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HomeMy WebLinkAbout0034 MISTIC DRIVE - Health 34 MISTIC DRIVE, MARSTONS MILLS A= 079 037 - - -- - - --- r \ Town. of]Barnstable P# Departinent of Regulatory Services t„►>stt�r,�t� : Public Health Division Date -o �A6;� �a 200 Main Street,Hyannis MA 02601 lFD MA't� Date Scheduled a d Time �.f�� Fee Pd. Ub Soil Suitability Assessment for Sewage Disposal Performed By: iCO �(,�,1, i ` Witnessed By: 01,Li� LOCATION & GENERAL INFORMATION Location Address Owners Name Gt�fy ,, C�rC.ly Address Assessor's Map/Parcel: . d 3'�- Engineer's Name NEW CONSTRUCTION REPAIR VIZ Telephone# }gyp o — -L i Land Use Slopes('Yo)Z d-4 !�A z:::Z Surface Stones Distances from: Open Water Body G I.7/� ft Possible Wet Area Thy U ft Drinking'Nater Well l✓ft ' Drainage Way lU _ft Property Line t 1 ft Other g SIKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) �--3 1 JM ZK psi p Parent material(geologic) Depth to Bedrock 1 Depth to Groundwater. Standing Water in Hole: Weeping from Pit Fsce ram,[�(+J:-..��.�tt.+�tD / =iv,�,ov i.i11�H if.•c'�iP Estimated Seasonal High Groundwater l \ t iw DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: X:&4t Depth Observed standing in obs.hole: _ in. Depth to Soil mottles: in. Depth to weeping from side of obs.:hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj,factor. Adj.Groutldwater Level,,,y PERCOLATION TEST Date '!hne_1.�.o Observation Hole# _ Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ 1 i'.D►9 'lime(9"•G" End Pre-soak 01 `lC Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data,To Be Completed on Back----=------ ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:1S EPTICU'ERCFORM.DOC 2ooq — �3/ DEEP.OBSERVATION HOLE LOG Hole _ Depth from Soil Horizon Soil Texture Soil Color Soil Oth Surface(in.) (USDA) (Munsell) Mottling ( ,Stoud,Boulders. Con istency.% ravel t ./a„t"jL4 o A• S L, Z a��{ ��� �u��y Wiz✓ Z; c.�-'' ., - . r � C, T i•7 At s°� .�,�-6�rt,-a DEEP OBSERVATION HOLE LOG. , Hole# Depth from Soil Horizon Soil Texture Soil Color Soil O Surface(in.) (USDA) (Munsell) Mottling (Strut ure,Stones,Boulders. Consistency,%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, 1 i• Flood Insurance Rate Man: L Above 500 year flood boundary No— Yes Within 500 year boundary No Within 100 year flood boundary No es . Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perviou material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervi us material? Certification I certify that on (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 training,expertise d e peri�encescribed�i � 0 CMR7 15.017. � Signature Date 1 I Q:1$EPTIC�PERCFORM.DOC TOWN OF BARNSTABLE LOCATION ...3� /�,"Sf�'c eve SEWAGE# ©0`/-/3I VILLAGE /0,o,,S,1f,HS /YJ,`lS ASSESSOR'S MAP&PARCEL 07I —0 3 7 2NSTALLER'S NAME&PHONE NO. T 3 SEPTIC TANK CAPACITY 15-00y LEACHING FACILITY:(type) eve f''�fr�f vyS (size) /O.H X 4 7 u NO.OF BEDROOMS OWNER C v trr PERMIT DATE: -%8' o COMPLIANCE DATE: t Yo 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 I a � � � 1y' 3a 5_ 3 _ No.211010 I FEE AM COMMONWEALTH OF MASSACHUSETTS Board of Health, J/aa-r, 5---1&M ,✓z MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair(�Upgrade(v/ Abandon( ) - ❑Complete System ®'Individual Components Location 7j t>y \5S'�� �� 1,A. • 1> Owner's Name G L� — Vc Map/Parcel# v Address �� \ r Lot# Telephone# Installer's Name C Designer's Name SUR E'N J. DI7N TE AND Address Address 42 CANTERBURY LANE i h S . /7 Telephone# �� Telephone# 508/540-2534 Type of Building Lot Size sq.ft. wellin -No.of Bedroomsu�, _ Garbage grinder( ) Other-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow (min.required) 4& 0 gpd Calculated design flow 4e Design flow provided �,s�43 gpd Plan: Date I—At,! 1 3 y Number of sheets t ni Revision Date Title L� �[ ►R f.�.�'� �—fLYL 'i K 1► e�c-1 t, 7-72 rz Description of Soil(s) r ,,c1 S µ•`. L. �y<-O Soil Evaluator Form No. Name of Soil Evaluator .,Date of Evaluation 5 1' o DESCRIPTION OF REPAIRS OR ALTERATIONS The undersi ed agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further al e s t ottplace the a operation until a Certificate of Fomifiance has been issued by the Board of Health. Signed Date Inspec �ns /..�j, � a fir. I..l 'r !�' T" � ' � , , .. ., ri i"tf•• . . P No. <i Dd "N.3 I t-_ i� ,�;.,i L{ x ' �' ,,� ,��1`. :.:;�� ,� J" � , L FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, 1 ,►il L`r'cr1' l+i�� ,MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct Re air �U raAe v�Abandon 0 Com fete System ©'I dividual Components '~ PP � O p (�a) pg O O P, Ys P Location �j G,- \5S1 v L,L y Owner's Name G GV W r" Map/Parcel# C -3 -� Address a ti �,i ^��, •• �� t f Lot# 4 Telephone# ' Installer's Name A,, AXV, Designer's Name STEPHEN J. DO YLE ADD ASSOCIATE Address � � ����S yah S Address EAST FALMOUTH,MASSA'PoCHUSETTS 02536 Telephone# '�� Telephone# Type of Building Lot Size 0 ,,, (o 4{p sq.ft. Dlweellig No.of Bedrooms L, - Garbage grinder( ) Other-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow(min.regitired) A 4, r) gpd Calculated design flow 4r4. 0 Design flow provided S; A gpd Plan: Date I-A"f 1-1 D q Number of sheets 1 Revision Date t Title �t 7''t ri"L t_ t� ant d! 1-77-As.n la Description of Soil(s) r C,4 40 k" �- Soil Evaluator Form No. �. Name of Soil Evaluator I t.c--Date of Evaluation 55 1'9 a 9 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees tyo�,not/to,,place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed � �G '''! v Date Inspections No.Ze90 FEE COMMONWLALT14 OF MASSACHUSETTS Board of Health, MA. CERTIFICATE OF COMPLIANCE Description of Work: ®I Individual Component(s) ❑Complete System /' The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired (L)iUpgraded ( ),Abandoned .1. ( ) by: c. .4, �4 at '3 4/ /4 � ,'! j2r,'✓, has been installed in accordance with the pro 'sions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. d16i- V&I , dated / Approved Design Flo 1qg6 (gpd) Installer--- .G. X.L.-to (Vvs�.��&,/ 0� t + �,1: , 1 y-� ,r r J Designer: I✓'(3 �i Inspector: \ Y � V� 9C��X_Y Date: 51 The issuance of this permit shall not be construed as a guarantee that the system will function as designed. t ! t No. �D�� �J1 FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, / li,,r l 07 1e , MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair(W Upgrade( ) Abandon( ) an individual sewage disposal system at 34/ 4,'S t,C ,y, as described in the application for Disposal System Construction Permit No. Oa-/.Sn dated S(/I of Provided: Construction shall be completed within three years of the date ofthis permit. All focal conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date /lc 0 Board of Health - •� wG � +_� , , TRANS. NO.: CITY/TOWN: �� . APPLICANT: 0k",lrk t-,—r c ADDRESS: DESIGN FLOW: 4�t> gpd REVIEWED BY: �c��,r �, - DATE: a 1-s .07 N/A OK NO R e' s I✓ Z�. d am' ax r�$y"¢3.;� 'd o ,'E. krra� „'�`�,,; .a �'�' L��,.�� ��as,s�e.x���,.�*.,�,, �'k�� ..✓��,s �� k�"s Legal boundaries denoted [310 CMR 15.220(4)(a)] Street, Lot,tax parcel.number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] Plan proper scale? (1"=40' for plot plans, V=20' or fewer for components) [310 CMR 15.220(4)] Easements shown [310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(4)] Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components and rem ve areas. [310 CMR 15.220(4)(e)] V System Calculations [310 CMR 15.220(4)(f)] daily flow septic tank capacity(required andprovided) soil absorption system(required andprovided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)] Existing and contours [310 CMR 15.220(4)(g)] Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR / 15.220(4)(h) and (i)] Location and date of percolation tests(performed at proper, elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? [310 CMR 15.2421 Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] Observed and Adjusted groundwater (method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Address 3 4 i -+%1 5-6 C, 'BIZ. Sheet 1 of 7 N/A OK NO Location of every water supply,public and private, [310 CMR 15.220(4)(k)] within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor (required if constriction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR 15.000] System components not> 36" deep (unless.Local Upgrade Approval or LUA requested) [310 CMR 15.405(1(b)] Address 3� �-41�S-�i L,— 1c1. Sheet 2-of 7 N/A OK NO Size,OK? [310 CMR 15.223(1)] Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base[310 CMR 15.228(1)] Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA' 310 CMR 15.405(1)(k)] Minimum cover 9" (Tanlcs buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<I 000gpd, ✓ two for systems>1000 gpd[310 CMR 15.228(2)] hE y i All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] F4 Yt > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation.Required/Done [310 CMR 15.221(8)] ✓ H-20 Where appropriate? [310 CMR f5.226(3)] Setbacks from resources [310 CMR 15.211] Required when other than single-family dwelling or flow>1000 gpd [310 CMR 15.223(1)(b)] First compartment 200% daily.flow; Second compartment 100% / daily flow[310 CMR 15.224(2) and (3)] �/ "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] Address -F-A y Sheer 3 of 7 N/A OK NO Located at least ten feet from any water line? [310 CMR 15.222(2)] Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) Cleanouts required/provided ?,[310 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] Siphonproblem/ (leachfield below pump chamber) Endcaps or vent manifoldspecified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)J Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 JC V CMR 15.323(3)(a)J Riser if deeper than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sump 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd);waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)J YP� ".�"•�P�"'�rrt,."—'"rl� � ,. �`� �. , � s^ rk � c� � �� ��3�� S�i {�,,p�� � ¢„t� Capacity(emergencystorage above working=design flow)? [310 CMR 231(2)] 1/ Proper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole.at least 20" MUST BE / TO GRADE [310 CMR 15.231(5)] V Service components accessible (not too deep with piping, ✓ - disconnects accessible Alarm floats alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and (8)] v Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)] Address 4-- Sheet 4 of 7 5. N/A OK NO - sa�.�.zs. ,vsz.x.ro..e �n t� '-� a,a..var.dsm..�a. ,..-a,,� �, �:.ar � � rr, ` w,i'_ •+»�"� �',,' , S, Calculations correct? ✓ 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed[310 CMR 15.247(2)] System Venting required/provided? (system under driveway or / >36" deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR.15.211(1)[4] and Guidance Document] Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] ✓. Each structure with one inspection manhole (if>2000 gpd must ✓ be to grade) [310 CMR 15.253(2)] Aggregate 1'minimum- 4'maximum. [310 CMR 15.253(1)(b)] 2' sidewall credit maximum [310 CMR 15.253(1)(a)] ✓ In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)] Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] V/ 100 feet -maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater (3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] minimum 2 distribution lines [310 CMR 15.252(2)(a)] ✓' Maximum separation between lines 6' [310 CM RI5,252(2)(d)] Maximum separation between lines and outside of bed 4' [310 / CMR 15.252(2)(e)] V Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] Separation between beds 10'minimum. [310 CMR 15.252(2)(0] Bottom area used in calculations only [310 CMR 15.252(2)(i)] Address Zr 7 Sheer 5 of r N/A OK NO �PN ., .# z3 N ,� .,. Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] If used in gravelless system-make sure jet is directed as not to scour soil interface [Guidance Document] Inspections once per year (systems<2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet ✓ the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer 310 CMR 15.255(2)(b)] V Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] s �ravellessSysem[ A=A�pov ZLeftersJ v, +t,, 3 � z � PRAM" , i• ,L vn/.�tfl..PK.wke r+P .yo..,:�e4 F�Z+e.m _-Satt84' ..SE' $.i. @�t3 .(Nu u�.�', .<w ..�;..��:��� .�� �'.•� 35E . Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge Vx to scour soil interface Aloe naitye�Sp iYste� PPQlettersfsx a�.,., ;,kea�,.,�x..+a„era �. ,st±xsxzr Was DEP Approval Letter provided and/or have you , reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate.circuits Did the applicant submit an operation and maintenance ✓ manual? Has applicant submitted a copy of a maintenance - g' fay+ .. ez Ef tE e x - a lances �"ls ## €>�ix z�s . ,«,.� F.�.te�,., „ao_ �,.x �"�:.. �. 1,�< Eat,¢ d� s.d� �: tti�`.t' ,.�,:�wt�. Are the variances listed ton the plan ? [310 CMR 15.220 (4)(q)] ✓ RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CMR 15.414] Address 4t A'f� �,� C� `�J1'L• Sheet 6 of N/A OK NO Is the system in a Designated Nitrogen Sensitive Area (Zone H for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and ✓' 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CMR 15,214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] V �- It�ds�e�lccn�v�s Pumping to septic tank ? [ 310 CMM 15.229] Shared System [310 CMR 15.290] I Address sit- Sheet 7 of 7 . Town of.Barnstable Regulatory Services Thomas F. Geiler, Director sncuvsenaM MASS& peg Public Health Division 039. Thomas McKean;Director 200 Main Street,Hyannis, MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: o 2 -e Sewage Permit# a 00`7-/3/ Assessor's Map\Parcel_ Designer: StPjJti H J, .D9y/� f/ssoc. Installer: Address: Z Address: 13o u 3 3 2 On 5--/9'-09 Al was issued a permit to install a (date) (installer) septic system at 3 � �� ��-�,L��� based on a design drawn by (address) S, emu.,'Lr✓ /J,sir,t_ dated n . (&signer) ! 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. Stripout (if required) was inspected and the soils were found satisfactory. 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. Stripout (if was inspected and the soils were found satisfactory. �N OF4j ►►♦♦A.a/4OF MASS DAVID Lny ® � -ERB. O't7e z'5 z�_!� Fpc�G� `y NIASOt'd cn ® STE°ri=`� �N ► (Installers Signature) Q y 0. 0 tto.1066 o y`y lgIVD r ✓y\Fy�� ( esigner's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 03-09-06.doc . 031 7 SUBSURFACE SEWAGE DISPOSAL SY TEH INSPECTION .FORM Address of prope ty f I - Owner C s name , Date of Inspection PART A CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _NJ& As built plans have been obtained and examined. Note if they are not available with N/A. v The facility or dwelling was inspected for signs of sewage back—up. V The site was inspected for signs of breakout.. _v All system components, excluding the SAS, have been located on the site. Y The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. Y The size and location of the SAS on the site has been determined base, on existing information or approximated by non-intrusive methods. Y The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance ,.of SSDS..' Recommendations 1 . Septic must be pumped. 2. Distribution box broken and has sand intrusion. Must be replaced. .. Remove garbage disposaL. System not re disposal 4. Recommend addition of 1 -1000 gallon t to sting s system. ( 78 Code three bedroom oo g �16 1995 C n 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential _5 number of bedrooms _ 0 number of current residents YP_ garbage grinder, yes or no" YCs _ laundry connected to system, yes or no FINK seasonal use, 'yes or no If nonresidential, calculated flow: Water meter readings, if available: 93=177, 000 gallons 484.93 GPD 94=143, 000- gallons 391 .78 GPD UNK Last date of occupancy GENERAL INFORMATION Pumping records and source of information: N System art as pumped p of inspection, yes or no if yes, volume pumped Reason for pumping: Pumped tank at end of inspection, Heavy solids in tank. Rec: Pump septic tank. once a year. ( Garbage Disposal Type of system Y• Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy NO Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components. Date installed, if known. Source of information: 6 1a 81 R.J. O Hearn Inc RLS RS Job # 1159 spp Attachp_r1 1 0?' 3 NO Sewage odors detected when arriving at the site, yes or no ..r C L TEST INVERT ELEVATIONS NOTES= TOIL TEST 4�12-'22-- INVERT AT BUILDING FT: ALL WORKMANSHIP AND MATERIALS I BY •e.o• �- .E'G INLET SEPTIC TANK —FT SHALL CONFORM TO D.E.Q.E. TITLE 5 z ION RATE eZ MIN./INCH OUTLET SEPTIC TANK ' / FT. AND THE TOWN OF Ra,e..,s,.2oiE RULES m I OBSERVATION HOLE 2 INLET DISTRIBUTION BOX 9/• FT.a AND REGULATIONS FOR SUBSURFACE � «, ELEVATION= ��. 2 OUTLET DISTRIBUTION BOX V!. 7 FT DISPOSAL OF SANITARY SEWAGE ko INLET LEACHING PIT 9/ y BOTTOM LEACHING T � 4 �v. I G PI B„• FT. DESIGN CALCULATIONS NUMBER OF BEOROOMIS .... .... . ... . .. .. . .. . . . . . . . . . . 3 GARBAGE DISPOSAL UNIT.... ... . . : . . o TOTAL ESTIMATED FLOW. /'G(_._GAL./BR./DAY BR.?„_ =' =• GAL/DAY 3 REQUIRED SEPTIC TANK CAPACITY.... .. ... . ...... GAL. ACTUAL SIZE OF SEPTIC TANK TO BE INSTALLED.... % ' GAL. LEACHING AREA REQUIREMENTS _ ; , SIDE WALL AREA 1 =• GAL./S.F. 9��' 'BOTTOM AREA • GALJS.F LEACHING CAPACITY ( BOTTOM- SIOEWALL )............ GAL. S./gyS`r•` i � RESERVE LEACHING 'CAPACITY.. . .-. . . . . . . . . . . . . _ r('f GAL. Ar-i' CONCRETE 4" SCH. 40 CLEAN SAND COVERS MIN, P`TCH CONCRETE I/8 PER. FT COVER t2 ., MAX. 2`/e MIN. PITCH SM OF tiNOo� �,N` c c 5CHAtD s O FLOW LIiME N 2 LAYER OF 1/8 L I/ f uaa� yes _ JAMES s WASHED STONE* � }a ��N H � « _ e • �� �. *. esa 0 O IRON _t o z ,g" L' e tow, 3/4- 1 1/2 9F N. PITCH o w �o WASHED STONE •i F T. DI ST, o /' > ° ° PRECAST LEACHING Box ADA G Uw o r BASIN OR EQUIV. f Y n 0 ko i✓.J^ GAL �o LLI O L�7T�q /�'�'• SST/� �/Z✓{/LG � SEPTIC-`1 �.ye., �,� .:: L . MASS. c TANK �� �,.,�,�. ,�,,,�, R. J. O HEARN,INC., .qL.S, RS 1348 ROUTE 134 EAST DENNIS, MASS. m PROFILE OF GROUND WATER TABLE AGE DISPOSAL. SYSTEM JOB N0. ,-5? ICLIENT. L yzve . 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DATE OF iMTNESSE PERCOL A' OBSERVATION HOLI ALE VATION= — c TOP OF ---- FOUND. ELEV. 4" CAS PIPE- t 1/4" PI r r SEN SUBSURFACE SEWAGE DISPOSAL S ?d INSPECTION FORM PART P SYSTEM INFORMAT7 tinued SEPTIC TANK: Y 1000 gallon tank. (locate on site plan) depth below grade: 14" material of construction: concrete �_.-. `al FRP other(explair dimensions: 8J x6 x5 sludge depth distance from top of sludge to bottr: - outlet tee or baffle scum thickness distance from top of scum to top of o :'.let tee or baffle distance from bottom of scum to bott. -..•- %-f outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) Pumped septic at the completion of inspection. No Leakage or cracks in tank,, Tank ctr,icturally sound Tnlet and nutlet- i'eAA are fine- Recommend tank i ump ed once a j7aar uaa rarbagedi coal. DISTRIBUTION BOX: Y (locate on site plan) n depth of liquid level above outlet invert Comments: .(note if level and distribution is egiAi3i evid ':-nce of solids carryover, evidence of leakage into or out of box, endation for repairs, etc.) Box not level. Badly cracked with sand intrusion. Distribution box must be replaced. PUMP CHAMBER: N (locate on site plan) None pumps in working order, yes or r. Comments: (note condition of pump chamber, condit ' rumps and appurtenances, . recommendations for maintenance or rep,. ) i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : Y (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. r leaching pits and number 1 G'x7 ' 4 ' stone leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. Pump septic tank once a year_ ( GarhagP nispogal ) No suns of hydraulir fai1lira No p nnai.ng egetatinn normal CESSPOOLS (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 (cesspool must be pumped as part of inspection) Comments: / . (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. PRIVY: (locate on site plan) materials of construction dimensions depth of solids Comments: (note condition of soil, signs of. hydraulic failu/e, level of ponding, condition of vegetation,. recommendations for maintenance or repairs;etc. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION •FORM. `J PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L=SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' i U I I 4 DEPTH TO GROUNDWATER 20 depth to groundwater method 'of determination or approximation: Test -Hole Perc Test see attached Per ape o ommission roun a er map for Town ot Barnstablu. Ground Surface a avation Per Town of BarnstabYe GIS mapping. Pit bottom above ground water. �#. MAP l 6W N 'N�o -isl F 2 'oe o-f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all i s a n t nces. •. If not deter-mined" , explain p in why not) N Backup of sewage into facji:ity? N Discharge or ponding of effluent to the surface of the ground or surface waters? N Static liquid level in the distribution box above outlet invert? Liquid depth in cesspool <6" below invert or available volume< 1/2 da flow? * Required pumping 4 times or more in the last year? number of times pumped N Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy : N below the high groundwater elevation? N within 50 feet of a surface water? N within 100 feet of a surface water supply or tributary to a surface water supply? N within a Zone I of a public well? _N within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS) ? N within 50 feet of a private water supply well? N less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water anal for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. TOWN OF Barnstable - BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 34 Mystic Drive ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Frank:_Simmonetti PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Street Town or City State Z COMPANY TELEPHONE 508-) 775 3338 FAX ( 790 ) 15 78 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system this address and that the information reported is true , accurate , and complete as of the. ti.me of inspection . The inspection was performed and an recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of site sewage disposal systems . Check one : X System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section this form. Systeto FAILED* The inspection which I have conducted has found that the system fails protect the public health and the environment in accordance with Titl 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form. Z Ins Signature Date . ✓� Wx Inspector g One copy of this cey-tifcation must be provided to the OWNER, the BUYER ( where applicable) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection , unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd. ie,CATION � ® . SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME 6 ADDRESS 9w c iUILDE III >> OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED /�Z/� r 1 JI N.. Z2 L • " ' Fimx ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD. OF HEALTH T_eV.............OF.......... ............................ ,� r�rlirttilan furiSntt� Works C�nnitrnrtinn .emit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Ar.. ---•-•----••.............................J.i. %.!�.........2_2��%.sly .._............... ................ ....._.._................_. .Lo n-�ddress ...-•..................................•_... Lot No. ........ •.................... Address i `j� Ow r .. ti-•a`4'— ................................ ..............................•-•-•---•--......................... .....------.................. � nstall Address �.t. �..Sq. feet Type of Building Size Lot_..._ _.a�__ d¢ Dwelling—No. of Bedrooms.........V5 .Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type T e of Building No. of persons............................ Showers — Cafeteria Cyr yP g ------------------•--------- P ( ) ( ) Pa Other fixtures ---------------------------------- %3:� --------------------------------------------------------------------------------------.---..... Design Flow...........//.4_... .. gallons per l per day. Total daily flow............. .. .c?....................gallons. W y�eYy ---------- WSeptic Tank—Liquid capacity-'gallons .Length_8_" _". Width. Diameter................ Depth...S`..- x Disposal Trench—No--------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No............./.... Diameter......./ff.__.. Depth below inlet....6........... Total leaching area.-Z417....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..........opj....fa�t`l ttl__.IN..G.- Date..........61.. 199 .... ,aa Test Pit No. 1....4�2....minutes per inch Depth of Test Pit..ZAL' ..... Depth to ground water--------- Test Pit No. 2...,e:..7.._minutes per inch Depth of Test Pit__-e�_2.4�.`..... Depth to ground water........................ ...............pf..................................................:........................................................................................ O Description of Soil-,#/...... -Yz4•....... ir. ...... ?d . V ............................................... .-.!2-0 --------------•�2j, Z<1"__��._.lti. �yl i.�fE --------------------------------------------------------------------5'.09 O-----------------------------------------_-_-------------------------------------5 C? 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 iTIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of..0 pltance has be sued by the boar iealth. Signed....... ...... .. ...... P -----------------•- ................................ �DDf�t Application Approv y..... :✓G.� - ------------_ . -, Z,...-_.... ................... Date Application Disapproved for the following reasons--------------------------------------------------------------------------------------------------------------••. -•-----------•-------•-----••--------------------------------------------------------------•-----------------------------•-. Date PermitNo......................................................... Issued........................................................ Date 1 No. 352.� - FEs. .... °................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ----........". O!�. ...........OF......... ��. !�1. �..1�.��c-. . Appliratiun for Bi-spniial 19orkii Tomitxnrtinn VarAft Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_.. .............��.? _4.Lz,= ................ D T...�....`7 ................................................... Loc . n-9�ddress or Lot No. .......... ^• ...........::».................... ................................................................................................. ............... . W i Owner Address a •.... - ------•--•-•----------------^.--.. .............................Address---••--•-••-......•........................ .4r. � r stall U Type of Building Size Lot.._. .9.5- v..Sq, feet Dwelling—No. of Bedrooms........s5..............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .............. No. of ersons....._......._..._......_... Showers a YP g -------------- P ( ) — Cafeteria ( ) dOther fixtures ............•-------------------------------------------------•---------------•------------- W Design Flow............ 1.61.......................gallons per pear-xsoit-per day. Total daily flow------------- ..... ............gallons. P; Septic Tank—Liquid capacity...!z'Opgallons Length. Diameter................ Depth..... Disposal'Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft: �Seepage Pit No............../... Diameter.._..._./Q..... Depth below inlet....6.�__-._.. Total leaching area.._2_....._7... ft. Z Other Distribution box ( ) Dosing tank ( ) ''" Percolation Test Results Performed by...,..__.. .__. _'t` !?��!��.....1AIC. Date...........?,/q 8.�--.. a Test Pit ....minutes per inch Depth of Test Pit--- Depth to ground water........................ 44 Test Pit No. 2! f_,.Z..minutes per inch Depth of Test Pit..- Depth to ground water...................... R+' - ...r...........................................................................................-•---..........---------•--------••-•----.----- 0 Description of Soil.. /--•-..�..:/ZZ.47........ ...................... '.'........ ................. G V ................ .> .`?.......C"4_ �1.:_ r= .r.�v.�................../?_ 20- .%`t: --------------------------------------------------------------------6A.1V.0-••--------------------------------------------------•----------•-----•---------. ......... 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'TITL 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 board of health. Signed...................................................................................... Date Application Approved By----- � .�--. t�,r�, 41-1 1---.------ 'Date Application Disapproved for the following reason : -------------------------------------------------------------------------------------------•-------•-•---« -----------------------------•-••--•------.•---------------------•-•... ------------------------------------------------- Date PermitNo......................................................... Issued_......................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. f ........OF......... , . . ............................... (9rdif iratr ,af Tuutphaatre THIS IS TO„CE TIFY, That t e Individual Sewage Disposal System constructed ( �or Repaired ( ) by.............. ---------� --•----•-•-------I -----••--------------------------------------- Installer // at. ` G ---; • "•---••--�-........---- -• � s -•-----------•-------•----.------•------------------- has been installed iaccordance with the provisions of TITLE: 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.--J/_. ---36L............. dated_.............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO SATISFACTORY. , g� /, DATE................................. �r..e.......... Inspector.............t���!� .................................................. y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH }ate.................OF^� •-----......_.... N 3'r'�Z.. +� FEE... o............ Elisp o s al Works OWntrnrtwi n rrntit Permission is hereby granted. ict ,a - -----------•---•-•-----------------------••-•-----.---_---..-.--------- to Construct ) or Repair ( ) an Ind ual Sewage Dispos ystem at No.. r>� .mom p .A ------------------------•-- as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... DATE..................... - ................................... TTs FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ANILr . ,. .. e _ Imm m. mI .: ..,r.: ,.. .. .. . -: .: _ - - x r , - - .. - . mm ...: - .,;. r „ ::.i. _. : i' >. SOIL TEST INVERT ELE�AT.IONS. NOTES _ / ALL WORKMANSHIP ::AND:..MATERIAL,S DATE ,OF 'SOIL .;.TEST / '. INVERT. AT •RUILDING 5' FT ) : C TA - �;_3 FT. SHACL_ , CONFORM:'„'iTO . D-.E.Q E TITLE, .5' WITNESSED BY E?: _ n <.: INLET SEPTI NK I ` - ,;•. - ` . AND THE TOWN OF Air>f 7 RULES; AT RATE: 2 N: :1 CH :: ,: OUTLET. SEPTIC TANK. , 9Z / FT: _, PE,RCOL ION , MI / N . �;:,. AND :REGULATIONS FOR ; SUBSURFACE . . INLET "'DISTRIBUTION=, BOX !, 9 FT: OBSERVATION HOLE _.; 't OBSERVATION : WOLE �. „ - �f DISPQ'SAL OF SANITARY, :, SEWAGE. . _OUTLET .QLSTRi13UT10N ,:.BOX `. . ELEVATION 9_ . -2 r,.ELEVATION, _, �/.,m . _ � : �. ,.F,T. INLET: LEACH,tNG PIT E. . BOTTOM: LEACHING, PIT 4 FT. ' ,. - . r r T .. _ ,:' / T -• t' NS : a F,4 ., DESIGN . CALCULI Q . ,. /,-. ,:; - N'UMBER -OF BEDROOMS . . .IIIII :; , . .. : ;.. .. :" '.."' ,',i:- -'::: '': ::.'-.:: , _ , vim k. I , f. -l'.r c.� - �. :,',.' GARBAGE DI"SPbSAL UNIT... • . . r .. :.'... .1"'/r'....t.-.r .3. r f:4,." iry. G4L..Ak DAY x� BR ):';. GAL:/DAY/ TOTAL : ESTIMATED FLOW - .s.� �+ R'E OIRE.D. :SEPTi:C TANK" CAPACITY.:.: GAL. "' ACTUAL. SIZE OF SEP::T1C TANK TO .BE INSTALLED .::'- GAL,'. LEACHING AREA REQUIRE:MENTS° E G `� SIDE' WALL AREA �. ,GA-L./S:F - _ . r4?`. ,;�.� , .BOTTOM ' AREA �,�`GAl :/S..F , - , , , . . . :,. , , L E,ACHI;NG . CAPACITY '( 801TOM ` SIDEWALL ") ..,-: =: `' GAL. I_ml I�":,­.Imm i . . ,_ . . . _ x a f. Y' �, F n -. GAL. . PAGITY. . ::: .- ;; . . RESERVE . LEACHING CA . - TOP OF., . _. ``` FOUND. . . - >. � . : . ,4' .., h/riV/ CONCRETE 4: SCH. . .40. CLEAN S.:AND ' ELEV. % . COVERS ... PVC: . PIPE; - . ,,, I:�,.,�i i I-,,1�_:L,mm-',,m.m�,I I�--�1`:�.1,.-.���.�,-.1�"7�..���,I,.,,.m..�..:.�,�,...:1m-..�..m.,�::�p,�I-,-4�, t-�-l.-,,i,:"-m,,I-,..,,--7 I�-1.;,-Mm.�-mM.*,".i �-Im k I-,.�����;�.�cm,I.e-''I�,-,�I�..:-.:-,;I.,�"m_-I:­"..�'I,�.,­ri L",I��*,,,,lI�%,I"::m m.,':.-,,; MI PITCH:. CONCRETE : N . ,"�?�,..-p� COVER - - L/'8 PER. ,F,T. o _ N,Of-, ��. AI - . . , 2 to MIN. FiTCH , of N ��,P 1" .5 , s,;, - 12, :MAX. P�"� ' ,� ' r s . , , _ :: :s_ �,� . _ n off : a R3,MES ,,, - o m ,, - p'HEARN: ,�++ � LAYER OF I/6 11 /�" „' :, FLOW LINE o'. M " ww,=rin . .. ;6, WASH O'HEARM - _ .:eve. 'n 9' - :Q ' 11 ED' STO Q = �, ..Q- v A s, z. . . w p 4 ,AST .I ` N.. : , ...,. 3/4-w i/2 S7 g. WASH STONE.: _ -'ti. :::PIPE, MIN: PITCH: . : . , p a - sllEt� R FT : ,_ ,�r,::.� A T.,:LEACHING. .i/4 , PE �t$T a °t-- P2EC, S , n' �-. c t c�. y.: u :, :,' BA ; BOk _ U D SIN OR EQ-UIY , $ ,� , .: :. .... : r r,. ,: b.' ., �, .r , a:: ..a ..: ._ ... A _ : .:. y. _ ,.,_: ,- _ .. Y. . - c {� __ , 1?11,I A r I- -: :tsJ /d <- :, . GAL : hrr �, 5 _ , ,. ,. _ _, _ _'. , , . . , , SEPT LC V �... { _ . . , :. ... : ., .. ry ..x .... _,.. .. ... : .. .. .. . .. _ ", _, , ..r:. _ .._.. .. r. S 1 _ N, t ,`� . ,< _�_.:_ r EaR N C !. R S,_ _ : .._ ._ _ _ TANK:. ,-_ n :: .. ... .. - ,.::.-. ..t _., a ... ... .. -.. -r, a .. ., '4 r . .. .c.,- A._ a. :,. 48 v,. r. _ ,.. , , -. s . ,...., _, :. T:. r.. . . _.. ,. v._ ,.. _ v .< r . s _ _ _ a. _ GROUND ABLE K v, F F. :,., r .. W ATEA T I L E, r PRO . - . , . . . .. _ . ... ..- .c. ,.r r ,t. b --..:.... ,- 2,t .. .... ,.,. t • ,..._ SOB NOs.r/ GIENT �e L : ' YSTIEM, W GE DISPOSAL. S.SE Aa _, tir , .. ,-. ,, . .. r , r .:_ c ,- .� .,,. -,.a. ,,. .. -k,._ - r k . ". T ':ff H ET.�;:OF r.. _ , ,, r :S E O TO ,SCALE ti U. - J/{ ..., N T _ - _ DA, . .... .-. F , .::' ,� .. ,,-: .. ....- . ). .:. 1. - _ _ ..f ..r Q _ ..,. .. ..-.. .a.. - _. _ .... ,..,. -. .. _ .. . .. ....v..... .. rt ... ., ...:.:. .: fl: 5 z _ .: z. .. . K TOWN OF BARNSTABLE LOCATION SEWAGE # I VII LAGE ��'`LDS ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 4 Y 3yZvi I I 1 r - o ; 1 - •_ SI \ / ir t . l .F'F J rf,;i.t; F-�.S,Eiv l/tii L C y T'�'� s�,r�•-rE. i f Y c) Z JAI iN i c� ! ZON /it/C� OF 9' G`�FARhf T rai.HAir r \ f t TE". \ _ 1 SCALE: APPROVED BY DRAWN 8Y f DATE' DRAWING NUMBER L CHARRETTE PRO-FORM 920PF PRINTED ON 920H CHARPRWT VELLUM - Vj 7'. C/� N O ~ II FINISHED GRADE EL. 61.8'f Ll- Q C/-) _ 6" 6'" r HAMBLIN POND j Q:J W = W RISERS 20" 20" FINISHED GRADE EL. 59.0'f P. WITH SCREW TYPE CAP TO WITHIN \ Q > Q INV EL DIA DIA. 1.0 3" OF FINISHED GRADE (3 TYP.) L Q BELOW SLAE 6'" GEOTEXTILE FABRIC SEE PLAN VIEW. �, �� 0 u TO REMAIN RISER FIN. GRADE EL. 59.0't = Q FIN. GRADE 59.0' ou r U � INV EL 10" MIN, I`'' INV EL ;, f Q F- o> \ / BELOW Flow LINE GAS 59.60' IN EL Min. 6" INV EL I BAFFLE 58.�'1 Sum _ EL. CLEAN j r' a J O LIQUID LEVEL-48" 16 MED. 4 6 Stone SAND J N INV. EL. • (SPLASH PLATE OR BAFFLE TEE REQUIRED) 55.84' MED. - MED. L I'l -L. 54.51' , z EXISTING 1500 GALLON TANK TO REMAIN DISTRIBUTION BOX SAND SAND \ 6 SEPARATION BETWEEN ROWS T"P.) . 6„ 43.75' EL. 54.51' 10.49' L,O C' LT.S MA P CL Q w 4.75' USE THREE ROWS OF (7) HIGH CAPACITY INFILTRATOR CHAMBERS `n C Q SEPTIC TANK NOTES: TOTAL CHAMBERS = 21 TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6 ABOVE THE FLOW LINE OF THE SEPTIC TANK AND BE ON USE THREE ROWS OF (7) HIGH CAPACITY INFILTRATOR CHAMBERS THE CENTERLINE OF THE SEPTIC TANK LOCATED DIRECTLY UNDER THE TOTAL CHAMBERS = 21 BOTTOM OF SOIL PIT = EL. 49.0' ASSESSORS MAP 79 PARCEL 37 CLEAN-OUT MANHOLE. -40,00 NO GROUND WATER OR �l RE:DOXIMORPHIC FEATURES OBSERVED DEED REFERENCE: 19841-235 THE INLET PIPE ELEVATION SHALL BE NO LESS THAN 2" NOR MORE THAN 3" ABOVE THE INVERT ELEVATION OF THE OUTLET PIPE. PLAN REFERENCE: 203-53 THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9", WITH TWO ZONING DISTRICT: RF 20" MANHOLES HAVING READILY REMOVABLE IMPERMEABLE COVERS 59.4 OF DURABLE MATERIAL SHALL BE PROVIDED WITH ACCESS PORTS. X: OVERLAY DISTRICT: THE TANK OUTLET TEE SHALL BE EQUIPPED WITH A GAS BAFFLE. 20' I S84'55'20"E AP, RPOD & MA ESTUARY Z.O.C. o FLOOD ZONE: "C" ' FRM r OnII 253.54 58 PIANE L REV. DATE: AUG 1 00159, 1985 Wrr 11 j' -' i LOCUS T ADDRESS: 34 M STICDR r Q' 1 58 59.3 MARSTONS MILLS, MA GENERAL NOTES: ° 0 ' o i 57.5 X 1. ALL THE WORKMANSHIP AND MATERIALS SHALL CONFORM TO THE ' X USE 21 HIGH CAPACITY INFILTRATOR CHAMBERS TOWN OF BARNSTABLE RULES AND REGULATIONS FOR THE SUBSURFACE L� I/ i IN FIELD CONFIGURATION WITHOUT AGGREGATE ,u V) DISPOSAL OF SEWAGE. of i - ' Cuz 2. ACCESS PORTS OVER TANK TEES SHALL BE ACCESSIBLE WITHIN 6" z r REMOVE_ LANDSCAPE TIMBERS o OF FINISHED GRADE. m ; w 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF oll w r' SOT 4 6'. z 44.75 TP1 I--16.40 Uj WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 wiI w I rn P L- ,� N L_ 1= G = N E= z OF DRIVES OR PARKING. H-20 LOADING SHALL BE USED UNDER OR WITHIN 51 646± S. F. O a d 10' OF DRIVES OR PARKING, UNLESS NOTED. I ,-- (n w 4. THE EXCAVATOR/CONTRACTOR SHALL CALL "DIG SAFE" AND VERIFY THE LOCATION o BM: CONC. SLAB L-- ---------J i �1 EXIST. LEACH PIT > OF SITE UTILITIES PRIOR TO ANY EXCAVATION, AND SHALL BE RESPONSIBLE FOR '1160 i ELEV. 62.3' 59 5 ��\O,' TO BE ABANDONED r ALL MATTERS RELATING TO ELECTRIC AND/OR GAS EASEMENTS. I DATUM: GIS± CA X EXISTING " 5. SEWER PIPES SHALL BE SCHEDULE 40 PVC. (4" DIA. UNLESS OTHERWISE NOTED) o j 1500 GAL. z p TANK TO REMAIN Q 6. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE I LP 'D BURIED ELEC. UTILS. __j o MORTARED IN PLACE. M �' z 7. FINISH GRADE SHALL HAVE A MINIMUM SLOPE OF 0.02 FT. PER FOOT. '1 \ _ ^ BURIED WATER LINE 8. EXISTING SYSTEM COMPONENTS - IF ANY - SHALL BE ABANDONED PER \� TITLE 5 REQUIREMENTS. \ 31 .6' EXISTING SPOT ELEV. 9. THE EXCAVATOR/CONTRACTOR SHALL BE RESPONSIBLE TO CONTACT DOYLE �� Cn AND ASSOCIATES 24 HOURS PRIOR TO ANY REQUIRED INSPECTIONS. , --------� i i \ 0 X 10. ALL COMPONENTS SHALL BE MARKED WITH MAGNETIC TAPE OR o , TIMBER , -It o I o DECK ABOVE 1 `o COMPARABLE MEANS IN ORDER TO LOCATE THEM ONCE BURIED. o CONCRPATETE i I �, 59 EXISTING CONTOUR o � rn o I� EXISTING DWELLING 60 NI IN, DESIGN DATA: PORCH EXISTING FOUR BEDROOMS - NO INCREASED FLOW 62 1 I�; '. 4 x 110 = 440 GPD REQUIRED FLOW i 62 00 USE 21 HIGH CAPACITY INFILTRATOR CHAMBERS J IN FIELD CONFIGURATION WITHOUT AGGREGATE -- - - \ I `'• +�':,:� o -;' Q 21 x 6.25 x 4.72 SF/LF = 619 SF N67 y2„ \ I W DRIVE ; :'�:. w w J I' 619 x 0.74 = 458 GPD TOTAL DESIGN FLOW �0•• I >` �..:' .. '; 1 / I �.... 6 I w Qom GARBAGE DISPOSAL NOT ALLOWED 64 - -- - - f ' Lli FpcF '� /J :'• 66 0 Cf) SEPTIC TANK SIZE: �� / C `'• N' 0 _ n Q 440 GPD ® 200% = 880 GPD REQUIRED / (`.;::. •' �' ;'; *�1 o w EXISTING 1500 GALLON TO REMAIN 66 4 1� " W r ,% 68 a� DAVID 9�y !._. •� �/ MASON yI i \��� / rr'. ,•: %;/ 9 No.1066 ~/ 68N" } + NN o PRECAST DISTRIBUTION BOX NOTES: �� TEST DATE: 05-12-09 ELF-', �`�9 %�' '• '`' i 70 W SOIL EVALUATOR: S. DOYLE M 'T��. :.. . j l Q Ln Q MINIMUM WALL THICKNESS = 2" // �•.• ..,...� ., / _ o MINIMUM INSIDE DIM. = 12" W/WATERTIGHT COVER (APPROVED 03-95) �� . ,. 'r 72 . . . . ,., U >1 OUTLET INVERTS SHALL BE EQUAL TO EACH OTHER AND AT HEALTH AGENT: DAVE STANTON \ 70 �' � '- 2" MINIMUM BELOW INLET INVERT. r ♦' T.P. #1 PERC <2 M/INCH T.P. #2 PERC <2 M/INCH �� - �� ��� >. v z Cn v7 THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX SHALL `^ -_ - ` ♦ Q EL. 59.0' 0„ EL 59.0' 0„ ` ' '• I `Sp i ~_ J ALL HAVE EQUAL INVERTS AS DETERMINED BY FLOODING THE �6 DISTRIBUTION BOX TO THE HEIGHT OF THE DISTRIBUTION LINE "A" SL YR 3/2 "A" SL 40YR 3/2 0 A _ s Z INVERT AFTER ALL LINES HAVE BEEN SEALED IN PLACE. �� a _�r o INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH "BW LS 10YR 5/6 "gW LS 10YR 5/6 \� �� `►�^ • ���' � � Q N DURABLE AND NONDEFORMABLE MATERIAL PERMANENTLY 26 (EL. 56.8') 26"(EL. 56.8') \'\ 72 ��-- �- FASTENED TO THE LINE OR RECONSTRUCTING THE LINES �' - o �q� _ �'�� O z o UNTIL ALL INVERTS ARE OF EQUAL ELEVATION. MED. MED. \ ' 73.9 GRAPHIC SCALE ! o C COURSE C COURSE X 20 0 10 20 40 eo N O PERC ® 44 00 DIST/BOX SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON SAND " SAND '� A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED z It Ln AND ONTO WHICH SIX INCHES OF CRUSHED STONE HAS BEEN PLACED Q TO MINIMIZE UNEVEN SETTLING OR ON A CONCRETE PAD WHICH IS 56150 ( IN FEET ) _ z AT LEAST SIX INCHES IN THICKNESS AND 1.5 TIMES THE BOTTOM 2.5Y 7/4 2.5Y 7/4 1 inch = 20 ft. EL � O Li SURFACE AREA OF THE DISTRIBUTION BOX. EL. 49.0' '>120 EL. 49.0' 120» \ ~ <LLJ w \ (I) J NO G/WATER OR NO G/WATER OR �`�\ LLJ REDOXIMORPHIC FEATURES REDOXIMORPHIC FEATURES