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0944 RIVER ROAD - Health
944 RIVER AvAI MARSTONS MILLS A = 045 012 001 E -11 SEWAGE INSPECTIONS DATE -OCATION ASSESSOR'S MAP do LOT VILLAGE •INSFBCTOR SEPTIC TANK CAFACM s�zc LEAGI G FACU TTYc (type) N0.OF BEDROOMS BUILDER OR OWNER Doan L OWNER MAILING ADDRESS 00 f.. C .. a 117 9� — i 114 I2`6 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION h I ASSESSORS MAp NO• v PARCEL NO• O TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: Owner's Name: Owner's Address: Date of Inspection: / Name of Inspector:(please print) A Wurr�' Company Name: />!/o,-v95 4Srridsc..0�0�eE Gc,✓Sr' Mailing Address: 57i�y DeD 57,Y�ggff� -:::'/ Telephone Number: SD& —-779— D_�2V5' CERTIFICATION STATEMENT. I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 . Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature; Date: __`7�T The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and-the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 page I Q Page 2 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ^1 a CERTIFICATION(continued) -----Pfdi erty Address:r to^ •�p �%�1i3'P�driS /lei•%l5 �/� Date of Inspection: Inspection Summary: Check A•,B >D or E/ALWAYS complete ete 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: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: oy & &if�7XV-, Owner: 'bC'AAIAL iG e G'z-r� Date of Inspection: (V n 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 Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a m ner 'hich will protect public health,safety and the environment: _ Cesspool or privy is within 5 e t.of a surface water _ Cesspool or privy is within 0 feet of a bordering vegetated wetland or a salt marsh 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: _ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other. Title 5 Inspection Form 6/15/2000 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Ay -e". /CB ��rndS p'j! S Owner: O �I¢ D r4 Date of Inspection: <p ace�0 y D. System Failure Criteria applicable to all systems: You must indicate`yes"or"no"to each of the following for all inspections: Yes No ✓B ku of sewage into facility or stem component due to overloaded or clogged SAS or cesspool P g's Y Y Po Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or ogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or — ,Cesspool _ Liquid depth in cesspool is less than 6"below invert or available volume is.less than 'h day flow -Le4equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number tunes pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. JZ y portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface 'An supply. t/ portion of a cesspool or privy is within a Zone 1 of a public well. portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well.water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (�(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 00 feex of a surface drinking water supply the system is wrthm 2 /feet of a tributary to a surface drinking water supply _ the system is loca d in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone H of a pub�c water supply well Bred" an question in Section E the system is considered a significant threat,or answered If you have answered ye�e' y q Y "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Title 5 Inspection Form 6/15/2000 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: ,�y ie fl-'r /eel Owner: N-V-4- old,z z o Date of Inspection: �G/dtl Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes o Pumping information was provided by the owner,occupant,or Board of Health . ere any of the system components pumped out in the previous two weeks _ .V- Has the system received normal flows in the previous two week period JZIHave 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) 1Z Was the facility or dwelling inspected for signs of sewage back up ZZIL 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 :l The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Existing information.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(3)(b)) Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: y OC.e ee- Yid Owner: Date of Inspection: OW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents:_0 Does residence have a garbage grinder(yes or no): (7 Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required] Laundry system inspected(yes or no):_ Seasonal use:(yes or no): {I Water meter readings,if available(last 2 years usage(gpd)): Ab—c'11 Sump pump(yes or no):_[0 Last date of occupancy: �2 O COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.20 end Basis of design flow(seats/p sons ft,etc.): Grease trap present(yes or no). Industrial waste holding r ent(yes or no): Non-sanitary waste disch .ged to a Title 5 system(yes or no): Water meter readings,if availab e: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: /I 0 9 Was system pumped as part of the inspection(yes or no): If yes,volume pumped:_gallons--How was quantify pumped determined? Reason for pumping: T TPE SYSTEM eptic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool —ivy _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) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: 42 /2=�0 ,saw x2gie g5'6C!Tz oo^// Were sewage odors detected when arriving at the site(yes or no): Title 5 Inspection Form 6/15/2000 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: <j/Uil/.� Liam v Date of Inspection: ( •�- /G f/ BUILDING SEWER(locate on site plan) Depth below grade: -"2`f I Materials of construction:_cast iron �/40 PVC_other(explain): Distance from private water supply well or suction line: ,fZeig X Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ►/(locate on site plan) Depth below grade: 49! / Material of construction:�crete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: ix to Sludge depth: ,(wIle Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: J/Z� Vx e ,r�IS�EcT a✓_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.). 3 Y" vt GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction: concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of s to top of outlet tee or baffle: Distance from bott of s um to bottom of outlet tee or.baffle: Date of last pum g: { Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): I 7 Title 5 Inspection Form 6/15/2000 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: to�-(vT{� 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): /SZd q.91 S/�dy'i G TiSz�rft DISTRIBUTION BOX: !/(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: vim 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.): PUMP CHAMBER:_(locate on site plan) Pumps in working order ye no): Alarms in working ord es or no): Comments(note co tio, of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C /SYSTEM INFORMATION(continued) Property Address: Owner, pbsri/!/rt /�/G ali2z o Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): orate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: aching trenches,number,length: ��{�`o.V�/ 1,2 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.): 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 constructio . Indication of groan, ater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY:_(locate o site plan) Materials of construction: Dimensions: Depth of solids: Comments(note con on of 61,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Title 5 Inspection Form 6/15/2000 9 Page 10 of 11 ` OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: /Yd4A�Pe,ZM4, Owner: �?e a/�� �.e.; o CiZa c, Date of Inspection: lD &/b SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet Locate where public water supply enters the building. Title 5 Inspection Form 6/15/2000 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: L z z Date of Inspection: /B 5.1 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water / 'Y feet Please indicate(check)all methods used to determine the high ground water elevation: //Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: eZ 53 c� T4 9--I< (e �T 7 2 6 Title 5 Inspection Form 6/15/2000 11 ,w TOWN OF BARNSTApB�LE LOCATION ��� !/�i� eCGt SEWAGE # Z�' 7-RO VILLAGE S ASSESSOR'S MAP & LOT ,INSTALLER'S NAB E&PHONE NO. d./Q��/�S%��J�i/�/ 7 - y q SEPTIC TANK CAPACITY /S� 6�6 L LEACHING FACILrIY. (type) ZM?1C.�/- (size) /oL !(34 NO. OF BEDROOMS 3 BUILDER OR OW\N�,ER DO/V V,4 PERMIT'DATE: ^7-eo COMPLIANCE DATE: i Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Welland Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by SC- G 1 11 d7 ' 1 7� WU r r ALE _ « � El..;�A . . FbIJ .DATION FIRST PIPE LENGTFI' ol> s CR ' CON E fE COVERS TO WITHIN E;a 57 5 .: " BE SET_LEVE TO - 6 OF FINISHED GRADE. FOR MIN: 2'' FINISH QRADE NaPVC s ,�` 4" P 4 HAMBER �n rw�r.r Cl' y I=G *�'`����, '. ,�;, IBC I •:Fi 1. b i , 5 OU,TLETI f GJ1f.LON DtST. BOX 6,3' SEPARATION s n r� k« P.T1ir TANK i 1 k 6" STONEBASE. NO, OB$ERVEiD GROUNDWATER 1 J BOTTOM (>F TEST NpL E ' 4 TOP: OF FOUNDATION r INVER.T AT -BUILDING _ 56;30 B 4 I.NVE.RT A�T-SEPTIC TANK. (IN) 54.34' C y 4" INVERT- .AT SEPTIC 'TANK OUT`/ 4 5' p �a 4. L:NVERT AT D15T. BOA IN) — 96' E INVERT AT DIST. BOX (=OUT) 53.79' F y t a INVERTS AT— LEA CHING FACILITY: Fri` r4{ . 4" ..INVERT AT BE } ' r QF LEACHING CHAMBER 53..74' G 7. �ELEVAT1gN AT: BOTTOM + n r ra OF " LL'ACHING CHAMBER 51 .7'. H Q, } Ss ` NO' GROU:NDWATER r; trBERVED; 45.4' J �. p: 5T a 9C5 DATE 6129104 -----i---- PROPERTY ADDRESS:__ 944_�2ivea i2d��N RECEIVED r_ (7aa�ston� lr1i���. �la. JUL 0 2 2004 TOWN OF BARNSTABLE HEALTH DEPT. On the above date, the septic system at the above address was Inspected. This system consists of the following: 1. 1- 1500 ga eion zept.ic tank 2. 1-d.izta.igut.ion Sox 3. 4-3050 ieach.ing chamkeltz Based on Inspection, I certify the following conditions: 4. 7h.iz .ins a t.itie dive Zept.ic ZyZtem, 5. The zept.ic . ayztem .iz in paopea woak.ing oadea at the /2aehent time. SIGNATURE• Name:213 u c�gacaLLiz.Laa-- ----- Company: .Tngep b 2- _&—Son, Inc. Add res s:_--P--o.-B.x_6.fi-_________ 1•!19,—MA 42 3 a v 0 6 6 i Phone:--- --------- ' THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY kvroqrpm JOSEPH P. MACOMBER & SON, INC. Tanks=Cesspools-Leachflelds Pumped & instal.led Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775.3338 775.6412 S •\pper� COMMONWEALTH OF MASSACHUSETTS ExECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OFNV1RONNiENTAt,pROTCTION V TITLE 5 OFFICIAL INSPECTION FORM-NOT-FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART-A CERTIFICATION. Property Address; 9 4 4 R ivea Rd. llaitston.6 Nitez, Na.• Owner's Name: Gonna R2igo.P.izzo Owner's Address: 414 C.it.izenz Rd. ' Ru,za,e Ret/teat, Va.. Date of Inspection: 6129104 Name of Inspector: (please print) ce_NAP q U ie!t Company Name: 7_ I _AacomLeg & .Son Mailing.Address: Can ezv.c e, Ta67..02632 Telephone Number: 5 0 8—7 7 5=3 3 3 8 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system.at this address and that the.information reported below is true;accurate and complete as of the time of 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:5ection.15340.of Title 5(316 CMR 15:000). The system: XX _Passes -Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Dater The system inspector shall submit a copy of this inspection reporr-to the-Approving Authority.(Board of Health or DEP)within 30 days of completing this inspection.If the system:is.a,shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner.shallsulimit the report to the appropriate regional,office of the DEP.The original should be sent toAhe system owner and copies sent to the buyer,if applicable,and the approving. authority. Notes and Comments ""This-report only describes conditions at the time of inspection and under the conditions of use at that under.the same or different address how the system will perform in the future time.This inspection does not s y conditions of use. ogee 1 i f Page 2 of 11 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 944 /2ivea Rd. Owner: Donna Rigo&zzo Date of Inspection: h/2 9/0 4 a Inspection Summary: Check A;B C,D or E/ALWAYS-complete=all of Section;D A. System Passes: no. I have not found any,information which indicates that any of the failure criteria described in 310 CMR 15303.or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: n_a One or more system components as described in the"Conditional:Pass"`:section.need to be replaced.or repaired.The system,upon completion ofthe replacement or repair,as approved by the Board of Health,.will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. no 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 of tank failure is imminent. System.will pass inspection if the existing tank is replaced with a complying septic tank,as approved by_the-Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n n Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection.if(with approval of Board of Health): broken.pipe(s)are replaced obstruction is removed distribution box is leveled"or replaced ND explain: n o 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 pipes)are replaced obstruction is removed ND explain: 2. Page 3 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.;FORM PART A CERTIFICATION(contin.ued) Property Address: 944 Livan- Rd. Owner:. Date of Inspection: A/J 9/(14 C. Further Evaluation is Required by the Board of Health: _rjo Conditions,exist which require finiher,evaluation by.the:Board-bffHeaithdn order.to:.detertnine 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(I)(b)that the system is not functioning in.a manner which will.protect public health,safety and the;environment: n o Cesspool or privy is within 50 feet of a surface water no Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2. System will fail unless the Board of Health(and Public Water Supplier;if any)determines that the system is functioning in a mabner that protects the public health,safety and environment: no The system has aseptic tank and soil absorption system.(SAS):and the SAS is within 100 feetrofa surface water supply or tributary to a.surface water supply. n Q The system has a.septic tank and SAS and the::SAS is within a Zone 1 of a public water:supply. n o The system has a septic tank and.SAS and the SAS is within-.50 feet of a private water supply well, n o The system has a septic tank and.SAS and the•SAS is less than 100 feet..but 50 feet or more front a private water supply well". Method used to determine distance mD oA,-Ll ad "This system passes if the well.water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution front that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5.ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: none 3. • Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART A - CERTIFICATION(continued) Property Address: 944 R-welt Rd. r1nn.Sf_on� Pl,r'.0.0_.s ' Owner: %Pnnnn Date of Inspection: D. System Failure Criteria applicable to all systems:. You must indicate"yes"or"no"to each of the:following;for all:inspections: Yes No _ T Backup of sewage:into facility:or.system component due-to overloaded.or clogged SAS or.cesspool X Discharge-or ponding of effluent to the.surface of the:ground or..surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool x Liquid depth in cesspool is less than 6"below invert or available volume is less than'%•day flow x Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped x 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: z Any portion..of a cesspool 7or_privyis within a Zone I.,of a:public well.. Any portion of a cesspool or privy is within.50 feet of a private water supply well. x Any portion of a cesspool or=.privy is less than 100 feet but greater than 50 feet from a.private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates:.that the well is free from pollutionjrom that.facility and-the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are-triggered:A copy of the analysis must be attached.to this form.] no (Yes/No)The system fails.I have determined that one or:.more;ofthe:above.failumcriteria 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 1.0,000 gpd to 15,000 gpd• .. .. You must indicate either"yes"or"no"to.each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ x the system is within 400 feet of a surface drinking water supply x the system is within 200 feet of a tributary to a surface drinking water supply _ X the system is located in a nitrogen sensitive area @nterim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or.failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional.office of the Department. 4 Page 5 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 9 4 4 / >»v_2 Rd.� Nnft,cfnnA PlllZA, 11a.- Owner: 7o lz a s R i go e i zzo Date of Inspection: Check if the•following have been done.You must indicate"yes"or"no"as to each.of the following: Yes No x Pumping.information was provided by the owner,occupant,or Board of Health X 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? x Have large volumes of water been introduced to the system recently or as part of this inspection? x Were as built plans of-the sysiem'obtained and examined?(If they were not available note as N/A) X — Was the facility or dwelling inspected for signs of sewage back up? — Was the site inspected for signs of break out? X — 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: Yes no x Existing information.For example,.a plan at the Board of Health. _ x Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance .. is unacceptable)[310 CMR 15.302(3)(b)J 5 Page 6 of 1 I OFFICIAL WSPECTIGN.-IMM—NOT FOR VO.LUNTARY ASSESSMENTS .SUBSURFACE SMAGE DISPOSAL;fSYSTEKINSEECTION FORM PART.0 SYSTEM:INFORMATION Property Address: 944 Rivet 12d.• Maaztonz Mi"U-s, 8 Owner: 1)nnna /2.i.go�i_zzo Date of Inspection: h/2 9'✓0 4 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): ,< .3. Number of.bedrooms.{actual): .3 DESIGN`flow-based on"310 CMA I5.203(for example:-I TO gpd z 4 of bedrooms)': 3X'110:3 3 0 gl2d Number of current residents%, n Doesresidence have a garbage grinder(yes or no):_an Is laundry on a separate sewage.system,(yes or.no):.,q,,- [if yes separate inspection required] Laundry system inspected(yes or no)y� : Seasonal use?.(yes or no): e Z)e the we 22 hays not Water meter readings,if available(last 2 years usage(gpd)): ,,,D P 0 ,, # Peen t e z t e d .i n .t h e Sump Purn (yes or no):_ 2a�s t 12 m o n t h it Last date o'occupancy: e h o u id g e done at ,. th:iz time. See COMMERCI,tih-: UUSTRIAL /a g e z 6 a&6 9 Typeofestab ` } at: na . Design flow(�''; on 310 CMR 15.MU . n a apd Basis.ofd�ig�u'''flow(seats/persons/sgteta.):,_ - na - Grease trappresent(yes or no):`n a Industrial waste holding tank present(yes or no): na Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water.meter readings,if available: na Last date of occupancy/use: n a . OTHER(describe):. n u GENERAL INFQRMATION Pumping Records Source of information: not ava"iiag$e Was system pumped as part of the inspection(yes or no):_ If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for.p..umping: TYPE OF SYSTEM 1p �e tic distribution box,soil absorption system � P t� � rP y . . as Single cesspool �aa Overflow cesspool Privy -OrShared 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 Ained from system owner) Tight tank. _Attach a.copy of the DEP.approval no Other(describe): Approximate age of all components,date installed(if known)and source of information: 2001 Were sewage odors detected when arriving at.the site(yes or no):_ 6 BARNSTABLE COUNTY DEPARTMENT OF HEALTH & THE ENVIRONMENT P.O. BOX 427 Of s�4N SUPERIOR COURT HOUSE a BARNSTABLE, M:ASSACHUSETTS 02630 o � AfA � PHONE: 362-251: EXT. 337 SAMPLING INSTRUCTIONS FOR PRIVATE WELLS An improperly taken sample wastes your money and has neither scientific accuracy nor legal acceptance. 1. Obtain sterile sampling bottle from the County Lab or Town Health Department. Bottles sterilized at home are not acceptable. 2. It is recommended to use a straight faucet, preferably NOT swingtype. 3. Turn on the cold water and let it run for five (5) minutes. 4. Fill the bottle leaving one inch air space. Do not till bottle to the top. Be careful not to touch the inside of the bottle or cap with the faucet, your hands, or anything else. 5. Fill out the reverse side of this form. The laboratory requires accurate and complete information. The person filling-the bottle must sign the form 6. The charge for a routine well analysis (coliform bacteria, pH, conductivity, iron, nitrate, sodium and copper) is 525.00. Checks should be made payable to Bnrnstable County. Exact change is required if paying in cash. Additional tests require additional fees. Consult lab or a price list for exact information. 7. Samples are accepted.Monday - Thursday from 8:00 AM-to 4:00 PM and Friday 8:00 AM to 1:00 PM. They must be delivered to the lab within 6 hours of collection or 24-hours if refrigerated. 8. Completion of tests and results takes 7-10 business days. Results will be sent in the mail 9. Special requests such as results in 2 -3 days and sample acceptance on Friday from 1:00 PM to 4:00 PM are available for an additional charge, Contact the laboratory for availability. NOTICE: WATER FROM TIE SAME SOURCE CAN PRODUCE CONTRARY RESULTS IF TESTED AT DIFFERENT TIMES AND/OR DIFFERENT LOCATIONS. THE QOUNTY OF BARNSTABLE SHALL NOT BE LIABLE FOR DAMAGES R.ESULTTNG FROM THE RELIANCE ON RESULTS OF WATER TESTS ACCURATELY PERFOR1vfD. PLEASE COMPLETE REVERSE TIDE�OF FORM PRIVATE WELL WATER SAMPLE DINT COLLECTION SHEET /IAL NUMBERS FIELD BLA14K -E ID IIUI•IDER DATE REC ' D COLLECTION DATE t 'NG ADDRESS COLLECTION TIME WELL DEPTH :T ADDRESS r YEAR WELL INSTALLED MAP/PARCEL 'HONE COLLECTED BY : APPOINTMENT NEEDED' ? F N FOR TESTING : ( ) SUSPECT A PROBLEI•I ,(EXPLAIN) ( ) REQUIRED ( ) FOR INFORMATIOtl ONLY ( ) NEW WELL ( ) REAL ESTATE TRANSACTION ( ) OTHER (EXPLAIN) C 14CE OF WELL FROM POSSIBLE CONTAMINATION SOURCES ( IN FEET) SEPTIC TANK\CESSPOOL FARM SALTED ROAD UST LANDFILL INDUSTRY SAS STATIO►t OTHER T . MENT USED: ( ) NOtI E ( ) WATER SOFTENER ( ) FILTER; SAMPLE TAKEN BEFORE/AFTER TREATMENT (CIRCLE) 4 x : RESULTS VOC ROUTINE C: )FORM TOTAL COLIFORM\100 ML 1 . TRICHLOROETHANE (PPB) PH _ CON.DUCTIVITY IRON ( PPM) 11ITRATE-11ITROGEN ( PPM) SODIUM (PPM) _- COPPER (PP14) At T_S DATE: ANALYSIS DATE: P4g9 7 of 11 f3FFI .:• . � ` "PIQI`� #�Rl1�i.-N-QT FOR.VOLUNTARY ASSESSMENTS AOE SEV�'�1�E AYS ` SA +SX$TE]1'i ITISFLC"I'ION FARM SYSTEM.•INFORMATION(4onttnwed) i'raiicrty�•�ctress:.9 /?i_,�o 14_ lyla. . owa..r: /Dnnna R jgnL Zz0 Nit of-hvivciflol�'# BLFI1:DT14G SEWER(koctte of slte plan) Depth kcl*t 09- ' IrlitSfiilt Of 60t4ittit9Ct Att;,.!-cyst Volt "V—. PVC atlur l istatrce&4M.privow we!"-supply waft ai svetivrt 1 tit: eorswncnts(Qtn et3itdtttQn o(}vtn'4,s,vcn�ltf>c,evidcAe6 of�'ege,its.t vented th2ough the houze vents. SEPTIC TANKi ,(locate on site pia) OVA below p4c: t+A.atct'iil:af constvuction.: ,,,�,avn�rcte,�,•,ttnetal,,,_,ftbergt�ss,�„polyethykna. otbcc(cxplatln� i? ri iAcwl t#st agt.,_,_ !s affa cvntir e; Y a Ccr�lflaate o bn!A•.ainee(yes or noj: (a*ch a copy of ccrtifna'ttc} � ' 1�ImcnsJons: •.' . Slud�s dcpih: 1 t�is�nec from tbp of s udge it,.battorn ut-lci tee or baffle: Scum Otiekncw.;,,,,,_.,,,,,;.,. Distant(tone tap of scum to.,lop Rf gytlel lee or baffle: D.isuutcc.kom.bonotn of scum to bottom o-f outlet tee or baflk: How�rcre dimensions detcrtnlned: C.csrgt;.(brt.punipit►g,reeortutietldatftr>t$, ,aet aq qot ci tee or bafc coadttion,structurtil Integrity,liquid levels u rclue4.4 :autFs.t invert,avidcit�a o.f.tett}tOtt;.,w);. - - , , GREASE TRAP:,_,(locate on site ply �� •' Death bctow ltrada:.— . Miteriatil.Of cofnstMotion'. aoncroto,_;,mfta1_. fj. orglass _polyethylene other (exQltin}: • DitineR}.IOF1'S: '' Scum tta.icicttexs: Distance OQm t.+ (scum to top-of outlet ker or baffle:,,_ �,._ Risuncc t?oni Wwm of scum to bottom of Outlet tee or bif114: Ditt of tut.ptunplAgt Cotatttn.ents(ctn pwmpirtg r000mmnomigns•ittlet'NW outlet tee or beMo eondidon,sltvctttraI Integrity;liquid levels i3 reltud to pttfi4t(nl!u%evIdCnce Of 91491,et;,� Page 8 of 11 OFFICIAL:INSPECTI.ON FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 9 4 4 Rive2 i?d. Ma2.tY_nn.s mj y-mR. Owner: -n 1?i qn P ;,n Date of Inspection: h/2 9/0 4 ' TIGHT or HOLDING TANK: n o (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n a Material of construction:n 2, concrete n a metal_aufiberglass wa_polyethylene mother(explain): Dimensions: nra Capacity: A66 gallons Design Flow: gallons/day Alarm present(yes or no): na ' Alarm level: na Alarm in'working order(yes.or no): n a Date of last pumping: Comments(condition of alarm and float switches,etc.): Ti_ghf nn hnPrIla 4. BQ s6 Q04 'Qq.A6a;; DISTRIBUTION BOX:_Le-3(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:n o 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.):101nLh a'Qnonn fig f'h _ A/n n f) n 1idnna 9 p1 4A+C /�/-d4=eeg%f��e19ev% No O))JnOn!•D nO OnnGg 6Jb�A 6��• 96db QeE1Y� PUMP CHAMBER:. (locate on site plan) Pumps in working order(yes or no): n a Alarms in working order(yes or no):h a Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): l mm.p rhnm0.on nnf Q,20642Ri 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 944 ffivea Rd." Owner• t)on n / j n� Lj7zo Date of Inspection: A/2 9/0 4 SOIL ABSORPTION SYSTEM(SAS):-y v 6c(locate on site plan,excavation not required) 4 n Onnnhinn rhrjmOnn t If SAS not located explain why: Located .bee /gage 10 Type go--leaching pits,number: 0 y e leaching chambers,number: 4 , n n leaching galleries,number: n n_leaching trenches,number,length: n leaching fields,number,dimensions: - n 0 overflow cesspool,number: n n 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.): Loamy .Sand to medium zand.-No 6.ign3 o� hydaautic �a.ieuae at ,th-ins time. Vegetation t-6 nolzmat. 3050 chamgeaz weae day at time. o -in.6/2ec -con. CESSPOOLS: n o (cesspool must be pumped as part of inspection)(locate on site plan). Number and configuration: 0 Depth—top of liquid to inlet invert: na , Depth of solids layer: na Depth of scum layer: na Dimensions of cesspool: na Materials of construction: n a Indication of groundwater inflow(yes or no)h,G Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): ( o.cA'nnn.PA aa0 not T AO/iD f PRIVY:�(locate on site plan) Materials of construction: na Dimensions: n-n Depth of solids:n Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): j)n,j 2)U nol ?Ae%ent - - .9. Page 10 of 11 J OFFICIAL INSPECTTOI�I FORM--'--NOT FOIL:YOLUNTAR'Y.ASSESSMENTS SIBSURF'A.CE SEWAGE•DISP.OSA,L SYSTEM INSPECTION:FORM PART C SYSTEM INFORMATI.ON(continued) Property. Address: 944 /2 ive2 /2c1. Owner: [donna Date of Inspection: h/2 9/N KETCH OF SEWAGE-DISPOSAL SYSTEM Pr ide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 1.00 feet.Locate where public water supply enters.the building. O ICI` :6 10 .Page 1.1 of I I OFFICLA.L INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued). Property Address: 944. / .Lve2 Rd_r- aa a At an A .M14LA, Na, Owner, Don n Rigotizzo Date of Inspection: 6/29104 SITE EXAM Slope . Surface water Check cellar ' Shallow wells r Estimated depth to Bound water 80 feet Please indicate (check)al.l methods used to determine the high ground water elevation: _Obtained from system design plans on record•If checked,date ofdesign plan reviewed: _Observed site (abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health•explain: T Checked with local excavators, installers. (attach documentation) Accessed USGS database•explain: You must describhaetyu establis c e/Z 0i' e n zourc v a°'e2 R'Ove Sea Leve e Uzgd:LISGS 92- - ' 1jARd:0&he2va.ti02 Uzi e Data Leaching Pit :cc( Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimptcr Method ,02 Therefore,the vertical.separation distance between the bottom.d Of the jcaching pit and the adjusted groundwater table is 11 �rw.—n,'r►*•"r'+",rn:Jn,•nr.+tnr�.na�.rrn�r•.•rt+•Rarr:�R*t t�T+•n`V 1'►P'�R� '1'OHN OF Barnstable WARD OF HEALTiI SUI1;4U[tFACR 9EKA(;F I)ISf'OSAL SYSTEM INSPRCTION FORM - PART D•- CERTIFICATION ern n•rni,�rrrt••.trnn•,t,•c•.�rrr•r• — •••T:4•T••,••.: —T• r^•�TTt;ISr:Tt'N.1tti 1•wH'„RTT}•7r,•,'•T-:•1 -7Ninr IRR1erf^R�'�f �'� -TIPC OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 944 River Rd. ASSESSORS MAP , DIOCK AND PARCEL # 045-012-009 OWNER' s NAME Donna Rigoiizzo PART D CERTIFICATION NAME OF INSPECTOR Fltace Nacaieis.tea COMPANY NAME Joseph P. Macomber & -Son Inc COMPANY ADDRESS Box 66 Center'ville Mass 02632 Street 19Mn Ot" Q1ty state E I P COMPANY TE4EPHONE ( 508 ) 775-33-38 FAX ( 508 ) 790-1.578 n/ C1:RTIFICATION. STATEMENT I certify that I. have personally inspected the sewage • disposa`1 system a :j ..this address and that the information reported is true , accurate, and complete as of the time of ,inspection, The inspection was performed and a,ny recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on site sewage disposal systems , Check one ; XX System PASSED The inspection which I have conducted has not found any information which indicates that th.e system fails to adequately protect public Ilealtlnor the environment. as defined i.n 310 CMR 16 . 303 , Any . failure criteria not evaluated are as stated in the FAILURE CRITERIA section of ,this form . System FAILED* The inspection which I have 'eona'acted has found that the system fails t protect the jitlb.lic health and the environment in accordance with Title 5 , 3.10 Cmn 15 , 3Q.3 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection. fore , ` Inspector Signature . . Date d ne copy of this _csKr .ification -must be provided to the OWNER, the BUYER "( where applicable ) and the BOARD OF 11RAVI'II, *, If the inspection FAILED, th'p ownor or operator. shall. upgrado ' tha vyetem wiChin one year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 15•, 306 , partd .do fC TOWN OF BARNSTLE LOCATION' 9, K k4j6e Al.ems' SEWAGE # 200" 7620 VILLAGE /,IRSMA)l ,h'&> ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ZV4KIAW 7-5n-eF,19/ SEPTIC TANK CAPACITY /520 67e L LEACHING FACILITY: (type) ZMLt /. (size) 1®2 NO. OF BEDROOMS 3 BUILDER OR OWNER4�/U� ZZ 0 PERMTTDATE: ZZ ^7'®0 COMPLIANCE DATE: Separation Distance Between p et een the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /V Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) %cS?> Feet Edge of Wetland and Leaching Facility(If any wetlands exist _ within 300 feet of leaching facility) _ Feet Furnished by Iq 5C- 6/ed7/ f b2 • oZ ,a 3 .3 /o2o No. � =� Fee�� / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Iles PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplication for lh5pooar *p6tem Conotruction Permit Application for a Permit to Construct(,4)Repair( )Upgrade( )Abandon XComplete System ❑Individual Components Location Address or Lot No. V 2 e-61 & -T Owner's Name,Address and Tel.No. , . / 4- 0 Assessor's Map/Parcel bQfY�f � Installer's Name,A, ress,aftj Tel.No. 60Q_tea o -9L/7.I Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size 77sq.ft. Garbage Grinder Other Type of Building N-vw4t No.of Persons ?i Showers Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 3 V/ gallons. Plan Date / : Number of sheets I Revision Date Title S e-,W44 ," S Size of Septic Tank / ,S'o U Type of S.A. i Description of Soil „� %G �-1 / K / Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and nItoce the system in operation until a Certifi- cate of Compliance has bee ' ued by this Bo o Health. Signed Date 4 Application Approved b Date zZd Application Disapproved for the following reasons Permit No. '`_ /j}v !� Date Issued �®` 1 • �Z .Af. Ya^L.la1 � w I � .�i1 . '++wrw�� I ,� R 77 Fee P �+ly /]J •fir._ l., j \ THE,COMMONWEALTH OF MASSACHUSETTS Entered in computer.- Tes 1 % PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppfication for Digogal *pg tm`Con!5tru-ction Permit _Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) Complete System Individu Components . r Location Address or Lot No `-t��� rt - _i ♦ i j ;. Owner's Name,Address and Tel.No. S P o- Assessor's Map/Parcel / fQ d e L J Installer's Name,A ress, d Tel.No. 6,9 w p- a.I Designer's Name,Address and Tel.No. o� 3 -fu=/, ° � GvG`.�j' %i�iP'•waGr<� Is.�y o �6��' Type of Building: Dwelling No.of Bedrooms 31 Lot Size 72sq.ft. Garbage Grinder(/*1V Other Type of Building 140"oc No.of Persons 1- Showers(Z ) Cafeteria( )' \ Other Fixtures "• Design Flow gallons per day. Calculated daily flow 31// gallons. -Plan Date r/ ? S- '59 Number of sheets / Revision Date Title . e4,W 6<E S ` 4'k a EF5 Qoe /e-, Size of Septic Tank / 5 ©O Type of S.A. Description of Soil �� /�' 111:VG I y ;y, Nature of Repairs or Alterations(Answer when applicable) t ` r '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 no to ace the system in operation until.a Certifi- cate of Compliance has bee =sued by this Bo o Health. Signed Date Application Approved b Dates Application Disapproved for the following reasons Permit No re..- " i Date Issued w ------�---- t S , THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS ` Certificate of Compliance THIS IS TO'CERTIFY;,that the On-site Sewage Disposal System Constructed e )Repaired( )Upgraded Abandoned( )by �- at 2(V � b w .' has been constructed in accordance with the protons o Se 5 and the for Disposal System Construction Permit l r9 0- 41ciated Installer •✓ .6 _1'�/.�r��' ��'�-� , Designer The issuance of tl}is permit shall not be construed as a guarantee that the s�stedi will function as des}gned. (� Date J 13 1 O i Inspector l ————— -- ..-�.. ------------------------------- � ,.y s No. i / i ' .6r C" Fee! '►" THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwisspool bpotem Conotruction Permit Permission is hereby granted to Construct(X)Repair( , Upgrade( don( ) f System located at and as described in the above Application for Disposal System Construction Permit. 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I I I 0 , �� ",",�,�" , , , I I - I NOTES: 1_SEPT1C TANK SHALL BE STEEL . - . I I 0 0 1 0 0057000 o ,,,, ,�� " .- I � I .1 I I I . 0 1 � I ,��- - - � , -�,!,: ,!.,�,�,,, "" ,.: I I I I � SCHED. 40 PVC OR CAST-IN-PLACE CONCRETE, I 0 0 ",I , I , " , I I I I GRD. EL:�.57.8, - GRD. EL. 58-94' * . REINFORCED CONCRETE. , I I I Q I I I I I I . I � I . 11,� " 11 I 11 I I 4 I - REmOVABLE� , - I � 1, ,�.:i�' %:, I - , I � � I I 1 040 1 1 1 1 1 1�� �, , �� I I I �1, � I I . I � I I - TEES TO BE �CENTERED UNDER MANHOLE COVER. I -1 � 2" WALLS 0 1 , I . 11�� I �� -, , I I � � � 11 I .1 I -1 � 0 0 I � 11 11 � I I , lj: I , I ,GW. -EL., : 00 � N/A , I � I I 11 � , , 1 NOTES- � ,;�,%`,%�,, � � op" N/A .' � -GW. EL..,� � � , 1 2. SEPTIC, TANKJO WITHSTAND H 10 LOADING co I � � I 1 4 UNITS 0 1 t — — , I � �L I � I , UNLESS UNDER PAVEMENT,� DRIVES OR I I I I � I I I 11 I � I I I I''. ,"_,:',� I , "I�1. . �1. 'I, , , . I . . I I - ''I � I ��, I 1� I I �, ,*, , , , � . - `� -` " I . . � I I I ING HIGH DENSITY 0 50" l2s 1 1 , �, " I ,� ,,,, .,- 7� , ," ',�r�-11,,�,,-�� I ,;��!,r ,,, ����,,�,-��',,'��,,�,.t��",.�,':�.,,� I I I ..-q..�V:.*-4�.q.'�:.',%�.�.;.,.'If,�.,". 0 "I "�,, , , 1., . � �� ,,,�!." ",,�,,,,, ��11 _`�,:�n_i�,,;'� "`�,�,-,��!I I I , - 1. . I -. �. ", . I ' - O� Fil 2w 0 � � I -0 11�-�,�",f�',:,�,--��`�,� ",�,,�,`:*,,',,-',�,', �', �� I p ,-, -- -:'-,'--,`�,--�, �� I I 1 ' 20 IS REQUIRED. I PVC RAMER 4" P VC 00 POLYETHYLENE INFILTRATOR 300 0 c I I � �,�,,, _ 11 _ � _,, ,�,�� 7 � 1. DIST. BOX TO WITHSTAND H-10 LOAD ,�,�,,' � " - I I TRAVELLED .WAYS VMERE.H I � ,,�� _ 1; �L � 11'1111,1,,��,, - -- " I I I I I I � . I I I I , I , . I L 111:",��, � � ��':,��,,',,�:,;�.A� LOAM 10YR 5/5 � I I I I . 0 1 � , � " , -, , I � '' , , I I 1 3. ALL PIPE CONNECTIONS AND CONCRETE I . 0 1 — I — � I , , , . �11 - ` � ��,� -��, � I , _�,,,'-�,,o,, ,1� " � I 1. I . 11 , "I SANDY LOAM 10YR 5/4 �. ,,, ," q;,,,�",:,'_ I TRAVEI ED WAYS WHEREIN H-20 LOADING PIPE 0 �� -, .�,�� ,� _11 I �� ,�, "�, �,-,�- _, , '' 11 �, -11, , 0 1 1 . ,Ap- I I , I � ��� . ,I , �,� ,. � 1 2, - �,,,�-�,�, _.";, I I I - - -- 0 0 -Z -0 0 000 0 . � I I � ,-� �-,,� 4 , 1 � ' "' , ,�� 1 2-24" DIA I 0 00 000 , I I I �, ,�;�"O�" ,� , ", I I I I C I - ,, " �, , " I �', �,,�.i�:,', ," I I o o 000 0 00000�O * 0 �'ill 11 __� -,';'�.',,�, -, ��...;" i: W/ METAL HANDLES BROUGHT on g 0 Q , (> . , 11 , " 1"", 11. I ' ' ,, ' opo 0 ) �,-,-- � ,11, I I I.� 1- 1 I , �"1,111_�111_1., , I - T o 00 0 o 00 00 60 0 0 , , "". . �, .!:��,,`�'�,',`" 1, � - I � � 7""��":� ".1 I I - I [ ='��,� ,,,,;,��, 1 ,�',�:�-,-�,,,,'�,',,�,',,���:"f"�,,�""-"""��,�,�,,�����I I I I I . . I UNLESS UNDER PAVEMENT, DRIVES OR �,"I I I 1 - �;�,��,--,��-,,-,����:;,�'r,,,�,-��',,�,�;,�,�"""�'-,,;,'-�;',� , - I. , ,v . ''. I , ,,,�:�-��_' , �,, ; I , ," I A �' SANDY CONSTRUCTION SHALL BE WATERTIGHT. CONCRETE MANHOLES t 0 1�I 0 1 1 1 " I 0 � _ � 1, . _ - , - , . , , ; , � , . I , �,, �'��,,�, I �� " ,%� " . -I, , , , " � 4. FILL ALL UNUSED KNOCKOUTS WITH , TO 6" OF FINISH GRADE— I . .� " : �,� I , '. -.2 1 - -1 ` ��� 11 " _ , - - I'll .,�, _($�, 15" 1 1 , 2" - 1� I t _ , _ I - , i,� I � �,', ,�-,�-,�,,," � 1 � � T . I GENERAL NOTES: I .� . , ,�, , � , ,� 1. I'll . I -1 :�, 11 I I , - '' , . ,� I ,�, � '� I ., 1. I I � ,,, , � � � . I 11 " I I I - . , 11 , � -�,�11',�� .11, I—- 30, ,,,� j . 1, - 1, _1 . - , I . I I . I � .. , 1:, , , I',"'� I '360 ,� , , �......�' ' I I I NISH .GRADE I , 1. 80 2. PROVIDE INLET TEE OR BAFFLE WHERE I I 1, ,1:"r'-,".- " ",, I "I ,� I I I � , - I I 1. I I e I - , � � 1 3'�- , , - . , 11 34" � I I I - 34' �. , �-, �_ '. . "'"', 1, "'. . F1 t* 5,5* OUTLETS I . �' " . I .. � � 1_�, I � ".,Z',�, '�;,,,�,, ; � I I I I 1. THIS PLAN IS FOR DESIGN AND I , I �, � . : �, _ _ � I- � - I WAMWOZ I � � I I , __ I ,,,,L��,' I I . 1141 mot-pl.'AR , - SLOPE OF PIPE EXCEEDS 0.08 FT./FT OR I .1 ��", "", 4 , , , CHING CHAMBERS CONSTRUCTION OF THE'SEWAGE I , , ,., '' I I , " �� 11 . I I " I � ;, ""� � I ,�',�",-" -, , I I -_ I PLAN MEW - LEA , � -_�',�13 �,�,',;,�-",,,�,,",".',S��,,",,""����",�",'��--�"-�,�"": � " I TO B ER- . IN PUMPED SYSTEM. I _�" ,," ,LOAMY SAND 10YR 5/6 LOAMY SAND IOYR 5/6 11 , ,., ��� . me_ � I ,, _�,:: - - ' !'.�_ v -'' ,. , " - I I -r " I I � I I , '. I I � I -1 4 rV.C:6 4 , " a "0,�� �, , 4� 1 I ,�,, �.'�. 11'�, '. I � I I "� .N Ll,t ,* .4 , �. , , 4' _ 4 4*- 1 , � 50 , TEE ON DISPOSAL FACILITY ONLY. , - , __ I- I � I .11 8" 1 ,�_ QS _ , � 1. I - � M.H. OPENING,�, 12* MIN. - S" ti M . � I 1 �' , III 1' EL -53.81 EL = 54.9' � I I W , 111-- , ��:", I I I I I I I I I u I �`, - 11 I 11 I I I I . - � I �I I I COVER 4. 1 ", — - 2w 3. FIRST TWO FEET OF PIPE OUT OF DIST. 1 2. AH CONSTRUCTION METHODS AND ,�� ��-�,� I . 1 :' I � I - I JW I UA UN I t VLL LOAM & SEED DISTURBED AREAS 11� �I 4� � I - "I 1 51 1 . 5p- � I RAISE M.H W/_.�. f I I I 1 6" 1 ,�, , � , , 10$ � MIN. 3/4- TO BOX TO BE LAID LEVEL. MATERIALS SHALL CONFORM TO MASS. , ", , , - _c. -- _� I , . , I . I ) SEWER BRICK .. . i! 16 I I � -STABLE,.,BASE ,11111111�rllllll,,rlllll777171771717111.;"-IlII717177,-///// ': � . . - , Fig lol: .'. ' .. I I 1 . . D.E.P T17LE 5 AND,LOCALBOARD �. ,'I, I I � 1. 11 I . . .: "MI ��',_�,;;,� ";,-, . ,I � � .,, c . : .t-.;--�l 1 1/2- CRUSHED q,� 1. � I I � : C , , , I I I & MORTAR �.* I V �, � I : � 1 MED. SAND 2.5YR 7/4 1 , , - 10. , I CROSS-SECTION 4. ALL,PIPE CON OF HEALTH REGULATIONS. ", _,�I I� I . 6p - � 1, I 1 MED. SAND 2.5YR 6/4 6'_ 1 _11r I - .!,� STONE BASE 3' MAX. C PACTED FILL 36" MAXIMUM, 12 1 M I 11 1',�-, 11 I . � � . I I I � � I- - . JcL I 12" _ I I I I I �. �4, �,�, I � 68" 1 : r' 1 1 NORMAL WATER t E) I -- CONSTRUCTION SHALL BE WATERTIGHT. -_ 0 0 0 0 0 0 000 0 0 0 0 0 3. ALL PIPES LOCATED UNDER PAVEMEN �� .1 I I I P_ . I I .;., 11 I . i ;k. I I I I I I � v ,-17":1� 7 �.:I- , ,I � � 7*- ! I � 7 _T_1z_j_ I I e& it f;_ 3. 1 -. 5. FILL ALL WI MORTAR. I 0 0 000 0 0 3" LAYER OR 'TRAVELED WAY,SHALL BE SCHEDULE �, I � I ' ;9 ,C� = , PEASTONE ",_ I . � Z , 0 HIG i 000 0 40 OR EQUAL. I � I I !� � I _',!�, I 1 PRECAST SEPTIC TANK � : I I � 000 I I � �__� I i�l I 89 I .. I — �, � 10 I'd 0, I I 11 - 4'- '/2" .4 1 1 1 � I � I ''I 1 '8p- 84"' 11 85 INLET TEE I I '990 30 1 1 DENS TY 0 0 :,,� -1, �, � I I - . 1 24 POLYETH NE 1 4. THERE ARE NO KNOWN PRIVATE WELLS I , - ,! 1 C2 � MED. FINE SAND 2.5YR 6/4 C MED. FINE SAND 2.5YR 6/4 1 , � - ' ' r ' 0 0 YLE 0 LOCATED WITHIN.150 FT. OF THE � , I �i,";�' ��%� -1 � , ,� _j T I , � Cb I I 1, 1, � I ,� � I .. I . . ... 10 1 14" H 11�0 11 I" 'I, *.e 1 30" 1 1 '' � . 11 I I ',",'�'� t � I I I - I u 0 1 1 ,,� - � ::1 -,, .,, ��, - - 9t-_: 2 - r N _� EFFEC. , INFILTRATOR 3050 -00 � I �, - , I 91- -6* - MIN. I ��" I . los" 110" I � V-2 ._1 5#-e 00 0-1 PROPOSED LEACHING FACILITY NOR I . � � 4' �. P�,� ;, ' ' I � I I I I �'- 4'-O w OEM ON .&: 0 , I . 1 I � - " %00 LEACHING ANY,KNOWN WELLS PROPOSED WITHIN � , � c LET -J 151/2' ) DEPTH I I - ". I lot I . TH- - �, - 11 11 - I - 5 `.- � �; CHAM 0 . 6 �. ,'' t I - � . V-8 , z :* UQUID DEP 'S COMM) .0 . , i I ��1_1 . 1, 1. - I . c 3 )(D c_ , rGA BER. 150' OF ANY KNOWN LEACHING FACILITY. �",�'�,1�, ,� , I ,lol- c , (D . PRECAST DIST. t --, X/1-11 ,I I ,. ' ' l I! I I I �� 1 1,4, .1 I .. I --, -�,/,/z,�,--,--,/�//-"--,-,z T1 I I - - ,1,li��, I 11 ", , I � . I I 1 3 1 1 1 1 :. I I 1 5. WITHIN LIMIT OF-EXCAVA ON REMOVE, 1 I - , $ 1 � .; :a- � I Box 1 1 1 1 ,I , ,, ; - I I lip I . I I I - ���� 3/4- - 1 1/2- 1 1 � I I I �� I 1�;,, ,I I 11 I MED. COARSE - MED. COARSE I � i " .. I - I — ALL TOPSOIL,, SUBSOIL AND OTHER I I,,,, , 1, I 11 - I 11 I . - I ,;. 1 _2t . 1. . 47", 1 = � . I ,-,,�,,,, " I I � i I I I - 50" 47" WASHED STONE 11 I : f I � - . I - � I I " , I . I I "I -- ,*-. -�<: :.i � - - _T_\ IMPERVIOUS MATERIAL I , ' ' , � , I I . 1 f ,e * . ,:: ,.�:t-. , I / I '_ �,�, ,I 11 I �, w : � 1 SAND,2.5YR 6/4 � r__1 -+._: !*.%-:'�i�'-.----,��,,t-.-.-- - I I d!:= 4:1-N - I , �. I I . � I I I I I � � I � AM I I I __. .. 0 - I /4 � . . 12$ . � I " I � -I�, I'll �I , I., -, "'. , I - :� I I I 11 I I � z � so %V:,;�, 31 1 1 ]7 / I - � 1 6. REPLACEWITH CLEAN'WASHED SAND � � ' . " , 12 - 1 1 , , � �,I ,,� 11,21 TTOM ON LEVEL,STABLE BASE . I 1 ' - 11 , . I ,,�_,_, 1, . I . - 11 ,� � � I I I I I I . . I I I - � , � I � I I I I I . 11. I " . I � �� I . I ,. . " I , 7 1 I ,1 .1 , -,I I I I I PLAN VIEW ' I- 1 I 10�_!v4_y1%1_1_ I I I 11 I I OR OTHER CLEAN GRANULAR SOILS, I I I I J,"�-'. , ly,;, . � I I , ,I�i 1 13*-I EL . I I I - L 6" MIN. -1/4" TO_ � I ' I� -SECTION OF CH8 .I I _ �1 �t,�, " , , I , � EL = 44.3' " �= 45.4' 1 � . 1 I - CROSS-SEC11ON: VIEW I I I I ; ,. PLAN .MEW � � �aROSS MBER CONFORMING TO THE FOLLOWING I .11 , ` ' ' �1� " I � I - I � 162 ' 166" . I I _� I I 1/2* STONE - � . I I I I I I � I I 1, I I I. ,�� 1, ,. I , I � . - . I I I - V- I ,,, ",,.�, . I I" . ' , I I 11 SIEVE ANALYSIS: I I I 1� L �,, ,, � I I I a I � I I � I . I �. � � I DATE:- � DATE: I _ I I I "''I I 11 1� -- , I I 11 - I I I . - I I �� I I 10% (MAX) BY WT. SHALL 1� I ��,_: _�, - I � I � �9/28/00 I 1 9/28/00 INDICATES ' I BENCHMARK I I I . I I. , I �, .�J,1, I I I . . � I I " of � . � I 11 PASS No. 50 11 SIEVE I I � I I '��' , , - I I - I I . . I I I v OBSERVED I I . I 0- I I TOP OFSTAKE I ' I 1 I - 11 "'�, ,�,�'11 1. I I I I I I � 0 1 1 ..e . , I TEST BY.e 11 � TEST BY: _1L__ I c _NSTRUCTION NOTES: <1 0 X OF,No. 4 SIEVE SHALL I I I I I 11" �z � I I ,�� - � GROUND WATER - I � 'm I I . I , - , I � � I I � ' t L� 4 I I I ",�,�-,� � I I I ��THE ,BSC GROUP, INC. THE BSC' GROUP, INC. I I I . . >_- \�.,, AND NAIL ELEV � PASS No. 100 , � 1, 1, I " DESIGN CRITERIA: 11 , , . I I � I I ct:I I - . -58.00' , I . - <5 % OF No. 4 SIEVE SHALL " ,�'' � : , � I � I , , 'k , I I I � . * I ,, � - I �, I �.---�_�. LENGTH OF DRIV(EWAY 560'± 1 1 1 1 � , I � �v ,,�, � _ - - I I ...I. � ''�,Ijt_ . � I . I WITNESSED BY: WITNESSED BY. � . I . - , in:�-, ___ 1 I, ,_1 , I- 1. ..,. -�. I PASS No. 200 1 "� ,- I - I I ",__ '. � .� I I I I I .... LENGTH OF PERIIMETER FENCE 1060'± P��S17GN FLOW:I I I LAJ 1! � I ��.I., I I DONNA MtORANDI . INDICATES I , m I- . I , ,\ ,- 111 .1 I ..01 --� I I 1'1�,'"_,'_ " _ I DONNA MIORANDI I I -, I I �, 11� I .01 .I*% UNIFORMITY COEFFICIENT 0 No, 4 1 1 ,q,N � . � - . ,. � . 1, I . LENGTH OF DIVIDING FENCE lgo"± I , I v ESTIMATED . /-.,z - ' . I I 1, .01 . BEDROOMS AT110G.P.B. 330 G.P.D. SIEVE </=6.0 1 1". I" � I **% �.� I , -1 'j- . '1� I PERC. ,RATE: . PERC. RATE: - SEASONAL HIGH I , � <1 ,"- I,- 11 I �-- .- ,. ,_ - - , I-1 "! I_. 111� '00. . 3 /D � . - I:",, . I I " � I - � �I - � � ,, I . I ,,, . I . �_ _.—_.'. . 111 I � - - I - � ,,�; _11- 7 1 1 - I 1 . � I I GROUND WATER � i Q.L . __', - , � - �.- ..".'.. 7. EXISTING UTILITIES MERE SHOWN � I 11, I I " ,I - � �11 � I 1. "� L, . IN THE DRAWINGS ARE,APPROXIMATE. ., 11 , � I I I I , X .� I , . I 1. , ''11, I I'll,� I I I i 2 MIN,/INCH N ILA MIN./INCH I i I I- ____I I� , T k - -1- .- I .0001, . -_. **.%. LENGTH'S SHOWTA ARE APPROXIMATE, � I . I " � I x � r %-� I I . � --... . . '. . I �, - I� ,-,� I . ) -, " . . . ,-ft. N. � .. - - �_ I . .�I 1_� I I � I I I I I " I _ 11". _..,I �-1 - _ 11 1, -,_.I-, . 11_ , .0* � -11, "' " :�- 11%..*-. . TO 13E CONFIRMED BY CONTRACTOR'S. THE CONTRACTOR SHALL BE RESF�'ON I I I� . I �_e �I - - I to 0 � -4,5 - - % , �' ,_ t� 10.0 I , ,- ,� SOIL EVALUATOR SOIL EVALUATOR 12- __,�. , - ,c� " - ,- 0 1 'I, I . 11�_..�, I " , , ,�B �--P_�.,,6io, . \. CATING AND � ., .11 ,� I I L � I C. FIELD . m I 1! ., * I.. _ I I .. /.�-* I " �, C-50 , IREQUIRED SEPTIC TANK:1 SIBLE FOR PROPERLY Lo I 1.� '.�jl,', I C. RELD , INDICATES � ix- , /11 - �'__ - ,, ,-- - - . I � I , I 1 2."a 1 I �,,a�l I I I ,'WE, ''. -,_-�A i-- " 1 18, '' ,%N. \ = COORDINATING THE PROPOSED CON- . .I�I"I I . - I I I ., L, , . Z77- _17!.7� .. ' - ' � I I � I 11.1� , . �; I ''I ,� I I 1, PERC. . >_ i I u--, ',- ,,, - � _-, N I �, �, 660 GAL. 3AFE 11 I � :" 'L ,�I . I SOIL C ; � - I—, t - - ". �-__� - V' -i, 1,1, , ' ' , �l 1,7 3"�,, ,, " , I I I 1, . ,� \ sTRuc,nON ACTIVITY WITH DtG-S I� ,`-, , " , I SOIL CLASS- LASS: I - I �,,;.* - , � 11 , " � I _ 1 I TEST I I af � I I �� - *_1- - */ - - I L I I I I � I . : � 1''. 11 _ I I 11 I $ , I DR ", - -- .. .. I ,�, I I 1, . I SEPTIC TANK PROVIDED: = 1500 AL. AND THE APPLICABLE UTILITY I � I � 1Y 1'� , 1 - . ai I �, 00- .11 � I I ,I 1. ,It I I ,� \ �,_, 11 .1 COMPANY AND MAINTAINING THE I j , , "" , . . , � . -, �� I . 1� - �. . I � I lv� , 'I� - - r - --, . 11 I I I . I , . I I I . . I I _�,e , I I . INDICATES Im / t - I � "I UMIT " - 57.0 -'1_ ___1 . - I - I . , , t, I I � ", , , �!� I I z 0- , I - . I I I \ ��, , \ EXISTING UTILITY SYSTEM IN SERVICE. �, I -1 I I � I I I % I I '':' , I � , .,, �, I � " , I � 11 I I � � . . I" . _ �11 � �. . VA I , � !PRO � I � I DIG-SAFE S14ALL BE NOTIFIED PER 11 , I � � L!T.A.R. L.T.A.R. El UNSUITABLE I < I � 0 t 1, 0 I ,-) , EXCAVA"()N � ./- _ I . , 11 . � I � � , I I � -I— I , ". . , I ", � I ft: I T_ - 1, . -11, , I i - � \ \ , I I - I 1 0.74 G.P.D./SQ,FT. MATERIAL � � 1� � I .� 57.2 . I , I I I , . I . --I'- . I I ", I THE STATE OF MASSACHUSETTS �,�,, . . -0.74 G.P.D./SQ.FT. 0 � EXISTING '-� - ") I ,/ \ 11 3'BEC . 1 \ I I , 1�I I . / I ISIZE OF LEACHING FACILITY REQUI I I ,�� , -�, - . I A ,_ i , I I ' � ,, . ,, 11. I x-, I . STATUTE CHAPTER 82, SECTION 409 1 1 - I , .�,,,� I . , � � I to I I; WELL ',,,, ,�,- .-vil I 1, 1`11� . .9. - ,-,-- \ � I DWEL \ , , N,o �� , I 11 . � . . , " .1 I ., <2 1 � I I I I I I I I * , I 1411.11, I I ,�, � I I _cv I � ". -soc . / - I\ � ', I \ -, I DESIGN PERC. RATE: MIN./ INCH . THE '' .11 . I I � - I * . z I I I 1 I - T.O.F., \ , %- 1, I .. �, 11 I . . 11 11 I . I . .. �l, I I I I I , . � \ \ I - , ,. \ ENGINEER DOES NOT GUARANTEE ,,,, I , v I � I I I I I 1, - �, I . F= k , 1� I A"M%t^ C" .A � 10, I I � 1� " , , I . I I ol � I' ll DATUM, \ _�� 12'x34",S % i - 9.0, *0 L '' . I I � \ I 1''.v � I I I - I /) ,� �N, I , , I ,� '' , "I'll I � I I , LONG TERM APPL. RATE 0,74 THEIR ACCURACY OR THATALL 111%, ,�;, - I I I I I L . I � �,� I �. 1� � 'I, .� I N - � �, I I I n I I �. .1x I I .1 . . I - , � ,, \ �11 -1 I , ,�� "I " � " " ; ,-' , I I . MRFACE STRUCTURES I 1 ,,, I 1,- �.� -1 I 'ERTICAL. DATUM: w I I / 11 _ - ,� / I I .1 I , � \ I . UTILITIES AND SU I I �, �V NSTABLE GIS DATUM. I - � * I � � I � I I , I � � "'. �: : I I I I - ( 1 , I , ONS AND A,�, , ,�_ 1 . � �, � � � I I : I I SYSTEM (S.A.S.) /,, ; I _ ,,,-� .1 I "I - . I" .I - ,,�, I 1"e, i I I I - � ",11 �� I "�j I I . , 5 -0 1 �.. . 1-1 " I I ,� .1 w I ,, I I I .", ARE SHOWN. LOCATI I I � - I I ,, 11 �J . I _ ; ,� I I . , �1_ I � ��, �, 'I., I � I .,�, . OUND UTILITIES ��., �, �w I � I ,BENCH MARK SET: TOP OF STAKE & NAIL - EL. 58.00 � I I . I - � , /L ,; 11 � .0* SF = 446 S.F. I . ��4111' *_-1`-1 I 1 I . .I 4 , � , I I � I � I I - 11 , ;I , 1 1, - G11 �-1 11� �I-_,�----- I �1 . I �"I " 1". " I � I .I / � llz� I I ELEVATIONS OF. UNDERGR - ' � I ,,,, . � I I � . �, , . I I I , . I � 11 11 � � I I � . � I I I 11 I L I - . / 'NK _ M - ,- I I I , "?, ..- / I � 1, � I TAKEN FROM RECORD PLANS., THE I L I . . I � 4 11*1�1 I ,,, 11 : I 1: "L _� '' � ' -, Im " � 01 . I CONTRACTOR,SHALL VERIFY SIZE, ,�" � I I I I I I I I Tj __ - , - , � i \ , - - , � I I I '. - I, I � I "I � I -I I. I � I L I , - I I I /� -D- -' "' ,� � '. . � . , ", * I I , I I _ I I . i I � , � I _11.�- . -1_-, .." I ",_ �I I -1 - N I .I I � I � . ' I � I . - �, �� �,, �, I %11.. -.1 " ,� F LEACHING FACILITY PROVIDED:1 LOCA71ON -AND INVERTS OF UTILITIES I �- ,";,, - ]�� � ,, .I I I 11 � I ,�, I I , " BOX "i -�' -.-- I- I I ,�, "Ill "- -� - I � I I I � - , _,�, , ' ' , � I � I - I : , #1 �% i , -41 � , , I 1 , �e " - � , - ,, 'r ,� � " I - �, " I � I PROFILE: , NOT TO SCALE � _', . �_ � '', I "_� I � . I - I " I, L I _ . , I I I I I I "'; I l-, I t � � i I '. , I � I , I" 1�I �, , � I ' .11 I I It, AND STRUCTURES'AS REQUIRED PRIOR : , I" I �. I - . , I , I 1,�,L I _11 I ,_ ,� I 11- I I I I 1 . I I � I � , I/ I i��,17 ' , * I I 1111111,1111 I- ,, I -� / 1 - "I �- .� '. ' '. , . I 1, ,:�_� I'll, I I ," � I I I I I I � I I . I I I " , 1�� I , .1w ,,L 'I., . �, . 1 I I I 11 � I I . I � I I I 'If - � I I � -I- __', - I I ,�j , "I I11 , V1 .��� . I " , I". I __ . ," �', _011 'TO THE START OF CONSTRUCTION. I 1, I I I I - . I . 11 I � I - I , I Ir, I - � � ,� I " � USE HIGH DENSITY P � . _ - I I I L I I 1�, " 1� I I I I I � . � I 1� 14V - i � , - / . i ,� , � ��` 11'1�;, I I I 1, I EL='A- I � I I I I , I 1 . . I :: c S "" � �, Ire, N I I I I 1, ,�, I 1. ., I ,, � .,� � I I I � I I � I � - / - � I � . ., ,i S, , 00MO ED, I ,�, "-, I"' � I . � ' -` � � ,� 1. I L I : _,"': � I � I I I I ,I � I I I I /- FIRST PIPE LENGTH I I I ey� ,-If 11�' ",,�,,,P'IR i I I I _1 , t � "" � . I - ,71 I i. I / -12 � - ' ' ' '- . I � � I �, I i I TP#2 I . ROP. S(4 UNITS), 12'X2'X34' , 11 I . _: I�;_ ,I .1,� I � .: /TdP TOUNDATION � I I � . � � -11 � I . L �, v ,03, 1 1 -11 ,,F' , . . , . I . 11 1,- . I 11.1, . - I� , 11 I � 11 . -TO WITHIN 10 BE SET LEVEL 11 I I � 1 zr ,� 1 56ft , � .VtLL*' - � �_ _', ,�, . I 8. ,THIS SYSTEWAS,NOT DESIGNED FOR . 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J:, le .cz-I I I I : ,EXIS �� I - I, ,� - 1, I ", , I I , � �, � '! � ,, - , I - ZNIZED I _. 'ill � �_ � , ., "e,, - I 11 � I I I ' � EL=57.2 . I - ''I 0 ) I 1, / , _.�� � I ,. . , - ,�11 , _", I �', - = I RECOM MENDE , P ''I .1 111'�� -11 � I I I � I I I : , 1 " , . . , D,DUL TO RECOG I � - -,,� , I 11 � " " I - �'. ,� , , . , "�" ,��, .� I 1� I �, I � � - , � � . � , � , , , L . ,,�WLLL � , �- _z.-kf-'\ � I— �, , " VbTfOM , = , 12' X, 3 4' ____ 408 , �- I I I -.-- ;.- -E,impAcls JU ,jHL ILEACHING ,- . L� I -I _,,� 1, 'I, 1: I - 1, , 11 � I . - � I I I I I . 4* PVC I � I - I , 11 " . I I " I I I , " . '1� . � _ ___ - -1 I -_ _ I I ,��. " I v � . I I I I . - I :1� ��/ ,. I - *171k �� I I -.----,, -___ . � I I Au;ERS I � , I � � I � , , � I I I,,, I I I ,,�� %,.� I .� 1, ". I 11 , - .111* ,_�_�" . I � �_ � . I 1�1 ,i ! I I I --I I , , " ,_ _ - 59ds,I . 1 FACILITY.,�,--�;, `� , I � 1". � I � . 11 , I . � I .I /_ - I I I I - I . - . ,;- ", � I � � I I 11, �_ " I . , I - ! , I I � . ,�,, �-',� , I '! ' 'I , I- "w ?_�b �__ I 1, I �, 11 . 1� I � -0" "', � . or-, 1� I I � I I � I "1,:1 I " � 11 - I 'Ipl� , I I I I � V. � � I ,� � I I I i I I I � I I I I 11 I I "� " I � I : 1�_/ , z � ..,LEACHING CHAMBER I 11 I I �'.- / I le", ""' . 1.4_/ 01 - - _��1�.� , I I 11 . I I I � �, 11 I . 4' k . � 11- I I � I 11 � I . I I �. I � I ;, �111 � , ." I I � M__m r , -1 ,. I ' 'I'll �, � ''t , - ;, �-" �: : � , , , I 1,� , � ,� I I , �SCH I ;1 I - " :_:��<E-X STIN'd', : " ��, \ ,_ -,,I (14i 11__�__t � I I I �, -'r� ,�. , -,, 1 * 67"0 I ,� . , - ,- �., , ;, -,�,, 11 , ' ' I , , I 11 I , , "I ' I � ., I I � - , - I � 11 ,- . I � 1� I 1� 11 I A " I I ., I . 1, � � " _ , , z .1, � , I I , I I I ''.1 ,�� � .1 I , I ---I_ � I "' . r, I / �� I ', �. � - 000 _ _ I , I Bi , - , 'IV I 11 i I 1 * " -2 ,S',F x 0.74 GPD/SF - �. -I.. .1 - - , � �1 ,:! : I I . I �'11 . - " , . , j, � � ,L-f I �00 ��_� I C ��rll� I . � � .0 ,, . 59 1 D ' � - I , I I "I i I I I ,_v ',�, I I I � 1-11 . 1 "'' Ill �tll - �J,0'1 I-, � .11 , 11 1��, -_1, % , ',� , ,'', '' . , � �', I � I . - **% , I �� <p� � I I -BLE , �\ ! I I . - I:t - 1- ,,, � -� , ". I . � �,, : I I I � 11 �% I 1 Z2 Jtv- , . _____ : , J / = 438GP ' - � I , � !, 11 Il .1 I I - r 11 . � " I � - ARN/STA * I ;. - I r � d I .� Y"' , � , , I I - . � . I ) )-, I . ,. I ,I �� . ,: 'I, 'I , ' ' I I I 1- , _., u s ut --.. . � I � "RUIN'S AND' , � / I � , I 1, , * j 1, � � -l- �,_ � , '' � I - 1- 11 �"I" ' 00: ,* , ,,." I I 11 � I e., � . 11 I .I=D, ,_� ,Oi�� , / ,cj . I I - -, LIN _, . " ;, I I I , -,-" , I� ,:� , 'I'll i`l 1�' . 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I .- y I , 1, I � Mt x , ; LOT 1 1 . � , / / 'BOTTOM = (12,*+1 X 34**+l) = 455S.F. - , * I - �I'll� .,� 11 : 1500 GALLON I I I / <-t I . I ,, ; � . IF I � I I I� * I 0 1 � : I . I 1 �1? � 11 , i ,1, 1:? - 0 1 1 .:"'.�. . I I lqz , ,\ ,I I � I ,� I, I I� 1��', I � ! . I �. I r , I I I 1�,�. , . I I 1, SEPTIC TANK � // 'I- " - . -11 'I � \ I / / I = I I I I I I - �"', I � 1 _---1,49 722± S.F. 1� , . . . . 455S,F x 0,75 GPD/SF 341 GPD 00 I �,,� ,,'' ! � I NO 013SERVED GROUNDWATER I I I p . I \o 1, � . \ I V. � I , � �, , I I I 6 STONE BASE .. � , . / I , :,�, ,. - ''. � ,� I � - ' �,,� .\ �w \ . /. �o - _ --- I _ I 11 I � � "I � � I I - - \ � I'll I , I I 11 I ., , 11q_ I I ,q C."', - I I I I J BOTTOM 'OF TEST HOLE '�_ ..- 3.44± ACRES , - -, ' I � - . //' C -Grr up,�_In �, " , 11 I I �,-,�,,,-, ��.� I I I � I I � I ., , I . � \ 7,� - --- - --- �, I - I 11 � is, I ( / . 0, ;e I I I I ,� � I - I I , \ '_1 I 11 :, , .,.- �I ., I I � - � I I � I 0.............. 1: SH. 36.02 11 . ' I I, . � �,,! � %1% � � 1111 -mv I 11 I - 1, , I ,- I : I � 1111111111111 V � : � .." ,10 .el c I LOCUS INFORMATION 1 E40 , I 11 ,��'. �, -1 I � I �.1 . � I I I le I I .� - /.,0� ' ' ." I . . I 1��� ' ' "I I 'I .111 , " I I , �N' ; , - 04 * I � . . * I / � . I 11 � . , '' '� I � **% lft44 . . I 11 �zi�,'� I ; .1_ I 0 11 ,� . 0.01 � �. �t`,:--` � ,� ; I INVERT ELEVATIONS I I I . � � , k1i",-1 , I I ,, � I ? I �* � t,, "��k.: �., _-%..'�% ."'. ,/ � I I I I I I I - . 11 � �.11,11"`-- " , I I � I � � *.% .1 I , , , . .0� � 1 , �_ � � � I I . � / t . i. � At- I - - . �, . .00' I � I � 1 , � !� � , I . 11 .� I � 11 I . � � ,_, ,� ': ----.—.— �� � I I— , �� , . ,, �. I I : I I � , -11 11. 1 � � p, ,1, . , , w, .,....-.__1 , 7 ROUTE,. 28,�, (UN-!T' 6) I I 1. , , � � � . I I j" . ,� . " I I �* .40" . "'�, I - I- I . � I , I � . � '' .� �, I I / , . I 1 I ., ID I � . � I " ,, , I -1 1, � I � I I � I " 1, I � I I , � � ., I I I'll, TOP OF FOUNDATION 58.0' A , � , 1, � 1, � "..- ," ..10* EST YARMOUTH, MA 02673 � � �,,�,� ,� I �_` , I I I I G '�- ......11,,,, � � , % , ,- %�, , � I I":,N':, N,,1� �% .1e* CURRENT OWNER: Ms DONNA RIGOUZZO I I . ".. I . I I � � I - , , ,-k%,,� I I I � . 1 .6 ., 11 I � �,, ,-.1 1;� � , - I . I - I . � � - �� � - . ,, 4 ,;� `/ i, I NNcvA_.", I . �. I I . � I I " _�� I ! 56.30' B 1�1 � ,u � ...��,k�, ,� 1% i . ��_� I I ",'- I � �,, ,I ,"� , , 1, � 50� '�o .w, . I . -8919 1 4" INVERT AT BUILDING CZ4 I � . I * ..... 11 1 I I � x -'k ,S'66 1, �, . / " � I ! � I - __. (508) 778 . . 1�� �f__ � . � I I I � � i , '',,,',.'�, '"�-_ .—. , . I , I . . I I � � I I ' ' I _ '7__> , . I 11 i � , � I , . PLAN REFERENCE: PLAN BOOK 461, PAGE 99 1 1 1 1 1 ", I � I � 4" INVERT AT SEPTIC TANK (IN) 54.30' C RN ��, I � � f : , � � I ' 'I -1-7--..2 1 `� 1 /11 � k I ? , I —_ ;,, I � I I . I ; e t :, , I " : � � I I " ___7 PLAN BOOK 501, PAGE 42 1 � I I �I � . - , , � � , .�� I . . � I I �___ I r I � I I g�",: I 'll � I I � I .�p �� - li , -1 �, t , , � � " ,,, ! ; .- ,� , f � "�I� � 1 4" INVERT AT SEPTIC TANK (OUT) 54.05' D � , � I I " I i , � � � � I .1 , � , ; : ) TITLE: 111- I I I � 11 � � i ,� , I PROJECT I I I- . - ; � i I , - ,. �,_ � I ( - - ' ' I. ! ' ' , I .� ;., I � � I I - I / ; � :� , I�1' : ", � EXISTING � ASSESSORS MAP: 45 � � I I _ , ' ' I 1. � :,:%,,,, � . . � 1 4" INVERT AT DIST. BOX (IN).' 53.96' E - 11 ,- 1. 11 I . I � I � I . 11 I I �1 I . ,,,,, - "', . I I Q1_ 11 I i , . I ! � � t HOUSE PARCEL: 12-1 , I I � I I �, I 11, , � _�, _1_1�, I . - ro "I I � � I � � I : � � I'll 11 �� 41t INVERT AT DIST. BOX (OUT) 53.79' F �, , , �, I " Z", - I � � � � � � I i I I � I �, I, - 11 �, , : I ! � ,�; I I � 1 "I", 11 _�_. I ,I I � I 11' ' I . � i i 1 � " I � I I f I __ - -11 " I .1 I � � F I kp- � -------- - " �_ " I � I , RESIDENTIAL ZONE: RF � , I _� . � I I . . . - I V�,�_ , I I PART OF " .. � 11 -1 - � ; , I 3 �� _______ SEWAGE DISPOSAL 11 ' "I'll � I " . . 11, . � 1, `-, � I I 11. I !'; I 1 � , . I 11 c'_ " � I I - � I �� 11 I ,� ,_" I ,/ ., ,� ! � t I :1 ? '� �', SETBACKS: FRONT 30' , , ---- - I , I I'll, I - 1 I I f I 1, '�_ LOT 1 /, , ,, -,.- � I I I . I - I I "I . 1 . I I i. �, I I I I I . � . �,� , , , I . I , 'I. I I SIDE 15' -" I "I m, INVERTS AT LEACHING FACILITY: /--_ / , � I I .1 " f - � , , i � 1. I SYSTEM DESIGN I I.— I ,,::I I � I I I ,�".�',.��1. 1�� io I I I - � �, 11-. 1, 11� 11 � . , I .1 � I I ,�, � , ry 11 " I REAR 15' 1 , 52,206± S.F / /�� I I . , , I � I - . . I 11 I I ", � -& -, I , - I -1 I I 11 I � I I I- I . I � I 4 11 �: I * / I-,_ " -�' 1, � I � I � I .1�- , � ,_-", � I �, I I I � �,7. 1 , , �, 1� " "�, ., ,,, , � I � " � . - , , , ,, .I I I C-) 1 4" INVERT AT BEGINNING DIVIDED OUT 11 . 1 I ,� - , I � ., , MINIMUM LOT SIZE: 43,560S.F. : . " I m I I I / , - " " , ��,I" ,5 , cn I , � . � ,"N I - ,,, ,� ,� I I ./ I � I . I I . I I . I , _�� , "" ,-:1t, . , , I . , , � , I �,�,, , OF LEACHING CHAMBER 53.7 4' G I , � 111� 1� I I < '' I ##1 5 J �', Im � � IN 1994 . , � , .�, , 11 � I,� ,� � , .C-- 11 I I 1, ' ' . . I I , I . I � I -, 1, I? j" 1�.r,�, ,- 1. � � . I I ��, " I �,�' I I I I I .1 1, .1. I . I I / , 11 - I , . I I I - ,,,�.�;, ,� , >1 . ELEVATION AT BOTTOM 11 .11 , "?I "I � ".1 � I � OVERLAY DISTRICT: CP (ZONEII) 91%O I� ml,� I - ,� , ". I - " I .1 _, .", _; I I -11, I I 1, I'll '., .'' I � 51.7' H I I ., . ,I � - I 11 11 I co -1 OF LEACHING CHAMBER � I I , � " 'e, � I b G R OAD �1 1"' , I _c) I I 1: I , I I I � I 11 �, I 11. I I � _,� cy) I 1 . I . I "I � ' '. 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CENTERVILLE, MA 02632 . I I �. I . . I - '..", ', ' n I 11 I I . � �,� - . ' ;I - �_ I _ �_ I o' ,� , � I i DRIVE I ",�, , I , � I . DATE: 12/5/00 , I I � ,� I � , I 11-1 - ,� . :;_, I - '�, I I'll - :�:''-_ , 1111 , I I I , 1, � ,:1, � 1�1,�,,� , '1� I 0- COMP /DESIGN: K. HEALY II, I :_ � . 11v:1.". � .' ' = . - 1 r4 ' - , ,. 1 2-1 1 I PLAN VIEW Q.,�_ ,�',, 11- ��, 1: I I CHECK, D. CRISPIN/L MACDONALD �, . . _1", �,, i I , "". !�, 1, 1� d, I , . I I Lj I .1 7 "'."', _ -, � � � - I I -, 11: - , 1: I - .0 FEET DRAWN:, K. HEALY � I I � 1� "I I cu � I SCALE, I' = 4 r:1 111. I �",� I> co - I '. ,'�, �,��, , ,�, _� , I I � � / pq FIELD: D. GAZZOLO' / J. McCARTIN ' 1, 11 i�.1,,, - :, 8 . I ,� ; I . 11 . " � I � � I ; I I I I I I �, ���� . I I I , 1� � -) � � I . I I " :, ,' li I 001 !-" I I �: � " ! i "r/I I I I I ,I , I I I I J.. , 1 I ,� I � I 1p - �I I N , 0 20 40 80 I FILE NO. 8215-ANR.DVIC ' � I , , I :� " I . - I ; 11 I I I I I . 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