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HomeMy WebLinkAbout1170 ROUTE 149 - Health 1170 ROUTE 149, MARSTONS MILLS A= 103 004 i k i i Town.of.BA -nstable P# / Department of Regulatory Services . , V grAB� : Public Health Division Date K 1639. tee$ 200 Main Street;Hyannis MA 02601 Date Scheduled ' Time Fee Pd. 6) , oil' Suitability Assessrriet fog- Se e D o �� Performed By: I Witnessed By: i LnOCATION dJL GENERAL'TIVY''ORMATION:- Location Address'. ('7 0 lea UI Owner's Name , 1+ � Address S Engineer's JL� lEn 's Name Assessor's Map&&reel: 10�/ ,b Q ! g S NEW CONS1RUd `i ION REPAIR Telephone# � 30—' �31 1 Land Use t ; 'S V -t`t ° Slopes(%) ' L S /' Surface Stones Distances from: Open Water Body ?Z ft Possible Wet Area ft Drinking Water Well�� ft breinage Way >/0Q ft Property Lincft Other ft ,SKETCH:($treet name,dimcnsiotis of lot,exact locations of test holes&pere tests;locate wetlands in proximity to holes) Sep. I • •I i • I cD C> ' r�? --t f J � G . k E.sJ Parent material(geologic) C /� Depth to Bedroe Q3 6�� Depth to Groundwater. Standing Water in Hole: i Weeping from Pit Face �- Estimated Seasonal ifth Groundwater 'Q i DtTE ATION FOR SEASONAL HIGH WATER TA-DLE Method Used: I I In. s Depth dbperved nding in obs.hole: _in. Depth to salt mottlr : it Depth to weeping from side of obs.hole 1 -1 in. Groundwater Adjustment _ A ,faelor,, _ Adj.drnundwnterlevel.,,,e Index Well#� Reading Date: Index Well level - � , PERCOLATIdON-,TEST • Date Observation ' I Tune dtt.9" --- Hole# I Time at 6" Depth of Perc Start Pre-soak Time.Cd End Pre-soak w�� • r Rate MinAnch ! Site Suitability Assessment: Site Passed _ 'Site Failed: Additional-Testing Needed(YIN) Original:.Public HcKth Division Observatioti Hole Data To Be Completed on Back-- ***If percolaAion test is to be conducted within 100' of wetland,you must first notify the Barnstable C6.1iservation Ditizsion at least one (1)wedYk prior to beginning. DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other I.Surface(in.) (USDA), (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel Cam,_ 7(� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel) DEEP OBSERVATION HOLE LOG Hole# _. Depth from Soil Horizon Soil Texture ,Soil Color Soil- Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel 1 1 .T DEEP OBSERVATION HOLE LOG Hole# N Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. ra 1 Flood Insurance Rate Map: ` Above 500 year flood bounds No._ Yes _ .. Y boundary Within 500 year boundary Nov/ Yes, Within)00 year flood boundary No, „ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring.pervious material exist,in all areas observed throughout the area proposed for the soil absorption system? e 5 If not,what is the depth of naturally,occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required inik,"expert'i sie�anAd experience described in 310 CMR 15.017. Si nature" �= - Date Q:\SEPTIC\PERCFORM.DOC TOWN OF BARNSTABLE A LOCATION ll:7D �Or/l l y� SEWAGE# 901,Y ' 20 q VILLAGE//f/�',lQP-5 ra;2-5 l/lS ASSESSOR'S MAP&PARCEL /Q INSTALLER'S NAME&PHONE NO. d120'��.5� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) !2.,�'pp JOA/w/may(size) 'q x NO.OF BEDROOMS 2. OWNER PERMIT DATE:, 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 FURNISHED BY 3 r3 -2=yo. 13-3 - _t V TOWN OF BARNSTABLE LOCATION 4-,flZ510e SEWAGE # VILLAGE Sl'r "*144s- ASSESSOR'S MAP & LOT L-3 i? INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 4� LEACHING FACILITY: (type) AiT (size) C.rL NO.OF BEDROOMS BUILDER O PERMITDATE: COMPLIANCE DATE: ? Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility fi 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 L Furnished by � K V O /�e, O p�/�c� ; moo, � s, a��' � r � 1_ No. Fee T COMMONWEALTH OF MASSACHUSETTS Entered incomputer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppY1LAtI0YC for Disposal *pBtEltt C0n8tCUCtIOtt 3pPrlttlt Application for a Permit to Construct(CY Repair(Z-)-`6pgrade( ) Abandon( ) . ❑Complete System ❑Individual Components Location Address or Lot No. l 7,9 oaa!5 /y q / Owl naerr's a Address,and Tel.No. Assessor's Map/Parcel fehS Y VV AO Installer's NameAddr ss,and Tel.N -- o.3`O 44/20-qy3�' Designer's Name,Address,and Tel.No. �J¢O�r'c7 s' ' 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(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 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 not to place the system in operation until a Certificate of Compliance has been issued is Board of Health. Si d ate Application Approved by - ate Application Disapproved by Date for the following reasons Permit No. -- Date Issued f No. E^ c Fee j Entered in c uter: P ITHCOMMONWEALTH.OF—MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS TippYicatiou for Disposal 6pstetu Construction i3ermit- Application for a Permit to Construct(L)--Repair(grade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.//7a PollTE /,�f 9 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 1V4i11( , Wljf�V` Installer's Name,Address,and Tel.No.j O `�l ZG-417:50 Designer's Name,Address,and Tel.No. ✓oSc�Li ���i�v'ry s" Type of Building: } Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 4o�5:I'J4 Date last inspected: r \ 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 Certificate of ,.Compliance has been issued .y his Board of Health. Sig\fled.; �, _ t' ate Application Approved by Date , 17 ,, Y - Application Disapproved by Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(G--)- Repaired( ¢ Upgraded( ) Abandoned( )by at / D /?i�l /tr /� has been con tructed 1, acc e � -4 , with the provisions of Title 5 and the for Disposal System Construction Permit N ate Installer /75 rf dZ Z?z�7j 6q��// 5- Designer , #bedrooms Approved d ice}flow gpd l a The issuance of thi a it shal of b construed as a guarantee that the s stem o as 'si e P g Y Date / as. G�/� I ------------------- -------------------------- - No. too Fee -' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction 3permit Permission is hereby granted to Construct Repair(y- Upgrade( ) Abandon( ) System located at72 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. I. Provided:C .ns ction mu be completed within three years of the date of this permit. /Cs Date Approved by r I JUL/01/2014/TUE 09:54 AM FAX No. P. 001 Town of Barnstable ' lRegulatory Services Richard V. Scab,Interim Director � waniuvr�xrs, d Public Health Division Thomas McKean,Director � 200 Maio Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form N Date: 7 ' 1 Sewage Permit# —a©�Assessor's MaplParcel 10 Designer: 5 Installer: Address: Po F5ChX G,4 Address: ,S�"VWKA I On / was issued a permit to install a (date) (installer) septic system at $ 71,:t 1 . l k1t15 based on a design drawn by (address) 6A.U49 4�W S ��4­ dated G1 1 t r (designer) I certify that the septic system refereed 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. Strip out (if required) was inspected and the soils were found satisfactory. 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&'Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the RA approval letters (if applicable) &4s DAf REN M. � alley Signature) E W4b� 0\,� Desi er's Signature) SgNlTAR�A'� l PLEASE RETURN TO BA STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COWLIANCE WILL NOT BE ISSUED UNTIL BOTH_THIS FORM AND AS- BCMT CARD ARE RECEIVED BY THE UARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Dcsigner Certification Form k v 8-14-0,doc i CERTIFIED SEPTIC SYSTEM REPORT LOCATION 1170 ROUTE 149 MARSTONS MILLS, MA MAP 103 PARCEL 004 LOT 35 PREPARED FOR r BELLES MR. & MRS. DAVID CASH 545 LUMBERT MILL RD. CENTERVILLE, MA 02632 BUYERM MR. & MRS . PAUL WARD RECEIVED1170 ROUTE 149 aD MARSTONS MILLS, MA 02648 DEC f PREPARED BY HILLIARD HILLER P.O. BOX 250 CENTERVILLE, MA 02632 508-778-1472 C Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection William F.Weld r3ov�mor Trudy Coxe t3.a.t.,y,EOEA David B. Struhs SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: /170 /E'ov?t /`11 /t 4Vl Address of Owner: Sys" Date of Inspection: /l ag s r'-`1 of different) G/�',vT,B/IvsGG� fs,q GaGT2 Name of Inspector: H/441,.f;C0 Company Name, Address and Telephone Number: �p� CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: h Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM SES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. 61 SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection.. _ _-Indicate yes, no, or not determined (Y, N,or ND).-Oesaibe basis of determination in all instances. If'not determined',explain why not) The septic tank is metal,cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/1S/9S) 1 One Winter Street • Boston,Massachusetts 02108 • FAX(617)W6-1049 • Telephone(617)292-MM Rimed an R.cy"Paper cs SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: /�7� iQo�T� �y`/ S/v.�s �'+lGGS ,�If Owner: /Li/iv e4 vi'0 G/f s-ll Date of Inspection: //1B rf !a/iJ9 B]SYSTEM CONDITIONALLY PASSES(continued) , Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply of tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria 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• D] SYSTEM FAILS: 1 have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. - Backup of sewage into4acility or system component due to an overloaded or dogged 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. (revised 8/15/95) 2 0 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: // 7v 7-9 /y9 /mil Owner: ft/jl Vw4/1O Date of Inspection: f//aF Ir D] SYSTEM FAILS(continued): Static liquid level in the distribution box above outlet invert due to an.overloaded or dogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to dogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of.a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public heahh and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA) or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 .l SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: //70 Aer'e /y9 Owner: /'M/.01 ewv l-01tS 4, ' Date of Inspection: Check if the following have been done: Pumping information was requested of the owner,occupant, and Board of Health. ,XNone of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or aS part of this inspection. 4V4As built plans have been obtained and examined. Note if they are not available with N/A. ✓The facility or dwelling was inspected for signs of sewage back-up. Zhe system does not receive non-sanitary or industrial waste flow ✓The site was inspected for signs of breakout. ` All system components,i0cluding the Soil Absorption System, have been located on the site. ZThe septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. ✓fihe size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. Zhe facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 8/15/95) 4 ;r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: //70 /y1? Owner: �s/,g Oe4-1-0 Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: taallons .Number of bedrooms:17 Number of current residents:- Garbage grinder(yes or no): —O Laundry connected to system (yes or no):yES Seasonal use (yes or no):_IO Water meter readings, if available: /�1 y' S'oT, GAL /�1'1� " 33. GGt� G/fL Last date of occupancy:jLO PAQ'.r/a Y COMMERCIAUINDUSTRIAL: Type of establishment: Design flow:_gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING REC RD and source of information: //&y�yy 'V'ex D.ow System pumped as part of inspection: (yes or no)_ If yes, volume pumped. eallons Reason for pumping: TYPE F SYSTEM Septic tan soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed (if known)-and source of information:-O01--M yGGrr�T -!% Gy S �.y5r79 �.v /�J 7J Sewage odors detected when arriving at the site: (yes or no)A!�7 (revised 8/25/95) S t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: //7O h�t/IS?ems' '011>u.S 'dsi9 Owner: rt/or Date of Inspection: SEPTIC TANK: (locate on site plan) Depth below grader Material of construction: l-foncrete_metal_FRP—other(explain) Dimensions: '7'� 8"n 8' OD ylr ',0AV a Sludge depth: T Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: O Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: — Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) 95 7X.45 11lO SlG.y 4l— _ LR,,4t E T/-dVXX AXiW 6/4iL.d /.BUT /T' GdiAS /.�i�orir'.�/ Tl�/1cr�G F/_ /PeGoir,e►L,v/> ��/�"r.%yG �C�Y GREASE TRAP:_ (locate on site plan) a Depth below grade: Material of construction: _concrete_metal _FRP other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom n' c{urn in bottom of outlet tee or baffle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 6/15/95) 6 r t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1l70 �vi7'� /y9 /7lt�.STbr-_S lr1GLS Owner: ""71A Qwyl'a Date of Inspection: /a h /9. TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of construction: concrete_metal_FRP—other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution equal, evidence of so!id! carryover, evidence of leakage into or out of box,etc.) f aUr� .4 lr PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 4 - i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Add AI �5lG� Owner: As, AA DstvlD G�Sf1 Date of Inspection: SOIL ABSORPTION SYSTEM(SAS):J (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) ' If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) ZX4 i0�j ,yO �oLi�S OX SGd�1 THE �T G✓�9-s /gP�/�aX/.�2�T� �/ 705• �^(/LL AA�v h.��vD �v�r.�i v� TH.P i°iT Bve,QY aT/YrX T//�i.E T/y f CESSPOOLS: _ (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 (cesspool must be pumped as part of inspection) 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.) (revised 6/15/95) B SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: //70 Anc--1,- 1yf ,"-1 •4110, Owner: AfAl djfv/,V C eS/1 Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' I � I om . I ad poRG// gvcic'- S^� tfs'f10 I .. DEPTH TO GROUNDWATER Depth to groundwater: 22L-t' feet ,- —=method of determination or approximation: ----._-- 9 8'-►-: ?h`Z AIr/s B,33' d4dfz, ?tf.!_ o OSlXAO tvitr'Y" aG..G 5fto&-s 7 tl,e 4dr?S.�/1 Tr�l�LL /gT BC�c viyT�oy 5�3 T�1/' c�S�S' �/1�2o�oy /5 7, o 39.47 ' (revised 8/15/95) 9 r LEGEND MARSTONS MILLS PROPOSED CONTOUR 9® PROPOSED SPOT GRADE LOCUS -- 98 -- EXISTING CONTOUR + 96.52 EXISTING O EXISTING WATER GRADE ERVICE ���� 0) RqC f r- TEST PIT o Sssss, LOT 37 �Qo� 0 Of N (P v ����o �' �4- LOCUS MAP 40 �. � so LOCUS INFORMATION PLAN REF: 157/97 h. Y TITLE REF: 10004/105 �0 �\ W -) ' \ �� PARCEL ID: MAP 103 PAR. 004 ZONING: "RF" /^ TRI FLOOD ZONE: "C'•0 � TP-1 O COMMUNITY PANEL: 250001-001 5-C DATED:08/19/85 c W �-2 tip' SEPTIC SYSTEM zo"o � vent 978 REPAIR PLAN LOCATED AT: #1170 _ o4z 0, ,��, 0 �� 1170 ROUTE 149 TOF=100.0_ /; '��� , o MARSTONS MILLS, MA. `ti PREPARED FOR 1100©11 7.4 PAUL L. & ALBERTINE M . 021, 36 S.F. EXIST./SEP. TANK: WARD AREA- ``�'��8.1 r TWIN JUNE 11, 2014 EXIST; s^, ►� `�6'�, F L.P. �,f 97.5 00 97.7 OF �Ss9l' WOODED ii 0� ti m D R,ENW 9 97.5 v o�\ E A�R EOF W. 1140 �. TBM = '� TOP BLHD=100 p� �• AEGIsi SANITAR\a� 1 ( , � l �O '30 J+ MEYER & SONS INC. 1so.89 i. P. O. Box 981 GRAPHIC SCALE E. SANDWICH , MA 02537 20 0 10 20 40 80 f PH. (508)360-3311 fax ( LOT 35 meyeran sons nc©gma8 IN FEET .com ( ) 1 inch = 20 ft. ' SHEET 1 OF 2 J#1661. T.O.F. N6TE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS F NOTE: PLACE RISERS OVER ALL COVERS W/IN 6" OF GRADE FINISHED GRADE (97.8) EL: 100.0 F.G.EL: 98.0 F.G. EL: 97.8 F.G.EL: 98.0 VENT 4 f- MAINTAIN 2% MIN SLOPE OVER LEACHING AREA .'a 2" OF 3/8" DOUBLE WASTD TOP TANK=EL. 97.0 3/4" - 1-1/2" STONE OR FILTER FABRI DOUBLE WASHED STONE Eaa n 3" 4" SCH 40 PVCf L t0„I 131313E 14„ 6• S= 1% (MIN.) ®F IlaTEE'S ARE TO BE INV.94.50 2 E F. DEPTH I Q 4' SCH 40 PVC INV.95.70 Q.:.:.4... INV.94.30 1 4' 2 X 8.5' 4' GAS PROPOSED DB-3 EXIST. INVERT BAFFLE .....,, (H20) DISTRIBUTION BOX EFFECTIVE LENGTH = 25' INV. 95.95 a INV. ELEV.= 91 .80 EXIST. 1 ,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON �Q��� �f Mgss9� BREAKOUT j OUTLET TEE AS MANUFACTURED BY DA ESE ti TUF-TITS, ZABEL, OR EQUAL � JPR ELEV.= 92.80 \ k_ TOP CONC. ELEV.= 92.80 No. 1140 INV. ELEV.= 91 .80 ®® ®® 1313E®®EE3 . NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING 13EE13®®13 PIPE INVERTS PRIOR TO CONSTRUCTION G/STEREO 1313131313E 2) D-BOX SHALL BE SET LEVEL AND TRUE S01TAR0' }} BOTTOM EL.= 89.80 131313131313E TO GRADE ON A MECHANICALLY COMPACTED SIX 1 ) lj 3.75' 91 5 FT. 3.75' INCH CRUSHED STONE BASE, AS SPECIFIED IN ) 310 CMR 15.221(2) SEPARATION 5.0 FT. EFFECTIVE WIDTH = 12.5 3) INSTALL INLET & OUTLET TEES AS REQUIRED SEPTIC SYSTEM PROFILE ADJUST. GRNDWATER EL: 8 4.8 0 _ SOIL ABSORPTION SYSTEM (SECTION) (500 GALLON (H20) LEACH CHAMBER) GENERAL NOTES: 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOGS P#: 14380 DESIGN CRITERIA BOARD OF HEALTH AND THE DESIGN ENGINEER. NUMBER OF BEDROOMS: EXIST 2 BEDROOM DWELLING/3 BEDROOM DESIGN 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE DATE: JUNE 5, 2014 LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: SOIL EVALUATOR: DARREN MEYER, CSE 1614 DESIGN PERCOLATION RATE: <2 MIN/IN - 310 CMR 15.405 (1) (B): DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.D. 1) A 2.0 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING WITNESS: DONNA MIORANDI, BARNSTABLE HEALTH TO BE 5.0 FT (MAX) BELOW GRADE VS REQ'D 3 FT. (H20/VENT PROVIDED) GARBAGE GRINDER: NO (not designed for garbage grinder) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXIST. 1,000 GAL. SEPTIC TANK TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE Elev. TP- 1 Depth Elev. TP-2 Depth DESIGN ENGINEER. 97.80 0" 97.80 0" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING A A LEACHING AREA REQUIRED: (330) = 445.94 S.F. ` FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN LOAMY SAND LOAMY SAND 74 9713 ENGINEER BEFORE CONSTRUCTION CONTINUES. 10YR 3/2 10YR 3/2 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. B LOAMY SAND 8' y%.1 J 8' B LOAMY SAND USE TWO (2) 500 GALLON (H20) PRECAST LEACH CHAMBERS W/ 4' 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 10YR I/% 10YR $/# STONE ON ENDS & 3.75' STONE ON SIDES: 25' L X 12.5' W x 2'D THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 94.80 36" 94.80 36" HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. C LOAMY C LOAMY BOTTOM AREA: 25' x 12.5'= 312.50 SF 7. WATER SUPPLY PROVIDED BY MUNICIPAL WATER SUPPLY. SAND SAND 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 10YR 6/6 10YR 6/6 SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 91.88 71" 9180 72" TOTAL SQUARE FEET PROVIDED = 462.50 vs. 445.94 REQ'D . 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE BOTTOM C2 MEDIUM C2 MEDIUM DESIGN FLOW PROVIDED: 0.74462.50 S.F. q THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING PERC ® EL. 90.88 ( ) = 342.25 G.P.D. vs. 330 G.P.D. re 'd CONSTRUCTION. SAND SAND 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. 2.5Y 7/2 2.5Y 7/2 PROPOSED SEPTIC SYSTEM UPGRADE P LA N 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 84.80 156" 84.80 156" 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 1170 ROUTE 149, MARSTONS MILLS, MA AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY PERC RATE <2 MIN/IN. (-C- HORIZON) Prepared for: Ward 13. NO ABUTTING PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. NO GROUNDWATER OBSERVED 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. System Design and Topography Plan by: SCALE DRAWN 15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED) 1, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 MEYER&SONS,INC. N.T.S. DMM to conduct soil evaluations and that the above analysis has been performed by me consistent with the PO Box981 DATE CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Evol. Exam in October, 1999. E4STSANDWICH,MA02537 508-362-2922 06/1 1/14 DMM 2 of 2