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HomeMy WebLinkAbout0020 MILLRACE ROAD - Health 20 Millrace Road Marstons Mills A= 047 — 142 i TOWN OF4BARNSTABLE LOCATION ,,Q SEWAGE# VILLAGE /0// / ASSESSOR'S MAP&PARCEL 0y7- /Y2 INSTALLER'S NAME&PHONE NO. �D$-y21- 9�38 JoSc�� l�.c t��o-SOS f SEPTIC TANK CAPACITY 1600 # } LEACHING FACILITY:(type) II_r" :(size) NO.OF BEDROOMS 3 OWNERZ- PERMIT DATE: , 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 facili�ty)j Feet FURNISHED BY�L�xL7"'" i'r,Gu1/l•G h r - Gvl2� - 9-3= 33Y 5 13, t Go No. bG 1 z Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4phration for MispoSAI *pstrm Construction Vermit Application for a Permit to Construct(vr Repair(Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot N40 n 11 ,9C am Owner's Name,Address,and Tel.No. Assessor's Map/Parcel OY7- / 2 (� Installer's Na e,Address,and Tel.No.5-0 '�Zd-g7�� Designer's Narpe Address,and Tel.No.Sd8"344" 05 eP�t Pt'Ywj,rvS r=y�'s^ 5 j' WI' z'Ne Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.8. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 331D gpd Design flow provided 34Z gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) fyJyTAo ",Z, T 1��i9�1S 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 of Health. 'ti Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued V No. o(i� r ��� Fee� W 00 - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Mispo$af *pstrm Construction permit Application for a Permit to Construct(v< Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.)0 f'YJ I�ZKqcrE A0A Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 0 y Installer's Name,Address,and Tel.No.�0�- S'?/J-y7�c4 Designer's Name,Address,and Tel.No._ 'os- 4)r 9,w PvaS no.'y'v / 141--'Zt Kr . E1 1 -51_0r/5 1w Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) y Other Fixtures Design Flow(min.required) 7. 3 D gpd Design flow provided 3HZ gpd ; Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Ld.5- 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 of Health. Signed Date Application Approved by Date Application Disapproved by 7/ Date for the following reasons Permit No. Date Issued ------------------------- i THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Crdifitate of Compliancr THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(e_-) Repaired( :f)-- Upgraded( ) Abandoned( )by at ;1/> i��,/`�`c���, j �1/'�j/��Sj/��S GTi/,l� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.- r ZZ-dated /Z�0(Ij Installer,/0.5eA;1 Designer e�Y/Giii%!�� �Ot1s Ili #bedrooms 3 Approved design flow and The issuance of this perm shall not be construed as a guarantee that the system will fur9ctiona s d/ gned) Date i � Inspector --------------------------------------------------------------------------------------------------------------------------------------- No. 00f — (zz Fee-9/00 a o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Disposal 6pstrm Construrtion 3pErmit Permission is hereby granted to Construct(Z__) Repair( 4-)` Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date 15 7eb Approved by i Town of Barnstable Regulatory Services Richard V.Scab.,Interim Director Public .Health Division 'Thomas McKean,Director 200 Main Street,Dyannis,YIA 02601 Office: 508-862-4644 Fa[: 508-790-6304 Installer &Designer Certification]Form 1 Date: �7 l Sewage Permit# �DI.S=�� Assessor's MapWarcel 047. /4 L- Designer: 1 YID_ Installer; 105-epll oe l � v S Address: s8 � r -- �)Address: Cm. -S� S� ✓off e/°k!/e�ya'o� was issued a pei-aait to install a (date) (Ustallef) septic system at SO- M t t 47 based on a design drawn by {' (address) dated_ (desigzlex) .Y��s��Ao�� I ertify that the septic system referenced above was installed substantially according to the desap, w.bieh may include minor approved changes such as lateral relocation of the distribution box and/or septic tank.. Strip out (if required) was inspected and fte soils were found satisfactory. 1 Certify that the septic system referettced above was installed) with major changes (i.e. greaten than. 10' lateral relocation of the SAS or any vertical relocation of any cot apoixent of the septic system)but in accordance with.State & Local:Regulations. Plan revision or certified as-built by desiper to follow. Strip out(if reTaired)was inspected aad the soils were found satisfactory_ I certify that the system ref;,renced above was constructed.in compliance with :he terms of the PA approval letters(if applicable) CYIE (Mistaller's S� sig>aer's Slpat ) +41T itl � PLEASE. RF:'t'rrurT TO AARNS'TABLE PUBLIC HEALTH DIVISION. Ck;It'rIFICATE QE G12MPk,I;Al`1ClE WILL NOT BE ISSUED UNTIL BOTH THIS F .AND AS- !2L60" / BLIILT CARD ARE RECEIVED BY 111E BARNSTABLE PUBLIC HEALTH DIMS ;, 37HANK YOU, Q_%SeFti6Desigaer Certifications Form Rev 8-1.4-13.doc i�C 100 *u 0N1 VV.j ., ��'i L,(' L' ;ICb1, AIL .' l/IT, Iti 3 f Town of Barnstable Barnstable �. Regulatory Services Department > p ent 16yq.h10� Public Health Division 200 Main Street Hy annis MA 02601 2007 Office: 508-8624644 FAX: 508-790-6304 Richard V.Scali,Director Thomas A.McKean,CHO CERTIFIED MAIL#7014 1200 0001 0358 0413 February 17,2015 T 20 Millrace Lane ✓� d�/ '' `� ,.,. a4; , Marston Mills, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 20 Millrace Road,Marstons Mills,MA was last inspected on 1/15/2015 by Mark Polselli, a certified septic inspector for the State of Massachusetts. The inspection of the septic system.showed that the system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00)due to the following: • System is in hydraulic failure. You are ordered to repair or replace the septic system within Sixty(60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health QASEPTIC\Letters Septic Inspection Failures or Future Evl\20 Millrace Rd MM Feb 2015.doc Deta1 � � issgl2�+irilr�ri�t(pro�d�G��.�rcelL?tail,,� gn'IL=3�7a , . ! 6 Y 1\` Mb lit c V4� Logged In As: Parcel . - Detail Parcel Lockup Prcel Info �� x a `3 ", ._. ..{_r.. ;_: Parcel ID 047.142 Developer Lot LOT54 Location 20 MILLRACE ROAD Pri Frontage 128 Sec Road . Sec frontage Village MARSTONS MILLS j Fire District C-O-MM Town sewer exists atthis address NO Road index 10% i Asbuilt Septic Scan; Interactive Map 047142_1 X y e 7x i �Wo.i �; :kk •� Owner Info, � �,� ��. ,�� �j '� Owner GOMEZ,TONY M&M4l co- Owner Streett 20 MILLRACE RD D Street2 city .MARSTONS MILLS J state MA Zip 02648 country Acres 0.64 use .Single Fam MDL Zoning RF Nghbd 0105 Topography Level Road Paved �D utilities Seplic,Gas,Public Water Location '� s' nc"'smw" x'' �c 'pt�'IM mv- 0 ',t'� `.. • Construction lAfo •.. , �r _ � a � ' 5t8Pt �:Md�aceRdMhlf�2„bi PaYc�Det�l{ � � r �� a ', � �� �"s _yU ® , , n+xF«s��i�+s� as �v-,.s3w a,5c a •".. Computer name: HEALTH899JF User name :flvnni Operatinq Svstem :Windows NT(5.1) � - - - - - ��' ��� (�(� � 1�V � � � 1 Commonwealth of Massachusetts Title 5 Official Inspection Form lvq�f Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Aw/. Prop"Address 1 �� H 60 LAW Z aN net Cw nets Name � '' /S reeq',�every ar Ns /'/�1S / a6�a? /A� page. atyfrown State Zip Code Date ofJ pee n Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checldist at the end of the form. lmportarrt:When A. General Information fling out fours on the computer, !fie only the tab 1. Inspector. key to move your cursor-do not kuse ey.the return laey Na me of Inspector ,/ O %E GAJ conpany Name to Company Address .L� Cayfrown Zip Code Ear $) Teleptrone tuber License Number B. Certification 1 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 CM 15.000). The system: ❑ Passes ❑ Conditionally Passes Fails ❑ Needs Further Evaluation by the Local Approving Authority avg- /J r Inspec s Signahre Date The s tern 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 DER The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. '*'This report only aescribes 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. t5rs•313 rig FartrtSubariaceSevr.geDispcsalSy m•Page1of17 r Commonwealth of Massachusetts 112 Title 5 Official Inspection Form Subsurface Sewage. Disp6sal System Form-Not for Voluntary Assessments a 0 Property Address Go�eZ ON ner Ow ner's Name information isrequaedfore very /1/a✓S�o,►S /4/i l/S Oa wy page. Ckyrrown State Zip Oode Date df Insp ction B. Certification (corn.) Inspection Summary: Check A,B,C,D or E/alwayscomplete 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: 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 ex0ain. 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): t5ra•3n3 rile50f5dd trapecten Form SuWjfwe Sewege Disposal S)slem•P%e 2of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a c i�,��,�Q Rd Property Address ov�e Z Owner ON nets Name °requ every als� �-i s i'� 1s 4�Y 0.)6 g� page. Oy/rown Spate Zip Code Date of nspec' n B. Certification (conL) ❑ 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 Heath): ❑ 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 mannerwhich 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 t5rs-3M 3 Title sof6dal I spaoton F orm Subsuface Savage Disposal System•Page 3of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a Property Address o vieON nor ON nees;Name /L� rreegoueedrmatio forevery i" a YTO0 s / ° page. City/rown State Zip code Date n B. CeMcation (cons) 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 colifonn bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogenJs 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 �� h �� S��h� � '/ � lh�✓� Backup of sewage into facility or system component due to overloaded or CO] �� logged SAS or cesspool ischarge or ponding of effluent to the surface of the ground or surface waters i due to an overloaded or clogged SAS or cesspool is liquid level in the distribution box above outlet invert due to an overloaded ❑ or clogged SAS or cesspool Liquid depth in cesspool is less than 6'below invert or available volume is less than%day fl ow ISM-yrg We SOWN brpecdon Form Subsurtem SewQeDisposal system•Page 4of 77 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a O /l-a tL >2y Property Address ON rrer owners Marne information is required for every page. City/rown State Code Date f trspe lion B. Certification (corn.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ I11 Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ B Any portion of cesspool or privy is within 100 feet of a surface water supply or ,,__,,// tributary to a surface water supply. ElL►� Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ff 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 fleet 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 d 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. Ell 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. Orr•3M3 T050f5cial ImpectionForm SuWWamSwA%eDisposal SWW•Pape 5017 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth•Not for Voluntary Assessments ao Property Address r-T-ow1ez ON ner ON nees Name �uired for every Gi,-s�✓rf OL P 16 page, Cityfrown State Zip Code Date of/inspeofion C. Checklist Check if the following have been done. You must indicate'yes'or"no'as to each of the following: Yes No ❑ umping information was provided by the owner, occupant, or Board of Health ❑ any of the system components pumped out in the previous two weeks? ❑ 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? Cj, Were as built plans of the system obtained and examined?(If they were not available note as NIA) 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? Ly' LJ 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 (f any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CM R 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms(actual): , �O DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): tF=,yf g Title 5Of5del Inspection F arm Subsufew Sewage Disposal System•Page 6of 17 Commonwealth of Massachusetts wiTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ao / / Property Address formation is ON neYs Name required for every Gt rs S page- Cdy/Town State Zip Code Date of pec D. System Information Description: / /' /6:-,��n✓1 /C- l �' / 4f /1bu411 LSc��5 Hdo O Number of current residents: 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? El Yes �� Seasonal use? ❑ Yes Water meter readings, if available past 2 years usage(gpd)): Detail: Sump pump? / C ❑ Yes Last date of occupancy: Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Cavorts per day(gpd) Basis of design flow(seats/persons/sq.tt., 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: t5M-3M 3 Tice 50f6d8 Impeofian Fam subsvtae sewage Disposd Spbm-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address vile z Ow nor ON no's Narrfe information's /'U,",is 1"ii//S Y od4�e requ'vedforevery pW. Cdy/rown State Zip Code gate of s n D. System Information (coat.) 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, wlumepumped: gallons How was quantity pumped determined? Reason for pumping: Type of Sy 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/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the VA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): ffis•3n3 Title 50f iallmpecknFamSubsufaceSevkpe Disposal Symm•Page 8of17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth-Not for Voluntary Assessments Properly Address C--©✓ye z- Ow ner Ow ner's Name information required for every page. aty/Town State Zia Code Date of Inspection D. System Information (cont) Approximate age of all components, date installed(If known)and source of information: 1 l— o�,rJT Were sewage odors detected when arriving at the site? ❑ Yes (9 No Building Sewer pocate on site plan): Depth below grade: feet Material of constructi�40 El cast iron PVC ❑ other(explain): 94, Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): /> Septic Tank(locate on site plan): Depth below grade: feet 7concrete al construction: ❑ 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: �` o Sludge depth: t5m-3"3 me 50NCid blSpeclan Form subeufaoe serege DLV*9d sin•Page 9 of 17 Commonweafth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,� / Property Address Ow ner ON ner's Name ireqnfoons orevery �.s�w.4l /��/s 11�4 >> page. CRyfTown State Zip Code We ofhspeodw D. System Information (cost.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I G v4 L, /✓1 Oo C Grease Trap pocate 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 Sm.-3n3 Tine5Ofrdd ImpeclanFor[SufaufaceSereDfspmd Spun page 10d V Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form/-Not for Voluntary Assessments � Property Address Ow ner information is ON ner s Name/ ///'/� t�a b vf required for every U✓s ✓1 S page. C ityrrown State Zip Code Date of I specter D. System Information (coat.) 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 worldng 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 One-3M3 TiaeWfidal WepectionForm Subwfam Sewage Disposal System-Page 11 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 020 Property Address ovle � Owner Ow ner s Name information is �✓ �s � �i required for every page. Cdylrown State Zip Code Date of inspection D. System Information (cunt.) Distribution Box (f present must be opened)(locate on site plan): Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Z7061 le"(' l 141-0 '�;o/j Chamber locate on site plan): Pump Cha ( p ) 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: Mrs 3M3 Me$Ot8cid ImpeebonFamc Subsutaoe SeveygeDispo$d System-Page 12 a 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments O Al, Property Address o ✓''7.e Z ON ner Ow pees Name informations Gt✓S fAllf � �64(� /v required for every page. Qtyfrown State Zip Code We3 Inspection D. System Info tion (coat.) Type: leaching pits / number. ❑ leaching chambers number. ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number. ❑ innovativetaltemative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 4-4 J/;r'L. /i 1141-e- Cesspools(cesspool must be pumped as part of inspection)gocate 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 15irs•W TlUeS Official ImpecficnForm SubsufaceSeviageDisposal System-Page 13of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address o zf,/LI ON ner O We-z Ouv ner's Name // requ'aredforevery Gl✓S�NSMfon is /fl � ed-b page. Cdyfrown State Zip Code Date of Insp on D. System Information (coat.) 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.): One-3H3 Title 50ftel IrepectlanRrm Subsurface SewafeDisposal SyMm•Page 14 d 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ftceny Address Om ner n4 �� information is owners i' "/G rSIYU /%�� requeed for evey Page- Oyfrown state T_p code Daft #is D.System Information (corn.) Sketch Of Sewage Disposal System:,ProHde a view of the sewage disposal system,inck&g ties to at least two permanern reference landmarks or benchmarks. Locate all wels.vMn 100 feef.Locate one of the boxes beloor. I 3 66 53 3 >= 26 j 45 : i - \ . \ \ \ . / / / /r: ♦ \ \ ♦ ♦ \ \ ♦��\ ♦ \ \ \ \ \ ♦ ♦ ♦ \ ♦ \ % r \ ♦/♦/♦ ♦ % ♦%/\ \/\ \'\ \ \ ♦ \ \ \ \ \ \ \ \/\ 1 ater - ervice Millrace Road �A _At rN h 2Ft N2i . d F� 5� 5 � rt Yw Nf j Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address ON ner ON ner's Nameinforn 1 �jJ required at fo is a�S 7l7✓=S / xx/- requvedforevery _ page. Cdylrown State Zip Code Date of spec on D. System Information (cont.) Site Exam ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells — Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ bserved site(abutting property/observation hole within 150 feet of SAS) Checked local Board of Health-explain: MC7 n s / 2--sf /A 4S ,�s ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. Swe•3h 3 Title 50ffidal hspecfion Form Subsurface Sewage Disposal Sptem•Page 16 d 17 Commonwealth of Massachusetts Title 5 Official Inspection -Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Ow ner Ow ner's information is Gi✓� �S !l /�� (/y b / /� �� required for every page. City/town State Zip Code Date of! pecticrfi E. Report Completeness Checklist Inspection Summary:A, B, C, D, or E checked Inspection Summary D(System Failure Criteria Applicable to All Systems)completed Ly' S em Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ms-Y13 Tide 50fficialmrpecfianForm subudwe Sewage Disposal System-Page 17of 17 Town of BA.nstabie P# Ln Department of Regulatory Services + Public Health Division DateKAM 200 Main Street,Hyannis MA 02601 ' l Fee Pd. �� C GZ_ Date Scheduled Time a ' o ' S'r�ita�5 lity Assess, rat fop ,sewage Dsposa,�, Performed By: ` Witnessed By: _��o� ^, ! LOCATION & GE RAL INI+'ORMATION Location Address'. ( .� Owner's Name & W,. vvt,i L_Ur �/1,/ Address �`A a_� Assessor's Map/P4rcel: ® -7 � I Engineer's Name (t v q°. l� fv g Sce -331i NEW CON SIRUt' ON REPAQt /� Telephone# Land Use Slopes(90) ' Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft i • prainage Way ft. Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proxitnity to holes) c i i i i i Parent material(gecilogic) 0 t `'' � I Depth t4 Bedrock ' Depth to Groundwater. Standing Water in Hole:' i Weeping from Pit Face Estimated Seasonal Righ Groundwater i Dt ATION FOR SEASONAL HIGH WATHR TALE Method Used: In. Depth observed standing in. Depth to Boll mottles:in obs.hole: i in, Groundwnter Adjustment tt. Depth toiweeping from side of obs.hole: A .factor Adj.draundwaterlevel.,,"e, Index Well# Reading Date: Index Well level - _ � I PERCOLATIItON TEST Dale Time Observation I Tittle at 4" w� Hole# 'I Time at 6" Depth of Pere f` �l®q.. I Time(V-6") — Start Pre-soak Time.@ End Pre-soak Rate MinAnch Additional Testing Needed(YIN) Site Suitability Assessment: Site Passed Site Failed: Original:_Public k,e$1th Division Observation Hole Data To Be Completed on Back— j ' ***If percola#6n test is to be condacted within 100' of wetland,you must first notify the Barnstable C44servation Division at least one(1) week prior to beginning. DEEP OBSERVATION MOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) i (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel 2 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon . Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel) ------------- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Cher Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consisten M .t Flood Insurance Rate May: Above 500 year flood boundary No Yes, Within 500 year boundary No Yes " Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi us material exist,in all areas observed throughout the area proposed for.the soil absorption system? -S If not,what is the depth of naturally occurring p vious material? Certification e� I certify that on 1 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required trains andxperience described in .10 CUR 15.017. Signaturerper'lise " Date Q:\.SEPTIC�PERCFORM.DOC Barnstable �me Town of Barnstable .�. Regulatory Services Department A14ffMftCft • fARPj8TAB1E, ' Public Health Division 639 A�$o 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7014 1200 0001 0358 0550 March 25, 2015 Tony M. &Marion E. Gomez, 20 Millrace Lane Marstons Mills, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 20 Millrace Road, Marstons Mills,MA was last inspected on 1/15/2015 by Mark Polselli, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T BOARD OF HEALTH G Thomas McKean, R.S., CHO Agent of the Board of Health QASEPTICU.etters Septic Inspection Failures or Future Evl\20 Millrace Rd MM Feb 2015.doc .ti -�4 Commonwealth of Massachusetts of 2 lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Movnihan Owner Owners Name information is Marstons Mills required for MA 02648 October 28, 2008 every page. CityfTown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. important: A. General Information When filling out 52 n forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508-428-1779 S112855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address y nd that "i information reported below is true, accurate and complete as of the time of the inspe ion. Th0hspection was performed based on my training and experience in the proper function and maint nance n sit& sewage disposal systems. I am a DEP approved system inspector pursuant to S tion 15 0 of`�- Title 5(310 CMR 15.000).The system: t9 ® Passes ❑ Conditionally Passes ❑ Fails0 "a ❑ Needs Further Evaluation by the Lo [Approving Authority ry Co Ln m October 28, 2008 Inspectors 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. (� 08 271 Moynihan.doc 013106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owner's Name information is required for Marstons Mills MA 02648 October 28,2008 every page. City/Town . State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: Tank had been pumped one month prior to inspection leaching pit has 8"of effective leaching 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. Answer yes, no or not determined(Y, N, ND) in the❑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. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 08-271 Moynihan.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 ti Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner information is owner s Name required for Marstons Mills MA 02648 October 28,2008 every page. City/Town State Zip Code Date of Inspection B. Certification (Cont.) B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: 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. I. 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 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. 08-271 Moynihan.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner owners Name information is required for Marstons Mills MA 02648 October 28,2008 every page. Cityfrown State Zip Code Date of Inspection B. Certification (Cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria 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_day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 08.271 Moynihen.doc-oa= Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address _Eleanor&John Moynihan Owner Owners Name information is required for Marstons Mills MA 02648 every page. City/Town October 2 State Zip Code Date of Inspection tionn B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ ® 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. 08-271 Moynihan.doc•06106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owner's Name information is required for Marstons Mills MA 02648 every page. CRY/Town October 28,2008 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)] 08-271 Moynihan.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owner's Name information is required for Marstons Mills MA 02648 every page. City own October 28,2008 State Zip Code Date of Inspection 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): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No i Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): 137,000 gal. _ Sump pump? 187 gpd. ❑ Yes ® No Last date of occupancy: Currently _Occupied 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: Last date of occupancy/use: Date Other(describe). 08-271 Moynihan.doc•08/06 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owners Name information is Marstons Mills required for MA 02648 October 28, 2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Tank pumped 9/30/08 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed(if known)and source of information: Compliance date: 9/6/91 Were sewage odors detected when arriving at the site? ❑ Yes ® No 08-271 Moynihan.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form WSubsurface Sewage Disposal System Form-Not for Voluntary Assessments �tj, 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owner's Name information is Marstons Mills re wired for MA 02648 October 28, 2008 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 1 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.): 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: 8.5'long x 5.2'wide- 1000 gal. Sludge depth: 0' Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 0 1. Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Measured 08-271 Moynihan.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner owners Name information is required for Marstons Mills MA 02648 October 28,2008 every 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.): Tank has liquid only, no solids. Baffles intact and clear, liquid level at bottom of outlet invert Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑metal ❑fiberglass 9 El polyethylene El other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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): 08-271 Moynihan.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owner's Name information is Marstons Mills required for MA 02648 October 28,2008 every page. Cttyrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 11 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out of box, etc.): No solids or high stains. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 08-271 Moynihan.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owners Name information is required for Marstons Mills MA 02648 October 28,2008 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: One 6x6 pit. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Liquid level was found 10"below inlet pipe with a high stain line 2"above current level. 08-271 Moynihan.doc•08f06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owners Name information is Marstons Mills required for MA 02648 October 28,2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): 08-271 Moynihan.doc-08M Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owner's Name information is required for Marstons Mills MA 02648 October 28, 2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 66 53 3 37 26 45 ater ervice Millrace Road f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Millrace Road Property Address Eleanor&John Moynihan Owner Owners Name informationis Marstons Mills required uired for MA 02648 October 28,2008 every 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 ground water: 30' 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: USGS topo map and town GIS. You must describe how you established the high ground water elevation: Town groundwater contour map shows water at el 50 and topo map shows property at el 100 08.271 Moynihan.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 ,F i 11 TOWN OF BARNSTA.BLE IsOCATION Mi AI rum S E WAS#�q VILLAGE ASSESSOR'S MAP&PARCEL ��- ?+8T=bER'S NAME&PHONE NO.'��arl(4k-V�,Ionrm C4a13- 11"9 SEPTIC TANK CAPACITY iQco LEACHING FACILITY:(type)' (size) (000 NO.OF BEDROOMS OWNER moyng f PERMIT DATE: �E DATE:�SP /0/408 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 i FURNISHED BY 53 66 3 ok rk 3 7 4. 26 _ 45 \ k \ \ t \ k 4 \ 4 \ t 4 \ 4 t \ 1 t k 1 4 t \ 4 1 t \ \ ff J J f 4 4 4 4 \ 4 \ 4 \ 4 \ \ 4 \ \ \ 4 4 4 \ \ 4 \ 4 4 4 f f f J f J J f f ! / J f f 1 4 \ 4 \ \ t 4 t k \ \ 4 t \ \ 4 4 4 \ 4 k 4 4 4 \ \ k \ k \ 4 4 4 \ 4 t t 4 \ 4 t \ \ t t \ 4 4 \ \ \ t \ t k 4 4 4 \ 4 \ \ k t Water Service of 13 h ITOWN OF BARNSTABLE�6LOC1n�N ,�® ► 1h3C.� SEWAGE ®-L� VILLAGE 2t �- A14 ASSESSOR'S MAP & LOT A INSTALLER'S NAME & PHONE NO. ND T40 ��f t ( -7 y f aG SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) / 00 NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WATER----' BUILDER OR OWNER eel Acid A41 DATE PERMIT ISSUED: lqlDATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No __ �_ t �-� , ��. ,� !� '� `� y� lad- ��l i No.._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tomitrur#ion Vamit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: o?O ................. -........".1-,�,��/��4...�11:.. ........... ............ ....................................... Location-Address or Irot No. I p .......!jgAA% .�y.....T._! �?..-------- -•-aY.._.GeeG,o.........-!A'U .... ,�,.. owner Address a T/yEa Cows yre..... r._i..^- C - - vG 7Lb�n /4r -------- Installer Address d , Type of Building Size .......Sq. feet U Dwelling—No. of Bedrooms................ _.__.Expansion Attic ( ) Garbage Grinder ( ) 4 3 p-, Other—Type of Building .&P4EkZZA4.... No. of persons...........2............... Showers (A) — Cafeteria ( ) � " f �a Other fixtures ------•- ..... .44 W Design Flow________________-S-s.............•....._gallons per person per day. Total daily flow..._.........3 ....................gallons. WSeptic Tank—Liquid*ca.pacity.�n gallons Length._._,.V.'_'-.Width...... Diameter................ Depth_.. x Disposal Trench—No. ................... Width...... Total Length............ Total leaching area..........a........sq. ft. Seepage Pit NoZ.... !,.A9P----- Diameter.......6;......... Depth below inlet.._._4........... Total leaching area. Y.....sq. ft. Z Other Distribution box (I-y", Dosing tank ( ) Percolation Test Results Performed by../Q�T2d 1v-...61Va1,U6E'_9?A2G....rju..('..t Date___..7/,),a/T!S.......... a Test Pit No. I........3------minutes per inch Depth of Test Pit_.....��?_ ...... Depth to ground water.-:..................... f14 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ P+ ........................................... -••------ -------•••------------- x . Description of Soil -� g� 5 _-So, -------•. 1 -----.... 7 nes.€6_S!!�V .!► �'!?�l 1._ SIN 7 %�e�. V /"?�.5 __..7�z__.���}!4s1�......Sf_te'. ......... . . W 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n issue�bydie board of. Signed ........... ........... ..............-- --------- .......... Application Approved By � / Date ............................................................--...... ........ �Application Disapproved for the following reasons- ----- -------------------------------------------------------------------------..................................................... - --- ---- --------------------------- ........................................ PermitNo. ......--.. .......................... Issued ........................... ate Date 71 3,36 qq ., THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE x Appliration for Uiipniial Works Ton,strnrtion ramit Application is hereby made for a Permit to Construct (V/) or Repair ( ) an Individual Sewage Disposal System at: p?O • - ------------- � S ................................................... Location-Address or Lot No. --- ..✓?. s.7......... Address �_. � ���f ............................................... - ,............................. Owner ess W T�/Y Err CuNS 1 2 G. -r U ti r r, 7'fvl • / rrf L,. /V.. r9;-D-t 6✓ Installer Address / 1 t Type of Building Size Lot.a:5•.Sy 3..._.....Sq. feet Dwelling—No. of Bedrooms.................3.......................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building �'rs, n�%w ..... No. of persons..........�............. Showers — Cafeteria dOther fixtures ........s_/o:�KS_._.:. 2:f�,• W Design Flow................�-s--.--..__....______.gallons per person per day. Total daily flow..__._.____..� ....................gallons. W"• Septic Tank—Liquid"capacity. '."- ..gallons Length_... ✓ .�._Width._.... ..._. Diameter................ Depth____!.-.3.' x Disposal Trench—No. .................... Width................... Total Length............ Total leaching area.......... ........sq. ft. _ Seepage Pit No _._. ----- Diameter.......t_........ Depth below inlet......4........... Total leaching area...r� ....sq. ft. Z Other Distribution box (✓)� Dosing tank `-' Percolation Test Results Performed _....Ae.C_- Date------ - _I__ ........... Test Pit No. I._._....I------minutes per inch Depth of Test Pit------L-?......... Depth to ground water..Y____________________ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---_____------------_--. P4 ----------------------------------------------•-.----• -----••--....... 7----------• ----_---------.....---------------------•------•-•••.....-------•-- �.'`" —.a- ., >�r.�,E' .inns t✓.. ........Description of Soil `'_ �.: . S= ... -• -------� --••- V .s_>..... -:_.. c a e sE....... -'............................ ----------------------------------------------------•------------------------.-----------------------------------------'-....------------------•-----------------...................•.._........... 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by t e board of heatthl Signed -------------------- 1 G / Date r ApplicationApproved By ............... -------------------------------------------------_-_---------- ----....�--�--:-. Date Application Disapproved for the following reasons: ..................................................................................* --------------------------------------------------- .-..-------------.-...........---.....-----------....................................................................................... ° ----------- .-- -------------------- Permit*No. f 33,6-------------- ----- Issued .------------......----------------- ------...Date...... 7/_ 3,36 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ger#ifi a e of C ampliance THIS IS TWL. IFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................................. .......... . ... ------.....--------...------------................------------- r Installer at --------------I -vT.... ��-------- '� 1�- 24.r e...---------G 42------------------ .................................... has been installed in accordance with the provisions of TITLE 5©of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....1-/- -l............... dated .................------.---------............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE, SYSTEM WILL FUNCTION SATISFACTORY. l �j )) DATE _.....-.... Y--[�-/q-1------------------------ Inspector ...-..- .. 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No....71-334FEE..... TOWN OF BARNSTABLE 0.d Disposal Works TInnfr ion amit Permission is hereby granted...........- %'l .................................................................................................................. to Construct (>�- or Repair ( ) an Individual Sewage Disposal System atNo. 1- .l.--------- .......................................................... Street 2/ as shown on the application for Disposal Works Construction Permit,N .O._ .Z�3.J3�- Dated.......................................... .]\. V Board of Health DATE....................:T.-_)...(.----- FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS - I HYF . ►CATION- CAMELOT rrm }T�_— NO I LLAGE Marstons Mills DATE .Ju1y.. " 1985 ,- PPLICANT Cedar Acres RPal,ty Trust _ DDRESS25 Great Pond Dr- So_ Yarmouth, Ma _ TELEPHONE NO. -1c) _g51 (1 (Non-refundable) I IG INEER TEL - ATE SCHEDULED )3 pp is Si nature) . . . . . . . . . . . . . . . . o . . . . . . . . . • . . . . . . . . o . . . . . . . . . o . . . . . o . . .. . . . . . . SOIL LOG 'JB-DIVISION NAME CAMELOT DATE_ ?' 22' TIME :PANSION AREA: YES X NO _ _��{L[. Ltd 6�C0 lt.) d t) G. ENGINEER )WN WATER X PRIVATE WELL 7(LL�W�1�'�� I� C.00VLOI�J BOARD OF HEALTH nT .���� 6j0%7-rZ. EXCAVATOR !:ETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to' test holes ) NOTES: 53 ` �73 t ►) ' ® y t, O '?RCOLATION RATE: ` tAjIQ wl�j "ST HOLE NO• ELEVATION: 1. TEST HOLE NO: ELEVATION: � -- 7509 1 -- 2 -- S7/6�/4S 2 _ 3 3 — 4 -- -- i�-SE 4 _.._._...—.- 5 -- �/�,Jp 5 -- 7 � 7 - -- - B 8' — 10 --- 11 _- 12 112 13 _ 13 14 _ 14 -- 15 - 15 16 _ _ _ 16 IITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD -LEACHING PITS_' LEACHING TRENCHES ]SUITABLE FOR SUB-SURFACE SEWAGE. REASONS: ATE: ENGINEERING PLA14S MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ".IGINAL: C_omPLETED IN ENTTRFTY BY P . F. . AND RETURNED TO BOARD OF HEALTH s -'D BY APPL1CAN,r py; ItLTAINI MARSTONS MILLS F LEGEND —1 PROPOSED CONTOUR R4CE ' 9® PROPOSED SPOT GRADE ENE EXISTING CONTOUR =� + 96.52 EXISTING SPOT GRADE W— EXISTING WATER SERVICE ° -77 TEST PIT Do SITE U QY o y moo. ' H64y9?g, 2 LOCUS MAP 105X8 LOCUS INFORMATION TITLE REF: CERT. 187434 PARCEL ID: MAP 047 PAR. 142 T - - - --- D6 � 106X, SEPTIC SYSTEM REPAIR PLAN DECK 2 LOCATED AT: 105X9 I o� 20 MILLRACE ROAD 05X7 MARSTONS MILLS, MA. 2s�y �c' �q �r^ PREPARED FOR of o�. ___, G O M E Z Q woe �� �. 106X �. OQ- APRIL 30, 2015 p, `` EXIST. 1 ,000 PIT 106X8 (see Note 10) PGA D REEN M. 0 EX15T. 1 ,000 GALR£c�stE ° SEPTIC TANK 105X7 MEYER & SONS INC. P. O. Box 981 f E. SANDWICH , MA 02537 PH. (508)360-3311 fax (774)413-9468 ¢ meyerandsonstitle5©gmail.com www.meyerandsons.com SCALE 1"=30' SHEET 1 OF 2 J#1491 ELEV. TOP FOUNDATION NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS (Existing) BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE FINISHED GRADE (106.0) 108.10� F.G.EL: 106.1 F.G.EL: 106.1 F.G. EL: 106.1 _7\ MAINTAIN 2% MIN SLOPE OVER LEACHING AREA �•f M 2" OF 3/8" DOUBLE WASHED F.G.EL: 105.0 3/4" - 1-1/2" . . STONE OR FILTER FABRIC DOUBLE WASHED STONE 6" ~��• 4" SCH 40 PVC 10"I s ®E E O ®®®® A: 14" © S= 1 (MIN. ®®E3OE33®®® TEE'S ARE TO BE INV.103.50 4" SCH 40 PVC 2 EFF. DEPTH ®®®®®®®®®®® INV.104.65 INV.103.30 4' 2 X 8.5' 4' GAS PROPOSED DB-3 EXISTING OUTLET BAFFLE DISTRIBUTION BOX EFFECTIVE LENGTH = 25' H2 ,.,Y, y, �,.. •.. .. .. .:.. :. . j INV. 104.90 INV. ELEV.= 102.50 EXISTING 1,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON ��1`� OF �Assq BREAKOUT OUTLET TEE AS MANUFACTURED BY �`` cyo ELEV.- 103.50 o DA IN Mt s - TUF-TITE, ZABEL, OR EQUAL TOP CONC. ELEV.= 103.50NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING � o.VRE 40 " INV. ELEV.= 102.50 FE3 PIPE INVERTS PRIOR TO CONSTRUCTION 2) D-BOX SHALL BE SET LEVEL AND TRUE TO AEG/STE�GRADE ON A MECHANICALLY COMPACTED SIX S01T00 BOTTOM EL.= 100.5 INCH CRUSHED STONE BASE, AS SPECIFIED IN 1 3.75' FT. 3.75' 310 CMR 15.221(2) 5 ," 1� ,3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK EFFEDTH = 12.5 WITH 1500 GALLON SEPTIC TANK IF FAILED, SEPARATION 5.60 FT. DAMAGED, NOT H2O LOADING, OR UNDERSIZED. SEPTIC SYSTEM PROFILE SOIL ABSORPTION SYSTEM (SECTION 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: 94.90 GAS BAFFLE AS REQUIRED (500 GALLON LEACH CHAMBER) GENERAL NOTES: DESIGN CRITERIA 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOGS P#: 14668 NUMBER OF BEDROOMS: 3 BEDROOOM BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: APRIL 27, 2015 SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN/IN LOCAL RULES AND REGULATIONS. SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 GAILY FLOW: 110 G.P.D. X 3 BR DESIGN FLOW: 330 G.P.D. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR WITNESS: DAVID STANTON, BARNSTABLE B.O.H. = TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE GARBAGE GRINDER: NO (not designed for garbage grinder) DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXISTING 1,000 GAL. SEPTIC TANK Elev. TP- 1 Depth Elev. TP-2 Depth FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN - ENGINEER BEFORE CONSTRUCTION CONTINUES. 106.0 0"A 105.9 0" (330) = 445.94 S.F. t 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. LOAMY SAND p LOAMY SAND LEACHING AREA REQUIRED: 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 105.5 1OYR 3/2 6" 105.4 1OYR 3/2 6" .74 THE J HEALTH FORCTOR OR PROPER INSPECTIONS DURING CONSTRUCTION.WNER TO NOTIFY THE D OF B LOAMY SAND B LOAMY SANG USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4' 1OYR 5/8 1OYR 5/8 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 104.0 24" 103.9 24" STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED C SANDY LOAM SANDY LOAM BOTTOM AREA: 25 x 12.5= 312.5 SF TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 10YR 6/4 tOYR 6/4 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE 102.58 41" 102.57 40" SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING PERC ® EL. 101.0 C2 C2 CONSTRUCTION. TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. MEDIUM SAND MEDIUM SAND DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req d 12. THIS PLAN NOTICE R ENGINEER S TO BEUSED FOR SEPTIC S 2.5Y 6/4 YSTEM PURPOSES ONLY 2.SY 6/4 I PROPOSED SEPTIC SYSTEM UPGRADE PLAN D IS 13. NO T TO BE PRIVATEWELLS WITHIN 1DERED A 150 OF PROPERTY ROPO EDLINE SURVEY LEACHING 95.0 132" 94.9 132" 20 MILLRACE ROAD, M. MILLS, MA 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. Prepared for: Gomez 15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED) PERC RATE <2 MIN/IN. ("C2" HORIZON) (� NO GROUNDWATER OBSERVED Engineering and Survey by: SCALE DRAWN • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 MEYER BOX SONS, INC. N.T.S. OMM to conduct soil evaluations and that the above analysis has been performed by me consistent with the EA BOX 981 requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October. 1999. EAST 2-2922 CH,MA02537 DATE CHECKED SHEET N0. soa-�s2-2sz2 04/30/15 DMM 2 of 2 GENERA 4 NO TEd 0 -1a 44X,. E!„EYAT/411/6 SHOWN ARE O/J 777 a . . P17 V ALL 41NE"S A �!f/,Nl�i�1lf�J Df T" C 0,Q 0 a I/Nt ESS OTHERWISE spec!FIEf? -�'k 3• A�.L PIPES TOANf/N THE SYSTEM $9Ak ,. BE FAST 11?0N OR SCREPME> 40 PVC. Y. 5E.Pr1C-TANns PISTR/BUTIO B XE +, N O ,S, •.0 w. • ,:. to - d� 4NP 44WCRING P/T,5 SW..44, BE PES/GNEI�' 0 (D (D 0 0 0 G@ 0 .*� Ff1� H- -Cl J�YHEE'.G .0 t7�lO/NG S Wh/ N ._ao C (D0� 0G0 :.,, .. -'•i' r..,rv., >:.. .. BENE.4rhq rHE 1NVC1?7' El,EYAr1o1V5 0000 � � � � � OF THE O/FFVS'4A`S FOR A o157ANCE 4F' f�� ` 5 Q QD 0 0 @ 0 0 /a A/YP BACKFI�,�t. WITH C�GA Y-F!'EE L mm W SAND,4NP GRA�'E'�. f/AY/NG A PERCOUT10 TYPICAL 0/�T I,64MCAN BOJ� � - _-,� 1 � .. 3 , .; i ,v.:-� R"A TE ©F" 2 �tf/NUTES PER (NCH QR AGES, _ _�. A 6 ?'NE. ,e�✓ 4A1?P OF HEAD(,T .tf!! 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T I-INGE%SS OrHEeW115E NOTE'P A�G4 SYST Ate/ ?IC N EC QI" EQ , EM NCIr ,70 $'CX..E ,C41NPC7N�'NT.S SHA�,�, BE ffVST.4�,�(,El3 /N C1,e���if't�.�T/G+/vs t Y•6.,fA.►�1�� ,,t�1 � ' r �e4sTAfz,L 00, ' OF RE444rIq NOTE'- r,4lv�rsE1N�-aRc . r�rRVvHaUT 4000A'P•4NCE" WITAI T'I TkE Z Of THE SUTE ;V/rR E�,60 RIC M'E�,PE� ! 1,fe l�t'1rq .0 �,�" SstN1�".4ft Y COPe ANP,4NY 1.0C,44, IF414.E0' E/I�G.INE R� Ai t'�Pt7 M ft�!G11V, "ER1NG //YC E.IIBEPPEP �5/`E'E.Gi/?4,latS lIV TC? .60r "C,�/ i'Y///C1',� �tAY ,gPFFiC,Y fi w GONCr r'ETE' !S 4 p4O f',S.t ree5 T. n70T,E••ACC E 55 NANHO,C.ES ro SEPT/C �AN,e rop FU.v ,E eLJI,LT- LIP TQ ,EAGH/IV6 P!7"5 TO ,8 €c ,r~cot�l P/I11.51-1 6,,e,9o,E. 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F,4�WOUTH HWY, . - � � T - v�'E1YYEE �GN ta ` , - , E F.4ldUTH RT, �� r SlPeW.4�C.4, 1T'K n G n Z. x .7 G; J SCAL F- • 1 - 4 U � cr�Ty 4 "`' + 'C.d.C.E- l�4X',E SHEET~: ,� . .• f t?347" pM 'T• x dx . �.c7 '�� t*"o' n„ o �t . 7 / `6r - ,, , ,tl AS RIOT G' �': . : O 1�!"N BY CH 'Ch'E�BY 40 Y: I'iC,.4N f✓O. r - I r n y