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HomeMy WebLinkAbout0049 SADDLER LANE - Health 49 Saddler bane'- - Marstons Mills -- A= 151 - 059 t i 9 1 k f TOWN OF BARNSTABLE 6 C• V LOCATION �`� Ja&4- SEWAGE # �,Me � • r� � ASSESSOR'S MAP & LOT I SI INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 4-a CV -,w LEACHING FACEL=:.(type) s� G'•[ C�gbijs-� � (size) NO.OF BEDROO BUILDER OWNER 1/za4s PERMIT DATE: 3 /D7 COMPLIANCE DATE: 3 IN Lo3 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 �a ei' JUL-15-2003 TUE 11 :06 AM FAX NO, P. 02 RECEIVE® THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ED RE ED C 'V JULJU L 1 5 2003 Certifirate of (CoIllpfi.alirc TOWN OF BARNSTABLE IFY, that t e(�-,Sit, HEALTH DEPT. t,-7 THIS IS TO CERj— e On-.Site wage Dispolkil System coll-struc Abandoned by 7 pured, li L at with the provihas ie Installer siulls 01"Title 5 and the for Disposal System Construction Permit No constructed in accordance dated The issuance Of Designer l's.P nilit shall not be construed as It guarantee that , Date the system U n ned. eS ---———--—————————————————— No. THE COMMONWEALTH OF MASSACHUSETTS li'ce PUBLIC HEALTH DIVISION — BARNSTABLE. MASSACHUSETTS Permission is hereby granted to Co K )-Repair Upgradv Systei-a located at ':)�A:!bpa/don and as described in the above Application for Disposal Sysiell,Construction Permit.'J.'11c applicant recognizes comply with Title 5 and the following local provisions or special conditions. his/her i s/her duty to Provided:Cons*( rflior must e completed within three years of the date of this Date- -Z mlit. Approved by 14 L;% CAT ION -� SEWAGE PERMIT NO. Lo-V I e So�Z�\cc x-� S-ck � VI L L A G E o� INSTA LLER'S NAME A ADDRESS d U I L D E R OR OWNER L��o-p-X - Sc�\\aw5 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 2 ( ��, - L� # � f F rOc�� t o 3 .—qS 17Flzs. . ........_ THE COMMONWEALTH OF MASSACHUSETTS BOARD QF HEALTH AA ..----.....OF..... .... .....:.. .� .................. Applutt#iun for Bhip sal Works Cnnnstrur#ion Permit Application is hereby made for a Permit to"Construct (7r Repair ( ) an Individual Sewage Disposal System at: L ion-Address or Lot No. oo� .... ..�...s..7 La_ A.. t�.S-•------------- ....................... - ---- _ ......................._...._.... y........: ---------------------- D d R a � .................................. Installer Address Type of Building Size Lot.!>r?-f.0 7....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder a No. of persons............................ Showers — Cafeteria (Other—Type of Building •---------•.....----- ) a' Other fixtures ..---•--•--••---•-'-•lons.--er er da . Total dail---flow.....................•--........:........---•lons. Wd Design Flow............11.Q......................gallons P � y � y o ��� gal i� WSeptic Tank—Liquid capacitylOOO.gallons Length.1.._G. Width..Q;-J.L?. Diameters- ....... Depth.. ..---..4 x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No... . Diameter....... Depth below inlet..4& Total leaching areaZ00,.-cMsq. ft. Z Other Distribution box (yY'. Dosing tank Percolation Test Results Performed by....... .. ................... Date.......1.4 ,.a Test Pit No. 1.;. ....minutes per inch Depth-of Test Pit....�4�.._:.._- Depth to ground water..�(„�Qlt,«.. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ........................................................... .................................................. Description of Soil......Q../i.'.�;....��Ti�'Nl.r /.. � •.�� a .�1. 5[9t • . 6� -i W ............................................................... ..............................•---------•-------------------- ------------------......------............................_.............. UNature of Repairs or Alterations—Answer when applicable................................................................................................. ........................................•-•--...........-•-----•------.......................................-•-•--------------------...-•----------•--•-----.......................................... Agreement: The undersigned agrees to install the aforedescribed Individt Sewage Disposal System in accordance with the provisions of LITLZ 5 of the State Sanitary Co 'r e and r ig f er agrees not to place the system in operation until a Certificate of Compliance has been s e a f lth. �_ n Si ed ....... ........ .... .............•••--•-...................... �........ ..� • ate ApplicationApproved By........... .... ....... ..... ............... ................................. ._ ..........1 .'..? ?..',..� Date Application Disapproved for th f 11owing reasons:.............:....................•--...---..........................-----..........--------•................... ....----•-•-•.............................•-•---.....------...........-----•--•--•--•---...---..................-----........---•----•--....---•-•--........... Date PermitNo..................•..................................._ Issued........................................................ Date r a No...... .: FEs. ............. THE COMMONWEALTH OF MASSACHUSETTS n BOA .F RDO HEALTH _,-. .. `L..... OF..... G111:!�.:Ip �4L .................. Appliratiun for Dispaiitt1 Works Cnnnitrudiun rrrmd Application is hereby made for a Permit to Construct (7or Repair ( ) an Individual Sewage Disposal System at: dZ2 '_-------,--t:/;___ •- Locauon Address/� or Lot No. ....... •. a ......................................... .......... e dre� .........._ ....... __ ............ .. .... ......... � / �� ...... 7jfC!L / I1 -•••••--•••---•.....................••--_.....Installer Address Type of Building •� Size Lot./5,.-�__���7....Sq. feet U Dwelling—. No. of Bedrooms............. .........................Expansion Attic ( ) _ Garbage Grinder ( ) Other—T e of Building . No. of ersons............................ Showers — Cafeteria a Other fixtures ................................... -- _ .....................••-------...........--•-•-••----...................---•--•---•--•-• a Design Flow.........../L�2......................gallons per•pe son per day. Total daily,flow............ ..-,.� .................Olons. �� Septic Tank—Liquid.capacity100'0gallons: Length- G. Width.t, , Diameter...... Depth.4'�_j7�-...-...;. x Disposal Trench—No.. ....... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No... , .. Diameter...:... ........ Depth below inlet.:.6./........Total leaching area..0 q. ft. Z Other Distribution box Dosing tank �) Percolation Test Results,' Performed by... -; .� '`1.g1U��..............:.... Date.....- ................ ..7 ,.a Test Pit No. 1_<.4�....minutes per inch Depth of Test Pit... 4...:.:_. Depth to ground water..-!(_v � '... f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil !r �` //.�M.2 _ 41. .'�2��J Z. _74 0..-...��a!' �'"/AE�4.(.:!_.:?�� ^ ...................................................... ....................... ... .......... ..................................p........................................ .... :._.. .............................................................................. U Nature of Repairs or Alterations Answer when applicable.............................................................. ----•........................::.....•---.........-•-•.-•-•-•-•-•-•--•---•---............:. ...•-•---.._....•--------..---- ••--•-••---- ....................................... Agreement The undersigned agrees to insiall the aforedescribed Indiuid Sewage'Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Co The fund . ig f ,ther agrees not to place the system in operation until a`Certificate of Compliance has been e k e a of lth:' �V Signed...... s ............. .... ...../........ . ..�.. ' ate Application Approved.By ='-...... s ... ..._.....� ............... .....•-......-------................. ..........in...�`�.....:�� I � ? Date Application Disapproved for the following reasons:...... .............. ;k ••-•----•---••---•.........................•---•----........------ ••---i;-._..._........._...----•---•-•- -•----- •---••- ............................................Due t......._.... _ PermitNo.....---. •-•-.--•- -••-••......•-••_.._.. Issued... --••--• ......-•--••............ ..... Date .......+....w.+.w......a.,c...c..a•....q r..w_s.w«a n.....-...........O w.w..Y.al ... .......w.. ..c .. ....r..................•. THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH ..........................................OF.. � .. �.%I....� .... . . ................ Tertif iratr of Tnmplianrr '- THIS IS CERT 5-Y, That th ndividual Sewage Disposal System constructed or Repaired ( ) ( ) •--by .` .....yl.� ...................................................................................................... ,� Instal der at.. '- .. ...........`..a'1. r ....:._......._... � � �/`f...._.... has been installed in accordance with.the provisions of TT���_,ofJhe State Sanitary Cod�U descr in the application for Disposal Works Construction Permit No._. ._.:_ .•.. dated. ......t.... .�......._`1.. ._.. _. THE ISSUANCE OF .THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTE THAT THE SYSTE14 WILL FUIJCTION SATISFACTORY. ---=� €€ DATE..:. . . _. ...? �.�.� .............................. Inspector...........�----•-•--........-----•---•-- ..... ................ F Y a>.-i.... . ....... ........,.w.+„n:ar..>�s«+;a:.r.+..- •.......,:w�..w..+..r»u.......... ......a. THE COMMONWEALTH OF MASSACHUSETTS 'BOAR F HEALTH �s No......................... Fn........................ " ��is�r�r�ttl urk �n iun �rrmit Permission is.her y granted.;.... 7 �. . . �e --•- to Constru ( r Repair ( annn iv >� Sewag Di posal Systenyy ,� rS. at No._.. .` ": .-- Street 4 - ......T... . == . - lit% �Y Street 1 S / f as shown on the application for Disposal Works Construction Permit(,No S115,1F ... P1✓ ate ...9.." ........... 4 Q.........::..................................DATE ": f`._.... � �. oard of Health .� " TOP FNDN. = 138.1' PROVIDE IF NECESSARY SYSTEM PROFILE ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) X / ACCESS COVER (WATERTIGHT) TO MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER 133.9' RUN PIPE LEVEL 2" DOUBLE WASHED PEL (EXIST) I FOR FIRST 2' EXISTING 1000 GALLON SEPTIC rr- TANK (H- 10 ) �--� 132.64' ,'. eavrie 132.81 moo 0 0 0 o O c MIN o 132.5' C] C7 O 0 ED 'C ( 2 % SLOPE) 6" CRUSHED STONE OR MECHANICAL COMPACTION. (15.221 [2])' 2' DEPTH OF FLOW = 4' ( 1 % SLOPE) ( 1 % SLOPE) TEE SIZES: 3/4" TO 1 1/2" DOUBLE INLET DEPTH = 10 OUTLET DEPTH = 14" FOUNDATION---- EXIST SEPTIC TANK 15' D' BOX 16' *UNKNOWN INVERT OUT OF SEPTIC TANK (GROUND FROZEN). CONFIRM INVERT PRIOR TO INSTALLATION OF ANY PORTION OF SEPTIC SYSTEM. PROVIDE GRAVITY FLOW TO PROPOSED D'BOX FROM EXISTING SEPTIC TANK, AT MINIMUM PITCH Oy v V 110.00' • LOT AREA C� 15,037t SO. FT. m Z+ 0.35f ACRES r � n DECK, 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 5. PIPE JOINTS TO BE MADE WATERTIGHT. DESIGN FLOW: _3 BEDROOMS ( 110 GPD) = 330 GPD 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. USE A 330 GPD DESIGN FLOW ENVIRONMENTAL CODE TITLE V. SEPTIC TANK: 330 GPD ( 2 ) = 660 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE USED FOR LOT LINE STAKING. USE A 1000 GALLON SEPTIC TANK (RE-USE EXIST) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. LEACHING: 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT 2(30 + 9.83) 2 (.74) = 118 INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED SIDES: FROM BOARD OF HEALTH. BOTTOM: 30 x 9.83 (.74) = 215 10. LEACH PIT TO BE PUMPED AND REMOVED. REMOVE ANY TOTAL: 454 S.F. 336 GPD CONTAMINATED SOIL WITHIN 5' OF NEW FACILITY. USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) WITH 2.5' AT SIDES, 4' AT ENDS, AND 5' ._ TI TLC' S SITE PLAN BETWEEN UNITS OF 49 SADDLER LANE IN THE TOWN OF: (WEST) BARNSTABLE PREPARED FOR: JOANN LUZANSKY BOARD OF HEALTH 30 0 30 60 90 Feet MA APPROVED DATE SCALE: 1 " = 30' DATE: FEB 19, 2003 off 508-362-4541 fox 508 362-9880 down cope engineering, Inc. '`H OF q `1N Of 4%, N N R• CIVIL E GI EE S oJA �r� �o ARH. NEze yJ LAND SURVEYORS � CIVIL S O,IALA N No. 30792 ;oQ 939 vain st, yarmouth, ma 02675 A JALA, P. L.S. DATE TF = 138.1' N ' 9 137.5 EXIST. GAR Or ��j O ST Q NOTE: GASLINE IN AREA :OF 0 137.8 0 PROPOSED SYSTEM - USE 7 4 137.0 CAUTION 1 , + 137.1 I TH WI �-- APPROXIMATE WATERLINE + 8 r- 1 LOCATION ONLY. IF WITHIN 10' OF PROPOSED LEACHING FACILITY, WATERLINE MUST 8E 1 ^rn SLEEVED. 13 0 1 1 / 138.6 + I 7 EXIST. SEPTIC TANK AND + 138. 1 BENCH MARK — NAIL SET �� _ -- 'r" IN 20 PINE ELEV 141.7 38 LEACH PIT SHOWN AS PER t6 139.1 1 AS BUILT CARD ON FILE + 13 . 13q.,1 0 1 WITH BOARD OF HEALTH �I I I �4d -< 1 140. 40.5 139.1 L=50.qo 1 R=559 2 o'4__ -i 141.4 _ —+-b".r— — SADDLER LANE LEGEND GAS LINE G WATERLINE W EXIST, CONTOUR 140 LEACH PIT LP 03-043 TEST HOLE LOGS ENGINEER: RICHARD FAIRBANK, PE LOCUS 137 WITNESS: J. CONLON (BOH) DATE: 6/6/86 PERC. RATE = < 2 MIN/INCH CLASS I SOILS p# 4596 o ��F 0 JOE iH°MPSON �' Q ELEV, 130,5' 0" 137.1 ' Z ONE LOAM LOCATION MAP NO SCALE ING SUBSOIL ASSESSORS MAP 151 PARCEL 59 fY 24" 135.1 ' 5.4' CLEAN SAND & GRAVEL W/TRACES _ SILT 96" 125.1 ' SILT AND SAND 144" 1 1 125.1 ' NO WATER ENCOUNTERED NOTES: ��oNo. Fee MHE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS V 01pphration for Migonl 6potem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade(i/)Abandon( ) O Complete System G'Ittdividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor Map/Parc Installer's 4arne:Addressf and Tel.No. Designer's Name,Address and Tel.No. �3a r l®mil c�es/-, Doman 6��e_ - 7i Type of Building: Dwelling No.of Bedrooms Lot Size Z�3 7 sq.ft. Garbage Grinder(1 Other Type of Building o.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 3,30 gallons. Plan Date Nu ber of sheets Revision Date Title - LO Size of Septic Tank L070V 67D/ Type of S.A.S. G Description of Soil Nature of Repairs or Alterations(Answer when applicable) np, f ING, ENGINEER MUST SUPERViSE i:O N CERTIFY ��..:C T T :-_ � Date last inspected: �,t Es,.-C,".NCE TO PLAN. Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued his o of alth. Signed A Date z. O Application Approved by At Date Application Disapproved for the following reason Permit No. Date Issued 24 Fee �✓ No. l THE COMMONWEALTH OF MASSACHUSETTa Enter!d'in co puler. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASACHUSETTS Zipprtcation for loigpogal *raem CodMruction Permit Application for a Permit'to Construct( )Repair( )Upgrade(✓)Abandon( ) ❑Complete System LrJ Individual Components Location Address or Lot No. i Owner's Name,Address and Tel.No. Assessor' Map/Parce Installer's ame,Addres and Tel.No. a Designer's Name,Address and Tel.No. 7 7/ -11-5 / Type of Building: Dwelling No.of Bedrooms _3 1 Lot Size �5�3 7 sq.ft. Garbage Grinder(/�0 Other Type of Building &5laiOWK FjNo.of Persons Showers( ) Cafeteria( ) Other Fixtures r Design Flow gallons per day. Calculated daily flow 3.30 gallons. Plan Date 4 3 Number of sheets . Revision Date Title .S S/ /2 224 4F/ 4/9 ,55 �f Size of Septic Tank /©�Gp UDC Type of S.A.S. Description of Soil �D�f'3��i'7 Nature of Repairs or Alterations(Answer when applicable) g Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is�sued�by this oard/7of Health. Signed/ T//G IY/ /1 Date c) �1'5�9_3 Application Approved by y aim a�/ Date / u � - _ Application Disapproved for the following reason Permit No. Date Issued V — — — 4 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS ISTOCERj7IFY, that t e On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded Abandoned( by 0/ (1�� / at q �/a �� �O 5t`Q' has b constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 1 dated Installer Designer The issuance of this p rmit shall not be construed as a guarantee that the system u:c n s e ' tied. Date I q Io 3 Inspector ——————————————————————————————————————— No. /��'-C Fee V � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi!6pozaf *pgtem Construction Permit Permission is hereby granted to Constructs ,Repair( )Upgrade S('�)�Aba don( ) System located at y? SQC wli�r le , ex i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Consttuctiorl mus�nk e com leted within three years of the date of this p rmit. - 61 i Date:_ ! �/_ Approvedby / � bll /F�7 -� ! TOWN OF BARNSTABLE •C LOCATION �� ✓a - l SEWAGE # VILLAGE �' � �Sl{ ASSESSOR'S MAP & LOT Rf INSTALLER'S NAME&PHONE NO.���j%��i �/'� 7'g9�L SEPTIC TANK CAPACITY !ocv 4570 • sad Ga( G�ge,�,c-� � (size) �i7• `.taf`�2' LEACHING FACILITY: (type) NO.OF BEDROO BUILDER OWNER uzaas �, Z �D7 3 PERMITDATE: COMPLIANCE DATE:. • Separation Distance Between.the\ ��.- . Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by 1 a I i SENT BY: BORTOLOTTI CONST; 5084280390; NOV-3-04 11 :58; PAGE 7'7 T6wn of Barnstable tx�r a Regulatory Services j t Thomas F.Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyanuis,N1A 02601 Office: 508-862-4644 I Fax: 508-790.6304 Installer& Designer Certification Form Date: /l Designer: _�W/1 2 Aeel-) Installer: Address: 6A Address: '�' ,r/- ��..r ,�. /P-,' db�- �f nil %/ " 'f! was issuer) a pa it to iLtall a (date) ai' installer septic system at based on desi�drawn by (address) dated (desi er) i i I certify that the septic system refermced above woes installed sIubstan 'ally according to W' the design, which may include minor app,oved changes such lateral relocation of the distribution lox and/or scptic tank; Y. certify that the septic systern referenced above was installed (wAli. 4ajor changes (i.e, greater than 10' lateral relocation of the SAS or any vertical relocation oaf any component of the septic system)but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. H Of P lysS9 ARNE oyGN` (installer's Signature) ' OJAL� CIVIL No. 3079 esigneP s bigriair (Affix llc taint Here) PLEASE *RETURN TO HARNS',MLE-P UBLIC-RE,ALTH IDINMSION. CER'IWICATE AS- OF COMPLIANCE; WILL NOT BEISSUED -9O-T � TMS RM. AND BMLT C AVRD ARE RL+CEIVrD BY 1f TT , BARNSTABLE PURLI I3 L; 3 kI DIViS4UN. THANK YOU. Q:Healtb/ScP:ic'Jcsiper Ceriifiration rorim i 1 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION _ y MAP PARCEL LOT TITLE S OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: G FAILED INSPECTION .z2ua Owner's Name. Owner's Add r6�_ Date of Inspection: Name of Inspecto please rint). ,- b O Company Name. ® I Mailing Address: V. Telephone Number: ol —77/. 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: 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 6/1.5120.00 page 1 e Page 2 of l 1 OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM,INSPECTION FORM PART A �""" � • . ITA4 CERTIFICATION (continued) .` :Property Address: Owner: o� /.F f� ?.4�22 Date of spection:� (I�� V Inspection Summary: Check A,B,C;D or E/ALWAYS complete all-of Section D A. System Passes: Ji0f-m-n have not_found anyiinformation which indicates that any of the failure criteria described in 310 CMR . 15:303tor T 3:10 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 over20 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: 2 Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owne Date o spection: 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. System will pass unless Boardof Health deterinines'in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public-health,safety and the environment: Cesspool or privy is within 50 feet of a surface_water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 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 I 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 thatthe 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: i - 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: le, Owner .Date of spection: p U' D System Failure Criteria aPPlicab1eto•all systems: You must indicate, yes or. no to each of the following for all inspections: Yes No r Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters.due to an'overloaded or . clogged SAS or cesspool Static liquid level.in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool . Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow Required pumping.m,ore than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ Any portion of the SAS,cesspool or privy is,below high ground water elevation. Any portion of cesspool or privy is within 100.feet of a surface water supply or tributary to a surface water supply. ; Any portion of a cesspool or privy,is within a Zone 1 of a public well. Any.portion of a cesspool or privy is within 50 feet of a.private water supply well. 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 certifiedlaboratory, 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 musf.be attacFI 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,,the'ref6re 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 facilitywith 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 400 feet of a,surface drinking watei supply _ the system is within 2,00 feet of a tributary to a surface drinking water supply the system is located,in a nitrogen sensitive area(Interim Wellhead Protection Area—'IWPA)or a mapped Zone II of a public water supply.well If you have answered"yes"to any question in Section E-the system is considered a significant threat;or answered, "yes"in Section-D above the large system has failed.The owner or operator of any large'system considered a significant threat under Section E or failed under Section D shall upgrade the system'in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office.of the'Department. 4 Page 5 of 1'1. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM` PART B CHECKLIST Property Address: Owner. Date'of spection: Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes. No Pumping.information was provided by the owner, occupant,or Board of Health fWere.any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? I Have large.volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of breakout 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? V11, _ 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 . Existing information.For example, a plan.at the.Board of Health. Determined in the field if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)], 5 - Page 6 of 11 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTM INSPECTION FORM. , PART C SYSTEM INFORMATION Property'Address: l n D Owner9�gAo /� Date of. pectin: "1 3 LOW CONDITIONS RESIDENTIAL Number of bedrooms(design) Number of bedrooms(actual): `3 DESIGN flow based on 310 CMR 15.203 (for example: 1].0 gpd x# of bedrooms): . Number of current residents: 0"3 Does residence have a garbage grinder(yes or noll�.- —t Is laundry on a separate sewage'system (yes or noh_ .. if yes separate inspection required]- Laundry system inspected(yes or no) Seasonal use: (yes or no Water meter readings, if available(last 2,years usage(gpd)): 0 �-,lsd o 0z Sump pump(yes or A&t4ce .Last date of occupaa noncy:����� � Awoee -0 ' COMMERCIAL/INDUSTRIA.k_,4(,#— Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft;etc.): 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/use:_ OTHER,(describe): GENERAL INFORMATION Pumping Records Source of information:-a -S Was system pumped as part of th inspection(yes o o)V ` If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _V!Septic tank,distribution box,soil absorption system. Single cesspool Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a,copy of the current operation and maintenance contract(to be obtained.from system owner) Tight tank _Attach a copy of the DEP approval Other`(describe): Ap oximate age of all com one ts,date ' stalled If known)and ource of information: Were sewage odors detected when arriving at the site(yes or nQ)A- _ 6. Page 7 of]1 OFFICIAL INSPECTION FORM-,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM-INFORMATION(continued) Property Address: Owner. Date o spection BUILDING SEWER(locate on site p.lan)Au)— Depth,below grade: Materials of construction:_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANKS ✓(locate on site plan) Depth below grade: �7,5 Material of construction:_✓concrete=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: Sludge depth: Distance.from top of sludge to bottom of outlet tee.or.baffle: Scum thickness: it Distance from top of scum to top'of outlet tee or baffle: Z Distance from bottom of scurn to bottom of outlet tee or baffle: /. How were dimensions determined: ezzil QZL- � Comments(on pumping recomme dation,, inlet and outlet tee or baffle condition,structural integrity, liquid levels related to outlet invert evidence of leakage,a R.): r A 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 scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,.]iquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE- SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION(continued) Property Address: ' Q � . Owner: Date of spection: TIGHT or HOLDING TANK(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Materialofconstruction' 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.): DISTRIBUTION BOX. (if present most be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of ;_l kage into or out of box, etc.): PUMP CHAMBER.A locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): s Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): , . . 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: AIA Owner. ,_. Date o section: 1Zd21f4VX SOIL ABSORPTION SYSTEM (SAS): locate on site plan,excavation-not required) If SAS not located.explain why: TYPe _.... eac'hing pits,number: / leaching chambers,number: Ieaching galleries,number: leaching trenches, number, length: leaching fields,number, dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: I Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, Q r - 0 CESSPOOLS cesspool must be pumped as part of inspection)(locate on site plan) Number.and configuration: Depth*—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition-of soil,signs of hydraulic failure, level of ponding,condition of'vegetation,etc.): PRIVYA V(Iocate 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.): r 9 Page l0 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBS URFACF'SEWAGE DISPOSAL,.SYSTEM.INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: i dam! Owner: . v Date o specti,on:�d0 3 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. � r 10 Page I 1 of I 1 OF INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: ����.�x�1L- 11 . Owner: o� Date of • pection:q�a,� IJA SITE EXAM Slope Surface water Check cellar Shallow wells 1 Estimated..depth to ground water Vd 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: , j . 11 Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: �,�' !�i /�l�°/^���,�1� � Lot No. Owner: [—(/ rjl� Address: Contractor: �G'!' � / �D��SJi Address:..... �' f/5j`✓YI^D� Notes: STEP 1 Measure depth to water table to nearest 7/10ft. ...........: . ... .Date ��/cJ ✓� `��.............................................................. month/day/year STEP 2 Using Water-Level Range Zone _ and Index Well'Map locate site and determine: �jO Appropriate index well...................................... OWater level range zone ...............................................:...... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well .......::.................. month/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3) and water-level zone (STEP 2B) 41 determine water-level adjustment-........,................... ....................... .... 'T STEP 5 .. Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water levelat site (STEP 1) .....................................:............................................................................ Figure 11--Reproducible computation form, 15 i r� }� •a'A � wrw.r�r....r.u�r+.srw.-n*-.rc+...w»....n_ - • h; 0. :. .. .- •.. r .«I ,.J... p...r,': ��' 1 s 1. sir ��.. x. ON SEWAGE SECTI .�.. lx f. M1 K f t /O -SEPTIC TANK- 5 _••D••BOX - S -LEACH TOP OF FF/ON -. �.14(2,C)MSL)s ^2••OFt/eTO.ih•• �. WASHED STONE a 1312 ICU • - ''' /IN OUT? ' IN ^' � _ � I . Op 1 4-Z I ,� , OUT• N I L2Q9 1 I SEPTIC ram, IAC�.4 140 2 TANK I'J�. 7 139.��/ ' 8 , / ELEV. ELEV. ELEV. t 1 ELEV (1 r _ _ lbD 0-77 :ELEV. ELEV. r Tb • ASH STONE /!14., t . EQ rc . 4 :.ev 1245.�0' 5.5' TEST HOSE LOG <0 TEST BY �0.trba,rtk Jr Cdn 14r� <<3• �.� ,i WITNESS 6 i TEST DATE DESIGN I ref g S BEDROOM HOUSE �Ptr {o T.N: * 1 T.H. *2 lot ILI lc�._t .K ELEV. 1,4 2-1 ELEV. NO �O G DISPOSER DISPOSER .tx I P..ERC RATE 2' ,.M.IN/IN: 24-,1 c9ag :kl9 oq FLOW RATE I I�x 3(�AL+�oaY) 'S 3C7 na. L� 15o I. Gl SEPTIC TANK 3150 V.%= REWDSEPTIC TANK-SIZE Ioo.GS 144? 9Co 34.D LEACH FACILITY 144, a 1 �l� k o.nd SIDE WALL 8 I ... S.G/D. � -�-- 129.0 BOTTOM ,`t(�8 6 Z _ SO. cI I.O! _ 56,?AG/D. 144 \ Z 1 TOTAL ZOn.96 � ....Z .�� 4 GAD° USE: LEACHING �I� 81t% btu• >< 6 I G'r '_WATER ENCOUNTERED NOTES: (UNLESS OTHERWISE NOTED) 5 1.DATUM(MSL):TAKEN FRO '12AUV�!IS,ca4 QUADRANGLE MAP G� S � r C� 2.MUNICIPAL WATER AVAILABLE �56�E"��� 1 ?S ��Q �� � VA-) c 3.PIPE PITCH:k%"PER FOOT 4.DESIGN LOADING FOR ALL PRECAST UNITS:AASHO- -�� .44 ARHE H. 51 S.MIN.GROUNDCOVER OVER ALLSEWAGE FACILITIES:(1)FT. OJ/►LA 6:PIPE JOINTS SHALL BE MADE WATERTIGHT 1 �yYlr►4 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. CIVIL f1' I 7i STATE ENVIRONMENTAL CODE TITLES �s2 (� I I' � ;. � SITE PLAN LOCUS:WTI Al/G7 - a�_bt_ra for �E uD �a� '.�CG.'3'•Y�`� t_.�T �c-d.�n._►t> �� G i - - i 1p 1 i / � I�t)f�•IT'Ft�-�t t-l' �lJ• ��i2NS�Ptl2�-� REG.PRO NAL ENGINEERS' r C,J�LA e2 c REF: LL. �Jv 2G>I dOWI! CQVe @/! /lEetl/18' PREPARED FOR: � �L-- h u-n_j� ' CIVIL ENGINEERS BOARD OF HEALTH LAND SURVEYORS REG.LAND SURVEYOR CONTOURS (EXISTING)............. 9 ���" (PROPOSED)-0-0-0-0- APPROVED DATE a`g MA Y*Avwmk " SCALE .� DATE TOP FNDN. = 138.1' PROVIDE IF NECESSARY SYSTEM PROFILE TEST HOLE LOGS ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) ";. ACCESS COVER (WATERTIGHT) TO ENGINEER: RICHARD FAIRBANK, PE Focus MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 137 WITNESS: J. CONLON (BOH) I 133.9' RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE DATE: 6 6 86 (EXIST) FOR FIRST 2' \ PERC. RATE _ < 2 MIN/INCH SADDLER _ 1EXISTING 1000rr- CLASS I SOILS p 4596 GALLON SEPTIC w '(' .. .. 132.8 TANK (H- 1O As BAFFLE "` 132.64 ' El 0 O CO MIN 132.5' O1=1 o � JOE2 % SLOPE) 6" CRUSHED STONE OR MECHANICAL � ELEV, 1t1pMPSON COMPACTION. (15.221 [21) $o 2' �] [� [] [� [� [] [] [� oQ 130.5' 0 ' 137 1 DEPTH OF FLOW = 4 ( 1 % SLOPE) ( 1 SLOPE) TEE SIZES: % 3/4" TO 1 1/2" DOUBLE WASHED STONE LOAM Z INLET DEPTH = lO" „ = LOCATION MAP NO SCALE OUTLET DEPTH 14" FOUNDATION--- EXIST SEPTIC TANK 15' D' BOX 16' LEACHING SUBSOILFACILITY ASSESSORS MAP 151 PARCEL 59 24" 135.1 ' *UNKNOWN INVERT OUT OF SEPTIC TANK (GROUND FROZEN). CONFIRM INVERT PRIOR TO 5.4' CLEAN SAND INSTALLATION OF ANY PORTION OF SEPTIC SYSTEM. PROVIDE GRAVITY FLOW TO PROPOSED & GRAVEL D'BOX FROM EXISTING SEPTIC TANK, AT MINIMUM ` W/TRACESf�'`'�ql Er,r�T SILT SYS'r'0N AND�EFf JJT { PITCH �CHORD TEM WAS CERTIFY S,�r' �e 125.1 ' 961, SET®p Aii AL 16 I 's 110.00' SILT AND SAND LOT AREA 15,037f SO. FT. 0.35f ACRES 144 1 125.1 ' NO WATER ENCOUNTERED NOTES: I DECK 1 . DATUM IS ASSUMED EXIST. 2. MUNICIPAL WATER IS EXISTING DWELL. 3. MINIMUM RIPE PITCH TO BE 1/8" PER FOOT. TF = 138.1' SEPTIC DESIGN: (GARBAGE DISPOSER Is NOT ALLOWED 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 5. PIPE JOINTS TO BE MADE WATERTIGHT. 103 DESIGN FLOW: _3 BEDROOMS ( 110 GPD) = 330 GPD 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. 137.5 GAR _ USE A 330 GPD DESIGN FLOW ENVIRONMENTAL CODE TITLE V. EXIST. o sT o SEPTIC TANK: 330 GPD { 2 ) = 660 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE NOTE: GASLINE IN AREA OF 0 137.8 o USED FOR LOT LINE STAKING. PROPOSED SYSTEM - USE 7.4 �q' a'ni USE A 1000 GALLON SEPTIC TANK (RE-USE EXIST) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. CAUTION 137.0 + 137.1 1 ' LEACHING: 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT TH W1 APPROXIMATE WATERLINE 2(30 + 9.83) 2 (.74) = 118 INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED + 8 1 LOCATION ONLY. IF WITHIN 10' SIDES: FROM BOARD OF HEALTH. I OF PROPOSED LEACHING 30 x 9.83 (.74) = 218 11 f l 1 FACILITY, WATERLINE MUST BE BOTTOM: 10, LEACH PIT TO BE PUMPED AND REMOVED. REMOVE ANY SLEEVED. TOTAL: 454 S.F. 336 GPD CONTAMINATED SOIL WITHIN 5' OF NEW FACILITY. 5 } 13 0 I 1 USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR L4 138.6 1 O) 1 7 EQUAL) WITH 2.5' AT SIDES, 4' AT ENDS, AND 5' I + 138. I EXIST. SEPTIC TANK AND BENCH MARK - NAIL SET BETWEEN UNITS 5 TITLE SITE PLAN = LEACH PIT SHOWN AS PER + 13 .6 139.113 I AS BUILT CARD ON FILE 139.1 1 0 IN 20" PINE ELEV 141.7 OF 49 SADDLER LANE WITH BOARD OF HEALTH 1 I ^ I 0 i D 1 IN THE TOWN OF: 74 < 1 40.5 (WEST) BARNSTABLE 140. L 139.1 -50.V', I 1 R-559�2 � PREPARED FOR: JOANN LUZANSKY -F 1-"t- , ;.4- -+ 141.4 •+-139.3 __.- '�°' BOARD OF HEALTH SADDLER LANE 30 0 30 60 90 Feet MA APPROVED DATE SCALE: 1 " = 30' DATE: FEB 19, 2003 off 508-362-4541 fox 508 362-98M LEGEND GAS LINE GOf 4 down CRAP engineering, inc, `AM Of MAss� ``ARNE,AJq�y W CIVIL ENGINEERS AEn �� H. GJ WATERLINE IV C.) -- 0iALA E LAND SURVEYORS � CIVIL No.2 EXIST, CONTOUR 140 No. 3o7sz ,UQ 939 Main st, yarmouth, mo. 02675 LEACH PIT LP _ 03-043 A JALA, P. L.S. DATE