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HomeMy WebLinkAbout0233 TREE TOP CIRCLE - Health 233 '-Free Top Circle 150-043 Marstons Mills 4 I No. 2oa '6V / Fee uJ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppYitatiou for disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(X) Upgrade( ) Abandon( ) ❑Complete System ><!Individual Components Location Address or Lot No. G[PhC$ Owner's Namg,Address,and Tel.No. , / ,C�1. 1JATl+At add ssla Assessors Map/Parcel `7 3 w c &4 rCL. Installer's Name,Address,and Tel.No. S©J-4f-77`8277 Designer's Name,Address,and Tel.No. Type of Building: Dwelling No:of Bedrooms i Lot Size sq.ft. Garbage Grinder(" ) Other Type of Building RESML� �/Ak, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) , gpd Design flow provided 14 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) RsEpt.�'& C W n fiic SeRrie tAo(,�, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maint nce of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the EnvironmAM Cod not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si ned Date 3 r 2,0-Z Application Approved by ff/ Date — Application Disapproved by Date for the following reasons Permit No. Date Issued 3 1 ^`� D 30 Z No. s 1)) , `6 0 ` Fee U CI THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpYiration for Disposal 6pstem Construction A3erntit !Application for a Permit to Construct( ) Repair(&•Upgrade( ) Abandon( ) ❑Complete System �vindividual Components Location Address or Lot No. -� �Dl GII .c:B Owner's Name,Address,and Tel.No. t't4" tjAY(4AAJ VSSIUY Assessor's Map/Parcel s, Installer's Name,Address,and Tel.No. 5p2-�4f'27-$�S 7T Designer's Name,Address,and Tel.No. p . .54 N� Type of Building: Dwelling No.of Bedrooms ►V RI n Lot Size sq.ft. Garbage Grinder( ) Other 1' Type of Building mme No.of Persons Showers( ) Cafeteria( ) "Other Fixtures Design Flow(min.required) 0 ,14 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) [,/ E' Cl,o f x)�; `S' 'Ie—, —TAW, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintena ce 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 "' ' 2&Z2 Application Approved by (I )J 1 t. ye Date Application Disapproved by Date E for the following reasons Permit No. ) v, - o Date Issued ' 1 , THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ° Certificate,of Compliance t i THIS IS TO CCERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X) Upgraded( ) Abandoned( )by :Roe epT 1) OLI;L Ca at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. . ..&I")­{'�� dated 3 2 Installer RL B 04R15 cam. Designer Nei #bedrooms k,I f>`l-- Approved design flow A! gpd The issuance of this pe Irr ittj all not be construed as a guarantee that the system will ct� a,designe Date yt II d O Inspector rl s' 0,V y No. u .7 3 Fee //0 d -- -� THE COMMONWEALTH OF MASSACHUSETTS _ PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS f' Misposal *pstem Construction Permit _ Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( ) .System.located at t tji4, Aet f k and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. { Provided:Construction must be completed within three years of the date of this permit..'" Date ! f-� Approved by '"'f`` k?'L' t 12 �. '� I -.' TOWN OF BARNSTABLE ( LOC.AI-ION M&TZLP CA SEWAGE # 62.-477 VZLAGE Yr �NS lM/,[.LS ASSESSOR'S MAP & LOT qk INSTALLER'S NAME&PHONE NO. 8&%'q 4,CIOTZ SEPTIC TANK CAPACITY /000; LEACHING FACILITY`t(type) d �MA66 (size) L` ')U NO. OF BEDROOMS T BUILDER OR OWNER DdY M©/cm-40 PERMITDATE: X0-5aj COMPLIANCE DATE: /0 49-0a 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 - i r i e tl 71 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 1y 233 TREE TOP CIRCLE U 0�'3 Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. Cityrrown Inspection results must be submitted on this form. Inspection forms may not be altered in any way. s� Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your MICHAEL DEDECKO cursor-do not Name of Inspector use the return key. COMPASS REALTY DEV CORP Company Name rQ P.O. BOX 2384 Company Address MASHPEE MA 02649 City/Town State Zip Code 508-221-5003 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and�tat the, information reported below is true, accurate and complete as of the time of the inspection7he inspection was performed based on my training and experience in the proper function and maintenape of�on site sewage disposal systems. I am a DEP approved system inspector pursuanf-io Sectiq%15.34`0 of Title 5(310 CMR 15.000).The system: ,. ® Passes ❑ Conditionally Passes ❑ Pa Is = ` � ❑ Needs Further Evaluation by the Local Approving Authority un rn 5/21/07 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 241 pine•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. Cityrr Nn B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ 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. ND Explain: ❑ Observation of sewage backup o�break eto aubrokeinhsettled otic r er uneven in distribution on box System istribution box willto broken or obstructed pipe(s) o pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 241 pine•08/06 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. Cityrrown B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: 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 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. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 241 pine•08106 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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 El ® 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. 241 pine•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is required for MARSTONS MILLS MA 02548 5/21/07 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection 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. 241 pine•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 L Commonwealth of Massachusetts Title 5 Official Inspection Form 141 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for wn State Zip Code Date of Inspection every page. City/To 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? ® ElWere as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ 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) 1310 CMR 15.302(5)) 241 pine-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is required for MARSTONS MILLS MA 02548 5/21/07 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No n/a Water meter readings, if available (last 2 years usage (gpd)): Sump pump? ❑ Yes ® No N/A Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): 241 pine-08106 Title 5 Official Inspection Form.Subsurface Sewage Disposal system-Page 7 of 15 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) General Information Pumping Records: n/a Source of information: 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2002 Were sewage odors detected when arriving at the site? ❑ Yes ® No 241 pine•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Town water Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): joints tight, yes vented, no sign of leakage Septic Tank (locate on site plan): 1' 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 --------------------------------------------------------------------------------------- 1000 gallons Dimensions: 3" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 31" V Scum thickness Distance from top of scum to top of outlet tee or baffle 11" Distance from bottom of scum to bottom of outlet tee or baffle 14" measured How were dimensions determined? 241 pine•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 9 of 15 I r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. City/Town 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.): no need to pump tee's intact structurally sound liquid level equal with outlet invert no leakage. 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 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): 241 pine•06106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Tight or Holding Tank(cont.) 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 Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert equal with outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D box is level and distribution is equal, no solid carryover, no signs of leakage Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 241 pine•08106 Title 5 Official Inspec tion Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is required for MARSTONS MILLS MA 02548 5/21/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): soil sand/gravel, no sign of hydraulic failure, ponding dry, no damp soil, vegetation normal. 241 pine-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) 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.): 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.): 241 pine-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02548 5/21/07 required for State Zip Code Date of Inspection every page. Cityrrown D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 4 �7Z 1 3 '7 241 pine-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 233 TREE TOP CIRCLE Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is required for MARSTONS MILLS MA 02548 5/21/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells 80, Estimated depth to ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: barnstable gis ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: barnstable gis shows spot elevation 81.06 241 pine-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form �1M Inspection results must be submitted on this form or on the official Title 5 Inspection Form dated 6/15/2000. Inspection forms may not be altered in any way. A. Certification Important: When filling out 1. Property Information: forms on the computer,use 233 Tree Top Circle -Marstons Mills, MA only the tab key Property Address to move your Dean Morgado cursor-do not use the return Owner's Name key. 233 Tree Top Circle Owner's Address Q Marstons Mills MA 02648 City/Town State Zip Code Date of Inspection: September 10, 2005 ernn Date { 2. Inspector: mwF, David D. Coughanowr, R.S. I ` Name of Inspector jam; Eco-Tech Environmental '4 '' Company Name 43 Triangle Circle Company Address ' , , Sandwich MA 02563 City/Town State Zip Cosd-e 508 364 0894 r�-E Telephone Number Certification Statement: I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails Needs Further Evaluation by the Local Approving Authority 4Lt(z). ca�—� P S September 10, 2005 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5-2187.doc•11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 1 of 16 I ' r Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form �M A. Certification Cont. 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Inspector's Note==> A septic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ 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. ND Explain: t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 2 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form �M A. Certification (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: C Further Evaluation is Required b the Board of q y 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 t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 3of16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form A. Certification (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection C) Further Evaluation is Required by the Board of Health (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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: t5-2187.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form �M A. Certification (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection 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 cesspool is less than 6" below invert or available volume is less than '/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 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] Yes No ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. t5-2187.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 5 of 16 Commonwealth of Massachusetts W Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form M A. Certification (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection 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. t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 6of16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form 'GSM B. Checklist 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection 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 dwellinginspected for signs of sewage back u ? P 9 9 P ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 7 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments iG M Subsurface Sewage Disposal System Form C. System Information 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 gpd Number of current residents: 6 Does residence have a garbage grinder? Removal of grinder is recommended ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 337 gpd 9 ( Y 9 (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: currentDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other (describe): t5-2187.doc•11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 8of16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection General Information Pumping Records: Source of information:. owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: Age: 3+years. Design Plan dated 6129102(Plan in owner's possession)) Were sewage odors detected when arriving at the site? ❑ Yes ® No t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 9 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments ;M Subsurface Sewage Disposal System Form C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 20+feet Comments (on condition of joints, venting, evidence of leakage, etc.): Sewers appear structurally sound with no evidence of backup or leakage into dwelling Septic Tank (locate on site plan): Depth below grade: 1feet 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 ❑ Yes ❑ No certificate) Dimensions: 8.5 ft x 5 ft x 5 ft(1000 gallon) Sludge depth: 8 inches Distance from top of sludge to bottom of outlet tee or baffle 26 inches Scum thickness 6 inches Distance from top of scum to top of outlet tee or baffle 7 inches Distance from bottom of scum to bottom of outlet tee or baffle 11 inches How were dimensions determined? Design Plan t5,2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 10 of 16 r Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments ;M Subsurface Sewage Disposal System Form C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping is recommended at this time and maintenance pumping is recommended every two years. Tank and tees appear structurally sound and functioning as intended. No evidence of leakage in or out was observed. Grease Trap (locate on site plan): Depth below grade: 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 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): t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 11 of 16 Commonwealth of Massachusetts w Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Tight or Holding Tank (cont.) 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.): Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert At outlet inverts 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.): D-box appears structurally sound with no evidence of leakage in or out. Few solids in sump. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 12 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments iG^M Subsurface Sewage Disposal System Form C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 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: 1 ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soils above leaching gallery appeared unsaturated. No evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. A bucket of water was poured into the distribution box and was observed to pass through in a rapid and unobstructed manner, and could be heard splashing down into the leaching gallery. t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 13 of 16 r Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form G1M C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection 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.): 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.): t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 14 of 16 Commonwealth of Massachusetts w Title 5 Official Inspection Form Not for Voluntary Assessments iG^M Subsurface Sewage Disposal System Form C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. LEACHING GALLERY 0 WATER LINE A 30 #233 ° D-BOX Q EXISTING ° z DWELLING SEPTIC TANK LOCATIONS A B 1 21 ft 32.5 Ft 2 65 f t 50 f t 3 71.5 ft 61 ft TREE TOP CIRCLE NOT TO SCALE t5-2187.doc• 11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 16 e Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form 'GSM C. System Information (cont.) 233 Tree Top Circle Property Address Marstons Mills MA 02648 City/Town State Zip Code Dean Morgado September 10, 2005 Owner's Name Date of Inspection Site Exam: Slope Surface water Check cellar Shallow wells Estimated depth to ground water: 40+feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ® Accessed USGS database explain: Barnstable GIS Department records You must describe how you established the high ground water elevation: Town of Barnstable GIS Department records indicate that the property is over 40 feet above groundwater table. t5-2187.doc• 11/2004 Title 5 Official Inspection Form: Subsurface Sewage Disposal System Page 16 of 16 I j TOWN OF BARNSTABLE CL LOCATION SEWAGE # ? VII,LAGE x � `�� ASSESSOR'S MAP &LOT-LED INSTALLFR'S NAME&PHONE NO. SEPTIC TANK CAPACITY _ a � , LEACHING FACILITY: (tyj 5) �V - (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: 42-ff COMPLIANCE DATE: rd i 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 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility (If any wetlands exist Feet within 300 feet of leaching facility) Furnished by i l � A-Val ' j ° I 7®°1" 3-T40 G&icH No. v.°� `t 7 7 FEE=� -S��LIL Board of Health,✓M S"1-1 b L<- , MA. . APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct(.) Repair( ) Upgrade Abandon( ) - ❑Complete System 4Individual Components Location Z�3 (' ��jc CQ ,e5.,1rj4 Owner's Name Pe �4 r 4 Map/Parce /sQ Q�Ct 1!S Address SccuA,,? Lot# ISO - 0�3 Telephone# Installer's Name d Designer's Name K ,r^ Address z.0 ?rase 7-- Cr !_ / �4rs1tO S �M Il Address -Z 3 � t j� �Tl✓� �� Telephone# 6OV 0 .- l+¢.q-5 l Telephone# -108)4-7.7 S i3 Type of Building S��G�tn�du Lot Size 22i 383 sq.ft. Dwelling-No.of Bedrooms 4- Garbage grinder ( ) Other-Type of Building N/A No.of persons Showers ( ),Cafeteria ( ) Other Fixtures N/A Design Flow (min.required) gpd Calculated design flow "T ,"' Design flow provided 4(-S`T gpd Plan: Date fe syo Z Number of sheets 2— Revision Date ^oi" Title 7r;ee 76" Cdng.L . /^ e" ,"".2 Description of Soil(s) 3`°/ �� �a Y2 3� r' `t �L �O�2 S L/`f�(�� C�° s�� 2c•S Y �/d Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS /n S fl /��'`*► �rf SA-S The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to of to place,slipsyste.YjKo xation until a Certificate of Compliance has been issued by the Board of Health. Signed Date /0-/,0-°Q �6 Inspections aw, FEE COM—NiONWEALTH Of MNsACHUUTTS- Board of Health, t-q b L< MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Apolication for a Permit to Construct( ) Repair( ) Upgradek) Abandon( Q Complete System 4 Individual Components Location C IrC tt wner's Name 0' Map/Parcel# Address Sc.,pce A)em; 1357:0- Lot# Telephone# Installer's Name Designer's Name lur-;,01c, &Vul- 5 Address 7po, C., Address Z Telephone# Telephone# Type of Building /de-.5"CL"4-1.0 Lot Size Z F, 383 sq.ft. Dwelling-No.of Bedrooms 4- Garbage grinder ( Other-Type of Building /,j/.4 No.of persons Showers Cafeteria Other Fixtures AJ/,O Design Flow(min.required) q U gpd Calculated design flow +4C) Design flow provided gpd Plan: Date 6 Revision Date& Number of sheets Title Se,:,L,' S'.,sl-ee-, 4,)t- r.,,& 743 —6 M,71ij 'MA I;Zee I I 3/;j 7,9 113; SL /,0 y/e-5/,y Description of Soil(s) A ! S-L 10 Y& SAI-4 ZS-X �/A Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS 5,1q, s,A''-S• The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to ofto place 0h/t t!pr;zjin�`o eration until a Certificate of Compliance has been issued by the Boar,d of Health. Signed Date 8.4.6 -*ir. T7 Inspections No. FEE COMMONWEALTH OF MASSAC14USETTS Board of Health, erl_^ S vni L Le CERTIFICATE Of COMPLIANCE Description of Work: Ll Individual Component(s) El Complete System ,The undersigned hereby certify that the Sewage Disposal System; Constructed Repaired Upgraded Abandoned by: at _9 4V M) has been installed in alcordance with the i . n of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. )o u,;�-V 7 7 , dated /0 0.2 —. Approved Design Flow—(gpd) Installer Designer: Inspector: I- Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. ')t)0?— V77 FEE 0 COMMONWEALTH OF MASSAC14USETTS Board of Health, -i&,-rl-5 I-qAoLe MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct Repair Upgrade Abandon an individual sewage disposal system 171 at_ 3 Try �,p as described in the application for Disposal System Construction Permi t dated II Provided: Construction shall be completed within three years of the date of this permitAll local conditions must be met. Date Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA 2 Board of Health L .0 �T ION SEWAGE PERMIT NO. VILLAGE INSTA l R'S NAIVE i AD RE S Av, BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ����� ti �z r w .� ire e- l-o� TOWN OF BARNSTABLE LOCATION 43 8 C. 10 C:•-C I SEWAGE # VILLAGE JSAP-3t on 5 i:77 -L A--,% ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO- er✓,r at b . coacher'larwr SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS�� WNER -Dean �n ot�adp PERMITDATE: COMPLIANCE DATE: �"m a. 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 Commonwealth of Massachusetts Title 5 Official Inspection Form ±, Not for Voluntary Assessments Subsurface Sewage Disposal System Form C.System Information(cont.) 233 Tree Too Circle Property Addrese 1 _ Marston Mills MA 02648 Cibyfrwm state ZJp Code Dean Morgado September 10 2005 owners Namo Date of Inspealon Sketch Of Sewage Disposal System:Provide a sketch of the sewage disposal system including lies to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building. f OERY WniEp LINE ' #233 D-BO%O EXISTING DWELLING IPTIIC LOCATIONS A B I 21 Ft 32.5 ft 2 65 ft 50 ft 3 71.5 ft 61 ft 1 I - TREE TOP CIRCLE NOT TO SCALE 15-2187.doc-1112OD4 Title 5 official Inspection Farm:Subsurface sewage Disposal System- I,,l Pea.15 of 18 I 5® a Au,, 71 3-AO GKcc , TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by s TOWN OF BARNSTABLE L LOCATION S TA C,1'2 SEWAGE # VILLAGE A4105r&S ftu-s ASSESSOR'S MAP & LOT J,a- °Y? INSTALL4R'S NAME&PHONE NO. ! P` khyOTT4 SEPTIC TANK CAPACITY lboo LEACHING FACILITY: (type) ��� Cfi�i�t8&ZS,, (size) �X 3ed NO.OF BEDROOMS BUILDER OR OWNER D61M I'l') gwo PERMITDATE: And -d COMPLIANCE DATE: rd`5,0Z 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 0 N ...... Fiat........4.- ---------,,�_� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH /S0 D �3 OF.......................................... --.... ---•------------------------------------ ,.._, it ation for Dig vii al Workii Tnntrurtiun VFermit - Application is hereby made for a P mit to Copstruct ( ) or Repair ( an Individual Sewage Disposal System at --......... d l -- ... --.....�. ........................... •.--•---•--�`..... s -- -............................_. . � - .. ` Loc ti n-Anddre�sgs or Lot No. ........... c../....... ...[.. .fZ... ....... .................. ......................... _._....----.................................._..... Cy�& erTT Address a .............\.2_._._cc//���_........... ...._..t/1q_/,..._...... Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.___,?____________________________________Expansion Attic ( ) Garbage Grinder ( d) '4 Other—Type T e of Building __._._____ No. of ersons____________________________ Showers — Cafeteria A� YP g P ( ) ( ) a Other fixtures -------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow____._.._: ....._.C�.____._-_.____._____gallons. W Q1D Septic Tank—Liquid capacity__I ._.gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No ____________________ Width—----_............ Total Length.................... Total leaching area._.__..__._1.......sq. ft. Seepage Pit No----_--------------- Diameter.................... Depth below inlet.................... Total leaching area..........\_......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------------------------------- •----•----------•----------------------------......_.._......................................................... ODescription of Soil............ �'••_••-6--0/�Ve'..•--•--......---•------------------------------------------------------------------------------------------------ x U ........... W --------------------------------------------------------------------------------------------------- ----------- -------- eo U Nature of epalrs Alterations—Answer when applicable_______________________________ __.'__'......-_' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal S stem in accordance with the provisions of iII'L p 5 of the State Sanitary Code— e u ersigned f ier ree t to place the system in operation until a Certificate of Compliance has been i ed e b d alt Signed.............. ..... .... • ---------....---------............. ............. — Date Application Approved By...................... --- •-• '.. . . ................ ........... .... Date Application Disapproved for the following reasons-----------------------------•--------------------_..----------------------------------------._._._........--••-- ---------------------------•----------._....------••---------...-----•----•------•---...--••-----.._.......__...-----------------•-------------------------= -----=-----•-------...----•------- ------ Date PermitNo......... G-- --`--- ----------. Issued....................................................... Date No:-`+•:............. FRs..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................................................................................... Aptira#ion for Disposal Works Tumulrurtion ramit Application is hereby made for a-,Permit to Construct ( ) or Repair (<) an Individual Sewage Disposal System at• / C4 1 �;o C..(• � _ �ff. ...Location-Address or Lot No. •...............ems,.._.`..._... ...... W !N�............S..... Wn� / ................................................................................................. Address �� 7"'r" Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.....��......................................Expansion Attic ( ) Garbage Grinder (IV,) '4 Other—T e of Building ............... No. of ersons.................._..__.____ Showers — Cafeteria QI YP g ------------- P ( ) ( ) Q' Other fixtures .......................................... W Design Flow............................................gallons per person per day. Total daily flow..........� ...0...................gallons. WSeptic Tank—Liquid capacity. 0.0...gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No......................Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ►-' Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ........................................ .................................................................................................................... o Description of Soil......C /,`.�l.. t ', !�U P �......... V --- .--------------- •--------------------------------------------------------------- •---•-•---------------------------------------------------------•----------- ------------- ----------------------- W ••••••-•-•-•......................................•-•----•---....-• 1......-•••-----•-- ........................... UNature of 'epairs r Alterations—Answer when applicable______. .._ .............�"U+:............_. -------•--------•----------------•-•-••------------•-----•-----..............----••----....------------------------•---•----------------------.._..._...••---••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITiZ- 5 of the State Sanitary Code--The undersigned fu il:erigreen not to place the system in operation until a Certificate of Compliance has been issued by /e b 'ard ofhealth! < � � � s � �C Signed.................... ..•----• •-----........................ --------•----- ................................ ,Date ApplicationApproved By............................... ----.........•.. . ...........--- -------------------- ................... Date Application Disapproved for the following reasons:-----•-•----------•----------•------•---------------------------•---------------------------------••--......•... ..............•-•----•---......-----------••------••---............-•------•------------•--•-••----•--•----•••-•-•-•--••--•----•.................................................................... .......................................... Date Permit No........ ' � - n---........ Issued----•--•-------- -• -- •-----...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. ...4......^...............OF........ -0 '( =............................ Trrfifiratr of ToutpfiFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b ....................... -k. - ..... ................................................................................................. i Installer has been installed in accordance with the provisions of TITLr. 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.___.___�_��____-_. _ dated............:.� ---------- THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL F N�TION SATISFACTORY. . zDATE............. Inspector... . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF C—r ........................................... .................................. p� No.' '?.....: !? FEE....I Rupos at Works 0onst ion rrutit Permission is hereby granted........ - . ...r._,............L......4"'2'_........_ . to Construct ( ) or Repair ( r--)'an Individual Sewage Disposal System at No...--• - ......--"` cic — , �ag -C'/11Y-1.-------- -----•----••------•--•-------------------------•-•-- I Street r- i/ // as shown on the application for Disposal Works Construction Permit-No....L.-_.._..._( Da' ted---- l.to J . ..........l�r l ... Board of Health---__DATE Ihz� •••. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ROUTE 6 LEGEND o gg PROPOSED CONTOUR a A p < F-991 PROPOSED SPOT GRADE t S I --- 40 --- EXISTING CONTOUR Z u TOP 30.23 EXISTING SPOT GRADE W \ TEST PIT W y J`s \ W EXISTING WATER SERVICE TOPFIELD DR Lj A� t �j `\ °�\\ EXISTING TREE DAD STAGE RD CL \ \ Locus °Y° p LOT 37 \\ 'sue a 4 02�2010 MAP 150 \\ 3�y LOCUS MAP N.T.S. �0 rk6 ,off' PARCEL 48 \ 22,383tS.F, \ � \ `\ \ Existino septic Tank GENERAL NOTES: Top Tank EL: 97,65 \ r \ Inv,(00T) EL: 96,3t 1• ALL'CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL Existing S.A.S. shall! be BOARD OF HEALTH AND THE DESIGN ENGINEER. pumped & Filled w/sand 2- ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS \\ OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE \99.D1 98.37 LOCAL RULES AND REGULATIONS. ' � \ \\ d \ \ 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR She X 98.19 \ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ,, �\ \ DESIGN ENGINEER. 94.46 ; 9 98,68 g; �` \ 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING �� �• `.� �\ \\ FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN O P°t'° 99.23 99_ —'X�`08 o9B�4 ENGINEER BEFORE CONSTRUCTION CONTINUES. EXISTING 9.91 'o `� �\ 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 4 BEDROOM SER#�33) �' ' ,^C ` 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF T,O.F,=100,57 �ru 99,13�` X 9�{36 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 994 T' 9 7. WATER SUPPLY PROVIDED BY TOWN WATER MAIN. 8. THERE ARE NO PRIVATE WELLS WITHIN 100' OF THE PROPOSED S.A.S. .' 37 "�?� + g, ALL AREAS DISTURBED DURING CONSTRUCTION ARE TO BE RESTORED X 99.97 99,55 SlaneL+99.3 GND Orlve TO A CONDITION AGREED UPON BY THE OWNER AND CONTRACTOR. � �t J� �. . � 1 98.36 ,� 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE Ti 99.89 �— 9,groit 99.49 f + CI THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION.98.70 �� 61 �0. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS E. 99.92 ,� . ti OR, - IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. y91 A X 1 13 S AND REPLACE.WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). g 99.44 9915 6 �6 O• k' �t ^`. BENCHMARK ?pA Rt. Bulkhead Corner t)F M l 99.94 EL: 99.93(assumed) \�� AJ' 99,87 99,80 1 100 ------ o PETER T. --_-_--_ 992 L' __ lop.gp--- f McENTEE UP 4 PK/SET CIVIL N PROPOSED SEPTIC SYSTEM UPGRADE 99.78 No. 35109 RFGiSi 233 TREE TOP CIRCLE, MARSTONS MILLS, ]SHEETNO,. FFSS L ENS'\� Prepared for:. Dean Morgado, 233 Tree Top Circle, Marstons Mi (, Engineering by: SCALE DRAWN ✓✓VV �� C� Engineering Works �"=30 P.T.M. 23 Deer Hollow Road, Forestdole, MA 02644 DATE CHECKED(508) 477-5313 06/29/02 P.T.M. PRC7VIDE RISER OVER D-BOX NOTE: TO PREVENT BREAKOUT, THE` PROPOSED 4t FINISH GRADE SHALL NOT BE < EL:95.5 TOP OF FOUNDATION TO WITHIN 6' OF FINISH GRADE F.G. EL: 99. FOR A DISTANCE OF 15' AROUND THE EL:100.57 � F.G. EL: 99.4t PERIMETER OF THE S.A.S. F.G. EL: 99.2t F.G. EL: 99.1 t (EXISTING) MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS W/COVERS OVER INLET 3-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER ONE CHAMBER & OUTLET TO WITHIN 6" OF FINISH GRADE IN SERIES WITH 4' STONE-ALL SIDES WITH HEAVY DUTY FRAME COVER L =35' -23( ) SET TO FINISH GRADE 4" SCH 40 PVC 4" SCH 40 PVC LL1(EXISTING) A 10• t4' @ S= 1% (MIN.) 6 @ S= 1% (MIN.) J: INV.EL:96.45 EXISTING 1000 GAL. INV.EL:95.92 INV.EL:95.75 2' EFF, DEPTH ®H®eeii SEPTIC TANK 4' 41 INV.EL:96.3t FFECTIVE WIDTH = 13,2' INSTALL INLET & OUTLET-TEES INV. ELEV.=95.00 GAS BAFFLE TO BE INSTALLED ON OUTLET TEE AS MANUFACTURED BY TUF-TITE, ZABEL, OR EQUAL TOP CONC. ELEV.=95.8 —BREAKOUT ELEV.=95.5 SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.=95.00 ®Be93Ba GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED ®M 37JUM Sal0IBM= STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). BOTTOM ELEV.=93.00 4 3 x 8.5' = 25,5' 4' 5' MIN, ABOVE MAX, SEASONAL EFFECTIVE LENGTH = 33.5' SEPTIC SYSTEM PROFILE (3) 5" DIA.OUTLETS HIGH GROUNDWATER ELEVATI❑N LEACHING SYSTEM SECTION 15.5• -�� 2• N,T,S. NO G,W. ENCOUNTERED �� pF Mgff --� BOTTOM OF TP, EL, 87.3 ji �,...... 1 o PETER T, McENTE 15.5' r:, e, DESIGN CRITERIA E No. 35109 2• NUMBER OF BEDROOMS: 4 BEDROOMS ��F I'61 D—BOX SOIL TYPE: CLASS I KTs. SOIL LOG _ DESIGN PERCOLATION RATE: 2 MIN./IN. "T.:. DAILY FLOW: 440 G.P.D. DATE: JUNE 20, 2002 DESIGN FLOW: 440 G.P,D. SOIL EVALUATOR: PETER MCENTEE GARBAGE GRINDER: NO INSPECTOR: NOT REQ'D Co rage LEACHING AREA REQUIRED: (440) = 594.6 S.F. .74 INVERT ®®®® O ®®®® Elev. ®®®®®®®®®®® 33" TP Depth SEPTIC TANK REQUIRED: 1000 GALLON (EXISTING) ®®®®®®®®®®® 24" ®0�®®®®®®®®® 99.3 A O„ SANDY LOAM 102' 10YR 3/3 USE 3-500 GALLON LEACHING CHAMBERS IN SERIES SECTION 99.0 B 3" SANDY LOAM �i.3. SIDEWALL AREA: 2(13.2' + 33.5') X 2 = 186.8 S.F. 10YR 5/8 EXISTING BOTTOM AREA: 13.2' x 33.5' = 442.2 S.F. 4" KNOCKOUT 97.0 C 28" 4 BEDROOM TOTAL AREA: 629.0 S.F. zo• OIA. COVER HOUSE(#233) o_ ''� T.O,F,=100.57 DESIGN FLOW PROVIDED: 0.74(629.0) = 465.5 G.P.D. 4" KNOCKOUT 4 KNOCKOUT gQ" A' S , O , - S - 4" KNOCKOUT MED. SAND ,� ' �,ej 2.5Y 6/4 43,2' Q� ;,�� PROPOSED SEPTIC SYSTEM UPGRADE 233 TREE TOP CIRCLE, MARSTONS MILLS, MA j Prepared for: Dean Morgado, 233 Tree Top Circle, Marstons Mills, MA 500 GALLON CAPACITY, H-10 LOADING 87.3 144" S.A.S. LAYOUT Engineering by: SCALE DRAWN JOB. NO. CHAMBERS NO GROUNDWATER ENCOUNTERED Engineering Works N.T.S. P.T.M. 80-02 KT.4. PERC RATE: <2 MIN/IN. ("C" HORIZON) I 23 Deer Holiow Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. " (508) 477-5313 06/29/02 P.T.M. 2 Of 2 r� ROUTE 6 'LEGEND o g9 PROPOSED CONTOUR ti 99 PROPOSED SPOT GRADE ---- 40 EXISTING CONTOUR Z W TOP 30.23 EXISTING SPOT GRADE W a r p \ TEST PIT m m v ems\\ W EXISTING WATER SERVICE TOPEIELD DR Q. N j \\ d EXISTING TREE DAD STAGE RD LOCUS G \ LOT 37 \\ °�� MAP 1508 \\\ ��7n\ LOCUS MAP N.T.S.PARCEL \ 22,383tS.F. \ � `\ \ Existing Sept/c Tank GENERAL NOTES: \ � Top Tank EL: 97.65 Inv.(DUT) EL- 96.3t 1• ALL•CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL Existing S.A,S, shalll be BOARD OF HEALTH AND THE DESIGN ENGINEER. Garage pumped & filled w/sand 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS \ \ OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE \ 99.01 98.37 \\ \\ LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR She x 98.19 \ \ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE � DESIGN ENGINEER. 99,46 ` 9 98.68 a \ 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING �• \ FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN O Pnt10 99.23 99' X�os o9e.e4 h 2 �\ \ ENGINEER BEFORE CONSTRUCTION CONTINUES. EXIS 98.91 ro \ 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 4 USE(#233) Ptt�'`' `�'� \ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF � _� gg 44 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF T.O.F,=100.57 99.4 6' Frul 99,13�� F ' x st{36 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER MAIN. N 9 i 8. THERE ARE NO PRIVATE WELLS WITHIN 1S0' OF THE PROPOSED S.A.S. 37 9. ALL AREAS DISTURBED DURING CONSTRUCTION ARE TO BE RESTORED 99.55 Stone - `4 L:99.3 9. I GND Drive � � r���. . Q� � i TO A CONDITION AGREED UPON BY THE OWNER AND CONTRACTOR. 98.36 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE 99,89 '�_ 9,�f4 xx 99,49 j THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING `\ Fr It p0 THE CONSTRUCTION. 9ea0 o tip 99.92 �+ oT 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS fl+ IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. 69 x 1\13 / AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). z< � / 99.44 N 3g O• i 99.5 BENCHMARKRt. Bulkhead Corner �A EL: 99.93(assumed) 99.94 99,80 99.87 1 C'e 100 - o PETER T. uP74N9.92 ------------- P -- McENTEE SET CIVIL N PROPOSED SEPTIC SYSTEM UPGRADE 99.78 No, 35109 i SZE��� �`� 233 TREE TOP CIRCLE, MARSTONS MILLS, MA FSS/ �'\ Prepared for: Dean Morgado, 233 Tree Top Circle, Marstons Mills, MA Engineering by: SCALE DRAWN JOB. NO. f Engineering Works 1 =30' P.T.M. 80-02 y (¢ ` 23 Deer Hollow Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. (508) 477-5313 06/29/02 P.T.M. 1 Of 2 rpr � NOTE: TO PREVENT BREAKOUT, THE PROPOSED PROVIDE RISER OVER D-BOX F.G. EL 99.4t FINISH GRADE 'SHALL NOT BE < EL:95.5 TOP OF FOUNDATION TO WITHIN 6' OF FINISH GRADE FOR A DISTANCE OF 15' AROUND THE EL:100.57 F.G. €L: 99.4t F.G. EL: 99.2t F.G. EL: 99.1 t PERIMETER OF THE S.A.S. (EXISTING) MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS W/COVERS OVER INLET 3-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER ONE .CHAMBER & OUTLET TO WITHIN 6" OF FINISH GRADE IN SERIES WITH 4' STONE-ALL SIDES WITH HEAVY DUTY FRAME & COVER SET TO FINISH GRADE L =35' L =23'(MAX) 4" SCH 40 PVC 4" SCH 40 PVC j 0' ®� ®e (EXISTING) LLi1 14• @ S= 1% (MIN.) 6 @ S= 1% (MIND 6BBB0�BB INV.EL:96.45 EXISTING 10b0 GAL. INV,EL:95.92 INV.EL:95.75 2' EFF, DEPTH a®®B®e® e... .... 4 5,2' j 4' SEPTIC TANK FFECTIVE WIDTH = 13.2' INV.EL:96.3t INSTALL INLET & OUTLET TEES INV. ELEV.=95.00 GAS BAFFLE TO BE INSTALLED ON OUTLET TEE AS MANUFACTURED BY TOP CONC. ELEV.=95.8 —BREAKOUT ELEV.=95.5 TUF-TITE, ZABEL, OR EQUAL SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.=95.00 GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). BOTTOM ELEV.=93.00 11 4 3 x 8.5' = 25.5' 4' 5' MIN, ABOVE MAX, SEASONAL EFFECTIVE LENGTH = 33.5' (3) 5" DIA.OUTLETS i6 SEPTIC SYSTEM PROFILE HIGH GROUNDWATER ELEVATION ' N❑ G.W. ENCOUNTERED LEACHING SYSTEM SECTION 4f• >�s s' F•--—:{�e' N.T.S. �`yPti�� Mgff9�yo BOTTOM OF TP, EL, 87,3 i1 . o PETER T, , $, HCIVILE 15.5' 6' DESIGN CRITERIA No, 35109 L , 2• NUMBER OF BEDROOMS: 4 BEDROOMS D—•BOX SOIL TYPE: CLASS I Km SOIL LOG DESIGN PERCOLATION RATE: 2 MIN,/IN. DAILY FLOW: 440 G.P.D. DATE: JUNE 20, 2002 DESIGN FLOW: 440 G.P.D. SOIL EVALUATOR: PETER MCENTEE GARBAGE GRINDER: NO INSPECTOR: NOT REQ'D LEACHING AREA REQUIRED: (440) = 594.6 S.F. INVERT ®®®® 0 ®®®® 74 ®®®®®®®®®®® 33" Elev. TP Depth SEPTIC TANK REQUIRED: 1000 GALLON (EXISTING) ®®®®®®®®®®® 24" E3 EM EM®®®®®® 99.3 A 0' SANDY LOAM tot" 10YR 3/3 USE 3-500 GALLON LEACHING CHAMBERS IN SERE SECTION 99.0 B 3 SIDEWALL AREA: 2(13.2' + 33.5') X 2 = 186.8 S.F. SANDY LOAM 1.3• 10YR 5/8 EXISTING BOTTOM AREA: 13.2' x 33.5' = 442.2 S.F. 4' KNOCKOUT 97.0 C 28" 4 BEDROOM �� TOTAL AREA: 629.0 S.F. 20' DIA. COVER HOUSE(#233) o_ ,'�, `\ T17,f,=100.57 4' KNOCKOUT O f 4" KNOCKOUT 62" A' '' S > DESIGN FLOW PROVIDED: 0.74(629.0) = 465,5 G.P.D. MED. SAND21 , �'� 4" KNOCKOUT 25Y6/4 43.2' Q4z�;,:��`' PROPQSED SEPTIC SYSTEM UPGRADE 233 TREE TOP CIRCLE, MARSTONS MILLS, lof py,N � Prepared for: Dean Morgado, 233 Tree Top Circle, Marstons Mi 500 GALLON CAPACITY, H-10 LOADING S7 3 144" SCALE DRAWN S.A.S. LAYOUT Engineering by: CHAMBERS NO GROUNDWATER ENCOUNTERED Engineering Works N.T.S. P.T.M. K's' PER( RATE: <2 MIN/IN. ("C" HORIZON) 23 Deer Hollow Road, Forestdole, MA 02644 DATE CHECKED (508) 477-5313 06/29/02 P.T.M.