HomeMy WebLinkAbout0032 OLDE HOMESTEAD DRIVE - Health 32 Olde Homestead Drive, Marstons Mills
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VILLAGE a <<<•S ASSESSOR'S MAP&
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY /D®
LEACHING FACILITY: (type / (size) ®C30
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 facili� - Feet
Furnished by �.��Q
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COMMONWEALTH OF MASACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS
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: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Address of Owner: 1660 CENTER PLACE CENTERVILLE MA.02632
Date of Inspection: 2125100
Name of Inspector: JOHN GRACI
lam a DEP approved system inspector pursuant to Section 15.340 of Tide 5(310 CMR 15.000)
Company Name: TITLE V SEPTIC INSPECTIONS
Mailing Address: P.O.BOX 2119 TEATICKET MA.02636 p
Telephone Number: 608-664-6813 -'
CERTIFICATION STATEMENT
I certify that I have personalty 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 prpper function and
maintenance of on-site sewage disposal systems.The system: ,9
rR 7
X Passes r.
_ Conditionally Passes yt•
_ Needs Further Evaluation By the Local Approving Authority <00,
_ Fails tFA�
s
Inspector's Signature: Date: 8/00
The System Inspector shall s mit a 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
shall 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.My
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 INPECTION.RECOMMEND PUMPING THE EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFULL
LIFE.
revised 9/2/98 Page 1 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: 2125/00
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 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.
n1a 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 complying septic tank as approved by the Board of Health.
I]& 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).
_broken pipe(s)are replaced
_obstruction is removed
_distribution box Is levelled or replaced
Na 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 Heath):
_broken pipe(s)are replaced
_obstruction is removed
revised 9098 Page 2 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA CIO COBB NOWAK BRIAN COBB
Date of Inspection: 2/26/00
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 16.303(1)(b)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 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&(approximation not valid).
3) OTHER
n/a
revised 9/2/98 Page 3 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: 2/26/00
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
1 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 Il.
- 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:
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
- 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.
revised 9/2/98 Page 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner: BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: 2/26/00
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 Page 5 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBS NOWAK BRIAN COBB
Date of Inspection: 2/26/00
FLOW CONDITIONS
RESIDENTIAL;
Design flow: 110 g.p.d./bedroom
Number of bedrooms(design): 3 Number of bedrooms(actual):
Total DESIGN flow: 330 gpd
Number of current residents:0
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: 111/00
COM MERCIALnNDUSTRIAL
Type of establishment: n/a
Design flow: n/a gpd(Based on 15.203)
Basis of design flow:n/a
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:
THE SYSTEM WAS PUMPED IN 1996
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)
_ IlA 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:
1988
Sewage odors detected when arriving at the site:(yes of no): NO
revised 9/2198 Page 6 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: 2/26100
BUILDING SEWER:X
(Locate on site plan)
Depth below grade: n/a
Material of construction: _ cast iron X 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 LINE IS ORANGEBURG.THERE IS TOWN WATER.
SEPTIC TANK: X
(locate on site plan)
Depth below grade: 48"
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: L 8'6"H 6'7"W 4'10"EMPTY"
Sludge depth: 0"
Distance from top of sludge to bottom of outlet tee or baffle: n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or.baffle: n/a
Hary 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.)
THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING THE SYSTEM EVERY ONE TO TWO YEARS.
GREASE TRAP: _
(locate on site plan)
Depth below grade: n/a
Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other
Explain: n/a
Dirrensions:n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or baffle n/a
Date of last pumping: n/a
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 Page 7 of 1
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: 2/25/00
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: n/a
Dimensions: n/a
Capacity: n/a gallons
Design flow: n/a gallonstday
Alarm present: NO
Alarm level:WA 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)
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 9/2198 Page 8 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: V26100
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:, %1000 GAL 6'X 6'
leaching chambers,number: (n/a)n/a
leaching galleries,number: (n/a)n/a
leaching trenches,number,length: (n/a)n/a
leaching fields,number,dimensions: (n/a)n/a
overflow cesspool,number: (n/a)n/a
Alternative system: n/a
Name of Technology: n1a
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 WAS EMPTY AT THE TIME OF THE
INSPECTION.
CESSPOOLS: _
(locate on site plan)
Number and configuration: n/a
Depth-top of liquid to inlet Invert: n1a
Depth of solids layer: n1a
Depth of scum layer. n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater: n/a 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.)
nla
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.)
Wa
rerised 9/2198 Page 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: 2126/00
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)
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revised 9/2/98 Page 10 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 32 OLDE HOMESTEAD DR. MARSTONS MILLS, MA MAP 44 P 22 02648
Name of Owner BUSSICHELLA C/O COBB NOWAK BRIAN COBB
Date of Inspection: 2/26/00
NRCS Report name: n/a
Soil Type: n/a
Typical depth to groundwater: n/a
USGS Date website 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
X 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
Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
USGS MAPS AND CHARTS-12+FEET
revised 9/2/98 Page 11 of 11
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COtTltf101"1V!1eotth<:of fiilOssoChsetts John Grac><
�~ nioi Affairs
ExecutNla office,6f- E>'ivlronR�e - �:E P �rtle V Septic Inspector
Y P O: Box 2119
{ Opal, ��f: 0� Teaticket,MA 025-3 j
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SUBSURFACE SEWAGE DISEOSAL SYSTEM'INSPECTION FORM
PART A:
r , r
CERTIFICATION
a ' +A1
// Address of Owner y
PiopertyAddress 32 Olde Homestead:Marston Mllis { v
�19f96 (If different)
Date of Inspection Greg Botsivlaes Box 2111 Cente ille Ma
Name:of Inspector Jahn'Gracl €_ 4
6Pis
Company Name,�Address and Telephone Number fd
CERTIFICATION STATEMENT b,
e dls osal system at this address and that the informa l orted belov{is true orate
1 certify that 6 have personally inspected the sewag, , p
as of the time of,ihspectioh.;The inspection was performed
and completebased on my training antl expene, er��p r f� rltio nd
,
maintenance of on-site sewage disposal systems The.system
X Passes.,.
Conditionally,Passes '
Needs Further, valuation 8y the Local Approving Authority .
Falls ra
Date:.9125196
Inspector's Signature: .
submit a co of this inspection report to the Approving Authority within hlrty(30)days of tempownertshall submit
The System Inspector shall sub PY tl or greater,the inspector and the sys
inspections. If the system is ashared system or has a design flow of 101)00 gp
the report to the appropriate regional.office of the Depart
of Environmental Protection,
The original should be sent..to`the system owner copi approving authority
es sent to the buyer, if applicable and the
INSPECTION SUMMARY
Check A B C,or D
A] SYSTEM PASSES:.
X I have not found any information which indicates-that the system violates any of the failure criteria
defined as in 310 CMR 15.303..Any failure criteria not evaluated are indicated below.
B] SYSTEM CONDITIONALLY PASSES
One or more system components need to be replaced or repaired._ The system,upon completion
of the replacement or repair,passes inspection. '
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,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 conforming septic tank as approved
by the Board of Health.
(revised l9'15/95)`
n' 292-5500
.'. FAX 61Z)556-1049 • Telephone(617)
Massachusetts 021 08 (
oa M assach ,.
One Winter Stre
et Boston,
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SU85URFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
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µ. .PART-A
M_.
-CERTIFICATION
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Pro arty Address: 32 oide Homestead Rd.Marston Mills
g$nz51WaP5,:Ba7E 2Q�f`aMPrvl11E Ma - '.
e of Ins ectiorr 91-1 6 M r `
Sewage backup or breakout or high stattc water level.6 s' m the distnbution box is due-to-a`broken; - k 4
settled or uneven distnbution box The system will pass inspectwn i#(wih approval of the Board of Health) J r
- broken ptpe(s)are rep ace
�' 1 - ' -
obstructioh-is removed
disfribufion box.is leveled or replaced
in more than four limes a year due to broken or obstructed"pipe(s) .,The ~`
The system required pump g
system will pass inspection if(with approval of the Board of Health) x 3
broken pipe(s) replaced
r
<µ obstruction is removed. r ,
C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH , y
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. r ;
1.) SYSTEM,WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM ISM
NOT FUNCTIONING IN A MANNER WHICH UVILL.PROTECT THE'PUBLIC HEALTH AN`D ,
SAFETY AND THE:ENVIRONMENT:
Cesspool or privy is within 50,feet of a surface water
vegetated.wetland or a-salt marsh
Cesspool privy is within 50 feet of a borderrrig. g ;
Y) t.:SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND,PU.BLIC;WATER SUPPLIER,IF_APPROPRIATE}DETERMINES
THAT TH:ESYSTEM IS FUNCTIONING IN A-
:'MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETYAND THE {
ENVIRONMENT:.
The system has a septic tank and soil absorption system and is within i00.feef to a
surface of watersupply ortributary to a surface,.water supply.
The system has a septic tank and soil absorption system and is within a'Zone 1 of a public water
supply well.
The system has aseptic tank and soil absorption system and is within 50-feet of a private water.'
supply well. -
The system has a;septic tank and soil absorption system and is less than 100 feet but 50 feet or from a private z'
water supply well, unless a well wate�the presenceof ammonia nitrogen cteria land nitrate nitrogen-is pounds lequaldi n.icator lesses tthan 5 the 1ppm.' a
free from pollution for that facility an p
3) OTHER
D} SYSTEM FAILS:;`
I Have determined that the'system violates one or more of the following failure criteria as defined in
3W CMR below: The Board of-Health should be
.15.303. The basis for this determination is identified `
contacted to determine what will be necessary to correct the failure.
_ Backup of sewage in faciAty;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
cesspool.
SAS is in hydraulic failure.
(revised 11116195)
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' SUB_SURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
y CERTIFICATION (continued)
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SYSTEM FAILS(continued) $' �#"f
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.Static liquid level*in the d'istnbution box above outlet invert due to an overloaded orfctogged SAS ar cesspool
°Liquid"depth m cesspool;"is less:than 6 below invert or available volume i,less than 1/ day flow � _. Vi
'S Required pumping more than 4 times i❑the last year NOT due to elogg
ed or obstructed pipe(s) ` 4 " L
- "
Numbers of times pumped
- xl
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3 T} Any portion of the Soil Absorpfion System cesspool or privy is below the high groundwaterf elevation r
r or tributary to a surface water supply` r'
_ Any portion of a cesspool or privy Is wthin 100 feet of a urface water supply
onion of`a cesspool or pnvy is within a Zone 1 of aI 11 c well h x }
-Any P .
t, p well s
_ ..Any portion of a cesspool or pnvy is within 50 feet of a ptivate wa#er , ply Y 4
} riv is,less than 1OO.feet but greater thian`50 feeti attach copy o wwell water analys s for
Any portion of a cesspool.or,p.- y
acceptable water"quality analysis.'If.the well has been analyzedao be acceptab, , {
coliform bacteria,volatile organic com pounds,`ammonia'nitrogen and nitrate Cn ., en
-
E] :LARGE SYSTEM FAILS
The following criteria apply to large systems in addition to the criteria .
The system serves a.facility with a design flow of 10,000.gpd or greater(Large Sys system)and the.sys
{ tam is.a significant threat to
public health and:safety and the environment because one or more of the following conditions exist
'the system.is.within 400 feet of a surface drinking watersupp.Y
I.l
the system is within 200 feet of.a tributary to a surface don..drn. .i g water'supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone Il;of a ,
— public water suPPN well) .
I
n such system shall bring the.system and facility into,#ull compliant memfoefurthe d nfoeinationnent program
The owner or operator of au
Y .
requirements of.314 CMR S.do and 6.00 Please consult the local regional office of the Depart
. .
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(revisedI. 11H5195) .
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max" - 'MSURF'ACE:SEWAGE DISPOSAL SYSTEM INSPECTION FORM
'"°Y' - ` a
'`. . ' _ f PART B j'
I < } s CHECLIST' 1 `
.. -
y AsLd. ..-32 tilde Homestead Rd.MarstonNulls -
Owtter
Greg Botsivlaes.-8 � en r�UI'
y- 82gS38Staa61� - w f a w rx i
i t h - a r. - dw"
Check rf tke following have been doneh ++ ti � 3
- ..
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6 , x Pumping informatiotr,was requested of-the owner occupant and Board of Health
_ ":
x x None of the system components have been pumped fort least two weeks and the and: he system has been r'' ' ' normal
: .flow rates during that penod Large volumes of-water have not tieen introduced into the system recently or as part of this r }
InSpeCtlOn ;'. E s r {F = h -4�, . s , q ', o _ c
x As built have been obtained and examined Note if they are not available with N/A' i . i
_
uS `� The#acihty or dwelling was inspected.for signs of sewage back up , f
'„ ¢rF`h
4 4
II
x The system does not receive non sanitary. I industrial waste flow _ Z x
r
The s it.
e;was inspected for signs of breakout _ _
I.
x All system components excluding the Soil Absorptlon;System,have been located, 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
.. • x'f b
I :The size and location of the Soil Absorption System on the site has been determ, based on ews_. information or
. approximated by non-intrusive methods
. � .
z The facility owner(and occupants'if different from owner) 'were provided with''information on the proper maintenance of Sub
Surface'Disposaf System
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;SUB"SU',RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ;
,4-- ,. PARTC. - ,,,
`r - 'T - r u SYSTEM INFORMATION +: I' ' z=
}ax' I A'� r L ° p
7 l A F 6 '�
Pro arty Address: 32 01de Homestead Rd Marston Mllis s r
reg 69tsIWaeS:807G20.1 CentELYllle.Ma _ u, - mow-P Y
Owner ,
91-1 196
-_ _D1tQ.of I s2ection Y 4 ;
`' � : FLOW CONDITIONS '�
4 t4 - r '� -
RESIDENTIAL , " x ; � f-
Design flow 330-- gallons ,,, � '
Number of bedrooms 3, ' 5
c x F t a} ,,c r '
Numbee'bf current residents 2
a
., -
Na a,� .} 4 Y
Garbage griirider(yes or.na) Yes Y
k Y } ,S •ate
Laundry connected to system(yes or no) r _ 7
Seasonal use(yes or no): No '
Water meter.readings,if available. Na Y F 1:.
.... , -I
:
C S. 5 R
' 6 h-� 3TI
Last date of occupancy. Na A�
.• i
✓ L
COMMERCIAUINDUSTRIAL - " `- t yr y
Tye of establishment: n/a
YP._ r ,
o allons/da -ti
Design flow: g Y �' ,` ,
-Grease trap:present:(yes or no) No e
Industnal Waste Holding Tank present (yes or no) No Y °
Non-sanitary waste discharged to.the Title 5 system (yes or no)'No
Water meter readings,,if available Na
..
,. .
. .:.
. r°•
Last date of occupancy: Na
1:
O.THER:.(Describe) Na' .:'.
,
Last date of occupancy:'_
: 4 Y=11
R A L'NF 0 RM A T ION
. : .
GEN
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E _.
. . ..
PUMPING RECORDS.and source of information'
system has not been umped in the last two ears
ed as. art of inspection:.(yes or no.)yes
S y stem ump d P- . - . ,
Y P
if yes,volume pumped'laoo gallons>,' x
Reason for pumping; Maintenance.
TYPE OF SYSTEM .
X Septic tank/distribution box/soil absorptions system -
Single cesspool .
of .
Overflow cesspo , ,
Privy .
Shared system(yes or no) (if yes;attach previous inspection,records,if any)_'
Other(explain) .
APPROXIMATE AGE:of all components,date installed(if known)and source information:
19ss .
Sewage odors detected when arriving at the site: (yes or no) yes
p,::
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(revised 11NSf95)
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`I - � � ` s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Y y w
n «x PART,C a ,
�S NtATIONu(continued)
.( r� �S 4'f 5 N k _
r _ YSTEM INFOR' ' r
yl f _ 5 1 S fi(
)` Pfoperty'AddresS: 3201deHomesteadRd MarstonMiits f.
tslvlaes Box 201.CenCervllle,Ma
Date of tnspection 9119196 x }+x z
t
_ r - ,
SEPTIC TANK X rt
�1-,• x T z t r kz
(locate on sloe plan)
,"
4; r j r
" Depth below grade a lain .
Material of construction:X concreate metal FR;P other(exp ) ;
'Dimensions t $'6�H 5'7"W 4 10 4 r ;: sy
Sludge depth 5'. ,. t y , r {
I.. Distance from top of sludge to bottom of outlet tee or baffle 22
Scum thickness: of outlet`tee or baffle 5 s.
Distance from top of scum to top. , r
Distance form bottom of scum to bottom oY outlet tee or baffle f 7 s ,' x
>;
' A
-:t 4 r r - •
.},. /^ ry .t - .a
5 # _ : t c „.
Comments x
diilon of inlet and outlet tees or'baffles`.depth of Ugwd level in rela- , to`outlet invert structural ite -ty �
(recommendation for pumping, con ; ,• tem eve rytwa'ears tar`matntenance
evidence cf leakage;etc.) , sound.Recommend pumpingsys
Septic tank and all components are structurally
..
;
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GREASE TRAP: => "
(locate or site plan)
. • -
.,
, . .
Depth below grade:nla lam
Materlai.of construction: _concrete_metal_FR-_other(exp )
. 1�_
Dimensions:n!a '
Scum thickness.
Distance from top.of scum to top of outlet tee.or baffle:nra ,
Distance from bottom.of scum to bottom of outlet tee or:b . ., nla f
Comments. ondition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural mtegnty;
(recommendation for pumping, c
,I' _,
evidence of leakage,etc:) ..
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K - z SUBSURFACE SEWAGE DISPOSAL SYSTEM TINSPECTION FORM
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PART C. ,
{ r ~t { $ � ' x SYSTEM INFORMATION{Continued} : k , q ,:'
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, -, . I. � : . . -, --�--.---�,-,�-,,,,,-M� -1_�i �, ,,, -" 10810M
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ddress 32 Olde Homestead Rd.,Marsto_n��M,l,l'iAs s
Owner Greg'Bo s v ae
ern na' d A S T
__ I- o�In.pactior1..9119196 : n
r,`. �s . x z y 4 ,, t -
TTIGiil OR HOLDING TANK ' - E x. f ry
''=(locate on site�pian) - u<
F x 'DEpth below grade Na ' = "'
dvlatenal of constructlon:_concrete metal FRP other.{explamj
r.- e
'.k
-e 2 t-
Dlmerisions Na A
k p 3
Ca aci n1a gallons _ 4�`.
Design flow Na' gallons/day P
Alarm leveV: Na 't r,
{
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Comments r Y r x . = �4
(condition of Inlet tee, condition of aiarm.,and float switches etc )
Na _ ,
`,-. DISTRIBUTION BOX.X
(locate on.site plan).
.
Depth of liquid level above outlet Invert: tiT quid level with bottom otpipe
.._
_
Comments:
(note if level and distribution is equal evidence_of sollds.carryover, evidence of leakage into or out of box.etc.) ..
0-box is structural sound. .
-
PUMP CHAMBER:
l
(locate on site plan)
s'
Pumps in working order:(yes or4no)
;'.
Comments:
K}
jI
, (note condition Of pump chamber,condition of pumps and appurtenances, etc.)
Na
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.,:' ='�" .,Y ':PART C �x>rt x " `
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SYSTEM INFO.RMATCON(contin�re-1
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Owner x. *. L
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SOIL-ABSORPTION SYSTEM (SAS) X
locate on site plan rf possible; excavation not required}but may be approximated by non intrusive methods) s ., _
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leaching trenches,number, length Na 3 K.
- t: t a- r,
leaching fields,.number;dimensions nla = k fr
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overflow cesspool number k`
Comm entsc(note condition of soil signs'tof hydraulic failure level of ponding condition of vegetation eta)' T S*} , •`
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" The leach 'it is structural .sound andfunctionin ro a yh ;;
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CESSPOOLS:_' _
{locate on site plan)'
Number and configuration Na
Depth top of liquid to.inlet invert. Na
Depth of solids layer, Na
. Depth of scum layer: nta z
Dimensions of cesspool:
n!a:. _ .
Materials of construction: rila
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'Indication of groundwater: nta x
inflow(cesspool must be'pumped as part of inspection) *'I.
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Na
Comments:(note condition of soil, signs of hydraulic failure, level of ponding;condition of vegetation etc:)
Na
PRIVY:
(locate on site plan) `'
nla Dimensions: nla
Materials of construction: •
Depth of solids: Na condition of vegetation, etc.)
Comments:(note condition of soil, signs of hydraulic:failure,level of ponding,
PrivyComments .
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r e !, — PART C- x
n t ': ,'r ,, - `'t' z of z �s .'r' S`' F , "'_ -
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- ,z -:SYSTEM U. ORMATION(continued} _
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32 OIde Homestead Rd Marston Mills >
Property-Address x
Owner. Greg Botsivlaes Box 201 Centerville Ma " _ ,
,Date Of Inspection '9119198 ` r ' t ' ¢ - <� f
1 5 N { A i { A
Y- r`` � -' rae.6s.,.nu.�royw'�Tyr Y` y4 ,. r 3 ,y 4ua
SKETCH OF'SEWAGE DISPOSAL SYSTEM +
T inc u e.:ies to at teasYtwo permanent references landmarks or benchmarks r ,
"`` loca#e all wells vrtthm 100' ` : a t
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method of determination or approximation:
11
USGS Maps and Charts
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(revised 11115195)
9
TOWN OF BARNSTABLE - 3 5 `
LOCATIO 16'rA-aV 0I�?c'Sr"�t� SEWAGE
VILLAGE ASSESSOI:ti'S MAP & LOT�I� �t c;P
INSTALLER'S NAME 6z PHONE NO. I) S60 ;0
(n
SEPTIC TANK CAPACITY /• 41
' LEACHING FACILITY:(type) (Lf,�p ICt4CA (size) 603,E /I/
�Q,NO OF BEDROOMS -�� VA Wes =WATER
PRI TE ELL •R rU13L
BUILDER OR OWNER
i
DATE PERMIT ISSUED: q;
DATE .COMPLIANCE ISSUED: 2
VARIANCE GRANTED: Yes
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No................_....... ._ I �p,Sp��L � S�
THE COMMONWEALTH OF MASSACHusE'�9SB�TALLED IN CO ILT�������.
BOAR® OF H EALT WITH TITLE 5
NV@RONMENTAL CODE A
......... .. .........................OF..... . ...-•-------...----. �
OWWREGULA WI
Appliration for Biopooal 19orkii Tontrnrfion Prrutit
Application is hereby made for a Permit to Construct (1/) or Repair ( ) an Individual Sewage Disposal
A t-
_7_ ........��...��- !..... �v c..�.... � ohs- ' I - -
-- -----.... ....
Lo,a�io >Address /' _�.... = or 0.
.._.
(off ww
ss
Owner... . Ad eY._.........`�
W
Installer" Address /
Z 0 �10
U Type of Building ,� Size Lot........... ................Sq. feet
�., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers
a YP g ---------------------------- P ( ) — Cafeteria ( )
Otherfix ures •--••••••-------••------------------------------•-•----•-•••......---------•-----•-•---•--••............--•--•••-• --••.••....
W Design Flow_____..__C1?......................gallons per person�perr77day. Total daily flow---....1�. .........................gallons.
WSeptic Tank—Liquid capacity d09.gallons Length�Y..... Width................ Diameter--...--......... Depth................
x Disposal Trench—No. .................... Width ....... Total Length......�.L_....� Total leaching area_...................sq. ft.
Seepage Pit No.............I-...... Diameter............. Depth below inlet•-..r[.�1..._..__ Total leaching area. .....sq. ft.
Z Other Distribution box (/) Dosing tank
`-' Percolation Test Results Performed byWAL.�A Z--VGKj...�_. ._ &�__ Date....5hlAk................
Test Pit No. I....�......minutes per inch Depth of Test Pit.......t�.........Depth to ground water........................
ft4 Test Pit No. 2................minutes per inch Depth of Test Pit.--................. Depth to ground water.--.....................
!
------
_.--
O Description of Soil 0-- .... .. C�� /�f ---`----Z--.......W.� '1 -��
x
M ............------
.-----
...-----------------
. -------------------------------------------------------...------------------------------------------------------•----------
-----------
x --••---------------------•-----------•---•----...--------------------•-----•----•••-------•--••••......--------•-----•-----------•---•••--••-•••------•-•--••-••••••-•••-•...-••----•--............--•-
U Nature of Repairs or Alterations—Answer when applicable........................................................................................._......
--------••------------------•--•------------•------•-----•-•---•---•------------•--•--------.......-----••-------------------------------------•------------------•-•--.....I.......----•---•-••......-•
Agreement:
The undersigned agrees to install the afored c ' Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the ate Sanitary —The undersigned further agrees not to place the system in
operation until a Otificate C. fiance ha issued by he board of health.
Signed..... _ /t/
�1.. �P_..._
Application Ap oved BY ` ,... `1......................................................... 7 I�&............
Date
Application Disapproved for the following reasons:----•--------------------------•----......--•---•-------------...--------------••------•------•........-----
.........••----•••••-•--•••--•-•-.....---•---•••...•------••.....•••-•-----•-••---._...••••••--•-..........-........-••---•--•-••-•-•-• ......•------•-•-••.
Date
PermitNo..�b....9�--•••-••••-••-•-..._•-•••••--...... Issued....................•---•-------••----•--•--•--'........
Date
No..--..........._..... FEB
-.
..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.....................OF.....e-) ..1rY? . .......................................
Appliration for Disposal Works Cnnnstrnrtion Prrutit
Application is hereby made for a Permit to Construct (V/ or Repair ( ) an Individual Sewage Disposal
. s at:
.....i�� obtS I
Loca io -Address / or t No.
owner At
.
W
Installer Address
dType of Building Size Lot..._......,c................Sq. feet
U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fi ures ---....................................................................................................................................................
W Design Flow......... .........................gallons per person per day. Total daily flow...... .........................gallons.
Septic Tank—Liquid capacitygallons Length .... Width................ Diameter................ Depth................
Disposal Trench—No..................... Width.................... Total Length.:-.-.._---- Total leaching area....`.............sq. ft.
Seepage Pit No.............I....... Diameter.......1.2..._..... Depth below inlet..... .......... Total leaching area.0.4.9.....sq. ft.
z Other Distribution box Dosing tank
Percolation Test Results Performed b WAA )-A- I C----- •-:_ GG__(_ (._. Date..._ � ................
Y
Test Pit No. I....It.....minutes per inch Depth of Test Pit.......1.0......._ Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
x ------------ ----------------------- ------ ---..............----......................................
Description of Soil. �J.':. ....... S.S.1. f , .......... !-LSD.....t` Q--V.C_L_qAV
V --------------------------------
W
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
Agreement:
The undersigned agrees to install the afore Individual Sewage Disposal System in accordance with
the provisions of TITIE 5 of th ate Sanitary —The undersigned further agrees not to place the system in
operation until a e tificate C liance ha Issued by the board of health.
t ned------------- ...................-- ................................
---------------------------------------------------
ry�cw / ate
ApplicationAp roved BY----- . .--•...............................•-•---•--------..............._.------ ------..7(1_ ,� ..........
Date
Application Disapproved for the following reasons:..............................................................................................................
----------------------------------------------------------------------------------------------------------------------•-•••-----------------••--.....-•-•-•............................................
Date
PermitNo.�4...--..-.-................................................... Issued_.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.......... .4 I!,�.. ..............................................
Tntifiratr of Toutplianrr
THIS IS TO CERTIFY,T`,h�at the Individual Sewage Disposal System constructed � ) or Repaired ( )
by1 .... 9 _s� ........ ----------------------------------------------------------------------------------------------•--...---------...---............------------
kAInstaller
has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----•-•--•-•••....7•- ._. 5.. .. -------------------------- Inspector....•�------... -.
' THE COMMONWEALTH OF MASSACHUSETTS
i
4 Z-- BOARD OF HEALTH
�s b�-e
r�G �`7S OF.......... (,t.I .......................
.......................................... .......................................
No. .................... FEE...._.....f.............
Disposal - �4unStr�u-rd�ci_o�n unit
. .-•••----Permission is rebY granted... �! .......
ato t No.Construct or Repair an Individual Sewage e Disposal System
( P ( ) ' g M
�_ . ......--•------------ --------- ..... - -�
Street
as shown on the,�app 'cation for Disposal Works Construction Eermi~:- ...ji�1.eo... Dated.... . ..........
( ` t
L
Board of Health
DATE.............. `= ............
FORM 1255`HO B & WARREN, INC., PUBLISHERS
SITE PLAN sHEEr I OF 2
SCAL E: I = 4LO
/ a
(10
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PLAN .REF: ayT �� MAE' DATE _ J L)L!f
BENCH MARK DATUM 1920) Mh(.- DATuM WM. M. WARWICK B ASSOC., lNC.
DOMESTIC WATER SOURCE T�`�'�", Wt�T`G��- BOX 801 - NORTH FALMOUTH
v - G- -
FLOOD ZONE.-� � �`� � � �D MASS. 02556 (6/7) 563 -2638
0 C
LEACHING I3ASIN SECTION NOT TO SCALE shcel z o f z
EARTH F/L L BRICK AND MORTAR COURSES AS REO'D' TO BRING
._.r•s_ COVER TO GRADE
4 8'FLOW L/NE
INLET _1 _ _ 2" y To%" IvASHED PEA 5TONE FREE OF IRONS,
PIPE
FINES AND DUST /N PLACE
' W OPENING WITH 4%B" 3/4 TO /%p"WASHED CRUSHED STONE FREE OF
OUTER DIAMETER IRONS, FINES AND DUST /N PLACE
ANO /3/q' INS/OE
DIAMETER
boo GAL, I. CONCRETE TO BE 4000 PSI 28 GAYS
r-
AG� 2. REINFORCED WITH 6"x 6" NO. 6 GA. W.W.M.
3. 2'AND 4' SECTIONS ARE. AVAILABLE FOR
GREATER DEPTH REQUIREMENTS
4'0" '� 6° I � —� 4, NUMBER OF PITS REQUIRED 906
MIN. l EFFECTIVE DIAMETER NOTE: EXCAVATE TO ELEVATION OR
' —�
} (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL
WATER TABLE - LOAM AND CLAY .'BENEATH PIT. REPLACE
EXCAVATED MATERIAL WITH CLEAN
TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. "
_v
lB"STD. LT. WGT. C.I.MH COVER
79.o
4"C/P/PE 4"8/T.FIBER PIPE
DWELLING FLOW_LINE TIGHT JOINT o OUTLET LEVEL
TO FIRST ✓OINT
,v F 14 00 110 00 1 1
?t 00 C.I. TEE ��. 1 1 0 00 1 1
r--" 7Z %' L`�' 1 1 1 0 0 0 O o 1 1 1 i
STD. PRECAST CONC. !6g,� i 1 000 O 0 1 1 1 I
D/ST BOX TO BE (p�,OD• (040GAL.SEPTIC TANK INSTALLED ON LEVEL, I I 1 000 0 0 0 1 I 1
g ._ ••..�: _ :.• STABLE BASE 1 1 0 0 0 0 1 '1
•
' 100 00
y�SEPT/C TANK TO BE 1 1 9 c 0 0 0 0 1 1 1
INSTALLED ON LEVF'L' 1 11 1001 0 0 1 I ;
STABLE BASE. 1 I 1 0 0 0 O O 1 1 I i
� 11100 001I „
LEACHING BASIN its Q O 0 0 0 11 1
BASE TO B£L EVEL i r I 0 p 1 p 0
SOIL AND PERC. DATA
PERC. RATE 2 MIN. /IN. O„ TEST PIT NO. 1 TEST PIT NO. 2
TEST BY : _W ls' 14 g,_�p 41 (L-
WITNESStD. BY: "roM Me-LtA,'O j 1W1!%i7ivM 6,AOD
TEST PIT GR, EL, 7Z-o TAGS U��v�eL,
DATE h g *lo l21 �eL.moo.o
tJo we.-197-
DESIGN DATA GENERAL NOTES 1
BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. .
DISPOSAL No SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD
EST. TOTAL DAILY EFFL.;��fGPD• PRECAST REINFORCED CONCRETE UNITS.
SEPTIC TANK oofl GAL. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE
SIDEWALL AREAZ- GAL./SQ.FT. TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE,
MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF
BOTTOM AREA-La' GAL./SQ.FT. SANITARY •SEWAGE EFFECTIVE ON JULY 1 , 1977.
LEACHING REQUIRED Z°o SQ.FT, ANY CHANGES TO THIS*PLAN MUST BE APPROVED BY THE BOARD
ACTUAL LEACHING AREA OF HEALTH.
Q.FT, AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE
BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION.
PITCH ALL SEWER LINES 1/4� / FT. UNLESS INDICATED OTHERWISE.
DF;9`9 SEWAGE DISPOSAL
OS L SYSTEM: MARTIN =`����
fOr9' PJ a&,`( 2 L)I L l IJ
MORAN Z4 .
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� lv�a�z S�-o ti r s A l t_C s m As s
�l Sc'OUAL E�� � I
SCALE AS INDICATED DATE_ 7 1 Gm/0 f,
WM. M. WARWICK a ASSOC., INC. .
A)ZK �` 8OX 801 - -NORTH FAL MOUTH
`�PROFESSIONAL ENGINEER MASS. 02556 - (6I7) 563 -2638
•