HomeMy WebLinkAbout0052 SAINT ANTON'S WAY - Health -
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Al Town of Barnstable
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Depart.rnont of Regulatory Services
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DARNBrAHI.E, t Public HealthHealth �fl�fl�Division
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`R 200 Main Street,Hyanuis MA 02601
9
Date Scheduled Time Fee Pd.
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,foil Suitability Asses,smentfor SO age 'isposall
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erfonned By:
Witnessed By: V(
1 '^
LOCATION & GENERAL IINI�ORNI[ATION
Location Address Owner's Name Ca` c. L /
�-/ t/ /(mil,✓1 !Ov�.O Vv"�/J
Address
Assessor's Map/Parcel: Engineer's Name lO0 of K �e
NEW CONSTRUCTION REPAIR Telephone It
—Jrv�/
n- , n ^^Land Use n� eGJ/ Slopes(%) go "z % Surface Stones A.10 NqL
Distances frorn: Open Water Body ft Possible Wet Area ` ft Drinking Water Well ft
Drainage Way R Property Line �J ft Other ft
SKETCH' (Street name,dimension tions of test holes&pert tests,locate wetlands�In proxinuty to holes)
�5,
ILL
ST �
o CIL
Parent material(geologic) ZAJn6 16 Depth tp OmIrOck, �nV,
Depth to Groundwater: Standing Water in Hole:4,7 to"L Weeping 1'I0111 Pit Pllee' v
Estimated Seasonal High Groundwater ti
DETEYtNUNATION FOR SEASONAL HJ[QvH WATER TABLE
Method Used:
Depth Observed sla ding in obs.hole: _ W In, Depth 10 svll tt101 8: lu,
Depth to weeping from side of obs.hole: l!1, drowidwuter AdjuSiment ft•
Index Well# Reading Date: Index Well level n- Ad1,factor— AJJ.dromidwater Level
PER COLA'I IO T.FST ` >unt�, �'>�„�I
Observation �—
Holc tF � Tithe at 4"
Depth of Perc o d Time at 6" �]
0 "6")9" r/. /
Start Pre-soak Time @ Time I�i ( ---
End Pre-soak
Rate Min./Inch L Mh"
Site Suitability Assessment: Site Passed _ Sil.�Failed: Additional Testing Needed(Y/N) .
Original: Public Health Division Observation Hole Data To Be Cotnpleted on Back-----------
***It glercolatiou test is to be conducted within 100' of Wetland, you must first Uotify tile.
Barnstable Conservation Division at least 011E (I) week prior to begdflll4 ing,
QASEPTIC\PERCroRM.DOC
DEE P.®rlSlERV.
�'g'g®1V rrOLE LOG prole#
Dcpth from Soil lfarizon Soil Texture
Surface(in.) Sdil Color Soil Other
(USDA} (Munsell) Mottling (Structure,Stones;Boulders,
L Co istedc %' ravel
,-ya/
—6 0 G r
—/ �. Inc 5 z , c ✓v
e
DEEP OBSERVATION HOLE LOG
Depth from Soil Horizon Soil Texture Hole#
Surface(in.) Soil Color Soil Other
(USDA) (Munsell) Mottlin
g (Structure,Stones,Boulders.
Consis ency,%Gravel
e 6 y/2 .
CJ
DE EP OBSERVATION IJ®L]E LOG
Depth from Soil Horizon Hole#
Surface(in.) Soil Texture Soil Color
(USDA} Soil Other
(Muns411) Mottling (Structure,Stones,Boulders.
Co siste c 0 vel
DE EP OBSERVATION HOLE LOG � _
Depth from Soil Horizon Soil Texture Hol #
Surface(in.) Soil Color Sol) Other
r
(USDA) .. (Munsell) Mottling (Structure,Stones;Boulders,
Consi ten c a I
r
Flood Insua'a nee Mate Ma
Above 500 year flood boundary No— yes
Within 500 year boundary No Yes.
Within 100year flood boundary No Yes .
Depth of Naturally�c Pervious Material
Does at least four feet of naturally occurring pervious material exist;n all areas observed throughout the
area proposed for the soil absorption system? �
If not, what is the depth of naturally occurring pervious materiAll
Certification
I certify that on 172Ut (date)I have passed the soil evaluator examination approved b the
17e P
Department of Environmental.Protection and that the abovey
analysis.was performed b
the required training, expertise and experience,described in 310 CMR 15.017. y me consistent with
Signature DatO
Q:1S.BPTlC1PERCFORM.DOC
I I .
BORTOLOTTI CONSTRUCTION, INC.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Address Prop 50 `-S4,
Date of Inspecl Map arcel Owner
PART_A7—_CHECKLIST
________
CHECK IF THE FOLLOWING HAVE BEEN DONE:
I,-PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH.
__NONE 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 COLUMES OF WATER HAVE NOT BEEN INTRODUCED INTO
THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION.
-AS-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.
✓ THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT.
__,�ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE.
THE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF I HE SEPTIC TANK WAS INSPECTED
FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH OF LIQUID,DEPTH OF SLUDGE,
DEPTH OF SCUM.
THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR
APPROXIMATED BY NON-INTRUSIVE METHODS.
_ .THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER
MAINTENANCE OF SSDS.
PART B — SYSTEM INFORMATION
FLOW CONDITIONS
RESIDENTIAL No of Bedrooms —_/---No of Current Residents 1(116 --Garbage Grinder
Laundry Connected to System 16 Seasonal Use
NON RESIDENTIAL:
jqalSykaWd flow
WATER METER READINGS,IF AVAILABLE:
--pi--Records i- c_§ ---"--o-- -f-of m ti- --- GALLONS
Oumng w ource f Information:
d- , 'P /_ ___ui- k2e,J
'0
SYSTEM PUMPED AS PART OF INSPECTION? ZA//) IF YES,VOLUME PUMPED )
��ALS
Reason_for Pumping:
16e 'Q61"naej Jav 0&e/—
TYPE_
0F7—SY-ST—EM:
v---- Septic tank/distribution box/soil absorption system
Single Cesspool Overflow Cesspool —Privy
Shared system (if yes,attach previous inspection records, if any)
Other(explain)
-Approximateage—of ail components. Date installed,if known. Source of information. C_j g-CA- 9 y-(, 9 rj
SEWAGE ODORS DETECTED WHEN ARRIVING AT THE§ILEL?
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B — SYSTEM INFORMATION (Continued)
SEPTIC TANK: ei - - -- ---- -----_—_--- ---------- --
Depth below grade: Dimensions: i� X �,�X �Az
Material of construction: Concrete Metal FRP Other}
Sludge Depth 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
Comments:
Jksv�c C)0/ eV,Ve e p ,end21
J)fC ) %S 04 be- 64
DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT
Comments-
PUMP CHAMBER: [Pumps in working order?
Comments:
SOIL ABSORPTION SYSTEM SAS):
IF NOT PRESENT,EXPLAIN:
TYPE: /UUCPC
Comments:
f :S a /OCO C G �° O GJ 4Cl
CESSPOOLS: p Number and configuration
Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer
Dimension of cesspool _ __—_ _ - _ Materials of construction
Indication of groundwater inflow(cesspool must_be pumped)
Comments:
PRIVY:
Materials of construction
Dimensions Depth of solids
Comments:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B — SYSTEM INFORMATION (Continued)
SKETCH OF SEWAGE DISPOSAL SYSTEM:
INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES, LANDMARKS OR BENCHMARKS.
LOCATE ALL WELLS WITHIN 100'
k9 It
/ II
DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER
METHOD OF DETERMINATION OR APPROXIMATION:
/�,►'in?Q'y�t' �r�s� Tdu�h G:.�S: Go f" ,�lE'i,��'7`i®h'S l�i�R�
r
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C — FAILURE CRITERIA
(Indicate Y—yes N—no ND—not determined.Describe basis of determination.If"not determined",explain why not.)
Backup of Sewage into Facility?
Discharge or ponding of effluent to the surface of the ground or surface waters? `
I_ Static liquid level in the districution box above outlet invert?
/Y/,4 Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow?
i✓ __ Required pumping 4 times or more in the last year? Number of times pumped
Al Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiltration?
tank failure imminent?
1� Is any portion of the SAS,cesspool or privy, below the high groundwater elevation?
Within 50 feet of a surface water?
IV Within 100 feet of a surface water supply or tributary to a surface water supply?
I Within a Zone I of a public well?
IV Within 50 feet of a private water supply well?
_it _ Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools&privies only, not the SAS)?
_ 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,amonia nitrogen and nitrate nitrogen.
PART D — CERTIFICATION
INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS
COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399
CERTIFICATION STATEMENT
I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION
REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY
RECOMMENDATION 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:
I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC
HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS
STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM.
I HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN
310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS
FORM,
INSPECTOR'S SIGNATURE:
DATE: <_5�
ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY
ASSESSORS VAp V4 4-
No....g6• gb PARCEL NO- �$......::.:..� '..:...._
oa
THE COMMONWEALTH
/ BOARD OF HE�L_T
� .............OF... � a?S_.... ............
Appliration for 11hiposal Morkii Tonstrur#inn ramit
Application is hereby made for a Permit to Construct (4-T-or Repair ( ) an Individual Sewage Disposal
Sy 3
st o
at: / 1
- em s Q -..� �s.............
Location-Addres or Lot No. /
ce�.�1_. �1._ r ... D.r �.---...--•-•••-•- . ._.....t •_ _..... l-
Owner Address
-1 ......................... .......................................................a
Installer Address
U Type of Building Size Lot./�.� c___Sq. feet
Dwelling—No. of Bedrooms____________________________________Expansion Attic (�j6 arbage Grinder &p)
pa-, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
G4Other fixture r•---••-•--••--...•-•-••--•••••••-._._...-•-•-•-•-
WDesign Flow.............. ____ ...................gallons per person per day. Total daily flow............. ..............gallons.
WSeptic Tank—Liquid capacity AOQ.gallons Length---------------- Width................ Diameter................ Depth................
x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank )
G
Percolation Test Results Performed by__.._ �.1 Date___.A.._... �____ .
`4 Test Pit No. S 5 minutes per inch Depth of est Pit_ De4 to ground water_____________________
Lr, Test Pit No. �!^. `_minutes per-inch Depth of Test Pit_ _/----__ Depth to ground water________________________
............................... ................O Description of Soil___-.. _ ...... !d - -_-- ._.....� .6___S=oc�_-�----_----
v -•••-••-•-••-•--•-••••-••••-•••••••. r 1 fi .=S'0�_e: _ ....:Q... G'r. �' - - ..............................................
•-•--••---•-------••----••---------•-----••••--••••----------------•-••••-•-•- •••••-•-•---•••-••••-----•--•------•------•--•••---•••-•-•••••-•--•-•..._._..:•-••-...._.._....----------------------•-•-
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iI'Ua 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee ued by the boa health.
Signe � f .. ----•••• �
(Da
Application Approved By............................... . •_-�- _______ ____. �--.......__.
Application Disapproved for the following asons---------------------------------------------------------------•---------•.---................................
_......---•••..................•••---......_..•-••-•--•-••••-•-••••......-•-•-•••----••••.......-•-••••..._.•--......._......••-•-•••-•-•••-••••-•••-•-••••--•-•--•-•••••••--•-•••--• ...-----.....
Date
PermitNo......................................................... Issued.......................................................
Date
No.....
._....... Fs$..................._.....
�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE. LT
Appliration,for Dispniittl Works Ton- Strurtiun Permit
Application is hereby made for a Permit too Construct ( or Repair ( ) an Individual Sewage Disposal
Systen) at A
�A:s----------
J�...................
......... le.�2'i
Location-Address - � �,,,�
�` yea (sr�Lot No
......................e ....�.....__�� �..4..�"."-._.... 1d.r...-..t.................. .. "�c%.... ry._E:1:�...
t
........ ........r. ._........._.. ... ..
Owner -
.�*•�-�-.• y � Address -
a ......... .�'y .. .. _� .t. .c ...... ..........••---..... ---.................--------•--------••---•-•-••-•.........................---••-......_......_...
Installer Address r t
UType of Building c� Size Lot_ __ .-sq. feet
Dwelling—No. of Bedrooms........... ?...............................Expansion Attic (d rj Garbage Grinder 410)
Other—T e of Building ....._..... No. of persons.......................... Showers
a YP g --------•----•--• P -- ( ) — Cafeteria ( )
dOther fixWres ........................................................................................
W Design Flow..............A... ...................gallons per person per day. Total daily flow............. ..............gallons.
WSeptic Tank—Liquid capacityl(F¢ggallons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area....._._..........sq. ft.
Other Distribution box ( ) Dosing tan ( )
W Percolation Test Results Performed by... =_! "�" �it.e
�` _r'?��"?�?__ Date.....Test Pit No. 1 _ :___minutes er inch De hlest .__ _.,� .. Dep to ground water-----
-------•-•------__.
fZ Test Pit No. LAY _minutes per inch Depth of Test Pit._ to ground water........................
. .. .......
D Description of Soil Cyr 7 ! G3 1 . 1 ------------------------------------------.................. ........
x .I.. ..I _ _ ...--•. .. I...........................................................................
W
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
-------------------------------•---------------•----------•---------•-•-•----------...........------------......-••-••...... ----••....---•----•--.....•••---••-----•••----•--••---.....__.............
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code The undersigned further agrees not to place the sys em in
operation until a Certificate of Compliance has bee •"uedhe boardoof health.
Signed ...._..
Dat
Application Approved BY............................... -. '. ._ ;f?e ..... {,
..---------
Date
Application Disapproved for the following reasons:--••-•-•••••.......•-------•----••-•----••••-----•-•----•--...---•-•-•------••-•---•------- ------------------_
4
.._•_•_________________________________________•____..._.._........_.__._....._......._..._._......_....._................................................................._............................
Date
PermitNo-------------------------------------------------------- Issued.......................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
... � .•e.............OF.... ..-r �S.re��h.. .. ......................
Trrtifiratr of T-ampliaurr
THIS IS T0,QRTIFY Th t the Individual Sewage Disposal System constructed ( or Repaired ( )
by.. . Q.. . Q. ...-- ...................................................... ...
Installer771
a�,
..._.__._ 5 `� _ .eE.............................
has been installed in accordance with the provisions of T.I.0 LT, 5 of.The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.__.._� 'j.......
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARAINTEE THAT THE
SYSTEM WILL NCT ON ATISFACTORY.
DATE..... .....-•-•-------•---.....••- Inspector -
THE COMMONWEALTH OF MASSACHUSETTS
,/ - BOARD OF HEAL H
f,< 'a ...............OF.... !�!!`•!! n !..I_......................... . .
No....��....�..........?6 FEE..... ` ie.........
Roposnl Work Tunstrurtinn Permit.
Permission is hereby granted : '_ .... 21.IS _ ....._...... ........................................................
to Constr c ( epaarf ,�' an Individ al Sewage D Sys
�.. . . .............................................
Street
as shown on the application for Disposal `'horks 2onstruction Permit N ,,. _,.. . Dated L
_.._._ .]L. %
•...................•---_... t a 111
Board of Health
.............i)-a-1- ..,I I
FORM 1255 A. M. SULKIN, INC., BOSTON t
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W r No. 19,o a
o p No.366
F. s �fGIS�ER�O, y�'
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LEGEND
EXISTING SPOT ELEVATION OxO. CERTIFIED PLOT PLAN
BXISTINO CONTOUR O
FINISHED` SPOT ELEVATION`_ 4 /3A ST.' KTo�lES SAY
FINIsHEO CONTOUR aT
NOTE: The location of. any existing _under ;i o_w, sewura�e, "'�'�' I N
wells,: or other utilities shown on this plan- is approx
imate only as doterm nea.;from records and/or verbal , ' SA I S7,49 L Ao IJ ASS*
inforatation. .The contractor is responsiblo for, the
verification of .tha existing locations an the;;field. gCALE1.` "- 50' '. DATE & ,2 .25 `
�.DRfDGE ENGINEER B Ca IN 606T. i' CERTIFY THAT THE PROPOSED
a B BUILDING SHOWN ON THIS PL AN
EOISTERE RE61STlI�Ep +.
'' JOS N0.`'
_ ti ,TO THE ZONINQ LAWS
CIVIL ;�; ,'LANO CONFORMS
r ' on,By OF gAl#,NSTABL MASS
' . 712 MAI N STREET+ -�S� ,r GN• OY� : Z
r
ry MYANNI9, .MAS3� �` eNEET,G:Of; 'Z ATE. :r REG. L.AND SURVEYOR
7 -•r�R i77�L.{f�t'4'�Js. .RnrS i is ,S , ,. .7,T7.7777.77,. �.
-71
1 20 FT. MIN. 0'E /F E/TNER S?s!E =�TIC �4N_k Di?
'.E,ac.,lnrG PIT ARE MORE T/�+A:`J /2' BELOyt/.
/O FT• M/�/•. �f` �:kAOE, fa 24 'O/AM E.TE�' G'oNC.�ETE COt�E'R
,�. '� ! S,+•IALL ®F ,9RDUGNT To.GJgAOE_L•i-�N EXTRA
4"o✓C PJ PE
E.4✓Y CA S T
CON R TE l
C E
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C'D i�ERS � //V ,f7R/1%E 1�VA Y
YB PER }
Gk•1oE. CCU VER CL EAN. .SAND ; 1
BACX�ILL. j
.L _ - _ L/gv/o LEVEL •s.r I ,. -
<j• DIA. tiz 2•LsiYF12
d--' S C HEO MA 4O ' �• R.ir-
y.c. -IRE r a o o a o o aF VB" 4
_cia M/N.P/rcnr G.4L. D/sT, o • • . . . . 1 r e �„� jyA5H1�0 STGh,E
j :: is-PEJs J•T [ SEPTIC TA/VK eax c. e 1 • •� • 1 • n n
i p • O � 1 1 •� 8 I • • • • � •�0 C
:: t ♦ p EFFECT/VE • �,
_ D .• DEPT// • • • ♦ p , WASHED STONE
:ram: •S: 7� e a PREC457"SEEPAGE
d : 7g a v. a 1 • a • • • • • • D pap P/7 OR EQU/✓.
ff t Ni/�R? t�L E i/AT/ON 3 a p o •,F�• . s: . . 1 1 a o
nn �/� o O �.
,./NYERT AT B!//LD/NG
to C SEE >
s/NL ET SEPTIC TANK _ FT. FT VI�4/+'/. TABUL.4 TON l
OtvTLFT SEPTIC TANS- Fr, 1
" `�/NrLET DISTR/,3Lj/ON BOX f°��'� FT. SECT/ON OF GROu/Vo W�1TEI� 7A9LE
OUrLE7D/STR/,941T/DN OX/d F. FT
INLET LEACH/II i F�/T ioS' o FT. SEWA SE Q/S/POSA L SYSTE/;'1 Ti4QULAT/ON
L EACH!/VG P/7'
SCALE l4'. _ /_ O" oJMENS/ON .A 3 FT.
DESIGN CRI TERlA D/JyEJYs/o N to FT.
NUM6FR OF 6EDRDOMS `� D/HENS/ON C= FT.
GARBAGE 0/SPO5AL (JN/T v-o,'d SO/L- LOG
SO/L TEST
TOTAL EST/M.4'TEp FLOW`-3._ SOIL. TEST #! SOIL 7jES7-#2 .
A(UMBcR 0,9' 404CRIM6 ,ojT,> _ EGEK ,DATE OF SO/L TEST
f S/DE!.EACH/Mr, PER PIT r'88 S $Q, FT. RESULTS w/T/VESSED BY
!eoT7To^f LziCH/NG pER P/T._7 S.O.'S FT {� O- 3 �'0"° PtJtCOLAT/ON RATE , !YI/N•/INCK
TOTAL LEACH/NG AREA a!"� SQ. FT. S✓i6 ,s. PERCOLi4T/ON RATEI�2 MI/V./INCH.
.Q c 3EKYE L EACH!NG Ai?EA_ ' 7 S, . F T. �
� xE , TEST
Cr s S!\ �P�TH'OF 4
PHILt
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>" WE115BERG '
<N1 ' f No. 366
\ ,%F o�Fc DREDG N.
E ENG/ EER//ti/G CO,JN
•�: \ a•i x rl ,SrEF` 7/2 M�1 JN ST. C.. .�
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/ NAL �. NO.GROUNv. Y6'ATER ENCOIJ/VTF 2cp L� -r .� E -je U.47
Y+iATER AT ELEt! - ✓OB NO F'40g�? SHEET=OF..2 —
5 0*5 i
L0 C !0N SEWAGE PERMIT NO.
&,21v\
t A AD0
rN T �, LLB N E
O
�`R U i L 0 E R DR . OWNER
CRATE -PERIiT ISSUED 61
VATE GDPAPL ! ANCE ISSUED g - �
L 6T /-3 )
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