HomeMy WebLinkAbout0101 SANTUIT-NEWTOWN ROAD - Health 101 Santuit-Newtown Road, Marstons Mills
031 - 003 - 006.
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is Marstons Mills MA 02648 March 11, 2014
required for every �
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out formsA. General Information
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not David D. Ccughanowr, IS
use the return Name of Inspector
key.
Eco-Tech Environmental
± Company Name
P.O. Box 1265
Company Address
West Chatham MA 02669
City/Town State Zip Code
508 364-0894 1328
Telephone Number License Number
B. Certification
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 ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
00W[ (tYI). 44, S March 11, 2014
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.
****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.
t5ins-3/13 Title 5 Officiajinspct bsurface Sewage Disposal System•Page 1 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
, M 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11 2014
.
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
_.-in 31-0 CMR 15.303 or in 310-CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
Inspector's Note==> The septic system described herein is deemed to pass this Real Estate Transfer
Inspection if it does not meet any of the failure criteria enumerated in Section D on pages 4-5, or
specified by local regulations. The scope of this inspection is limited to health and environmental
compliance and the septic system has been evaluated according to the conditions observed on the
day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing
determination.
B) System Conditionally Passes: R
❑ 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.
Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if-the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
I
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11 2014
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ 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 ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ 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 ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
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 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
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
F Property Address
Dorothy M. Crowley
Owner Owner's Name
information is Marstons Mills MA 02648 March 1.1, 2014
required.for every_ _ _
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
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
. ❑ Y p p Y (SAS)
100 feet of a surface water supply or tributary to a surface water supply.
❑"The system-has a'septictank and SAS-and the-SAS=is,wthin':a=Zone.1-of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent 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:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No"to each of the following for all inspections:
Yes No ,
❑ ® 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
g; ❑ ` ® due to an.overloaded or clogged`SAS or cesspool
r _ 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 '/2 day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
i
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�M 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11 2014
page. City/Town State Zip Code Date of Inspection.
B. Certification (cont.)
Yes No
❑ ® Required pumping more 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.
Ariy portion of p+roSpool 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 certified
laboratory,for fecal coliform bacteria indicates absent 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
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection
El El 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.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 5 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March.11, 2014
page. City/Town ' State Zip Code Date of Inspection
C. Checklist
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
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® 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 break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
Z ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of thejailure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
L W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11, 2014
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
System was installed by.Rodger Roberts in 1997 with no plan required by the Board of Health.
Number of current residents: 1
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d 232 gpd
9 ( Y 9 (gpd)):
Detail:
2012: 75,000 gallons 2013: 94,000 gallons
Sump pump? ❑ Yes ® No
Last date of occupancy: current
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11, 2014
-
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: owner
Was system pumped as part of the inspection? ❑ Yes ® No
If yes,volume-pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® 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)
El Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
Other(describe):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
I
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
101 Santu it-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner
Owner's Name
information is required for every Marstons Mills MA 02648 March 11 2014
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
16+ years. Certificate of Compliance for new leaching gallery was issued 1/5/1998 (Permit#97-731)
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Sewer line appears structurally sound with no evidence of leakage or backup into dwelling.
Septic Tank (locate on site plan):
Depth below grade` 1.5
feet
Material of construction:
E concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is.metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
8.5 x 5 x 6-1000 gallon
Sludge depth: 4 in
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11, 2014
page., City/Town State. Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle 30 in
trace
Scum thickness
..10 in. .,
" Distance from top of scum to,W of outlet tee or"baffle.
Distance from bottom of scum to bottom of outlet tee or baffle 14 in
Ian
How were dimensions determined? Design »
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert,evidence of leakage, etc.):
Pumping is not required at this time. Maintenance pumping is recommended every 2-4 years. Tank
and tees appear structurally sound and functioning as intended. No evidence of leakage in or out was
observed.
Grease Trap (locate on site plan):
Depth below grade Y feet
—,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'orbaffle`
Date of last pumping: Date
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11, 2014
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level': . Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11 2014
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert at outlet invert
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
_ Camera inspection.showed no adverse-conditions. _
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11, 2014
page. Cityf town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits. number:
❑ leaching chambers number:
®-- leaching galleries numoer:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology: - .-- -
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Soils above leaching gallery appear unsaturated. No evidence of surface ponding, breakout, lush
vegetation, or other evidence of hydraulic failure was observed. An observation hole was dug into
leaching gallery stone and no effluent contact staining was observed in the stone or overlying soils.
No standing effluent was observed to a depth of 8 inches below the top of the peastone layer.
i
- - -..Cess pools.(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 ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
r
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11, 2014
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection. Form
Subsurface,Sewage Disposal System Form - Not for Voluntary Assessments
N cwM 101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner
Owner's Name
requir ation is Marstons Mills MA 02648 March 11, 2014
required.for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
NOT THIS SKETCH IS
TO BEST VIEWED IN
SCALE LEACHING GALLERY COLOR FORMAT
DISTRIBUTION BOX 0
• 1000 GALLON -OF SEPTIC COMPONENTS
•
SEPTIC TANK -DISTANCES IN DECIMAL FEET
A B
A g 1 23 31
2 26 39
EXISTING -BASED ON AS BUILT CARD PROVIDED BY
D B/�►AI�B Q I�QG INSTALLER TO BARNSTABLE HEALTH DEPT.
Q 1%IYLSL-15 uvl�
w 1101
Q
LU
Ln
0 _ =
Z 2
0 J
-o.
508 364-0894
SSA nM UIT-nNEWTOWnNl ROAD
t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
. � a
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
101 Santuit-Newtown Road Assessor's Map 31 Parcel 3-6
Property Address
Dorothy M. Crowley
Owner Owner's Name
information is required for every Marstons Mills MA 02648 March 11 2014
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:.
❑ Check Slope
❑ Surface water
Check cellar_
❑ Shallow wells
Estimated depth to high ground water: 50+
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
❑ 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:
Town of Barnstable GIS Department records
You must describe how yowl established the high ground water elevation: .
Town of Barnstable GIS Department records indicate that the property is over 50 feet above
groundwater table.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection _Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments'
�M 101 Santuit-Newtown Road Assessor's Map 31. Parcel 3-6
Property Address
Dorothy M. Crowley
Owner
Owner's Name
information is Marstons Mills MA 02648 March 11 2014
required for every +
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A,B, C, D, or E checked
® Inspection SummaryD(System Failure Criteria Applicable to All Systems)completed
® System Information- Estimated depth to high groundwater
® Sketch of Sewage.Disposal System either drawn on page 15 or attached in separate file
GEOHYDROL.OGICAL. PROFILE
NOT TO SCALE
BOTTOM
OF Y
LEACHING
GALLERY
LEACHING IS
ABOVE HIGH
GROUNDWATER
GROUNDWATER ELEVATION
PER GIS MAPS
t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-:Page 17 of 17
OF BARNSTABLEv
LOCATION L to I\jt1lR SEWAGE # 7
VILLAGE) s '� .S nn ASSESSOR'S MAP & LOT0)1 "003"026
INSTALLER'S NAME&PHONE NO. �rz ee2"
SEPTIC TANK CAPACITY S
LEACHING FACILITY: �-- size OKy�K
NO.OF BEDROOMS 3
BUILDER O OWNE
PERMITDATE: I�Z-Z3-1'1 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Pr yate::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 `
I. -_ _ ._
� Su�cSo�L
77,
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No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS
01pprfcation for Zigogal *pztem Cow5truction Perron
Application for a Permit to Construct( )Repair(/pgrade( )Abandon( ) El Complete System El Individual Components
_SR rr1 --
Location Address or Lot No.Ioi N 6wTQwNG XaAD Owner's Name,Address and Tel.No.
(Vl�Vl/CiI�S �ZS 1�� S
Assessor's Map/Parcel
O , o�
In ler' Name,A ss,.and Tel.N —(�jp��/ Designer's Name,Address and Tel.No.
`2,
MA
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3-30 gallons per day. Calculated daily flow gallons.
Plan Date 2-a Z3 7 Number of sheets Revision Date
Title f 0 S S
Size of Septic Tank G 2!,t SA Type of S.A.S.
�--
Description of Soil An min S
Nature of Repairs or Alterations(Answer when applicable)
(A i y2LCI i2S L— 1 St-
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 be
Signed Date A
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued &_—WjY7__
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
ZIppYication for oitpogar *pttem Congtruction Permit
Application for a Permit to Construct( )Repair(/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
'" —
Location Address or Lot No.101 /y j5W7 pl.WNC�- A--0 Owner's Name,Address and Tel.No.
Assessor's Map/Parcel PA,
Mi t V-1
O o a �J
In let's ame,A, ss,and Tel No Designer's Name,Address and Tel.No.
c MA C -fl-CA&_ $c P G
Type of Bu ding:
Dwelling No.of Bedrooms' Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
-- Other Fixtures
Desigd Flow 33 0 gallons per day. Calculated daily flow 3y 9 gallons.
Plan Date I Z-"'23- `( 7 Number of sheets Revision Date r'
r Title R�
Size of Septic Tank _ t STi Type of S.A.S. Gt �t—
Description of Soil 0
Nature of Repairs or Alterations(Answer when applicable) 1/J-1 o ST`
"tn�kjv- f� C., C U in(-r'r-ti_ ,1 LA_ (-T vu.TO V?S t., - LA t S1 a V,S;
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 harbe eal
4 Si `� ' Date 1�
Application Approved Date
r
Application Disapproved for the following reasons
9
Permit No. r Date Issued
-----------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-siteSewage Disposal S stem Constructed( )Repaired( )Up g ded
Abandoned( )by �l�a t(� S y\ I 6-C APE &6 0t
at W 7u (,L S has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. — dated
Installer Designer
` The issuance of this permits all not be construed as a guarantee that the syst 11 f c ' s desagned
Date / ' S" Inspector -
r
--------------------------------------- -
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
xigoont *proem Construction Permit
Permission is hereby granted to Construct( )Repair( Upgrade )Abandon( )
System located at 101 e Jj —\O W L) -H S b 1,1
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:Construction st be co leted within three years of the date o thi pe tom.. C
Date: Approved by
r 1019/97
NOTICE: This Form Is To Be Used"For the Repair Of Failed
Septic Systems',Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR
DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT
ENGINEERED PLANS)
hereby certify that the application for disposal works
construction permit signed by me dated �� •concerning the
property located at 1 fti����l^'` meets all of the
following criteria:
e There are no wetlands located within I o0 feet of the proposed leaching facility
There are no pr
ivate wells within 150 feet of the proposed septic system
There is no increase in now and/or change in use proposed
e There are no variances requested or needed.
If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the
proposed leaching facility will flW be located less than fourteen(14)feet above the maximum adjusted
groundwater table elevation.
Please complete the following:
A Top of Ground Elevation(according to the Engineering Division G.I.S.map) l v
B)Observed Groundwater Table Elevation(according to Health Division well map)
�1 -T
DATE:
SIGNED
LICENSED SEP IC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
(Attach a sketch plan of the proposed system.Also If the licensed Installer posesses a certified plot plan.
this plan should be submit(ed].
q:health folder:cert
��� � �>
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TOWN OF/B�,ARNSTABLE
LOCA
ION L O I N�r�w� SEWAGE # J7' 3
VILI AGE ASSESSOR'S MAP& LOT 31 "003-0040
INSTALLER'S NAME&PHONE N0.
$EPTIC TANK CAPACITY
:ZrpCHING FACILITY: (type) �— (size)
Nq OF BEDROOMS
BUILDER 0 OWNE Ci� v1 S P094,y- S
P.EgMrr DATE: 12-Z Z'°I 7 COMPLIANCE DATE. 9
Separation Distance Between the:
Iylaxiatum Adjusted Groundwater Table and 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
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• a6' a3�
31
sj
9A,AJA
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No. �.....lC'qj
...`
®� THE COMMONWEALTH OF MASSACHUSETTS
BOAR®"OF1 LTH
- llot�J.�I.................OF..... �RiI/C..-.-._._---------_.-.-------------.--
Appliratiou for Btipnsal Marks Toustrur#ivit Errant
Application is hereby made for a Permit to Construct ( �or Repair ( ) an Individual Sewage Disposal
System at
.. ...... ... .. � ......... ---ter°
-- ---------------------------------- -..-.- ............-------•-
Loc s� e�� ` A �... .._.......6. _-••_•-•--•••-----• •.. .....
* Owner Address
Installer Size Address g
J.. ..0YY...S feet
Type of Building Lot..._ q.
Dwelling—No. of Bedrooms..._...................................Expansion Attic (j'ly Garbage Grinder (Q�p
Other—Type of Building No. of persons............................ Showers — Cafeteria
Pa Other fixtu s •-------------- ---•--•-------• . �gy
W Design Flow.......... ..........................gallons per person per day. Total daily flow......al.c30............. ...gallons.
WSeptic Tank—Liquid capacityj00A.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 )
, t4 °Ot. P 47./ry aPercolation Test Results Performed by..............�.t . �...... . ���1�1 Date....._ . .._-.
Test Pit No.-�" � __ inutes per inch Depth of Pit___ _"..). .. Dept o ground water_�D�_ __-
fs, Test Pit No?�............... nutes per inch Depth of Test Pit.. Depth to ground water........................
�j ............ . �'.____ ...._•......... ..._._..._........P.r..._........------------------
............_.......-----------------
..-.----------•-----
O Description of Soils �-9 *� !1
.. .....
V •_-••---•-••_---•_••--•_••............... ��.�y. ..... ✓/ ` .�. C2Y►"1
U 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 TITLL 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 t4akoard of health.
Si ned-- LA -- h /O
' Dat
Application Approved By....................•• ? ----
Application Disapproved for the following reasons:-------•-------------•-_---...----------------------------------------------_-------....._...•--•__--_----•-•••.
.............................................. -•-_---•-•____--•---•-•-•••------•-_--_.........__----....._...........__........_.....-----•---•-...•---••-•--•--•-•___-•••-----•----•••---•-----•••-----
^ Date
PermitNo.......��-- -`v-•-•---1--•-_-......... Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF H ALTH
..................OF....
ApplirFa#ion for Uiopooaai Works Tontrnrtion Errant
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at
* Loc Address . or r� No.
�z x.-•- 4I!' n-----------------• ..t¢", .... ..... f' .7` �1�� !.. .........................
Owner Address
w �►_ = s� .c2.�.�. .---------- ...................................................•......................
Installer Address
Type of Building Size Lot _ _...Sq. feet
Dwelling—No. of Bedrooms....... ...............................Expansion. Attic ( Garbage Grinder
p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures -----•--------------------------------- -
W Design Flow........ = ..................gallons per person per day.' Total daily flow...... _1<)............_............gallons.
WSeptic Tank—Liquid capacityy Q0..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
Percolation Test Results Performed by..._ !'e _'P_. 1. '_le1 Date....I...
Test Pit NO. _ inutes per inch Depth of Pest Pit. ...__. .__r Depto ground water_ ? _ ___.
fs, Test Pit Ntz�
________________ nutes per inch Depth of Test Pit-J._��.._�_.. Depth to ground water........................
��gg -_ j
D Description of Soil ` ��tC,+ 2 ���tl ------ --- .
...
W -
-f_ _.1 .----- •-- _ &.. -------------•-------•-- ----- ----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 system in
operation until a Certificate of Compliance has been issued by t oard of health.
Signed . .C„� ............................. j =
, Dark
Application Approved By....._.. ._ .......... _'
Application Disapproved for the following reasons-..............................................•------- ----------------------- te--------------
--••••---•••----•----•----••-.........•--•••--•--•................•-•-••-•--•--••-•._........•-•----••----•---...-••._............------•-••-•--•----------•---••---••••-----•-------•----••-------_..._
Date
Permit No. tl.."_ :L_...f..-•-•--------•-_. Issued-----•.................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................o .................................
Trrtif iratr'of ToutpliFanrr
T IS TO RTIFY, at the Individual Sewage Disposal System constructed (�or Repaired ( )
by..... rf:5" ............. ----------.. .................................
.0_
//�� er
at... 5. .•----------------------------------------------
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code s de cribed in the
application for Disposal Works Construction Permit No _ ";<_ ?�!• .._-.(-1_.�: .................
PP P - �-------
dated___
THE ISSUANCE OF THIS CERTIFICATE SHALL NO? BE CONSTRUED AS A GUA ANTES THAT THE
SYSTEM WILL. FUNCTION SATISFACTORY.
DATE............ . ....Q...�.............................................. Inspector--•-- avet...... ............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEA T
j &d'I `> t
No FEE: ...
io o fork �,�no r ion ami#
Permission is eby granted---•- ..,. f:<t..... .--•-----------------------------•---........--------.................. ....
to Const ct ( Rep i (. ) an v1du ewag Disposal yst
/g..
--� Street
as shown on the application for Disposal Works Construction Permit No.597_tvyQ Dated..........................................
----------------------
�/ f Board of Health
DATE. ••.... • --------------------------
FORM 1255 A. M. SULKIN, INC., BOSTON
4�_
Massachusetts Water Resources Commission/Division of Water Resources
WATER WELL COMPLETION REPORT
W LL LOCATION n i
Address Q.W -m (Cd
City/Town {
G.S.Quadrangle Map
I Grid Location
Owner &fL��VI `o r-� A rL oP� ow
Address 1, 6 V 3-1 r► OyA,Ac r J,I I
WELL USE CONSOLIDATED WELL
Domestic 9 Public ❑ Industrial
Type of Water-bearing Rock
Other
Water-bearing Zones
METHOD DRILLED 1) From To
Rotary(type)` C a Cable ❑ 2) From To
Other 3) From To
4) From To
CASING Depth to Bedrock
Length 1'70 Diameter
Type �i/C'_ UNCONSOLIDATED WELL
STATIC WATER LEVEL Water-bearing Materials
Feet below land surface Sand: fine❑ medium❑ coarseO
Date measured Gravel: fine medium❑ coarse
GRAVEL PACK WELL Screen:
Slot# )�- length 3 from_ 0 W 13
Yes No Pr
Split Screen(or 2nd screen)
WATER QUALITY TESTS MADE Slot# length from to
Chemical Biological ❑ Depth To Bedrock
17
PUMP TEST
Drawdown feet after pumping days hours at GPM.
How measured Recovery feet after hours.
LOG of FORMATIONS COMMENTS: (On well or water)
Materials From To
0
� 1
Firm CLIFFORMWELL DRILLI14C o
Blue65 Kock Road
Qel d Address `
c City bouth Yarmouth,Mass. 0266
Registration No.
per tors Signature
Please print tirmly
tOM-8181.164843
Log% Numbtr: 4165 Bottle # D150 Date: 1.0/1.1/84M°
f BAQ
BARNSTABLE COUNTY HEALTH DEPARTMENT
SUPERIOR COURT HOUSE
V BARNSTABLE, MASSACHUSETTS 02630
o •
A1wsa DRINKING WATER LABORATORY ANALYSIS PHONE: 362-2511
EXT. 331
Client: Greenbriar Development Collector: Fred Clifford
Mailing Address: Box 510 Affiliation: , well driller
Centerville. MA 02632 Time & Date of .
Collection: 10/.9/84, 12:00 P.M.,
Telephone: Type of Supply: well water
Sample Location: Lot 6, Newtown Road, Well Depth: 73 ft.
Mars _ ns Mills., MA Date of Analysis: 10/10/84
PARAMETER SAMPLE RESULT RECOMMENDED LIMITS
Total .Coliform Bacteria/100 ml 0 0
H
Conductivity (micromhos/cm) 500.0
Iron ( m) :F 0.3
Nitrate-Nitrogen ( m) 10.0
Sodium ( m) 20.0
,a
I. X Water sample meets the recommended limits for drinking of all above tested parameters.
II. Based only on results of the parameters tested for this sample, the water ,is
suitable for drinking but may present the problems checked below:
A. Water sample has higher than' averag'e levels of Nitrate.' Future' monitoring is
recommended (2-3 times per year) to establish any upward trends.-
B. The low pH of the water may shorten the useful life of the house's plumbing.
C. Water may present aesthetic problems (taste, odor,• staining) due to
D. Water sample has high levels of sodium. Persons on -low sodium diets should
consult their doctor: ' ±
III. Due to one or more of the reasons checked below, this water sample is unfit for
human consumption: A. High Bacteria B. High Nitrates
REMARKS:
CC: Barnstable Board of Health
CC: Clifford Well Drilling
Laboratory Director
7/17/84
Explanation of Test Results
Total Coliform Bacteria t F
Coliform bacteria are an indicator of the sanitary quality of a water,supply, Water supplies may become
contaminated.from malfunctioning septic systems,cesspools and surface runoff. A total coliform count of zero
indicates that your water supply is safe and approved for human consumption. A total coliform count of greater
than zero.is most often,the result of accidental contamination of the sample bottle through improper samrling
methods. For this reason, it would be advisable to retest any well water that is not approved.
PH is the measure of acidity or alkalinity of the water. On the pH scale, the number 7 is neutral, less than 7
is acidic and more than 7 is alkaline. The pH of water on Cape Cod tends to be acidic in the range of 5.0 to 6.5
Conductivity -
t
Conductivity is a measure of the dissolved salts in solution. Amounts in excess of 500 micromhos Icm are
generally considered unacceptable and may have a laxative effect upon users. . .
Iron
The presence of iron in water in concentration of .3.ppm or greater may: give the water a bittersweet
astringent taste, cause an unpleasant odor;often gives the water a brownish color and cause staining of laundry and porcelain. The average concentration of iron in Cape Cod's water is .2 - .6 ppm. Although the presence of
iron in water may cause the"problems listed above, it:is not considered deleterious-to health..,Iron may be.,
removed by use of an iron removal system
Nitrate-nitro en a
�— ` A c.7 1- 1 00
W '' n v xi n a 'nant level f nitrates
The Massachusetts Drinking Water Re u)ano 5 have set a maximum co t mt a or rates at 10
e
8 g _
•s
m: Excessive concentrations may cause methemo lobinemia (an'infant disease and have been su ested to
PP rat o Y g
form potentially carcinogenic nitrosamines. Contamination sources include fertilizers,cesspools and industrial:
wastes.
a
Copper_
Due to the.acidic nature of the,water on Cape Cod, copper tends to leach from pipes. This normally does
not present a health hazard; however, concentrations in excess of 1.0 ppm may cause a metallic Ftaste an&or a
bluish green stain on porcelain fixtures.
Sodium
A concentration of sodium over 20 ppm is only of concern to people who are on a low soditim diet. if the ,
water supply has more than 20 ppm sodium, it is up to the people who are on such a diet to find another source
of drinking water or contact their doctor to determine if consuming the water is advisable. Concentrations
exceeding 50 ppm indicate that there may be ocean water or road salt runoff water vetting into the well.
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A "PROVED � BOARD OF HEALTH IN
VAS
44°DATE AGENT SCALE: "_`..QQ
DATE 8 t ..DREDGE ENGINEERING CO. INC) CLIENT
CERTIFY THAT THE PROPOSED-
' ; EG($fERE REGISTERED JOB N0. ff4 07 7 BUILDING SHOWN ON THIS PLAN
CLVIL LAND
ENGINEER SURVEYOR
DR.BY: �°'� CONFORMS TO THE ZONING LAWS
OF BARNSTABLE MASS
_ ' 712, M A I N STREET CH. BY:
R.r3-E '/y
H,YANNIS,. MASS
h : ' . SHEET— OF A E REG. LAND SURVEYOR
Af $1
20 FT M/N. /YOT€ /F E/TNt¢R .TNE SEPTIC TAN OR
LEficNiwG P/T AN& MORE TNA/V lZaP& tOW
�N rRAOAW j,A c"�PIAA4 ETER CONC'R�F7'A_ COiOER
/D /•T M` SNALL QIF 0ROtJ4 Aj7' TO 6JrAOE.�Al✓ EXTRA
CONCRETE' q�PVC P/PE -0E.4VY CAST IRON COVER Sf/.44L SAF USED
M/N. PITCH h=/N ORI VEN/A Y
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M/N.P/TGN r 0O O GAL. 1 • ' eo._ • • . . . • .• • > wo WASHED SMNE
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INLET .WPTIC T.4IKK FT, /Z FI. O/Alr9. C C.SF'�TAdIJLATJOA��
OUTLET SEOT/C TANK �g FT.
//YLET D/STR/B!!T/ON BOX. 9 S8 � SECT"/ON OF GROuNv x�ITER TABLE
OUnXrD/SMf0&'7`/ON MX FT.
//VL,ET LEACN/Nlr PIT 4-7-FT. SEWASS O/SAOSA L SYSTEM TA4W4A*rlDM
LE/4CH/N49 PIT DJMENS/ON A_ XT.
-SCALE _ %s" _ /_O.
DESIGN CR/TE/4/A D/rfiE/vsloN i—`-L—f'T•
4 F /"r t�d,
NUMBER OF BEDROOMS 3
D/HENS/ON C T..
GARdtAGE0/SP05A'L UNIT A/o^!� SOIL LOG
O/L TE3T
S
TOTAL ESTlMA'TEO FL0AV 3 3� Gw4L.10A'r SO/1- TEST A/ SOIL T.�ST 2
NUMBER OF 4r-4CAflVa P/TS ff`ELEY. `��•� ELFY, PATE OF SOIL TEST
S/!>E LG`ACHl N6 PER P!T 1 1 S/ Sfk PT = Z RESULTS/�/ITNESSED 8V S I E
60TTOM LS4C.V1,VG?EJt P!T / 1-3 -Sq. FT :'. LO "� AERCOLAT/ON MATE O GC=ss M/I1ArI/NCK
26 Su3Sor� I°EICCOLATIONRATE�2 rN�+yM/N. lNCN
TOTAL LEACH/NG �4REA _�SQ. /�T. 1
RESERt�E LEACw1N6 AREA 2d` SQ. FT. Z �— ¢L
l S,4;w s v r L ?EsT 3 s 3 7 .
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