HomeMy WebLinkAbout0083 REGENCY DRIVE - Health 83 Regency �N�JL
Marstons Mills
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i
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Citylrown 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 filling out forms A. Inspector Information Sly#- mo/D
on the computer,
use only the tab Sean M. Jones
key to move your Name of Inspector
cursor-do not S.M.Jones Title V Septic Inspection
use the return Company Name
key.
74 Beldan Lane
1
6 Company Address
Centerville Ma 02632
Citylrown State Zip Code
774-248-4850 smjonestitle5@gmail.com, SI4522
sean@smjonestitle5.com 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
8/28/2020
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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
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:
The property located at is served by a Title V septic system consisting of a 1000 gallon septic tank,
distribution box and a 1000 gallon precast leach pit. Although the system was found to be in proper
working condition at the time of inspection this report does not guarantee future performance under
similar or increased usage.
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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
f
�. � 83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
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 linspection 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
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Citylrown 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.
❑ Tne 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
Commonwealth of Massachusetts
p Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is
required for every Marstons Mills Ma 02648 8/28/2020
page. Cityrrown 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 '/2 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
o ❑ 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
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. CitylTown 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
Commonwealth of Massachusetts
r� Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
V
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Citylrown 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): 330 gpd
Description:
Number of current residents: 0
Does res Bence 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: 1/2020
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
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mil s Ma 02648 8/28/2020
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:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
4. Type of System:
® Septic tank, distribution box, soil absorption system
❑
Single cesspool
9 P
❑ 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:
original system installed 1994
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: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Joints in good condition, no leakage, vented through roof.
t5insp.doc-rev.7/26/2018 Idle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M / 83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 1.5
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 gallons
Sludge depth:
5"
Distance from top of sludge to bottom of outlet tee or baffle
3'
Scum thickness
2"
Distance from top of scum to top of outlet tee or baffle
7"
Distance from bottom of scum to bottom of outlet tee or baffle
10"
How were dimensions determined? Opened covers and took
measurements
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 does not need to be cleaned now but should be done soon and again every 2 years for proper
maintenance. water level was even with outlet,'tank was not leaking and was structurally sound. Inlet
cover is on a riser
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
l
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
v
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Cityrrown 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.7/260018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18
L_
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
I. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
- J/ 83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Citylrown 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.):
Distribution box was level and in good condition with no rot. Water level was even with outlet invert
with no signs of past backup.
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
✓" Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
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: 1x1000
❑ 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.R26f2016 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
!P a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Citylrown 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 dry at time of inspection with a stain line approx 3'from bottom.
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
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
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.MiSQ018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Cityrrown 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
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3 TL
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t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18
L
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Citylrown 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: 12'+
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:
Groundwater was established by accessing town of Barnstable groundwater contour maps.
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
f
Commonwealth of Massachusetts
�d Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
83 Regency Drive
Property Address
Jonathan Venezian
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 8/28/2020
page. Cityrrown 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 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.7/2&2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
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No... ' .-.1 F)1$..... gad....
THE COMMONWEALTH OF MASSACHUSETTS
1167 BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratiun fur Diupuuttl Wurku Tunutrnrtiun ramit
Application is hereby made for a Permit to Construct (X or Repair ( ) an Individual Sewage Disposal
System at: p � �
Lo ti n- k dress r,Lot No
O er Address
W
Installer Address
Type of Building Size Lot...`T[ �.....Sq. feet
�-t Dwelling—No. of Bedrooms.___ Y .______________________Expansion Attic (��d Garbage Grinder ( d,b
aOther—Type of Building _-__- .............................. No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures ------------------- -.---_ _-.
W Design Flow...................15:5--____---.-•____gallons per person per day. Total daily lflow-...........................................g4lons.
WSeptic Tank—Liquid capacity-1.OIIQgalIons Length__&-_-_ Width... Diameter..._N�A.... Depth....
x Disposal Trench—No. .................... Width ....... Total Length--------
I�...__ Total leaching area.........._.sq. ft.
Seepage Pit No..-__-__-..-------- Diameter....._.___...--- Depth below inlet---- Total leaching area.._....... '...sq. ft.
Z Other Distribution box ( ) Dosing tank
Percolation Test Results Performed by......���4. 1�.,��.....N.!�E................... Date....................._____....
a --minutes per inch Depth f Test Pit____________________ Depth to ground water_.__ . ---.__-.-.
Test Pit No. 1___.�__._._
(Z4 Test Pit No. 2...............minutes per inch Depth of Test Pit.................... Depth to ground water... ..gKXCA).N.T
a F -E
--••---_...._...---••-------•--•-•-•--•••------•--•--•-•••••-••-•••----•---.---•••......----•-..--_ ••--•---••---- -•-••--•••-•• -...--•--------------! J
0 Description of Soil----.0.J2....... -'0----••---------LCAA.....
x
U
w
-------------------------------------------------------------------------------------------------------------------- ••---------...............................................................
U Nature of Repairs or Alterations—Answer when applicable.----.-. R_" .........................................................................
------....-•--------••••••••-----••-•--•-•--•-----•-•---•--•---•--••-------•-••-----------•-••••-•••--•••-•••••-----------------•••-------------- ......................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environ I Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compl ance has �S__i
ssue y the board of health.
Signed ._. ------ ---
�e.�.-�------................................................................................. .................Date..........:..__..
Application Approved BY � .... 1--------------------------------- ----------------------------------- y
---------t'�-- -5----"--g
Date
Application Disapproved for the following reasons- ----------------------------------------------------------------------- ------._..........----------------------------
---------------Date..................
PermitNo. ..........IY---`-----1-7-�--................ Issued ........................D azee...t.................................__....
_ No..7 IZ2- FEB ? ?....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
ApIptiratioit for Dhjipm Ml Norlai Tomitrnrtion Permit
Application is hereby made for a Permit to Construct (><) or Repair ( ) an Individual Sewage Disposal
System at: ,
� l�t-a ....t4� 1e !'�i� �{ --------•----- .r......--n-........--•---------•...................
• -.A...._.. A ccr��aa\t;/f... p A.... ------- y �ti♦ + /`�T (_C T y J ' �!
MAC ��� Lo V n Ks7 1F^�� G6r� !'ila�\I -.> .fit,N l�> 1 !�(�l kL4,r.
O ncr ' Address
� Installer Address �!
UType of Building Size ......Sq. feet
Dwelling—No. of Bedrooms____ ..__.__________________Expansion Attic (or) Garbage Grinder ( �)�
aN
Other—Type of Building _____f: ............... No. of persons-----------................. Showers ( ) — Cafeteria ( )
dOther fixtures -------------- ---------------------------------------.....----------------...---------- ---------------•••-•••••-•••••-•-•••......-••--••...-----•---
W Design Flow...................F5i"--y__-_-___-__-____gallons per person per day. Total daily flow_.-__._......_____....`f_..._._.___.........__gallons.
tx Septic Tank—Liquid capacity_1_C�1^Cgallons Length_��... Width__ =l:.�--- Diameter___�!Q_.__ Depth...�-..�:..�..
Disposal Trench—No_ ____________________ Width___-__ii__-__------ Total Length.................... Total leaching area..................tsq. ft.
Seepage Pit No--------A.;.._-------- Diameter-___�_''�__-__ Depth below inlet___16 ..... Total leaching area... �...sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by...... .................... Date........................................
a Test Pit No. I----a--------minutes per inch Depth of Test Pit____________________ Depth to ground water...5h,jtx r......
(i, Test Pit No. 2......-...__._minutes per inch Depth of Test Pit.................... Depth to ground water... 1'.'f ?..N- � 1*Y l
0+ ----••-•••-•----------------••-•••••- --•-••------••---•-•-•••-•-•--------•••••••--•........-----.--....................................V- ..
D Description of Soil....n ... - '' --------------- --`....Via: ---I?-1 -a---�---- rTalU111 8,�7 p.
W
V ....-•••-••-•-•--------•••••-------•--•-••-••-••----•-•••-••••••......••-•--••••••-----•-......--••-••••------------•----•-••---••-••---•..............................................................
W
-------------------------- ----------------------------------------------------------------------------------------- ---------------...............................................................
/�. U Nature of Repairs or Alterations—Answer when applicable--------- A_"1........................................................................
.....................................................................................................................................................................................................•--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State EnvironMe= l Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compl=ance has,\ e n issued�by the board of health.
Signed - .................................:...._ t
a -
`�...� ............................_ Date
Application Approved By ---------- ��.,c,.�, .� cry,
Date
Application Disapproved for the following reafons: ....--...................---......----------------------------------------------------------------------------------------------_,�
................................................................................................................................................................................................................ .................
Date..._..------
Permit No. .........T,. ..--------- 71--. Issued D ate
F
..---- —..._--.. —:.__-- -—.—_. —.—.----- ————— --'--- —:--- ----_.----_._.--_.�-„�.-----.-------..--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Qxr#ifi atr of CITomplian e
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( �) or Repaired ( )
by ----------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------.............----------------------------
�it
Insrauer
at
has been installed in accordance h e provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. _. �._-----I---7..P....... dated -------------_---------------------.__-----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.. �j'�f
DATE...... � `......G- ..-`'. �..-��_75--------------- Inspector,._ =' �-..'.Z
----- -------------=-------------------------------------- - -------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
' No..'��..�............... FEE.--:I..i'11�........
Difivosttl Nork.5 Tomitrurtion permit
Permissionis hereby granted..............................................................................................................................................
to Construct or Repair ) an Individual Sewage Disposal System
atNo.................... .- - -•----•.....�' h � ..�.e•, �---------,-A.....
Street Q _
as shown on the application for Disposal Wor -s Construction Permit
...---•-----.......•----••.....--•-•-. ._...-•-------•••......-••-•••---•-
B and of Health
DATE--- ." � V•.................................
f
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
ENVIROTECH LABORATORIES, INC.
MA Cert. No.: M-MA 063
449 Rte. 130 • Sandwich, MA 02563
(508)888-6460 1-800-339-6460
FAX(508)888-6446.
CLIENT: John Britton LOCATION: Lot 29
ADDRESS: P.O. Box 492 83 Regency Drive
Barnstable, MA Marston Mills, MA
SAMPLE DATE: 3-30-94
COLLECTED BY: D.A.Scannell DATE RECEIVED: 3-30-94
TIME: 11:00 AM SAMPLE I.D. : G-7
JOB #: Marstons Mills, MA WELL DEPTH: 74,
RESULTS OF ANALYSIS:
Parameters Units Recommended Limit Result
Coliform bacteria/100ml (MF Method) 0 0
pH pH units 6.0-8.5 5.36
Conductance umhos/cm 500 104
Sodium mg/L 28.0 9.83
Nitrate=N mg/L 10.0 4.70
Iron mg/L 0.3 IT 0.05
Volatile Organics
EPA Method 601/602 ug/L N.D.
COMMENTS: Low pH indicates high corrosive characteristics.
* See report attached.
Yes No WATER IS SUITABLE FOR DRINKING PURPOSES OR PARAMETERS TESTED.
XX
Date
Rona d J. aari
Laborator Director
IT = Less Than
U'1'ECH SOS 759
GROUNDWATER
ANALYTICAL EPA METHODS 601 and 602
Volatile Organics (GC/PID/ELCO)
Field ID: C-7 Lab ID: 7317-01
Project: Britton/tot 29 #83 Batch ID: VG2-0354-W
Client: EnviroTech. Sampled: 03-30-94
Cont/Prsv: 40mL VOA Vial/HaHSO4 Cool Received: 03-31-94
Matrix: Aqueous Analyzed: 04-04-94
PARAMETER CONCENTRATION REPORTING LIMIT
(u9/L) (ug/L)
Dichlorodifluoromethane BRL 5
Chloromethane BRL 5
BRL 5
Vinyl Chloride
BRL 5
Bromomethane
Chloroethane BRL Trichlorofluoromethane BRL 1
1
BRL 1
1,1-Dichloroethene
Methylene Chloride BRL 1
BRL 1
trans-1,2-Dichloroethene
BRL 1
1,1-Dichloroethane
BRL 1
cis-1,2-Dichloroethene *
BRL 1
Chloroform
BRL 1
1,1,1-Trichloroethane
BRL I
Carbon Tetrachloride.
BRL 1
Benzene
BRL 1
1,2-Dichloroethane
BRL 1
Trichloroethene
1,2-Dichloropro ane BRL 1
Bromodichloromethane BRL 1
2-Chloroethyl Vinyl Ether BRL 5
cis-1,3-Dichloropropene BRL I
Toluene BRL I
trans-1 ,3-Dichloropropene BRL 1
1,1,2-Trichloroethane BRL I
Tetrachloroethene BRL 1
Dibromochloromethane BRL 1
Chlorobenzene BRL 1
Ethylbenzene BRL 1
meta-and Para-Xylene * BRL 1
ortho-Xylene * BRL 1
Bromoform BRL 1
1,1,2,2-Tetrachloroethane BRL 1
1,3-Dichlorobenzene BRL 1
1,4-Dichlorobenzene BRL 1
1,2-Dichlorobenzene BRL 1
QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS
a,a,a-Trifluorotoluene 30 31 103 % 87 - 113 %
1,2-Dichloroethane-d4 30 28 92 % 83 - 117 %
.�2
BOARD OF HEALTH
TOWN OF BARNSTABLE
ApplitationArVell Congtruction Permit
Application is hereby made for a permit to Construct Alter ( ), or Re it ( an individual Well at:
Location — Address Assessors Ma d p and Par ce
(,)
--Owner( Address—
SlJ___�lS.��_�ni4 ( ( _ l^ie!_1___9C 11�" L3�• 16GKJ4001 1-rd ;U&S 1A
Installer — Driller Address
Type of Building Lj
Dwelling S
Other - Type of Building----- ------ No. of Persons------
T e of Well_Y��__� c-----____--
YP ---------_--_-----_-_-_-_-- Capacity--------------------_____-_--
Purpose of Well c ----wa le-f------------- —
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certifin�catt of Co pliance has been issued by the Board of Health.
Sig
ned
dG�Lu g — — — date
Application Approved B —— En!
date
Application Disapproved for the following reasons:-----___—_______—_---________-__
date
Permit No. -- r- —-------- Issued-------- —
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of Compliante
THIS IS TO CERTIFY, That the Individual Well Constructed (�, Altered ( ), or Repaired ( )
DA -
f Installer
a 9 �p �ewC D` aiS �awS M r
at---------6 a$-_--- �_—
It
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit Na. Dated ,��—" ��.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE- ----- -- --- — ---— - -__— Inspector --
No.-------'---!� Fee- __l
BOARD OF HEALTH K
TOWN OF BARNSTABLE
Zipplitation-*rVel[ Con.5truct ion Permit
Application is,hereby made for a permit to Construct ( �), Alter ( ), or Repair ( )an individual Well at:
Y' Location — Address Assessors Map and Parcel
Owner Address
/ n y!lr r rJ c,_. e- / ( 0i_, l_/r- 3/_l,�Qo!'1 11 /11 b,—
Installer — Driller — f Address
i /
Type of Building
Dwelling ---------------------------------------------------
Other - Type of Building No. of Persons---------------------------------
Type of Well—`I -�� -------- -- - —- --- - --------
YP - -- - Capacity--------------------------------------
Purpose of Well--)c M c��a 1`� - -- -
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed-A"""4_ --------------------------------- ---
%`,%�j date
Application Approved - ---------------
date
Application Disapproved for the following reasons:----------------________________________________________-____________---__—_—____
-------------_-- ----- ------------------------
/� / date
Permit No.----- � Y'''—` ---- - ------------- Issued---------- �— �Y '47 � - -ate ----
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( �, Altered ( ), or Repaired ( )
y / Installer
at �+
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No g�-� --Dated-= —�-=-e,1711
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE---------—-------------— -- -- ------ ---- Inspector- -- ---- ------------------- --
BOARD OF HEALTH
TOWN OF BARNSTABLE
Yell CongtructionPermit
1 No. - �—---- �f Fee- -'------------
Permission is hereby granted--�. -'=!��--'j= �/---------------
to Construct�), Alter ( ), or Repair ( ) an Individual,Well at:
- - ------- ---------------------------------
Street
as shownon the application for a Well Construction Permit
No.-- C r" 0_04/__11-/ -- - - - Dated -_- ='
_ Board of Health
DATE -- —=' 'tom--_��� Q�,�_
i
- -------------------
47
EXISTING
100' radius
LOT 30 /
0 / LAND.
r i 1000GAL / PT FA TER-LINE '�o o �,�►
`\ TANK PT -PROPOSED- '��',�,� -\
HOUSE- \
JOHN
,+ RESERVE ��\` 1 ' \ �sl r - - / \ �v LANDECVILAULEY �
• �,30 AREA D.B0X �(� - - 0 i/ \ No.35101
A
----- ----— 10 150 ' radius N_
�\ �/ 1 PROJECT LOCATION
�\ ► �' `� RAILROAD SPIKE LOT 29 REGENCY DRIVE
SET IN 12" PINE MARSTONS MILLS
ASS. ELEV = 50. 0
APPLICANT
LOT 29 ..
MARYANN VENEZIAN ..
44,329 s.f 920 MAIN ST.; OSTER VILLE, MA
LOT 28
\ VACANT LOT YANKEE SURVEY CONSULTANTS
\\ o Q \\ • 1'S0'+ UNIT 5, 40B INDUSTRY.ROAD
a P..0. BOX 265
MARSTONS MILLS, MA. 02648
TEL. 428-0055, FAX 420-5553
FsCALE.- 1'=30' JFDATE: 03-22-94
REV REV
4-
` JOB NO, 50440A SHEET 1 OF 2.
EL, =_5_0.5 PROPOSED
TOP OF FOUNDATION
20' MIN.
CONCRETE CO VERS
2"LAYER OF
2,
49.8 PROPOSED GROUND EL.=_48.5f CONCRETE COVERS WASHED STONE
A5T' IR611� / T 7 I 4
/ i i 4 7.8E LEVEL
7.5E
OR SCHEDULE40 Box
Ef ,
P. V.C. PIPE 12
S=0.02, D=15' 4"" SCHEDULE 40 P.. V.C.DIS
PIPE — MIN. M N.
—FLOW LINE S=0. 02, D—15' S=0.01, D=21' PRECAST
10'"
INVERT MIN. 19 B %g oo LEACHING
0 0. C
EL.= 46.80 — INVERT CRUSHED 88 W EQUIVALENT
STONE o o°o S a 8%S o S BINVERT o
INVERT EL.= 46_25 `� c
EL.
— 46 50 EL.=_45. 78 c oc
o� 5' � oC
INVER INVER o �, 3/4" TO 1-1/2"
_1000 ___GALLONS EL = 45.95 EL.= 45_57 0 cc WASHED STONE
SEPTIC TANK p W c
EL.=40.6
LEACH PIT 13,
3' � s'
PROFILE OF 12'DIAM.--�
SEWAGE DISPOSAL SYSTEM - - - - - - - - - - - - - -
NOT TO SCALE BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE EL=_36.3_
ALL ELEVATIONS ARE ASSIGNED PETER SULLIVAN, PE
WITNESSED BY: EDWARD BARRY
HEALTH OFFICER I" OF
TOWN OF __BARNSTABLE o ��
-- e JOHN y�
SOIL LOG LANDERS-GALLEY
GENERAL NO TES PERCOLATION RATE _2_ MINI INCH CIVIL
P NO. 8187 No. 35101
1. THIS PLAN IS FOR INSTALLATION OF NEW SEWERAGE DISPOSAL SYSTEM. �P,,
DATE _ 03=0_7_—_94___ �o,� �',,o�r
2. LAND COURT PLAN REFERENCE 16427D SHEET I OF 3.
3. THIS PLAN IS FOR INSTALLATION/ REPAIR OF SEPTIC SYSTEM`
AND NOT TO BE USED FOR SURVEYING OR ZONING PURPOSES.
TEST HOLE 2 TEST HOLE 1 DESIGN DA TA:4. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. EL — 48.3 EL. =48.6
TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS THREE
FOR THE SUBSURFACE DISPOSAL OF SEWAGE. LOAM and NUMBER OF BEDROOMS
5. ALL COVER TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN SUBSOIL LOAM and
12" OF FINISHED GRADE. 3' 45.3 3' SUBSOIL GARBAGE DISPOSAL NONE
6. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE
SAME, UNLESS NOTED BY FINAL CONTOURS. TOTAL ESTIMATED FLOW 330 GPD
7. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE ( -110 _GAL./BR.IDA Y x _ 3 _ BR.)
OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER MEDIUM MEDIUM
OR WITHIN 10' OF DRIVES OR PARKING AREAS. H-20 LOADING SAND SAND SEPTIC TANK CAPACITY --10-0-0--
SHALL BE USED UNDER OR WITHIN 10' OF DRIVES OR PARKING.
UNLESS NOTED. LEACHING AREA REQUIREMENTS
8. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL 36.3
BE MORTARED IN PLACE. 12' 12' SIDEWALL AREA 1 B_8.5 GAL.IS.F. 188.5x2.5=4 71
9. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH BOTTOM AREA 113 _ GAL./S/F 113x1. 0 = 113
DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO LEACHING CAPACITY (BOTTOM & SIDEWALL) 584 GAL.
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
NO WATER ENCOUNTERED
10. THE EXCA VA TOR�CONTRACTOR SHALL VERIFY THE LOCATION OF ALL 584
UNDERGROUND UTILITIES PRIOR TO ANY EXCA VATION. RESERVE LEACHING CAPACITY -- — GAL.
11. THE PERCOLATION TEST LOCATIONS WERE TAKEN FROM SHEET 2 OF JOB NO.:50440A
INFORMATION PROVIDED BY BAXTER and NYE
E.USTING
100' radius LL
\� .v
iv
��\ • ��i� of ����y.
PAW
MERITHEW
LOT 30
Ile OF
JOHN
LANDERS-CAULEY ,a
16, Q ' •-p ,l CIVIL ;
I p.�C' �� 0.$ �p cS� No.35;fl1 CIO
1000GAL 60 // / / o, 16' / �p �' on
(SEPTIC
i TANK
48
RARER VE
592 i 1 \21 .-\D.EOX
0
----- ----- � I � O ra
Tdz'uis
PROJECT LOCATION
RAILROAD SPIKE, LOT 29 REGENCY DRIVE'
SET M 12 PINE MARSTONS MILLS
\ �� �� ��, ,,�' 23.3 ASS. ELEV = 50. 0
LOT 29 APPLICANT
MARYANN VENEZIAN
44,329 s.f.
920 MAIN ST., OSTERVILLE, MA
LOT 28
VACANT LOT YANKEE SURVEY CONSULTANTS
p UNIT 5, 40B INDUSTRY ROAD
63•g15 P. 0. BOX 265
MARSTONS MILLS, MA. 02648
TEL. 428—0055, FAX 420—5553
1'=30' FDA 03-22-94
\` REV REV' : 04-04-94
\ _
JOB NO. 50440A SHEET 1 OF 2.
EL:= 50.5 PROPOSED
TOP OF FOUNDATION _
w 20' MIN.
CONCRETE COVERS 2"LAYER OF
49.8 PROPOSED GROUND EL.=-4B.5f WASHED STONE
i �n 4 7.8f LEVEL CONCRETE COVERS
4 CA5'1T IR6NI / / i / / / / 4 75f
OR SCHEDULE 40 6'f
P. V.C. PIPE
4" SCHEDULE 40 P. V.C. 12"
S=0.02, D=15' DIS M N.
PIPE — MIN. BOX
FLOW LINE
S=0.02, ,
S=0.01, D=21 PRECAST
INVERT iMN Ig,< B" 08 os � `C LEACHING
EL.= 46_80 _ INVERT CRUSHED 08 g , �y IT OR
STUNS 0 o 8 0 8 08"" B INVERT W p EQUIVALENT
INVERT EL.— 46.25
EL.= 46.50 EL.=_45. 78 0 5 0c
INVER INVER p G ( 3WASHED STO14" TO NE
_1000 ___GALLONS EL = 45.95 EL.= 45.57 0 pC
SEPTIC TANK o W
EL=40.6
LEACH PIT 13,
3' f— 6'
PROFILE OF 12'DIAM. -
{ SEWAGE DISPOSAL SYSTEM - - - - - -
'! NOT TO SCALE BOTTOM OF TEST HOLE OR OSGS PROBABLE WATER TABLE EL=_36.3_
ALL ELEVATIONS ARE ASSIGNED PETER SULLIVAN, PE
! WITNESSED BY-
HEAL
WARD BARRY
HEAL TH OFFICER Q�
BARNSTABLE
TOWN OF ------------ l0E-IN
SOIL LOG LANDS s-CPU EY
GENERAL NOTES P NO. 8187 PERCOLATION RATE _2_ MIN./ INCH � � ciVeL
o.351L1
P
1. THIS PLAN IS FOR INSTALLATION OF NEW SEWERAGE DISPOSAL SYSTEM.
DATE _ 03-07-94
2. LAND COURT PLAN REFERENCE 16427D SHEET I OF 3 —
3. THIS PLAN IS FOR INSTALLATION/ REPAIR OF SEPTIC SYSTEM TEST HOLE 2 TEST HOLE 1
AND NOT TO BE USED FOR SURVEYING OR ZONING PURPOSES
! EL.= 48.3 EL= 48.6
DESIGN DATA.
4. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO DER --
TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS THREE
FOR THE SUBSURFACE DISPOSAL OF SEWAGE. LOAM and NUMBER OF BEDROOMS
5. ALL COVER- TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN SUBSOIL LOAM and
12" OF FINISHED GRADE. ,g' 45.3 ,3' SUBSOIL GARBAGE DISPOSAL NONE
6. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE TOTAL ESTIMATED FLOW 330 GPD
SAME, UNLESS NOTED BY FINAL CONTOURS.
j 7ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE ( _110 _GAL./BR./DAY x _`3_ BR.)
OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER MEDIUM MEDIUM
OR WITHIN 10' OF DRIVES OR PARKING AREAS H-20 LOADING SAND SAND SEPTIC TANK CAPACITY _—10-0-0--
SHALL BE USED UNDER OR WITHIN 10' OF DRIVES OR PARKING.
UNLESS NOTED. LEACHING AREA REQUIREMENTS
8. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL
BE MORTARED IN PLACE. 12' 36.3 12 SIDEWALL AREA 188.5 GAL/S.F. 188.5x2.5=4 71
BOTTOM AREA 113 _ GAL./S/F 113xl.O = 113
9. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH -
DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO LEACHING CAPACITY (BOTTOM & SIDEWALL) 584 GAL.
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
NO WA TER ENCOUN TERED
10. THE EXCA VA TOR�CONTRACTOR SHALL VERIFY THE LOCATION OF ALL
UNDERGROUND UTILITIES PRIOR ,TO ANY EXCA YATION.
RESERVE LEACHING CAPACITY 584 _ GAL.
11. THE PERCOLATION TEST LOCATIONS WERE TAKEN FROM SHEET 2 OF 2. JOB NO.:50440A
INFORMATION PROVIDED BY BAXTER and NYE. `
` .