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Home My WebLink About0635 SANTUIT-NEWTOWN ROAD - Health l (, S_AANTI�IT NEWTOWN' RoPrp MARSTONS MILLS - r A = 029 007 o i LOCATION /0?'/ l� �doc,„r nil:"-, SEWAGE #aZf1L�(3 VILLAGE ASSESSOR'S MAP & LOT44r,7,41;o j INSTALLER'S NAME&PHONE NO. Af k,n.e�`,� _ o I SEPTIC TANK CAPACITY.__ f.SaU S,ttL a� LEACHINC'FACILr Y (type) DEC 4' (size) NO. OF BEDROOMS BUILDER OR OWNER �/2 PERM:ITDATE: . 45Z$d COMPLIANCE DATE Separation Disance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet~' Pnv.ate Water Supply WeII ang Facility: (If any wells exist on site or within 200 feet of leaching facility) Feet /LD . :Edge of Wetland and Leaching.Facility(If any we.darids exist within 30)feet of leaching facility).. Feet Furnished by IL�P_V cat yiq•� } i s _ .. i I 0 N1F B�--" OMB� � h SEWA#-P j# 00 624 t.!ILLAGE_.�,�e' ASSESSOR'S MAP & LOT&47,00/ INSTALLER'S NAME&PHONE NO. d"— SEPTIC TANK CAPACITY /.5"00 %4/- LEACHING FACILITY: (type) (size) )1 /JJ NO.OF BEDROOMS BUILDER OR OWNER Z�V,0�e2 SACJP4 PERMITDATE: Zklll SCOMPLIANCE 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 /L��tJ 617-ef."111ky" yJ 417 s +� ne*1 35 TOV� F B�1 STABLE t. �!V (,)CATION — �_t� SEWAGE # VII.LAGE /�(l2�ss A/7,�/s // ASSESSOR'S MAP & LOTO�� N. INSTALLER'S NAME&PHONE NO. Y SEPTIC TANK CAPACITY 05 0 ad, LEACHING FACILITY: (type) (size) NO.OF BEDROOMS _. BUILDER OR OWNER J�� f3 >✓ na PERMTTDATE: 11 ' _00 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 1 Furnished by �n Y�6 1 .� to TOWN OF BARNSTABLE Lr?CATION ��' �a:.��°'Z' .N`C��—[sa�..�w .SEWAGE # off. - ASSESSOR'S MAP & LOT -�INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY `C]® <Z A 14. LEACHING FACILITY: (type) �---C i'+. nn4t�(size) 3 SOC) NO.OF BEDROOMS BUILDER OR OWNERa PERMITDATE: /l 3 (Do _COMPLIANCE DATE: _7 o 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' 'l'ZC ":n /�- >5 L� - i _ 10 4 i1' J FEE COMMONWEALTH OF MASSACHUSETTS ? &&K P � A (3 L� .Board of Health, , APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Perm.t to Constructq>-<epairO Upgrade( ) Abandon( - C omplete System ❑Individual Components Location I&< 5 j7r - r1 6-isi 1`Ow ji &P Owner's Name- Map/Parcel# (t-4\ L Address Lot#0,;?1- 9-7-y LoT ;t, Telephone# 24 9�-p,0 y� Installer's Name Designer's Name /g N*,P! Suvve c ac C"f Toq�S Address �6 Address -1/0 buc- R-0 A Z M AA S-16AJ Telephone# Telephone# JvA8-Cb t, Type of Building Lot Size L/ 6 4R.6 sq.ft. Dwelling-No.of Bedrooms Garbage grim 0 Other-Type of Building No.of persons Showers( ),Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Calculated design flow �'�� Design flow provided gpd Plan: Date Number of sheets cz Revision Date Title S I Sei,uAq j-e. AJ Description of Soil(s) S e-e 42(-oW° Soil Evaluator Form No.94 97867 Name of Soil Evaluato YQckG •NO J ate of Evaluation IO a 7 ®0' DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to' tall the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agr to no torpc the system in operation until a Certificate of Co pliance has been issued by the Board of Health. Signed % Date W No. Cet sr% F. FEE Boaro of Health, K N S� ,MA. At# + eq� APPLICATOR FOR,DISPOSAL. SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct(1.�-4epair( ) Upgrade( ) Abandon( ) - complete System ❑Individual Components ' Location W SAN IT N&AJ TOLU/lJ R, Owner's Name Map/Parcel# a Address ) 1A Lot#4?R9"&1,Q-7--y LoT ;t, Telephone# S --ooP Installer's Name Designer's Name Yg pee--C S(,VVL- sUCT gAJIS Address 36 Address 7U .,v tw R.,4b M,4RS�1US Ml� M09 Telephone# -7 ' Telephone# �-f,�,�f,t0 s- Type of Building r Lot Size L�3 G / / -6 sq.ft. Dwelling-No.of Bedrooms Garbage grind 0 Other-Type of Building No.oftpe ions Showers ( ),Cafeteria( ) Other Fixtures Design Flow (min.required) ��U gpd Calculated design flow Ly g o Design flow provided 17�Sy gpd Plan: Date - a—O0 Number of sheets Revision Date Title S ! 1-e +Se wA'1 Z 0 L 4 N 0 Description of Soil(s) S"e-e 1 C AJ' Soil Evaluator Form No.9 4 9'8&-7 Name of Soil Evaluato Yuce&. NU 14 q Date of Evaluation /b d 7 0o' DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to' -tall the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agr14 s to no top�c the system in operation until a Certificate of Co pliance has been issued by the Board of Health. Signed !^ / ' Date f 4FS 7P-(C 7eP - 6----------------- rrn� j • No.�� FEE COMMONWEALTH-Of MASSACHUSETTS Board of Health, 13 4 R N S to 9 G 6� MA. � N G (f 36 lPS CERTIFICATE l Description'of Work: ❑Individual Component(s) W-Complete System CrW The undersigned hereby certify that the Sewage Disposal System; Constructed (44-,09epaired ( ),Upgraded ( ),Abandoned ( ) by: at �9 �� $�N'r(� "— ILJ��c.J�'UW J✓ �.0 1 has been installed in accorda ce with the pro .si ns of 310 CMR 15.00 (Title 5) and the a}�proved design plans/as-built plans relating to application No. �� , dated ��f 1 11 . Approved Design Flow % ! (gpd) Installer Designer:yAPt/+rt°P �y✓V�/� SU�-Ty$ spector .ratsx i Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. I No.-Z<rry 66/ FEE /Q i Board of Health, 1J1q k O STA 1?16 A. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct(L<Repair( ) Upgrade( )) Abandon( ) an individual sewage disposal system at SA Al TV t T `j 2G A� as described in the application for // � Disposal System Construction Permit No.7�'V 6/, dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date o/ zao--,Board of Health { L I• ,I i ! t I III ; If i a1 ( ja, i A € 7 1 I s I l ! , I ¢¢ gp I 1 1 II I !i t - ua I � I r i I I { 6_ I r r • 3 I i J I� I I r I --- �508 428 6191 s � o -_�I s�evl€n. — �I — gustom a+ - �esl ns , 8 3 6SO j Ci ' I' •e _ i '�. .`.. _.,..o li .,��.Cu...n� voa`c r_ /s..--Ci-._ e) .on,..a•:c vn v„ I � t �I 0 a m 1 4 LL Public Health Division Town of Bamstable PO Box 534 . '� T Hyannis, Massac�tts Fax(508)775-3344 Fax Phone (508) 790-6265 !/�� v.e •iv5- S. 1 AY - 1-___._ -n..�- IOTII J ' - ---- „ - ---- ---t j II i~x custom I :i I °j I J Public Health Division Town of Barnstab��. PO Box 534 Hyannis,Massachusetts 02601 Fax(508)775-3344 111-0Zev Phone(508)790-6265 r e COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS 2 DEPARTMENT OF ENVIRONMENTAL PROTECTION e C I t �y Sy TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 635 Santuit Newtown Road ti.lTv�96;— Marstons Mills Owner's Name: Virginia Sullivan ~' _ Owner's Address: w Date of Inspection: 9/27/2005a, � n N) # Name of Inspector: (please print) Patrick T. Sullivan ca' Company Name: Ready Rootera ` Mailing Address: P.O. Box 371 Sandwich,MA 02563 ;,; r- i Telephone Number: (508)888-6055 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 1 approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The System: asses Conditionally Passes Needs Further Evaluation by the Local Authority 4' FailsI Inspector's Signature: '� Date: ,,) .r t The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or j 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. 1 €I Notes and Comments } ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D C. System Passes: —ZI 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 not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditionalss"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. �r Answer yes,no or not determined (Y,N,ND)in the for therfollowing statements.If"not determined"please i explain. ✓ j j f 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. j r i ND explain: , Observation of sewage backup or break q,Zor high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled neven distribution box. System will pass inspection if(with approval of Board of Health): / broken pipe(s)are replaced i robstruction is removed distribution box is leveled or replaced ND explain: t 7' The system required pumpA more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approvaVof the Board of Health): broken pipe(s)are replaced }� obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 C. Further Evalua-lion is Required by the Board of Health: Conditions exist which require further evaluation by e Board of Health in order to determine if the system is failing to.protect public health,safety or the environme . 1. System will pass unless Board of Health de rmines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner w 'ch will protect public health,safety and the environment: _Cesspool or privy is within 50 fee f a surface water _Cesspool or privy is within 50 f t of a bordering vegetated wetland or a salt marsh 4, 2. System will fail unless the Board of Health(and Public Water Supplier,if ar 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 absorptions stem(SAS)and the SAS is within 100 feet of a Y ) surface water supply or tributary to a surface water supply. f J� The system has a septic tank and SAS and the SAS is within a Zode" 1 of a public water supply. The system has a septic tank and SAS and the SAS is within O feet of a private water supply well. _The system has a septic tank and SAS and the SAS is less4han 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,performdd 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 mutt be attached to this form. I � 3. Other: j r I i r Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 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 due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to and overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow _1Z 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. ,/ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is 50 feet of a private water supply well. f 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.] _L00 (Yes/No)The system fails. I have determined that one or more of the above 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 facil' with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the followi� (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface dri ing water supply the system is within 200 feet of a tributa to a surface drinking water supply the system is located in a nitrogen sen tive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any questio in Section E the system is considered a significant threat,or answered "yes" in Section D above the large syste has failed.The owner or operator of any large system considered a significant threat under Section,E or fa* ed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should co act the appropriate regional office of the Department. I Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 635 Santuit Newtown Road P Y Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No j,L`-_ 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? a 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? .Z'_ Was the facility owner(and occupants if different than owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No Existing information.For example,a plan at the Board of Health. _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] 1 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 FLOW CONDITIONS RESIDENTIAL 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): C. Number of current residents:5— Does residence have a garbage grinder(yes or no); Is laundry on a separate sewage system(yes or no):�[if yes separate inspection required] Laundry system inspected(yes or no):— Seasonal use: (yes or no): �- o a 3 = 33 ` Water meter readings, if available(last 2 years usage(gpd)): L f Sump Pump(yes or no): Last date of occupancy: COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15. 3): gpd Basis of design flow(seats/persons gft,etc.): Grease trap pres/eno): Industrial waste esent(yes or no): Non-sanitary wad to the Title 5 system(yes or no): Water meter readlable:Last date of occuOTHER(descri i I GENERAL INFORMATION Pumping Records } Source of information: Was system pumped as part of the inspection(yes or no): ��, If yes,volume pumped: S gallons--How was quantity pumped determined? "— Reason for pumping: i I 7YPOF SYSTEM Septic tank,distribution box, soil absorption system _Single cesspool I _Overflow cesspool Privy Shared system(yes or no)(if yes, attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): j Approximate age of all components,date installed(if known)and source of information: j Were sewage odors detected when arriving at the site(yes or no):,,,t-3 I Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron 40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: locate on site plan) Depth below grade: L2'L j" Material of construction:_V150'ncrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: Sludge depth: Distance from the top of sludge to bottom of outlet tee or baffle: ";s k Scum thickness: !q`g Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: I D `y How were dimensions determined" ,"G Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 1 GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberg s_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee 7ffle: Distance from bottom of scum to bottom of optlet tee or baffle: Date of last pumping: 1 Comments(on pumping recommendationi, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of,}eakage,etc.): { Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 TIGHT or HOLDING TANK: (tank must be pumpedZtimenspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fibergla ylene_other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in workm rder(yes or no): Date of last pumping: Comments(condition of alarm an oat switches,etc.): DISTRIBUTION BOX: u/0-0f present must be opened)(locate on site plan) Depth of liquid level above outlet invert: p" Comments(not if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: (locate on site pla Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump c tuber,condition of pumps and appurtenances, etc.): I I{ 1 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION(continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ ,_--,leaching chambers,number:- 6,` ccG�-. �� .• Slav-e leaching galleries,number: 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.): CESSPOOLS: (cesspool must be pumped as part of inspection)(locate 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: i Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydra /-cfailure, level of ponding,condition of vegetation,etc.): , I PRIVY: (locate on site plan) { r,• I Materials of construction: j Dimensions: ' Depth of solids: Comments(note condition of soil,signs of hydraulic failure evel of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 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. i Y � ,A , vs 4,3 ' �owl Ca.y�.o lr�•J" I � , 3 Q � I f Page I 1 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 635 Santuit Newtown Road Marstons Mills Owner: Virginia Sullivan Date of Inspection: 9/27/2005 SITE EXAM Slope Surface water Check cellagj Shallow wells Estimated depth to ground water>�J_feet , Please indicate(check)all methods used to determine the high ground water elevation: _&Z'Obtained from system design plans on record—If checked,date of design plan reviewed: cn' z� 04 Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: i I You must describe how you established the high ground water elevation: I I k 1 PLAN REF.- 560126 MARSTONS MILLS ` DEED.' 7621365 ASSESSORS MAP 29 PARCEL 7-1 LOT 2 OF OVERLAY DISTRIC7` "CP"G. RES. ZONE- "RF" Y OL a � 749 PAULA. � ;1iiURPH \ SETBACKS SC140 � MEWHOW 9 6 ' FRONT SIDES REAR 9x No. fi �c f'EV, ea` 4'� 10 30 1 15 1 15AlIT 0 4N0 SURD 39.01 106 �/ 1p11 PONDY .' ojlll �° `J1c3• LOCUS /45 2 �.' �. /. 1"-1000' cp arn_ LOCUS MAP 42 0' p�ang o � ��/' �4 ,' ,, 104 i A.M. 29/7 LOT 1 ti 20•0 , 36 0,- , 102 SITE & SEWAGE PLAN m, / �o LOCA TED IN BARNSTABLE. MA. (MARSTONS MILLS ——� 7 —— PREPARED FOR� le MA RGARET FITZGIBBONS NO VEMBER 2, 2000ell `` ✓v J 6 w � ro s I E 100 ASSUMED) p CD ELV �• �C P \ TOP OF CB SCALE 1" = 30 FEET L-2 \� W. ,. 212. 61 ' o_____o�—X -- R_294.23 - �' _ S5_9 49 37 W -o-___----__- -0 1 G _ 106.11 ___ __———J—r�rNE �9' 0 99 IVE �/�� R O AD YANKEE SURI/EY CONSULTANTS GUTTER g TO I d __ P.O. BOX 265 ,S,,gNTUIT ______ ____ UNIT 5, 408 INDUSTRY ROAD ASPHALT ' WIDE— TOWN MARSTONS MILLS, MA. 02648 L. a � 22 WIDE 1928 0. 4 0 TNI��E p 1 PH.(508)428-0055 - FAX(508)420-555J JOB# 52544 CB Mp OF F157N,bATION 20' MIN. 10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. VC MIN. PITCH 1/8 PER FT. 2"LA YER OF EL =108 1/8=1/2" CONCRETE CO VER WASHED S717NE 6' MAXEL = 107. 0 4' CAST IRON PIPE •• POOR EQ A4) P . 6 MAX MINIMUM CLEAN SAND 10.1FLOW LINE "T" EL = 104. 0 INVERT MIN 14" _ = _ = O = _ _ _ -- 0 00 = _ _ _ _ _ _ _ _ _ = o EL.= 106.5_ GAS INVERT LEVEL °0 0 8 6 SUM 20•� ° °° o = = = o = 00000 � O INVERT BAFFLE EL.= 106. 0 INVERT INVERT o°0 0' o o c o 0 0 0 0 0 0 0 °°°8° EL._ .5 = 106.25 EL.= 104.25 EL.= 104. 0 4 EL. - -- (3) 500 CAL LEACH/NC CHAYBE/LS (7V BE PLACED ON FIRV BASE) DISTRIBUTION MECHANICALLY COMPACTED OR 8" OF S70NE BOX WITH "T" EL.=103.5 __10Q2_-GALLONS TO BE WATER TESTED SF,PTIC TANK IF MORE THAN ONE OUTLET !Z. x 25' TRENCH fnRMATlON PLACE ON 6 S719NE SOIL ABSORPTION 3/4" 7t7 1-1/2" DOUBLE WASHED SMAW SYSTEM (SAS) PROFILE OF SEWAGE DISPOSAL . SYSTEM P f 9667 BOTTOM OF TEST HOLE ELE V. =_94. 0 NOT TO SCALE OBSERVATION HOLE 1 ELEV.=_107. 0 PERCOLATION RATE S�.__ MIN./ INCH AT _36----------- OBSERVATION HOLE 2 ELEV= 106. 0 DEPTH HORIZ TEXTURE COLOR M07T OTHER DEPTH HORIZ TEXTURE COLOR OTT. OTHER SANDY LOAM . 4 4 0-10" A SANDY LOAM 10YR 4/4 I 0-10 A lOYR / GENERAL NOTES 10'-36" B LOAMY SAND 10YR 5/6 10"-36" B LOAMY SAND 10YR 5/6 36"-138 C MED. SAND IOYR 6/6 PERC 36"-144 C MED. SAND IOYR 6/6 I) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TOP 42' TITLE 5 AND THE TO WN OF _BARNSTABLE____ RULES AND NO WATER ENCOUNTERED NO WATER ENCOUNTERED REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO SOIL TEST WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 10127100 SOIL TEST DONE BY BRUCE MURPHY RS. 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITNESSED 1.3Y: DONNA MORAINDI WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DESIGN CAL CULA TIONS.' USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO:. BRING COVERS TO CRADE SHALL INS TA LA NUMBER OF BEDROOMS . . . . . . . . 3 BE MORTERED IN PLACE. (3) 500 GAL LEACHING CHAMBERS GARBAGE DISPOSAL . . . . . . . . . NO 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH WITH 4' STONE,". ALL AROUND TOTAL ESTIMATED FLOW DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO 12.8 X 33.5 ( 110__GAL/BR/DAY x __4__ BR) 440 GAL/DAY OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. REQUIRED SEPTIC TANK CAPACITY 1500 GAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VATION CONTRACTOR IS TO CALL "DIC- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS SOIL CLASSIFICATION . I PRIOR TO COMMENCING WORK ON SITE. DESIGN PERCOLATION RATE . MIN./IN. 1 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS EFFLUENT LOADING RATE . . . . . . 74 GAL/DA Y/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. LEACHING CAPACITY (AREA X RATE) 454 GAL/DAY 8) PARCEL IS IN FLOOD ZONE___C __. RESERVE LEACHING CAPACITY . . . 454 CAL/DAY 9) LOT IS SHOWN ON ASSESSORS MAP z9__ AS PARCELS _7-1 LOT ,2 (33.5XI2.8X 74)+(33.5+33.5+12.8+12.8)MX 74) JOB NUMBER__ 52544