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0047 PEACH TREE ROAD - Health
47 Peach Tree Road Marstons Mills A= 057-097 I TOWN OF BARNSTABLE 1;OCATION 97 Ada _rret / SEWAGE# V Ia'11 C LLAGE/°Y�o►���� � ASSESSOR'S MAP&PARCEL 3-7 �l 7 INSTALLER'S NAME&PHONE NO. i^►`s 7j- �7 SEPTIC TANK CAPACITY /00 6 LEACHING FACILITY-(type)al') AKC,34 HC , H dO (size) -2:-7 X NO.OF BEDROOMS 3 OWNER&gA CJet&Wp./-o1,1 PERMIT DATE: S 3 l 2-® i — COMPLIANCE DATE: ( 6 Separation Distance Between the: sVa 8/a U q Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /3 O' 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 A/ 300 feet of leaching facility) /�' Feet FURNISHED BY (�.�- 0 Dec(-, A 1=37'- t3- o A`�,3 Y o 2"_Qs5. A -3=��` r _ :3� I 1a3 A -+ =&ar' 13—f q4*.3� _5=70: /No. J73 Fee s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pprication for Migogal *pgtem Construction Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.i4q P(Spt3,4 'Tj'& M M,t(, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 14 0S K4 Installer's Name,Address,and Tel.No. -10 411���� Designer's Name,Address and Tel.No. GAPCw+ Oc; C6.f k(SGS It 11G swC o 153 Comma4f 4A, S-r 0(q,S �8 54 C 4 14 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided S , '� gpd Plan Date vQ01 _X, Number of sheets I Revision Date Title PC!)hGL•f MtZ R641b M06TO1JS Ak(t -S, Size of Septic Tank 1 ,000 Type of S.A.S. AO 1.1�c Description of Soil Kg tFp ".44S9 if Nature of Repairs or Alterations(Answer when applicable) USE L%IUST%kig 1,006 Cam. 1G0TlC 'OW V_ IV Peki If-a o -O vK 'i`o 20 AQ-d 3G &d -2 a 10 AF�1 641L-dW r~k Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H lth. Sign d or Date :-;,-p " 31 Application Approved by Date Application Disapproved by: Date for the following reasons -- Permit No. /� Date Issued No. �1 f/�s�' Fee O V -sr THE COMMONWEALTH MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN-OF BARNSTABLE, MASSACHUSETTS Yes Rpplication for Mi000al Opztem Con.5tructfon Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. T l PEAGA _7� iM M-M• Owner's Name,Address,and Tel.No. Ill rq H"-4 3 C>AftmotJ Assessor's Map/Parcel 57 N 7 4 I p� -,-t1� KI) nWSTOOS K4 1�9 In taller's Name,Address,and Tel.No. '.A T� 7 7 Designer's`Name,Address and Tel.No. tom. a8—.Z73`037 7 s i4Pcw10Q; G PR.ISG% " t -sc Er1 11JL- ��16C :rW4 53 Co 4WOV A.t, S-r NA supra: ;28 54 t+Wlf, E khVF_tA Pt" Type of Building: Dwelling No.of Bedrooms Lot Size a�pl gQ(61 4- sq.ft. Garbage Grinder ( ) Other Type of Building POSMC.1T 04 No.of Persons Showers( ) Cafeteria( ) Other Fixtures } l Design Flow(min.required) 330 gpd Design flow provided 35 S" ;t.- gpd Plan Date rJ-a'9 'rI01 X Number of sheets Revision Date Title 41 PL-ACH MeF, Ro*b M40SToWS A c, Size of Septic Tank 11000 Type of S.A.S. f3 4 100(FFVSt 2s I Description of Soil PLC t'� "004j"(5 so-of-V l 49 6e PLALJ Nature of Repairs or Alterations(Answer when applicable) U56 I;NGlSTMIU to Co CAL. 5OTiC -pW V T Nrtiv I{.aO D-bvac TO ;to A" 3(900- 14-;o OtoDtFrost&S iN h Fi6u cwrk. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. I Signed '� Date 3( 'a 1�•. Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 35 Date Issued THE COMMONWEALTH OF MASSACHUSETTS 4 BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( X) Upgraded ( ) CA P�t�6 CNTi C< c S Abandoned( )by o � at 147 P&-A .F! 1-Q..o g;ytb In oWSiuig (MILL$ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.40/-9 —,/ 73 dated 5 3/h Installer Co(pE wl4t` t�cPd(S� L.<.C_ Designer ZC #bedrooms Approved design flow 3 s$ a.. gpd The issuance of this pe t shall of be construed as a guarantee that the syst m wt1Y funo jn as designed. Date (0 �� a Inspectoo�!/�-------- No. "�! `�= f I Feer, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Di!5pogal 6p5tem Construction Permit Permission is hereby granted to Construct ( ) Repair (x ) Upgrade ( ) Abandon ( ) System located at 4-1 Pe—k 4 TAeit Roo wsksroAu5 xvu.S and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this perm . 5/73 // Date Approved b�y "'�—"•—�--..._._,__.,,,___"�'-""7` 1 Town of Barnstable Regulatory Services Thomas F. Geller, Director BARNSTABLE, � Public Health Division MA88. Thomas McKean Director fp Med � 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 509-790-6304 Date: 6-6- 1 Z- Sewage Permit# I — t73 Assessor's Map/Parcel a Installer&Designer Certification Form Ucsii;ner: SC Enq[tieerinq, G _ Installer: CQ�ew�d2 C-nf er�rfs z5 LAG Address: 2LSy Cs-nyv-rry Hi�hw! Address: On S-3� " Z®�z j-g- L , p was issued a permit to install a (date) (installer) septic system at Pe46n Tcee_ (BOG+-J based on a design drawn by (address) �G c n,nt n e e(m s Tv1 G dated HOX / (designer) V I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if req .nspected and the soils were found satisfactory. ,MOF&Ak, oti JOl;N l., CMUFC!'I:L s )� JR. (In.. ller's Sign re) No �41307 r /4jesigner's Signatur (Affi) esi e s mp Here) PLEASE RETURN O BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. cl ',tl'I'itc I'unnsWc;igncrc�nil is i ion foi m.doc Town of Barnstable Pit �� 5 ' Departinent of Regulatory Services AMWgrABLAr Public Health Divis ion DateMAM (4 e , jED Mltt�, 200 Main Street,Hyannis MA 02601 Date Scheduled Time_ Fee Pd. Soil Suitability Assessment for Sejvage Disposal Performed By: M l Gy1 Ga Z.\ i VYt e tl V-1 E=TI G S C Witnessed By: LOCATION& GENERAL INFORMATION Location Address `I'1 ne�� -rje_ n - _ Q Owner's Name tj , Address L-1-7 Assessor's Map/Paroel: 0 ®�(-7 Engineer's Name C', i c!-oqk!,.- -i) F �G �o1`�ji 03 NEW CONSTRUCTION ((( REPAIR Telephone# W-?7 7 SO 8-2 73-0 3 7 7 Land Use: SIT c �amily dweltiV5 Slopes Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well "- ft Drainage Way ft Property Line 0 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands•fo proximity to holes) • see ak�ac�ne(;� ,-(1�a�n Parent material(geologic) 0Uk')ctS41 Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit FAce Estimated Seasonal High Groundwater 7 1310.� dog S DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: D'CeCE o0SUU0V0A Depth Observed standing in obs.hole: i 3Q I4, Depth tq sgil mottles., In. Ucpth to weeping from side of obs.hole: in, Groundwater Adjustment — f. Index Well# Reading Date: hidex Well Irvol _ ._ Adj.factor y Adj,Groundwater Levxl, PERCOLATION TEST bate 5-2212 Thne it 4 Observation Hole# Time at 4" — Depth of Perc y'� �O�' Time at 6" Start Pre-soak Time @ i I; 26 AN Time(9"-6") End Pre-soak 11;2 y An ' Rate Min./inch C 2 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) N Original: Public Health Division Observation Hole Data To Be Completed on Back- ------ ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC'1PERCPORM.DOC i DEEP-OBSERVATION HOLE LOG Hole# i 2 Depth from Soil Horizon Soil Texture Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,,Boulders, onsistenpy,%•Gravel) i2-y�3 13 S l0 Y� 54. _ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gra e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C__Qnsistencv.%O e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes, Within 100 year flood boundary No-✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ` e_5 If not,what is the depth of naturally occurring pervious material? Certification I certify that on /0'2 ^9 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise a d exper' a described in�10 CMR 15.017. Signature Date 3"Z9'! - QAS..EPTICIPERCFORM.DOC .. • to ru Ln -21 Postage $ u r-I Certified Fee HYgN t7 Po C3 Return Receipt Fee Here C7 (Endorsement Required) Restricted Delivery Fee r (Endoreemerd Required) 7 O Total Postage&Fees $ 4�ti r Mr Hugh Cameron 47 Peachtree Road Marstons Mills, 02648 Certified Mail Provides: ; ■ A mailing receipt ® A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. ■ Certified Mail Is notAvailable for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return, Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ® For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". I ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047 I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sighature item 4 if Restricted Delivery is desired. Xta4' 4❑Agent ' ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, 1 ' or on the front if space permits. q^6 i e�DG D. Is deliv ry address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No Mr Hugh Cameron { 47 Peachtree Road Marstons Mills, 02648 3. Service Type ❑Certified Mail ❑Express Mail ❑Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes Article Number — , �I ransfer from service labeq l i ;7 011 0 4 7 0 0001 '4 5 2 5 713 0* rm 3811,Fe6ruary-2004. Domestic Return Receipt 102595-02-M-1:0 I UNITED STATES POSTAL SERVICE -� y it IM Mail os "r"ees.R.aid � _ aad. .�,.t� ..a, .,•w;a;•,:., «, ra,r+�.rw�� �!,.�„rj• V• Sender: Please print your name, address, ana-Z-1P44 this boxes Y' Town of Barnstable Public Health Division I 200 Main Streety Hyannis, MA 02601 v 6 IIitii1A 11 fill 111.1111111111111.1111111111141111111111id111'IIl1 THE Town of Barnstable Barnstable �F T BOARD OF HEALTH e"aCi BAE.N Ss.LE, ' 200 Main Street, y Hyannis MA 02601 �m 9�,0 639• A\�� � rEo MAt _007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M. 7unichi Sawauanagi CERTIFIED MAIL# 7011 0470 0001 4525 7130 May 31, 2012 Mr Hugh Cameron 47 Peachtree Road Marstons Mills, 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located 47 Peachtree Road, Marstons Mills, MA was last inspected on 2/21/2012, by James D Sears, a certified septic inspector for the state of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5(310 CMR 15.00) DUE TO THE FOLLOWING: • The System is in hydraulic failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system with the deadline period will result in future enforcement action PER ORDER OF THE BOARD OF HEALTH ean, R. O Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\Regulatory Authority}doc F ComloomNealth of Massachusetts Title 5 Oloal Inspection Form Subw Sewage Orsposat System Forme brVbluntaryAssessffwAs 7 Peachtree. Rd_ PMPW1yAddrM HughCarneron Owner OwmesNaffle hftnnationis M.Mills MA 02W 5-21-12 Ems- W Zip Code Daft Of htspecdon results must be submitted on this form inspection forms may not be aftred in any way.Please we completeness checklist at the end of the fie, "�MOMM A. General information on dwe Compuler; �```� OF My to Mwe Y" jwvesD Seam _ JAMES Muse t+ ute ratter of rtegpector _6: SEARS ' Capewide LLC 163 C;omgw rt ial Srea i�q�lF 5 I N SIP , Compate)rAddms unuunen 141azsh MA 02649 Cwtom ZIS COde -4 - $'1W3 Tek"wme Number tit nse Number B. Certification l try OW l two persmily hapeded the sevaige disposM sysWn at this addrm and OW te ration reported below is tna,accurate and completa as of the lime of the inspection.The inspecfin was performed based on my Dining and experience in the proper fit and maintenance of on site Title S(310 GMR#SaIW The system: 0 Pages 0 Conditionally Passes Fak 0 Needs,Furffw Evalinifim by the LocW Approving Augwiy s 2142 �a ems SkInat" Daft . The system Inspector shall submit a copy of dulls inspection report to the Approvetg AuDwrity(Bo l ,rr.. of Health or D within 30 days of completing Wis inspection.ff"syste►»is a Owed sy m or s has a design met of 1%OOG gpd or greater,the i t and the system suer steal report to the appropriate regional office of the DEP.The f should s i be sent Myths cys t t�v and copies sent to t1 buyer, 'applicable,and#ve aMmw*V a te. 5 4 *"*This report only describes condom at the teae of inspection and under the conditions of use at that timiL This•- ' - do"not address how tree system will perform one the futum ttnas Ow sane or dWerend conditions of€se. LPF.W2L 1vTt%50TSyabam-Pea#dl? Commonwealth of Massachuse#ts Title 5 Official Inspection Form Su"vrfaw Sevr4p DbpmW Vs4sftm Fom-Not fir Voluntary Amsessments 47 Peacftee Rd. ftoWtyAftM ownet-fugh Cameron s AbM M.Mas. MA 02648 5-21-12 Zp code DiftofMVectfon a. Ceraftadon Inspection Summers':Chic A,B,C,D or"f#~complete all of Section Q A) Systain Pasm 0 l have motes any irdbintation which in-d tes that any of the€aftm criteria d i in 310 CMR 15,303 or in 310 C R.1 ,3W exist.-Any Wure criteria not evacuated are indicated bey Comments- 6) -44,%ftm Condftrwft Passm 0 Om or more system components as desatted in the T"iditional PaW section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of fah,wig pass Check the ,,,box for°yes ,nrW or°not"c emtsr "'(V,N,ND)for the following statements,If"'rot det ermined,"please,explain- The septic tank is metal and over 20 years old'or the septic tank(v+rhether metal or net)is spray unsound,exhibits substantial infiltration or ex nation or tank Wure is imminent System va-11 pass inspectim 9 the existing tank is replaced with,a tank as aired by the Board of tee. *A rat septa tank will pass inspection 0 it is structuraHy sound,not wakyV and if a ate of Compliance indicating that the tank is less than 30 years old is avail. O Y ON 0 ND(Exptain below): -}ono W,sso -ftp 20117 Comnumwealth of Massachusetts Title 5 Official Inspection Form S Wsposaf System Form-Not for V€artr Assessrrvents 47 Peat%tree fed. PMPe1WAd&M Hugh Cameron NMW mqubvdforevery 5-21-page- CJWTOM SWL- Zip Code DSW Of inspection 12 Cerfficadon (cont.) B} System conditfo taffy Passes(cam}. 0 Observation of sewage backup or break out or hhffi static water level in the distributiori box due to broken or obstructed pipes)or due to a broken,settled or uneven d��ution box.System will pow Inspection If(with approval of Board of Health)- 0 broken (s)are replace 0 Y ON 0 ND(explain below: 0 demon box is leveled or replaced 0 Y ON 0 ND(Explain belowy 0 The system required pumping more ti ara 4 tunes a year clue to broken or obstructed.pWs�The sWem will pas inspection if(with approval of the Owd of Health): 0 broken pipe(s)are replaced D Y ON ONO(Explain below} 0 oars is removed 0 Y 0 H 0 tD(fin below): furffw]Evahw trn is Required by Me Boacf of Baffle. 0 CWdM vrt#ch sire krOwevOluaborrbytim Board c(HeaM a order todeternww W ft system is tailing to protect public hem,safety or the environments 9. System will pass untess Board of Health detenninees In accordance with 310 CMR 1;t.303(i)(b)that the system b riot functiorifng in a mangy which wig pmted public sty and the wall nitient: 0 Cesspool or pmry is within 5D fW of a surl�tce,water 0 Cesspool or privy is within 50 het of a bordering vegetated wef#and or a salt marsh terns-tt/!� _ TdReSo �petlfiatfomeBy�Ce-pag���t3 CornmOMNeaM of Massachuseft Title 5 Official Inspection Foy Suhsurl*ce ftMW Disposal System Form-Alot fbr Voluntary Awmsments 47 Peachtme Ltd. Cameron t 0%"V% tit.mi is MA 0264$ - 5-21A2 r - Ci rom stUe zo coax DOW or ft"ecow E. Cermciaon(wit.) 2. System will fall unless the Board of Health{and Public Water Supplier,If determines that the system Is functioning In a manner that protects the pules health, safes andrim 0 The system has a septic tank and soil absorption system(SAS)and the SAS is wffhn 100 feet of a surface water supply or ftutary to a surface water supply. 0 The system has a septic UM w4 W and W is whin a ZQne 1 of a putt waW supply- 0 The system has a septic tank and SAS and the SAS is within 50 feet of a private water Supply Well, 0 The system has a septic tams and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply weir. MOM used to debordm chstamice '*This system pasm if the mell water analysis, performed at a BEP c erbfied laboratory,for teal conform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitram is equal to or less than 5 ppm,provided that no odw f dwe criteria are kWwed.A copy of the anaWsis must be attached to this form. onw- D) System Failure Cruets Applicable to All Sys: You must` 'Yes°°or"tom"to each of the ftnowing for aff hapetftw. Yes NO M 0 Baclaip of f into facility or system dtwtooverlixidedor dogged SAS or cesspool ❑ 19 Discharge or porm ft of effluent to the suftw of the ground or surface wad slue to an overloaded or dogged SAS or cesspool Statue liquid level in the daft Am box above outlet Invert due to an overloaded or cloo QW SAS or cesspool 0 0 Liquid depth in cesspod is less than T bed invert or avakbW volurne is less than l day flow miffs-7g1E0 7i�s5tFattt; �4tS� Commmmealth of Massachusetts Title 5 Official Inspection For &1bSUA3Ce Sewage Disposal System form Mot for Wuntary Assessrnents 47 Pearce Rd, ftpertyAftm H29 Cameron tM.Mills MA 02648 5-21-12 € - CKWTOM s#ato 210 code Date of ftmpecoon S. C+ertffi don (cont) yes NO F] Eg Wired pwrnping more#van 4 times in ft last year M*Tdw to clogged or obstructed pipe(s).Nwyd er of finves pumped: 0 0 Any portion of the SAS,cesspool or pnvy is below ho ground wrier elecration. Any porgy of cesspool or privy Is wif 100 fm of a.surfacia water supply or tributary to a surface weer sue. 0 IR Any portion of cesspool orpnvy is wfttdn a Zone 1 of a put 0 0 Any poitm of a cesspW or privy is w0m 50 feet of a pry water supply well. 0 Any p x*m of a cesspad or pm#y is less tharr 100 feet but gar#tram 50 feet from a private water supply well with no acceptable++fir quality analysis.frift system passes If the well water analysis,performed at a DEP certified gory,fbr fecal coRkm bacteft hiftates aW Ow presence of ammonia ndragen and n-ftrate ndmgen is swat to or less than 5 ppm, provided that no other fallum critevia are triggered.A copy of the analysis and chain of cuslady must be albiched to this form) The system is a l swing a facility with a design flow of 2t�gpd- ® 10,000gpd. Eg 0 The faft.I have deterrnined Mat one or mom of the above failure criteria exist as described in 310 CMR 15.303,#rerefore the system fads.The system owner should contact the Board of Health to determine what will be E) Large Syeftme: To be consWered a tam system*e sysftm must serve a facility Wo a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must ind%ate either�ye!C or°no"to each of the kftwing, in addRion to the questions in Semen D. 'des No © 0 the system is within 400 feet of a surface drinking water supply n 0 the system is wAiin 200 feet of a try`rotary to a surface drinking water supply 0 13 the system is located in a nitrogen sensitive area{interim Wellhead Protection Area—IWPA)or a mapped Zone It of a public'water supply well If you have answered"yes"to any question in Section E the system is censickred a significant#u+eat or answered Syee in Section D above the large system has#ailed.The owner or operate of any large system considered a sSnificart threat under Sectim E or b under D s l upgraft the system in accordance with 310 CMR 15.304.The system owner should contact ttte ap�prta� regional office of the Department COMMO weafth of Massachuseft TIMe 5 Official Inspection Foy Subsur Sw*-W Disposal System Form_plot for Voluntary moments 47 Peachtree Rd. Hugh Can'lem M.Mills lam+ 02648 5-21-12 Wroma stm Zip Code C100 Offt*P$COM C. CheC ,Check if the following have been done You amst indcate W or ano'as to each of the frig: Yes NO 0 0 Pumping infmatiort was proud by the owner,oommt,or Huard of Heaft 0 N were arfy of the system Components d out In the preAous two weeks? 0 Has the system received normal Ikm in the previous two week mil? fbve hirp violumes of w0w been Modem to the zystern or as pat€# this ink? 0 0 Were as built plans of the system obtained and examined?(If they were not available note-as PJA). 0 0 was the facrf r or dmiliing inspected for signs of sewage back up? 9 0 was ft ske Inspected for signs of Weak+ram 0 0 Were all system Mwomft.excluding the SAS,located on site? 0 0 Weft tank MWftM ur ,opened,and tie RVOW of tl*tank inspected for the condition of the baffles or tees,material of consYuctm, dimensions,depth of liquid,depth of sludge and depth of scum? 0 0 was the faci t owner(and occupants if different from owner)provided wdh kftmiMon on the proper maintenance of sum sewage doosM systems? The stim and bcation of lire Solt Absorption System(SAS)on the sty has been damned based on: 0 0 Existing information.For exam,a plan at the Huard of Health. 0 Q DoWniftel in tl*fmO(if any of Me tame wiftift mWed to fit C is at ima approximation Of thstanGe is unacceptable)1310 CMR 15.302(5)1 Ds System Information ResMenW Flow CondWorrs: Number of bedrooms(design): NA plumber of bedrooms( uai): 3 DESIGN flow bad on 310 CMR 16.203(for example: 110 gpd x#of bedroom): Commonwealth of Massachusetts Title 5 Official Inspection For 47 P Rd. ftVNtyAftm Hugh CWMNM omm M.mms MA 5-21-12 vpcoft oftofftispection D_ System Inf4rn-ablon €option, The system is a 1000 Gal Precast Tank ® sox and Pit Number of current reWent$. 2 Does residewe have a garbage gdftder? Yes No #s launy an a sqwate sere sysbam?[if yew separate kq=bw mWbvdl 0 Yes 0 Alo laundry system inspected? 0 Yes 0 f seasonal ? Ye No Water meter readings,if available(fit 2 years use( )., 201W OOO Gal surtv lam? 0 Yes 0 No Last date of occupancy. Pry Type of Estalftmient Gesign ftw(bwW an 310 CllR 15203): Gaffim pgf day f Basis of din flDw(seatstperso"A.,etc,), P 0 y4m Oft Inckistrial wasLe tvokling tank pnment? 0 Yes 0 No. Nm-sw waste-&mharged to t we TWe 6 system? 0 Yes 0 NO Water meter reaffiW;if ass-,�nQTwosWSPOCOM Fam ampiftm 7san f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface SwrW Dbpmt Sys%m f -Not fbr Voluntary Assessments 47 Pead*ae Rd. tNm � € ors flail,a -feqwredforemy M.mills MA 02648 5-21-12 POW CWTOVAsZip Code now OfhyApeed" D. System Info (cont) Last dateof oomputCyltsw. DAD belmy Generathdarmadan Pig# rft; Source of kibrrrratkn; MA Was system pumped as pad of the inspectionl 0 Yes 0 NO If yes,vokime p : a r was quantity Wiped determines Reason for pumping; Tp06of SYMOM 0 Septic tank distributkrn box,wil abs rpfion sys€un 0 Single cesspool 0 Overflow cesspool 0 0 Shared system(yes or no)(if yes,attach previ *irtspection remds,if any) 0 lmtovab l'Altemative twhnology,.Aftch a copy of the cunt opembon a maintenance conbW(to be obtained from system aver)and a copy of latest inspection of the ltA system by system operator urdr cones 0 Tight tank.Attach a car of the DEP approval; 0 ( ): i Commonwealth of Massachusetts Tiatle 5 Official Inspection Form %Wmrfb4e S%vajW DbpmW Syd form- for Vluft"Assess"wts 47Peachtive € d. €Lun Cameron 0%,Mft� as M.mitts lA MW S-2142 D. Sys illfonn {Cow.) Appromate age of all oompments,date irw"le#(d kr )arf souroe of WOmfim; 1984 Pest # 84-'177 Were sewage ors detected when a"tft at the site? 0 Yes 0 to BuWmg Sewer(locate on ske pLn): Depth below grad; Ur feet Material of cofu tru%w- 0 cast fm 0 40 PVC 0other ferny Distance%, m pry water supply well or suction tom: C4mmerf(on can of jwft, w3,evWwm of# e,etc,) Pqxft is 4P lvc sch 40 Sepft Tank(locate on site pis). Depth below ra&= �t matsw Of constrUchm, 1 f 0 povethYlOm 0 Q"W(ems) Iftank.is ram;fist a . Is age confirmed by a Certificateof Compliance?(enacts a copy of certificate) [I Yes 0 No Disiom 100DGalftecast inns-�4n4 s f�sa:� - ��stt� Commonnreafth Massachuseft -;+ Title 5 Official Inspection Form Sttt f S Dh p"System Form-toot for VohmtM Assewmft 47Peactib" Rd. PWPWtyAdftSs Hugh came= C1*W*ft t PWjimdforevery M.MMS MA 0260 5-21712 Wroym SM& zio Oft Ofk"P"U" D. System Infonniaon (cow.) Septic Tank(Cont) Dmtmice front top of sludge to bottom of ou t too or lie Ar Scum thickness from top of sin to top of outlet tee or baffle DzWm from bottom of scum to bottom of outlet tee or baffle How were€tire errttirtett? Tape-AsbA Sludge Judge Commetft(on pumping tecominei mlet and outlet tee or t condition,Ww*ffaf ink. liquid lei as relaW to outlet invert,evi*tce of leakage;etc:): Tank and covers at V, Tank at woditrtg level w I inlet Tee, oulet Baffle No s4n of leakage Gnaw Trap( an Me *' DepM tit lam' fed Maleft Of oW%Wv . 0 cOIncrete 0 metal 0 fiheqons 0 P""W&M a cow(e m): © enstons: Scum one from top of scum to tap of outlet tee or to from titof=toboftmofww.too Orbm 4 Date of last PUMPNKX Commnnweafth of Massachusetts Title 5 CMicial Insertion For Subsurfmm see DhMvsW sy9ftm ftm- for Wurrtary Ants 47 Peahtriee Rd Htxfi Camem n*m Wl_ � 6-2`1-12 page- cwr&&n Sim& zoca* of D. System 111forma"m (mot.) Comments(on pumper recommendations,inlet and outlet tee 4r baffle condition,structural Integrity, liquid GIs as related to outlet mvert evidence of Wimp, _): TWd or RokraV TAM(W*#!ust to pmqW at time of n) sft pW Depth below graft_ Aftftdal Of 0 ni 0Concrete 0 metal 0 fterglass 0 pt etryieene 0 other(explain} Dimens; capaw. Design Fa gaE[cns per day Alarm pwent 0 yes ONO Alarm !: Abrm in woftV order 0 Yes 0 W Date of fast pumping.- Comments(wxl tan of aim and RM sw t hes,etc copy of current pumper c a ntran(requk ..Is copy aftwhW. Yea des-iota 4de6 - 3� e7 eatth of Massachusetts Title 5 Ofcial Inspection Form Bum ftw"v Mspmwf sum -NotfbrVduntmAwewffwft 47 Pis Rd. ft"ftMdrew Hugs CWMM O*Mws M Mft MA 02648 "1-12 paw CWTOVM state 2*Caft DaloofftwpeoWn D. Sim Inform (cony) Din Box(d present must be )flocate on site ): Depth of fiquid level above otMet invert 0 Comments(note if box is WAW and doftutim to outlets equal,any evidence of solids carryover,any evince of image into or out of box,etc.y D Box Is l 21 x 4'Bebw grade, €r*fine,out Box Is no ea PuaW Chandw(locate on>;ke ): Pumps in=*M order: 0 Yes 0 No Wms in wa*.M order 0 Yes 0 No G`1m6�ients(n *DMition of purrs dwygw,condition of pumps and apFufta�a'nces,etc.;: ifSAS not ice,explain why: x 44fF4 Tft5 W"OcftftFmttlK-subuNba #2r 4T Comm onweait# of 1Was=cfitr t u. Title 5 Official Inspection Foy s roviticesmW DIsposals -Wt for VduAmessments 47 Pead*se Rd. tjum cam CMM for evwy M—MMS to M48 5-21-12 - Pap D. System 1,401,11van (cont) Type: leachiropft number � 0 taming chambers nu 0 galleries number 0 aching trenches number,length: 0 leaching faMs �¢ 0 overflowcesspoof number system Thame of technotogyj Comments(note conckawof sot sow ofhydrauk b6nv,- WvW of vegetatim LRaching is one 1000 Gal Precast Pit w 11'stone, Pit at 5' bebw grade w lbover at 3tr, Pit is tuff up W inlet fine Need tD rephaca tam Cesspools(eesspoo€must be pumped as part of inspection)(kx ate on se gtanY NwTdx!r and confturatim Depth-top of tom!to OM Depth of so#dr>layrer Depth ofscurn law Dine of cesspool Materials of construction kxkation of groundwater lr w 0 Yes [I No ass-4grto °S cii& csFarn �- 43�4T Commonweafth of Massachusetts Title 5 Official Insertion Form Sttbmubm ftwW DlWwW Sim€$rm-Mat f©r Wurt r Awessrmft 47 P ee Rd. Prope tg Address Hugh Camerctrt omm nnadf M Mils MA 02648 5-21-12 fewWreremy CWW S# t& Zit Code Dow Of W40000aft Da Sys I n (COS} C mments{rye C"i+ of sue,sus of hydraft ire, of P am,mWitim of vegetation, etc): Pnvy{fie on site plany Materials Of Cortsbitchm- Depth&solift CW#Mft(note,mwifion Of SOIL sign of h~ftim,wCAW Of Pmdm mwcarr 40f vesetagm etc.): -ttt4Q Tft5GwAw ee6ast _ 4 g6 R-PapmCal? Commonweal of Massachusetts Title 5 -Official Inspection Sum Stem€orm-Not for Vbtu€t "A ss"wds U Pead&w Ltd. PmpeftAddress Hugh Cameron o Mmm...� � M.MULS MA 02648 5-24-12 CRWTOWft SM& np c6do Oft of Sketch Of Sewage Disposal System Provide a view of the sewage d*KSW SyStSM,4XILKfing fieS to at feast two permanent re€ermce landmarks or bendi }arks_Lie aH wells within 100 feet Locate where pubfic water rl�a�the bukft,Chet*one of ft boxes hand-sketch in the,wea below dravf+ing attached separat* 1,4 El f A-I ::: 361 ya3 - � f 0 13-/ t3-3 _ �� Cammom veaM of Tie 5 Official Inspection for Strtmrrribim&wmive MsposM&fAm Form-Not for\ftmWy As emmft 47 Fem%beq Rd. PrqmftMdfm CkfM � earrrero� kOMMOM mqWmd i*sc=y CVTOM state zip COCIOM DE System MfOl On (mot.) Site Exam: JR Owck MMe 0 surface ws Cc cellw shower Esthnated depth tD high gMWWfed Please Micate,a#mWwft used to detemwe ft hogmund water eWmbn. ObWrad to I wed,fate€f desgn plart revowed: 2 2 79 Date Obser4W Sft(abAfing prOMtyftftwvMm hole wi to 150 feet of W) 0 Checked wth knal.Board of Health-e)qWan 0 Checked with Wal a=mWM' ®(fir�n ) 0 Amy USGS _ -sett: You must descnbe tt the NO gmM water ear; G.W Tit of DeW 2-2-79 Ir No water tot Before Ming this inspectton Report,pieese see Report commpteteness checkrist on nwd pegs, t5ft-11flo Tdie 5 9ffteW tilt Form: dm Sewage Dose!System-Pap 16 of 17 Comm mea of"Musachusetts 'title 5 Official Insertion Foy &ftUfftM UWW &fSb=ftM-!Dt for orgy Awwwreft 47 Rd. P�e�ty l�kfress Liuh Cmem CMW 'S p fir► swe ZIP Cate of E Report C eteness Checker [I x)ction Summy.As'Bs Ct D¢or E d*cked 0 Inspectkm SumuD(System Falm CrAmb AppficabLe tD ANC 0 SrA ma#m-Estated depth to ho gmundwatet rl Sketch of Swauge DlsposW System edw drawn on pap 15orattached in sepwatete tine-ttno TM 5 9ffidg hBPK§M Finar&ubataca Smage System-rage 17 of 17 LOCATION SEWAGE PERMIT NO. VQ L A G E /A _ -� J I N S T A LLER'S NAME i ADDRESS i y c C� 8 U I L D E R OR OWNER 0DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED Cl • r j ' o /��'� Fx$..:3..................... THE COMMONWEALTH OF MASSACHUSETTS BAR SALT �. 0 S�-a �� W. .... .........0 F.................. .. ......._.......-•-----•.......................................... ApplirFation for Uigvii al Works Tomitrnrtiurt runfit Application is hereby made for a Permit to Construct ( or Repair• ( ) an Individual Sewage Disposal System I ........................L....a-A .... . -- l o�lion- ddress or I ( .........-•-- ---- S-........................................................ OCh Ad'}rgss W QC ............ -----. gV.7SQ U�' 1Q►-� ...............( Installer Address Type of Building Size Lot... ��__ o ...Sq. feet U Dwelling—No. of Bedrooms.............................. .. Expansion Attic ( ) Garbage Grinder ( p Other—T e of Building No. of persons............................ Showers — Cafeteria P., Oth*.rxtl res •---•--•---•---•--------•--•-••. . W Design Flow________. __________________gallons per person per day. Total daily flow____.__..___...... ..................gallons. WSeptic Tank—Liquid capacity-/OM- .gallons Length---------------- Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area../- .....sq. ft. Seepage Pit No-------- --------- Diameter.................... Depth below inlet.................... Total leaching area...... ..........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •------•--•--------------------------•--.....-----•-----------------•---...----------.....--..-•--•-......................................................... 0 Description of Soil........................................................................................................................................................................ W V ----•-•--------------•--------•----•-•--._...._.............-------•---------.......---------•--.........---•-•---•---•----............_..---•----------•-------•------...--------------....------------ W ------------------------------------------------•----------------..............----------•----------------------------------------------------------•---------------•---------------------...._......... V Nature of Repairs or Alterations—Answer when applicable._....................................................................................1......... ..........-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'ITL%. 5 of the State Sa e—The undersigned further agrees not to place the system in operation ntil a Certificate of Compliance has been issued he boar of hea Signed................. - App ica'ion Appro By--- - -------------•-•---•------ ........................................................ .. ..------ Date Application Disappr a ollowing reasons:----•---------••--------------------•--•---------------------...----------------------------•------------------ --------••----•-------------•---••-----------•--------------------•---•-----•-----------........-----•....__..........---------------•-•---•-•---•----------------•---•----------....................... Date PermitNo......................................................... Issued....................................................... Date w;? y ........................ THE COMMONWEALTH OF MASSACHUSETTS B0,AS®---0•__. EALTH .............OF................. 1 1 I P . .. - .............__....... Appliratinn for Diupoal Works Tontrnrtion Famit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System ------------- "^ — "Location 1Address_ or .... _____, �I.S? .r.............. ....;?.�,? ------ ...A;..C...------......` +�j Address ----.....--•-----•---..IN \r........-•• GS w.dR '�l tw.....••.. ................`��.._s�c"�"�C!r.�1 C..1`�--•--t----•-•............................. Installer Address Type of BuildingExpansion Attic Size Lo g Dwelling No. of Bedrooms............................................ e G Sq eet a g— p ( ) Garba e Grinder a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures Design Flow...... 11 . ._ gallons per person per day. Total daily flow.......... W g g P P P Y Y gallons. WSeptic Tank—Liquid capacity/". .gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area./,-5 ......sq. ft. Seepage Pit No-------- ---------- Diameter.................... Depth below inlet.................... Total leaching area...1'...........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ ; a �4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G;, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x 0 Description of Soil........................................................................................................................................................................ x U --•----------•---------•--•----••------•--•••-•-•-------•-•---------------------•-•---------------------••----•------•-••--•-----------•------------•---...-•---------------•--------------...----....-- W ---•---------------------------------------------------------------------------------------------------------------------------------------------••-------------------------••-•--•--------------•--• U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...................•--------------------------------------•-----------------•--- .................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.L 5 of the State Sanitarf Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance as been issue the boar-d of - Wit!------------------!..' - ---- •-•---=--•---•• ---._�.� ::..... i atc✓ Ap on Approv ned ed By.-:: %% ---------------•-----...� � ..---------.......- ------ e Application Disappr ved f o s f ollo s:-----•------------------------•••-•--•-------•-•-------------•-------•-----•------------------••-•-------....... ...........................--•-----•--..-------•---•..__....•••. Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH ..............OF.........:.. w?�L:1 ``T! )•(•tiC............................... (9rdifiratr of Tompliattre THIS IS/in TIFY, That the Individual Sewage Disposal System constructed ( r Repaired ( ) bY--......._ •�. � ..............•--•......-•--• •-........._.. ... - ----- .- ---- -- ---- at.. =/ /f I - ------•----- . // -----------•.... �,� has beeyr m� rdance�`wil`t�provi�aons` o'f TITS f The State Sanitary Code a de/cribed in the application for Disposal Works Construction Permit No-------- . -.._. _........ dated----- 10, . f , i .. �`f ' ------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL N7 BE CONSTRUE® AS A GU RANTEE THAT THE SYSTEM WILL FUNCTI N SATISFACTORY. DATE............................5 1 .....- --._.._...._........_.. Inspector..........K-.�7............................................................. THE COMMONWEALTH OF MASSACHUSETTS e _BOARD--Q HEALTH f _.�G�seta ... _..._ Roposal Wor k ,� onutrnrtion rrutit Permission is hereby granted........ ... - -----------------------------••-•--------- --... ............................................................. Construct ( ) o epair u �.Ilisposal System at No.. as show n the plica ion for Disposal Works Construction Permit No......•...._•-....... Dated.,....................................... . / rd Health --- -- DATE---•---- --• -' ---•.............•---.........---............ FORM 1255 A. M. SULKIN. INC.. BOSTON _ 51NGLCG FAMILY - '� BGORooM ►JD "GARBAG6 (�¢�NDE2 � `i',r DA1L�( FLovV z 1►0 k,5 -- Z,30 G.P. A SEPT►G TAQK = 330x i 54>% = A9�;G.P q # �I L)SE- 1000 015PD5AL PIT v5E lao0 6AL. 3 ' ; 's►DG•h/ALL A2GA. _ 1 Jo S.F � .� �� 6p ' - 50TTO/A AREAS., l��.5 F•- `� 1 � , ere \ 5a 5F. x ►• o 5o b•P�� 1 -ToTA1-. plrSlt:N Q .g-25 G.RD. \ 1 -1- --- TOTAL. PE2.GOLATION RATE j I''lN ZM1N o�L�55 1 � � \ ��� � ' � • • N. t• .s,.l,;�, .a�p�,1H Of M9S`f-q 1 + \ L^ � .T.jo �.��.�. \ � : � vNQ 16I � MACE /'/ /� IZG � `\ �, '•\ \ 1 !/ I T6`�T �9 B TO P'Fop GT o NoLF iGG1A loov IN'j• g6 • INS / 5IPTIC 6P7�G Z � I o0o INS To.NK ; Ga►-. Gz s �' PIT INV. INV. W I T 4I cL.7 cz,y .�4�✓p WASKGD 6TvN6 x • SG.S '1 �'1 G6RTlF►GD P1-�T P1..AN PR.nFil..r= L0ZA. oN �vfq raN. '�1ic1-S 140 5 CA.L E r `j GALE ,�_ ATE 3/7/6 cl( IZ G F S zet4 GE GERT1FY THAT THE e,po,S0:� F►r,D,SuoWN NE,2Eo1•i GOMPL`(5 YJITN-CHE S 1 oEL1N r-- 4 oT S l AND S6-r-5ACK R.6Qu►R_fcMEN�"� DF 'C1�� foww o t��.2t•►S-cp.31-E Ar.+� ►`� t�!bT' O�44AII Z A!.4N,6.S��GL��•vG. LOCATED •WITN11.1 1a•6 G%.0 7D PLAIN >-47 rP ,z-4& 7-,/y7e9 DAT E� CA 1,/ 6Ayc'r E cz a W`{E INC. REG 1 S'T E•Qrw'D I►-A►•►D 5 u my EYoe'S Tul�j PL&KI 115 WOrT 4n�7��.0b N 05TG9-\1ILLS Ss• i IW,$T?,uMENT 5U9-V e Y 'TNE c>1=F,5ET5 SuouL, NOT D� V5EOT0 DETE.R./�11N� L.oT 1-INE-j APPLIGA►J'r 4S 0a � � 4"SCHEDULE 40 PVC MIN. SLOPE 1 % PROP.4"VENT WITH CHARCOAL. � � GENERAL E R 1 C Q /� L NOTES C C� T.O.F. EL.= 64.7 ± FINISH GRADE OVER D-BOX= 62.3�' FILTER TO ABOVE GRADE FINISHED GRADE OVER BIODIFFUSERS= 62,43 - 61.00 1\i E RA 1 V ! E S PROVIDE EXTENSION RISER SLOPE @'2%MIN. INSPECTION PORT WITH-\\ WITH COVER OVER INLET S REMOVABLE WATER-TIGHT COVER OVER ACCESS BOX TO WITHIN 3"OF 1. UNLESS OTHERWISE NOTED'ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OUTLET TO WITHIN 6"OF F.G. RISER TO WITHIN 6"OF FINISHED GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL.= 63.8'+ F.G. OVER TANK EL. = 63.8'+_ 5"DIA. OUTLET(S) F.G. (ONE PER OUTER ROW) CODE AND ANY APPLICABLE LOCAL RULES. 1 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 1 DESIGN ENGINEER. EXISTING 4"' PROPOSED 4" SEE NOTE 21) (SEE NOTE 21) TOP OF SAS/B.O.= 57.43' 3• 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE- _ _ r SEWCH.40 PVC ( - SYSTEM UNLESS OTHERWISE NOTED. SEWER PIPE n` „ 3"DROP MAX „ I 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 3 2"DROP MIN 3 9 MIN.SLOPE@ t% L = 60± PROVIDE WATERTIGHT ELEVATION =57.43' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A �-JOINTS(TYP.) 1.33 t 16" 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF '. 10" 4"PVC IN FROM _ T ��' " '± SEPTIC TANK 4"PVC OUT TO (TYP.) THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 14 ' �� .5 ,�,. 0.90' 10).75"(TYP) CONTRACTOR TO PROVIDE • LEACHING FACILITY 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. SPECIFIED DROP BETWEEN INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL 1 OUTLET TEE 57.27' MIN. 6 57.1 Q' 57.00' �-56.10' (laid flat) 2.s75'(34.5")---I 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF (TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES7; GAS BAFFLE 5 0� FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS 6"CRUSHED STONE Np• 5'MIN. EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY 11.5 NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH ( TANK NECESSARY COMPACTED BASE REQ'D i 25.0' AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX (TYP.) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= < 50.17' BIODIF'FUSERS (END VIEW) 66.00'ESTABLISHED ON A 12"OAK TREE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. BIODIFFUSERS (PROFILE) THROUGH OR SA L V LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT (BY INFILTRATOR SYSTEMS, INC.) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES CROSS SECTION VIEW p ,�^� p r� SEPTIC TANK PROFILE ARC 36HC 3616ED1 BIODI FUSERS (H-2O TO THE DESIGN ENGINEER. *CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR H-20 D I STRI SUTI ON BOX DETAIL l / ` 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT. TO ANY WORK NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING • 4 -, �-/ � . .;� w �,� , TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM NOTES: PERC NO. 13654 APPROPRIATE AUTHORITY. 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH � INSPECTOR: Donald Desmarais, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS SEPTIC SYSTEM COMPONENT. 3) �' ZONE 2 k' .P ! �` , LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE _ EVALUATOR: Michael Pimentel, E.I.T. .x THEY SHALL WITHSTAND H-20 LOADING. 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE 4 C.S.E.APPROVAL DATE: Oct. 1999 PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA ( r " - /!' 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. ♦ar ,s 5 .. Q , DATE: May 22,2012 SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. ALSO,CONTRACTOR SHALL TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE EXCAVATE A TEST PIT IN THE LOCATION OF THE PROPOSED SAS AT TIME OF s 2) :� _ MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. O. 'D ; ELEV TOP 61.00 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, INSTALLATION TO ENSURE NO GROUNDWATER IS ENCOUNTERED ABOVE EL. 86.5T. . +� _ a < FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ��' ELEV WATER= 50.17 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS ONLY. 1) _ 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN L P. a • PERC RATE- <2 min./inch Q SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. LP . DEPTH OF PERC= 48"-66" 16. PROPOSED PROJECT IS LOCATED WITHIN: s • � ' ` TEXTURAL CLASS: 1 ASSESSOR'S MAP 57 PARCEL 97 na. - - FLAG �,� � , r � R� `' c� POLE LOG'U S OWNER OF RECORD: HUGH B. CAMERON,TRUSTEE OF THE HUGH B. CAMERON 2000 TRUST 8 M 1 $ h. k m Fp d t� " ADDRESS: HUGH B. CAMERON,TRUSTEE OF THE NANCY H. CAMERON 2000 TRUST o- HC 0 Fill 61.00 47 PEACH TREE ROAD ' 0 8" Loamy Sand 60.33' MARSTONS MILLS, MA 02648 x A/E MAP 57 X " 10Yr 3/1 60.00' FEMA FLOOD ZONE C 12 DC COMMUNITY PANEL# 250001 0018 D PARCEL 06-05 *_ rx © � ' r B Loamy Sand (� 4 10Yr 5/6 17. DEED REFERENCE: BOOK 25060, PAGE 149 #47 DECK EXISTING 48" 57.00' 18. PLAN REFERENCE: P.B.337, PG. 1 3-BEDROOM Per, DWELLING : f1 'O . " 66" 55.50' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY / FOR SEPTIC SYSTEM UPGRADF- JQ ENGINEERING WILL NOT ASSUME ANY LIABILITY �- l PROPOSED 4"PVC VENT PIPE; µ e 4 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. . i EXACT LOCATION PER OWNER MAP 57 ' C Med.-Coarse Sand 11 �, $' s= 21. IN ACCORDANCE WITH 310 CMR 15.401 •15.405,THE FOLLOWING LOCAL UPGRADE \�, � P) N80 PARCEL 98 _ "7r - �a - � x 2.5Y 6/6 APPROVAL IS REQUESTED FROM 310 CMR 15.221,(7): MAP 57 o x so �'47"w SWING-TIES (11.) A 2.00'WAIVER(3.00'-5.00')FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. ` 1 SCALE: 1"=20' LOi('` S PLAN (2.) A 1.1 V WAIVER(3.00'-4.11')FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. PARCEL 06-06 / V (P N X HC DC FP LP (4 1 \� 6PX10� DESCRIPTION SCALE: 1"= 1000' _5r 130" 50.17' >c"- \ 25.6, TP 2 ° BIODIFFUSER CORNER(1) 52.3' 52.0' 29.1' 35.7' � 61x0' \ \ No Mottling,Weeping or Standing Observed PROPOSED TOTAL 20 ARC 36HC X BIODIFFUSER CORNER(2) 48.9; 56.31 30.9; 28.9, TEST PIT DATA (#3616BDABIODD CONFRIGURATION , d - 1--, Sg � \ � �/ BIODIFFUSER CORNER(3) 73.5 79.3 55.1 52.5 DESIGN DATA PERC NO. 13654 LEGEND sD BIODIFFUSER CORNER 4 75.9' 76.3' 54.1' 56.5' x50.O' EXISTING SPOT GRADE a \ � �� O INSPECTOR: Donald Desmarais, R.S. PROPOSED INSPECTION PORTP• 1 6p a - - 50 - - EXISTING CONTOUR 3 EVALUATOR: Michael Pimentel, E.I.T. WITH ACCESS BOX(TYP OF 2) X NUMBER OF BEDROOMS (DESIGN) C.S.E.APPROVAL DATE: Oct. 1999 \ �/ / 50 PROPOSED SPOT GRADE X zr D m CRUSHED STONE DRIVE c� �" -' - DESIGN FLOW 110 GAUDAY/BEDROOM DATE: May 22,2012 L.S.A. r 50 PROPOSED CONTOUR LAGI 6g TOTAL DESIGN FLOW 330 GAUDAY TEST PIT#: 2 PROPOSED H-20 X \` o \ POLED 62 r DESIGN FLOW X 200 % = 660 GAL/DAY E/T/C EXISTING UNDERGROUND UTILITIES DISTRIBUTION BOX 1 0 \ / 60 ELEV TOP= 61.00' W! \ o USE EXISTING 1,000 GALLON SEPTIC TANK ELEV WATER= <50.1T W W EXISTING WATER LINE Lu 6, o cv PERC RATE= GAS EXISTING GAS LINE u- M s> Q -60 0 : X ? X-X-X-X-X- EXISTING FENCE LINE X 0 � / �` �' O DEPTH OF PERC= Benchmark D �.S A. ---_G! �" M I w g INSTALL 20 - ARC 36HC (#3616BD) BIODIFFUSERZS (H-20) TEXTURAL CLASS: 1 TEST PIT LOCATION Nail in 12 Oak x -, Elev. =66.00' ` z #47 1-- _o Approx. M.S.L. ! - DECK EXISTING = SYSTEM CAPACITY EXISTING 1,000 GALLON SEPTIC TANK x� 3-BEDROOM f- 62 0 � (TOTAL L.F. OF BIOS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)=GPD 0" 61.00' EXIST 1,000 GAL. SEPTIC TANK f�G DWELLING Q (100.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 355.2 GAL. LEACHING J DAY Fill PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE TO BE UTILIZED €€'J THIS DESIGN - X / TOF=64.7'± , W „ 60.33' I� 11 A/E Loamy 10Yr 3/1 d 13 PROPOSED H-20 DISTRIBUTION BOX I m TOTALS: 12" 60.00 / �, q ppRO /`" \ TOTAL NUMBER OF BIODIFFUSERS: 20 PROPOSED ARC 36HC(#3616BD)BIODIFFUSER(H-20) EXIST. LEACHINGE -' ` v TOTAL NUMBER OF COUPLINGS: 0 Loamy Sand F`€T TO B� k �9r� w � v B 10Yr 5/6 PUMPED, FILLED wl CLEAN-� 1 m TOTAL LEACHING AREA: 480.0 " , SAND & ABANDONED �- MAP 57 eiT\Cqs w\fi I Z TOTAL LEACHING CAPACITY: 355.2 48 57.00 REV. DATE BY APP'D. DESCRIPTION x PARCEL 97 \ w� PROPOSED SEPTIC SYSTEM UPGRADE 26,906 S.F.t f�T�CGgs GA wV NOTE: PREPARED FOR: o / EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE CAPEWIDE ENTERPRISES �� tDEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER' od MODIFIED APPROVAL FOR GENERAL USE ISSUED TO INFILTRATOR C Med.-Coarse Sand Z S82°10'00 SYSTEMS, INC., DATE OF ISSUANCE OCTOBER 3, 2003(LAST MODIFIED 2.5Y 6/6 J76.89' MARCH 14, 2012). TRANSMITTAL NUMBER=X235253. LOCATED AT 47 PEACH TREE ROAD MARSTONS MILLS, MA 02648 MAP 57 SCALE: 1 INCH = 20 FT. DATE: MAY 29,2012 „ , MAP 57 PARCEL 96 No Mottling,Weeping or Standing Observed � � o �0 20 ao so FEEr PARCEL 06-07 ��� cy OF Sgq PREPARED BY: RESERVED FOR BOARD OF HEALTH USE �o FAN JC ENGINEERING, INC. 2854 CRANBERRY HIGHWAY EAST WAREHAM, MA 02538 SITE PLAN F s ; . 508.273.0377 SCALE: 1"=20' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.2229 �T