. .----Expansion Attic ( ) Garbage Grinder (00 Other—Type of Building No. of persons_-_.__-____________________ Showers — Cafeteria Q' Other fixtures -------------------------------- - W -.. Design Flow___ - --------------------...gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter--.--___-__-._. Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter.:./_�-r.... Depth below inlet_4/_ ......... Total leaching area..9..sq. ft. Z Other Distribution box ( ) r Dosing tank ( ) Percolation Test Results Performed by.... ....... Date____-(� ,4 Test Pit No. 1................minutes per inch Depth of Test Pit----/-.Z..(......_ Depth to ground water........................ (% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...-.__--_-.._...--_--. �+. ----------------------------------------------- ��--------. V 'J----....S-/�------------------------------------------ --------------------------------------------------•-------•-----------------...........------------•----------- WZ- u----------t'`� -....-......-------------------------------------------------------------•--------------------------------._...----... .. -------- UNature 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 TI'I L 5 of the State Sanitary Code—The undersigned further agrees not to place the system in op ah n iMil a'C/`?fica.te of Compliance has been issued by the board if health. Sign •.----- ... -•... -- -------- ----------------- �.....=.......... / D e Application Approved B .... .... ... . . . .....__.___ PP Y Date :,Application Disapproved for the following reasons:................................................................................................................ -------•••---•-•-•--...--•-----------•......................•--••--------.........•---------•---•-••...--'-----------•-----•--------•------••----•••--•••---••--•-----•--•.........- ......----•-•--- Date PermitNo......................................................... Issued....................................................... i Date L 7 Fmc ............... THE COMMONWEALTH OF--MASSACHUSETI-'S. _-4 BOAR® OF HEALTH .................. .................._OF..._........................._.........---- Appliration for Disposal Works-Tons trurtion "umit Application is hereby made for a Permit to Construct',('0 .:O';r- Repair an Individual I-- Sewage Disposal System at: 4................... ... .......... ...................................Location K70--------------------------------------- 4.JAkess or I Lot J_r.... ..... .. ... . . .y ........V.. ----- Ovi rer y Address-- -----------------------------—----- ........................................... --- ...........14-q Installer Address Type of Building Size Lot.../-.._2_tAq4feet Dwelling—No. of Bedrooms.....A------------------------------Expansion Attic Garbage Grinder ((V Other—Type of Building ............................ No. of persons............................. Showers Cafeteria Otherfixtures ................................................................ ........................................................ Design Flow... ..........................gallons per person per day. Total daily flow---------------------------------------....gallons. Septic Tank—Liquid capacity............gallons Length................ Width._............__ Diameter__-_____.._..... Depth............___. Disposal Trench—No..................... Width......_............. Total Length___................. Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...1.4P...r..... Depth below inlet-4/............. Total leaching area ..9.9..sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.... E......... Date...... ..k'y �_l I 1 ------------ Test Pit No. I................minutes per inch Depth of Test Pit... ........ Depth to ground water........................ fT4 Test Pit No. 2................minutes per inch Depth of Test Pit...___._....__...... Depth to ground water.___._..............__... P4 ............................................................................................................................................................. 0 Description of ..........I............................................................................................ . ........................................................................................................................................................... ..V .......... ........................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable............................................................................................ ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in op at n it a.�Qr ificate of Compliance has been issued by the board health. Sign ......... ...... 110111 1 1 _Z 6; . . ......... . .............. ... ................... ......... _ ......Y D A Application Approved By............ ............................... ... '0 ............ Date Application Disapproved for the following reasons: ........................................................................................................ If ......................................................................................................................................................................................................... Date PermitNo....................................................... IssuedL....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS 'Irl BOARD OF HEALTH .........................................OF..................................................................................... Trrtiftrati'of Toutplianu THIS s TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by..... .................................................................................................................................................... Installer at. ...... ....... . In . ..... ... ... has been installed in accordance with the provisions of T (r-'F 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit ......... - dated_...______._._.___...___________......._._...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® A GUARANTEE THAT THE SYSTEM W SATISFACTORY. I DATE....Z7M... ........................................ Inspector.... .... ........................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No. 51 Y/P .......................................:..OF..................................................................................... FEE...S5P............ Disposal Works Tons trurtion ";Irrutit Permission is hereby granted_. ....P....... .................................... .............................................. to Consyuct or�Repair an Indivi.ual Sewage Disposal Syslem at ">---------- ....... ....... ­O.".K)......t� P+Ia_ 011__ Street as shown on the application for Disposal Works Construction Permit No................... Dated.._........_.............................. 1. . . .................................................... oard of Health DATE....................................... .................................. FORM 1255 A. M. SULKIN, INC.. BOSTON � I .`ice\ f• WMassachusetts Water Resources Commission/Division of Water Resources WATER WELL COMPLETION REPORT ��.� % LLVELL LOCATIOR Address /J C D City/Town e G.S.Quadrangle Map Grid Location _ Owner 1/ � 1J � Address` �' � &i 4o P4, WELL USE CONSOLIDATED WELL Domestic©/Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones METHOD DRILLED 1) From To Rotary(type) Cable❑ 2) From To Other 3) From To 4) From To CASING o! Depth to Bedrock Length Diameter Type fQA�-C, UNCONSOLIDATED WELL STATIC WATER LEVE�Lr Water-bearing Materials Feet below land surface �` Sand: fine❑ medium 4 oarse Date measured "1 — 5f#_ Gravel: fine❑ medium❑ coarse❑ GRAVEL PACK WELL ol Screen: Slot#length j' from to Yes ❑ No Split Screen(or 2nd screen) WATER QU LITY TESTS MADE Slot# length from to Chemical Biological ❑ Depth To Bedrock PUMP TEST Drawdown 0 feet after pumping days hours at ® GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 m --' DRILLER > y Firm a Address �o \ City Lr Registration No. /7 erator'sSignature Please print tirmly 10M-9-78-150519 Log Number: Bottle # B049 Date: 5/1.0/84 pF 13A O BARNSTABLE COUNTY HFFALTH DEPARTMENT 7 SUPERIOR COUFFT,HOUSE. c� _ f v BARNSTABLE, MASSACHUSETYS 02630 ° lyAS$ ° DRINKING WATER LABORATORY ANALYSIS PHONE: 362-2511 EXT. 331 Client: Edward J. Fanning Collector: Meehan Well Mailing Address: Box 474 Affiliation: West Hvannisport. MA 02672• Time & Date of 'Collection: 519184, 8:30 a.m. Telephone: 771-8997- . Type of Supply: well water Sample Location: Lot 10 Long Pond Rd. Well Depth: 75' Marstons Mills, MA Date of Analysis: 5/9/84 Parameter Sample Result Recommended Limits Total Coliform Bacteria/100 ml 0 0 . pH 5.5 Conductivity (micromhos/cm) 61 . 500.0 Iron (ppm) 0.13 0.3 Nitrate-Nitrogen (ppm) 0..05 10.0 Sodium (ppm) -- 20. I E Xx Water. sample meets the recommended limits of all above tested parameters. Water sample has higher than average• levels of nitrate. Future monitoring is . recommended (2-3 times per year). The low pH of the water may shorten the useful life of the house's plumbing. Water sample may present aesthetic problems due to Water sample has high levels of sodium: Persons on low sodium diets should consult their doctor. Water sample is not recommended for human consumption due to Retesting is suggested. REMARKS: Cc: Barnstable Board of Health cc: Meehan Well Drilling Lab Director 11/7/83 • i No.-- -��- -- Fee-----� BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rVell Con0ructionPermit A plication is hereby made for a permit to Congtruct (ZAlter ( ), or Repair (' )an individual Well at: -----------__------------ Location — Address Assessors Map and Parcel Owner {� �{ Address l-_✓1_ 44 Installer — Driller Ad esdf s —— — —~ Type of Building (� Dwelling... 1`rr`�------------------------------------------- Other - Type of Building - No. of Persons----------------------------------- s� 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 — -------------------------- ls/J/_ _ date Application Approved By— -- = ----- -------_--- date Application Disapproved for the following reasons:------------------------------------- ----------------- -------------- date Permit No.----- ------------------ ��---- -=�-----__--------- Issued---------------------- date BOARD OF HEALTH TOWN OF BARNSTAB LE (Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (>-�, Altered ( ), or Repaired ( ) - ------------------------------ Installer at-- - 1_- - -- -__ ___ - -- --- - ----------------------------------- has been installed in accord ce with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. — _ - --Dated--- ------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE---- ------- — - —-------- Inspector- --- -- -- -- ------------------------ Fee------ = -� BOARD OF HEALTH ` TOWN OF BARNSTABLE Appfitation_*rVell Congtruction permit Application is hereby made for a permit to Construct (ZAlter ( ), or Repair ( )an individual Well at: 2'3=' PA_`---tjjj Vic.--- ---------------------le)]�-----—-t"-G'------------------------------------------- Location — Address Assessors Map and Parcel __E-_Ya c✓ j --- �- (/'v iJ_G ------------------------------------------------------------------------------------------- Owner p Address ----------- Installer — Driller _ Addless _ Type of Building Dwelling - s ---------------- -------------- Other - Type of Building—---------------- ----------- No. of Persons---------------------------------------------- ., ---------------------- Capacity ------------------------ Type of Well-y-----��C=-------=------------------- P Y------------------------ ------------------------- 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. Y_ Signed--/ . - date Application Approved B - = - -� � - ------------------------- PP PP Y----------- :date Application Disapproved for the following reasons:------------_____________________—_______—_____�______ date Permit No. ---------- at Issued--------------------------------d •---- --- --- _ date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of itompriante THIS IS TO CERTIFY, That the Individual Well Constructed (�.); Altered ( ), or Repaired ( ) Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --!y ,¢--=,L ---Dated---------------------------- 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 lVell (Con5tructionVermit �%l/ i- l�/ /� No.--------;------------ Fee--ra-= ---------- Permission is hereby granted-------• - ----------------------- to Construct Alter ( ), or Repair ( ) an Individual Well at: No. -- - ; Street as shown on the application for a Well Construction Permit No.--------------------— ----------- Dated---------------------------------------------------------------------------------- --- �. s- - Board of Health DATE L i q }4 • t � �.J?I � ,off . 4 .�. N ,, . ,7r��' q�� -• <'' ' rye? r /�v Aj Sl r v`� '�, AlV ---- ` 71 j c S� Q 0 Aj 90 ` 6� A N 0 v� CAO ti . p� '• l Y _I_ws �s y a l hti /. v 'f 0 Vj ti vA% ,4,'�r� r/ vo5 f.d . M1j a � LL (,titl.t ��"G�tt, C�)F" 1-DT' 10 Co v;L 374�i g s�4. 2 u a. Li.47 � (LEy. QUG. Zvi Ig90 5 � -D G HN t'T �• ` i 1 � 9;..�r � i � c6 h n•f dh �eSe f ZG UI p •i N d �9 � � ',nc °. S, i l Ae� y,r' ,•(4, �j u S. nA ^N 917 �a ., Al14 Z � cad ,��.% ;r.�+�. � dam• �� d Nli � of � SEPTIC UPGRADE PLAN' �.� LOCATED AT +l0� #291 LONG POND ROAD y� MARSTONS MILLS, MA, / PREPARED FOR- MIKE VILLANI SEPTEMBER 6, 2003 MAA'BBY \ ROAD \ 6 � VACANT LOT A.M. 13/55 q 9815 341.05 ! \\ LOCUS MAP #s8� 9e� r9".9B/! LOT 14. \\ N83-30'55"E s815 \AREA=4B,679 PLAN REF` 37493C / E S.F. \ PROPOSED - // A.M. 13/56-1 \\ �0 ZONING. RF" N " GROUND WATER S.A.S. ,ENT - �/ \ PROTECTION ZONE. GP 9e ag ASSESSORS MAP 13 3g. 10'_-- SHED �, #gel. '-----' - GRA VgL _ A VE _ 98.S6 ,�� APPPDX c# �� -- I LOCATION ' 9 -- r OF EXIST. SEPTIC \ - .14 ✓� 22,3 98 7s SYSTEM ;' #98 2 rs \zj 155.4 �- 8' ,885SLAB I ° BENCHMARK � o g 3 5' TOP OF FOUNDATION 0 Ar 9 881 993g 47 4 1S' 1$'� �� I '_-- ° ® (ASSUMED)Or !� lfs55� r n0 L � 12.5 ' . fir. 'p 0 EXIST 99 43I r 31 1,000 GAL. 1 W p s9 4e 1\ 114. �� TANK WELL � 1 I '4 b W . b LOCATION 1 1 p PER OWNER 1 w _ 242. 4' � m _--- _� 11w -- - 1 9yoo, 58014'05- of - ------- SCALE.• 1 "=30 ' g G CE �HEfV A.M 29/34 YANKEE SURVEY CONSULTANTS MURPHY ZI UNIT 1, 40 INDUSTRY ROAD No. 7a9 04YtL N i P. O. BOX 265 ,�sl Rio NM 37559 MARSTONS MILLS, MASS. 02648 TEL• 428-0055 FAX 420-5553 a' SHEET 1 OF 2 J# 53456 GM EL. =_100'_ 1 719P OF FYIVNOATION 20' MIN. 10' MIN. CONCRETE COVERS `_ CONC;RETE COVE`ia 4" SCHEDULE 40 P. VC OBSERVATION MIN. P.7L^H l/B PER FT PORT 2"LA YER OF VENT 1/8"_1/2" CONCRETE CO VER WASHED S719NE ? 6" MAX / / 6" I(A:Y / i, i i i , i C 6" MAX 4" CAST IRON PIPE INVERT 6" MAX . (OR EQUAL MINIMUM EL.= 95.5; R/SER + PI7rH 1/4' PER FT. ---j RISER CLEAN SAND 9 MIN. EXISTING FLOW LINE i INVERT 1 10"' f EL=94.3 MIN. 14" EXISTING ! ` o 0 EL.= 96.3 INVERT 6 SUMPLEVEL EXISTING CAS _ 95 9' 16- SUMP 00 0 °o °°o°o INVERT EL.—___ INVERT INVERT o 0 0 0°o 0 (TO BE INSTALLED) — 94 8 ° ° EL.= 96.1 INVERT L.-- '_ EL.= 94.6 _ o° ° ° IEL ,93 EXISTING 1000 GAL EL.= 9513' DISTRIBUTIONL _s4.3' � ,1a SEPTIC TANK DISTRIBUTION BOX 5 HIGH CAPACITY INFILTRATORS TO BE WATER TESTED 11' X 38' TRENCH FORMATION BOX (EXISTING) IF MORE THAN ONE OUTLET PLACE ON 6" S719NE s�4" To 1_.1 SOIL ABSORPTION PROFILE OF ` lYASHED S71'INE ,SYSTEM (SAS) SEWAGE DISPOSAL SYSTEM BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELEV- =_8B __ NOT TO SCALE , NO OBSERVED WATER TABLE (03115184) ELEV.= 86 E OBSERVATION HOLE I ELEV.=_ 98'_ DEPTH DESCRIPTION OTHER 0-3' LOAM & SUBSOIL GENERAL NOTES ' 3'-12' MEDIUM SAND P#306 7 1) ALL WORKMANSHIP AND MA TERIALS SHALL CONFORM TO D-E.P. { TITLE 5 AND THE TOWN OF _.�_RYVSL LE—___ RULES AND + NO WATER ENCOUNTERED REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO SOIL TEST WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 3/15184 SOIL TEST DONE BY BAXTER & NYE 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITNESSED 'BY: BARN. B.O.H. WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H—20 LOADING SHALL BE DESIGN CA L C ULA TIONS: USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL NUMBER OF BEDROOMS . . . . 3 BE MORTERED IN PLACE. GARBAGE DISPOSAL . . . . . . . . . NO 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH TOTAL ESTIMATED FLOW DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO ( 110--GAL/BR./DAY x 1___ BR.) 330 GAL/DA Y OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. TOP LC)A1D 5 HIGH REQUIRED SEPTIC TANK CAPACITY 1500 GAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR '- IS TO CALL "DIG— SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS CAPACITY I1NFILTRATORS WITH SOIL CLASSIFICATION . . . 1 PRIOR TO COMMENCING WORK ON SITE. 1. 4' STONE :SIDES AND ENDS DESIGN PERCOLATION RATE . . . . . < 5 MIN./IN. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL u�AS s ° 11'tX 38' EFFLUENT LOADING RATE . . . . . . 74 GALIDAY/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. `' LEACHING CAPACITY (AREA X RATE) 381 GAL/DAY 8) PARCEL IS IN FLOOD ZONE___'=C" _ . �;, ', RESERVE LEACHING CAPACITY.. .. 381 GAL/DAY 9) LOT IS SHOWN ON ASSESSORS MAP __13 AS PARCEL _561 f (38XI1X. 74)+(38+38+I1+IIX. 74) JOB NUMBER__ S •�f !mac. 3 ��� . •G �-yo f i y p , � t JY•��c.._ r ' QE_S;6.�./ P�.�''��4T'ila�/ .art T�: / " ✓N 2 M�>v'. =�E ' f ASS " % 1 i f TE,S7',1j/G7L.E All- -311 /v©o --�=— ems'• Z / � G v U /N✓ //t/,t� Gid L . /i5/� Y a i I u j . �,E' v _.: ti/ � . S /�c/iT,�/ THE S✓© .0/�t/ .�1/�,<O "' y .l — cue: .�/ E f.•'c ZG'�f',�i E 4 S.�r,Q�c,� ,e L�c J✓, `'�-•�-> �L` .3 -r�,� 7Wz=- 7'v u/.�c.' C4. T-,�g - .�.��T> ✓s ��r- Tf=p v,/i>-yiM 7'�YE ,,� --r .1 :�-',� ,� �r� �v, ►- r'o, ► 77/S//.5" ICI--4AI /_S i(/p7- T.4/