HomeMy WebLinkAbout1558 RACE LANE - Health _ 1558 Race Lane, Marstons _lI
A = 047-1:61 Mills
Iva Commorwveotth of Mossochusetts
Executive Office of ErMror nwrytoi Affcdrs John i
D.E.P. Title V Sept Septic h>spector
Department of P.O. Box 2119
Envf ronmental Protection Teaticket,MA 02536
(508 - R 13
A �
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A &CE1VEO
CERTIFICATION �
J"U2
1558 Race Lane Marstons Mills r 199-
Property Address: Address of Owner: ,
Date of Inspection:712197 (if different � � T
Name of Inspector:John Gracl Flnan ) i)EPT.
1
Company Name,Address and Telephone Number:
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
X Passes This Inspection is based on criteria dented in Title V
_ ConditionalIV Passes code 310 CMR 15.303.My findings are of how the system is
Needs Fu er aluation By the Local A Approving Authority performing at the time of the Inspection.My Inspection does
PP 9 ty not Imply any warranty or guarantee of the longevity of the
Fails septic system and any of its components useful life.
Inspector's Signature. Date: 712197
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this
inspections. if the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority.
INSPECTION SUMMARY:
Check A, B,C,or D:
Aj SYSTEM PASSES:
X I have not found any information which indicates that the system violates any of the failure criteria
defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below.
B) SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system, upon completion
of the replacement or repair,passes inspection.
Indicate yes,no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined", explain why not.)
The septic tank is metal, cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved
by the Board of Health
(revised 11115195)
One Winter Street • Boston,Massachusetts 02108 9 FAX(617)556-1049 9 Telephone(617)292-5500
1
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 1558 Race Lane Marstons Mills
Owner: Finan
Date of Inspection:712197
Sewage backup or breakout or high static water level observed in the distribution box is due to a broken,
settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
_The system required pumping more than four times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the
system is failing to protect the public health,safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS
NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND
SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)DETERMINES
THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system has a septic tank and soil absorption system and is within 100 feet to a
surface of water supply or tributary to a surface water supply.
The system has a septic tank and soil absorption system and is within a Zone 1 of a public water
supply well.
The system has a septic tank and soil absorption system and is within 50 feet of a private water
supply well.
The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private
water supply well,unless a well water analysis for coliform bacteria volatile organic compounds indicates that the well is
free from pollution for that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm.
3) OTHER
D] SYSTEM FAILS:
I have determined that the system violates one or more of the following failure criteria as defined in
310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be
contacted to determine what will be necessary to correct the failure.
Backup of sewage in facility or system component due to an overloaded or clogged SAS or
cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged
cesspool
SAS is in hydraulic failure.
(revised 11115195;)
2
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 1558 Race Lane Marstons MBIs
Owner: Finan
Date of Inspection:712197
D]SYSTEM FAILS(continued)
Static liquid level fin the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow.
_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Numbers of times pumped
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone 1 of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen.
E] LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a
public water supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further Information.
(revised 11115195)
3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECLIST
Property Address: 1558 Race Lane Marston Mills
Owner: Flnan
Date of inspection:7097
Check if the following have been done:
x Pumping information was requested of the owner,occupant,and Board of Health.
X None of the system components have been pumped for at least two weeks and the and the system has been receiving normal
flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this
inspection.
NaAs built plans have been obtained and examined. Note if they are not available with N/A.
X The facility or dwelling was inspected for signs of sewage back-up.
X The system does not receive non-sanitary or industrial waste flow.
X The site was inspected for signs of breakout.
X All system components,excluding the Soil Absorption System,have been located on the site.
X The septic tank manholes were uncovered,opened, and the Interior of the septic tank was Inspected
for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.
X The size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non-intrusive methods.
X The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-
Surface Disposal System.
(revised 11115195)
4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 1558 Race Lane Marstons Mllls
Owner: Finan
Date of Inspection:7097
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 330 gallons
Number of bedrooms: 3
Number of current residents: 2
Garbage grinder(yes or no): Yes
Laundry connected to system(yes or no): Yes
Seasonal use(yes or no): Yes
Water meter readings,if available: n1a
Last date of occupancy: n1a
COMM ERCIALIINDUSTRIAL:
Type of establishment: nla
Design flow:o gallons/day
Grease trap present:(yes or no) No
Industrial Waste Holding Tank present:(yes or no) No
Non-sanitary waste discharged to the Title 5 system:(yes or no) No
Water meter readings,if available: Ma
Last date of occupancy: rda
OTHER: (Describe) Na
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
System has not been pumped In the last two years.
System pumped as part of inspection: (yes or no)Yes
If yes,volume pumped: 1000 gallons
Reason for pumping: Maintenance.
TYPE OF SYSTEM
X Septic tank/distribution box/soil absorptions system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no) (if yes,attach previous inspection records,if any)
x Other(explain) n1a
APPROXIMATE AGE of all components.date installed(if known)and source information:
9 years old
Sewage odors detected when arriving at the site:(yes or no) No
(revised 11115195)
5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1558 Race Lane Marstons Mills
Owner: Man
Date of Inspection:712197
SEPTIC TANK: X
(locate on site plan)
Depth below grade: V
Material of construction:X concreate_metal_FRP_other(explain)
Dimensions: L 8'6'H 5'7"W 4'10-
Sludge depth:3'
Distance from top of sludge to bottom of outlet tee or baffle: 24'
Scum thickness:2'
Distance from top of scum to top of outlet tee or baffle:6'
Distance form bottom of scum to bottom of outlet tee or baffle: 16•
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,
evidence of leakage,etc.)
Septic tank and all components are structurally sound.Recommend pumping septic system every two years for maintenance.
GREASE TRAP:_
(locate on site plan)
Depth below grade: nla
Material of construction: _concrete_metal_FRP_other(explain)
Dimensions: n1a
Scum thickness:nia
Distance from top of scum to top of outlet tee or baffle:n1a
Distance from bottom of scum to bottom of outlet tee or baffle:nla
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,
evidence of leakage,etc.)
n1a
(revised 11115/95)
6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1558 Race Lane Marstens Mms
Owner: Flnan
Date of Inspection:712J97
TIGHT OR HOLDING TANK:
(locate on site plan)
Depth below grade: n1a
Material of con struction:_concrete_metal_FRP_other(explain)
Dimensions: n1a
Capacity: n1a gallons
Design flow: n1a gallons/day
Alarm level: rya
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
n1a
DISTRIBUTION BOX:
(locate on site plan)
Depth of liquid level above outlet invert: nla
Comments:
(note if level and distribution is equal,evidence of solids carryover, evidence of leakage into or out of box etc.)
Na
PUMP CHAMBER:
(locate on site plan)
Pumps in working order:(yes or no)
Comments:
(note condition of pump chamber,condition of pumps and appurtenances, etc.)
n1a
(revised 11115195)
7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1558 Race Lane Marstons Mills
Owner: Flnan
Date of Inspection:712197
SOIL ABSORPTION SYSTEM (SAS):X
(locate on site plan,if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
nla
Type:
leaching pits,number: 1,000 gallon leach pit
leaching chambers,number:nia
leaching galleries,number: nfa
leaching trenches,number,length: nfa
leaching fields,number,dimensions:nfa
overflow cesspool,number:n1a
Comments:(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) .
The overflow is structurally sound and functioning properlyA was empty at the time of the Inspection.
CESSPOOLS:_
(locate on site plan)
Number and configuration: nfa
Depth-top of liquid to inlet invert: nfa
Depth of solids layer: nfa
Depth of scum layer: nfa
Dimensions of cesspool: nfa
Materials of construction: nfa
Indication of groundwater: nfa
inflow(cesspool must be pumped as part of inspection)
Na
Comments:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.)
nla
PRIVY:_
(locate on site plan)
Materials of construction: nla Dimensions: nfa
Depth of solids: n<a
Comments:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.)
nfa
(revised 11115195)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1558 Race Lane Marstons Mills
Owner: Flnan
Date of Inspection.712197
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'
C+ A
G b
Ag
�R 4Ly
DEPTH TO GROUNDWATER
Depth to groundwater.12 feet
method of determination or approximation:
USGS Maps and Charts
(revised 11115195)
9
' 4 r� TOWN OF BARNSTABLE
LOCATION � 7 /64CE 44q� SEWAGE
VILLAGE Zjdt&g6U�,AU IM/L.C_S ASSESSOR'S MAP & LOT
NSTALLER'S NAME & PHONE NO. Ftx-7-3�--"7 C'OAM`
EPTIC TANK CAPACITY /06ej
q.EACHING FACILITY:(type)
p47
NO. OF BEDROOMS PRIVATE WELL OR 99ELIC WATER
BUILDER OR OWNER a9
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: 7
VARIANCE GRANTED: Yes No
1'
I
I
of
No...F$-jb .... (
THE COMMONWEALTH OF MASSACHUSETTS
iIBOARD OFF HEALTH
...........OF............. .............
��.............._
,� lirtt Ilan for Diip,aiittl Workii Tnnitrnr#ion ramit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at:
- ------------•---------------- -_j--� -•---------------•-------.................
J_,�cation- dress �/ '
•--•...•-•-•..... �- -•-- Lid �/�' .. ...r!!U/ . .......... �_./.!� . :3� 11 - ......S�
•; Q/w�ner�� ✓ j / ._ lA��ldress yJA /`�I
W ® .0..b+CL. ...---_i�.�/`_•` ; `............................... A'lx_ l��. re✓.... ...--V-....---.
1.4 Installer Add ss �!�
d Type of Building Size Lot_____...,�.................Sq. fee
U Dwelling—No. of Bedrooms... - _ Expansion Attic ( Garbage Grinder (i
Other—Type e of Buildin ____.___._._ No. of ersons____________________________ Showers — Cafeteria
a YP g ------�---- P ( ) ( )
a Other fixtures -----••-•--•------------•------•-•-••--•-------------- -
d •
WDesign Flow............... 5.....................gallons per person er day. Total all flow..........---- ___._ _._ _._.....___.gallons.
WSeptic Tank—Llgmd capacrtyf� gallons Length _ ____ Width.___ Diameter________________ Depth__.1:.
x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No......... _____ Diameter....../_V..... Depth below inlet.....41_..:........ Total leaching area__Z�:Z...sq. ft.
Z Other 'Distribution box Dosing tank ( ) _
`" Percolation Test Results Performed by---•-EI7Gf,. )_-�-�._�.... '. o, Date. �i_..�. ��I
,aa Test Pit No. 1.... -.Z:_._minutes per inch Depth of Test Pit...�� ____. Depth to ground water._._/!��t `�.._....
Test Pit No. 2... ....minutes per inch Depth of Test Pit... Depth to ground water....._.....'_U.......
_--------------------•----•-•---------------•..... ...............................................................................
A� Description of Soil....... --...... C� DfL---.-••- t/ �?.C�.••--•--•----------------•-•-----------------....--•-------•-----..
�___--� ---- T --
(� e,, ........-•--- ------••••----•--•--•-------•---••-•-..._......-••-•......•-•---•----••----••-•••••..
. •--••-•••--•-••••••-•••-•---•-•-----•-••-•----•----••••----•••..._..•--•-•--------•---•----
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 iITLL 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been • ed by the bo rd of health
Signed.: - - - - ---------------•....... ............... -------- ...................... -
j Date
Application Approved By-._----•-•• _..-•-
J Date
Application Disapproved for the following reasons------------------------•-•------•--...--------------------------------------•--•---------------•••--••••_-•----
------•-----------•-----___ •---••-•-•---
Date
PermitNo........ .......1.a ...................... Issued_.......................................................
Date
} THE COMMONWEALTH OF MASSACHUSETTS
'( BOARD O HEALTH
a ,
Gtl/ ...........oF..................... c- �G1.. r� .
Appliration for Disposal Works Tonstrudion Vrrmit
Application is hereby made for a Permit to Construct (v-1 or Repair ( ) an Individual Sewage Disposal
System at
..- ....... lz,qc� � :N ........ .L. ��.�1.... ........-•.................../6.. .: . .............---....._..._.....�...... _
( I,ocati�n- dress (7 iV S T .11.: ..... ..... .. a or t � ...... ......(��2- 6PV�/ 1_
................... .. . ...•-: -((-. . ..ts...L..........._...... � .� .......� /
ner dress
�-
i..._.... "57:............................... ......e�..................
!.��._-'...�+ ....� .>.:..6�r�/1 ...........
Installer Addss
U Type of Building Size Lot...Y.�1 6 S�....Sq. f
U Dwelling—No. of Bedrooms......... Expansion Attic (A Size
Garbage Grinder (�
'6 Other—Type of Building !V A............ No. of persons............................ Showers — Cafeteria
a YP g P ( ) ( )
aOther fixtures ...............................•--...........----•-.......--•--
WOWxG ... ��Design Flow--------------5.5.....................gallons per person per day. Total fly flow....................... d.................gallons.
l.lo..
Septic Tank—Liquid ca acit ,400.1Qg�lons Len h.�..... Width.. _ .. Diameter................ De th.... .. ."
Disposal Trench—No..................... Width.................... Total Length.................... Totalleaching
area...................sq. ft.
3 Seepage Pit No---------/_.......... Diameter......{_C?..... Depth below inlet.....la..:....... Total leaching area.. �...sq. ft.
Other Distribution box (� Dosing tank ( )
P _ Date , c1 /�/ /`95
a Percolation Test Results Performed by Cd l ... ....��.' '! .... ,.. .....
,.a Test Pit No. I....e...2...minutes per inch Depth of Test Pit ....... Depth to ground water..... ---
0-4 0, Test Pit No. 2...4.2....minutes per inch Depth of Test Pit._. Z.y__..... Depth to ground water........................
x --••---••-•------- •----•......... ..........................• -• ......:.....,:.... ..........
..-.........................
..-----------
o e
Description of Soil...... . ...-:.- ` ........��?-p..Q. ! ..f ..t! _ _9 < ....--••--------------------•--........_4..................
W ---•-•-------------------------- ?2� -=f`� ------------�e r.o.....-5�..�fn�v--------------------..............-----•-------.----............---------------------------
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 TITIS 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been i ed by the bo d of health
Signed. ---.._`.......... .......................
° `t
r
- Date
-�Application Approved By............. .. .lt.t.:I�a�t:�r .................................. ...--- - 1
Date
Application Disapproved for the following reasons:..........................................................................................................---
.........................•---......--------•--.....--•--•---------......---•-------------------..............._......•....-----•-----•---...........-•----------•--•------------•--•----•---•-•-----•---
Date
Permit No........ .......1 ................----_ Issued.....................................................
...
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........l.1/--LC)V.. OF............ ;SeIV� AF................ ...........................
01rrtifutttr of Tomplittnrr
THIS IS TO CERTI Y, That the Individual Sewage Disposal System constructed ( or Repaired ( )
by......-... r�� � ........... . .................................................................................................. .__.._
Installer
at---------------- ?`-.....7---.... n.-----..�.A........ 1-?--•--...................................................................................................
has been installed in accordance with the provisions of TIT I ,�5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.._..._._........__..1/1.?.......... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............... -z ...: .................................. . Inspector.................
..............................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ro. ...........0 F.........
Disposal Works Tonstrurtion rrrmit
Permission is hereby granted.---........Ca 'NG = - ............L-Pti!!' .:._..........................................................
_.._..
.to Construct (>� or Repair ( ) an Individual Sewage Disposal System
at No......... ..... ........!? p.e..._._. 'N o[_...............G�1...e9'1..........-•-------........................................... .....
..
Street
as shown on the applicatio for Disposal Works Construction Per No._ :_�G'.. -(.� .... :.........
..._.realtih�-_
Board of
DATE............
FORM 1255 A. M. SULKIN, INC., BOSTON
S/ ? Z Sf/� TS
LOCATION .! FSi/S >/GGS ► .
SCALE . ��`.t'���. . . DATE M19-a
PLAN REFERENCE
;v
i
EDWARD
E.KELLEY
/
-� N0. 26140
9,CISTiQ�� V
u I V/S7:P17-
L��4cy '� Boy(
St�rnc /
\ 13Z
r` Lzc£Y lop cr /
IS,
1130 Mti I
u
h
I
L. . .Vie. .5.�. ... .
TOP OF FOUNDATION
T � CONCRETE COVER
CONCRETE COVERS
4"CAST IRON 12� 12"MAX. AAIV—
ORR SCHEDULE 40 4 SCHEDULE 40 PV.C.(ONLY)
P.V.C. PIPE PIPE- MIN. LEACH
Je, ' PITCH 1/4"PER.FT. PITCH 1/4"PER.FT PIT PRECAST
LEACHING
INVERT a
o EL Zo,Qo,„ INVERT INVERT o . Q•;' PIT OR
SEPTIC TANK DIST. c9 w EQUIV.
EL...1� � . . EL./.9.... >x
e INVERT BOX , —� Q; .°.
/ S8 �. .. GAL. INVE T INVERT0. G �° a: :;�. 3/4"TO 11/2'
o; EL...9 ....... ELl. :z6. /8,�t�ki-:
wo WASHED
EL......... �wSTONE
CL./2.6c :.:
PROR LE OF GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
NO SCALE
SOIL LOG WITNESSED BY :
DATE !!-.6: TIME.�0'30 14-11 `T'�~?``3 ,�``��•'�, BOARD OF HEALTH
TEST HOLE I TEST HOLE 2 1 ! ENGINEER
ELEV. . ./?:So
. . . . . . . . . . . . . . . . . . . . .
WovOCoayry / INdoDG.vF37`j
DESIGN DATA
eZ.1, ,sa Lrl.Z®•Gv NUMBER OF BEDROOMS 3. . . . . . .
y��+/G2 G2Ay� TOTAL ESTIMATED FLOW 33p. GALLONS/DAY
h" 7zv BOTTOM LEACHING AREA D. SO.FT. /PIT (:P2>
SIDE LEACHING AREA . . . . . 50-
. . SO.FT./ PITf47/a,PP,R
/7CD' ��• GARBAGE DISPOSAL . O"� .(50% AREA INCREASE)
TOTAL LEACHING AREA . •Z67 0[� SQ.FT
PERCOLATION RATE L3S ! ! /Q. MIN/INCH
Alo LEACHING AREA PER PERCOLATION RATE .� �. . SO.FT.
WATER ENCOUNTERED NUMBER OF LEACHING PITS . OA/e--
APPROVED . . . . . . . . . . . BOARD OF HEALTH •� • 5 I,'" 4&� �>D�
DATE . . . . . . . .
AGENT OR INSPECTOR
6 OF
�N OF Mq
Eca
DiAR
E. G�
KELLEY 4
y No. 26100 0 TEAS
7-&/Y'S. . 1y'1GL$ 'PECI$TER4� AMUR%
PETITIONER : ���L� j,�j�v� s�/o��L LA ��