HomeMy WebLinkAbout0082 SANDY VALLEY ROAD - Health k 2 8ANllY VALLEYd
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TOWN OF BARNSTABLE
LOCATION_ FJ SAA D VA'1I Q f SEWAGE# 2—01:7 Z J
VILLAGE M AISAAS M% �/,S ASSESSOR'S MAP&PARCEL _ 161 - 6
INSTALLER'S NAME&PHONE NO.
SEPTIC';TANK CAPACITY C�;, G
LEACHING FACILITY.(type crib, §-DJ LC (size)'. 1, - X Zj-k Z-
NO.OF BEDROOMS
OWNER /�!V
PERMIT D TE: / /'C�. 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
r
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leachin ility) Feet
FURNISHED'BY
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A Z 34, .
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1 VO z- 'C
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N4 20 ' J Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2ppliLatlon for Misposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade(0<) Abandon( ) ❑Complete System kndividual Components
Locat*on Ad ess or Lot No. 2.S A./uL(VA t(.2'i(/L 4l, q er's Name,Address and Tel.No.
K A ("A s
WSac� (-(�`< 2�Assessor's Map/Parcel C S- -S r1 I stall s NameE Address,and Tel.No. D si ner's Name,Address,and Tel.No.
�<<i G•-f .e K�a-�4.�,a✓1 ��y
aubb�i �p�dw►U1 �►� � S L�sno 3�x�i�-1 � s-7Sik.��r.���i-i D� 360 33/1
Type of Building:
Dwelling No.of Bedrooms Lot Size 2U(0004' sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures Design Flow(min.required) 33 b gpd Design flow provided Z '2-�� gpd
Plan Date (O Z 4). ( -7 Number of sheets 2 Revision Date A Z)°�—
Title
Size of Septic Tank (0�0 .QJ�c Sfi/l (� Type of S.A.S.I 2- -!5PD e,-1n-gi7 C-6t 4-vi lj-2rj
Description of Soil S-t-f2— A-3,!�j V
Nature of Repairs or Alterations(Answer when applicable)
LP t,w 14-0 Z (.
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 by this Boaz ealth.
Signed Date
Application Approved by e
Date
Application Disapproved by Date
for the following reasons
on
Permit No. y l Date Issued ( _f
Fee
No. 2017
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes
F
2pplication for ;Disposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade(X) Abandon( ) El System ,Individual Components
Location Address or Lot No. eZ S Ali•)q 0A R+ e,-(✓l d Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel ( �
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
l�,eItCtl,3 / Uuie P .C, "-j -4,-14-44-i,.,,l t E( Fed Su/t5
A w av�,6(t S 'ic{ ic:� Alck �v &c 2. 6 Z ov �°X�t� � L !1 7 1/1/1)Wtc(I 56f 36D 331;
Type of Building: `4
Dwelling No.of Bedrooms -- Lot Size 2 U1Ob o-1 ' sq.ft. Garbage Grinder( )
Other Type of Building ,-t/10 C tin (y No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33 b gpd Design flow provided 3� Z gpd
Plan Date (o Z ? , Number of sheets �- Revision Date yj Z)^-•9--
Title
Size of Septic Tank -P l S fi /1 E Type of S.A.S. 5DD C h.e iS
Description of Soil kel
9.
76 �
FYv'f
Nature of Repairs or Alterations
l(Answer when applicable)
" /Y I A e-e '{'1'1(e f� L P (r-,1-k'(/t Z. t spo Cj A ((o/I '-e C o 4-;41 h-e--J w 1r
Lj !s�/-C
Ay—am 14
Date last inspected:
Agreement:: 1
• 1
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 by this Boardof ealth.
Signed Date ( � /
Application Approved by " ( Date 77 (3" � -
.� Application Disapproved by Date
i
for the following reasons
Permit No. ,�O 1 ( Date Issued r
---------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( X)
Abandoned( )by (�)V e 4 0 1 1 S I J D/V c' Q,C-101
at 8 2 S A✓!c U/1 Le vI 12.C4 M✓"( has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.A01 I ,2Ij dated -�' '
Installer '6✓e-4t D ( 1 5 Designer (-A-t Glen
#bedrooms 3 Approved design flow �3 (L 'L 5 gpd
The issuance of this permit
`s all not be construed as a guarantee that the system will fimctio'n as esi ned.
Date '� 1 1 J�-7 Inspector
'a.
---------------------------------------------------------------------------------------------------------------------------------------
No. PC)F3 — k Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Disposal *pstem Construction Vermit
Permission is hereby granted to onstruct( ) Repair( ) Upgrade(X) Abandon( )
System located at 6 2 )A nC4U V� j r�G/1 R. 'y� A,4
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.
Provided:Construction must be completed within three years of the date of this permit
Date Approved by �
I
__ I
Town of Barnstable
Regulatory Services
g Y
Richard V. Scali,Interim Director
f BARNSrnat.e.
9� MASS. 10 Public Health Division
'�FunnA�" Thomas McKean,Director �3
200 Main Street,Hyannis,MA 02601 i
Office: 508-862-4644 Fax: 508-790-6304
Installer &Designer Certification Form
Date: 1 Sewage Permit# Assessor's Map\Parcel d
Designer: ?_ &7VJ
� Installer:
' Address: -1 Address:
_E VVJ 1644 l
� -
On D6NIQ l 4 as issued a permit to install a
f1
(date) costa 1 r)
septic system at Vq VA u, based on a design drawn by
( ddress) q
W dated l0 4 ,1
(d signer) I.
Fix W of�
X I certify that the sep�em referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. 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 squired) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was construct e with the terms
of the IAA approval letters (if applicable)
(Instal er s Signature) ` •: 9 9
_LJ,t (7
(Designer's Signature) (Affix Designer ' amp Here)
PLEASE RETURN TO B STABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
QASeptic\Designer Certification Form Rev 8-14-13.doc
I
Town of Bknstable.
P#��C —
. � Department of Regulatory Services /) 2
• Public Healer Division Date
tee$ 200 Main Street,Hyannis MA 02601
' rEo�" ' •
Date Scheduled i Time Fee Pd.
oil Suitahi ity Assessment for Sew e Disposal
Performed By..
rA..V v {1 CQ A. ' Witnessed By:
i
LOCA O & G I INFORMATION 's
Location Address S�n
Owner's Name je_ ` t i'ol S
M M,,`1
Address —5 7pk -
Assessor's Map/P4rcel: �I /V b� I Engineer's Name 2
NEW CONMRUt"ON !(( REPAIR '\ Telephone# J�� ��•0 J
, -A
Land Use , r[� L _ Slopes(%) ® Surface Stones Iv
Distances from: Open Water Body , ft Possible Wet Area Drinking Water Well ft
inage Way ��
Dra ft. Property Line ____L0__ft Other
ft
SKETCH:(street name,dimensiads'of lot,exact locations of test holes&perc tests locate wetlands in proximity to holes)
064
S �
� i
f in i p U1 al�te�Q
i
i
Parent material(gedlbgic) �e Y � I Depth to Bedrock
Depth to Groundwater. Standing Water in Hole:' i Weeping from Pit Face
Estimated Seasonal ilfth Groundwater l� '
DItTERUN `TION FOR SEASONAL HIGH WATER TADLE
Method Used: ! I ln.
Depth db,5erved standing in obs.hole: In. Depth to boll mottles, ft
Depth toiweeping from side of obs.hole in. Cimundwatet Adjutltment
Reading Date Index Weevtil ' Act.faetar,,,._,- Ad.OrnnndwateeLeval..,,.
Index Well#-_.r... Well -- '
I
PERCOLATItON TEST • Hate-•-----. Time
Observation Ii 'l Itne 6t 9" - —�
Hole#
Time at 6"
Depth of Pere
..
1 S I lime(9"-6") -
Start Pre-soak Time. --
End Pre-soak
Rate MinAnch !
Site Suitability Assessment: Site Passed X ._
Site Failed:. Additional Testing Needed(YIN)
Original•.Public Health Division Observation Hole Data;To Be Completed on Back
***If percola>itjn testis to be conducted within 100' of wetland,.-You must first notify the
Barnstable 6d servation Division at least one(1)wetYlt prior to beginning.
DEEP OBSERVATION HOLE LOG Hole# ` C
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistencv.%Gravel)
tj
FD
DEEP OBSERVATION HOLE LOG Hole =�
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistencv.%Gravel)
2�-�-30" 6
1
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)
II
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Sop V Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders.
ie
Flood Insurance Rate Map:
Above 500 year flood boundary No_ - Yes X_
Within 500 year boundary' No Yes„v
Within 100 year flood boundary No Yes
Depth of Naturally Occurring Pervious Materlal
Does at least four feet of naturally occurring per io,s m terial exist.in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring p ious material?
Certification
I certify that on Lo (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 requir to experns and expe 'ence described'n 3;10 CMR 15.017.
Signature Date
Q:WMCVERCFORM.DOC
T
TO OF BARNST LE
LOCATION �� SEWAGE #
VILLAGE C N(11,31 ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: 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
f
C,
13 N OA
Ab
a�
33
LOCATION tom" SEWAGE PERMIT NO.
_ J MW
`VILLAGE
I N S T A L E 'S NA i ADDRESS
h
® U I L D E R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
4
i`
�No.l._. .`" d... FEs.... .`.............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town i�arnstabl e
...................... ....................O;F..........................................-----.----..........---------.............-----•
XpVtiratiun for Uiipuial Works Tonotrnr#iun ramit
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
System at:
Lot '24, Sandy Valley Rd. , YlarStons Mills ; IiA
.................................................................................................. .............................................................................•---...........----••
Ca ricorn RMT' 'Tpust 765 Falmouth Rc�a�;N�iyannis
...................------................... y...........••-------......................... ......._.............----.....----..•... --.
W Owner naaress............................................
Steve L e bel
----.......-••-----•---......---••................•--•-....................---•-.......-----....--- ---.........•-••--.......--•--•.......-----.................------------•----......--------.......
Installer Address
� feet Type of Building Size Lot...........................S q.
U Dwelling—No. of Bedrooms. ........................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building Y'anGll.............. No. of persons............................ Showers (2 ) — Cafeteria ( )
Otherfixtures .................-....................................................................................................................................
Design Flow........55...............................gallons per person gger day. Tot 1 dail flow........�39............................ lons.
W 000 °b" '1ff" It
WSeptic Tank—I_iquad capacitv1.......:..gallons Length............... Width- ....._....._.. Diameter__._.__..___.... Depths..____.____...
x Disposal Trench—No..................... Widt _............_...... Total Length...... _------
SeepageTotal leaching area... _. ... sq. ft.
.____.. Diameter.........__..... Depth below inlet.._..�......._. Total leaching area.. 66....._.sq. ft.
� Pit Not...._._....;
Z Other Distribution box ( ) Dosing tank ( )
Eldredge Engineering Date Percolation Test Results Performed bY......................................................... .........._....__.._____..
Test Pit No. 1 2.�0..._...minutes per inch Depth of Test Pit__-12�.......... Depth to ground watefione encounter-
•--•......_._minutes per inch Depth of Test Pi _ Depth to ground water_.. cl
Lti Test Pit No. NIA �� .�..:.__._.__. �
W •-- --•- ••••------ --------• ---------
...................................................................
0 Description of Soil-----....��.. 2 -loam..&...topsoil
----• - . -•-•••......----•................
x 2' - 10' Iviedium yellow sand
----....-•-••-•-•-•-••-•--......••.•... -•-•-
W 10' - 12' med. white sanditraces 0f gravel rio water at 12 '
---------------------------•-----••-•••--•-••••-•--•-•--•---------••-•--•-------......-•-••-•---•---•----•--•---•-••--------•••----•-••••--•---••-•-•--•-••-••--••...••-•••......••--•---•-------.-•---
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 ITLL 5 of the State Sa •tary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance as n issu d by he byrdoAealth.
gned. . ... . axe- ' 9 22.....3.......
Application Approved By.... �..... l�-----�...�.............
Date
Application Disapproved for the following reasons:..........................................................................................:...................- ,
.........................................................................................................................................................................................................
Date
PermitNo......................................................... Issued.......................................................
Date
Noll"_f� •-- FEs...$162.,............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
J:ovm Barnstable
..........................................OF...........................................---------.....
Apli iration for Uiipoiitti Workii Tonutrurtion Permit
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
System at:
Lot #24, Sandy Malley Rd. , Marstons Mills , IriA
......----•-•--•.......................................,•d•--.._.......--•---...----------------••-- ----------••-•-............------•-•-•--•---•------•--p--�------...--------•--..............._------
Capricorn Re�TttYA'dPdst 765 Falmouth RoN&t N17yannis
......................_.......................................................................... ........................._..__.....•-------...._.............----••-----.............._.........--
W
Steve L e b e l Owner Address
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms—---------------•--_--.--_--------___--.-Expansion Attic ( ) Garbage Grinder ( )
Other—Type of BuildingranCh................ No. of persons............................ Showers ) — Cafeteria ( )
Q, Other fixtures .----•--•---•-••-•------•--•-------••-•.............. ......6...•------•••-•---••------------------
Design Flow......33.................................000 gallons per person,per day. Total daily flow__._..33�...._......................_gallons.
WSeptic Tank—Liquid capacit,. ...gallons Leng ................ Widt ..._.0._.._.. Diameter................ Dept ...
x Disposal Trencll—No. .................... Widgh............._...... Total Length..__67__._....... Total leaching area.. �......... ft.
26
Seepage Pit N6.----_- Diameter.................... Depth below inlet........._...._____ Total leaching area......__.___......sq. ft.
Z Other Distribution box ( ) Dos iL t�nk (,g) g g S
L�l rea a Engineering 11-2 -81
Percolation Test Results Performed by........................................ __ Date........................................
a 2.0 12� one er�counte
Test Pit No. 1...............minutes per inch Depth of Test Pit Depth Depth to ground wat�_;.rr..___.-.-------._. e -
f=, Test Pit No. lA__...___._minutes per inch Depth of Test PW/A.............. Depth to ground waterl----`..................
pi .............................................................-_-__-..........................................................................................
0 Description of Soil........O f ' 2# loam & to soli
-- -__ ---------•-•--------------••-----•-------•-•---
xIviedium ye ow..san
U v----------•---,-------i6-----------
10 - 12 med. white sand traces off` ravel no watt a 12
UW ------------------------------------------------------------------- --------------- ..................................................................................................................
Nature 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 system in
operation until a Certificate of Compliance has been issued by the board of health.
i ned !I r S• 9/22/�3
' g -•-•-•----•••-•--........•-----•---••---•--••--------------•---•---.....---•-•-••_.._ Z")"t-e
Application Approved B - �
Application Disapproved or t following reasons:---•-••----------------••-------•---------------------------...---------------••-------------•-•........--_.._..
----------------•-•-----•----•----••-----••••--••••--.....---....._..---•--•--............---------...---...------............------------------•------•-••-••-----•----•-----•-•--•' -•-••-------•-
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH'OF MASSACHUSETTS
BPARD OF HEALTH
Town...................oF.....Barnstable........................
--••••-•..............
(Irrtif irate of Tompliattrie
THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ) or Repaired ( )
by.................... eve Lebel
-St-----------..._.........---------....-----------------------..._....._..---..........---.._.._....---.............._..........-----------_..._
at.
Lot 1 24, Sandy Y alley Rd. , Instal kIarstons Mills , liA
•-------•--•--•----------•-••- - ---•-•-----••...--•--•-•-----------••-••---•-••-•-•-••••-------•--••-----------------•-••-•-----
.......----•----------•-XesibeYi-n
- ----------
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary CZA.1;eN
the
application for Disposal Works Construction Permit No} __.-r-.. S: ............ dated _ __.__.__..____._..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............................................6,�51.94................ Inspector................ ---�...................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
`%'o :�i of Barnstable
_C ..................... .........._..
N . ......l� FE>..1 ...............
Did aout Mork Tonstrurtion rrmit
• � Steve Lebel
Permission is hereby granted ......................
to Construct _ „) Repair ( a v,'d 1 Sewa a Disposal System
at No....�Ot '�-•--�4.'...�andy....:`�a��e�"...d, 0 l arstons Mills , i�lA
Street
as shown on the application for Disposal Works Construction Permit No.................
.................. -------- .. ............................................................
D A
••.....----...._........... Board of Health
FORM 1255 A.M. SULKIN, INC., BOSTON rt�
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LEGEND
EXISTING SPOT ELEVATION Ox01HOF ^fR.p CERTIFIED PLOT PLAN
E ISTING CONTOUR --- p -- - ' ,�- s'cy Go7 zg sgNpY Y•R3�� Y �U
F�NISHED SPOT ELEVATION ��^ ROBERT G
FINISHED CONTOUR 0 �` BRUCE 'aI�T�STa�cs- /�It� G.s
EIDRED
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APPROVED , BOARD OF HEALTH :o. IN
A.
D SURd,y
DATE AGENT SCALE, / "= 3 o r DATE /0// 3`83
CLOREDGE ENGINEERING CO. IN CLIENT ��.�__�"_ I CERTIFY THAT THE PROPOSED •_
E C'IVIL E REGISTEfiEO JOB Np, �Y3 ��6 BUILDING SHOGUN ON THIS PLAN
CIVIL LAND CONFORMS TO THE ZONING LAWS
ENGINEER SURVEY R DR•BY'- ' OF BARNSTABLE , MASS.
712 MAIN STREET. CH. BY,
HYANN I S, MASS. SHEET /
OF DATE REG. Li,ND SURVEYOR
20 fr MI/V. /OTF /F /TNL`�? ;-AV
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�XUMBEe GF 4C•1CXtNa A/73_ /
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SQ. f T. J'2<3
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APPROVED , BOARD OF HEALTHSTf-
DAT E AGENT SCALE' / "_ 3 0 ' DATE , /o`/ 3`83
LDREDGE ENGINEERING CO. IN CLIENT ' _ I CERTIFY THAT THE PROPOSED
EGISTERE REGISTERED JOB NO. 3 2 6 BUILDING SHOWN ON THIS PLAN
CIVIL LAND DR.BY� CONFORMS TO THE ZONING LAWS
ENGINEER SURVEY OF BARNSTABLE , MASS.
712 MAIN STREET.
SHEET Z CH. BY,
HYANN I S, MASS.
� OF DATE REG. Li:ND SURVEYOR
%TOTE : /F c-/TNLR Ts,l 'w SEr�T/C TAN,f OR
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N
COMMONWEALTH OF MASSACHUSETTS '
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
v
DEPARTMENT OF ENVIRONMENTAL PROTECTION
m �
ti
ve ..
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS w
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A a
CERTIFICATION
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner's Name: LENTO
Owner's Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
i
Date of Inspection: 2/12/01
Name of Inspector: (please print) JOHN GRACI
Company Name: SEPTIC INSPECTIONS
Mailing Address: P.®"BOX 2119 TEATICKET,MA.0253C
Telephone Number: 508-564-6813 FAX 508-564-7270 x
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:
X Passes'
'
_ Conditionally Passes t ;
_ Needs Further Evaluation by the Local Approving Au:liority
Fails }'r
Inspector's Signature: / Date: 2/12/01
The system inspector shall submi a copy of this inspection report to the Appro-,i ig Authority(Board of Health or DFP)within :x
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 T. i
THE SYSTEM PASSES TITLE V INPECTION. RECOMMEND PUMPING SYSTEM NOW AND EVERY TWO YEARS
TO PROLONG THE SYSTEM'S USEFULL LIFE.
****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.
,
,Y
Title 5 InenPrtinn Fnrm F/1 5/1000. 1
f
Page 2 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648 '
Owner: LENTO p.xd
Date of Inspection: 2/12/01
Inspection Summary: Check A,B,C;D or E/ALWAYS complete all of Section D }Ly
nr5
A. System Passes: ' i
X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310
CMR 15.304 exist.Any failure criteria no'Cevaluated are indicated below.
Comments: s
THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM NOW AND EVERY TWO '
YEARS TO PROLONG THE SYSTEM'$USEFULL LIFE.
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(YN,ND)in the for the following statements.If"not determined"please explain.
n/a The septic tank is metal and oveeN 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. t'
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating f
that the tank is less than 20 years old is'available. 4.
ND explain: n/a
n/a 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 pipes)are replaced
_ obstruction.is removed
_ distribution box is leveled or replaced
ND explain: n/a
n/a The system required pump►rig,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
A
. 5
ND explain: n/a �.
• y��' f
•i
{
Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS .W '
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner: LENTO t
Date of Inspection: 2/12/01
C. Further Evaluation is Required by the Board of Health: ✓ '
_ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to
protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is i
not functioning in a manner which will protect public health,safety and the environment:
a
_ 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 �Yy.
system is functioning in a manner that protects the public health,safety and environment: ''
t
_ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water
supply or tributary to a surface watWsupply. j
f
_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water
supply well".Method used to determine distance n/a
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and
volatile organic compound§'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 + ks
of the analysis must be attached to this form.
42
3. Other:
s 4""
n/a
1
11
f
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner: LENTO
Date of Inspection: 2/12/01
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for alLinspections:
Yes No
X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged
SAS or cesspool
_ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool
X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times
pumped nLa.
X Any portion of the SAS,cesspool or privy is below high ground water elevation.
X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
_ X Any portion of a cesspool or privy is within a Zone 1 of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well.
X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with
no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP
certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free
from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be
attached to this form.] +:
(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310
CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design!low of 10,000 gpd to 15,000 gpd.
You must indicate either"yes"or"no"tp each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
X the system is within 400 feet of a surface drinking water supply
_ X the system is within 200 feet of a tributary to a surface drinking water supply
X the system is located in arnitrogen 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 3.
"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 r sa upg y
should contact the appropriate regional office of the Department.
; a
a
Page 5 of 11 '
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648 t
Owner: LENTO }
Date of Inspection: 2/12/01 ;
Check if the following have been done.You must indicate"yes"or"no"as to each of the following:
Yes No
X _ Pumping information was provided by the owner,occupant,or Board of Health = t [
X Were any of the system components pumped out in the previous two weeks? ;t;
X _ Has the system received normal flows in the previous two week period? :
X Have large volumes of water been introduced to the system recently or as part of this inspection? is
X Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X _ Was the facility or dwelling inspected for signs of sewage back up?
X _ Was the site inspected for signs of break out?
X _ Were all system components,excluding the SAS,located on site? �
X _ 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?
X _ 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: t
Yes no
X _ Existing information. For example;a plan at the Board of Health.
X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is
unacceptable)[310 CMR 15.302(3)(b)]
a.
141
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Page 6 of 11
3g
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
' F
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C ,.
SYSTEM INFORMATION
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner: LENTO
Date of Inspection: 2/12/01
FLOW CONDITIONS ,.
RESIDENTIAL
Number of bedrooms(design): 4 ->Number of bedrooms(actual): 4 ;
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440
Number of current residents: 1
Does residence have a garbage grinder(yes or no): NO ,; R
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(Yes or no)- NO `
Seasonal use:(yes or no): NO
Water meter readings,if available last 2 years usage d n/a ` }
Sum um es or no : NO
PP pump )
k
Last date of occupancy: n/a
E.t.KAI .
COMMERCIALANDUSTRIAL kit
Type of establishment: n/a
Design flow(based on 310 CMR 15.203):1n/aged `
Basis of design flow(seats/persons/sqft,etc.): n/a -_
Grease trap present(yes or no): NO
Industrial waste holding tank present(yes or no): NO
Non-sanitary waste discharged to the Title 5isystem(yes or no): NO
Water meter readings, if available: n/a
Last date of occupancy/use: n/a
OTHER(describe): n/a
GENERAL INFORMATION 4
Pumping Records I
Source of information: n/a 1
Was system pumped as part of the inspection(yes or no): NO
+If es volume pumped: n/a allons"—How was quantity pumped determined? n/a
Reason for pumping: n/a
TYPE OF SYSTEM .
X Septic tank,distribution box,so'i'l absorption system
_Single cesspool
_Overflow cesspool '
_Privy %` rs
_Shared system(yes or no)(if yes,attach previous inspection records, if any) i
_Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract to be obtained from t'
system owner)
_Tight tank Attach a copy of the DEP approval
Other(describe): n/a
Approximate age of all components,date installed(if known)and source of information:
1984 '
Were sewage odors detected when arriving at the site(yes or no):NO
3.
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r.:.
PART C
SYSTEM INFORMATION(continued)
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner: LENTO '
Date of Inspection: 2/12/01 -
ew.
BUILDING SEWER(locate on site plan)
Depth below grade:9" +
Materials of construction:_cast iron X407PVC_other(explain): n/a '
Distance from private water supply well or suction line: n/a
Comments(on condition of joints,venting,evidence of leakage,etc.): '
TOWN WATER
SEPTIC TANK: X(locate on site plan) r l
Depth below grade: 1" `
Material of construction:
truction: Xconcrete_metal_fiber lass_polyethylene other(explain)n/a r
If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) ,
Dimensions: 1000G L 8' 6"H 5' 7"W 4' 10""
Sludge depth: 4"
Distance from top of sludge to bottom of outlet tee or baffle:30"
Scum thickness:3"
Distance from top of scum to top of outlet tee or baffle: 6" =i
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
How were dimensions determined: MEASURED
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related {. ".
to outlet invert,evidence of leakage,etc.):
THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING
NOW AND EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE
GREASE TRAP:_(locate on site plan),j4, tx
Depth below grade: n/a '.
Material of construction: concrete metal_fiberglass_polyethylene other(explain): n/a :.
Dimensions: n/a M
Scum thickness: n/a .
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
Date of last pumping: n/a '
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related
to outlet invert,evidence of leaktage,etc: : w.
n/a
gg
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Page 8 of 11
}
motif �
l '3
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS '
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM t
PART C
SYSTEM INFORMATION(continued) `
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner: LENTO
Date of Inspection: 2/12/01
TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: n/a
Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a
Dimensions: n/a
Capacity: n/a gallons s
Design Flow: n/a gallons/day `
Alarm present(yes or no): N/A
Alarm level: N/A Alarm in working order(yes or no): NO F F.
Date of last pumping: n/a ''}
Comments(condition of alarm and float switches,etc.):
n/a
DISTRIBUTION BOX:X(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into a
or out of box,etc.):
THE DISTRIBUTION BOX IS STRUCTURALLY SOUND.
PUMP CHAMBER:_(locate on site plan),
Pumps in working order(yes or no): NO
Alarms in working order(yes or no):NO
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
n/a
P.'s:
...i,:d+:3.
1
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Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648 ..
Owner: LENTO r`• Ytfi.f
Date of Inspection: 2/12/01
SOIL ABSORPTION SYSTEM'(SAS): X (locate on site plan,excavation not required) ? '
S
If SAS not located explain why: ,
n/a '.
Type
1000 GAL 6' X 6' leaching pits, number: 1
n/a leaching chambers, number: n/a
n/a leaching galleries, number: n/a E
n/a leaching trenches, number, length: n/a. ''
n/a ieaching fields, number: n/a
n/a overflow.cesspool, number: n/a
n/a innovative/alternative system
Type/name of technology: n/a
Comments(note condition of soil,"signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.):
THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT
HAD 2'OF WATER IN IT AT THE TIME OF THE INSPECTION.THE PIT HAS NOT HAD MORE THAN 2'OF
WATER IN IT.
.j..k
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) . s +
Number and configuration: n/a
Depth—top of liquid to inlet invert:: n/at'
Depth of solids layer: n/a
Depth of scum layer: n/a
Dimensions of cesspool: n/a
Materials of construction: n/a r`
Indication of groundwater inflow(yes or rio): NO
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
n/a
PRIVY: (locate on site plan)
Materials of construction: n/a
Dimensions: n/a
4
Depth of solids: n/a '
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): :4,
n/a `' ';.
Q
Page 10 of 11
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OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS a ip i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner: LENTO
Date of Inspection: 2/12/01
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.
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Page 11 of 11 ,
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OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS s
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C ,x
SYSTEM INFORMATION(continued)
.i
Property Address: 82 SANDY VALLEY RD MARSTONS MILLS,MA 02648
Owner: LENTO l:s,
Date of Inspection: 2/12/01 7 ..
64
SITE EXAM , , t•
_Slope
_Surface water
_Check cellar „ ,
Shallow wells ar .
Estimated depth to ground water 12+feet 'F
' -.;..•'fig;.
Please indicate(check)all methods used to determine the high ground water elevation:
NO Obtained from system design plans on record-If checked date of design plan reviewed: n/a r.
Y g P � 1�P
NO Observed site(abutting property/observation hole within 150 feet of SAS)
NO Checked with local Beard of Health-explain: n/a 1
NO Checked with local excavators,installers-(attach documentation) p4.:
YES Accessed USGS database-explain: n/a
j;
You must describe how you established the high ground water elevation:
USGS MAPS AND CHARTS- 12+FEET
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UPOLE�' LEGEND MARSTONS MILLS
\ PROPOSED CONTOUR
Nh \\\ ® PROPOSED SPOT GRADE RACE LN.
—— 98 —— EXISTING CONTOUR
LOT 25 + 96.52 EXISTING SPOT GRADE LH- AEL
\ W EXISTING WATER SERVICE �p
TEST PIT H MBLIN
N
_ POND p
SCALE: 1"-20' �.
LOCUS o
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L0 O
� Cps /
bq-
i EXIST. ,000G,1' ,' 4 '' �� �/ LOCUS MAP
! \\\ SEPTI TANK '
LOCUS INFORMATION
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TBM= / ' %' ,/' Q,/' PLAN REF: 334/5
COR. STOOP TITLE REF: 13637/205
,! o EL=72.0 40 , ,� �,' PARCEL ID: MAP 101 PAR. 86
' ZONING: "RF"
FLOOD ZONE: "X"
�}Ci; COMMUNITY PANEL: 25001CO542J DATED:07/16/14
Zz '' + �� '' ` SEPTIC SYSTEM
=G w REPAIR PLAN
' ,' i
TOF=71.65 ' �O / / ' Ile /'�
/ � /r / Q�' �` Q- % LOCATED AT:
82 SANDY VALLEY ROAD
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MARSTONS MILLS, MA.
1/0
PREPARED FOR
KRISTINA KATINAS
,
JUNE 29, 2017
10 OF
N M. ys
i i I R —+
/ - 1140
LOT 24
AREA=20,000f S.F.
MEYER & SONS, INC.
10, ss628' P.O. BOX 981
GRAPHIC SCALE
OT0, F�, F ;� ;' EAST SANDWICH, MA. 02537
'yST� �q� ) , zo o �o zo ao so PH: (508)360-3311
me erandsonst t4e5 —gma8.com
Y 09
( IN FEET )
i 1 inch = 20 ft.
SHEET 1 OF 2 J 1930
ELEV. TOP f
FOUNDATION NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS
(Existing) BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE FINISHED GRADE (66.0)
71.65 F.G.EL: 69.0 F.G.EL: 68.75 F.G. EL: 66'iii50 VENT
a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA
.s
F.G.EL: 68.0 PLACE TEE IN 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2"
D-BOX STONE OR FILTER FABRIC DOUBLE WASHED STONE
6" 1 " 4" SCH 40 . PVC
(MIN. ®®®®®®®®®®
A' TEE'S ARE TO BE INV.63.50 ) ®®®®®®®®®®4' SCH 40 PVC 2 EFF. DEPTHT=rl-= ®®®®®®®®®®
. ..a::: INV.66.75
INV.63.30 4' 2 X 8.5' 4'
GAS
EXISTING OUTLET BAFFLE PROPOSED DB-
3 ,
EFFECTIVE LENGTH = 25'
INV. 67.0 DISTRIBUTION BOX
(H20) INV. ELEV.= 59.0 "
EXISTING 1 ,000 GALLON SEPTIC TANK
GAS BAFFLE TO BE INSTALLED ON ����` OF Mgss9 BREAKOUT
OUTLET TEE AS MANUFACTURED BY
0 oA N M. s ELEV.= 60.0
TUF-TITE, ZABEL, OR EQUAL TOP CONC. ELEV.= 60.0
--------------------------
NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING No.,1 II INV. ELEV.= 59.00 �®®� �®
PIPE INVERTS PRIOR TO CONSTRUCTION ®®®
2) D-BOX SHALL BE SET LEVEL AND TRUE TO 'PFGISTE � ®®®®®®®
GRADE ON A MECHANICALLY COMPACTED SIX SANITAR�P� BOTTOM EL.= 57.00 ®®®®®®®
INCH CRUSHED STONE BASE, AS SPECIFIED IN I 3.75' 5 FT. 3.75'
310 CMR 15.221(2) (( �
3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK l�C v 1 1 SEPARATION 5.40 FT. EFFECTIVE WIDTH = 12.5'
WITH DAMAGED,
GALLON SEPTIC TANK IF FAILED, SEPTIC SYSTEM PROFILE
DAMAGED, NOT H2O LOADING, OR UNDERSIZED. SOIL ABSORPTION SYSTEM (SECTION)
�
4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: 51 .60
GAS BAFFLE AS REQUIRED (500 GALLON (H-20) LEACH CHAMBER)
GENERAL NOTES:
SOIL' LOGS P#:15366 DESIGN CRITERIA
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 3 BEDROOOM DESIGN
BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: MAY 31, 2017 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF)
OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN/IN -
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614
- 310 CMR 15.405 (1) (B): DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.O.
1) A 3.00 FT. VARIANCE FROM 310CMR15.221(7) 70 ALLOW LEACHING WITNESS: DON DESMARAIS, BARNSTABLE HEALTH GARBAGE GRINDER: NO (not designed for garbage grinder)
TO BE 6.00 FT (MAX) BELOW GRADE VS REO'0 3 FT. (H20/VENT PROVIDED)
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR Elev. SEPTIC TANK:
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE TP-1 Depth I Eley. _ TP-2 Depth 330 gpd x 200% 660 gpd, USE EXISTING 1;000 GAL. SEPTIC TANK
DESIGN ENGINEER. 65.20 A 0" 61.60 0" LEACHING AREA REQUIRED:A (330) = 445.94 S.F.
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING LOAMY SAND LOAMY SAND
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN tOYR 4/2 10YR 4/2 .74
ENGINEER BEFORE CONSTRUCTION CONTINUES. 64.20 12"
5. ALL ELEVATIONS BASED ON ASSUMED DATUM. B so.so B 12" USE TWO (2) 500 GALLON H-20 PRECAST LEACH CHAMBERS W/ 4'
e 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF LOAMY 6/6 SAND LOAMY SANG STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D
f THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 10YR 6/6
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 62.62 C 1 31" 59.10 30" BOTTOM AREA: 25 x 12.5= 312.5 SF
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. C1
SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF
8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED PERC
TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. MEDIUM TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D
9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE EL 60.37 SAND MEDIUM
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 2.5Y 6/6 SAND DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd
CONSTRUCTION. 2.5Y 6/6
10. EXISTING LEACHPIT TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. PROPOSED SEPTIC SYSTEM UPGRADE P LA N
REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5.
11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 55.20 120" 51.60 120"
<2MIIN/INCH IN "Ci' SOILS 82 SANDY VALLEY ROAD, M. MILLS, MA
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY NO GROUNDWATER OBSERVED Prepared for: Katinas
AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. Engineering and Survey by: SCALE DRAWN
14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 MEYER&SONS,lNC. N.T.S. DMM
to conduct soil evaluations and that the above analysis has been erformed b me consistent with the PO BOX981
15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/Fi (UNLESS SPECIFIED) ' P y DATE CHECKED SHEET N0.
requirements of 310 CMR 15.017. I further certify that I have passed.the Soil Eval. Exam in October, 1999. EASTSANDW/CH,MA02537
506-362-2922 06/29/17 DMM 2 of 2