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HomeMy WebLinkAbout0855 SANTUIT-NEWTOWN ROAD - Health 8 ti tui_t- 1eztown load Marstons Mills / r A= 028 — 033 l . . VK� S L�A Pam_ J V. ,t/ '�� - " ` L O C AJT�10 N S E W A G `"(rr[\) �/�(�P E ///R���M I T NO. ��^ V f VILLAGE INSTALLER'S / NAME _���y ADORES $ O UvI L D E,R OR OWNER I 5 1 ` ,DA T E P E R M I T I S S U E D I % AT E COMPLIANCE ISSUED ���/� gy c,, .., ��� �%' -� _ �s s� = ' �°1� � = i ��� �„ ��-� y.'• � s. h�� r' ,pry a, e+ w+a �j���2��`�`�f � l.�' .� KIP o;l-&d 33 Commonwealth of Massachusetts 1� Title 5 Official Inspection Form I a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 855 Santuit/Newtown Road _ l v p,, Property Address Tom Geiler } Owner Owner's Name information is : required for every Marstons Mills ✓ MA 02648 __ 5/6/2019 �1 page. City/Town Stater 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 A. Inspector Information filling out forms on the computer, (� use only the tab James Ford key to move your Name of Inspector cursor-do not Ford Septic Services, LLC use the return key. Company Name P.O. Box 49 ray Company Address Osterville _ MA 02655 City/Town State Zip Code 508-862-9400 ' S12482 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4 ❑ Fails } 5/14/2019 Insp or's gnature Date The tem 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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 perfo m in the future under the same or different conditions of use. l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 7 f s cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u!% 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is required for every Marstons Mills MA 02648 5/6/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 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 not evaluated are indicated below. Comments: 2) 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. 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 855 Santuit/Newtown'Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is required for every Marstons Mills MA 02648 5/6/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 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. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I" Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .c.v!% 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 1/2 day flow ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments mil% 855 Santuit/Newtown Road Property Address P Y Tom Geiler Owner Owner's Name information is required for every Marstons Mills MA 02648 5/6/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact ti-e appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: 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 El ® 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: ® ❑ 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(5)] l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c v!% 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is required for every Marstons Mills MA 02648 5/6/2019 page. City/Town State Zip Code Date of Inspection D. System Information 1. 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 Description: 2 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: 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 years usage (gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last date of occupancy: currently Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 c Commonwealth of Massachusetts �. Title 5 Official Inspection Form I. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: pumped 3 years ago- per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every State Zip Code Date of Inspection page. City/Town D. System Information (cont.) 4. 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) ❑ 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): Approximate age of all components, date installed (if known) and source of information: installed date 9/6/07 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 f < Commonwealth of Massachusetts : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 27" Depth below grade: feet Material of construction: ® 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: 1000 gal. 2 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 20 3 Scum thickness Distance from top of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 18 How were dimensions determined? measure 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 liquid level was even with the outlet invert. There were no signs of leakage. The covers were 12" below. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is MA 02648 5/6/2019 required for every Marstons Mills page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as rebated to outlet invert, evidence of leakage, etc.): 8. 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): N/a Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts i� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !% 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) 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.): N/a *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert even 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.): The box was normal Speed levers were present I l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .v!% 855 Santuit/Newtown Road Property Address i Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): N/a * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 2 galleys,10x29x2 ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts �. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): There was no sign of failure from Galleys.A camera was used to inspect. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): n/a 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments e� 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is required for every Marstons Mills MA 02648 5/6/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: N/a Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •, 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is Marstons Mills MA 02648 5/6/2019 required for every — page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 A i a 3 ys 3 f ya6 3 9 3 O `i t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 c Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u!% 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is required for every Marstons Mills MA 02648 5/6/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 40' Estimated depth to high ground water: feet Please indicate all -nethods used to determine the high ground water elevation: ❑ Obtained from system design plans on record Y 9 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: topo and water contours map ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 � r P Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments v 855 Santuit/Newtown Road Property Address Tom Geiler Owner Owner's Name information is required for every Marstons Mills MA 02648 5/6/2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 I TOWN OF BARNSTABLE '`LOCATION QSS /'U6040wf-J (ZZR q SEWAGE# Qoa'7_759 VILLAGENP_5��c,, Jul (S ASSESSOR'S MAP&PARCEL 3 INSTALLERS NAME&PHONE NO. d2phi��06� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) GA/ (size) 10?(,?1j AZ NO.OF BEDROOMS 3 OWNER 7f oMk� 4 bC-_�o24k PERMIT DATE:2�aOU'7 Be COMPLIANCE DATE: gh-k`7 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 Q o o IA � f f 6C THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 3pplicatiou for Migpogaf 6pgtem Cottgtructtott 3permit Application for a Permit to Construct( )L Repair(K) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. n T' Owner's Name,Address,and Tel.No. 7 7 6—6 9 5 9 855 Newtown Rd, Marstons Mills Tom Geiler Assessor'sMap/Parcel 28/33 855 Newtown Rd, Marstons Mills Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4-0 8 9 4 Wm E Robinson Sr Septic Eco—Tech PO Box 1089 Centerville 1 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (n0) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd; Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 leach system to plans of Eco- ec , 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 Board of alth d � ne Date �" 0 — Application Approved by Date . Application Disapproved by: Date for the following reasons Permit No. '-3 I Date Issued ell No. 35 t �` Y�M, ` J,00.00 ' -I THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 Yes �,PUBLIC HEALTH DIVISION ,TOWN OF„BARNSTABLE, MASSACHUSETTS . 2pplicatiott for �Bigogar *pgtem Conotructiott Permit Application for a Permit to Construct O Repair?K); Upgrade O Abandon O ❑ Complete System ❑Individualt.Components Location Address or Lot No. S -f zc" r N Owner's Name,Address,and Tel.No. 7 7 6-6 9 5 9 855 Newtown Rd, Marst� s Mills Tom Geiler Assessor'sMap/Parcel 28/33 ` 855 Newtown Rd, Marstons Mills , r t Installer's Name,Address,and Tel.No. 7 7 5-8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4-0 8 9 4 Wm E Robinson Sr Septic Eco—Tech PO Box 1089 Centerville 43 Triangle Cir, Sandwich 1lype of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (10) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date e Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(A�nnswer whe p licable))__� Install a new Title 5 leach system to p` lass o"fa �Eco-'r , ETE02733 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 Board of Pealt (S�—d Date " O Application Approve Application Disapproved by: Date for the following reasons Permit No. CO / —3 q Date Issued / - ----------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Geiler (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired {X ) Upgraded ( ) Wm E Robinson Sr Septic Abandoned )by P at New owri Roa , Mars OriS Mills has been constructed in accordance with the provisions of itle 5 and the for Disposal System Construction Permit No. 9S r�7-3�59 dated Installer � C�`�\6,gc� Designer �C v✓-� #bedrooms Approved design flow U 33 0 gpd The issuance of this permit shall not be construed as a guarantee that the system will function as,designed. ` C Date - - (�. _ Inspector ————————————————— ———— No. --Jl..�-mil� � Igo.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Geiler lwigogal *pgtem Cottgtructtott Permit E A Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( ) System located at 855 Newtown Road, Marstons Mills 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 must b completed within three years of the d to of this permit. Date "� � Approved by L F ,1 oWn-o BarnAzble 'film.° Regina a S6 ces -Thomas 2V.--CreI� iijiireor ._ • -- ,. . a - ^ - et - - - 'AR.VStABI i mass• 1 #'.d # � l' ion - ' Thomas WKean -Do-ector - 2 NlaiaStree#,-Hyaainis,bU,8MO1 Office: 508-862-4644 Fax: 508 790-6304_ Inst er&k2gaer Cerffication Perm Date: i �' Sewage PerndW 6 � J �`- Assessor's Niag\Parcel 2 8/3 3 ' Desiguer• Eco-Tech IRS t aj}jr: Wm E Robinson Sr Septic Address' - 43 Triangi.e:Cir .Addrew: -PO Box 1089.. -Sandwich-- -Centerville c �-G Wm. E -Robinson. Sr S ep t' s_issued a pennit to-install a (data) `.. (installer) 855 Newtown.Road septic system j.t.. . - - based on a design drawn.by (address) _ . - -Eco-Tech - dated _ 08/15[07_ -. (designer)_ I-certify tliat the septic.:system referenced above was instaRed substantially_according to the-design, which may=.include-minor.approved-changes,such-as iateral_relocation of the. . distribution-box and/or=septic tank.. _ I certify that--the septic system rem-above m-i led.with major changes (i.e. _=.greater than_10' lateral reloam#ion of the SAS or any vm*al relocation of any component.. of thu septic syttenij but in a dance-wifh State`8i Local regulations: -Plan revision or certified-as-built by designer to fallow. ZH OF Mgssl��� w(n g � LiSA C. •. �:. anst1lleT s S1gIiatlii�} IN e LYONS N , ;LIC. N11a 3 o (Deli S� ( _ tamp Here) PLEASE.- RETURN--TO BARNSTABLE PUBLIC HEALTH DIVM0N.- . - CERTIFICATE OF cUMPLIANCE WILL-NOT:BE--ISSUED UNTIL PAYM TIIIS PORK AND AS-BITILT CARD ARE RECEIVER BY THE BARNSTABLE PUR11C HEALTH DIVISION.-THANK YOU. Q:Health/SeptidDesigter Certification Form 3-26-04.dos aF� Town of Barnstable P# , Department of Regulatory Services MARNSICA" i Public Health (�t�Division Date 200 Main Street,Hyannis MA 02601 Date Scheduled ® Time Fee Pd. Soil-Suitability Assessment for Sewage Disposal Performed By: �aL i c Oonnci ��l i©)gleeC Witnessed By: / LOCATION& GENERAL INFORMATION Location Address Sa Ad Owner's Name '✓"��✓tOr�S UU�i l G S Address �S'A�,�_N�v✓ib/���� Assessor's Map/Parcel: Z� 3 3 '''l�l p5M) A,11•S Engineer's Name u�l/l� ®v�Ll4lZOtyr NEW CONSTRUCTION 'REPAIR I/ Telephone# t� I� 50119 Land Use 05/4p / I Slopes(%) <O Surface Stones 140 w e Distances from: Open Water Body l O O t ft lJ possible Wet Areamb G 4 ft Drinking Water Well tD6 + ft Drainage Way SO ft Property Line jy t ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) I O 1 W Z I �i GROUNDWATER ADJUSTMENT ' � I Z EXISTING GROUNDWATER LEVEL m / I BASED ON TOWN OF BARNSTABLE GIS DEPARTMENT RECORDS. Q INDICATED GW 46.00 ®2®7-PI Wm INDEX WELL SDW-253 I m Z i ZONE B I READING DATE DULY. 2007 READING 47.7 j ADJUSTMENT 1.9 O t ADJUSTED GW 49.9 Parent material(geologic) PCB �lCr�l l d C/ WGS� Depth to Bedrock 1'`0 n e i$! N ne Depth to Groundwater. Standing Water in Hole: ho Weeping from Pit Face- y10)g e Estimated Seasonal High Groundwater See -Ibe✓e 9? - y CS� g-- DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: See Gt lb'o y e Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level—.;.--,—. Adl.factor Adj.Groundwater level PERCOLATION TEST Date IPIV o707 Thne 11 Observation ^� Hole# L TSme at 4" Depth of Perc 6 l h Time at 6" G 9 ~ Start Pre-soak Time @ 1�1" Time(9"-6") End Pre-soak 4 1 Rate Min./Inch 2111 p i Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N) _ Original: Public Health Division Observation Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:SEPI'ICIPERCFORMMOC {' SOIL tTESTY � OG DATE OF TEST: AUGUST 14. 2007 SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. = w ._ WITNESSED BY: DONNA MIORANOI. HEALTH DEPT. PERC NUMBER: 11697 NO TEST PIT I PAARENOTUMAATERI L:ENCOUNTE PROGLACA LED OUTWASH PERC AT 60 to - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER j (INCHES) HORIZON —TEXTURE (MUNSELL) MOTTLING 80.00 0-6 A' LOA-MY_SAND _10 YR 3/4 NONE FRIABLE 6-42- - B --- - ,LOAMY-SAND - 10 YR 5/6 NONE _ 'FRIABLE 76.50 1 . . 142-128 C MEDUIM ,SAND - -10"YR 5/4 NONE LOOSE 69.33 1 r TEST PIT 2 R'NO GROUNDWATER ENCOUNTERED PARENT.,' ARENT MATERIAL: PROGLACIAL OUTWASH 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL j USDA SOIL SOIL COLOR SOIL OTHER i 76.60 (INCHES) HORIZON —, —TEXTURE (MUNSELLI MOTTLING 0-5 A LOAMY SAND 10 YR 3/4 NONE FRIABLE.-_. 5-38 Bt LOAMY SAND 10 YR 5/6 NONE FRIABLE 75.63 38-126 C _ MEDUIM SAND 10 YR 6/4 NONE LOOSE 66.13 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) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes ..,., 11 Within 500 year boundary No Z, Yes 0 Within 100 year flood boundary No Yes f 'w Li Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pert'ous material exist in all areas observed throughout the area proposed for the soil absorption system. If not,what is the depth of naturally occurring pervious material? Certification OV �(q S I certify that on (date)I have passed the soil evaluator examination approved by the i Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and,experience described in 310 CMR 15.017. jH of MaSSq Signature Cam LS� Date �uguSt tS, DAVID oyG� o D. COUGHANOWIR Q:\S.EPTICIPERCFORM.DOC �O F Q • /����V O AL\JALUP� tS No.��_...65,E Q�`(� i�S Fps... . . ...... THE COMMONWEALTH OF MASSACHUSETTS B®AR F HEALTH ----�G'^i..a`.J............OF.... ...�4 /� ✓f. .�. .......................... AVVliration for Disposal Works .Tomtruriiun Vrrmit Application is hereby made p for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: JG 1- (,(L� /v VJ4p�Jt� a --• _----- Location- s r t o. .+ ►e '/��sv.S .l ,l° ----------------------------------- ow ss 1..7 ............. Pa Installer Address Type of Building Size Lot_ _ /_®®.0.....Sq. feet Dwelling—No. of Bedrooms--- ..... ...............................Expansion etic ( ) Garbage Grinder ( ) Other—T e of Building t4 . No. of persons............................ Showers — Cafeteria a' Other fixtures --------------- --------------- - W Design Flow...........43".........................gallons per person per day. Total daily flow------- at!PP_.........................gallons. 9 Septic Tank—Liquid capacity/PPgallons Length--------_------ Width................ Diameter_............. Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. �. Seepage Pit No------------ _.. Diameter....... ........ Depth below inlet..........06...... Total leaching area..Z120...sq. ft. Z Other Distribution box ( ) Dosing taply( )Percolation Test Results Performed by__`- i ..*f.-____.__JA<44,6... .................... Date_..•._ ..... a Test Pit No. I_____ ________minutes per inch Depth of Test Pit--- ....... Depth to ground water...... .............. ._. G -. Test Pit No. 2................minutes per inch Depth of Test Pit__._-___--..__-_-__- Depth to ground water........................ ............. - 0 . . .......... --xDescription ofSoil-----.OQ1 ---- -� �.�oOtsq� ------. pp U ........................... - --• - . . •• • -----------o .y. ---------- -� -• -- ------! U Nature of Repairs or Alterations—Answer when applicable--------------------------------------------- ca- . ----__: --------- -ca -•---___. Agr Thenundersigned agrees to install the aforedescribed Individual Sewage Disposal F��s t rnsf `b���Q� nce with the provisions of TIT ' p 5 of the State Sanitary Code— The undersigned further agrees not -"a�"��he system in operation until a Certificate of Compliance has been . e the b and of health. —7 . 7�/g� G == . . ' -- ....................... -- ------ 4 •-----•-- Signed Date Application Approved BY -' c �j% ......................................... ------- Application Disapproved for the following reasons--------------------------------------------------------------------------------•------......................... --------•-•---•--------------------------•--•-----------------------------•-----------......-•----------.--•------------•---•----•-••--------------------------•---------•-----•-...-•-•- Date PermitNo......................................................... Issued............................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR ;,,HEALTH .........................................OF....... ..............S.I..b`.!,l " ..................................... �rrtifiratr of f�nnt �i�anrr THIS IS-`TO CERTIFY, T>ffo the Individual Sewage Di posal System constructed or Repaired ( ) by..-r-------- .---....•-•-. .: •. .[:T.t.a pv . ��,� J — s Installer-� �/s at ---------------------•---••--•--•-../--•- •. has been installed in accordance with the provisions of TITLE; j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....99n_4_✓`._d............... dated.....__.--_.-._______.____...._-............... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT TIME SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH �K✓r S // .OF.............. ..................... / �J ..'l/!- :................... NFEE.......................... Disposal Iforks Tway irndiaan �rrntit Permission is hereby granted.------. .....�Pam.................... to Construct �' or Re air ( an Individual Sewage Disposal Sy at No.--•-•---.�. _.... ,�1 �... .AJ----'� N... !.. /.. ... Street as shown on the application for Disposal Works Construction rmit No-------- rDated.......................................... --- t• _ =Z --------------------------------------•-- oard of Health DATE................................................................................ 4 FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No. ......... .. FEB...3. THE COMMONWEALTH OF MASSACHUSETTS BOARD---OF HEALTH �...-- k�._.-.-......OF. � - K `. Appli.ration for UinVuiial WorkB Tnnitrnrtiun rrMi d Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at• R , -..... .. ... ....... . •..... ...........••--- ........... ......... !""Y Location-,&ddxess or'Lot No. ------. ........................... O�ner �� d,0 Ad;ress a .................... ......... , ........ o •- ••. ................................ •.. ............. •----...................•--------••••. Installer M Address d Type of Building ._... ._....... q. feet Size Lot•-_ e . f� S Dwelling—No. of Bedrooms....... _..................................Expansion ttic ( ) Garbage Grinder ( ) ._...._. .: No. of ersons______.__ "'______________ Showers — Cafeteria P4 Other—Type of Building '�`��� _'��k'_.... p ( ) ( ) dOther fixtures W --------------------------•-------•-----------------------------------------....._....------•---;�-•-------------------......_........--------- Design - - o sP person Per day. Total daily _ ---..........................gallons. � Septic Tank—Liquid ca acity/ .�allos Length i ... Diamto ___--__-•__- Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No-----------/...... Diameter...... ......... Depth below inlet......_..6....... Total leaching area._ Q_...sq. ft. Z Other Distribution box ( ) Dosing to ( ) Percolation Test Results Performed b .-__... E. ;� E.. ..................... Date._ '�_.___ Y :. . Test Pit No. I--_-`-�"'-__minutes per inch Depth of Test Pit../ �........ Depth to gr r - 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to �, a. t�r. . _... O ........_ t j . ................................................f O.A�................O O ......... Description of Soil. rl ia° = .... r �}r a-----------------------------•--- � ......... -y Vd ' ----------•----------------------- W °y = .'� _ x � .� � �--- ----------------------- ----•-•-•-•••-•... •-� -------------•--------- U Nature of Repairs or Alterations—Answer when applicable_________________________________________________ ��s�RED SPA°fie mac:: •�,a� -• � �� --•----•------------------------------------------------------ - ------ - ------------------- Agreement: The undersigned agrees to install the 'aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTTLE, y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has be ' u X by the board of health. I /f Signed `` •-• ••--------- --- ------ ----------------•--- ........ Z- ate Application Approved BY _:.e�- s�` ............... _...__ o �,�_lrt-_-- D t� Application Disapproved for the following reasons-------------------------------------•-----------...-------------------------•--•-. --------•-•-............. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOA OF HEALTH O F. '' .......:....................................:........................................ �rr#ifirtt#r ,af f�unt�li�nrr THIS ISM,TO CERTIFY, hat the Individual Sewage Disposal System constructed ��or Repaired ( ) r . . by........... .M. }_�, a .11J�v Installer `."J at..........................................................--•-••-•-----------------------------••--- ----- �'f _ has been installed in accordance with the provisions of TI 1 1Z j of Tlae State Sanitary Code as described in the application for Disposal Works Construction Permit No._c a. ........_�` ............. dated_...._---_.-__._......._.._.___.. _---------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH .... ........... ... j 6 fdf.,� ............... FEE J....__.. N .--• ------.. Dispoal Norkii Tonitnuton� rrntit Permission is hereby granted - ----------- -=-----i � ......... -- to Construct ( r or Repair ( ) an Individuaf SewAge Disposal System Street as shown on the application for Disposal Works Constructio rmiitNo/........✓..........__ ated.......................................... Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS LOCATION LBT 4— kA&1A01vA, X11 �1, �//ueg _ NO. //,I _ VILLAGE /V ,g-G0 / G LAJ IJ DATEArfi� 3o iyd� 'APPLICANT FEEou (Non-reft-Adable ' ('ADDRESS ° TELEPHONE NO. ENGINEER "_/p _TELEPHONE NO. Z `DATE SCHEDULED Z CC> i (Applicant' s signature) . . . • . • • o o o o 0 o • o • o 0 o o o • • e • • • • o o o • o • • • . . • • • o . . • • • • . • . • • • e • •-• • • • . • o • • • • • o • • o • . .. SOIL LOG SUB-DIVISION NAME Kj DATE O — ? Z. TIME EXPANSION AREA: YES (NO _ �6¢CGalo/--- _ ENGIN_EER ,TOWN WATER PRIVATE WELL � �j f�`�j�� BOARD OF HEALTH Z31 Id EXCAVATOR SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percolAtion .tests, locate wetlands in proximity to test holes ) NOTES : A J /r t W' I I PERCOLATION RATE: ' TEST H.GLE-. NO: ELEVATION: TEST HOLE NO: � ELEVATION: 1 1,00Oct G o.16 1 21. d sotL_ 2 3 3 4 4 - 5 5 6 6 7 WD, A 8 8 9 ` Co123G� 9 10 10 12 12 14 ._ �V 214 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD__LEACHING PITS / LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE . REASONS: NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . E . AND RETURNED TO BOARD OF HEALTH COPY: RETAINFD BY APPLICANT SOIL TEST LOG DESIGN CALCULATIONS DATE OF TEST: AUGUST 14. 2007 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD. 3 BEDROOMS PER BARNSTABLE SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. BULDING PERMIT #66961. PROPERTY LIES WITHIN A WELLHEAD PROTECTION OVERLAY DISTRICT. WITNESSED BY: DONNA MIORANDI. HEALTH DEPT. PERC NUMBER: 1189� SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL TEST PIT 1 NO GROUNDWATER ENCOUNTERED CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) PARENT MATERIAL: PROGLACIAL OUTWASH DISTRIBUTION BOX: USE 3 OUTLET D-BOX. PERC AT 60 in - 2 MIN/INCH IN C SOILS SOIL ABSORBTION SYSTEM: A 29 Ft x 10 Ft. x 2 f t LEACHING GALLERY CAN LEACH ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER A6ot- = ( 29 x 10 ) = 290 s (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING Asdw = ( 29 + 29 + 10 + 10 1 x 2 = 156 sF 80.00 At.ot = 446 sf 0-6 A LOAMY SAND 10 YR 3/4 NONE FRIABLE Vt 0.74 x 446 = 330.04 GPD 6-42 B LOAMY SAND 10 YR 5/6 NONE FRIABLE USE A 29 Ft x 10 Ft- x 2 Ft- GALLERY. Vt = 330.04 GPD > 330 GPD REOUIRED 76.50 42-126 C MEDUIM SAND 10 YR 5/4 NONE LOOSE 69.33 TEST PIT 2 NO GROUNDWATER ENCOUNTERED L EA CHING GA L L ER Y PARENT MATERIAL: PROGLACIAL OUTWASH USE SHOREY PRECAST 500 GALLON NOT TO 1000 GALLON SEPTIC TANK 2 MIN/INCH IN C SOILS LEACHING DRYWELL (H-10 LOADING) SCALE DIMENSIONS AND DETAIL NOT TO ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER CONSTRUCTION DETAIL USE EXISTING H-10 UNIT SCALE (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING '�8.80 DRYWELL UNIT SEPTIC TANK IS TO BE PUMPED DRY 0-5 A LOAMY SAND 10 YR 3/4 NONE FRIABLE STON AT TIME OF INSTALLATION AND IS TO BE EXAMINED FOR STRUCTURAL 5-38 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 29.0 f't INTEGRITY. INSTALL NEW PVC OUTLET TEE EOUIPPED WITH A GAS BAFFLE. 75.63 38-128 C MEDUIM SAND 10 YR 6/4 NONE LOOSE N 4 I In 68.13 TAPER GROUNDWATER ADJUSTMENT N ` EXISTING GROUNDWATER LEVEL - ° BASED ON TOWN OF BARNSTABLE 4 �t e.5 t 4 �t e.5 t 4 Ft 11 o +1 GIS DEPARTMENT RECORDS. 29.0 Ft Lo INDICATED GW 46.00 INDEX WELL SDW-253ZONE B 1� READING DATE JJULY. 2007 500 GALLON DRYWELL 8 READING 47.7 DIMENSIONS AND DETAIL ADJUSTMENT 1.9 ADJUSTED GW 49.9 USE H-10 UNIT INSTALL ONE INSPECTION INLET OUTLET RISER TO WITHIN THREE COVER COVER INCHES OF FINAL GRADE AND INDICATE LOCATION ON AS-BUILT PLAN 3 IN DROP FLOW LINE BUILDING 10 in 14 TO in D--BOX in NOTES o 33 aB.n LIQUID GAS pppp O�� in LEVEL BAFFLE 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. ooC p UZI OOp�O 2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED oppppoppQo 0� L� FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. CROSS SECTION VIEW 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS 10� In OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES-<, BEFORE EXCAVATING FOR SYSTEM. � CROSS SECTION VIEW SEWAGE DISPOSAL SYSTEM PLAN 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED '� 2 in PEASTONE 2 in PEASTONE 61 ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND�DU.ST6IN PLACE. -TO SERVE EXISTING DWELLING cl 71 ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF,'LSOW,>!FLOW� FIXTURES 2a,n THOMAS AND DEBORAH GEILER AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. % i 28 3i4,n ro EFFEcrrvE 3ia,n ro 26 `�. � 1 In -!�2 in c AVEL DEPTH 1-112 GRAVEL In 855 SANTUIT-NEWTOWN ROAD MARSTONS MILLS. MA 81 SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING D9 NOT " , PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. 581n 31 rn ECO-TECH ENVIRONMENTAL 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADEi ONd A LEVEL 120 In STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON, TO WHICH 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE FABRIC IN PLACE OF THE 2 in. PEASTONE LAYER SPECIFIED. ETE-27351 AUGUST 15. 2007 1 1212 CONTOURS - ` =t W'�KEBY 17Oy0 BEONCH TMARK EXISTING - - - - - - - 50TOP o 0 TANK ELEVATION = 79.30 MINIMAL GRADING PROPOSED ( (� C, _ ct LOCUS BARNSTABLE GIS DATUM 3 139.36 Ft rtic o 0 CDs6� --- --- I s'o 2 OThl o I I I �f � 2 Q \ I MARSTONS OJO m MILLS. MA Sri 1 U pi 84 — 1 6 DRIVEWAY I —_ LOCUS MAP mm=z z� I ` ti�0 NOT TO SCALE m ow I wW�� � <3 82� a�o1 � wo c.� I 1 DISTANCES a- E0 0Z -i E-'J Z � � w wo I 0� \ I / GAS LINE 1 I TO LEACHING GALLERY �U z (n J �-A 3 ff of 80 G IALL<O<\ <w = W W Z O �� \ Z FEET DNOT IN FEET AND DECIMAL wu w� U —i > o ��_ I \ �,� 1 Z Jd � < _j O m o= �sl \ 1 moM A B �? Lr) ``� �� W w w mo ❑ I�1 I rn 1 29.6 3�.9 o m _J (� o I \ ❑ X 1 I O 2 38.1 25.5 W Z < _< m ........ w �6 I �� O rn rn ATER I-IN� 1 GATE 3 46.2 35.5 <0 ( � wz s M71 F-, 1 1< z w� S- \ �Z o z 1 3 LEGEND ww w o-i X TD � \ +z Zoe mw w Z O u� I I m IZ EXISTING o cn n- Lo -' I 3 1 n 1000 GALLON w w Lo W OZ W Ln o � 74 \ 3 1 SEPTIC TANK _ � o z , U wO 1 U Lu Z z O \ \ 29 f 1 A -- 1 EXISTING w ss LEACH PIT a� X ow w Zw \ —r \ J cn F-_ C o cn I \ \- \ 1 �e U o �< I Ft x Z Ff- P- \ 1 Z z w? cU M p� 29 Ft x 10 rPa \ \ 1 UTILITY POLE e a v z w I LEALHING GALLE7 e 0 3 Z Z 1 1 O TEST PIT D-BOX ❑ \ \ DECIDUOUS CONIFEROUS dQ O W_ \ p \ 1 W❑ ~ w~ I m ' m I �Q�Z-o \ \ TREE 0,0 TREE W Ul O 3 �• � � � (0 \ (n w w F �` N I \ \ ; ❑ dU 12-M *2-P Ln O B x I -NUMBER REFERS TO DIAMETER IN J X u w \ \ \ INCHES. LETTER DENOTES TYPE. W w O-OAK M-MAPLE P-PINE C-CEDAR co W w Z V \ \ _��''/ 86 SEWAGE DISPOSAL SYSTEM PLAN w J 0 z \ , \ �/ s4 �® �o -TO SERVE EXISTING DWELLING 3 << J LOT 5 \ I,,��' 82 EST. THOMAS & DEBORAH GEILER O 0 O \ \�� 0 OWNERS OF RECORD z � iL Cn (. U AREA = 21982 sf+- / i���•00 78 �jNOFMgs �y(NOFlkgss9 � 1995 855 SANTUIT-NEWTOWN ROAD m I �� 76 �`� � ��' �y MARSTONS MILLS. MA e W W I /� 74 0�' DAVID tiG �o DAVID GJ, p + N� ®���� PROPERTY ADDRESS 9 m ��/ D. ai �' D v' ASSESSORS MAP 26 PARCEL 3 3 O ao ��/ FLAN ' COUGHANOWR COUGHANOWR 43 TRIANGLE CIRCLE O LL / No. 1093 S �� o SANDWICH MA 02563 LAND COURT PLAN 3 4 6 4 6-B � " ? ? ��G/STE��O �< CENSE ,gyp 508 364 0894 DATE: AUGUST 15, 200-F N cn X SCALE: I n = 20 f t sq 1 P� E L P LS� JOB #E T E-2 3 5 PAGE 1 [)F 2 VERSION: O x w w GARBAGE GRINDER ~ w IS NOT ALLOWED 20 0 20 40 THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED �1s+ �� SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM WITH THIS DESIGN. 0 10 20 /-F U V- L V DEPICTED HEREON. FOR ANY OTHER CHANGES TO PROPERTY INCLUDING PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS. OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. CJ 5 4, K . . 2' ~ y f+ dosrt i S �€ rt o w Bedroom a r Level 185 00, i S ';/'kV kC�, -k G� Rear Deck Gc - .I Q' 6. —Y Mal po ^^ , r Level gas meter 34.GO' Ground � Deck nod ci.3�i� s C1) 8.001 s urn ��M c� Level r"M ' _ 5��