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HomeMy WebLinkAbout0083 SAWMILL ROAD - Health a VwN' - T,.7 04 ki�.�� K`Nw's D'tV«��y"��cSq�:Tt�i'IL�$k�Y.xX,i"i Nlarstons Millsz4 �° tXr, y , was M t �khk 1� . 063: 058 �. x,ppJ�y ,,ti�n x ` 1 TOWN OF BAMSTABLE, LOCAII ION ci W M SSEWAGM VILLAGE. 11Grs ►-►s /�l 'Il a SESSOns n ,r iox IWSTALLER'S NAME&PH Qn PIO SEPTIC TANK CAP�CTt'Y CS(D qc. LSACi3tl�TG T+�C1E=1 (fie) (sixe). 16 3. y t. 1-but.t� tt.o�t t 3F�A/1I-MATE' ,.. Cpl�di'iI CE 1R E. iS pEuatia �esWn 6 Bc:Evieen k$io IYla�cimumAcijuat�ii,Cn�auriclwatecTahte to iuc BMtnm of�aaGhtn R�uiliE -. ��� yaEc,'Jat r Sidi+ly V`lc;6l iild wai Pacify .�trerty.s�alls aRfst ' gn att�s ac wltbst ?Atf feot of t�nstur►g fticUity) ca9 Eder cyf Wetland aid :eac ink aicatfey.([Fany wwetinnd exht v3tlatti:300 fe tafl�aGju l ci1Rry) ee lklYl�ShlSd, y10-63 M . If DL o - �re t _ t� 7aue 105 0-3- 60 ' I D 36 OCATION SEWAGE PERMIT NO. o VILLAGE INSTALLER'S NAME i ADDRESS © ® U I L D E R OR OrIIN ER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED w� _ _ �; .H �,, �� � :��� �� � . M (7v .� - � �_ Fim�� /....... y THE COM ,.PN1 _eALTH OF MASSACHUSETTS BOAR® OF HEAL-TH _ Town -OF...-..Barnstable ./, Y" 64 3 �S 1 9I;q�o6, Appliration for Ditipaiial nrki Tomitrnrtinn Pumit Application is hereby made for a Permit to Construct (X ) or Repair ( } an Individual Sewage Disposal stem at D Sa- -•:-_l R — Martsons Mills Lot 362 - - ....-- tion-Address or Lot No. Owner Address W Installer Address d Type of Buildin Size Lot...4 4 0 9 9 - Sq. feet Dwelling—No. of Bedrooms________________.. ...................._-----Expansion Attic ( ) Garbage Grinder ( ) a Other—Type T e of Building _______________ No. of ersons._.__..__.___.__._._________ Showers G.i YP g ------------- P ( ) — Cafeteria ( ) Q' Other fixtures __________________________________ W Design Flow.............55_____________.___._______gallons per person �r day. Total daily flow........................._..................gallons. P; Septic Tank—Liquid capacity_10 0 Ogallons Length___8___6.___. Width__.4 ' 10"Diameter.____.. Depth................ Disposal Trench—No_____________________ Width...........z........ Total Length.................... Total leaching area....................sq. ft. ` Seepage Pit No........l_.......... Diameter....l0_11_..__... Depth below inlet...5._6 7_.____ Total leaching area.... 5�_�____sq. ft. Z Other Distribution box (X) Dosingtank ( ) axter & Nye - A. Jones 4/29/8_ a Percolation Test Results Performed by-------------------------------y---•-_-__-- -------------_•------_••-- Date.______________________ "���®FfAq�, Test Pit No. 1....... per inch Depth of Test Pit....l� _______ Depth to ground water_._It ,,. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..-4�� ....... �i+UL� � ,ej® MICHVIEWICZ O Description of Soil_________0-36 •. wood loam -& subsoil , 3.6. ...1 med_:::-:sand __ E o �s1ysL ®P x " (� -___--•-•-•---•-------------•----•--------•--•----- W V Nature of Repairs or Alterations—Answer when applicable.................................................................... __ ___ .............. Agreement: F" 7 . 83 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI-. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Application Approved ............................................................ �1� ... -----•-••••••••--••- Date Application Disapprove or following reasons-----------------••-•---------------•----•--------• ............................................................. -----••-------•--••-•---••---•---....••••-•--•---•••---•-•-----••...-•---•••--•---••-••-••••--•-•-----------••••-••-•--•--•--•----•----•-•-•-••••-•-----------•---•-•--•-•----•------•--------•----•-- Date PermitNo......................................................... Issued-.................................... .. Date Fu$........................... THE COMMONWEALTH OF MASSACHUSETTS • BOARD OF HEALTH Town Barnstable .................OF............................................................................... Appliraftaan for Di!ivwial Wurkfi Tonitrurtinn Vantit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Sawm' 1 Rd - Martsons Mills Lot 362 ...................... :------------- ................................................. --------•---....---•-----.....---•--•------- 4,.- tion-Address or Lot No. ........................=!. P.✓is c.2 ............................... .........._-..................................................................................... Owner Address W ............ ............................ ....•-................••........... ..................••....................... IIIstalier Address 44099 d Type of Buildin 3 Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P+ Other fixtures -------------------------- 55 Design Flow...................... gallons per person 4ay. Total a 1 w__................ gallons. � Septic Tank—Liquid capacgy___..__.__..gallons Length................ Width__...._..._..... Diameter._______..__.... Depth................ W Disposal Trench—.To.................... Wi Total Length._____......._ Total leaching area s ft. x p Tdf•r-..•--......... 5.67•1.. g 25'7-r... q- Seepage Pit No_____________________ Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosi to k axe Nye - A. Jones 4/29/8 .. Percolation Test Result Performed by.......................................... ... Date..................... �_;_ �mkOF ,a Test Pit No. 1----------------minutes per inch Depth of Test Pit---------.-------- Depth to ground water.- •-------__. '-' ro ROGER y Test Pit No. 2................minutes per inch Depth of Test Pit__-____........._... Depth to ground water.._ _.____PAIL O 0-36 wood loam..& suY i�il�•---31=1-4-r�-"--min-: sand ��� .MtNo 3to�a2o Z Descriptionof Soil---------------------••-------------------------------•----------------------------------------------••------------------------------------••••. • CVVIL W •----•-•••-•-•---------------•--------------------------------••-•-•-•--•-•••---.....•-••-•--------•---------------------------....-----------•-•-•-•..................•-••-•.. UNature of Repairs or Alterations—Answer when applicable__________________________•____........................................ '.. .° ... Agreement: ; �. al s Y r? The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of`T''Ll, 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in . x operation until a Certincate of Compliance has been issued Py the board of he .- Z�.;; Application Approved ....` _r Date Application Disapproved or t following reasons--------------------------------------------------------------•----------------•----------_------------------ ....-•--------•------------------------•--------•-----------------------••-------------------...........................................................-.............................................. Date PermitNo......................................................... Issued-....................................................... Date Y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................................................................................... fle ,. QwrtifirFatr of T antpliFatta T� I j 0 CERTIFY, That the Individual Sewage l�sposal System constructed ( ) or Repaired ( ) by....--•--.:c.... - ,...._. ..fly.--- . ------------------------------------------------------------------------------------------ . --- at:__:.4..f�-'--.._...sue �Ft" "'+-3 ---ns '__._..----•--•---•-------•................................. "ff �.............. ' t' I G' TIr - r has been ifistalled in accordance with the provisions of l r ofe State Sanitary Code s dbed in the application for Disposal Works Construction Permit NTo.... -----•••• dated_,��''le-- ---------------=-------- THE ISSUAN OF THIS CERTIFICATE SHALT: NOT BE CONSTRUE® AS UARANTEE THAT THE SYSTEM TION SATISFACTORY. DATE.-.��............ Inspector..:. :. .... THE COMMONWEALTH.OF MASSACHUSETTS t BOARD OF HEALTH CK `f/� .OF.. No. ...................... FEE...... ............ 13hiposp;�,, �rk.5 �onstrt ilan rrmit Permission is `eb�4 anted-... '--.- - ---- ----•---•------------------------- -----............._._.. S.....- to Construct ( , a air ) 2 Individ l Sewage s sal j stem atNo......................... ---.... --0...•••---•-....rx ,,� ,,....�!'66..P-------e.. ------------------------------......--------•-----•---......---••-. Street as shown on the application for Disposal Works Construction Per ; .N ................ Dated.................................... i •---------- ------- --------------------------------------------------------•--•------------------- Board of Health DATE................................................. -- - FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Taw- ,C ,, Commonwealth of Massachusetts 01[03 " oSs r� Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments rri r 83 Sawmill Rd !� Property Address , Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town State Zip Code Date of Inspection �.i 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. A. Inspector Information S/4 Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City[Town State Zip Code 1-508-495-0905 S 13971 Telephone Number License Number B. Certification 1.certify that] 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 thepr6perty 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 9-5-18 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 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 perform in the future under the same or different conditions of use. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts , y Title 5 official Inspection Form ill Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 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: ® 1 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: System is in good working order with no sign of failure. 2) ' System Conditionally,Passes: a ❑ One or more system components as described in the "Co nditionalPass" 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 Commonwealth of Massachusetts fij� fy Title 5 Official Inspection Form 1�111 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town 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 El ❑ ND (Explain below): ❑ obstruction is removed ❑ Y El ❑ 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 ON ❑ 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 Commonwealth of Massachusetts ,w. Title 5 Official Inspection Form - ! i Subsurface Sewage Disposal System Form Not for Voluntary Assessments, >" 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town 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 El` ® Backup dsewage'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..712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts r� Title 5 Official Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. Cityrrown 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 %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. ❑ N, 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 16,000 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 Commonwealth of Massachusetts Title 5 Official Inspection Form i .i3Ol Subsurface Sewage Disposal System Form Not for Voluntary Assessments • 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town 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 the 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? N. E] 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? ® ❑ Wasthe 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: ® ❑ 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)] t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ? C�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 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 flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: 5 Number of current residents: 0 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 ears usage Well water 9 ( Y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 2018 Date i t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts 1� , . Title 5 Official Inspection Form p Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: I - 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: N/A 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 r Title 5 Official Inspection Form i�f Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. CitylTown State Zip Code Date of Inspection 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: 2008 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: , ❑ cast iron [E 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r a ; 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 18"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 Sludge depth: 12" " Distance from top of sludge to bottom of outlet tee or baffle 20. Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts 1� Title 5 Official Inspection Form r�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is MarstonMills - required for every s M Its MA 02648 9 5 18 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): 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: I Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of i nspectio n)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 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 r� ,w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments > 1.7 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 . page. City/Town 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.): "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 0 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.): Good condition with water at working level and no sign of back-up from field. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Il Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �q Fys_ ` 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 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.): * 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: 16-biodiffusers ❑ leaching galleries number: ❑ 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 p/ Title 5 Official Inspection Form ' N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . r a 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 i 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.): Biodiffuser field in good working order with no sign of back-up into d-box or surrounding stone. 12. Cesspools (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 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 c Commonwealth of Massachusetts .� Title 5 Official Inspection Form MI Subsurface Sewage Disposal System Form -Not for.Volunta Assessments ' 9 p Y rY t� . a 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form Ii i� wa .01 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 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 irk t V, A2 9�1 5 , AM t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 f c :� Commonwealth of Massachusetts r� Title 5 Official. Inspection Fora 1.1 I Subsurface Sewage Disposal System Form Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ 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: pate ® 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: You must describe how you established the high ground water elevation: Original design plans show no groundwater at greater than 12'. 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 Commonwealth of Massachusetts y Title 5 Official Inspection Form I,r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Rd Property Address Thomas Deisboeck Owner Owner's Name information is required for every Marstons Mills MA 02648 9-5-18 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.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 ec 1414 07:19p p.1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sawmill Road Property address Denise Gurian Owner Owner's Name inforrnation is re wary Marston Mills required for eve MA 02648 12-12-14 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 and of the form. trn When A. General Information fillingng out out forms — ``���uaruiiq�rr / on the computer, \`���`� 1N OF 4f Ass use only the tab 1• Inspector `�� . ss ' � key to move your ;`02: •.�'� G cursor not James D.Sears _ = � JAMES kse ey rat the return Name of Inspector = SEARS :y CapewideEnterprises,LLC ' '_A ° o Q Company Name %,� � � ,N `�. 153 Commercial Street �''%.,;�5 iNSPEG����`�� Company Address Mashpee MA 02649 CIWGwn state Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification 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. 1 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 12-12-14 ctors 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. lM t5 m-W3 Me 5 Form:Subsyrraoe Sewage Isposel system•Page 1 of 17 f Dec 1414 07:19p p.2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gunan Owner Owner's Name information is required for every Marston Mills MA 02648 12-12-14 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E l 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 310 CMR 15.303 or in 310 CMR 16.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system is a 1000 Gal.tank D Box and sixteen biodiffusees_ B) System conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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 Q N ❑ ND(Explain below): Ibinz•3/t 3 Title 5 OlRdal Inspection Fenn:Subsurface Sewage Disposal System•Page 2 o1 17 Dec 14 14 07:20p p.3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Nam information is Marston Mills required for every MA 02648 12-12-14 page. CdyRown State Zip Code Date of Inspection B. Certification (Cont.) ❑ Pump Chamber pumpsialarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cunt.): ❑ 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•W3 Title 5Official Inspection Fom SubsWace Sewage oisposal System-gaga 3 or 17 Dec 1414 07:20p p.4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 83 Sawmill Road property Address Denise Gurian Owner Owner's Name rformation is every Marston Mills squired for eve MA 02648 12-12-14 page. Cityrrown 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 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. 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 due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in his less than 6"below invert or available volume is less than %day flow/—£/e111�G' t"ns 3M 3 Title 5 Offidal tnpecton Form:SubsWaoe Sewage Disposal System-Page 4 of 17 Dec 1414 07:20p p.5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Plot for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name information a Marston Mills MA 02648 12-12-14 required for every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ 23 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 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.] ❑ 0 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 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•3f13 Tdle 5 Official trtspection Form:Stbaisface Sewage Disposal System•Pie 5 of 17 Dec 14 14 07:21 p p.6 Commonwealth of Massachusetts W UTitle 5 Official Inspection Form Subsurface Sewage disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name in formation onnati is quires for every Marston Mills MA 0264$ 12-12-14 page. Cityfrown State Zip Code Date of Inspedion 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? 0 ❑ Was the site inspected for signs of break out? 19 ❑ 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: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ 0 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)] D. System Information Residential Flow Conditions: Numberof bedreoms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•3113 Ti11e 5 Official Inspedbn Forth:SubsuAace Sewage Disposal System•Page 6 or 17 Dec 1414 07:21 p p.7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner owner's Name `equine for is every Marston Mills squired tar eve MA 02648 12-12-14 page. City/rown State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal.Tank D Box and six biodiffuser's. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection El 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)): Well Water Detail: Sump pump? ❑ Yes No Last date of occupancy: Present Date Commerciallindustrial 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: t5ina•3N3 Tole 5 Oftal Inspection forth:Subsurface Sewage Disposal System•Pape 7 al 17 Dec 1414 07:21 p p.8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name Informrequired tion is Marston Mills MA 02648 12-12-14 required for every page. Cityrrown state Zip Code Dale of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 20111 2013 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) ❑ 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): twins-3113 rNe 5 Official Inspedion Form Subsurface Sewap Disposal System-Page 8 of 17 Dec 1414 07:22p p,9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner owner's Name information is required for every Marston Mills MA 02648 12-12-14 page. cityrrown State Zip Code Date of Inspection D. System Information (cant.) Approximate age of all components, date installed(if known)and source of information: Tank 1983 Permit #83-1150 2008 Permit # 2008-349. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 32" 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.): Pipeing is 4" PVC SCH 40. Septic Tank(locate on site plan): Depth below grade: 21" 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. Precast H-10 Sludge depth: 15ins•3N 3 Title 5 Official Inspection Form:Subswace sewage oisposal system•Page 9 or 17 Dec 1414 07:22p p.10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name information Is required for every Marston Mills MA 02648 12-12-14 page. Citylrown state Zip Code Date of inspection D. System Information (coat.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 29" Scum thickness 0" Distance from top of scum to top of outlet tee or baffle 8n Distance from bottom of scum to bottom of outlet tee or baffle 1811 How were dimensions determined? Asbuilt-Tape-Plan Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Tank at workink level. Tank at 21"below grade w/covers at 6". In and outlet tees. No sign of leakage or over tiding. Grease Trap (locate on site plan): Depth below grade: 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 or baffle Date of last pumping: Date t5ins-W 3 Tdla 5 Official Inspection forth:Subsurface Seurege D'iSgosal System•Page 10 ot'17 Dec 1414 07:22p p.11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name information is Marston Mills MA 02648 12-12-14 required for every 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 Wens.W13 title 5 Oftlal Imp action Farm:Subsurtece Sewage Diep0eB1 Syslem•Page 11 of 17 Dec 1414 07:23p p.12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name information is required for every Marston Mills MA 02648 12-12-14 , 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 0 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.): No Box is 16"X21"-40" below grade w/cover at 6'. Box is dean and solid w/four lines out. Inlet line has a tee. No sign of over loading or solid carry over. 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•3113 Title 5 OKidal Nspedon Form Subsurface Sewage Disposal System•Page 12 of 17 Dec 1414 07:23p p.13 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name information is required for every Marston Mills MA 02648 12-12-14 page. cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number. ® leaching chambers number: 16 ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Leaching is four rows of four each biodiffuser- Total sixteen chambers stoneless. Ck D Box and camera out to chambers. Chambers are clean w/wet bottom. Cesspools(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 tMns•3113 Title 5 Olflcfel In3pec6m Fmm:sub4Leace Sewage 01sposal system•Page 13 or 17 Dec 1414 07:23p p.14 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name infonTlation is Marston Mills MA 02648 12-12-14 required for every 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.). Inns•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pepe 14 or 17 Dec 14 14 07:24p p.15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner ownees Name information is required for every Marston'Mills MA 02648 12-12-14 page_ Citylrown State Zip Code Date of Inspection D. System Information (coat.) 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 0 drawing attached separately A 0 a Q-,= Div C -3 ?/r� ,Q- 7=fig, . 7G.3 TdM 5 Ofitlat trepeelim RX I, Suexrraoe Se■aps Dimmal System•Page 15 of 17 Dec 1414 07:24p p.16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name Information is required for every Marston Mills MA 02648 12-12-14 Ci !Town page_ tY State Zip Code Date of Inspectlori D. System Information (cunt.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth t ilhigh ground water 12' 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: 7-18-08 Date ❑ Observed site(abutting propertylobservation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain. ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: T.H.on Design plan 7-18-08, No G.Kat 12'.Bottom of Chambers at 5'below grade. Bottom of Chambers at 7'above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3F73 Title 5 Official Inspection Form:Subsurface Sewage D I System-Page 16 of 17 Dec 1414 07:24p p.17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sawmill Road Property Address Denise Gurian Owner Owner's Name information is required for every Marston Mills MA 02648 12-12-14 page. Citylrown State Zip code Date of Inspection . E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(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 t5ins-3113 Title 5 O1Flde1 Inspection Form:Subsurface Sewage Oisposet System-Pepe 17 of 17 No. ;L00 �� r _ Fee v" THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for �Digoal *pgtem Conotruction permit Application for a Permit to Construct( ) Repair(-A Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. �3 �� *:.�� �. Owner's Name,Address,and Tel.No-- %U-ne I�cS�ens M-As `$ 3 Assessor's Map/Parcel I4 ---b kb rt, 'M\lkS YWA 1 Z kg Installer's Name,Address,and Tel.No. �tr�} Designer's Name,Address and Tel.No. v p + x* —119 3 1 Z. 5 H C•vss�-�t c-o�,.. �--&,le Mfg Type of Building: Dwelling No.of Bedrooms Lot Size y3019.5 .6 1 sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) •�3 0 gpd Design flow provided -�� gpd Plan Date \ Number of sheets Revision Date Title Size of Septic Tank _ l oo U q i. Type of S.A.S. JUG` jA-Z 0 Description of Soil C.-N I C 6), z Nature of Repairs or Alterations(Answer when applicable) � , , , L� eAA -r- Date last inspected: c1-u s,,34- -L-4 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 Health. Signed Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. ;-0 d — -S Date Issued b ' 3'ro G L ;00t -r Fee IVTv Entered in comput THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for �N!5po5a[ �pgtem Cow6truction Permit Application for a Permit to Construct O Repair Upgrade O Abandon Complete System El Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No__Z1>0,ixt, Assessor's Map/Parcel Installer's Name,Address,and Tel. Designer's Name,Address and Tel.No. t.j f."tk.5 7� T pe of Building: Dwelling No.of Bedrooms Lot Size LA—,)CA9S 6 sq. ft. Garbage Grinder Other Type of Building No.of Persons Showers Cafeteria Other Fixtures Design Flow(min.required) D gpd gpd Design flow provided. Plan Date 0 Number of sheets 2. Revision Date 4t Title A Size of Septic Tank N _Type ofS.A.S. bk-.2 0 Description of Soil 0\6 N- 1 L 61 2-q, f. Naturi of Repairs or Alterations(Answer when applicable) ti Date last Inspected: fj%jG,S-r -twi Agreement: ,The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in P" 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 Health. Signed Date U Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. ;_CC)�— Date Issued ----------------------------------------- THE COMMONWEALTH-OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired (x Upgraded Abandoned by at. "'s has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. L dated Installer Designer C, N-9" , -\c,, J #bedrooms Approved design flow 2t)d The issuance of this permit shall no beRingrued as/a guarantee that the system v4!1 fu4ction as designed. Date 7 f Inspector ----------- ----------- ---------------- Nc Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS lwifSpooal *p.5tem Construction Permit Permission is hereby granted to Construct Repair (6 ) Upgrade Abandon System located at VNN 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 be completed within three years of the date of this permit. g 2.6.0 y Date Approved by 09/19/2008 12:31 5084775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Rels:tory Services Thomas F.gedber,Director Public Ileaitlk Division Thomas McKaan,Director 290 Mahe easel, Rpmals,MA 02601 o18x: 50"62-4644 Few 509-7W$304 Date: I I ladQ� s wage Form �1 Assessor's Mai'areel � tf ' .10 l[a italier: (fe, Address: r2 N1 . ~ lr fAcfldr�sa: ?�+C. 17 eAi Z� on �'_ icy:o� � '�., a�.e `�, r. iwas'issued a permit to install a, septic system at -� '�^'►� l �. based on a design drawn by ( r0,1` lt dated fY that.tho stlriec system nfcrcnceil abavl. was installed subst�daliy according to the des*% which may i c e minor ap=Y", 1 chait$es such as relocation of the distribution' bo E and/or septic tank. Stripout (if required) was insl ecCQd and the soils were found satisfactory. I certify that the septic system rcf=aced abode *M finished witb� M1Pr changes greeter than 10, latim relo'cstion of the SAS:ar any vertical f aay component of the septic sys-ftm)but in accordance with Stwe dt Local revision or c tificd as-built by designer to follow. stripoul;(if re d the soils were found sett rf K* a nY• PETER T. n 'C McENTEE � CIVIL °' No.' 35�09 er's I uTC� ss'ro►�E (Desiper's ignatwe} �'AM Dmper's Stamp Here TO B 'i'ABir M IEALfi1� � BE ITB AM ftNiFiN IP,L�t g BY BA►�NgT;ABLE.P 14KYOU, OF (' alutttce. �fan.�oc '. TOWN OF BARNSTABLE JCATION $.3 Sc1 wtY1► 1 aj SEWAGE# VILLAGE M m.l u ASSESSOR'S MAP&PARCEL 0 .S5 INSTALLER'S NAME&PHONE NO. �a avc�rd� �'w yZ.B yl»iP SEPTIC TANK CAPACITY /0p0 LEACHING FACILITY:(type) (size) 143 k 2S^ NO.OF BEDROOMS OWNER ��✓t� �unre nay%- 1. PERMIT DATE: COMPLIANCE DATE: 'GA - O$ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .00 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 L aching Facility(if any wetlands exist within 300 feet of leachinefacility), feet FURNISHED BY Qc ( Scs Al P.o Az P-310 61 vi-O 97 A.s $� (co.o (pqr o7 16(o b7.o e3 �i,o Syr C� 7� 0 '741 LEGEND N / E- --Dg ...-- EXISTING CONTOUR _ -, r x 100.98 EXISTING SPOT GRADE / ° / W EXISTING WATER SERVICE o 0 v` UGW UNDERGROUND WIRES rp e G EXISTING GAS SERVICE R o LOCUS i/ s /1 TEST PIT U BENCHMARK Blackthorn Qo`r �r Lot 362 IN, Qa ��7i ati�\ -3 1 a, 3 ,l 4�,O99f S.F. S 66 Debbie Path 1.Olf AC. 2� 9�2•• Benchmark set ova Pa m a tt / .�>o F Left cor. bo t. step Emerald Lc / A/10�0 6.3 EL.=102.68 Assumed °0 Parse/ 58 ► 102.68 0 Drive 0277 102.24 102 a / I'h 103,12 Stone j t Drive LOCUS MAP / ^ry• P v 102.70 10 9 S� 100' 100.42 NOT TO SCALE x 1 2o GENERAL NOTES: / mo w, N 102.86 102,30 Stone 1 W L x 103.U5 lr ,75 -100 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL rrt 1U2.75 x 10, L4 BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 102.94 �� -' OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE / 2.44 LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: / o 310 CMR 15.405(1)(b): / HOUSE(#83) �/ O� 99.31 1) A 2' variance to the 3' maximum cover requirement, for no greater 'h T0USE(.34 . 46;' i x 99.06 1 than 5' of cover. S.A.S. shall be vented and H-20 Rated. / 10''k %>r LOCAL REGULATION: 150' SETBACK REQUIREMENT-WELL TO S.A.S. / µ(As sum ed),- µ f x,1102.25 - / �S0 x 97.36 --- --" 2) A 46' variance, private well (subject site) to proposed S.A.S., / t ! -- x 97.56 1 fora 104' setback. / x 101. 3 i �' /�' ' x 9 7 ~ �� 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR / :�' 1U2.57 �� '� STRhPOUT �o TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 10 - :^ r F~ J '1 i ,/ / x �b z�811 A�, *� 1 t DESIGN ENGINEER. I pq 1' 87 �� -,r','�"'��X" VENT SEE NUT�E 1 0 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 102.47 V / //',.�;����V�, \ 4 O FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN / r `v ��/ x 96.03 o ENGINEER BEFORE CONSTRUCTION CONTINUES. / h x.103.28 r 1'..1 ,/ ,,iy; \ , 7 -o c9/ 101.84 , /\ 1 ?�','rl��/ o;--980` 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. / h`O oo F�.• ��.-� �.,..x 6. r,, TP-3 D .� t� I `" 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF -'-/ 104- - °f��' • } o C q 97.73 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF of, 97.4/6 fi 93.9j a 102 / � + l 7 /931 92.50 t ,� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. x'1iO4.29 ' I /y , �O ^O O 7. WATER SUPPLY PROVIDED BY PRIVATE WELL. x 105.01 r I �c 93, 7 9�o4�O 93.86 1 '� �1 MAG0 97.31 8. THERE ARE NO PRIVATE WELLS WITHIN 150' OF THE PROPOSED S.A.S. ` � �P-2� - .t �_ G � 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS EXISTING SEPTIC TANK x �04.50 _ �- ( 96.35 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE y \ 96 x ` , DIRECTED BY THE APPROVING AUTHORITIES. o `TP-1` ~` 958.2 x 96.93 96.79 �I TOP OF TANK, EL.=101.53t 96.91 INV. GUT =100.20t � '`y � "'`-•�._.� 1 v 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE ( ) i ® 96.48 � THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING x 105.01 lq 261 ` ` \\ BASIN CONSTRUCTION. EXISTING LEACH PIT N p^ 68• ~ -- �. 11, WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS TO BE PUMPED, FILLED W/ \28,• 100'78 `-- - --- 1� Q� IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND SAND & ABANDONED. \ U`75 + REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 105.50 ` �. cd o PROPOSED SEPTIC SYSTEM UPGRADE PLAN PETER T. s, i McENTEE i 83 SAWMILL ROAD, MARSTONS MILLS, MA a I J o CIVIL 70` y t I 0, 35109 - Prepared for: Capewide Enterprises. P.O. Box 763, Centerville, MA 02632 RFCI SERA` �Q 700- �f Engineering by: Surveying by: SCALE DRAWN JOB. NO. OWNER OF RECOED 99,00 F 1 t E't� CB/DH/FND/TC-FED 98.29 Engineer9ngWorks WARNER SURVEYING 1"=30' P.T.M. 211-08 DAVID SURPRENANT 12 West Crossfield Road 22 Long Road 83 SAWMILL ROAD �I 2` ( /1 Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET N0. MARSTONS MILLS, MA 02648 �J J lJ U (508) 477-53t3 (508) 432-8309 7/31/08 P.T.M. 1 Of 2 + t 1 A NOTE: TO PREVENT BREAKOUT, THE PROPOSED _ FINISH GRADE:'SHALL NOT BE < EL:90.33 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. PROPOSED TANK PROPOSED D-BOX PROPOSED S.A.S. ii 21 5-4.EAL'INLETS INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL INSPECTION PURT OVER END UNIT 2'. 3" T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE F.G. EL: 94.0-95.3(MAX.) VENT EXISTING F.G. EL.=103.0t F.G. EL: 102.0f , MAINTAIN 2% GRADE (MIN.) OVER S.A.S. N O INSPECTION L = 77' L 7'(MAX) a PORT f7 ® S=1% (MIN.) @ S=1% (MIN.) f 4"SCH40 PVC 4"SCH40 PVC s nl Top View Section 6 11.3" TO INVERT D-BOX EXISTING 48" LIQUID LEVEL ADD cqs DAPPLE. INV.=92.67 INV.=92.50 4 ROWS OF 4 UNITS AT 6.25'/UNIT = 25.0` . . . • INV.=100.20t INV.=89.94 EXISTING PROPOSED D-BOX SOIL ABSORPTION SYSTEM (PROFILE) EXISTING 1000 GALLON SEPTIC TANK WITH INLET TEE X RESTORE TO PRE-EXISTING CONDITION 4 OUTLETS (MIN.) BACKFILL WITH CLEAN NATIVE OR �- 75 PERC,SAND TO TOP OF CHAMBERS NOTES: 1) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED BREAKOUT=TOP STONE BASE AS SPECIFIED IN 310 CMR 15.221(2). TOP ELEV.=90.33 2) INSTALL INLET & OUTLET TEES AS REQUIRED. INV. ELEV.=89.94 3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM ELEV.=89.00 Ill `tm Intl®II VERIFY SOIL CONSISTANCY OR EQUAL. 2.8 3' F TITE ZABELLOCATION PRIOR BY TU AS MANUFACTURED AT S.A.S.S.A.S COCA 76" T F I� ' MIN. ABOVE BOTTOM 0 TAL TON 5 TO INS LA I 4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE EFFECTIVE WIDTH=11.3 INVERTS PRIOR TO CONSTRUCTION. T.P. EXCAVATION OR G.W. PROFILE EXISTING SUITABLE NO G.W., EL=80.3(TP-3) = MATERIAL 4 ROWS OF 4 - 16" (H-20) ADS BIOUIFFUSER UNITS /6 AN SEPTIC SYSTEM PROFILE WITH NO SEPARATION BETWEEN EACH ROW & NO STONE TYPICAL SECTION 16" N.T.S. N.T.S. 11.2" SOIL LOG DESIGN CRITERIA -�o ,�\ �� DATE: JULY 18, 2008 (REF#12,307) SECTION END CAP \`��^G�' ` ` \ \' `' SOIL EVALUATOR: PETER McENTEE PE \oID��L\\ WITNESS: I � DONNA MIORANDI R.S. NUMBER OF BEDROOMS: 3 BEDROOMS , .\�w w ��� \ "FACT" AGENT 16"" HIGH CAPACITY (H-20) BIODIFFUSER UNIT SOIL TEXTURAL CLASS: CLASS I ELEV. TP- 1 DEPTH ELEV: TP-2 DEPTH ELEV. TP-3 DEPTH O DESIGN PERCOLATION RATE: <2 MIN/IN ~ ", 0 0" MODEL 16" HICAP 97.5 A 94.7I A 92.3 A DAILY FLOW: 330 G.P.D. SANDY LOAM SANDY LOAM SANDY LOAM LENGTH 76" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT 10YR 4/2 1 10YR 4/2 10YR 4/2 EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY DESIGN FLOW- 33D G.P.U. 97.3 6" 94.2 6" 91.8 6" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. GARBAGE GRINDER: NO B B B SIDE WALL HEIGHT 11.2" SANDY LOAM SANDY LOAM SANDY LOAM OVERALL HEIGHT 16" LEACHING AREA REQUIRED: (330) = 445.9 S.F. N 10YR 5/5 1 10YR 5/8 10YR 5/8 4640 TRUEMAN BLVD co 95.8 24" 9 2.7 24" 90.3 24" OVERALL WIDTH 34" HILLIARD, OHIO 43026 EXISTING SEPTIC TANK: 10004GALLON CAPACITY CA' 01 iv C1 C1 C1 901me O SILT LOAM I SILT LOAM SILT LOAM CAPACITY 13.6 CF PROPOSED U-BOX:: 1 INLET, 4 OUTLET (MINIMUM) 10YR 5/3 I, 10YR 5/3 10YR 5/3 1(101 GAL) ADVANCED DRAINAGE SYSTEMS, INC. USE 4 ROWS OF 4 - 16" (H-20) ADS 91-8 72" 68.5 74" 86.1 74" EC2 PERC I `2 C2 PROPOSED SEPTIC SYSTEM UPGRADE PLAN BIODIFFUSER UNITS FOR ANN S.A.S. WITH 84" MED. SAND MED. SAND 83 SAWMILL ROAD, MARSTONS MILLS, MA WITH DIMENSIONS 11 .3' x 25.0' MED, SAND 2.5Y 6/4 2.5Y 6/4 2.5Y 6/4 Prepared for: Capewide Enterprises. P.O. Box 763, Centerville, MA 02632 SIDEWALL AREA: NOT APPLICABLE R0p S,q S` T Surveying by: SCALE DRAWN JOB. N0. ^'� 85.8 144" 82:7 144' 80.3 144' Engineering by: BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.7 SF/LF) ' •,_ Engineering works WARNER SURVEYING NTS P.T.M. 211-08 16 UNITS x 6.25 LF x 4.7 SF/LF = 470.0 SF \y f 12 West Crossfield Road 22 Long Road PERC RATE <2 MIN/IN. ("C2" HORIZON) Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 x 470.0 = 347.8 GPD S.A.S. LAYOUT NO GROUNDWATER ENCOUNTERED 7/31/08 P.T.M. 2 of 2 (508) 477-5313 (508) 432-8309 TEST PIT- DATA DArE c,� TES 4- z g - �3 PERC. TEST DATA : SEPTI C TANK DETAIL : sIzE- REVISIONS: ---- _- �--��� �-�� _ _ D/S T. BOX DETAIL LEACHING FACILITY/T Y DETAIL :I L � NO DATE TEST ;,v Ya- - -/ _ TO CONFORM TO T/TL E 5 REOU/REMENTS: P DATE OF TESTING' _��-_ � `3=83 TANK TO CONFORM TO TITLE 5 REOU/REMENTS. j' w/TNEssEO BYE .�. a,.c�a,zD -- - _ TES BY xTd.z NYC -. .�-�� �� _--- NO. OF OUTLETS,, �. WITNESSED BY _�. ,�,� ,�o � f - .�. - - �� ---� �y REMOVEASLE COVER - - — --- — � � i � i� �/ /� � y/l� --- vim,`/ \\?�\�� \ \� yc�S�` �MAX MANHOLE BROUGHT TO :��' o F/N/SH GRADE. i 2'PEASTONE M$FILL / ---- - - - ---- SvB --- r — t - - - -- - 3 CLEAR 3 CLEAR :. - _ LOA-- --- ----- ------ ----- --- OUTLET 1oL 9r7 DEPTH OF TEST - - — 6"M/N. 2"M/N 6"MJN. i',Ilf ASREOU/R/EDS �_ ! i = _ 1 — ----- INLET i , I --- ! ... 7 _ - --- -- - -- - -- — RATE: _ � ..., ,� - - - - - - —_Gl /0,M/N. Ili D/ST � ! INLET TEE --- - OUTLET TEE , � i t i u BOX I ! \ N I 24'r I • : 4 C. /000- GAL. i INLET AND OUTLET 4 O" M/N/MUM OUTLET TEE DEPTH: i ? - __ TEES TO BE CAST •` L/OU/D DEPTH /4"AT L/OUID DEPTH OF 4' :, 2 �,• ✓ SEPTIC TAN LL_-_______! I . PRECAST OR, 'MIN t 6 K ! REC 9LOCK /RON, SCHED. 40 /9" " " " 5' / CONCRETE h I SEEPAGE PIT DEPTH OF TEST _ P V.C. OR CAST IN ' 24 ' " b' a., .. o o . .. CONSTRUCTION /O' i' ' ; _s PLACE CONCRETE i 29' „ „ „ T' •'. , . ,. _ . .....�..• M/N I RATE' CONCRETE ,. 34 „ B BOTTOM ON LE STABLEBASE ! --- VEL - -- - - - ' CONSTRUCT/ON s �' pf ! ' . ' • . (WATER ri 6 T IO .; . ., ... _ .. • . . . ._ , •.,,.,. .. ..,,.. ,,,.p INLET TEE PROVIDED WHERE SLOPE FOUNDATION 4 I I ! • ` • TANK TO BEABLE TO W/THSTAND O.OB % OROF INLET PIPE EXCEEDS � . .J• -' / ! _ BOTTOM OF TANK ON LEVEL STABLE BASE H-/OLOAD/NG UNLESS UNDER /N A PUMPED SYSTEM. 20'M/N. _! I PAVEMENT OR/N DRIVE.H-20 \/% WASHED STONE ---- ! LOAD/NG UNDER PAVEMENT OR ! DRIVE. ! - /C - PLAN VIEW INVERT ELEVAT/ONS� ---- /. THIS PLAN/S FOR THE DESIGN AND CONSTRUCTION OF THE SEWAGE DISPOSAL FACILITY ONLY. SCALE : I 2. ALL CONSTRUCT/ON METHODS AND MATERIALS SHALI. ram/'✓FORM TD _. _ INV AT BUILDING MASS. D.E.O.E. TITLE 5 AND THE _f,'��% .'� '��-?i_ N��<a, U OF �_ /Nk' AT SEPTIC TANK(lN) - �oi:_� Z �� 1 INV AT SEPTIC TANK() 101 3� .SCT -c�r+��-� r � HEALTH REGULATIONS. � _ 3) '7'C"s 7- 4"' '" L O G N �s../ 7�J,�C E/�/ q/�',� G / _' . : 7 i C�s✓ .",� %9 !/ /S"' CP G 2cr►� /S ' A — -v� !NVA'"DiST BO.Y(//'✓1 l-Z. z 7 �+ /NV. AT DIST. BOX(OUT) A T LEACHING FACIL/TY: %. AT BOTTOM OF PI T. 9 < i BOSTON, MASS. WORCESTER, MASS. �--� HALIFAX, MASS. NORWELL, MASS. `y BEDFORD, MASS. LEXINGTON, MASS. HYANNIS, MASS. MANSFIELD, MASS. CRANSTON, RI.I. DERRY, N.H. x Y B C ""^ -___-• _...._„.....__.,_...._.,.._ .. ,.tip_ J 4 I lI 4 3• 70 s DESIGN DA TA : _. DES/GN FLOW I C� 3_F.c� x Z/cc, c..dG> _ =- G+P't> - 7 ' 0 `' 1 REQUI RED SEPT lC TANK: -- tlz - _ ----- SEPTIC TANK Ph'OVIDED r, �e Q GAL CAPE CAD SURVEY 4Q � x __ _ _ _ -_- � CC�NSULTAI�Tb REOU/RED SIZE LEACHING FACILITY: 1 I~ q --=- F?O BOX 56 HYAN IS. MASS. 601 N 617 / VISION OF BOSTON SURVIEY CONSULTANTS INC. I I SIZE OF LEACHING FAC/L/TYPROVIDED ENGINEERING SURVEYING PLANNING .0 cV I 4( ' I 1 I I I 1 0' O 'YPE OF SYSTEM TITLE: 1 ,� I I I " '� SEWAGE DISPOSAL SYSTEM �4, 7 rL DESIGN .= J � � _ �� �-57 � �2Q laPG� S,J,"✓ P?/. 3/ - - o/U \ \ L 0 T jo(fl 2 SAlwW14 L RDA D L OCUS PL AN` 9ff�"_S (MA R, S T ON 5 1$4!L L 5 HA c' _ FOR: T /V 7/9 Sg;,.�"';r�f ' / \ — f-n,� L�i l�E SCALE: AS SHOWN METERS O 4t a FEET 0 /4 2C 8.A! CQ DATE: OCT )S-) i 98 3 �'8/D�/ F./!/D U COMP./DESIGN: C,F.W/R.P,M EL. /00.0 o .,, . � _ ASSUMED • .__—__.____ __-- -- &C 4L E ; ?Gc>cJ'* CHECK: C.,FW / R. p M. R DA TO DRAWN: T. ,6/•�', FIELD: R 4 ,)y V B, FILE NO: DWG. NO: 600 JOB NO: �- /Z 32 SHEET: I OF: I ! I