Loading...
HomeMy WebLinkAbout1200 OLD STAGE ROAD - Health _ 1200 Old Stage Road Marstons Mills A= 173 —003 —002 f i O n COMMONWEALTH OF MASACHUSETTS %, ) EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS 'r DEPARTMENT OF ENVIRONMENTAL PROTECTION ' ONE WINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner CHRIST CHAPEL CHURCH C/O HEBERT VOLLMAN Address of Owner: 515 BAY LANE CENTERVILLE MA.02632 Date of Inspection: 10/3/00 Name of Inspector: JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT 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 inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes _ Conditionally Passes _ Needs Further Eval tion By the Local Approving Authority Fails Inspector's Signature: I Date: 1015100 The System Inspector shall sub ja copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 s.-iall submit the report to the appropriate regional office of the Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. NOTES AND COMMENTS "The inspection is based on criteria defined in Title V code 310 CMR 15.303. My findings are of how the system is performing at the time of inspection.M,. inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its component's useful life." THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEN PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. I revised 9/2/98 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 1013/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. 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 o the replacement or repair,as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. nla The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiitration,or tank failure . is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. n/a Sewage backup or'breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)o due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced _obstruction is removed _distribution box is levelled,or replaced nIa The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed 4i p, , 1 if. ft revised 9/2/98 Paoe 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 10/3100 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM 11 NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance n(a (approximation not valid). 3) OTHER nla revised 9/2/98 Paae 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 10/3100 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No - X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. - X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. - X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped n/a. - X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. - X Any portion of a cesspool or privy is within a Zone I of a public well. - X Any portion of a cesspool or privy is-within 50 feet of a private water supply well, X 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: 11 The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply s, X 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. ,z. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner: HERBERT VOLMAN Date of Inspection: 1013100 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X - Pumping information was provided by the owner,occupant,or Board of Health. X - 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. X As built plans have been obtained and examined.Note if they are not available with N/A. X - The facility or dwelling was inspected for signs of sewage back-up. X - The system does not receive non-sanitary or industrial waste flow. X - The site was inspected for signs of breakout. X - All system components,excluding the Soil Absorption System,have been located on the site. X - 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.The size and location of the Soil Absorption System on the site has been determined based on: X - Existing information,For example,Plan,at B4O,H, X - Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 1 5.302(3)(b)) X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Paae 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 1013/00 FLOW CONDITIONS RESIDENTIAL Design flow: n/a g.p.d./bedroom Number of bedrooms(design): 0 Number of bedrooms(actual):n/a Total DESIGN flow: 0 gpd Number of current residents:n/a Garbage grinder(yes or no): NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no): NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): n/a gpd Sump Pump(yes or no): NO Last date of occupancy: n/a COMMERCIALIINDUSTRIAL Type of establishment: ACCESSORY BUILDING Design flow: n/a gpd(Based on 15.203) Basis of design flow:nla Grease trap present:(yes or no): NO Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no): NO Water meter readings.if available: n/a Last date of occupancy:n/a OTHER: (Describe) n/a GENERAL INFORMATION PUMPING RECORDS and source of information: n/a System pumped as part of inspection:(yes or no): NO If yes,volume pumped n/a gallons Reason for pumping:n/a TYPE OF SYSTEM X 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) _ I/A Technology etc.Attach copy of up to date operation and maintenance contract _ Tight Tank Copy of DEP Approval Other:n/a ` APPROXIMATE AGE of all components,date installed(if known)and source of information: THE SYSTEM IS 20 YEARS OLD. Sewage odors detected when arriving at the site:(yes or no) NO revised 9/2/98 Pape 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 1013/00 BUILDING SEWER:X (Locate on site plan) Depth below grade: 22" Material of construction: X cast iron _ 40 Pvc _ other(explain) Distance from private water supply well or suction line: n/a Diameter: n/a Comments: (condition of joints,venting,evidence of leakage,etc.) THE SEWER IS CAST IRON-THE PIPE FROM TANK TO PIT IS 40 PVC SEPTIC TANK: X (locate on site plan) Depth below grade: 16" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: n/a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 1000G L 8'6"H 5'7"W 4'10"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 2" 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: nla How dimensions were determined: MEASURED 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,etc.) I, THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS. GREASE TRAP: (locate on site plan) 1 Depth below grade: nla Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other Explain: nla Dimensions:nla 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 'r 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,etc.) n/a �_. revised 9/2198 Sri Paoe 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 10/3100 TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection) {locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other Explain: nla Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm present: NO Alarm level:NIA Alarm in working order:NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n/a DISTRIBUTION BOX:_ (locate on site plan) _1 r Depth of liquid level above outlet invert: n/a Comments: (note if level and distribution is equal,evidence,of solids carryover,evidence of leakage into or out of box,etc.) n/a PUMP CHAMBER: _ (locate on site plan) Pumps in working order:(Yes or No): NO Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n/a revised 9/2/98 Paoe 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 10/3/00 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number:(1)1000 GAL 6'X 6' leaching chambers,number: (n/a)n/a leaching galleries,number: (n/a)n/a leaching trenches,number,length: (nla)n/a leaching fields,number,dimensions: (n/a)n/a overflow cesspool,number: (n/a)n/a Alternative system: n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT HAD 3'OF WATER IN IT AT THE TIME OF THE INSPECTION.THE PIT HAS NOT HAD'MORE THAN 3'OF WATER IN IT. CESSPOOLS: _ (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: nla inflow(cesspool must be pumped as part of inspection)NO 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 t t revised 9/2/98 "'' Paoe 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 1013100 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) ------------------------LIA AA 1" A� OC, revised 9/2/98 Page 10 of 11 N SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1200 OLD STAGE RD CENTERVILLE, MA 02632 M173 P003 L002 Name of Owner HERBERT VOLMAN Date of Inspection: 10/3/00 MRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a USGS Date webs ite visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep_ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps _ Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET revised 9/2/98 Paoe 11 of 11 TOWN OF BARNSTABLE LOCATION I-Z00 0L2 5196,L ED«t-r-) SEWAGE #98-3-7 VILLAG ASSESSOR'S MAP & LOT 'ls3 6�. ca a, INSTALLER'S NAME&PHONE NO. 0L 7 — -70 SEPTIC TANK CAPACITY 1 � C �P LEACHING FACILITY: (type) T:i rej—.� (size) Z /fl k YD 922 SF NO. OF BEDROOMS I).A, BUILDER OR OWNER r r 2osra�a�►aJ C�ci1�" r�o PERMTTDATE: I-9"96 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility. Feet Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �7rJ Feet Furnished by O Z D 5 � � g c '6 g 2K t 24•�S'� G 2-7 y 0 „pper� — V—I j1 �.\ COMMOMNT-ALTH OF MASSACHUSETTS a (Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFF ft�S DEPARTME -NT OF ENVIRONMENTAL PROT -TIO&EP 2 2 199 ONE WINTER STREET. BOJTaOdr. NIA 02108 61 i-292-5,00 TOwNpF T � 3 -D 1// r N.A(H p pjTAB(E 3 oXE WILLIAM F.W'ELD L 9 etsetan• Govemo: ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner ' PART A CERTIFICATION Property Address: /apaCeA7? -k— a Address of Owner: GJrr,sT C ha / 1�c. Date of Inspection: jW7e"7 f r (If different) PO• ,0o X 6 Name of Inspector: Carp&e J:4oy/P. 0,'67, Lc,-YPrv�/�c'� i9aoP63oZ I am a DEP approved system inspector pursuant to Section 13.340 of Title 5 (310 CMR 13.000) Company Name: _ Mailing Address: C J Engineering Telephone Number: 449 Route 130, Suite 13 (So8)Ps8- y9 7.s Sandwich, MA 02563 CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: This inspection is based on criteria defined in Title V / code 310 CUR 15.303. My findings are of how the system is _ ✓ Passes performing at the time of the inspection. My inspection does t Cord it Tonal Iv Passes not imply any warranty or quarantee of the longevity of the _ Needs Further Evaluation 3� the Local Approving Authority septic system and any of its components useful life. Fails Inspector's Signature: _ Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) d pleting this inspection. If the system is a shared system or has a design Flow of 10,000 gpd or greater, the inspector andter�t pin shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original a tfie,;fy tern owner and copies sent to the buyer, if applicable, and the approving authority. CAROL Y111 J. - `} ` > INSPECTION SUMMARY: Check A, B, C, Or D: 3 DOYL E No.3.:.3'. A] SYSTEM PASSES: �V o tj 1 have not found any information which indicates that the system violates any of the failure criteria CMR 15303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass” section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no,or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the Worid Wide Web: http:/twww.magnet.state.ma.us/dep Printed on Recycled Paper C o* SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: C OFoQ e-1 .`Owner: eLiq B/ Date of Inspection: G9/i�i�/9>Z 4 31� Bl SYSTEM CONDITIONALLY PASSES (continued) e '•_f Sewage backup or,breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed Cl FURTHER EVALUATION 15 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy.is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER (swiaed 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: f D] SYSTEM FAILS: You must indicate either "Yes" or"No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to cow the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). k Number of times pumped_ Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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 wiFh no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliiorm bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. n EJ LARGE SYSTEM FAILS: You must indicate either "Yes" or"No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (rev ned 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: GLii-i3 T C4a/ei -xrG Date of Inspection: Check if the following have been done: You must indicate either "Yes" or"'No" as to each of the following: Yes No Ch 01e.K.be/- ✓ _ Pumping information was provided by the•ewner occu,panttor Beard of wealth. r/ _ 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. _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. ✓ _ All system components, excluding the Soil Absorption System, have been located on the site. 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. 5e, 40 rP.s aAWel' 7`P,07 1< The size and location of the Soil Absorption System on the site has been determined based on: The facility owner ;and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. w1o, _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] i (revised 04/25/97) Page 4 of 10 I� I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ` SYSTEM INFORMATION Property Address: fro aV s 7V9 Owner: Clri3T e'4a10" / Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: e.P.d./bedroom for S.A.S. _t Number of bedrooms: Number of current residents:_ Garbage gr,rder (yes or no):_ Laundry connected to system (yes or no):_ Seasonal use ryes or no):_ _ Water meter readings, if available (last two (2)year usage (gpd): Sump Pump (yes or no): _ Last date of occupancy: COMMERCI.AUINDUSTRIAL: Type of establishment: Cliuz k Design flow:aA/3gallons/day Grease trap present: (yes or no)AO Industrial Waste Holding Tank present: (yes or no)�i Non-sanitary waste discharged to the Title 5 system: (yes or no)Q0 Water meter readings, if available: 95�' r-7L 000 ct/ -- lzg6 V4 00o yQ/ Las:;Iate of occupancy:Cur-t�t ;' 'r �c��i&� OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: yr a 7`e eew-7 ef- 1&W ystem pumped aY part of inspection: (yes or no)_ If yes, volume pumped: eallons Reason for pumping TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy _ Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: //YErs�/JPr doy Sewage odors detected when arriving at the site: (yes or no) dO (revised 04/2S/97) Page S of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: /moo o/a�STn�� �Poao� Owner: Cti 73 T eha oe Date of Inspection: q//t///I�L BUILDING SEWER: (Locate on site plan) Depth below grade:N// °T 7v f :n le Material of construction: _cast iron Z40 PVC_other (explain) Distance from private water supply well or suction line AIA Diameter t 11 _ Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:/ Zits w,7-el0 f 91111A?;4 (locate on site plan) Depth below grade: 3Y/ ra ��"z'r T �' rar'X' " �T Material of construction: ✓oncrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: iff" n x 519"X Sys e FF•dPgZ�2_ Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle:_ Scum thickness: (6 it 1 Distance from top of scum to top of outlet tee or baffle: id- e-�� x�M 7V Tap filer s J Distance from bottom of scum to bottom of outlet tee or baffle: elf- e How dimensions were determined: a,'17e7-7ee Comments: ►re/I/�/-Calbra7z'd IV� (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, etc.) Ore �•V/e T 7pP i� g; moo.-'17;o � ©y�eT�Q-, rJa vP.x �n --� y!o 7- p�P�e�� its/�T�t^./� o/� i�5 y.�c%.� 22 /�, GREASE TRAP:ld,� (locate on site plan) Depth below grade: Material of construction: _,concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: 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, etc.) (revised 04/25/97) Page 6 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: /ROO c 0�d Sri,,P ��ad .Owner: GLtri3Tfba/o--� Date of Inspection: TIGHT OR HOLDING TANK: ,Nl/f (Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete_metal _Fiberglass _Polyethylene —other(explain) Dimensions: Capacity: gallons Design flow: gallons/da) Alarm level: Alarm in working order_Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and Float switches, etc.) i DISTRIBUTION BOX: / (loate on site plan) Depth of liquid level above outlet invert:�arovT/eT ii1✓ —7) Comments: (ncte if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) Y-60A i-� leeef r rl7'!1 U7/ cl%slT,bu 17a YO if VuT/CT�ipF� -���5 Ca Myo vP` or' Q PUMP CHAMBER:N/�¢ (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order (Yes or No,, Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: IpVo ol,-I_ �e •Qoav/ Owner: 14'w Zr f Date of Inspection: 9�ifi�/9,Z SOIL ABSORPTION SYSTEM (SAS): Lrs�Dc�c -el o01 91/19; (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: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) LeacGr�., 4* was ew e- ;., c o' c ,b : je r a eu chi"'- hole '— P h"e r5-2t 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, etc.) PRIVY: 4111V (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (zavisad 04/25/97) Pag• a of 10 SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTION FORM ,PART C sSYSTEM INFORMATION (continued) Property h Address: � ��O O/,p/ 377 eOei POwner GA; Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) - S Ta 1 /4k'7-M.V 5-?' SY' 5 77trJ/l a e77e7 /Hff TD 6 � 9/' r — GG.rzr- Ch e 1 � t Q Pa` � / J ' N It BIT. CONC. PgyENi ' t -7 / 1 �/e�4T r--_J o .7 de ' a Corer.07- --� ' WATER MANHOLE fD Sraye L /?0, BM#2 --- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ea C/o0'572t'ce s 0w.01 Owner: G�ir;'.s 7- Date of Inspection: Depth to Groundwater 30 Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records ;y Check local excavators, installers Use USGS Data ,0-1+QX•j91V&* /4ute7"&f far,-IV u�- Describe in your own words how you established the High Groundwater Elevation-. Must be completed) '� per !/5 G� i''►a,� SiTp �/�!! ._ �C'r �r Ma�(. 6.GJ• . eO)i ~X 6• w = ya -k 3o ' (zeviaod 04/25/97) Page 10 of 10 I f May-21, 2002 Ms. Susan Rask, Chairman Board of Health Town Hall-200 Main Street Hyannis, MA 02601 RE: Christ Chapel-1200 Old Stage Road Centerville, MA Engineer's Certification Dear Ms. Rask: Inspections conducted and engineer's certification for the referenced septic system are presented below: The completed force main and leaching field.installation was inspected in February 2002. A surveyor was retained to lay out the irregularly shaped leaching field. The field was found to.be constructed substantially to the dimensions specified and in the location shown on the approved design plan. The 3"manifold and 1-1/2" laterals were laid out in accordance with the approved design. 1/4"perforations were drilled into the 1-1/2" laterals in accordance with the approved design plan perforation layout. The completed duplex pumping installation was inspected in March 2002. The pumping system was found to be installed in accordance with the approved design plans. Water was pumped into the pump chamber to test for proper operation of the pumping system Automatic, manual and high water alarm controls functioned as they should. The pumps were found to discharge at approximately 40 gallons per minute (gpm) which correlates well with the design rate of 35 gpm In conclusion I certify that the septic system was installed and functions in accordance with the approved design. Please call me if you have any questions or comments. My phone number is 781-826- 3316. ,A OF k4sS�o 7amniei� . ly: DANIEL AR,Smith, P SMITI5 ld®< 36630 � CIVIL '09 9F'AIS7EaE� �� ��`�SS/ONAL Town of Barnstable P# �Op Department of Health,Safety,and Environmental Services �1►+ Public Health Division "Date —� 0� 367 Main Street,Hyannis MA 02601 anewgrearE, � �s . y MA35. f- �pr t Date Scheduled us 7 �G FD JM �9 / � Time I Fee Pd. 0 . Soil Suitability Assessment for Sewage Dispo'sal Performed By: Witnessed By: LOCATION:& GENERAL INFORIVIA'TION . _ Location Address aW Owners Name S j � -KS Sr' fn — T Address Kr Lit Assessor's Map/Parcel: 73/4 Engineer's Name �>yj-,j)& t�. S�.tJet r r• NEW CONSTRUCTION REPAIR Telephone# 791 r g2e, Land Use Slopes(%) Z Surface Stones ►_ ►)o Distances from: Open Water Body ft Possible Wet Area k S6 t ft Drinking Water Well ft i t Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of t71— oles&perc tests,locate wetlands in proximity to holes) _ I_!, 110 X Pit 17 1-7 3 w'T-1+ a Parent material(geologic) G(..A,�'rA- _. Depth to Bedrock (JO(--e G�YQ ,,.177RLO) Depth to Groundwater: Standing Water in Hole: N�i�L Weeping from Pit Face . a Estimated Seasonal High Groundwater .3Z .... b T NAT OPV PO i :ASO A�,UGH ATI��t.TA13L�' Method Used: 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.Groundwater Level PEJ C.0.AT! N U Ti. Date Observation Hole# Time at 9" /O- 4'3 c, h Depth ofPerc 1 Time at 6" /U: P';, Start Pre-soak Time @ r'V Z 5 3 U Time(9"-6") Z }•�i p.� :=nd Pre-soak __ 10: 4-0 ; 30 _ Rate Min./Inch � Site Suitability Assessment: Site Passed l� Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant _ i _. DEEP OBSERVATION ROLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel 44 94 C 1 LOAM f y Z-SY'I/Z r-30 FA4 I � DE ' OBSERVATION HOLE LQG Hole#: Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. . C nsistenc ° Gravel t - t ''r exd4 h I .: - 71 :. DEEP bBSERVATIQN ROLE LO;G Hole# Depth from Soil Horizon ( Soil Texture l Soil Color Soil Other Surface(in.) !t I (USDA) ! (Munsell) Mottling (Struct.uc,Stones,Boulderes. C n i tent °o ravel I i ... DEEP OBSERVATION HOLE LOG Ilole# `k Depth from Soil Horizon Soil Texture Soil Color Soil ...... Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. I Consistency, ravel Flood Insurance Rate Man: / Above 500 year flood boundary No— Yes V Within 500 year boundary No—Z Yes Within 100 year flood boundary No..✓ Yes Depth of Naturally Occurring Pervious Material 1 - Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on rA ll 96 (date) I have passed the soil evaluator examination approved by the Department of Envirgnmental Protection and that the above analysis was performed by me consistent with the required traini expertise and experien e described in 310 CMR 15.017. Signature Date U i Town of Barnstable P# -Department of Health,Safety,and Environmental Services . Public Health Division Date 1013 d16) 367 Main Street.Hyannis MA 02601 . • aARNWABL& MAW `P ...►'^. °rFp Date Scheduled OG-tD' e i9 -ocgo- Time '//;pOuw! Fee Pd. t i - Soil Suitability Assessment for Sewage Disposal Performed By: 6a h 61/_1 ✓` ®O Y�P ,10411� Witnessed By: Po oy gy /l/i 9I�+AG LOCATION & ENERAL INFORMATION Location Address'/d0o 01W_5,V �Ou Owner's Name 6h 1 fs IX,IIP Address (ud�'a ce y 7o c.h r,s T c h q�e/) /ADO c7la�S he �2ou o� Assessor's Map/Parcel: Ma/O lir9, GoToo It Engineer's Name 6J`--E7�%',ilPF ri.V ,Z, NEW CONSTRUCTION REPAIR Telephone# Land Use 0&!nKMo .¢�e'o Slopes(%) O-:VPb � Surface Stones reu! Distances from: Open Water Body ft Possible Wet Area 7,30-0. ft Drinking Water Well N//¢ ft Drainage Way ft Property Line ti /D r' ft Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) so,o, ' a 6� a �l,ns r GkaPei Ge. �— old ,5 rq�� /loco/ OG Parent material(geologic) e✓Ttraah O/gI)f ice cv4r Depth to Bedrock �leovos.7�' - Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face 7- -/ Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABU Method Used: ,//le77.r qd-oc/ Depth 6bserved standing in obs.hole: in. Depth to soil mottles: -- in. Depth to weeping from side of obs.hole: 2_167 - in. Groundwater Adjustment ft. Index Well#50&4 l Reading Date:,: oe, Index Well level. S/, %S Adj.factor Adj.Groundwater Level PERCOLATION TEST Date o ao Time Observation Pole# Time at 9" :0 Depth of Perc �f Time at 6" Start Pre-soak Time @ 0.100 Time(9"-6") End Pre-soak / "Ot7 Rate Min./inch Site Suitability Assessment: Site Passed V11 Site Failed: Additional Testing Needed(Y/N)_ V Criginal: Public Health Division Observation Hole Data To Be Completed on Back--j Copy: Applicant DEEP:OBSERVATION HOLE LOG Dole;# TP Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % (,0el 46 o 66/eS ,yed%vim 7v DEEP OBSERVATION HOLE LOG Hole'#; Depth from Soil Horizon Soil Texture Soil Color Soil Othcr Surface(in.) ' (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % O /aZ 19" Loui►► uh /oY/1�/� Y3.6oi c Lour+ �uwa� loy.,eb/�? !.✓ .Th Lobb/ems A rv*t70 68— 1 G Lou ef#-c/ ,+30 Fov e 7a �.. .. >DEEV.0BSERVATION STOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency, Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil'fexture. Soil Color Soif Other Surface(in.) (USDA)' (Munsell) Mottling (Structure,Stones,-Boulderes. % - .. . .._.._._._._...----- _._ ... ._............._... ..__..._.........._ . Flood Insurance Rate Maw. Above 500 year flood boundary No_ Yes Within 500 year boundary No c/ Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in-all areas observed throughout the.. area'proposed for the soil absorption system? v� F If not,what is the depth of naturally,.occurring pervious material? Certification I certify that on _orr, /995' (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 and experience described in 310 CMR 15.017. Signature 4L _ Date lologolo 0 Town of Barnstable P># Department of Health,Safety,and Environmental Services aim Public Health Division Date (� Q, 367 Main Street,Hyannis MA 02601 • aARN9M • ^ MA88. Date Scheduled aG tbhe/' /`� ,�OQO Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: CG rV&, ,7 J-.. /1®,v/ �. Witnessed By: Agw,", //1i0/ s> ., '—fir. 7t G/' LOCATION & GENERAL INFORMATION Location Address 18400 o/A'-51 VIC k cVa/ Owner's Name `dpcP� 7-- 7t7 G�/`i3TG���P// ` Address /AUD DIc/STnye�`�u� Assessor's Map/Parcel: Engineer's Name GT ,r-p sec ir���y�yj. Y+E g 1.3 el,51,YrP/3,5 �ra/a ie_4., NEW CONSTRUCTION REPAIR - I� Telephone# _ 9 Od Sb Land Use Slopes(%) a-3% Surface Stones -rB rnJ Cistances from: Open Water Body &�,Jt ft Possible Wet Area. 73o V ft Drinking Water Well Al ft Drainage Way N/.y ft Property Line 7/O a ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ' a tk a ea a B�TO--d �Ans r Gh�P�1 •0174 a/la 0 4. E--- Old s r4q 04� tl C /loo� Parent material(geologic) 6y?-„*j%A O�ii�f- ite co�. T3aT Depth to Bedrock deoos"rs Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face(� Q6 v iW 7-,,V/ Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE M c t h o d Used: Lope Cod 6o"-w.by/1e77n 93-ev/ Depth Observed standing in obs.hole: �- in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: `f(o'6T in. Groundwater Adjustment ft. Index Well#ley_'tS9Reading Date:P� Index Well level_ / Adj.factor Adj.Groundwater Level PERCOLATION TEST Date oA AM Time Observation Hole# r/O-;z Time at 9" Depth of Perc _ Time at 6" y�Ya Start Pre-soak Time n 0t OO Time(9"-6") End Pre-soak l OV Fate Min./inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)_ t/ Original: Public Health Division Observation Hole Data To Be Completed on Back Copy: Applicant DEEP OBSERVATYONROLE LOG Dole;# yam Depth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % if- �9< G Loon, /o 'e �cwo !e o(',,N -Fao77 r9 a sCo&, 7`-e� 16 A h�� reel�Ci` �ei 7`D erisl` DEEP OBSERVATION HOLE LOG ;Hole# Depth from So.!Horizon SeiLTexture t Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % a3—ion C 104,0"y 5c4. w toYoe Alf, — w/—rh C.,k h/r /o OX.0 DEEP OBSERVATION DOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel) i DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon soil'fexture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel) e P Flood Insurance hate MaK Above 500 year flood boundary No_ Yes ✓ Within 500 year boundary No_✓ Yes Within 100 year flood boundary No_� Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area.proposed for the soil absorption system? Jf not,what is the depth of naturally occurring pervious material? Certification I certify that on, Og,t. (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 and experience described in 310 CMR 15.017. Signature _ � ������_ Date TOWN OF B ABLE I &C T?ON ® 0Id S- SEWAGE # 1'J3 VILLAGE ASSESSOR'S MAP & LOToI 36b'l- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER Cfi PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 4A IbL TOWN OF BARNSTABLE A I Z Op oLr-> S N&L EDAT) SEWAGE #98-3-7 L�JCA�TI N VII,LAGE ASSESSOR'S MAP & LOT .03 Da a, INSTALLER'S NAME&PHONE NO. 6CL 7 — -70 SEPTIC TANK CAPACITY 1 C.- LEACHING FACILITY: (type) (size) Z NO.OF BEDROOMS A)A, BUILDER OR OWNER r_»aesn-v-22."mcAnib-J Ckria'-C r,,k PERMIT DATE: 1-9"9 P COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -f-6.( Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) N L Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) f 275 Feet Furnished by s�pTlL �. 0:9 P �, 30r,!:PO 64r o PAN O G '6 313 2'f 24.f tZ G1.�iyD r l No. / 7 Fei A THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Tipplication for 30k;paai *pgtem Cong ruction 3permit Application for a Permit to Construct k)Repair( )Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. 17-W OLD $7 J?0+ Owner's Name,Address and Tel.No. C*Zt:5r-G r4�c�.L Ce-JM�-VI44A44. Assessor's Map/Parcel `7 3 o03.00Z_ I Zva 01,6 S YG�QQ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. yyR 12 —/30 ft irr_13 508 ssr ps Type of Building:C-0k)LCA,�- Dwelling No.of Bedrooms Lot Size 5_ b 4cm sq.ft. Garbage Grinder Other Type of Building C4yyxA4- No.of Persons Showers( ) Cafeteria( ) Other Fixtures bP�eg ^5 Design Flow /�y� W d'�?I 3 s rst'egallons per day. Calculated daily flow Aei 30M gallons. Plan Date /0127 Number of sheets A—o?, Revision Die Z Title fj& rZ pZA- Size of Septic Tank Jbw S;F.91-te- k. e'er ;✓ 979aType of S.A.S. Description of Soil ® - �� /D "'-?Z"• / Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss-upd by this B f Health. Signed Date 17- , Application Approved by Date Application Disapproved for the following reasons Permit No. �`' 3 7 Date Issued No. " ` Fee' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Miopoal 6potem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. /„ (;Q O t_O j 7"4 GQ Owner's Name,Address and Tel.No. Assessor's Map/Parcel U r. O / 7 5Z 00'5 007 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: a"I(J e C 14-- Dwelling No.of Bedrooms Lot Sizes"S sq.ft. Garbage Grinder Other Type of Building c a,,m c No.of Persons Showers( ) Cafeteria( ) Other Fixtures ei ..e Design Flow / ?� �s ,�f�y+ gallons per day. Calculated daily flow Ir 5 ?OD / ;' gallons. Plan Date 1,,—I r' " � Number of sheets Revision Date 0/? 7 % 7 Title ,J Size of Septic Tank 56�<, s/Type of S.A.S. Description of Soil n - 12' A,& VZ,Z /7 32' L VO /6) J j^10' .C"", sn A,i'.9 rA1' f.,t�f-CLI i)fr F lt�`/,���/� f/')'4• - l .t'�) � ht��-� /lii/1 �,nin 1)�6!/J�', L 6 Y 7/3 - s . Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this�ard f Health. Signed Date t z Application Approved by /��- / b -. 1� Date— 5,F Application Disapproved for the following reasons Permit No. -7 Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( `-)Repaired ( )Upgraded( ) Abandoned( )by at has been construct in accordance with the pr isions of Ti fe 5 and the o ' isposal System Construction?e-t.N� / 7" S 7 dated Installer Designer- "� "�f C r h Jj The issuance of this permit shall not be csnstrued as a guarantee that the system will fu tion as designed. Date ^�..b " �1� Inspector 7, ——————————————————————————————————— No. Fee/0 0• THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Milpo4a pgtem�Congtruction 3Permit Permission is hereby(gtanted;to(�onst�iic�t( )R pair( Up ra e( )Aban on System located'at / �C and as described'%in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 51and the following local provisions or special conditions. ,m Provided:Construction must be completed within three years of the date of thi'sp 't. d Date: �' �' Approved by g /010� �► TOWN OF BARNSTABLE LOCATION SEWAGE # '!73—o ou),-®0 VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. r , SEPTIC TANK CAPACITY 3otP gl LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER�� 1 BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: n )-t5—, VARIANCE GRANTED: Yes No>' �.r �9 s �$ � �� �� 1 ,� �� � �� _ ,,; �� �? .� � �.; �: _ � , �:.�. Fps...................��- THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH iv^j.........OF......... Oooe1" ---._...............•----------- Appliration for Bi4pniial Works Towitrurtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ........__ .t............................................ ............................................................ Location-Address A/C —or Lot No. Owner Address w �zz.�_ . .. -------------------------------------------------------•----•- __ U. Se, Address Q Type of Building Size Lot.2� �._.�b_ .....Sq. feet U Dwelling—No. of Bedrooms____...... --_•__________________Expansion At is ( ) Garbage Grinder ( ) p''LOPO`'`� No of persons ..__...._ Showers — Cafeteria� Other—Type of Building 2ffV�.� � p .. ( ) ( ) QOther fixtures -----•-- - - ----- --------••.•• •••••-•••••...---•••-••-•..............••----•••--••-----•-•-••-••-••-•••••................ W DeS1gT1 Flow. 5/L�l'Lg^' g �P, .,P, nn .,P, aay. Total daily flow -�oo----------------gallons. 1:4 Septic Tank—Liquid capacit,Y _gallons Length---------------- Width---------------- Diameter---------------- Depth................ Disposal Trench—No. -----N4- ...... Width___ - Total Length----__...._:_...... Total leaching area____________........sq. ft. ' Seepage Pit No.......�_/----------- Diameter...-l2------_--- Depth below inlet..... ?........... Total leaching area.3F�.._..sq. ft. Z Other Distribution box (t4 Dosing tank ( ) Percola;.ion Test Results Performed by...-D ...Ao�K_A.-�?4iJ.................................... Date.JU�.Z�.1-V�...__. Test Pit No. 1.._._—------minutes per inch Depth of Test Pit-----lS----------.. Depth to ground water..!?t' 'C_____-_--- LT4 Test Pit No. 2.-/—..Zn...minutes per inch Depth of Test Pit..... ........ Depth to ground water__A"" ...------- Descrip.ion of Soil_ l ��.3�- -5ygs"``�c j------ -i__1:- - -----------------------------------------•----------•--- ------••••-•-----------------• a.�..�....... `���'Sa�`� —����` -Ae>---:ArD_ff�_�1�C_. !41'. 1 aM 61� 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 rov-isions of'TT LE, the State Sanitary Code— The undersigned further agrees not to place the system in o ation t .il a C rtificat of Compliance haSbDn issued by oar of health. SE' Signed $'"'- 3 v< =c � D to PPlica:ion Appr ed By--------- •�•'�-��'!•�"-�-----------------•--•--•--• �Z.� ----- ----------- Date Application Disapproved for the following reasons------------------------------------------------------------------------------------------------------------•--- .............•........---•-•----------------------------------................----------•------------------••-•--•••--•-•--••---•------. ............................................................. Date E' Permit No.. .....77 _2............ Issued....................................................... Date _J r � FEE.... .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .--......OF......... S /-.............. ---------•....................... Appliratiou for Rapagal Ourks Tomitrurtion rumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 61&-��) �j'films T ip /'�7� mac//G�c r c�,�,� Gl r� :�c _ Z677 Z_ ...............;.......... ..._...----....._...------•---•-•-----•------- -- ..... .....-- --•----•-----•-•-•----•-••----............--•- /' / Location Address or Lot No. . }Owner Address a .............................. ....�......�.. .... { ............................................ ...................................................... _�_Insta r Address Type of Building Size Lot_2`r`3i.__.FID`rt.._..Sq. feet Dwelling—No. of Bedrooms.......... '.......................Expansion Attic ( ) Garbage Grinder ( ) a —Type g _ !`o�� `' N71 p "JL ____.___. Showers Cafeteria ( ) Other—T e of Building n No. of ersons_______________ � O er fixtures ----------------- ------------------•- - ------- _ 'i L (' �- Il ,, .,o / 7n lops. W Design Flow---=-••�--------`=-=-='--•------- ------g�r•�,^�->��-rr-day. Total daily flow--------••-------•----- - � 34 Septic Tank—Liquid capacity_ _gallons Length................ Width---------------- Diameter................ Depth................ Disposal Trench—No. __._.N_ ...... Width.............. Total Length.....-77�;...... Total leaching area_.-••-•.............sq. ft. Seepage Pit No-------5/�---------- Diameter.....!2.......... Depth below inlet..... .......... Total leaching area..:?:. 9._...sq. ft. Z Other Distribution box (L4 Dosing tank ( ) '-' Percolation Test Results Performed by... .................................... Date_:I�:'_ ..2��.! ..._.. ,`4j Teat Pit No. i.__..'"......minutes per inch Depth of Test Pit_____�5.......... Depth to ground water_. ........... Test Pit No. 2..�z-...minutes per inch Depth of Test Pit...... Depth to ground water_.----- '. ..__._..__. D Description of Soil--#. ��` -= ��� -= = ..... =• � .... ------------------------------------------------------- x r ------------- r •r rJ, -1' J U 1' 3 ! Q- 3 <✓!x`a/ �- !'t�)� 5tn rJ (f !i_/-�i/ 'Ir.. h hr c 1•- W [—f'----2-- U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with dnrovisions of TTTLE, i of the State Sanitary Code—The undersigned further agrees not to place the system in tion til a C tifi f Compliance has b n issued b=eoar of health. L� Signe . ..... •--••-------^----------••---- ��--------•-•-----•••-•.. � tt�Io-_.... ication Appr ed BY - - --------------% _--- Z-:5g �'pplication Disapproved for the following redsons:-----••----••••-•-------••-----•-•--•---------••----•--•-•----••----••--•-••-----•••-•-••- Date .....---•--. ................•--••--------------•----......-•----------------------......---------......-•-------.--.--------------------------------------------------------------------------------- ------- Date Permit No.....�'`�:-f' Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF _HEALTH 1... .............OF..................-- .I1� ................................. Tntifiratr of Toutpliatta THI K c T I CERTI.-Y, That ithe Individual Sewage Disposal System constructed ( ) or Repaired ( ) -� ...... Y.................. .. Installer at.............................. ---- �- ---.`�~� has been installed in accordance with the provisions of TITIZ j of The State Sanitary Code a described in the application for Disposal Works Construction Permit No.....�f�p__"72 ..._....... dated.....__.�1_.Z- ._�S -------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ --_ ----------------------------------------- Inspector'.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS r------ BOARD OF HEALTH �p ...�!11........OF............�r-�. 1J............ . Cam^ o...................... FEE......I.. ....... Disposal Workii Tomitrurti.o u atttit Permission is hereby granted. --_:: .__ .._... D. N'______ ________ _ to Construct ( ) or Repair ( au—Individual S wage Disp System .................. Street as shown on the application for Disposal Works Construction Permit l c �____ Date _._.__..__ ._ : . G z. p: Board of Health • ''PATE........ ...... . FO 1255 HOBBS & WARREN, INC. PUBLISHERS 7 -77-7 ,7� 7 �,z 4 TOTAL CHURCH CAPACITY ='580 580 03- GPD = 1, 740 GPD SOIL TEST LOG 5014L TEST LOG PERC TEST P-9018/1 PERC TEST P-901812 EX. SEP77C SYSTEM CAP. - 2,713 GPD DEPTH 3,000 GALLON SEP77C TANK, D-BOX & HORIZON DEPTH HORIZON 4 LEACHING PITS-6' X 6' W/J' STONE 0. OR. - EL IM.00 0. GR. M 102-50 LOAMY SAND MED. DESIGN FLOWS: SAND Ap 10YR4/13 Ap *28SO .,GREASE TRAP (ASSEMBLY AREA KITCHEN) 9. 200 -SEATS AT 15 GPD 3,0 00 GPD LOAMY SAND ------------- SAND BIN 10YR5/S Bw A". DOMESTIC FLOW.'' ISYR413 200 SEATS AT 3 GPD 600 GP6 (BASED ON DAY CAMP, MESS HALL) 32' 700SF OFFICE 0 75GPD11000SF 53 GPD FINE TO TOTAL MED. SAW ----------------- 653 GPD Wlt*A VEL Cl MD. SAND C1 ---------- Z5YRO/4 ------ 2.5 Y7116 -------------- SEP77C TANK 1,500 GALLONS Ice* GREASE TRAP 3,000 GALL ONS ---------------- NO CARBAGE DISPOSAL FINE TO TOWN WA TER MED. SAND W1,GRA VEL C2 lc� N ----------- 2.5YZ/3 sizE or LEACH FIELD REQUIRED: ------ I I I I,\ I __1 I \ \ DRANAGE RETENT70H AREA TO BE 551 S.F. DESIGN PERC RATE. 2 MINIINCH 728' 144" COVER W/6' L-OAM 9 HYDROSEED REQ'D AREA,- 600/0.75 - 8001S.F. 130TTOM OF FMHED BASIN TO SLOPE FROM SOIL TESTS CONDUCTED ON 9/25 7 EL_ 100.00 TO TOP GRATE AT 99-50 AREA PROVIDED: BY CAROLYN J. DOnE AND SX)E SLOPES HOT TO EXCEED 4 TO -1 AA (10' + 1) x (40' + 1) x 2 902 S. F, WTNESSED BY BARNSTABLE BOH PROVX)E 6' X 6' LEACFM1S Prr, TYP. AGENT JERRY DUMVNG WANLET GRATE NO GROUNDWATER AT 10'e (EL 90,33) EACH FIELD: EFFEC77VE LENGTH = 40' ----------- EFFEC TrW WID TH - 10' NUMBER OF FIELDS = 2 fit 02:11 'J A - - - - - - - - - SOLID PVC, S=0.0208 KITCHEN FLOW, AR 1-ITIO" _AA TO BE 897 S.F DRA?NAGd RETE S=0.0138 FOR EAST WING, " I I t COVER W�' LOAM 9 HY'PR 0) S=0.01 78 FOR KEST WING I SI DOTTOK OF %HfT 8AS9SrLNFE FROM 7;- R.��E I EL. (;K pr I SOLID PVC, S-0.0156 SOLID PVC, S=0.0104 ;.C?b TO T AT 96W SVE SLIOPES TYOT TOtEXCEED .4' TO 1 SOLID PVC, FIRST 2' TO BE PROVX?�5 6'X 6( LEAC8,M PIT -1`YP. W/1N1_ET0kATE LEVEL, REST AT S=0.005 ------ cm p -------- I ------- ----­--------- 0 0 0 70 - � I 000 lot f/ r -DEPTH L"D 0 Ailt, 11 J FIN -FO SLOPE it f itHry cikAvE 7 8 Jp 1 11 N c Ikkk I 12" 4 10 AWAY F M IDING t TO 0 1 E 3 LE GREASE 'TRAP SEPTIC TANK -9 OR EQUAL, WGGIN D6 40, PROVIDE INLET TEE OR 4Rff.4 f 01 J ,0. 08 FTIFT V 7 BAFFLE IF S, 46, PROVIDE GAS BAFFLE SOIL TEST LOG SOIL TEST LOG SOIL TEST LOG PROPOSED SEPTIC SYSTEM - PROFILE 2A PERC TEST 1A PERC TEST PERC TEST JA HORL7 J DEPTH HORIZON DEPTH ON DEPTH HORIZON 0. ORADE-EL 98.50 GRADE -EL. 98.70 CRADE-EL 97,20 0. 0. c/ TOPSOIL & TOPSOIL APIPw TOPSOIL & APIPw COMPON I FVA T7 ap /. , 0 1 6iSTzEA4_, Ap/Vw SUBSOIL "7 SUBSOIL SUBSOIL W10CLAY 1. FINISHED, F1 I OOR- .......................................................... 101.50 10d :� , ;Z7 01 Y 2 'INVERT or PIPE AT FOUNDA TIoN .............................. 99.50 A --- ----------- . 0 ACED. SAND j rp, 42* PERCHED cl, 3.- INVERT OF PIPE AT GREASE TRAP INLET ......... ...... 98.88 (KITCHEN ONLY) 0 WATER 0 156' .500 GALLONV\', L 1- 7;! 00 \10x�t 7 r89 ST LOG L TC' C TEST 3A ORIZO14 -EL X0 SEPTr_ TANK 4. 'INVERT OF PIPE AT GREASE TRAP OUTLET ........ 98.71 (KITCHEN ONLY) V\ FINE SAND W17RACES Or C7 5. INVERT OF PIPE AT SEP77C TANK INLET ............ MIN. SLOPE 1/8*/F7 w --------- 98.13 ALL CONNECT70NS FERROUS OXIDE -11, - UED. SAtO C1 ? INVERT OF PIPE AT SEP77C TANK OUTLET ....... 97'96 Q 0 BELOW AT C2 .3,000 J:/CHRIST/CONST �2�TE.DWG lob / N ADDENDIUM #1 ,"A' ,&27 OCT. 1997 I ARCHITECTS IROWN a LSIDQMT. Iric 926 MAIN ST. YARMOUTHPORT, MA 508-362-2727 CIVIL ENG. 449 RT. 130, SJ� 43 SANDWICH MA. 506-888-4975 STRUCT. ENG.' W. %M" 'ALAM R0. BOX 79 SANDWICH, MA 505-888-3154 Mf=CH. ENGINEER, .ARM MC-MEMNG M P.0-BOX'328' SAGAMORF_ MA 605-888-6464 I- L I- C T.' I- N G, L4q"m"cwp_ CXXi&X_TAmTs 79 N. MAIN ST. MANSf=IELD MA. 508-339-4444 Now nwfivl. IN VER I Lor Pirc A I U-0VA INLC I .......... I ...... I ........... I LOAhf &- HYDROSEED 8. IN VER T OF PIPE AT D-BOX OUTLET ................. ...... 97.48 Or r -7f LA 9. INVERT OF PIPE AT DIFFUSER INLET ...... . .............. 97.343 GROUNDWATER AT NO GROUNDWATER u -;z (m 85.50) 15 AT 15' (EL 83.70) OPOUNDWATER AT (EL 84.20) 13 7 J 0. BOTTOM OF' F TYPICAL SWALE SECTION N� 1OW DIFFUSER ......... I SM TESTS CONDUCTm ON ................ 96.47 _j LEVY & WAGNER ASSWATEES� NOT TO SCALE 'lee WTIOESSED or TOW MCKEM 11. BOTTOM OF AGGREGATE ............................................ 95.43 40� -L OCA TED ON SECTION & PROFILE FOUR PRECAST CONCRE FL w DIFFUSERS, 4' x & EACH, H 31 r 40 Val SHOULD UNSUITABLE, MATERIAL BE ENCOUNTERED I rfl-E T INV. 90 STONE ON SIDES & 4' STONE ON END -14 BELOW 98.33 IT SHALL, BE REMOVED & REPLACED 2 _j .40 SO&- TEST L-CIG 500- TEST LOG -c4:>?L TEST LOG `4 M TH A115' OVERDIG' PER TITLE 5 REGULATIONS PEPC TEST TP-1 PERC Im TP-2 PM 7UT TP-3 'N' DEPTH NOP20N MIN. TOPSOIL lc�/N P�/_. Mf)Pjz&i FRANC 8 GRA ORICKS MAY MLL ?M7 OF TOPSOIL 01. 0 0 t ------- 01 GRADE -EL CRADE-EIL IOL3.50 CPADC- I FSARON FOU?)ORY CO.' BE USED FOR ORGANIC MATERIAL & Ml� ACP COtMCTOR AT. EL_ 92-50 j4M, SAND MED. SAW Ap 71LET 15 All BOULDERS, IN COMPLIANCE of WITH-310 CMR 15.255(3)), 7.5YRJA 7.5W3/1 MODEL L-F 248-2 GRADE AIDuVSTMENT WD. sAic OR EQUAL FRAME TO 8E,55T IN RA-L 5EV,OF MORTAR 97.50 14, COMPACT TO 907. DRY f P, 40, P CON TOR A r= DENSI TY vigil 2" LA or 1/8-1 Wa SAND �gw MED. SAND Bw MED. SAND aw 15YR51s Z5YR4/3 z5yR413 DOUBLE WASHED S E ZE Opa 24' 3e 3e 31 TT-9 he'Al 40' CONNECTORS AT EL. 9200 .3 MIED. SAND cl POP, io, d1W C qw (.0q 6 N SIT. LIMITS OF A TERNATE #4 LOAM C2 r A4ED. SAND C1 MIM. SAND C1 pm Ya 3 0 INCL-UD�eA�14WN�IZAINAGF_ STRUCTLRES 7.5YR4/4 314-1 112- DOUBLE IE FZI�51 0 OF PAV1NG SURFACES WASHED STONE IA,' C3 INLLT V qL:`k15' 0 720^ 132" i2o. L SOIL TESTS CONDUCTED ON 2AI96 100 .,BY CAROLM J. DOnE A -ROUNDWTER EWOUNTERED SECTION A G I NO C \ I t )N ANY OF THESE TEST P17S TYPICAL SECTION 70 El- 92.25 STAMP NOT TO SCALE �-S f 41 ow 11 1 W 10- A P COtp ORS PRECAST CONCRETE MANHOL&---\ 0 DASE MIN. OA2 50. 171. STEEL T EL. 92, 1 -97- PER W!RT. FOOT, PLACED IN 7 lot, WITH AASHTO M199 OESIGHAT)ON Y YPICAL CATCH BASIN SECTION NOT TO SCALE t F�IST. DR INAGE 94- ?40 3�� 3-,rRUCTU ES CL 4 MU_ POLYETHYLENE CE mArf 93- 0 DINATE L_ A Z3S -- ----------- VELi RKING 'LEGEND C-OMPACT60 GRAVf�L aAcKpbj EX.. AREA In 0(�ATIO OF B %�4 GpADE Ltru-ITI k4/ 02 - k 0 'T P1 AN r1V VLET INV. EL_ .15 ! b EXIS �5TFZUCTUW_S PROPERTY 1-INE SEPTIC 0 SITE UTIL-ITIRS PEASTONE to ELECTRIC 4' IN DEPTH, 61 SITE G 'DING lui 0 0 0 0 0 -0 -G- GAS RAL W- WATER IDATR 314*- UTILITY POLE f 0 0 0 0 0 0 B ]2--�, LIGHT POST 5 TOHJ! '----PRECAST CONCRETE LEACHING PIT; -C)URS A EXISTING CONT SHOREY PRECAST CONCRETE 0 0 0 0 0 0 -1,000 GALLON LEACH PRODUCTS, CATCH BASIN C. J. a KER 04 PROPOSED CONTOURS IOU" ST.- CATCH 13ASIN OR EOJAL 0 0 0 0 0 0 474. Oc> _9 ---- 0 LEACHING PIT 0 0 0 0 0 0 10 NOTED 11100F, SEPTIC TANKIGREASE TRAP 0 0 0 0 0 0 PARTIAL OA IDRA"4; Re.- NT EX. TREELINE 0 0 0 0, �0 0 ITE PLA11 DRAINAGE SWALE t-011 SCALE :'1" 30 TES7 PIT 7YPr�AL LEACHING PIT, SIEC770 N T SCALLE TEST PIT BY OTHERS I in �- --z - --�---.--�• •-..w...___.. .._...:w.•..-.•..•ate ___._ ,_'... .-..__,-. _�.«. ...-.., ..• ._.,...�.. ._w.w ._. _. .. �__ .., ._._... .. �._ .. _. .. ,. .. .-- -__ .._._ .-.. - .. � ... ... ... �.. ___-__.,.._ --.. ,. ._ .. _ .. �_.. _. .. ,. . _ _ ... .. -. _ � .� - ._. _. _.. � -- -. -. -•_._ _. .. .._... I T (-,4 PAC I t Y i ST. U R(_ F C.A PAC.1TY 33 00 YE W-S01J5 ao it 1'7l�u 3 7 3 GAL-1 PE R5,01v/15-rAT_x 300 PE RLOUIS = q00 GAL - DAY /D F T. /'7 /M. ,` ;_,er,.. •� � :, -r- ,� (17' EFF DIA.) i LHUEC-It r-IT(-HEN: 200 QERSUNS �' r�ilvly�ir I 2Y HEAVY purr $07T,lN at'EA : �trjc} = 1/3.0 S,F/PIT. t S GAG. PEP-500 +' 200 = 1000 &AILIlb f EL ,Irl � r_gsT�.ave�a —�°. r __ ._Pt���T. ' '' I� 12n1t �rDE AREA. :�r(r�}(6)=2z6.1 GA 9�%% i O G RA E 2 �e K /+u� >� LOVE R_ 'y G/'�t� c t Z,4p 5i4 N C t TOTAL- : 1 q00 C,AL.I DAY Sc %' "��s� : r 4`} m j:�r•- 2. S x Q PrTS = L71� ! 6AL./DAY i qVD r� (_16rU I E4/EL r"' �`'�y`'� 113_C) r I.0 X4 PITS _ S/� Z C,AL./,D,4Y r i E/=59o' SLMED Du` Mp `r '�'�_''T.,-?-T.. 1 + 3 F.t i'v� "' p V. C. ..�,"� £. ?. ! ► a r s '• r y a ,� ),� tfE!� ..aaE +/y+l of �x r�i,r'1(- "ZNIK Ez -9,.5J �r,7' IJp�� o r " ,0 � �.*� ec� ;,'i �i T�� 2 %(� L-/�L./D14y ?17' :'J�?`"!`%.li}/ jfax, , x >, ` EI 97,0 W 1/ (j A o Q e' Alt * H { j 'y 's r..i 4 SZ t::Sae'l,V•a.: EL- 7a5 1 jCJ r, # r � j' 0t f j • e .i • - 1 S, a �.� P• S D,d l !l i C� it ��i , t��� - i ` IT AX. s .0 r' �t ' T!� Rrt "A 1�G F ..._. �G__ r- L . - tr �f • Z j Jr , L E fir.-�,e -y r , (P ^y t lo Nt tl TA le F � t ! i i i r. ti._,.�,�_- ice__'_ �'_--",_•- � 1 ~�-�_'_---•--•r,�.,y� '' -- 1 /• % �^'' �•. � \.j to., ! < rtle 4 "..1 r4�,, � �^t •ice' ' '` —�-� l i� _ -""•-'-_.'_-.--.-,__.,t„_�_'^_----�.___ __-'�•_._�`••+�M`.__-.;--•�' r� � i i- rs �� Y �r. D �lolx3l �' �5 3 , �Jr�1 ''�•�/ `. 1 �` DA?"F_ ^' SOt!_ �IsSY , Ttt Alf 16,, 1`/i�4, fir' / T7y , /- ;TAJE> 5 F D a Y: T fk +Cew. f I t r-�--_ �s vo rs � , A air IJ 2 7r� f, ,� oa A)b A- rl oA) ' i 9q, - -- — �� i.,, p� c. A710 T6 #; Yrt Tp,� a 7771 ',. �; it •� � .____-._-.---- ----- -�• --- i l ._....___�---._ _-_...._"_._ _ ___._._; / � ! �/r' .��'SU+t� 4 Ala :>r'G_ / , , ; } r > U ? a 0r L LA Y - - - _ PIC f — ' ' b 4 � lI7 /fit+l/ills `j1� tr� /� TO r'At r,+;11° s Al.j!4 Al\ 3 oOt` t ed. C T 7i r* ,r.�� ''ter , ,' I'��i�1. � � `., `+ ( � � 1 '*: + �t ri !r � s, � Y �'� •{ �,i5'i__�i'A � � I i` iJR-CP 7D i - .a' +,j G•,�•.''T '•+`"{a`/' :•{ rJr }. I 1 ' n' k±,fsy,�4"..c ; TUT, ' ' y ,. _ �c••'' it 1 _. ! .� ......�----___•___.....___— - C, ` .4,,pA '+ ,... _+ , I r t� �,� A! "�-•�_ �, ir'. ,`, •R•+� � Y' y _... ! ', t ' �I ' ,' • ,'�.'!r': W^t•�'✓�+1. { Z t:i<1_rP't.'� Q. it �''� S /M h. -��._ .,'^.. �� •.� ' i\?r✓ ,+'^ t, �� '.-•''" \ n t '' k ' � it 1 ' M.N , "`a�r. `` l � � •, J-p .: /,_+ r i, ?.' J a ` -- ,\ � ..., ...; \-.�..�.__ . Ll zo TT i t ���` 9r � k E a'� re'=� 1 ' ^• 2 ". '' �1Cn f 11� 11 rAUY) JAI C'7A}JDA dif 14;dfY At #.2 I',' 7'C„ ' u i/: yr y 5-' if s :7_ `?�►?t ! �' -. rvt7Fi? '!.2' aGw"ETE i V,,4k. -huND /c7YPE ..� .G. `' t}�� I6•' cHi- � I � }• ` f c�.i^Hi'�'/'T - `i �� rlr.)T l�f'�,'�L•f —"__".c'_ ,.;j fl Y ti �ffayt=t_r /, _._2 _qill i�JT';i'r P ' _ ^77f e/w/ H `i bR Are Gt1i� f c� �frG rvr JIJ�'L toop0?0%F r.� :f } ' f s T 5 SA 17 . S { - 150 r (' . 3 ._.. 'err t, � I j.-.. _. _ - s v ! A 1iV � . f', J. ! („� Jam* 1 Z J U l 3, 1986 trzri PEE T. s e C (f