HomeMy WebLinkAbout0136 OLDE HOMESTEAD DRIVE - Health 136 Olde Homestead Drive, Marstons Mills
A= bLv;- CO, C>\1
i
o
-\ COMMONWEALTH OF MASSACHUSETTS
r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
-1M Svey
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: >�
Owner's Name: y
Owner's Address: f0 /
a�
Date of Inspection C� SI: 319�
r
Name of Inspect (please rint) j• �(�
Company Nam
Mailing Address:
Telephone Number: C'7 v
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 the inspection.The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
JPasses
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
ils
Inspector's Signature: Date: r
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
F Notes and Comments
}' ****This'report only'describes conditions at the time of inspection and under the conditions of use at that
�,. time.This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
r
Page 2 of 11 �.
01_,.
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:4,ffvvollffl��,
,
Owner:,
Date of Inspection: -
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
I have not found any information which indicates that any of the failure criteria described in 310 CMR
15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass"section need to be replaced or
repaired. The system, upon completion of the replacement or repair; as approved by the Board of Health,Will pass:
Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined'.'please
explain.
The septic tank is metal.and over 20.years old* or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent:System will pass inspection if the
existing tank is replaced with a.complying'septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is,less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass.inspection if(with
approval of Board of Health):
broken pipe(s)are.replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping.more than'4'times a year due to broken or obstructed pipe(s).The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
2
Page 3 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A,
CERTIFICATION(continued)
Property Address: ➢�.J/G�J�'�
Owner:
Date of Inspection:
C. Further Evaluation is Required by the Board.of Health:
Conditions.exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health, safetybr the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health (and Public Water Supplier, if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
_ The system has aseptic tank and soil absorption system (SAS)and the SAS is,within 100 feet of
surface water supply or tributary to a surface water supply.
_ The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply.
_ The system has a septic tank and SAS and the SAS:is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis, performed at a DEP certified laboratory, for 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, provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
3
Page 4.of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM,INSPECTION FORM
PART A.
CERTIFICATION(continued)__
Property Address: 1 .1,4 Al 4V-41�
Owner:
Date of Inspection (Y71 1�
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes Nq►
Backup of sewage into facility or system component due to overloaded:or clogged SAS or cesspool
Discharge or ponding of effluent to the surface of the ground or surface waters due to an.overloaded or
l clogged SAS or cesspool
I/ 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 day flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
of times pumped
Any portion of the SAS, cesspool or privy is below high ground water elevation.
Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
. Any portion of a cesspool or privy is within a Zone 1 of a public well.
_ Any portion of a cesspool or privy is within 50 feet of a.private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than,50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds.
indicates that the well is free from pollution from that facilityand the presence.of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.]
(Yes/No)The system fails. I have determined.that one or more of the above failure criteria.exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should,contact the Board of
Health to determine what will be,necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a.facility with a design flow of 10:000 gpd to 15,000
gpd•
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)
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—I WPA)or a mapped
Zone I1 of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes" in Section D above the large system has failed. The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR.
15,304.The system owner should contact the appropriate regional office of the Department.
4
Paee 5 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
c�E ,
Property Address: 1, CrGL'(�(yqII' 'V"
4 X-1A
Owner:
Date of Inspection:. ;r�
Check if the following have been done. You must indicate"yes"or"no".as to each of the followine:
Yes �No
Pumping information was provided by the owner,occupant, o-Board of Health
_Were any of the system components pumped out in the previous two weeks
Y� Has the system received normal flows in the previous two week period ?
Have large volumes of water been introduced to the system recently or as part of this inspection ?
Were as built plans of the system obtained and examined?(If They were not available note as N/A)
Was the facility or dwelling inspected for signs of sewage back up?
Was the site inspected for signs of break out?
_ Were all system components, excluding the SAS, located on site
�theaffles
Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition
o or tees,material of constriction, dimensions,depth of liquid, depth of sludge and depth of scum
Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems
The size and location of the Soil Absorption System (SAS)on the site has been determined based on:
Yes o
Existing information. For example,a plan at the Board of Health.
Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable) [310 CMR 15.302(3)(b)]
5
Page 6 of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM
PART C
SYSTEM.INFORMATION
Property Address: - 'fXIly ��Cy
Owner: I[y
Date of Inspection: t
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): Number of bedrooms(actual)':
DESIGN flow based on 310 CMR 15.203 (fox example: 11.0 gpd x#of bedrooms):
Number of current residents: 0
Does residence have.a garbage grinders or no):
Is laundry on a separate sewage systeir ( es or no): , ` .[if yes separate inspection required)
Laundry system inspected y sNable
or no).W � Q
Seasonal use: (yes or no): 0,3
Water meter readings, if av (last 2 years usage(gpd)): 'D q`` 1j0&o
Sump pump(yes or no)., /
Last date of occupancy: 4/v
COMMERCIAL/INDUSTRIAL /v
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):_
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: 0A
Was system pumped as part of the i spection(yes or no): O
If yes, volume pumped: gallons--How was quantity pumped determined?
Reason for pumping:
TYAfE OF SYSTEM
G/ OF
tank, distribution box,soil absorption_system
_Single cesspool
_Overflow cesspool
_Privy
Shared system(yes or no)(if yes, attach previous inspection records, if any)
_Innovative/Alternative technology.Attach a copy of the.current operation and maintenance contract(to be
obtained from system owner)
_Tight tank _Attach a copy of the DEP approval
_Other(describe):
Approximate age of all om onents, at ' sta d 'f kno wm)and source of information:
Were sewage odors.detected when vrriving at the site(yes or no):.
6
r
Page 7 of 1 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
aQ�SYYSTEM:INFORMATION(continued)
Property Address:
Owner: �� Sr
Date of Inspection:
BUILDING SEWER(locate on site plan)
Depth below grade:
Materials of construction:_cast iron _40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints,venting, evidence of leakage,etc.):
SEPTIC TANK: (locate on site plan)
Depth below grade t �
Material of construction:_concrete_metal_fiberglass_polyethylene
—other(explain)
If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of
certificate) _
Dimensions: P-` ;
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle: 2170.
Scum thickness:
•Distance from top of scum to top of outlet tee or baffle:
Distance from.bottom of scum to bottom of outlet tee or baffle:
How were dimensions determined: twjzo;/ OA
Comments(on pumping recomme ations, nlet and outlet tee or baffle condition,structural integrity, liquid levels
bs related to outlet invert,evidence of leakage,etc.):.
°r % , ,,;al
,
GREASE TRAP)Id(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(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
7
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
G STEM INFORMATION(continued)
Property Address:
Owner:J4 '
Date of Inspection: w
TIGHT or HOLDING TANK-V1 ;tank must be pumped at time of inspection)(locate on.site plan)
Depth below grade:
Material of construction:; concrete _ metal fiberglass- _polyethylene, other(explain):
Dimensions:'
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments (condition of alarm and float switches, etc.):
DISTRIBUTION BOX: /of present must bei opened)(locate on site plan)
Depth of liquid level above outlet invert:- "
c�1�25 ,
Comments(note if box is level and distribution to outlets equal, any evidence.of solids carryover, any evidence of
1 ka me into or our of box,etc.
PUMP CHAMBER(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.):
R
Page 9.of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
YSTEM INFORMATION(continued)
Property Address: J
Owner:
Date of nspectior. ,L
SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Ty"pe�
C/leaching pits,number:
leaching chambers,number:
leaching galleries, number:
leaching trenches, number, length:
leaching fields,number, dimensions:
overflow cesspool,number:
innovative/alternative system. Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil,condition of vegetation,
tc.):
CESSPOOLS,(cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth'—top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of.groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation,etc.):
PRIVYA (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.):
9
Page 10 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY.ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM-INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: /3
"A
Ownej/19AA d �.
Date of Inspection: j o
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the disposal system"including ties to at least two permanent reference landmarks or
benclunarks. Locate all wells within 100 feet..Locate where public water supply enters the building.
i lia
-lip
/
c�l la n
Ct
ll�n
r
M
Page I I of I I
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE,DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
40�E
Property Address: d �'
Owner:
Date of Inspection:
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
Checked with.local excavators, installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation: R
r. J Jam. 4v Zee .
ll
Permit Number: �iDate:
Completed by: ��Vt
HIGH GROUND-WATER LEVEL COMPUTATION.
Site Location: 1/!/ � �JX�- � Lot No.
Owner: I V Address:
9 e^ y�--
Contractor: of d � Address: Gl cl._fl xx�����"�
^1
Notes:
STEP 1 Measure depth to water table
;.
to nearest 1/10 ft. ......................:.
month/day/year
STEP 2 Using Water-Level Range Zone
and Index Well Map locate
site and determine:
OA Appropriate index well................................cJ� ✓
OB Water-level range zone .......................................
STEP 3 Using monthly report "Current
Water Resources Conditions"
determine current depth to
water level for index well ........................... / 7 7
month/year
STEP 4 Using Table of Water-level Adjustments
for index well (STEP 2A), current depth
to water level for index well (STEP 3),
and water-level zone (STEP 2B)
determine water-level adjustment ..........................................................................................
STEP 5 Estimate depth to high water
by subtracting the water-
level adjustment (STEP 4)
from measured depth to water
level at site (STEP 1) ..................
Figure 13.--Reproducible computation form.
15
I t o /oD.
LAO
Ir d F 1i
i
r ��i..�.[� �`z.�' Et ,,;�:6 5x�- yi� "'a��.rs�'� �,��y s � :}• ' �'i •� - -�:' - �' x...
_ ,_..,
eUrnrnonweotm of mo�sacm setts John Grad
AL
_ Exect�tfve Office of ErM onnmecrtai'Affairs D.E.P. Title V-Septic Inspector
Department of
P O Box 2119
- Teaticket,MA 02536
_ Erg ►�ronmenta Protsc#�0n
4=6813
- . -
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR
PART A
S
CERTIFICATION - ZP
Propeirty Address:- 136�tiomestead Dr.Marston Mitts Address..of Owner:
Date of-Ins pection:9111/96 (if different) _
Name of Inspector:John GradBussichella,
Company Name;'Address and Telephone Number: '
CERTIFlCATION`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 Evaluation By the Local Approving Authority.
Faits
Inspector's Signature::
Date: 9111196
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this
inspections. 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.
INSPECTION SUMMARY:
Check A, B,C,:or Dc
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 exfiltration,ortank 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 11115195)
One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500.
M _ f
s u4
SUBSURFACE.SEWAGE_DISPOSAL SYSTEM INSPECTION FORM
PART A
. CERTIFICATION'.(contlnued)
Property_Address-_ 136 Old Homestead Dr.Marston Mills - I
Owner: Busslchella
Date of Ir,spection9111196
7.
Sewage backup.or.breakout or high static water level observed in the distribution box i5 due to a broken, -
settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health).
broken pipes)are replaced'
i
- obstruction"is removed
distribution box is leveled.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• he Board of Health):.
broken,pipe(s)are replaced
obstruction is-removed
C] FURTHEfi EVALtlATION 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 THAT THE SYSTEM IS
NOT FUNCTIONING INAMANNER WHICH WILL PROTECT THE PUBLIC HEALTA AND
SAFETYAND_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 PROTECT THE PUBLIC HEALTH AND SAFETY AND THE_
ENVIRONMENT:
_ The system has aseptic tank and soil absorption system and is within 100 feet to.a
surface of water supply or tributary to a surface water supply.
The system has aseptic tank and soil absorption system and is within a Zone 1.of a public water
supply well:
The system has a septic 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 more from a private
water supply well, unless a well water analysis for coliform bacteria volatile organic compounds indicates that the well is
free from pollutiorrfior that facility,and the presence of.ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm.
3) • .OTHER
DI SYSTEM FAILS:
_ 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 correct the failure.
Backup of sewage in 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
cesspool
SAS is in hydraulic failure.
(revised 11115195)
2=
r
- SUBSURFACE SEWAGE.DISP..O.SAL SYSTEM INSPECTION FORM
PART A _
CERTIFICATION (continued)
Property Address: 136 Old Homestead Dr.Marston Mills — -
Owner:. - Busslctiella -
Date of Inspection:9111106 _
-Dj SYSTEM FAILS.(continued)
-- 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 112 day flow. -
_ Required pumping more than 4 times-in the last year NOT due`to clogged or obstructed pipe(s).'
Numbersof 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 I00.feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool'or privy is within a Zone 1 of a public well.
Any portion of a cesspool or privy is,within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
welw t f Iattach-copyof I a er anal sis or
acceptable water quality analysis: If the well has been analyzed to be acceptab e, y
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
El LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria:
_ The system serves a facility wither 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:
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.
y
(revised 11115/95)
3
r t
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART.(3 -
CHECLIST.
P-roperty Address: 136 Old Homestead Dr.Marston Mills
Owner: Busslchella _
Date of Inspection:9111186
Check if the following have been done:
X~Pumping information was requested of.the owner,occupant, and Board of Health.
X None of the system components have been•pumped for atieast`two weeks and the 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.
n1aAs 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 Thesystem does not:receive non-sanitary orindustrial waste flow:
x The site was inspected for signs of.breakout.
x All system components,excluding the SoilAAbsorption System,have been located on the site.
x The septic tank manho.les.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 The size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non-intrusive methods.
x . The facility owner(and.occupants,.if different from owner)were provided with information on the proper maintenance of Sub-
`Surface Disposal System:
(revised t1J15J95)°...^ ,. ,., •. < . - a
4
SUBSURFACE-SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C--_ -
SYSTEM INFORMATION' _ _•_
Properly-Address: 136 Old Homestead Dr.Marston Mini: --
Owner`. Bussicheila
Date.of Inspe6tion:9111/96 ;
FLOW-CONDITIONS..
RESID=NTIAL -
Design flow: 330 ; gallons
Number-of bedrooms: 3= <_
Number of current residents: 2
_ -
Garbage grinder(yes-orno):-:Yes `.
Laundry connected to system(yes or no): Yes _
:Seasonal use(yes or no): No
'Water:meter.readings, if available: nla.
.-Last date of occuponcy...n1a
COMMERCIAL/INDUSTRIAL:
Type of establish ent: nfa
Design flow:0 gallons/day
Grease trap present:(yes or no) No.'
Industrial-Waste Holding Tank present: (yes or no)`No
Non-sanitary waste discharged to the Title S system: (yes.or no) No
Water meter readings,iYavailable: n/a
Last date of occupancy: Na
. . OTHER: (Describe) nla
Last date of occupancy:
t, GENERAL INFORMATION
PUMPING RECORDS and source of information;
System has not been pumped in the last two years.
System pumped as part of inspection: (yes or no)Na
If yes,volume pumped: 0__gallons
Reason for pumping: n1a
TYPE OF SYSTEM
X Septic tank/distribution box/soil absorptions system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no) ( if yes, attach previous inspection records,if any)
Other(explain)
APPROXIMATE AGEof all components,date installed(if known)and source information:
1987
Sewage odors detected when arriving at the site:(yes or no) No
(revised 11115/9
5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM -
- .PART.C _i..
_SYSTEM.INFORMATION.(contin-u_ed)
Property Address-;, 136Old Homestead Dr.-Marston Wills -
Owner: .. Busslcnella _
-Date of Inspection:,9111196
- -..-
SEPTIC TANK. X
(locate.on'site plan)
Depth below grade-6' !
Maferial of construction:X concreate metal FRP_other(explain) _ I
Dimensions: L 8'tY H 5'7"W d'10'.
Sludge depth:3' -
Distance from top of sludge to bottom of outlet tee or baffle: 24' t
Scum thickness
Distance from top'of scum to top of outlet tee:or baffle:6 i
Distance form bottom of scum to bottom of outlet tee or baffle: t)
_
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.)
G _ Septic tank and all components are structurally sound.Recommend pumping system every two years for maintenance.
GREASE TRAP:
(locate on site plan) .
Depth below grade: Na
Material of construction: concrete ' metal_F.RP other(explain)
Dimensions: n1a
Scum thickness:n1a
Distance from top.of scum to top of outlet tee or baffle:rda
Distance from bottom of scum to bottom of outlet tee.or baffle: n1a
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.)
nla
(revised'11113/9d)
6
`SUBSURiFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
-Property Address: 136,Old Homestead W.MMUMIVIMS
Owner: - `s Bussichella.
_ Date-of Inspection:9111196 —
TIGHT OR HOLDING TANK:
(locate on site plan)
Depth-below grade: Na
Maieral of construction: concrete metal: FRP other(explain)
Dimensions: n1a -
Capacity: -n1a gallons
Design flow:.Na... gallons7day
Alarm level: Na
Comnents:
(concition of,inlettee,condition of alarm and>;fcats'witches, etc.)
Na
I ,
DISTRIBUTION$OX: X
(locate on site plan)
Depth of liquid level above outlet invert::Uqutd GI with bottom ofplpe
(note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.)
D-box is structurally sound
PUMP CHAMBER:
(locate on site plan)
Pumps in working order:(yes or no)
Comments:
(note condition of pump chamber, condition of pumps and appurtenances. etc.)
Na
k
- .(revised 11115195)
7
SUBSURFACE-SEWAGE DISPOSAL SYSTEM INSPECTION FORM _
PART C
SYSTEM INFORMATION (.continued)
Property Address: 136 Old.Homestead Dr..MarsomMiOs
--Owner: susslchella
Date of'Inspection:
SOIL ABSORPTION SYSTEM (SAS):X >.
- - -(locate-on.site.planjf possible; excavation notrequired, but may be.approximated by non intrusive methods)
If not determined tote present, explain:
n1a - -
- Type.
'leaching pits,.number: 1,000 gallon leaca p
leaching chambers,number:n1a _
leaching..galleries, number:n/a
leaching'trenches number,.length
leaching fields, number., dimensions:
overflow cesspool,.number:n1a
j Comments: (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
{ The leach pithad 2'of water in it at the time of the inspection.It is structuraly sound.
j
CESSPOOLS:
j (locate on site plan)- -
Number and configuration: Na
j Depth-top of liquid to inlet invert: n1a
Depth of solids layer` n1a
Depth or scum layer: n1a
i Dimensions of cesspool: n/a -
Materials of construction: nla
Indication of groundwater: n1a
inflow(cesspool must be pumped as part of:inspection)
Na
' I
Comments:(note condition of soil, signs of-hydraulic failure, level of ponding, condition of vegetation, etc.)
n1a
PRIVY:_
(locate on site plan)
Materials of construction: nta Dimensions: n1a
Depth of solids: nta
Comments`.(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PrivyCormnents
(revised 11it5195)
j
M
' SUBSURFRC.E.SEWAGE DISPOSAL SYSTEM:INSPECTION FORM' -
PART C
SYSTEM INFORMATION(continued)
Property Address:. 1360Id.HomesteadDr..Marsfnm s
'Owner: Busslchella
Date of Inspection:.91t114e -
-SKETCH OF SEWAGE DISPOSAL SYSTEM:
_ include ties to at least two permanerrtreferences landmarks or benchmarks
locate all'we-s within 100' - -
- - ---- -
D A�
DEPTH.TO GROUNDWATER
Depth to groundwater.12 feet
method of determination or approximation:
USGS Maps and Charts
(revised11H512} "
TOWN OF BARNSTABLE �-
L�!X°AIION 1 (p h��—�All SEWAGE #
:LAGE �l,� ASS SOR'S MAP & LOT • 3-
tGPbr—'TOR,'j NAME&PHONE
SEPTIC TANK CAPACITY
0
LEACHING FACM=: (type (size)
NO. OF BEDROOMS
BUMDER O OWNE
PERMITDATE: COMPLIANCE DATE:
Separation Distance Betvween the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
. within 300 feet of leaching facility) Feet
Furnished by—
a llor)
�c000
co e �
Ll 3
TOWN OF B.ARNSTABLE o
?,'-,OCATION (.-� O r7 Ol c� �1��,� tc� pc�v2 SEWAGE #
=Y
VILLAGE Mg(i-I lm ASSESSOR'S MAP & LOT
i
INSTALLER'S NAME & PHONE NO. -7 0411
SEPTIC TANK CAPACITY 1,000�Jd H S
LEACHING FACILITY:(type) Ire-Inc[ (size) (p00
NO. OF BEDROOMS PRIVATE WELL ORCPUBLIC WATER
BUILDER OR OWNER S Piv �c� Ca
DATE PERMIT ISSUED: 0,4, 1-7 G 4 (o
DATE COZIPLIANCE ISSUED: L 7
VARIANCE GRANTED: Yes No ti *'
i � r � 1
L��-� I�
yy � 1
G / �
2 6;�
—�
.o
�u
��� e
�`�
w
t
�.
�,
f
,�
No.. ........._...�. F>s................... ......_
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
� .......OF....... R/UST16.L
Appliration for Bi-opnsal Works Toustrurtiuu Prrutit
Application is hereby made for a Permit to Construct ( V/ or Repair ( ) an Individual Sewage Disposal
System at: OLDS,
.� 0T i7r� Q 5T� A-D Z)R 1-n/foesraNs �ILLs
_-
Location-Address or Lot No.
-•_....��Ys � .�-�.�_..------ l.------•-----•-•---•._.... _----•• .. a .3 ax v i��
- _ . -- ...................................---•-
Owner Address
W S19MF_ __
5 m__"
Installer Address
Q Type of Building Size Lot____._.._�.__�37____Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures ------------------------------•. .
W Design Flow.........................6..._5-.._...._.....gallons per person per ay. Total daily flow__._....-33.Q_........................gallons.
WSeptic Tank—Liquid capacity.OaLgallons Length.._d . Width................ Diameter................ Depth................
x Disposal Trench—No- -------------------- Width........ ----------- Total Length___..........`.._. Total leaching area. ........sq. ft.
Seepage Pit No--------/---------- Diameter.......19_...._ Depth below inlet.... ......... Total leaching area..................sq. ft.
z Other Distribution box ( V) Dosing tank ( )
Percolation Test Results n Performed byeX..L. A ..���G--.-i�G_...... Date___?�_ ...............
�a Test Pit No. I......1 rr`��minutes per inch Depth of Test Pit.......�_�l'........ Depth to ground water......._----------
.--
Test Pit No. 2._._-e..Lniinutes per inch Depth of Test Pit........1.0..... Depth to ground water------- .............
fYi �.... ...........�.......... .......................
0 Description of Soil.........a..... ._. 1� kk. ��f�L1-.. f 3 :!!1 �A
.....................
V --•--------•--•--------••-•----------------•--•--- -----•------•--•...---------•----•------•-•-••-----------•-------...•-----•--------------••-•-••----•-------•----•----------
W ................. ---------------------••••••••---...------•--------------•-•---•••--•----------------•--------•--------•-•-•-••----------------•---------•.:---•---------------•---•......---•----_....
UNature of Repairs or Alterations—Answer when applicable_____________________________________•-__-____-___-____---.--__.._________-_.---_----_.-_-..__-
-•----------------------••--•-•.._..••••---------------••-•--------------•----...-••••-••----...-----------------•----------------•--------------••---••••--------------------------------•-----....._..
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of i i Y =
p 5 of the St Sanitary Code— The undersigned further agrees not to place the system in
Pipplicatioun
ion ntil e cafe of o iance has been issued b the board of health.
Signed ��-�l ��'�V ------- .........9f.-�......
to Dad Approved BY 7
Date
Application Disapproved for the following ea-sons:................................................................................................................
------------------------••-•-------•-•------•---------------•----•-----•----................-------•----.--------------••----•--------------•---•----••-•-••••-------•----••----------------------------
Date
PermitNo........................................................ Issued_.......................................................
Date
No. ............`� FEB.. ..�........._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
- OUlli0........OF...... O��/.5T46I-rZ
Appliratilan for Eliipniial Workii Tomitrnrtiun Prrutit
Application is hereby made for a Permit to Construct (vl) or Repair ( ) an Individual Sewage Disposal
System at: 19
L-0 T !� /-Is kk t6' 5 �"At tb 1 r /1,e,57 d'v 5 Ott � S
.... ........... ......... .-------.-----------.--•-•---------.----- .------- -.--------•-----------.-.---.----.-------------•---•---..---------•----
Locat:on-Address or.Lot N
Co f3ox
_.._..... - ...�...._. ..._...--• .... ......................................
Owner Address
a ..................... ---••-------........_.................... .......................-••-•--•-•••---•--•••-•••-••--•••---•-••---••--•-•--•-•..................--
Instaler Address
d Type of-Building Size Lot---_.._..:._`..............Sq. feet
Dwelling—No. of Bedrooms..................3.......................... Attic ( ) Garbage Grinder ( )
'4 '�
a Other—Type of Building
No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures ----------------------------------------------------------------------------------------------------•----------------------------------••-----------
Design Flow.......................�.5............gallons per person per day. Total daily flow.........: r✓_..._._..._._.__.____----gallons.
W fP ?
� Septic Tank—Liquid capacity_..._.......gallons Length...._T(�... Width.............. Diameter---------------- Depth................
Disposal Trench—No. .................... Width._-._..j............ Total Length............ Total leaching area _ter. __ sq. ft.
Seepage Pit No-------I........... Diameter......, __..._. Depth below inlet...J��.......... Total leaching ary. ......sq. ft.
Z Othcr Distribution box (V/) Dosin tank ( )
'-' Percolation Test Results Performed b U _!_LV ll�1� .........{_�SMOG (J.)G Date_6...Z..�v................
,aa Test Pit No. 1...._] . .minutes per inch Depth of Test Pit....... ......... Depth to ground water------------------------
Test Pit No. 2......9�_..L..minutes per inch Depth of Test Pit........[[...... Depth to ground water.-------...............
De_cri Description of Soil d= f- ; 1 _' :fit N --------•-•-----•-----
x I
W ----•••--•-•----------------•------------•-----••--••-••••-•--------•---•...........-•----•--•-•••--...•-•-••••........_........---•-••--------•---•-•-•-•--•---•--•-•-••-..................--•-•-......
Nature of Repairs or Alterations—Answer when applicable................................................................................................
--••..._ ...•-------• •-••--•••-•-•--....-•-•-.....-••.......•-•..........•--•----•-••••--•••••-•--••---•-•••••-•••-••--••--•••-••••-•---•-----•-•................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the S e Sanitary Code—The undersigned 'further agrees not to place the system in
op tion until C care of fiance has been issued by the board of health.
SigneSigned ...............•---------•-•---••-----• ••---- q } -•-••-
d-------- -� # �1! �•-d`�
er-plication Approved BY--- / �'
Date
Application Disapproved for the following easons:...............................................................................................................
--••--•••••--•-•-••-•••-••-•--••••...---•---•••••----•--•---•-----•-•-•-••••-•--•................•••--•--I•-••-----------•--•------•-----•-----••-•-•-••--•---•---•••--••----•-•---------•-•-••.....-•---
Date
PermitNo....................................................... Issued_.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
.��• BOARD OF HEALTH
....................... :..........OF..... /.5 ! C.' .....................................
(Irtgf irtt#p ,af Tuntplittnrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed �/) or Repaired ( }
by ---`_-------✓l� !S G�1-C ---------------•----- ----------------------------------
4.U! OZ. D r�u rt C 5 i r::/l b Install-
has been instailed in accordance with the provisions of Ti"�is j of T e State Sanitary Code as described in the
application for Disposal Works Construction Permit No.___J'�i__.!_f.U ._.__.._.__ dated-------- _.:'___ �..�_ �
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector................:...................................................................
THE COMMONWEALTH OF MASSACHUSETTS
'TY BOARD OF HEALTH
7-0WI 54Xl'746�
ti� `.J:
............""• FEE---. .......
Biap.nsnl ork�r�nnotr ion antit
Permission is hereby granted_....`�. '_..:.._.... ..�:�.............•................
_o Construct ( LV or Repjair ( ) an Individual Sewage Disposal System p
LtITG.. r L C}+91 f r..........................................� ...�* l.. a �l�3 ................................................
Street 14;
3s shown on the application for Disposal Works Construction Per` it No3.51_.. �_ _. Dated.__._(J__._.�_.�..__�.
.a „V
{- Board of Health
DATE..... ..........................V
ee.
=ORM 1255 HOBBS& WARREN. INC.. PUBLISHERS �M4{
- q
i �
SITE PLAN SHEET I OF 2
SCAL E: I rr= A '
mot-
\ 03' 00
&A
a 7-
5,437 . 2 3
Joe. T'05
�-, a-pax tax 6Nk
h W,TANK -----
600 CwAL,l gh e PIT - -� 0
E A9c-V,JD
N s
?a �
?� �tip,
i
1IA OF algsf�y
9
�o WILLIANi
.•VMRYVICK
No. 19771 'f
r•
FOR O-A\-(l 1 r2'p' 07 'P , C-62.
REGISTERED LAND SURVEYOR OT 4 7 a 1,p �40M 6/� A d
btu E M A'�- M I L L•
• ... O PLAN ' M A r 49j PG I-
F DATE
BENCH MARK DATUM 12779 DAT04A WM. M. WARWICK 8 ASSOC., INC.
DOMESTIC WATER SOURCE- "owl WAr�� 80X 801 - NORTH FALMOUTH
FLOOD ZONE.-ND� ' I-�l1�,1�+ 1� �IGI� MASS. 02556 - (617) 563 -2638
LEACHING BASIN SECTION NOT TO SCALE Sheel e e f Z
I�iFfY'Lx= 24 C.I.MHCOVER
v 5
BRICK AND MORTAR COURSES AS REO'D• TO BRING
1' COVER TO GRADE
B FLOW LINE / ..
INLET 1_ i;'i 2 TO WASHED PEASTONE FREE Of IRONS,
PIPE FINES AND DUST /N PLACE
�,.. T .' '
�! l •. /q TO I/2 WASHED CRUSHED STONE. FREE OF
I/ : OPENING WITH 4/B ••
OUTER DIAMETER IRONS, FINES AND DUST /N PLACE
�I AND 1314,.INS/DE . .
DIAMETER ' 1. CONCRETE TO BE 4000 PSI 28 DAYS
2. REINFORCED WITH 6°x 6° NO. 6 GA. W.W.M.
3. 2'AND 4' SECTIONS ARE AVAILABLE FOR
GREATER DEPTH REQUIREMENTS
' I�'�� —I--6,0" 3�--� 4. NUMBER OF PITS REQUIRED Otis
MIN. I I z� NOTE: EXCAVATE TO ELEVATION OR
EFFECTIVE DIAMETER
(NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL
WATER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE
EXOAVATED MATERIAL WITH CLEAN
TYP/CAL PROFILE GRAVEL TO DESIGNED GRADE.
77
/B"STD. LT. WGT. C.I.MH COVER
4"C.%PIPE 4"8/1:FIBER PIPE
OUTLET LEVEL
DWELLING FLOW L/NE TIGHT JOINT TO FIRST JOINT -;-�ti-, - t,_•
qq£_ „ O 00 / 0�op I
.I. TEE /4 ��� !p5 I I 0 I O 0 1 1
111000 00 1 I I I
�p.00 sm PRECAST CONC. �/���f �D/ST. BOX TO BE / I ( 0 00 00 1 1 1 1
' 0OGAL.SEPTIC TANK. INSTALLED ON LEVEL, 7 1 1 I too 00 0 1 1 1
S 1 !1 000 0 0 1,1
TABLE BASE 1 1
g .. .,.. .�: • 111 100 0011 1
W01-0: PI L VL \SEPTIC TANK To BE 1 if 0 0 0 00 1 1 I
I{'OvSE .�ELd4J bSn�"(. INSTALLED ON LEVEL, 1 !1 100100 1 1
STABLE BASE. 1 1 1 0 0 0
, Moo 001111
h L.A FD' LEACHING BASIN , 1 t A Q O 00 0 1 , ,
BASE TO BE LEVEL i 1 I 0 O O 1 1 , , L�•�JB 9
SO/L AND P£RC. DATA
:PERC.RATE 2 MIN. /IN. P5 S7�j 0„ TEST PIT N0. I 0�� TEST PIT N0. 2
-Co f7y0'61,-
1 TO r4U1<,
fZ���
:TEST BY t,p � h�gcIt,
Ll
WITNESSED. BY: �ea6 M Gi, AiJ MI�pIum
> el,���S
TE9T.PIT GR. EL. e�.(c ,o YvI01p1UM 12
DATE: - _Z 41641 I�' 7A1.1 2� S log CI 5S. o
No ul�kt�z : t,lo wAr� •
DESIGN DATA GENERAL NOTES
'.,BED.ROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM.
DISPOSAL NO -SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD
EST.' TgTAL DAILY EFFL�±�GPD. PRECAST REINFORCED CONCRETE UNITS.
SEPTIC TANK, looc� GAL. ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE
TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE,
SlDEWALL AREAZ GAL./SQ.FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF
BOTTOR AREA GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY I , 1977.
:'.'LEACHING REQUIRED .SQ.FT.. ANY -CHANGES OF HEALTH.
TUAL LEACHING AREA -
TO THIS PLAN MUST BE APPROVED BY THE BOARD
.'AC: :
-"74'2SQ;FT, '-,.,AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE
BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION.
PITCH ALL SEWER LINES 'A / FT, UNLESS INDICATED OTHERWISE.
SEWAGE DISPOSAL SYSTEM
MARTIN 9cGN / 5 fl� �V D&.
E. FOR' `'�
w MORAN r`ii,
ai„ ,e QF
;:.'.`._:' •Poi G�S•flr`�G���4. YV1 Ac 5�0�S /vl l l.� S, /Vl�S S
X
ss/Orr4EN o�rt Iles, l�>36
SCALE AS INDICATED DATE
WM. M. WARWICK d ASSOC., /NC.
BOX 80/ .:- NORTH fAL MOUTH
.,,
` MASS. 02556 (6/7) 563-2638
"PROfESBIONAL ENGINEER