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0034 PEBBLE PATH - Health
34 Pebble Path Marstons Mills A= 046 056 r No. �=01 Fee U� THE COMMONWEALTH OF MASSACHUSETTS Entered in co pater PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for Misposal �p tPDtt Cunstruttion Permit � Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) ❑Complete System adividual Components�. i Location A dress or Lot No.34 P�b tf_ �/� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel s 6 Installer's Name,Address,and Tel.No. �,� � y�� Desi ner's Name,Address,and Tel.No. �S S0 -176lQS 3 0-3 ;t Type of Building: h 1 f ie� �J7' Dwelling No.of Bedrooms �— (/ Lot Size ?6,N2_ sq.ft. Garbage Grinder( ) Other Type of Buildings No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '3,30 gpd Design flow provided�3�1 gpd Plan Date ithlhcr Number of sheets 2. Revision Date Title 1 Size of Septic Tank 1666 q/}', Type of S.A.S. [{�,,,�et s 52)0 CA�21 Description of Soil Nature of Repairs or Alterations(Answer when applicable) jjVgML_� 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 Boar e Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 6'`=F — Date Issued 41 No. 1 t1 Fee U U w" THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zippritation for Bisposai *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(✓Abandon( ) ❑Complete System E3,fndividual Components Location Address or Lot No.SN A6161 c P3\to Owner's Name,Address,and Tel.No. 0 N YY� RS�oh/P vhj,lS ► az` 8 3�I Pebble. pa4�, ha.5�v►� ���15 O'n. Assessor's Map arce a Installer's Name,Address,and Tel. o. C R,` SkeJca.S Designer's Name,Address,and Tel.No. VIA,! T SOK3 �G x i ma�51�S mills i�b• 6 -?76- a �" �$1 f � �w �h rip. 675-3� Type of Building: / h I or -7'7-..5_b�Dwelling No.of Bedrooms 2. Lot Size '26 q2_ — sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) :�'.'3® gpd Design flow provided 2 C 2- gpd Plan Date��lTa Number of sheets Revision Date Title Size of Septic Tank�/�4 j Type of S.A.S.`► , � `ax' ��� (-7 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance withthe 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 f-Hralth. 'Signed Date 7 C,, Application Approved by Date_41 d s Application Disapproved by d Date l for the following reasons Permit No. Date Issued G, ------------------------------------------------------------------------------------ - - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS CErtificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( •�� Abandoned( )by E,, 5,T Z at has been constructed in accordance # with the provisions of Title 5 and the for Disposal System Construction Permit No.)n 1�dated Installer �r_ �, Designer #bedrooms Approved design flow ? o gpd The issuance of is permit shall not be construed as a guarantee that the system will functio �4gned. Date f, , Inspector l I -VL/ - - No. - Fee tlG THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at 2" � ?U!S a� and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 permit. Date Approved by i ✓ 1 �TOWN`O1F BARNSTABLE JLOCATION 3q ���al� ��th SEWAGE# Zo - Y 3 VILLAGE (14P►JZ5T0 ►c.l S ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 121C SEZjC�5 S-66 776,,-9d� SEPTIC TANK CAPACITY LEACHING FACILITY.(type) d%9+tb?5 (size) NO.OF BEDROOMS C 3&d Mw 77-54�� ) OWNER lc.l PERMIT DATE: Pt COMPLIANCE DATE: I( Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY P i o . T7'1z Town of Barnstable .�` .� Regulatory Services Richard V. Scali, Interim Director WARM MASSPublic Health Division 16Mfd6,� , Thomas,McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 J Installer& Designer Certification Form Date: Sewage Permit# - Assessor's Map\Parced� � Designer: &,kj 9 So�S 1k1 U Installer: EkI c STE J&jS Address: p6 (3&x Address: d -1 1 -E . SmAmt*W !JZ- a�� 1Y1►�25�-a�S iu.� V�� . o� U8 _ On l I bd 9 Ek,c was issued a permit to install a (dat ) (installer) septic system at �j�' � 1?iL;C- Ph:T 4 ► �s based on a design drawn by (address) dated ,(dessiggn� L hick I certify that to septic stem referenced above was installed substantially according to fi' � Y Y g the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (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 to septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required)was inspected and to soils were found satisfactory. I certify that to system referenced above was constructed in compliance with the terms of the IAA approval letters(if applicable) 5521 DA Q- (Instalre' ignaidfej C��V" ` . 1940 l �� (Designer's Signa (Affix ere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH D ON. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc / J TUV N-OFB�AMSTA.BLE .L(}CA'IZC?IxT �G SEWAGE# -------- yII.LAfJFt ASSESSGR'S c°L .UT INSTALLERS. PIROM IBC} S6PTLG TA t`IK'CAIAGTI'X: 0� IBACFIIrtG FACT€ ''Y hype ptulITDATE G©MPIFAI`ICE Separauan Distance Betwesn:tha Feec h[axtttium,Ad}usterl Groundwater Table to the Battom of Leaching Facility Private'+�ater SupplyTeli aridl. ng Fes► E �Y vrs exist'' an seta ar unttun 7Atf fziet a€Iestung fact) Fesi. . Edge.gf W�t�and and Leaching�aa'l�'(ff�Y�►etlands exist Peei vnthtn 3(l0€eel of Ieachiti�fa«litY) // pt _ .._ . -- _..__ A r � D � J o a L"�3 0 o�`"E' ' " Town of Barnstable ° Public Health Division h• • � U.S.POSTAGE��PIrNEYBowEs II BARNSTABLE. ' 200 Main Street - - z ! •�# (/��� MASS..639. ° Hyannis,MA 02601 '+ '�'�. ° 5, 0ZIP 2 41N601 $ 006.800 7015 1730 �301 4988 1005 1 •. 0000336455 OCT. 30. 2019. x , r �O _ - yy►lip�111,C `� � 20d NOTICE 11- mTVMED I BAYRIDGE REALTY LLC 34 PEBBLE PATH { _,T__MARSTONS MILLS, MA02648 RETURN TO SENDER UNCLAINKED li'NC SC: 02601409200 *3022 -02516-30-42 '� ���-�'$� ii 1�1� � 1 �4i1 ��,�� z 1► l+ls � - l .�..§ s �1�� 1 .� _ Y^ Iloilo I • I C• • • DEL VE rI j ■ Complete items 1;2,and 3. A. Signature I ■ Print your name and address on the reverse X ❑Agent { so that we can return the card to you. ❑Addressee I, + I ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery f c ' I or on the front if space permits. I 1..-s.ti�—la-Addressed to: D. Is delivery address different from item 1? ❑Yes ` ""- elivery address below: ❑No I I BAYRIDGE REALTY LLC i 34 PEBBLE PATH=r I MARSTONS MILLS, MA 02648 ' --- ❑Priority Mail Express® ❑'AdulCSignature� ❑RegisteredMailT" II I'III�I III)I'I I IIIIII)IIIIIII I'I I II II II II III Adult Signature Restricted Delivery ❑Registered Mail Restricted Certified Mail® Delivery 9590.-9402 5357 9189 1904 01 Certified Mail Restricted Delivery Retum Receipt for ❑Collect on Delivery Merchandise 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationT"' -••-- •'ail ❑Signature Confirmation 71115 1730 0001 4988 1005 ;il Restricted Delivery Restricted Delivery t i till, 'i PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ! Town of Barnstable Inspectional Services Department v MRNfiTABLE, M''; i639' Public Health Division ` 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 1005 October 29, 2019 BAYRIDGE-REALTY LLC - -—- _ -- 34 PEBBLE PATH MARSTONS MILLS, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 34 Pebble Path, Marstons Mills, MA was inspected on 10/04/2019 by Shawn McElroy, certified Title V Septic Inspector for the State of Massachusetts. --The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH ,� T n, ., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\34 Pebble Path Marstons Mills.doc f Z Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1 34 Pebble Path .1 Property Address r BayRidge Realty Owner Owner's Name / information is required for every Marstons Mills ✓ MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information S!filling out forms on the computer, use only the tab A.Riker key to move your Name of Inspector cursor-do not Cape Dig Inc. use the return Company Name key. PO Box 726 Co � Company Address South Yarmouth MA 02664 City/Town State Zip Code 508-776-6460 S14590 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails, 10/15/2019 I or's Signature Date 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of.18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)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. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts j: Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . � 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection C. Inspection summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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, safety or the environment. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i � 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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 a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 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 fecal coliform bacteria indicates absent 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ❑ ® 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 clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form IN to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 Y2 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 water supply 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 fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® ❑ 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. 5) 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. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form .I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ 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? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, 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: ❑ ® 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(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330GPD Description: plan on file dated 08/18/1977 with COC issued 09/12/1977 Number of current residents: 2+ Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 2019 for 6months readings= 83 GPD average 2018=77GPD average and 2017= 129 GPD avaerage Sump pump? ❑ Yes ® No Last date of occupancy: currentDate t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: n/a Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: biannual pumping recommened t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form G11. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: COC issued 09/12/1977 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. town water at front feet Comments (on condition of joints, venting, evidence of leakage, etc.): dry with no leakage observed t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I; a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town . State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1.2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5x5x8'6" Sludge depth: 4-6" � Distance from top of sludge to bottom of outlet tee or baffle 28" � Scum thickness 2-3'1 Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Concrete baffler on outlet with no obvious defec is observed at tank t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet 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: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (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 per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert equal to invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box 3 feet deep with no riser used camera from tank outlet to D-box t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 6x6 w/2'stone ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Liquid level in interior of tank was 12"from bottom of inlet invert with stain line above inlet invert" Less then half days flow avalible 12. 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 ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately v A 4j# r�s�' pro -Q �aS di Scf� FT L) a' S� llyt� t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form (' le Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �r t / 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ 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: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts 1. Title 5 Official Inspection Form iIo Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address BayRidge Realty Owner Owner's Name information is required for every Marstons Mills MA 02648 10/15/2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 LOECATION ft"�0*-3 � SEW ,A PER 1T NO. VILLAGE V ^o INSTALLER'S NAME & ADDRESS OR OWNER DATE PERMIT ISSUED, 7 DATE COMPLIANCE ISSUED���/ .� .7 i zs` � RA+L or7 N14 rvA UW E J CO c THE COMMONWEALTH OF MASSACHUSETTS v� BOARD OF HEALTH �a\9� ............ TOWN......OF......BARNSTABLE ................................................................. Appliration -for Uiopoottl Workti Tonotrurtion Vrrutit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Pebble---Path ....................................Lot_ 433 . - - Location-Address or Lot No. 1 W Owner Address a ..................R,---- ®. . ....................................................... SA "KUL----------- Installer Address 2 0 3 4 2 UType of Building Size Lot__---...�..................Sq. feet Dwelling—No. of Bedrooms------------___3.__..._...___________..___.Expansion Attic ( ) Garbage Grinder W/ aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures _________________________________ ---.. . W Design Flow._______._._l!_o......................gallons per n per day. Total.daily flow..............330.--_--.._-------_---gallons. WSeptic Tank—Liquid capacitv_1.0.0.Ogallons Length$.'-6..... Width4'.-1.0.'.'Diameter................ Depth---5!—4.'- x Disposal Trench—No- -------------------- Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------1.----------- Diameter...10.-'_......... Depth below inlet__6'............. Total leaching area....-_2.6.7....sq. ft. Z Other Distribution box (X ) Dosing tank ( ) aPercolation Test Results Performed by.Gape...C.Od---Survey_...Conault-arit0ate---Aug_____22.r_..19.7-7 Test Pit No. I A�,2....___.minutes per inch Depth of Test Pit......9............ Depth to ground water.....nOne........ (14 Test Pit No.`2----------------minutes per inch Depth of Test Pit____________________ Depth to ground water----- 9 ......-----•--------------- ----------•••••••------------••----..........••••...............--•---•............---•••......------. O P 0- 7-0-=gravel.. _._... ... . Description of Soil__4_^0__..�_..�Liri1L1S,____0_,._�-�.._0..__�.QaIri�...s_�,x1Cd_,_ s x ----------------------------------Ss'1--ud..-•-7-•-0-9-"-0---5s�>' d...------ � RENWICK yG (� - - ------- . . _ --- ----------- -- o- --.----- - ----- N u -- 1,2 ----------------- cv- CWaPNrJ�N ti V Nature of Repairs or Alterations—Answer when applicable.....__.......................................................... .. .p_Na.-2,�65,,. ---------•-•------------•------------------------••----•------------------------------••-----•---•------•--•--------••----------------------•_------•-•-•---- Agreement: N The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in acc0 1 the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. gned- , ----------------------------------------------••--•--------- -------------------------------- Date Application Approved By-------:- -- ;' !l -------- — Z..... -7--------- Date Application Disapproved for the following reasons:................................................................................................................ ••--••--••-•••••••••••----------------------------------••-••-------•--•••••••-----•-•••-••••--------••....••••-••••••--••-------•--••--•-----------------------•----•---••--••----------•---•••••••----- Date PermitNo......................................................... Issued..---- ........... ....................... Date 4" No......................... Finc ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH ..... ....... .... .. TOWN-----OF.......AARNSTABLE .... .. .......................................................................... A.VVItration -for Mapoiial Workii Tomitrurtion Pumit Application is hereby made for a Permit to Construct (X) or Repair an Individual Sewage Disposal System at: ....Pebble...Rath ..........................................................I... ..................................... ........... .......................... ................ ............ Location;Address or Lot No. .......... ..�7 &./?/....... ...... ----jr-, .46.. ............................. Owner Address ......................... ............................................... ..............................f..A Installer Address Type of Building Size Lot... -------Sq. feet U Dwelling—No. of Bedrooms................3.........................Expansion Attic Garbage Grinder ( ) PL4 Other—Type of Building ............................ No. of persons..______--__________---__-__ Showers Cafeteria ( ) Other fixtures --------------------------------- ---- ...... ..................... --------------------------------------------------------------------- Design Flow-----------/?V.....................gallons ;.4w"a6per day. Total dally flow................3-3.0....................gallons. 9 Septic Tank—Liquid capacity__100_Q�allons Length.8-'--6"- Width.V.—IO."Diameter------_-------- Depth----5'--.4." Disposal Trench—No. .................... Width..........._........ Total Length.................... Total leaching area....................sq. f t. Seepage Pit No........I---------- Diameter----11).......... Depth below inlet----6.............. Total leaching area.......26-7---sq. f t. Z Other Distribution box ( X) Dosing tank ( ) Percolation Test Results Performed by---Cape---Cod..Survey...Consultant hte....Aug_.___2Z,_.__19_77 Test Pit No. 1_42-------minutes per inch Depth of Test Pit-------9-1........ Depth to ground water-..---none------ 1:14 Test Pit No. 2................minutes per inch Depth of Test Pit-.-___.___________-- Depth to ground water--.-..------_-.--_----. a ------------------------------------------------------------------------------------------------------------------------------------------------------------- 0 Description of Soil----0_-10,5---11UMU.S_,_Q..5:n3..0...1QaMy...4and..__3_A!n7.._0."graVel...with--------------- -------------------------------------Sand,----7.0...9...0...sand....,... -------__?t7 U OF ---4- -------AAI'_ _Jr-------------- 'A ------------------------- ------------------------------------------------------------------------- ... ..................................... .......... ... ... U Nature of Repairs or Alterations—Answer when applicable ------------------------------------------ ------- -------------NMI '4 Agreement: -4 The undersigned agrees to install the aforedescribed Individual Sewage Disposal_ ystem in co Moe 0 the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to plac operation until a Certificate of Compliance has been issued by the board of health. At, ------•------------ Application Approved By..... . _,�Igne ---------------------------------------------- -2-Da*7---------...... 7, Date Application Disapproved for the following reasons:............................................................ wr................................................ ............................... .......................................................................................;;iz............................................................................... Date Permit No. ...................... Issued.. ................... ......... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF LTH OF..........................:. ...... . .........................................(Intifirate of lgh�wfianrr .,>THIS IS T&CERTIFY, That the individual Sewage Disposal;System constructed or Repaired by...- = ....................................................................................... Installer at.........i-?.z--------- ---fq�.4: 6!,�........................................................ has been installed in accordance with the provisions of /40 JI o The State ..",nitary Code as described in the r application for Disposal Works Construction P (.2 0! '_4 dAted..... ---A-M ......... hermit 1140. . ...... ........... At A 21 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED �,1A ARANTEE THAT THE SYSTEM WILL FUNCTION SA1,160ACTORY. DATE................................................................. .............. Jnspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS C%r .. BOARD 9f. HEALTH ...........41 .. ...OF....... ...................... ------------......... No......................... FEE/.r Permission is hereby ranted........- ......a-'a •&..................................................................................................... to Construct or Repair an Individual Sewage Disposal System > .� P at No....A� lbl. A_ A-7' ....................... Street as shown on the application for Disposal Works Construction Per No ..i ... ... . Dated_4 .-/- -----7_10......... . R ir J ..................... 0a DATE....? ..................................................... ----------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS HE Town of Barnstable AARNB'l'AHLE. Inspectional Services Department � r MAM Public Health Division rF4 t 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 1005 October 29, 2019 BAYRIDGE REALTY LLC 34 PEBBLE PATH MARSTONS MILLS, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 34 Pebble Path,Marstons Mills,MA was inspected on 10/04/2019 by Shawn McElroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH iEtVn, N., CHO Agent of the Board of Health QASEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\34 Pebble Path Marstons Mills.doc IKE Town of Barnstable • fl FUNFrABLF, Inspectional Services Department ar fD MA'S� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS O 1 YEAR DEADLINE CRITERIA tatic liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts O's(0 I / le 3 Title 5 Official Inspection Form �w�' -ri Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address r.7 Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 , page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information cS/ �y�89 _Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S 13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);I have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal sy%ems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails 10-4-19 Inspector's Signature Date 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 s Commonwealth of Massachusetts ,w Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) S•ystem`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: 2) System Conditionally Passes: ❑ One or more system components as described in the "ConditionalPass" 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. Check the box for"yes", "no"or"not determined" (Y, N, ND) 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. ❑ Y ❑N ❑ ND (Explain below): t5insP.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r a 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y El ❑ ND (Explain below): ❑ obstruction is removed ❑ Y El ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑Y ❑ N ❑ ND (Explain below): ❑ 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 ❑Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) 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, safety or the environment. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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 a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 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 fecal coliform bacteria indicates absent 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ® ❑ 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 clogged SAS or cesspool t5insp.doc•rev.712 612 01 8 Title 5 Official Inspeclion Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ® ❑ 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 'h 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 water supply 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 fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® ❑ 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. 5) 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. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form hl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1"J 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.), If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department.nt. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ 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? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe 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: ® ❑ 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(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form C�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 10-2019 Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r , ``' 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner----pumped 2yrs Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 ,ill Commonwealth of Massachusetts Title 5 Official Inspection Form �lb I Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments W T, >" 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1977 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form wa i.,l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 12" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 611 Distance from top of sludge to bottom of outlet tee or baffle 26" 1 r Scum thickness Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts ,w Title 5 Official Inspection Form hl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet 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: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of i nspecti on)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form C�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box had signs of overflow with stain lines above outlet invert. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 c Commonwealth of Massachusetts r� ;w Title 5 Official Inspection Form tr•"I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cost.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 II I Commonwealth of Massachusetts r� Title 5 Official Inspection Form PI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is Marstons Mills MA 02648 10-4-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit was holding water at 24" below inlet invert with clear stain lines above invert. 12. 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 ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 sue` Commonwealth of Massachusetts 3 Title 5 Official Inspection Form r i-.I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (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.): t5insp.doc-rev.7/26/2018 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form b'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately d 0 I e 3 r r D •l e, Cj & 7 ' -716 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form r�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® 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: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form hr Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 34 Pebble Path Property Address Dennis Kerkado Owner Owner's Name information is required for every Marstons Mills MA 02648 10-4-19 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank-Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 k - BENCH MARK / LEGEND MARSTONS MILLS PROPOSED CONTOUR R,qc PAINT SPOT ONs � f BULKHEAD CORNER \ ENE ��� ® PROPOSED SPOT GRADE 59.61 � — EXISTING CONTOUR BARNSTABLE GIS DATU 60 — 98 — n 96.52 EXISTING SPOT GRADE `' 3 , W— EXISTING WATER SERVICE 0 'v / �.Yf� �'�' r A• Pv ry �r TEST PIT O R RD, SITE 0 3 / oo`sl P2 � LOCUS MAP s��` 13,0 / 58 LOCUS INFORMATION N PLAN REF: LCP 30751-1 / o TITLE REF: LCC 196561 \� TP-1 / �- /' PARCEL ID: MAP 046 PAR. 056 ,� o // FLOOD ZONE: PROPERTY NOT IN FLOOD ZONE 60- c> —0 � SEPTIC SYSTEM cv REPAIR PLAN LOCATED AT: 56 34 PEBBLE PATH MARSTONS MILLS, MA G \\ PREPARED FOR \O `\ R I C H A R D NYE 'LOT 433 54 -SOP 60 35� �\ \\ /' AREA = 20342 sf+- NOVEMBER 11, 2019 0\. /� LAND COURT PLAN 30751��' ASSR MAP 46 PCL5, OF�\ 9 .�� MqS �� ° 1 D RR Gn \\ q ; / "1 \ o. 1140 55r \ / �� MEYER & SONS, INC. F PP �� I�. P.O. BOX 981 PLAN , '' �• ��° �a°� � fEAST SANDWICH, MA. 02537 ' ' G 55' `� i' / ` �/ SCALE: 1 in = 20 ft PH: (508)360-3311 FAX: (774)413-9468 0 20 4o meyerandsonstitle5(ggmail.com TOWN WATER ON ALL ABUTTING PROPERTIES o io 20 40 SHEET 1 OF 2 J 1894 ELEV. TOP DROP FND. NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS (Existing) BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE FINISHED GRADE (59.50) 60.35� F.G.EL• 59.0 F.G.EL: 58.7 F.G. EL: 60.5 a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA �t A At �J lF�i1r4 9 XF EL 57.64 ;' 2" OF 3/8' DOUBLE WASHED 3/4" - 1-1/2" ... . ;; STONE OR FILTER FABRIC DOUBLE WASHED STONE a 6' " 4" SCH 40 PVC 10"I 6 (MIN. ®®®®®®®®®®® TEE'S ARE TO BE 14 ® S= 1 INV. 56.10 ) ®®®®®®®®®®® 4" SCH 40 PVC 2 EFF. DEPTH ®®®®®®®®®®® INV.56.35 INV. 55.90 _ 4' 2 X 8.5' 4' GAS PROPOSED DB 3 EXISTING OUTLET BAFFLE DISTRIBUTION BOX EFFECTIVE LENGTH = 25' . ..M INV. 56.60 (H20) INV. ELEV.= 55.70 EXISTING 1,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON ���� OF '�ss9 BREAKOUT OUTLET TEE AS MANUFACTURED BY �`� �y NOTES: ' o DA R N M. s ELEV.= 56.70 1) CONTRACTOR SHALL VERIFY ALL.EXISTING TUF-TITE, ZABEL, OR EQUAL o M, TOP CONC. ELEV.= 56.70 .. PIPE INVERTS PRIOR TO CONSTRUCTION `� o. 1 0 INV. ELEV.= 55.70 ®® 2) D-BOX SHALL BE SET LEVEL AND TRUE TO ®®® ' ®®®®®® GRADE ON A MECHANICALLY COMPACTED SIX / ®®®®®13 ' INCH CRUSHED STONE BASE, AS SPECIFIED INNITAR�a� BOTTOM EL.= 53.70 EffE130EME31E311i3lEill 310 CMR 15.221(2) 3.75' 5 FT. 3.75' 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK WITH 1500 GALLON SEPTIC TANK IF FAILED, VV SEPARATION 5.10 FT. EFFECTIVE WIDTH = 12.5' DAMAGED OR UNDERSIZED. 4) INSTALL INLET & OUTLET TEES W/ SEPTIC SYSTEM PROFILE SOIL ABSORPTION SYSTEM (SECTION) GAS BAFFLE AS REQUIRED BOTTOM OF TESTHOLE EL: 48.60 _ ) 5) PLACE SANITARY TEE IN D-BOX (500 GALLON LEACH CHAMBER) GENERAL NOTES: 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOGS P#: TPT-19-184 DESIGN CRITERIA BOARD of HEALTH AND THE DESIGN ENGINEER. NUMBER OF BEDROOMS: 2 BEDROOM EXIST/3 BEDROOM DESIGN 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: OCTOBER 30, 2019 ANY APPLICABLE SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 LOCAL RULES AND REGULATIONS. WITNESS: DAVE STANTON, BARNSTABLE HEALTH DEPT. DESIGN PERCOLATION RATE: <2 MIN/IN 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFlLLED PRIOR DAILY FLOW: 110 G.P.D. X 3 BR = 330 G.P.D. TONSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE GARBAGE GRINDER: NO (not designed for garbage grinder) DESIGN ENGINEER. Bev. TP-1 Depth Elev. TP-2 Depth 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 60.10 0" 60.50 0" SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXIST. 1,000 GAL SEPTIC TANK FROM THOSE SHOWN HEREON SHALL TI REPORTED TO THE DESIGN ALOAMY �` LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. ENGINEER BEFORE CONSTRUCTION CONTINUES. 1OYR SA ND f LOAMY�S3/2 AN2D 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 59.68 / 5' 60.00 / 6" 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF B LOAMY SAND B LOAMY SAND USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4' HEALTH FFOR PROPER INSPECTIONS NER TO DURING CONIFY THE DUCTION. OF 58.52 10 YR 5/8 19" 58.67 70 YR 5/6 22" STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. C SANDY LOAM C SANDY LOAM 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 2.5Y 6/6 IT 6/6 BOTTOM AREA: 25 x 12.5= 312.5 SF _I- TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 56.43 44" 56.75 45" INS►'` C2 C2 SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF ^�` 9. SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE PAC TEST G THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING MEDIUM- MEDIUM-a ss.10 TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D CONSTRUCTION. COARSE t COARSE 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. SAND a SAND DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 2.5Y 7/4 2.5Y 7/4 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 48.60 138" 49.0 138" AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY PROPOSED SEPTIC SYSTEM UPGRADE P LA N 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. PERC RATE <2 MIN/IN. CC2" HORIZON) 34 PEBBLE PATH, M. MILLS, MA 15. ALL PIPING TO BE 4" SCH 40 O 1/8"/FT (UNLESS SPECIFIED) NO GROUNDWATER!OBSERVED Prepared for: Nye Design and Site Plan by: SCALE DRAWN DATE • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 MEYER&SONS,INC. N.T.S. DMM 11/11/19 to conduct sotl evaluations and that the above analysis has been performed by me consistent With the PO BOX 981 REV DATE requirements of 310 CMR 15.017. 1 further certify that 1 have passed the Soil Eval. Exam in October, 1999. EAST SANDWICH,MA 02537 CHECKED SHEET NO. 508-362-2922 DMM 2 of 2 I /u$O�IL LOS . fttLiM►.V,pN.w,.,. ., 11 A_,.a,W1�[�� yU/r1U5 TONE ...LOAM N IFILL I!"MAX. 4 C.I, BOX o f, • r 2♦"MKI. to otli. 1000 � e, • 1000— GAL. .4 GAL. I '' PRECAST' OR ° SEPTIC 6'I� •••�. BLOCK TANK I;'. • SEEPAGElZ'PIT o 10 ,• •0 • 09 20' MINIMUM I► • FOUNDATION I I %:° WASHED STONE tiE2r_ by 1', Fy'/�4tT '71S- :q5 1)ZkAcT-4 SCALE: 1"= 4' 1 A K J a MIlV l y A�ti4�Ac rletd. "��c+7+9 Y oiv f� Y. — 10'. Pape. RATt S �- I / 3 J� F}Mv Cc" 7';, 74p'Z4wt''`� /.r�E,ywS.` 4r TEST BY : TOWN INSPECTOR PAUL• /I ORRA i i k � �. �y% � t BACKHOE OPERATOR za� RdBE.xnT' t�ifltil ' © � a. 2, .-� •o TEST MADE ON '$•A �+� (L. TFs25►� LgNal Sk�i3fipR` j tot ALAN , Asa +, 100a(aALGo)v > YAIijR, 0., ld, zo 342 hy p F9 let S k � " v . • - UR 4. ! — �' k . # ; - /qo WELL No.27654 O y ELEVATION SCHEDULE - ;I SLE" P41t,q 40Wrat PROPOSED SITE PLAN 4 I. INV. AT FOUNDATION j = /ya.90 • ,: + • SEWAGE SYSTEM DF-SiaN /Ala 70 iN 2. INV. INTO SEPTIC -TANK - 3. 1 NV. OUT OF SEPTIC TANK 4. INV. INTO DISTRIBUTION BOX =f�-�-==33 SCALE: I"= a() f`�pv 19?? 5. 1 NV. OUT OF. DISTRIBUTION BOX CAPE COD SURVEY CONSULTANTS i 6. a#1V INTO SEEPAGE PIT . ROUTE 132 7BOTTOM OF PIT = � T HYANNIS,MASS. _ A 01VISION BOSTON SURVEY CONSULTANTS, INC.' ..,, WS. 'BOTTOM OF STONE LAYER = �s' .. - TE$-i'•_Pt7' 400,41-lolV- ' • "