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HomeMy WebLinkAbout0422 REGENCY DRIVE - Health 422 Regency Drive Marstons Mills A = 064 053 "-7 Commonwealth of Massachusetts .� Title 5 Official Inspection Form' rat Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) ' Owner Owner's Name information is -4` required for every Marstons Mills MA 02648 8-24-18 �,x page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Shawn Mcefroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs FurtgEv1 the Local Approving Authority 8-24-18 In pector's SI re 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 should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 II r ' Commonwealth of Massachusetts ;w Title 5 Official Inspection Form MI Subsurface Sewage Disposal System-Form -Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) ' Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) 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: I System is in good working order with no sign of failure. t B) System Conditionally Passes: ❑ One or more system components as described in the "ConditionalPass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined;',(Y, N, ND)for the following statements. If"not determined," please explain. Th e septic tank is metal and ov' p er 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 ON ❑ ND (Explain below): t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form M Subsurface Sewage Disposal System Form Not for Voluntary Assessments 422 Regency Dr s Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. Cfty/Town State Zip Code Date of Inspection B. Certification (cont.) ' ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y El ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑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): 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 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: ❑ 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 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 r sue" Commonwealth of Massachusetts Title 5 Official Inspection Form !<01 Subsurface Sewage Disposal System Form:-Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) 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: I ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal; coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) 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 ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 4C.� Commonwealth of Massachusetts Title 5 Official Inspection Form �lal Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,i�I ; 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Marstons Mills MA 02648 8-24-18 required for every ` page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® An portion of a cesspool or privy is less 0 y p p p vy s than 10 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 2000gpd- 10,000gpd. ❑ ® 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. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well 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. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 .: Commonwealth of Massachusetts y Title 5 Official Inspection Form I1I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `V 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Marstons Mills MA 02648 8-24-18 required for every ' page. City/Town State Zip Code Date of Inspection C. Checklist 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 ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected'for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of,liquid, depth of sludge and depth of scum? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: .Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 . 6 r t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form ,I I w' I�1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 422 Regency Dr �r Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection Y P Yes No info Elrmation in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? El Yes Z No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown Date 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 Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts P Title 5 Official Inspection Form Iw�' C,�i Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts y Title 5 Official Inspection Form �i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: El cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 1811 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: 1500 gal Sludge depth:, 12" t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts � ,. Title 5 Official Inspection Form i>�t Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 611 Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with,baffles installed and no sign of leakage. 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 t5ins.doc+rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 a Commonwealth of Massachusetts Title 5 official Inspection Form 4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r a fk >' 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) , Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of i nspecti on)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day 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 t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 L s Commonwealth of Massachusetts Title 5 Official Inspection Form 16l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt I@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): Good condition with water at working level and no sign of back-up from field. 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. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3-500's ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach chambers in good condition and empty at inspection with stain line at 3"off bottom of chamber. 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 t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts y Title 5 Official Inspection Form .�"I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - % Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): ' II t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form C�4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 422 Re Dr Regency Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 r a Loill A- � . 33 t t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts 3, Title 5 Official Inspection Form i Subsurface Sewage Disposal System,Form -Not for Voluntary Assessments 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Rea[Estate 1-800-966-2448) Owner Owner's Name information is Marstons Mills MA 02648 8-24-18 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information.(cunt.) 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: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form r�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ap' Kl 422 Regency Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 8-24-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 OF BARNSTA:BLE L OCAMON rl VDLLA g✓ /J,� SEWAGE# AsSESSOIt�s >�9T'A�,�it'S NAh9E 8c I'>��AIB NO.. : MO&LO'!',,.,_,,,_....---�•�.� I s$p'tc TArIx cApAc>< /�5� I�MGAcar, f ) Ci000, s iaQRoa, WWI B .>�ii.OR OWMR CO MM IANCE SaPamtiop D�staaae Batwee��; I�xlanum,9;tl :. i �t�l Gt�anudwstet�bls m �1c lMtocn oi'LeatEngFacility o Water S10,ty'Pfcslt`nud Y. whin alto oc whin 7A0 S �' C�eay walls< i faatof laactiing factlityj EtIS ��I/ d ari LoRcbloS Padu (Lf my wetlands exist Fao WWI tea a l�acbing pawl �ua�alsb�d.by f. �f AL__j vl _Ot 3 L—LI-01-1 44- I- 33 ` q /. 31/4 . Ara - Ynt Q _a - �,o .. A �3 �cl` ' ZO. 3 80 J TOWN OF BARNSTABLE LOCATION LZ Z R E' ` LV C °/ SEWAGE # VL.LAGE,�YI r4 k' l eV A4 (ZL S ASSESSOR'S MAP&LOT —OS� INSTALLER'S NAME&PHONE NO. tit 11 C 6!f�6 ©'y SEPTIC TANK CAPACITY l LEACHING FACILM: (type) ' ��Y e 1 s (size) l �3 3 NO.OF BEDROOMS BUILDER OR OWNER M 1 PERMTTDATE: ' �- b S COMPLIANCE DATE: Separation Distance Between the: .. Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet f Edge of Wetland and Leaching Facility(If any wetlands exist Feet E within 300 feet of leaching facility) �! Furnished by O � Y 33 i S:�V z R'��4P LOCATION �V41d ? SEWAGE PERMIT NO. VILLAGE I NSTA LLER'S NAME i ADDRESSAN 'reity/4-t-F BUILDER R DATE PERMIT ISSUED A� DATE COMPLIANCE ISSUED G ITV S�vti! wc�c TOWN� BA NSTABLOF �LmOC*A IIQN. _ SpEW,� q., /� V LVS.�MY�� Y S J ��+� 79wYJA5e.7OWS M"&�i7./T,,..�..;..�.w„Y,�;, � �r� ppJ b�y �+ Ii1WTeWP�..S1 �"F..FT71OMNO.'.. - .. Epuc TANK CAPACITY �LE ►C�ll1�iG PAwCIA..TTY: (fie) Cj2 cr ei� (sate)' NO.��"$RR�d.OUNdS 1 MMIT1,2ATE: Call CE DAM. �...:r._....,.�....,..:..:.:,r: ' s �Sepjuaticp tmr►ae$illtmen M(s �Mfaxlmum'�.cf}u�t�tl,Gt�u�iciwatet�Tabisto-tile�cttarnuf'Laac,�hlnS�?tu;ili�y. � ,;,...,:..... Piiv*' �1latar S 1�lcsill.u�id ahirb Baca eri Neils ax{st a�eltd ar+arlAk 26D feet ft i ..don at;Wetia�d twi d i4A hth$PA-0,01 y(1My wetland 3 exisE �+rlttain '06 f«eta leaming 4c1 r ,R rPuritlshdd b � � � fz y ... .. Fran fl 1 �atlo' i Q -�3 `- Sol ,� L0CAT10N `Vdd SEWAGE PERMIT NO. VILLACE i INSTALLER'S NAME & ADDRESS t7Fyno&hFV-r — t�.9r C�2vwc� d UILDE R � R DATE PERMIT ISSUED f D E COMPLIANCE ISSUED AT A i I IZ s 10 c TOWN OF BARNSTABLE L LOCATION •7 - R G �` C a R• SEWAGE 11 �f�a VEJ-AGE—IY AR L?" M /LL S ASSESSOR'S MAP& LOT 15-3 INSTALLER'S NAME&PHONE NO. T- -44 Af A eR. SEPTIC TANK CAPACITY l -I-v O LEACHING mcmrrY: (type) &u a<<s NO.OF BEDROOMS BUILDER OR OWNER ✓�larj'a/'Q PERMITDATE: �f 5 b S COMPLIANCE DATE: Separation Distance Between the; Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet J Furnished by N I � 0 pi 5� . Na m Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplic Lion for Ai! tpoml Op$tem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. ,�9 Owner's Name,Ad ss anddTel No. y FQ,ex�e,U �x . s��ng s � Y Assessor'sMap/Parcel C �(( 0$3 (,o+�7 Qik ��A r CJ �Q, , Installer's ame,Add ss,and Tel. S� ? Designer' es t�ddress d Tel.N �j�$)3(a— 0`� m ez'an ' s� Inc• Designer's Name � MAX Type of Building: Dwelling No.of Bedrooms_ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design.Flow 14440 gallons per day. Calculated daily flow 9 ��( gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil: Nature of Rg airs�o'rAlterations(Answer when applicable) V V Date last inspected: Agreement: The undersigned agrees to ensure.the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been' 's of alt Signe C Date Application Approved by Date Application Disapproved for the following reasoey Permit No. Date Issued THE.COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ' Certificate of 'a pliance THIS IS TO CERTIFY,that the On-site Sewa e:Disposal System Constructed(, )Repaired( Upgraded( ) Abandoned( by f t C G at /kp I I Cl V1, a ' as been constructed in ac or dance with the p visions o i e 5 d the for Disposal System Construction Permit No. -o 5 ✓ dated � o Installer zp ( tYl 1 =Designer M The issuance of e t shall not be construed as a guarantee that the s st w' .f nction as d signed:' Date � � � Inspec6r. i ——--- —._�—° ——————-- — —--y No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION . BARNSTABLE, MASSACHUSETTS mig o�aI &paem c�CoriMruction Permit Permission is hereby granted t Construct( )Repair OC)Up rade( )Abandon System located at (_4'� ACjj Ift 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:C s ct n must be completed within three years of the date of this�germit !t� Date: Approved by_.< f Apr 04 05 10: 16p Darren Meyer, R. S. 17815850293 p. 1 � s 9n6/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMIPTION FORM I, ���t f`(r-t� f`1 e�� ,hereby certify that the engineered plan signed by me dated�- 1 i) �-O ,concerning the ��property located at 4 Z.ZTJ�;�( ��:!��G4 �l, i U.S meets all of the following criteria: • This failed system is connected to a residential dwelling only. There.are.no commercial or business uses associated with the dwelling. • The soil is.classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct deep test holes and percolation tests at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The.bottom of the proposed leaching facility will_be located no less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) Lllr�� ��'� o65cn v�C;1 ors B) G.W. Elevation +adjustment for high G.W. = fir i V /6 ;_ 1 6 ell DIFFERENCE BETWEEN A and B N � SIGNED:� � Uv"t�, DATE: NOTICE Based upon the above information;a repair permit will be issued for bedrooms maximum.. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\percexemp.doc Town of Barnstable Regulatory Services Thomas F.Geiler,Director + sa�irisrABre. + 9�AHAM Public Health Division TFo ;�e. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: $ U S Designer:D ftw'� Installer: , Address: . T •a - 60X l Address: ?,A j)OX�� . ft-02VV1C ► 02�'7 Cen On RC�kf t4 ?IW I was issued a permit to install a (date) (installer) septic system at 4 Q 4\E(, c based on a design drawn by (address)* M A � •I�•"S-dated (designer) XI certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. _ I certify that the septic system referenced above was installed with,major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State& ations. Plan revision or certified as-built by designer to follow. a N OF MIS, �o'v �RRREN' yGN M. 4—Y a, ;;: 410 (Installer'sSignature) �STE SgNITARX (Designer's Signature) (Affix.Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- WELT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR I QUALITY ORIGINAL (S) I M A(�Y,� L DATA THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1C` Town ..................OF............:Barnstable------.......-•-•-•-----••• 053 A/ Appliratiun for Disposal Works Tonstrurtiun Frratit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Regency Drive Lot 37 .._- .L'...... -Address--••••........................... ............................................. Lot No•••....................................... Ovtq�r Address W 0....... Installer Address 4 5,335 Type of Bui Size Lot........ ..................Sq. feet Dwelling—No. of Bedrooms...................................... . .............................Expansion Attic ( ) Garbage Grinder �ei aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures .. Design Flow..._........5 ...........................15....gallons per person per day. Total daily flow...._......330 gallons. Septic Tank—Liquid capacity.-_.•-.--..-gallons Length-_-•_-•.-....... Width.- .....___.. Diameter________________.Depth5_'A"••••.. W tje_ x Disposal Trench—No. .....................Width_......___._......_ Total Length..........__...._... Total leaching area_.__._.._...._......sq. ft. Seepage Pit No.......... -___-__-- Diameter......1 2......... Depth below inlet..5. 6 2....... Total leaching areal 2 l....._....sq. ft. Z Other Distribution box ( ) Dosing tank ...Percolation Test Results 2 Performed b _c-ape...Cod Survey Corisultantbate...L;L/ 83 p p 12 ' Depth gr none Test Pit No. 1___._____2.._..minutes per inch De th of Test Pit____________________ D th to ound water..__......_............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit---12�......... Depth to ground water....... a or O TP#1 0-6 humus .. ' Description of Soil ��....._.. .....r...-6_.1_24"-••subsol.....24.".-��"..clay �� y e ....ROGER G 60"-144" medium-coarse_..sand-_.•.-•_.-•-•_ � PAUL V ..........-•-•-••------------------•-----••••-•-----.............._......--•-•..._............ ....------•.............----•-------. rt A#feN.ttfE{rtI1C2 TP#� same as -TP#.1.....••...... .-_... �. .....n..1 0 V Nature of Repairs or Alterations—Answer when applicable................................................. ', ,® Clv p •-----•-• •-- •----------------------------••----•-••--......--•-• --•---•••......--•--••-•-----•----•-----•--------•-••--•-•-••-•---•----------•-•-•-- Agreement: . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance 3.2t.94 the provisions of iITA 1Z- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the board of health. Date ApplicationApproved By------ ------- •....-----••-••••••---•••••••-•--••-••••-•-•••••.............................• ........................................ Date Application Disapproved r t ollowing reasons:---------•--------------•--•---•----......-•--•-•-----••------...---------......-----•••--........•••......... ............................••---........-------•--••------•••---•------•--••----•------..........---•--.---•-••-•••-----------•-...•••----•••--•••-•-----...•---•-......•-----••--•----•-••----•-•-•- Date Permit No......................................... --- Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ......................... ....•O F........................................ .... ....... - Trrfffiratr of f�uutpliattrr, T I ERTIFY, That the Indivi Sewage isposal 'stem constructed ). or Repaired ( )' by - --......... ......................................... . Installer has been insta e in accordance wi rovisions of Tl�' Syo T�e State Sanitary d as d in the 's^ / ~ application for Disposal Works tr -tion:Permit No.... ......... ...., dated.._ ..........:_......._.. ..._.... THE ISSUANCE'OF THIS CERTIFICATE SHALL NOT-.BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SA ISF/ CTORY DATE.... ............................... t Inspector...................... f.. THE COMMONWEALTH OF.MASSACHUSETTS BOARD OF HEALTH o ...... OF............................I...... E y� Fg ✓ ... 'srn 1gn0tr 11 rn rntit Permission is e y gran .... ... cr ........., '`--' !y- -to Constru or R air ) an •Ind wage Disposal System at No. ----.. ....----• •. ................... •---•••. ....................................................... -.. led Street as shown on the application fo ispo orks Construction Pe '-:.,_::_..._ Dated.:........................................ .--........ • _..... .._... ...................................................... Board of Health DAT FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS I Log Number: 3550%;_ : B;)ttle ,# B026 Date: 3/29/84 BARNSTABLE COUNTY HEALTH DEPARTMENT SUPERIOR COURT HOUSE v BARNSTABLE, MASSACHUSETTS 02630 ° SAS$ ' DRINKING WATER LABORATORY ANALYSIS PHONE, 362-2511 EXT. 331 Client: PMC Development Collector: S. Jos. DiMaggio Mailing Address: . 901 Main Affiliation: Aqua Jet Well Drillers Usterville, MA 02655 Time & Date of Collection: 3/27/84 Telephone: - Type of Supply: well water Sample Location: Lot 37 Regency Drive Well Depth: 83' Marstons Mills Date of Analysis: 3/27/84 Parameter Sample Result Recommended Limits Total Coliform Bacteria/100 ml 0 0 pH 5.9 Conductivity (micromhos/cm) 128. 500.0 Iron (ppm) .09 0.3 Nitrate-Nitrogen (ppm) r,04 10.0 Sodium (ppm) 16. 20. XX Water sample meets the recommended limits of all above tested parameters. Water sample has higher than average levels of nitrate. Future monitoring is recommended (2-3 times per year). . The low pH of the water may shorten the useful life of the house's plumbing. Water sample may present aesthetic problems due to Water sample has high levels of sodium. Persons on low sodium diets should consult their doctor. Water sample is not recommended for human consumption due to Retesting is suggested. REMARKS: CC: Aqua Jet Well Drillers CC: Barnstable Board of Health Lab Director", 11/7/83 Massachusetts Ill(eter Resaiirces Commission/Division of Water Resources WATER WELL COMPLETION REPORT [Address O WELL, TION City/Town r 1 G.S.Quadrangle Map Grid Location Owner ci )TI Address I�� WELL USE CONSOLIDATED WELL Domestic Public❑ Industrial❑ Other Type of Water-bearing Rock Water-bearing Zones METHOD DRILLEED 1) From To Rotary(type)— Cable❑ 2) From TO, Other T 3) FromTo 4) From Q CASING it Tom__ Length v D" meter C� Depth to Bedrock Type_ (l— UNCONSOLIDATED WELL `. STATIC WATER LEVEL Water-bearing Materials Feet below land syr ace 4 I Sand: fine❑ medium JS coarse J Date measured Gravel: fine❑ medium❑ coarse❑ GRAVEL PACK WELL Screen: / Yes ❑ No r'y[ Slot# /d length 49 r from i 0 'to A%? ��r` SPlit Screen(or 2nd screen) WATER QUALITY TESTS MADE Slot# length from to Chemical ❑ Biological Depth To Bedrock PUMP TEST Drawdown feet after um in P P� g days hours at GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS- (On well or-water) Materials From To `.�� 0 M rf �D DR R Firm Address �} City Registration No. Z, per ease print irm y or ignature 10M-9-78.150519 I s NOTES: ,. iiy ��' :rt� _ ASSESSORS MAP U(�� TEST HOLE LOGS , d PARCEL : Q5 2j f E 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH ", THIS PLAN 1995 MASSACHUSETTS TITLE V & TOWN OF SOIL EVALUATOR :� t�/� oR FLOOD ZONE: a01� {1RZ��1D p� ;if� �� BOARD OF HEALTH REGULATIONS. WITNESS: L�-� Vif!.E:D REFERENCE: LC� �1o73Z�1 DATE: 1JE(",Cy,11n�?— C� 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, v _ ' PERCOLATION RATE �/LMiN Vi( SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO w .� P� INSTALLATION. Su GtP(Ss = so►� L_� =o, 6 TH- I TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION EL� °�D ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE LOAM DETERMINATION. U 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS 1 SPECIFIED OTHERWISE) S"iJ� �7n �rnr` LOCATION MAP T-S� .�D t`4 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A G, 5 2.sYY� ry GARBAGE DISPOSAL. 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON A BASE OF 6"OF CRUSHED STONE. 7 EXrsTIN4 c, t Pt r -- v � �_ NI LA�l7y — YL_� �1. �p tit) W ,_ SEPT I C SYSTEM DESIGN , _�Q K-00w�,j pqxr,,k% Vi -_ s_ rl,�o 0 - FLOW ESTIMATE �j °l I uVe-t-i,.,q- s_ - - 10. T7 BED300MS AT 110 GAL/DAY/BEDROOM - GAL/DAY' AL/DAY - SEPTIC '.TANK $N�._��A�_W��� �Dd VNt S/31V M / 440 GA' /DAY x 2 DAYS GAL II 00 /_ 4-_ 5.��� ! TI TL.a V oil T6Mr Aj D F ~o / USE GALLON SEPTIC TANK --1Ejt1g7t4_ KEtOLttCtc w�h S� 6��o r1 -- - -- - �'— — ---- '' 56MC, T�k- t� APT It :__�2 +✓ �� SOIL- ASORPTI ON SYSTEMij ' -- --- -- I NC. fit 33-51L k,-m1uc)�Y, 2 Q� SIDE AREA:��33�S� Z 4-(r3)Z]K Z X 0, 7V z. BOTTOM AREA: 33 S x 13 x Oi 7Y _ ':�22. pn P 0 y _ SEPT I : SYSTEM SECTION Tor,--EL /61-91 t <�NG vC� , E(.= 1o�. 7S ReMOVkt,1-0 q M�� N 14' � 3G i►►'+x 103.7� Top a F C �hyE� 8 ; eve TES 103. (, *y1c 103.1 'T C y D�$0 1D3.62- 3 / ,� h?S' IG✓ vG ��-�= GAL l 03,r U1arSf L�J L� FI _ujSEPT iG TANK U Vou ICE.�Z l,Ie a z /` ��k bra ✓ Inld$�tG �j{D»G S� t L b i N � LcaW Prr 7 ,�� SITE AND SEWAGE PLAN ME ER 1 iZ Df� V E No.114a PZS 7�yvS MIt.L-5 l�t�- NAG W$�� sANr;aR�P 2� PREPARED FOR : <' E \ice cn rw� \� SCALE.- =40 C 0� DARREN M. MEYER, R.S. DATE P.O.' BOX 981 o J EAST SANDWICH, MA 02537 w DATE HEALTH AGENT Ph: (508) 362-2922 Z -------------- p j Z� REVISIONS: r LEA ' SEP TI C ' TA NK DE TA IL : j� 0 DIST B0)( DETA/L CILITY DETAIL A rA F, OF'' NO. DATE _DAr rl D CHING FA ERIC, BY AIK')'O CONFORM TO TITLE 5-REOUIREMENTS. 70 CONFORM M r171F 5 RF0U1R6`M6NrS: 'rF$r1N !:'T4 D A OF. O,Tp BY SrBY ' NO. OF OMErS AL 4%, 4d%1 t J,. W/NtssElo By-.� VEABLE COVER /2"T '��G r 7-0 T1 L04 M a FILL 2AE ,'11V1.!iH &HAUL. 2 iceAS --'12"MAX 3 Cl EAR _J�CLEAR OurLEr PIPE5 7 INLE D/Sr T uz, 6'�iVN. 2"MIN. 6"M IN. IN. 'AS REOUIRED T fiArtt I d MIN" A 77-77- INLET TEE r rEr BOX GAL,.' 4"C.I. Yl, DE OUrL ET EE PrH: INLrr AND ounEr 4'0" MINIMUM , ." 11 - I * I *I '1 z 6 PREa 4 s r Lv BL 0 CK TEES TO BE CAST L IOUIP DFP7H 14:,ATt10U10 DEc TH Of- SEP TIC MW > 19 5 CONICRErE SEEPAGE PIT IRON, SCHEP.40 rRUCTION COWS DEP M OF TES T -CAST IN 61 10 P.VC. OR rE 29 7 PL ACE CONCRE MIN. BLEBASE', RATE: ColvCRETE 34" 40 BOTTOM ON LEVEL 57A lCrION CONSTRL y FRrIGHT) INL E r rEE PRO vIDED wHERE sL oPE L(WA r f/� P-'O* 9 FOUNDA r/OtV OF INLET PIPE EXCEEDS 0.08 Z OR 710 BEABLE ro wlmsrAND IN A PUMPED SYSTEM. -Tom oF 7ANK ON LEVEL 5T48L E 84 SE H-10 LOADING UAILESS'UAIDER 20 MIN 8o7 rAK P.4 vr,4f EN r OR IN ORI VE.H-20 W ED 5 rOE LOAD ING UNDER PA VEMEN TOR DRI VE. i-a got W Al INVERT 'EL E TI ONS 0, T �PLAN ­:WE c oA rd, F SMA 6t ZYE,DE�51GN_AN�, (srRucrl N OF IS PL A N/6.F01? CA L E DISPOSAL.- FACILI r Y,ONL K-- INV AT BUILDING A Lk'.CONSTRIACTION MtTHOPS� ANL7,*A'78YiA U WNrO.OM. TO IN V A TSEPrIC TA IVK(IN) qFp;r1C ;rAAlK(0&T) �6-44 MASS, P.E. TI 7F -5,,,,A NO: rH JaL INV :80 A R , Af, WICZ TH REGULA rIONS. 29869. t 3ftA�N) ALL, 1AfP i. 15RA 44--8t ve. 400 'o V1 0 L)!: 4v !Vll ;r A i V A rDIST BOXON) RIA Ve�4, t�%� A.7 IN A .1>' . � , .9 - - I Y, 'A ,,ArD1srBox(our _ALINV 7/ r BOSTON, MASS. WORCESTER, MASS. AT LEACHING FAC �7_ IL17 HALIFA L60A rE AT BOTTOM OFPIT: X, MASS. NORWELL MASS. BEDFORD, MASS. LEXINGTON, MASS. HYANNIS, MASS. MANSFIELD, MASS. CRANSTON, R.I. DERRY, N.H. c B S _ Ile �S7 7A DESIGN DA C/;7.4 4e DESIGN FLOW IT 5TUNle d=D I Ell REQUIRED SEPTIC 7ANK., 0 AL. IC rA NK PROVIDED G A L. Y t WAIN .-4,< EPT ? (c ONSULTANTS REWIRED SIZE LEACHING FACILITY. loo P 0. BOX 56 -NIS, Y. - HYAN MASS. 02601 -7,155 -617 _775 0 0, DIVISIONOF BOSTON SURVEY CONSULTANTS INC. Lt. 19 �5- SURVEYING LANNING Z,4�7 7 SIZE OF LEACHING FACILITY PROVIDED tENGINEERING p 01. 4e 4, TEM: s' s_fov3f_ TITLE: TYPE OF SYS c,1p V) 01TIom I A 72� 12 'T 1:�P 6v SEWAGE DISPOSAL SYSTEM 1 v3c DESIGN E GFDjCj*T DR-,IVE- L OC.US AN: FOR*. PKC ID E-VE L-C)p M EJ3 1 SCALE: AS SHOWN METERS DATE: W-,'RC�A �5 COMP./DESIGN: J�PjPt CHECK: , p DRAWN: *H DA Tum L FIELD: N%L.CA. FILE NO: Al DWG. NO JOB NO: C G. E' 6 101NrL SHEET: , OF::'