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HomeMy WebLinkAbout0059 MILLRACE ROAD - Health 59 Millrace Road Marstons Mills 064 100 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address r.. , Daniel McGrath a Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 January 16 2020 -! required for every ry page. Cityrrown State Zip Code Date of Inspection tw. Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information /J3 S on the computer, use only the tab Troy Williams key to move your Name of Inspector cursor-do not Troy Williams Septic Inspections use the return Company Name key. Hummel Drive Company Address South Dennis MA 02660 Cityrrown State Zip Code (508) 385 - 1300 S1682 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails January 16, 2020 Inspector's Signatu 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18, Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 •u, Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: , ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System meets minimum standards set by Massachusetts DEP at the time of inspection only.This inspection is not a guarantee or warranty on the future working conditions of leaching, pipes, components or the future structural integrity of said components and only represents conditions found at the time of inspection only. 2) System Conditionally Passes: - ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑. ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form 4 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .V 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 0 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 January 16 2020 required for every ry page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No El 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form I a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 Janua 16, 2020 required for every ry page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h 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. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ❑ ® The system fails I have determined that one or more of the above failure criteria exist as described in 310 CM 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. 5) 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 CA. 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 t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 I i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 mot,, Property Address Daniel McGrath Owner Owner's Name Information Is required for every 59 Millrace Road Marstons Mills MA 02648 January 16, 2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate 9 p"yes" or"no"for each of the following for all inspections: Y Yes No I ® ❑ 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? ® El available as built plans of the system obtained and examined? (If they were note 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? i ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tI nk Inspected for the condition of the baffles or tees, material of construction, dimensions, depth'of liquid, depth of sludge and depth of scum? i ® ❑ 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: I ® ❑ 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)] I II I I i I i I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18I I Commonwealth of Massachusetts Title 5 Official Inspection Form = 1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'u 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road Marstons Mills MA 02648 January 16, 2020 page. Citylrown State Zip Code Date of Inspection D. System Information 1. 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 gpd Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: N/A Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage 19=13,000 gals. 9 ( Y 9 (gpd)) 18=29,000 gals. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 c Commonwealth of Massachusetts ,p Title 5 official Inspection Form io Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P- 100 +� Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/A Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: N/A Industrial waste holding tank present? ElYes ElNo Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: N/A Last date of occupancy/use: N/A Date Other(describe below): N/A 3. Pumping Records: Source of information: Last pumped in spring 2016. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 required for every ry page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: D-box and leaching were installed to existing tank on 8/2/04 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 18 11 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.): Lines were found clear at the time of inspection. t5insp.doc-rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 1' Depth below grade: 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: 5'X9'X6' 1000 gallon 41f Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 2' 8" Scum thickness thin layer 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 16" How were dimensions determined? probe/measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet and outlet tee with filter were found present and in working order. Filter cleaned at time of inspection. No evidence of leakage or damage was found. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 13 Commonwealth of Massachusetts Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road Marstons Mills MA 02648 _ January 16, 2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: N/A 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.): N/A 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Capacity: N/A gallons Design Flow: N/A gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 c Commonwealth:of.Massachusetts Title 5 Official Inspection Form Ali; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P- 100 Property Address Daniel McGrath Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 January16, 2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: N/A Alarm in working order: ❑ Yes ❑ No Date of last pumping: N/A Date Comments (condition of alarm and float switches, etc.): N/A *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert level Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was found level and in working order with equal distribution to outlet lines. No evidence of solid carry-over or backup in the past was found at the time of inspection. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 13 c Commonwealth of Massachusetts Title 5 Official Inspection Form I a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 'u Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road Marstons Mills MA 02648 January 16, 2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): N/A * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3-500 gallonwith 4' stone ❑ leachiing galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number. ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 �LN Commonwealth of Massachusetts :. Title 5 Official Inspection Form _ I. Subsurface Sewage Disposal.System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 required for every ry page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil was sandy. Chambers 3" of water present at the time of inspection with a Stan line approx. higher. Checked stone and found dry and clean. No evidence of hydraulic failure or problems in the past were found at the time of inspection. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth —top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction. N/A Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form 1) Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .�� 59 Millrace Road, �Marstons Mills M -64 P - 100 Prope rty Address - Daniel McGrath Owner Owner's Name --- information is 59 Millrace Road, Marstons Mills _ required for every MA 02648 page. CitylTown January 16, 2020State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 c Commonwealth of Massachusetts . P. Title 5 Official Inspection Form 'a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is 59 Millrace_ Road, Marstons Mills_ MA _ 02648 January 16, 2020 rpe 9uired for every City(rown State .Zip Code Date of Inspection e. D. System Information (cont.) 14. 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 � A O t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspects®n Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 59 Millrace Road, Marstons Mills M -64 P- 100 Property Address Daniel McGrath Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 required for every — ry page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12.0+ 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: 9/13/85 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: SDW 253 Zone B 47.1' 1.3' adjustment You must describe how you established the high ground water elevation: Test hole recorded on plan showed no water found at 12.0'. Groundwater adj. at the time of inspection was 1.3'. Bottom of leaching at 7.5'was found not to be located in the high groundwater elevation at the time of inspection. System was installed to plan from 2004. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection.Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons.Mills M -64 P - 100 Property Address Daniel McGrath Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 January 16, 2020 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1 2 3 or 5 as completed appropriate P 4 (Failure Criteria) and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on . 16 or attached 9 p Y P9 For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ; rM 59 Millrace Road, Marstons Mills M-64 P - 100 Property Address n�a Robert Sandsbury Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 gin; page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, t7 use only the tab 1. Inspector: key to move your cursor-do not Troy Williams use the return key. Name of Inspector Troy Williams Septic Inspections �y Company Name 19 Hummel Drive Company Address South Dennis MA 02660 City/Town State Zip Code (508) 385- 1300 S1682 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 February 1, 2018 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 Sy Page 1 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 59 Millrace Road, Marstons Mills M-64 P - 100 Property Address _Robert Sandsbury Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System meets minimum standards set by Massachusetts DEP at the time of inspection only.This inspection is not a guarantee or warranty on the future working conditions of leaching, pipes, components or the future structural integrity of said components and only represents conditions found at the time of inspection only. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ® N ❑ ND(Explain,below): t5ins•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 y 59 Millrace Road, Marstons Mills M-64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 required for every rY 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•3/13 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 ww ,.•''yVa 59 Millrace Road Marstons Mills M -64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is required for every 59 Millrace Road Marstons Mills MA 02648 February 1, 2018 page. Cityrrown 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 cr 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M-64 P - 100 Property Address Robert Sandsbury Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 February 1 2018 required for every rY page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 required for every ry page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ` ® El available 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? I ® ❑ Were all system components, excluding the SAS, located on site? i I ® ❑ 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: I ® ❑ Existing information. For example, a plan at the Board of Health. j 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)] i D. System Information i Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 I DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms). 330 I I I i 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P- 100 Property Address Robert Sandsbury Owner Owners Name information is ►Y 59 Millrace Road, Marstons Mills MA 02648 February 1 2018 required for every , page. Cityrrown 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 ears usage d 17=51,000 gals. g ( y g (gp )) 16=48,000 gals. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupiedDate Commercial/Industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/A Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A 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: N/A t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 59 Millrace Road, Marstons Mills M-64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is required for every 59 Millrace Road Marstons Mills MA 02648 February 1, 2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (coot.) Last date of occupancy/use: N/ADate Other(describe below): N/A I ' I General Information Pumping Records: Last pumped in spring 2016 per owner. Source of information: I 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 I ❑ Overflow cesspool ❑ Privy j t i ❑ 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 j ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): i i i I t5ins-3/13 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 59 Millrace Road, Marstons Mills M-64 P- 100 Property Address Robert Sandsbury Owner Owners Name information is 59 Millrace Road, Marstons Mills MA 02648 February 1 2018 required for every rY 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: D-box and leaching were installed to existing tank on 8/2/04 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 18"+ Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet ,Comments(on condition of joints, venting, evidence of leakage, etc.): Lines were found clear at the time of inspection. Septic Tank(locate on site plan): 1' Depth below grade: 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: 5'X9'X6' 1000 gallon Sludge depth: 4" 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 M ,•''y 59 Millrace Road, Marstons Mills M-64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is required for every 59 Millrace Road Marstons Mills MA 02648 February 1, 2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 2'8" 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 11" How were dimensions determined? probe/measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet and outlet tees were found present and in working order. No evidence of leakage or damage was found. Grease Trap(locate on site plan): Depth below grade: N/A p g feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of lastpumping: N/A Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of V Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P- 100 Property Address Robert Sandsbury Owner owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 Februa 1, 2018 required for every ry 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: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Capacity: N/A gallons Design Flow: N/A gallons per day Alarm present: ❑ Yes ❑ No Alarm level: N/A Alarm in working order: ❑ Yes ❑ No Date of last pumping: N/A Date Comments(condition of alarm and float switches, etc.): N/A Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M-64 P - 100 Property Address Robert Sandsbury Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 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 level Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any -evidence of leakage into or out of box, etc.): D-box was found level and in working order. No evidence of solid carry-over or backup in the past was found at the time of inspection. 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.): N/A * 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 Forth:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M-64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3-500 gallon with 4' stone ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of' vegetation, etc.): Soil was sandy. Chambers had 4"of water present at the time of inspection with walls found clean above. Checked stone and found dry and clean. No evidence of hydraulic failure or problems in the past were found at the time of inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A 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 59 Millrace Road, Marstons Mills M-64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is required for every 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of•soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A Privy(locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P- 100 Property Address Robert Sandsbury Owner information is Owners Name 59 Millrace Road, Marstons Mills MA 02648 Februa required for every ry 1, 2018 page. Cityfrown 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 C_ I) f t5irts•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P- 100 Property Address Robert Sandsbury Owner Owner's Name information is 59 Millrace Road, Marstons Mills MA 02648 February 1, 2018 required for 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 high ground water: 12.04 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. 9/13/85 Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Test hole recorded on plan showed no water found at 12.0'. Bottom of leaching at 7.5'was found not to be located in the high groundwater elevation at the time of inspection. System was installed to plan from 2004. 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 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Millrace Road, Marstons Mills M -64 P - 100 Property Address Robert Sandsbury Owner Owner's Name information is 59 Millrace Road Marstons Mills MA 02648 February 1 2018 required for every � ry , page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 AUG-16-2004 06 :56 AM DOWN CAPE ENGINEERING 508 362 9880 P. 02 Town of Barnstable Regulatory Services Thomas F.Geller.Director Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 office: 508-862-4644 rax: 508.990-6304 Installer&pesigner Certification Form Date: 8 1 Sewage Permit# ZoDq-32VAssessor's Map\Parcel b �D to 2 �.i nt►�n Installer: &��, Designer: �D�J _ "� N I Address: ✓ hr0� ' Address: ,�L n M. p� M�fi on Z,19 1��Z�ilo�was issued a permit to install a (date) A (installer) septic system A at �� / �"t i 0 lai.u ' based on a design drawn by (address) 0,_V-V't 0-1A dated (desi er) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation o any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. CL F Mgs9NE �,, ��(Installer's Signature) ALA8348 ANo suave°� (Designer's Signatu (Affix Design s tamp Here) EL„ RETURN SO BARNSTABLE PUB_LIC HE L� DJUSION CEitMICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS_B I[�LT CARD A __ BZCEIV&n By THE B USTABLE PUBLIC HEALTH DIVISION, THANKYOU. Q:Health/Sepucmesigner Ceniflcatlon Form 3-26-04.doc TOWN OF BARNSTABLE r_ t- „LOCATION . 6I Q-f_` ��� SEWAGE # e -�7 VILLAGE d"�1tt�S'� o�-LS ASSESSOR'S MAP & LOT t"- 6V INSTALLER'S NAME&PHONE NO. of � +�� -7-7 SEPTIC TANK CAPACITY /ace e'a //\\ c LEACHING FACII.TTY: (type) J04L Chew! .—j CD (size) /oi«a KZ � -NO. OF BEDROOMS 3 r ^� BUILDER OWNER ✓ 6 :!COM�PLLkN�CEDA�TE -1�����.�. PERMTTDATE: Q Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist ✓ within 300 feet of leaching facility) Feet Furnished by A ", d.w,.-84 F r . e 1 � �S� f/��r .' �r ti �� a�, a�` ao' .� a 6' �s 1 No. � 3 7 4 Fee ` "THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zipprication for ligpogal *pgtem� Conotruction Permit Application for a Permit to Construct( )Repair(44Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel o. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size �sq.ft. Garbage Grinder(alb Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 O gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title IT!4 — §'--rk- PL s4f 44 1L_L_ �- Size of Septic Tank I cry rL; Type of S.A.S. -TTZhe14 614- ' tj Description of Soil C'-tL- Nature of Repairs or Alterations(Answer when applicable) i eu_�i_ ACC 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 Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has issued b o alth. Si ned Date_ 11/ Application Approved by Date Application Disapproved for the following reasons Permit No. '2�7 Date Issued ,...y, ,. No. r [[ Fee 'THE COMMONWEALTH OAF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN'OF BARNSTABLEs;MASSACHUSETTS '�,. ' Yes " -1[ppYicatiott for Zt5 o5af *i5tg-m, Co g uction Permit Application for a Permit to Construct( -,)Repair( x)_Upgrade( ')Abandon( ) El Complete System D Individual Components Location Address or Lot No. � Owner's Name,Address and Tel.No. Assessor's Map/Parcel 16�a S._rL,(1 t—L s Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 't 4 t—t_C ?? t 151 Type of Building: Dwelling No.of Bedrooms .3 Lot Sizelnsq.ft. Garbage Grinder(eta. 3. Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Z 31 gallons per day. Calculated daily flow 3 3S"^ gallons. Plan Date G.-4 -e-4- Number of sheets .- Revision Date Title i i-rrt= 5" S T� t�i_.E�f e--y SR All tt_L2 � 03, . Size of Septic Tank I aCp /se 1 S; Type of S.A.S. —Mew Ct �c�3 3 ��� fit- t~tl•F•u3 ^� Description of Soil k Nature of Repairs or=Alterations(Answer when applicable) 1 A x-rT J-tom t j 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/bf Title 5 of the Environmental Code and not to place the system in operation until a Certifi- k-.z cate of Compliance has been issued b -, oa� o health. r Signed t �— Date -71di 71f (j1i Application Approved by Date Application Disapproved for the following reasons Permit No. �� Date Issued G - - —.—..------------------------------------- NN THE COMMONWEALTH OF MASSACHUSETTS - BARNSTABLE, MASSACHUSETTS r Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(X)Upgraded( ) Abandoned( )by i at `) M I/ c ¢ R' AA t/J , 7 D has been constructed in accordance with the provi ions of Title 5 and the for Disposal System Construction Permit No. ra>k/- 7�� dated 7 Installer &r 4�1,: k- Designer IN The issuance of tjiis permit shall not be construed as a guarantee that the sy tern ill j ction as desigirr Date a I dq Inspector nAZ1_ No. r�.�-�� 37L+ — — ------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mizpoe;al *pztem Conotructiou Perron Permission is hereby granted to Construct( )Repair( �U ade( );abandon System located at YYl a�� f`cc c Q. ( v-1s( )<, and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construc 'on must be completed within three years of the date of this p t. Date: Approved by --^- AUG-11-2004 07 :06 AM DOWN CAPE ENGINEERING 508 362 9880 P. 01 Town of Barnstable Regulatory Services Thomas F. Geller,Director Public Health Division Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508.790-6304 Installer& Desiner Certification Form Date: Sewage Permit# Assessor's Map\Parcel� DO Designer: e- t nte0 'T Installer: _ Address: q,35 LL I Address: _nit. de: l44� On was issued a permit to install a (date) (installer) � � l f septic system at M �' Pro.U_ based on a design drawn by (address) 0-1V1_VJ, a, dated_.5,� _ 0 Y (desi er) .. I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. 4AtiS1"A CF Mas AR . H (Installer's Signature) OJALA ,� No.28348 ' �g0�ESS��A Q- � ' 4N�SURVE.�O (Designer's Signatu (Affix Design r Stamp Here) PIFASE RETURN TQ BARNSTABLE PUBLIC HEALTH DMSIQ . CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED MIL BOTH THIS FORM ANp AS-BUILT CARD ARE RECEIVED BY THE BARK TABLE PUBLIC HEALTH DIVISION. THANK X-OU. Q:Health/Septic/Designer Certification Form 3-26-04.doe TOWN OF BARNSTABLE C LOCATION J � �' --�.-+ -� =� SEWAGE # Qer4 VILLAGE 6`" t om' P/Ltt LA-- ASSESSOR'S MAP & LOT �— 60 INSTALLER'S NAME&PHONE NO. 01Z ert-e�� { eAaL7 SEPTIC TANK CAPACITY' 10" G'v t ll LEACHING FACILITY: (type) 1204 61r aLi L30 (size) 1aiC7o i�.? NO.OF BEDROOMS 3 r BUILDER OWNER ✓ �COMPL�LkNCE PERMTTDATE: 0 �DATE�.-44�0-� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility f Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist ✓ within 300 feet of leaching facility) Feet Furnished by ".s�f�-' ��s �7 O tg y — I o6 LOCATION SEWAGE PERMIT NO. 104 <d VILLAGE � 6LY5 '�or,l5 lis INSTALLER'S NAME i ADDRESS M-0 uiL d U 1 L D E R OR OWN ER DATE PERMIT ISSUED " T- DATE COMPLIANCE ISSUED �� I 11 13 i©. Lair 2 9 e , 1.. No. ... _...3 � Fzs..........®............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® Off" HE LT ....- ..OF...... ... . ... .. . Xpli iration for Bispoottl Workii Tonitrnrtion thrutit Application is hereby made for a Permit to Construct (- or Repair ( ) an Individual Sewage Disposal System at ..... '1 :. ®1_. .... /. .......................... ... Location-Address or Lot l � . �.� No --•--6 ......................... ..Wa 2� Y_.._7Y � T ... ........... Owner Address Y j ......: 1 _1 ----------- ------------------ ..7f a $4 Installer Address ,g Type of Building Size Lot....�._! �_0--Sq. feet Dwelling—No. of Bedrooms.......3................................Expansion Attic ( ) Garbage Grinder ( } Other—T e of Building P.{,g1644 N6. No. of persons.....__.// Showers — Cafeteria Other fixtures W Design Flow................. -_gallons per person peg' day. Total dai y fi;w-_--_--. galJ,o �ns. W Septic Tank—Liquid capacityAW-gallons Length..- - .._ Width..., . Diameter................ Deptli..�,S.-. x Disposal Trench—No..................... Width.../............... Total Length........... Total leaching area..... .----sq. ft. Seepage Pit No........I.......... Diameter.....?�-.-.-.--._. Depth below inlet................ Total leaching area... _.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.... � ---�,1VX.6VYCAJ.6................. Date....` ..... ........... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.--'.fLnv 9171-67 Test Pit No. 2................minutes per inch Depth of Test Pit...................... Depth to ground water........................ K a .................................. -••---......---•----•-------------------------------•--•-••---••----------•-----•-----••-----•------•........------•. 0 Description of Soil------- D.L.U.M--•-• 12V 0........d.&.6 ...................................................x U .....-----••--•----•-•-••--•-----•--•-•------•-•......•---••-----•---•----•--....---•--.--•----•-•••-----------••-••--•-----•.---••-•••-----•.....•-----•••------•-••-••--......--•-----•---•----•------ w -------------------------------------------------------------------------------------------------------•--------------------------------------------------------------------------------------...----•- V Nature of Repairs or Alterations—Answer when applicable........................................................................................._..._.. ----------------------------•------------•------•----------------------...--------------......------•--•--......------------------------------------------•-----------------------------....._......•••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of^IITI L: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the boar f heal Signed- . •----•..-_... ' -------------- n �,,,, Date Application Approved By...............................-•-•------------- `"'` ... a 5� 6 Application Disapproved for the following reasons:------.... --------•-----••------------------------------ ----------------------- S -•..................•-..------•---------------•------••••--...----•••------•----...----........-----_--•- Date PermitNo......................................................... Issued-----•--.......-----------------•--••--------•----•--- Date �W_�_-- ------- --- - --- ---- �� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A- m -7 DATA No......................... FEs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. r l 1' _ �?�..._......�....... , ....'......OF............:...z...:; i �r`� , _ Appliration for Disposal parks Tonstrnrtion Funti# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: • 1 ` Location-Address or Lot No. Owner d ... ................... .A r W __ -J /' .-1.}.. 1._. . it 1 f j lZCI7 ddess /-f Installer Address UType of Building Size Lot_.____...__...•E C[......Sq feet Dwelling—No. of Bedrooms_...._% ________Expansion Attic ( ) Garbage Grinder ( ) a, Other—Type of Building !_ __� ��- No. of persons........6_--____._-_--- Showers (9 ) — Cafeteria ( ) Other fixtures --•---------------------------- ---------•------------ - -----..........-•••---•-•.••.- ------------------------- ------•------ Design Flow................. ______....__..gallons per person per day. Total daily flgw__......✓.Z.Q..........._._........gal ns. W Septic Tank—Liquid ca acitYl:2:�.gallons Length..r(52-,,,b`---- Width._�1 .�� . _ Diameter.. .............. Depth. x Disposal Trench—No..................... Width...?..........._.... Total Length_.......______..._. Total leaching area_.____._______._.._.s . ft. i g q Seepage Pit No--------,f____....... Diameter..... Depth below inlet.._....V........... Total leaching area._f �-.sq, ft. Z Other Distribution box ( ) Dosing tank ( ) -- '-' Percolation Test Results Performed b ._ ,9_L? _._� _.__--_-•••-•••-- q Y { Y � � ,r Date----- `.. Test Pit No. I................minutes per inch Depth of Test Pit__-•--_._-••----_••_ Depth to ground water..__ !&I.A (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... ............................- .........-.......... = = __ O Description of Soil =��=- (�l•O �7'1 rf t-/j1 �.a "ti rJ f/�. ... f x --------------•-------------------------------------••-•. U -•-•---•-•••••••-•--•-....••-•••-••--••---................................................ x ............................-........................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ........................................•••-•---•••-•••••••..._..........._.._.._._....._..._______....••'-----••-•--•-----•-•---•-•-•••---•.._--••-----••••--•-••••----••••-......................... f Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.,1 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been,issued by the boar •of health.' Signed........;%.._..__ ----h--u-------t-" -------- --- Application Approved By_ / Dat Application Disapproved for the following reasons: ---------- ki --•-------------------------•.:------------•-----------------•---------...----•-•----••-•-••••-••--•...•- ........._..-- ! Date Permit No.................................................. . . Issued.. 1 Date , THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........''Z.. ...LA/...'Y.!....OF....... .0 �Z �-Y A' �,................... �rr�ifirtt�.e n� f�.unt�rli�tnre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (_4 or Repaired ( ) Installer -- has been installed in accordance with the provisions of TITS ohs State Sanitary Code as described in the _ application for Disposal Works Construction Permit No-__•________________ _ (. /_.... dated.......................... THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM W4JEUfCTION SATISFACTORY. DATE................... .­_'­__1.f(.......-....................... Inspector__F_171'�.-•-------------•--------------------------------•------------•------ f}µ, THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH, ........... ...1--7...OF.......... .... •,�` FEE ..... Disposal Works Tontrudion ttrrmit JF_ Permission is hereby granted.................. ,/� k> :' ,_...............=......-••= - -- _- to Construct ( �-) or Repair ( ) an Individual Sewage Disposal System .� , , . a o. _.J -=------------- = r-===-------` •-- i=- ----•---------------•-•- ........................................................... Street as shown on the application for Disposal Works Construction Per NCB. 77__.-------------__ ate - ...___.__ . S ----•---------------- DATE................................ Board of > lt>� t FORM 1255 A: M. 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F'. t 84 T TDL _ 1 ,� i ' A Np E' c /S T T�4�. t' I - 1, ' f f . D # 1 , .. .�.. 1 # Ofi'dYYh/_ BY L� Y t'P . Y i t DflEcrYE B .�# G 8 P.C.AN N4. I , . -a ,, 3 1 E C2 .� r . . t , 1 - I , III �I 1: _ ,. y ! �iC� . : . �. _I -- ,st: r „ 1 f wy.k _ - __.,._ . ,._.___ e TOP N. AT EL. 108.4' SYSTEM PROFILE - TEST HOLE LOGS RACE LANE FNDN ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) PROVIDE INSPECTION PORT WITHIN ACCESS COVER (WATERTIGHT) TO 6" OF FINISH GRADE ENGINEER: ARROW ENGINEERING MINIMUM .75' OF COVER OVER PRECAST /� WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 105.5' WITNESS: JAMES CONLON (BOH) ELM ° . I �• •`~ EL. 106.2' d�UN PfRE LEVEL 2" DOUBLE WASHED PEAS ONE DATE: 9/13/85 �FQR FIRST 2' 3 MAX. PERC. RATE _ < 2 MIN/INCH EXISTING 1000 102.8' CLASS I SOILS P# 4720 LOCUS GALLON SEPTIC 104.8'f* TANK (H- 1.0 ) GAS -1-0-2.V CJ CI CI 0 0 O r m (RE-USET BAFFLE 102.27 �""� 99 102.0 0 Lp p 0 0 0 IC 177 0 r 6" CRUSHED STONE OR MECHANICA go Q = � � 0 IC O C mCOMPACTION. (15.221 [2)) g2 a s C� IC O iC Oo 100.0' o„ Q 1 LEV. DEPTH OF FLOW 4' 1 �� '� �`� (4-7 % SLOPE) ( % SLOPE) 3/4 TO 1 1/2 DOUBLE WASHED STONE TEE SIZES: TOP & INLET DEPTH = 10" OUTLET DEPTH 14" SUBSOIL LOCATION MAP NTS 42" 103.5' FOUNDATION-• EXIST. SEPTIC TANK 53' D' BOX 12' LEACHING 5 07' COARSE ASSESSORS MAP 64 PARCEL 100 FACILITY SAND & *THE INSTALLER SHALL VERIFY THE GRAVEL 72" 101 .0' LOCATIONS OF ALL UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 95.0' ( $*9 CLEAN MED. E / SAND / 7. 144" 95.0' 5 + 4 NO WATER ENCOUNTERED =NOTES: �10 / _ + losa SEPTIC DESIGN: (GARBAGE DISPOSER Is NOT ALLOWED ) APPROX. NGVD BENCH MARK -- CORNER OF 1 . DATUM IS •CE)t4C:•-&ju<t�+E-AD--EL. = 107.6 DESIGN FLOW: 3 BEDROOMS ( 110 GPD) = 330 GPD 2: MUNICIPAL WATER IS -___EXISTING ` -- - 1oa. '� USE A 330 GPD DESIGN FLOW TH + 1oa.2 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 104.4 107.5 SEPTIC TANK: 330 GPD ( 2 ) = 660 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 / + 107. 5. PIPE JOINTS TO BE MADE WATERTIGHT. 108 USE A 1000 GALLON SEPTIC TANK (RE-USE EXIST.) EXIST. LEACHING: - 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. + 104.1 �` 104.3 059 DWELL. 10 / - ENVIRONMENTAL CODE TITLE V. / P = 07.6 107.7 07.7 2(30 + 9.83) 2 (.74) - 117 DRIVE FNDN SIDES: 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT / t 218 30 x 9 / 106 Q .9 108.4' + 1 6oz g .83 (.74) = TO BE USED FOR ANY OTHER PURPOSE. 106.4 07. + 107.5 BOTTOM: 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 4103.9 , 106.9 ® 6 SHEDS TOTAL: 452 S.F. 335 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT -le'106. 1 7. 107. USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED DECK lo7.a EQUAL) WITH 2.5' STONE AT SIDES AND 2.25' AT FROM BOARD OF HEALTH. 1062- 106 + 1 ENDS 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) FAILED LEACH PIT 0 0 N N 8" - 1 OAKS + 107. .6 + 1 h 5.8 �� 105.7 � LEGEND TITLE .5 SITE PLAN ��7 100.0 PROPOSED SPOT ELEVATION OF MILLRACE RA ROAD > + 105.4 ..LOT '28 100x0 EXISTING SPOT ELEVATION CE 59 LL 29,290t SQ. FT. IN THE TOWN OF: `ss. 100 ` PROPOSED CONTOUR INSTALLER TO CONFIRM SUITABLE + 106. ( MARSTONS MILLS) B A R N S TA B L E SOILS IN AREA OF PROPOSED LEACHING FACILITY PRIOR TO + 105.7 1 OO EXISTING CONTOUR PREPARED FOR: INSTALLATION OF ANY PORTION OF M/M R O B E RT SAN D S B U RY SYSTEM. 30 0 30 60 90 b� BOARD OF HEALTH + 106.1 APPROVED DATE MA SCALE: 1" = 30' DATE: JUNE 4, 2004 off 508-362-4541 f fox 508 362-9880 I ZH OF ASS OF � , ARNE H, 9Oti down cape engineering, Inc, r ARNE OJALA H. CIVIL OJALA CIVIL ENGINEERS No. 30792 LAND SURVEYORS �0/sTE", a�P Z - L �4- 29 939 vain st. yarmouth, ma 02675 ARNE H. OJALA, ., P.L.S. DATE - ------- H