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HomeMy WebLinkAbout0508 RACE LANE - Health 508 RACE LANE, MARSTONS MILLS \ A = 126 060 r 1 RONALD J. CADILLAC, PLS, RS Professional Land Surveyor & Registered Sanitarian P.O. Box 258, West Yarmouth, MA 02673 (508) 775-9700 (800) 520-5591 MEMO To: Donna Miorandi, RS and M/M Gene & Julie Kimball From: Ronald J. Cadillac Re: 508 Race Lane, Marstons Mills Date: October 8, 2001 At your request I have researched the capacity of the system installed at 508 Race Lane under permit No. 97-9 on 1/17/97. The Asbuilt and disposal works construction permit show a new 1000 gallon leaching pit added, with a 1000 gallon tank. Kimberly of J.P. Macomber & Son, Inc. looked up the stone slip on this job. She reported 11.16 ton of stone. Using 1.3 ton of stone per cubic yard yields 8.58 yards of stone used. A foot and a half of stone all around a 1000 leach pit uses 7.85 yards of stone. So slightly over 1 1/2' of stone was used. Under the old code, using 1 gpd/sf for bottom and 2.5 gpd/sf side area I calculate the capacity of 1 1/2' of stone as : Bottom -----------------63.5 gpd Side------169.56 x 2.5= 423.9 gpd Total capacity 487.4 gpd Under the 1,978 code the capacity of this system is over 4 bedrooms. Please call with any question. TOWN OF E:ARNSTABLE � LOCATION CC' Gad We SEWAGE # 9l'l`" 9 VII.IaAGE A4 Ai,' St U Al 5 /M i L 15 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. I / .Al A G 0 4 IS el * S eel SEPTIC TANK CAPACITY /4 OB LEACHING FACILITY: (type) T .1 z k) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet - I Furnished by i { ,vet ' —�No. Fee$50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ves PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 3pplication for �Diopozar *pgtem Construction Permit Application for a Permit to Construct( )Repair(X�Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. rl�_Ra,c e Lane 04 Owner's Name,Address and Tel.No. — 57 Iiarsr s M}11s ,Ma�ss . Gene & Julie "Kimball ssessors ap/Pazce 50 Little lPond RoadnMarstons Mills 02648 Installer's Name,Address,and Tel.No.5 0 8-7'7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0.8-77 5—3 3 J.P.Macomber & Son INc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass . 02632 Type of Building: Dwelling XX No.of Bedrooms 2 Lot Size sq.ft. Garbage GrinderN0 ) Other Type of Building RES No. of Persons 0 Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 3x1 1 0 gallons. Plan Date 12/30/96 Number of sheets Revision Date Title Size of Septic Tank 1 000 Type of S.A.S. 1-1000 Pit Description of Soi10-3 '=Top & Subsoil, 3 t=6 t=Tight Sand & Gravel, 6 1-12 t =_ Clean Sand & Gravel Nature of Repairs or Alterations(Answer when applicable) 1—1 0 0 0 gallon precast pit, Date last inspected: 9/16/96 Failed Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss d by this B ar!�o4%th. Signed Date 12/ 0/96 Application Approved by Date IN Application Disapproved for the fol owing reasons Permit No. Date Issued -� f TOWN OF BARNSTABLE LOCATION LU 7 /i C e `A We SEWAGE # 9I'7` 9 VILLAGE' A A C)zV S /wJ i L C S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. T c. o 4,t /Y el SEPTIC TANK CAPACITY /-O OD LEACHING FACILITY: (type) /,�Ii T ,t1,a, , r (size) NO:OF BEDROOMS BUILDER OR OWNER ('Z_A�L PERMTTDATE: I (v COMPLIANCE PATE: Separation Distance Between the: _ Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private W.ater.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 x � No.` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS t 2ppficatiion for Digaal *pgtem Congtruction Permit Application for a Permit to C ct( )Repair(7 upgrade( )Abandon( ) El Complete System ❑Individual CompTlents .1 Location Address or Lot No. IlieT Race Lane ir Owner's N e Ad e s and el.No. 428-045-7 Marstons Mills ,Mass . Gene �u re Kimball Assessor's Map/Parcel _ 50 Little Pond RoadnMarstons Mills m­a. 02648 Installer's Name,Address,and Tel.No.5 0 8-77 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—77 5—3 3 3 9 J.P.Macomber & Son INc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 Type of Buildin : Dwelling X No.of Bedrooms 2 Lot Size ft�sq. . Garbage Grinder,(0 R ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures t "?it `.' Design Flow 330 - gallons per day. Calculated daily flow 3x110 gallons. Plan Date .112130/96 Number of sheets Revision Date Title Size of Septic Tank 1000 Type of S.A.S. — 000 pi Description of Soil0-3 '=Top & Subsoil,3 t=6 t=Tight Sand & Gravel, 6 t-121 Clean Sand & Gravel Nature Repairs or Alterations(Answer when applicable) 1-1,0 d;0 gallon precast pit. DateMast inspected: 9/1 6/9,6 Fai ea Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss trd by this War doff lth. Signe '�' � k: Date 12/ 0/96 Application Approved by Date �l Application Disapproved for the following reasons t Permit No. Date Issued s , THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance -� k THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired�(,XX)kpgraded(`r ) Abando ed( )by, J.P.Macomber & Son Inc. ' at 50V Race .Lane Mars tons Mllls,Mass. has been constructed in accordance with the prq.iY.1vIa c om b e re foripri System Construction Permit No. dated Installer JJ Designer J•P•Macomber & On lI c. The issuance of this pemt shal n t be construed as a guarantee that the system ill fjjr MCJ as designed. Date —�.` d Inspector — q7_q------------------------------ z�� 'No. `c Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ; wigpogar 6pgtem Congtruction Permit Permission is hereby nted to Construct( )Repyvr(�X) g� e( l)Abandon( ) Systemlocatedat Race Lane MarSLons �1 a,M€iss . 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 permit. 16bDate: ) /7 Approved by� ' r CERTIFICATION OIL 0,1<ETCI1 AND A1'I'LICA'FION FOR A DISPOSAL WORKS CONSTRUCTION PE RNII'I' (WI'I'IIour DESIGNED PLANS) I, J.P.Macomber Jr L il';r '�)' cat Lily that the application for disposal works construction pert it signed by nic 12/30/96 , concerning the prjperty located at 507 Race Lan_e�IArGi nne M; i i ��M�ssr meets all of the following criteria: There are no wetlands within 300 feet of the proposed septic system • There are no private»ells witllin 1 5U fcct or the proposed septic system The observed groundwater table is A feet ur �rcater below the bottolll or the leaching faculty • There is no increase in flow and/or cllculge ill use proposed • There are no variances requested or needed. SIGNED : r DATE: 12;/3o/96 O LIC ED SEPTIC SYSTEM INSTALLER IN 1'iiE- T01yN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed systclrl. Also if the licensed installer posesses.:a certified plot plan, this plan should be submitted]. rtLK�•�►�%� 3' .P 1 ._�-�--a...... � .. y`O•�.-.�.,... 7�'l C...E Y 4 ST1 ►J�,� - """.�- -�.--a �--r,,• -�r�..�,...��.�,.., _— % . .-•, 7-�"�__.____ - --- - i _�� '�- i �' —" �' �-sue"`+-�,-"�• -� - �_7' �. T ��4 v�t_ i : � �I.-y-�"".�..` ��..... r_ 71Q �. r Y 1 t <, h_ !� 4 7, TW Its. 4 t p ILI DATE) 0/22/01 :----------- PROPERTY ADDRESS: 508 Race Lane----------------------- Marstons Mills Mass.02648 ------------------------ On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1 -1000 gallon septic tank. 2 . 1 -Distribution box. 3 . 2-1000 gallon precast leaching pits packed in stone. ( 6 ' X10 ' Based on my inspection, I certify the following conditions: 4 . This is a title five septic system. ( 78 Code ) 5. The septic system is in proper working order at the present time. 6 . Pumped the septic tank at time of inspection. Heavy solids and scum layers were present. 7 . 1 -Leaching pit is dry. The other pit has waste y�ater 42 inches below the invert pipe. / SIGNATURE:. Name:-J . P . Macomber Jr___-___ Company: Jose_ph_P. Macomber_& Son , Inc . Address:- Box-66 --- --------------- Centerville , Ma . 02632-0066 -------------------- Phone: 508_775=3338---__-- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY (r!1nQFP�WP. MACOMBER & SON, INC. 10�1 Tan ks-Cesspools-Leachflelds ons N. Pumped & Installed gP�NE BoxT66 n Center Sewer ville, 02632-0066 �o�NEP��No 775-3338 775-6412 I ,per l COMMONWEALTH OF MASSACHUSETTS ` z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL, PROTECTION .i TITLE 5 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 508 Race Lane Marstons Mills,Mass. Owner's Name: Gene Kimble Owner's Address: Same Date of Inspection: Name of Inspector: (please print) J.P. Macomber Jr. Company Name:Joseph P. Macomber & Son Inc Mailing Address: P.O. Box EF rpnt.erville Ma 02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my trainirig and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system Inspector pursuant/toFasses ectlon 15.340 of Title 5 (310 CMR 15.000). The system: _ Conditionally Passes _ Needs Further Evaluation by the Local Approving Authoriry _ F ils Date:Inspectors Signature: J 40-0) The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments I—This report ocly describes conditions at the time of inspection and under the conditions of use at that 1 time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of I I OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 508 Race Lane Marstons Mills,Mass. Owner: Gene Kimble Date of Inspection: 10 22 01 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A.-12 ystem Passes: I ha�10 ound any information hich indicates that any of the failure criteria described in 310 CMR 15.30 or tMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. AQ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. •A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: ,d, (Z Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: A The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 r Page 3 of 1 1 ;, OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 508 Race Lane Marstons Mills,Mass. Owner: Gene Kimble Date of Inspection: 10/2 2/01 C. Further Evaluation is Required by the Board of Health: W0 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. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health,safety and the environment: N� 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 I 2. System will fail unless the Board of Health (and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: NQ 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. XM The system has a septic tank and SAS and the SAS is within a Zone ] of a public water supply. .U� The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply wet]. The systern has a septic tank and SAS and the SAS is less than 100 feet b t 50 feet or more from a private water supply well". Method used to determine distance 444 "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 508 Race Lane Marstons Mi 1s,Mass. Owner: Gene Kimble Date of Inspection: 10/2 2/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes N4ackup _ 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 t/ Static liquid level in the distrib Lion box above outlet invert due to an overloaded or clogged SAS or cesspool g'L squid depth in-resspaz� is less than 6"below invert or available volume is less than ''day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number J2of times pumped i. 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. 1/,Arty portion of a cesspool or privy is within a Zone 1 of a public well. y portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes If the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) yO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply system is within 200 feet of a tributary.to a surface drinking water supply G the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 y Page 5 of I 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 508 Race Lane Mars tons Mi s,Mass. Owner: Gene Kimble Date of Inspection: 1 0 22/01 Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health ywere 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,+xcluding the SAS, located on site ? e/ — 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 ? 4 /_ 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: ;Y /no Existing information. For example, a plan at the Board of Health. Z— Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(3)(b)) 5 I 1bPage 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 508 Race Lane Mars tons Milis,Mass. Owner: Gene Kimble Date of Inspection: 10 22 01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CM&I5.203 (for example: 110 gpd x#of bedrooms):7&,g � Number of current residents:" Does residence have a garbage grinder(yes or no):6 Is laundry on a separate sewage systet es or no}re (if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): Water meter readings„ if available(last 2 years usage(gpd)):Sump pump(yes or no):7�' � Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): 42A d Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,, if available: AW Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records ;�y1 Source of information: l 6 J4 0 1 y¢ /4' Was system pumped as part of the inspection(yes or no): If yes, volume pumped: gallo s-- How was a tt�y ump�d�determined?J .;�1J Reason for pumping:L Y �G°1/lam f 1�__6 il✓1R7�(.y^� ltf6'd"�!py' - TYWOF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool iU 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 syst m owner) 26 Tight tank Attach a copy of the DEP approval 10) Other(describe): Approximate age of all c mponents, date installed(if own)and of of information: Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:508 Race Lane Marstons Mills-,Mass. Owner: 10/22 01 Date of Inspection: Gene Kimble BUILDING SEWER(locate on site plan) N Depth below grade: Materials of construction: ast iron _40 PVC iCfB other(explain): it!/F Distance from private water supply well or suction line: . � - Comments(on condition ofjoints, venting, evidence of leakage,etc.): joints; appear tight _Nn evi rdPnne of leakage_ The system is . vented through the house vent.,/ SEPTIC TANK:Zlocate on site plan) j�i1 Depth below grade: Ir Material of construction: concrete ild meta 11Zdiberglass polyethylene Oother(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no)-.60 (attach a copy of certificate) �6,'� �r „ a), Dimensions: , V�:a4 Sludge depth: C Distance from top of slud a to bottom of outlet tee or baffle: Scum thickness: _ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottpm of ou et tee or baffle: How were dimensions determined: yyj >¢j'z" /�) Cornments(on pumping recommendati s, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of.leakage, etc.): Pump the septic tank every 2-3 years Inlet & outlet tees are in place The ink A G ',c;triirfiirs l 1 v cnLtnrl and Ghnw-, nn Pvi r1PnnP of leakage. GREASE TRAPJ"ocate on site plan) Depth below grade:1?.0 Material of construction;&concretej)AmetaJ, fiberglass ApolyethylenedZAother (explain): Dimensions: AIM Scum thickness: .(lid 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: e)4 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Grease trap is not present 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 508 Race Lane Marstons Mi s,Mass. Owner: Gene Kimble Date of Inspection: 1 0/2 2/01 TIGHT or HOLDING TANK(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: 10 Material of construction:,&/Aconcrete 41Wmetal eVAfibergl&ss,A polyethylene other(explain): Dimensions: Capacity: izallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: N4 Alarm in working order(yes or no): efd Date of last pumping:_A Comments(condition of alarm and float switches, etc.): Tight or hoiding ranKs are no . DISTRIBUTION BOX: 2(if present must be o ened locate on site la P )( plan) Depth of liquid level above outlet 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 has two laterals.No evidence of solids carry over.No evidence of IeaRage into or out of the box. PUMP CHAMBEFLZ�C(locate on site plan) Pumps in working order(yes or no): V,4 Alarms in working order(yes or no): 41of Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is not present. 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 508 Race Lane Marstons Mills .Mass. Owner: Gene Ki mh1 P Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): Zlocate on site plan,excavation not required) 2-1000 gallon precast leaching 17its.Packed in stone. 6 ' x1 0 ' If SAS not located explain why: Located Tyt/leaching pits, number: i'� W leaching chambers,number: A)0 leaching galleries,number:__O_ ,V0 leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool, number: �( innovative/alternative system Type/name of technology:ZZ.7 A Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): C OOLS(cesspool must be pumped as part of inspection)(locate on siteplan) and configuration: top of liquid to inlet invert:f solids layer: AM f scum layer:ions of cesspool:ls of construction: n of groundwater inflow(yes or no): nts(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): sand to medium sand to fine sand.No signs of hydraulic failure or nonding_VPgetatinn ig nnrmal one_eaching pit iS dry and the other has waste water 42" below the invert pipe. PR1VY��(locate on site plan) Materials of construction: ,Ufi Dimensions: tit¢ Depth of solids: Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy is not present- 9 Page I0 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 508 Race Lane Marstons Mills,Mass. Owner: Gene Kimble Date of Inspection: 1 0 22/01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. \ �") ` /crL �ry 10 Page I 1 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 508 Race Lane Marstons Mills.Mass. Owner:Gene Kimble Date of Inspection: 10 22 01 SITE EXAM Slope Surface water Cheek cellar Shallow wells 5 Estimated depth to ground water fa feet Please indicate (check)all methods used to determine the high ground water elevation: _Obtained from system design plans on record- If checked,date of design plan reviewed: _Observed site(abutting property/observation hole within 150 feet of SAS) _Checked with local Board of Health-explain: Checked with local excavators, installers- (attach documentation) _Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used: Gahret & Miller Model 12/16/94 - High ground water elevat-inn above sea level - Fsed F ilSGS 92-0001 —2 Pl ate#2 r1c;prl 1ISGS nbservation urell clata r1'or dtipz 1 gg2 Top of Ground Leaching Pit /a t:eet T Groundwater Feet Below Bottom of Pit High Groundwater Adjustment 'tom 7 Therefore, the vertical separation distance between the bottom of the leaching pit and the adjusted groundwater table is �l� / feet. 11 ,k' y..•wrn rw T-n!T�*-�T'amrmr•nmrrs�ert a�nmar!•n.+aTan►a+.•*t*+ma nenratnr�Ts.n wTa _ 1 Barnstable TURN OF WARD OF HEALTH � SUBSURFACE SEWAGE 1)131"OSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATI N Tl1�T".•:: -T.II1.�.TTT 11.'.'111'II.TRI TIT.i1T1/iq'!R11'T-!.'T•'111TT7�1T7-T!'1R1Ar1�►�.tA7R7 T11 .,�I•�'1'•���..� 0 -TYPO OR PAINT CLEARLY- P110PERTY INSPECTED STREET ADDRES$ 508 Race Lane Marstons Mills,Mass. ' ASSESSORS MAP , BLOCK AND PARCEL OWNER I NAME Gene Kimble PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME Joseph P. Macomber & s•an Inc COMPANY ADDRESS P.O. Box 66 Centerville Ma 02632 Street Town or Clty State ZIP COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 ) 790 _ 1578 A CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposaj system at this address and that the iinforination reported is true , accurate , and omplete as of the time of -inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one : System; PASSED .The inspection irhich I have conducted has not found any information which indicates that the system fails to adequately protect public heal0i or, the environment as defined in 310 CMR 15 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have con acted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 16 - 303 , and as specifically, noted on PART C - FAILURE CRITERIA of this inspection form . r , J, - Inspector Signature Date ecopy of this ce tification must be provided to the OWNER, the BUYER On Where applicable ) and the 130ARD OF 11RALT'll. * If the inspection FAILED , the owner or­ perator shall up grade system within one year o(' the date of the inspection , unless allowed or required otherwise as provided in 3.10 CMR 16 . 305 . partd . doc TOWN OF-BARNSTABLE LOCATION Rg_C_C. _SEWAGE # - e 7,$ VILLAGE ;(J, ASSESSOR'S MAP & LOT d INSTALLER'S NAME'& PHONE NO. � P)I SEPTIC TANK CAPACITY I �� LEACHING FACILITY:(type) L4_ (size) NO. OF BEDROOMS_PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: /J,. __ �6 '1 DATE C011PLIANCE ISSUED: 1 VARIANCE GRANTED: Yes No i • R _ s • No....�5.7. ..� :�( Fizic .. ,5 ............ 9 THE COMMONWEALTH OF MASSACHUSETTS i _ BOAR® OF HEALTH v ............ . --. ...OF.......i t . ��.S�.�1...------------- _ �' , ppfiratinn for Dhipaii al Worke Tonitrurtiun rantit Application . hereby made for a Permit to Constmct ( �or Repair ( ) an Individual Sewage Disposal System atd�dYi ---- -lUc = - -- ------------------------------ Locatio Addressor Lot No. wne '' !.��.n_.1. ..... 4 -1° ........................ ....t........... .......AAe ........''8:.�-�A.A!.S.j---- Installer Address Type of Building Size Let............................Sq. feet U Dwelling—No. of Bedrooms____.._................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) aOther fixtures __________________________.............................................................. ............................................................. W Design Flow........33Q........................gallons per person per day. Total daily flow............................................gallons. 0' Septic Tank—Liquid capacity-1IMPgallons Length................ Width---............. Diameter................ Depth................ Disposal Trench—No--------------------- Width.................... Total Length.................... Total leaching area--------------------sq. ft. > Seepage Pit No.C.Od©.79*�/ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( i Dosing tank ( ~' Percolation Test Results Performed b STE. ..PYj........4......HA&S......... Date.... _-_. _'- .......... y------•---•---- aTest 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........................ P4 -----------------------•-----.•... -•---•.........-------•------------.........--••- --•--•---........-----•-----•---•--------•.................--•----- ODescription of Soil--...514 --1-10--------- ------jq1. f4 V"I------------•---..•..-------------------....--------------------------------------------------------•-•---- U •--------------------------------------------------- ---------------------------------------....... W -----------------------------------------------------------------------------------------•---------------•--••-••---------------------•----...---------------•••-----•--••••--•---------------------- UNature of Repairs or Alterations—Answer when applicable..----------------------------------------------------------------------------------------•__-. •-------•-------••----------•---•••-•-------•--------•••------------------•---•-••-•-.............------------------------••---•------------------••--•-••---•--------••-••-------•---••-----•.....----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i i of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en issued by t1Aboard of lthrD Signed------' ,. ....... -...... . / ----Ql.3_'S Date Application Approved By------------- --.. ` �/- j3--- Date Application Disapproved for the following reasons:.............................................................................................................._ ..----•.--•-•----•--•......---••-•--•-----••-•--•--•------------••--•----•--------------•---•----------....------.........-----••------------•----••---•--------------••---------•-•-•---•---•-•........_ Date Permit No..... .7.... /. Date r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _.... .OF.._............................................................................•...... Appliratinn for Uhipmal Works Tonstrnrtiun rvomit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: /_. -- ------ --------------------------------------- 4�,!__.. ----•z Tr/i7�C ,v,� Loc t n-Address or Lot No. 70AZ7_._ �1�?!�'��................................................ -••--•- ..-- // O er dress �J a -•--•••---P.7/5----- • _`,-r. 40 -•-•-------------------•--....--.......... ..l�.:....����'1.....Z.�-----.�'�1.allF�.c r..'A� Installer Address Type of Building ? Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q, Other fixtures ------------------------------ . W Design Flow......... .......................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity/t!?�Rgallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—NTo. .................... Width.................... Total Length.................... Total leaching area______..------------sq. ft. Seepage Pit Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing to , ) `�' Percolation Test Results Performed by._....___ 1� 'L.._�_..._.. /��-`.S............. Date........................................ Y Z Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water________-.___-__-.-___-- (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil-------- x i 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 TITHE 15 of the State Sanitary Code— The undersigned 'further agre s not to place the system in operation until a Certificate of Compliance h en issued by th oar f he t Signed..... ------------------ - ----- -- •-•--- ----..._--••-- l-= .` 7 Date Application Approved By------...... --•--............................... . .... Date Application Disapproved for the following reasons---------------•----------•--•-••--------------------------------------------------------------------------•---- -•-•--•....••••••---------------------••--•---•-------•-----•------•--------------------•--••------....----------------------••-•---•• ••--••-----•--•---•------------------•----------•-----•---•------ Date PermitNo....F..7......7 i ......................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............................:............OF................................................................................... Crrtifiratr jaf Tomphaurr THIS AS TO,CE IFY Th t the Individual Sewage Disposal System constructed ( ) or Repaired ( } by � !S � ..............•-•----•-•---...-----•----------......-----•------•--••--•---•---------------------.....-----------------•--•--._.._..... ` Installer at...........SC _• --------1 _rc-e _c. ..--------------------------------------•------------••--••-------•------•-----•---------------•-•-----•------------------------------- has been installed in accordance with the provisions of T I T i.E j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.Z.7-_---:7.t.`1............. dated-.---------------------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL ii FUNCTION SATISFACTORY. DATE............... -�= - ................................ Inspector.............. . ...'�---------.........--•---.....•----......---.----- THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF HEALTH �j�••� ....................0(V70F..--1!�Rl._!...4�--•---....._.............--•-----•• 2 �i��r.��� nrk� ��an�tr Uan permit Permission is hereby granted........ --- to Construct k)e) or Repair ( ) an Individual yy��Sewage Disposal System atNG..— J =' ..........Al...... e t ���......................•-------•-------....-----------------•..............._........... Street ,, as shown on the application for Disposal Works Construction Permit No.�_1=D.'�7.... Dated.......................................... ---------------------------•---•-------------------------------------------...........................- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Department of Environmental Management/Division of Water Resources WATER WELL COMPLETION REPORT LL CA I N x Address City/To s G.S.Quadrangle ap Grid Location i Owner Address '1�_ � V'IELL USE CONSOLIDATED WELL Domestic /Public ❑ Industrial ❑ Type of Water-bearing Rock ` Other Water-bearing Zones Method Drilled 1) From To 2) From To Date Drilled 3) From To -- 4) From To CASING 4 Depth to Bedrock Lengttt3�-2— Diameter Type UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface 1tT Sand: fine❑ medium❑ coarset Date measured -Gravel: fine❑ medium❑ coarse❑ Screen: >- GRAVEL PACK WELL Slot#110 length from.fa to Yes ❑ No Split Screen (or 2nd screen) WATER QUALITY TESTS MADE Slot# lenqth from to Chemical El Biological Imo' Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 av+✓G i /SCb i0l�G� �s )� / DRILLER -// — m Firm en At4ll4 Addres. e City O� AwvYo(! it9�ar,�` Registration No. Operator's Signature Please print tirmly CUS_T_OMER COPY 15M-2 84-176471 sf{+{+ss{s?{f:si{::s:s:s:{:sss{f#s sf?ff?►'ssfs:{:sis:ssss:s:ssss:s:sss:s:ss:s:n:F 'E „` .... ...I..... i �i=i ,. ENVIROTECH LABORATORIES 449 Rte. 130• Sandwich,MA 02563• (617) 888-6460 CLIENT: John C. O'Malley LOCATION: 507 Race Lane 516 Race Lane ADDRESS: Marstons Mills,MA - Marstons Mills, MA 02648 COLLECTED BY: J. O'Malley SAMPLE DATE: 11/25/87 TIME: DATE RECEIVED: 1 1/75/87 SAMPLE ID: M496 JOB #: New Wpl 1 WELL DEPTH: 30 f RESULTS OF ANALYSIS: Parameter"-"" Units Recommended limit Result x' Coliform bacteria/100 ml (MF Method) 0 0 Y pH pH units 6.0-8.5 5.79 Conductance umhos/cm 500 74 = Sodium mg/L 20.0 8.0 Nitrate-N mg/L 10.0 .10 Iron mg/L 0.3 <.05 Manganese mg/L 0.05 Hardness mg/L as CaCO 3 500 Sulfate mg/L 250 _ =x Potassium mg/L 20.0 Alkalinity mg/L 200 Chloride mg/L 250 i»� I COMMENT: » YES NO XXX ❑ WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TEST D DATE' (? /p1 c= .. ii`!-Iii`i i` ' 'i 111111 i' :Ill,' -;i-`i _;-;'k Ill its, i i.i. .: :., ilf` .........i;i'i... ;' iu-'i u: ....... jr.:::::131i11tlEll ti!!llll:l:l:lluil:l!lul:E:::lsl:iii:ul:::ll:i:ll::ll:!!1:#:{:1::::I:II::::#ull:llll:I:ll:lslslii lu'itl:::f:l:l:l:i l::,fEslc,:!!lliiif iiiiisiiliiiiulit:#li ii 81111411il illiitfiiiiililiiii i i ili ii r }4[ t •ILK\9T It J� jr 71-0 —LOT S _ ' 1 n`i ``~`'a -t tip--• . � � (,L i'n` a - t , >J l F A A�T O �. ��� � 9?,rr iG.- 4s ' , _�\` ►-.K 7 p. o� i � ti- C � L L - +, l ' •`E.F.�C T.L. C r Q CCi._` Lr0 i.1 t—t A--Ti-\ �c-T*1 i r c� • �'`f 'ate ?!1 � 2 { .i t��;,7 7w ii�`�la � '� { .� �, s,.� w �i� � ? H o u EYOL E It EA t i lt Gl-�fit-` G�•.yti� � - �p E r'-,; _ G�C.E t., .. � i (; , w+y 7, I �N q v la Q 'tv.. ef _ { i ELI v 7C' e2 ✓A�CT t-'� ?:h••,.k ly s _ Per a� n MAIMUM DUIL91WA cvf✓T O NDA t AV\AN H O t, �O TO xT O FIN13+1 GrLAflE MHJ /o ` 'y �,;, t t �LE� .NtTNllj Ot4F. Fr�OT of FINISF+ GRAVE / OV ER LEACH AREA €' Q ;•+ y_ •_=fit_ ' " �4 toG►J �Q �j 25 (t� MIN) �J Z*1'DW• GOB I ��16T�1� 1Olj IMi14�/iO�� vVFi� — t _ �F •� �. tt- ; 1�ZtEYEL PfZEvr✓NT rsrJsry mom MW. ' - -�+ CN jTnMT IZ M,N. „ ! T ' aR +• qo r%z j t•' IDrM,N 114 /Foar- �--+r F I n A• "' �k1JT ' L� 7-- �,C'x-�� f 1 LI' �t=,i S �• f'3 t T L-EI►GN v�A N 60 1 { SToN� IM/E-RT — _ ' i C�A L LU td 4'M,r4 ,I c u -¢T 1 ALL, <: Gpp,p� �AGITY AR0��1v ,- S E PT i C TAN K i 4 pI A. P1/C e NVEQ I PE I. t ,rJVfcRT P G.(n. ,.,,.3•. _ -.., 's � �br3 p _ _GAQ 3AGE GRIMC)IR �p"Ml�J ? y __ _- --- _--- D E TA I L w� c� 5c a.L , 1 ON S: OE5{C���L UA 1TATiONS: 1 SEPTt G SYSTEM CoN sTa�oTlon� _ � � ` � � ' i �•'�ALL CONFORM TQ THE MASS. �A�`� OF �/1n6� OF - iN'41 RONMENTAL GQDF, TITLE REV i I7 7- 1-77 THE -rOW" Jos i (�A2v vF µEA�.TI-+ R6CaL11,AT�oNS i M. Ir A 4 MONA J H " LEAGN tNC.-► rZAT� i °' ►.; ! ` �� t { .� o R el 0 1,EAC 4 CA G lTy �,� AtNO LEACH IN14i PIT O (3E OF' .gNoc�s a o 9I REI t.tFoRc>�� GvrICRGTE sumLs ; v\sJ .-Yor tcaP-rF, �T2GNGT�4 �rX;10p I PrZOPC35>✓� �,c.N CaPa�1Ty _ N ► 0 L-OA p OF i e]2 N E WA>/ r1Or TO 13S L0C,47't-V CRAIG �y i � 1 LO SHORT clvlt. OGATT No. 27483 • — — Y T - - _ �ti� L -� c s ` o is i✓I�` c_ e TI��,t� y,�o -� ��. a /; DARNS. WeCa• OF DEE9S F �^. r �G , ,, % F E. D. -A- C> Fog,* _s ri } --,t ry'�Av� of PL►. LEI O1J /� II - — -- - - ' � -- ` ENGINEERING I ■ DESIGNING SURVEYING I I INC ' __- AY' 'tZvti�.:1.t_ DENNIS, MASS. 385 -2831i1 t,