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HomeMy WebLinkAbout0038 TURTLEBACK ROAD - Health 38 TURTLEBACK ROAD MARSTONS MILLS /� A= 047- 083 ` _ 094-oE33 Commonwealth of Massachusetts �. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information 1533-f Frank Nunes III Name of Inspector x.. saa Company Name Box 841 Company Address East Falmouth MA 02536 City/Town State Zip Code 508.272.6433 13010 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 16.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 4/8/21 Inspect Us na u 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.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owner s Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 .3 r - - Commonwealth of Massachusetts �. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 38 Turtleback Rd Property Address Collins Owner Owner s Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 r Commonwealth of Massachusetts � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments vy/ L- 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts ,? Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments e u 38 Turtleback Rd Property Address Collins Owner Owners Name information is required for every Marstons Mills MA 02648 4/8/21 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 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 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 an of the system components pumped out in the previous two weeks? Y Y P P P ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ 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 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Permit and plan for 3 bedroom septic on file at BOH 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 d 12 GPD 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 f Commonwealth of Massachusetts ,F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Turtleback Rd Pro perty Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Pumped 2019 per owner Was system pumped as part of the inspection? ❑•Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts �. ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,. 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. City/Town 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: 1985 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10' feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 i Commonwealth of Massachusetts �. ,F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments < �o 38 Turtleback Rd Property Address Collins Owner Owners Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 12"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) H-10 tank appears to be structurally sound If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000g Sludge depth: 8" Distance from top of sludge to bottom of outlet tee or baffle >12 Scum thickness 1/2 Distance from top of scum to top of outlet tee or baffle >2" Distance from bottom of scum to bottom of outlet tee or baffle >2" How were dimensions determined? measured 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 suggested every 3yrs to prolong the life of the system t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Q Commonwealth of Massachusetts ,9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owners Name information is required for every Marstons Mills MA 02648 4/8/21 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: 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 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts �. ,nP Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments v, 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 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.): D-box was video inspected, no adverse conditions observed t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts �m ,t? Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form Not for Voluntary Assessments u 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 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: 1 ❑ leaching chambers number: ❑ 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 �e ,3-� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8121 page. Cityrrown 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.): Leach pit was excavated, it is 2' below grade, there is 6"of effluent in the pit at this time, stain line 2' below the invert, sidewalls are clean above the stain line, no indication of past hydraulic failure 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 Commonwealth of Massachusetts �n ,9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown 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 I Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 38 Turtleback Rd Property Address Collins Owner Owner s Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown 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 S C_ Ls`I 'Vo S(Ate t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts �s 11P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityfrown 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: 1984 NGW 12'Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: 4'seperation per 1985 compliance ❑ Checked with local excavators, installers -(attach documentation) ® Accessed USGS database-explain: TOPO mapping shows the site at 86'msl and nearby surface water at 43'msl You must describe how you established the high ground water elevation: See above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments •� 38 Turtleback Rd Property Address Collins Owner Owner's Name information is required for every Marstons Mills MA 02648 4/8/21 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6(Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 I 1 No.....'•...�._.....Z FEs..... ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ._..---..T0V�1 .....................OF..........BATSTABLE..-----•--- ... Appliration for BiopooFal Works Tonolrnr#ion Prrmit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: LotNo. 305 Turtleback Road ................__.......................................•--•--•-----------........----------_.. _.._......--•--•----•----•---------------------•--•----•--....---------•--•--........-----......-- { a Location_ ddress ' or Lot No. a �J o J,M 4 9r i-k L �-C d� ���CI r yI i"N , tot,, kah.+j)- _ -----------•.................. ... ss a �f.. e '.... �l.�c:�.. —Owner �\I O C S .... ....� 5 , re ' ..... Q.. �.lt W!fti,V� 1��`Y�d� J Installer Address Type of Building Size Lot........30..,......709............Sq. feet Dwelling—No. of Bedrooms.__...._...................................Expansion Attic ( ) Garbage Grinder (NO) Other—T e of Building No. of persons............................ Showers / — Cafeteria Otherfixtures -------•-------------------------------------•--------------•-•-•-----•--------- ----••-•----------------------------------.......-----••--•-----••-. W Design Flow......._330............................gallons 080POOM per day.. Total daily flow............3aQ............._...........gallons. WSeptic Tank—Liquid capacity.1(100._gallons Length._$_'.b"'___. Width---4'.8...... Diameter................ Depth_..4'_...Liq. Level x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area___--__------------sq. ft. Seepage Pit No-------- ----------- Diameter........111.'.._._. Depth below inlet......6'.......... Total leaching area....267_......sq. ft. Z Other Distribution box (X ) Dosing tank ( ) aPercolation Test Results Performed by. -associates............................... Date....11�6184 a Test Pit No. 1.....2........minutes per inch Depth of Test Pit.. 12. Depth to ground water No Gi, Test Pit No. 2................minutes per inch Depth of Test Pit___ .............. Depth to ground wate .'�........... R+' --•-------•-•-------•-----••--•..................•---•-------•--....-----._..............•...._...........•---•-.................. O?-STEPKI<N M. Py 0" Description of Soil...... .0-1.0 Woodloam, roots, _1.0'-2.5' Med. -Brn, Subsoil, X BRAKS Im_-1_•---CIVI v some grayel{2,5"-12' Loose coarse--meditun,tan SAND!__2q� ..gravel 3 g - ---------- ---- W ................... .-.. Per... :Test No...P-3822---)---- U Nature of Repairs or Alterations—Answer when applicable............................................................... .. Fs NX -----•-•--------------•----------------------------------------........------------------•-----------------------------•--•--------------------------•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beAn issued by the board of health. / to Application Approved By........=............. - --. . ., .............. 1 ^ ................ ate Application Disapproved for the following reasons--------------------------•-•-------------------------------------------------...-----------------......._------ ••---•-•...._.......••------•.............................................. ............... Date Permit No.......... 5 - ............. ............ Issued.........I....-•--...4---....--...-•---5.............. Date r � { s Fss........................... cs<J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TM ...•--- .. . ............OF........... ... Appliration for Disposal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: LotNo. 305 Turtleback Road .................................................................................................. .............-----------...---•---•--•-----•••-------•-•••••....••--•-•-•-._....--•-•-....._----•• Location-Address or Lot No. ......................».......................................................................... ..........--...........................................-.......................................... Owner Address W Pq Installer Address 30,709 Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...........i..............................Expansion Attic ( ) Garbage Grinder fjp) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------•------------------------•----••••-••-•••-•-••---•-•-•---••--•-•••-••••----••---•-...-••----••.....-•--..........---•- W Design Flow........33Q.............................gallons 0209GOM per day. Total daily flow...........3.30..........................gallons. WSeptic Tank—Liquid capacitylDDQ-.gallons Length._8 E"...... Width...VV_.... Diameter................ Depth_'..Ljq. Level xDisposal Trench—No....................: Width.................... Total Length.................... Total leaching area.._.._..............sq. ft. Seepage Pit No.......1........... Diameter...._.•1Q'.._.._ Depth below inlet.....5....._._.._.. Total leaching area...267.......sq. ft. Z Other Distribution box (X ) Dosing tank ( ) '-' Percolation Test Results Performed by.A.A.S. associates ___________ __ Date...l1./04 Test Pit No. 1-----2_........minutes per inch Depth of Test Pit__ 12 Depth to ground Ovate INOt ed _.._._ .___ _ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water ..-•-------•--------•........................•..----•-----•--•-•--........._----•--•-------••--••-_............... O Description of Soil.....D.D-1.0 Woodloam, roots, 1.0'-2.5' Med. ,BM, Subsoil, o srEPHEN M. s� ---------- ---------vel.---•------...._ o c A ....._... ...............•. ---••- W ( Perc. Test.No. P-3822 ..... o. z................. txj Repairs or Alterations—Answer when applicable___________________________________________________________ _ 9o%-�Gpg Nature ofI------------••----•-•-----------•---------•--•---------•-•----•--••---------•-••--•-----------•--••-------•--••-•---------•------•-----•---------•---- ----awl Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ....�-' ig ed---•-•--••-----•--------- -------•;--..._... -----.._..-•--:..------------•-•--- ................................ -. . te "'" -APPlication Approved BY :. ---•---• C - Date Application Disapproved for the following reasons-------------------------------.........................--------------...................................... •-------------------•------•-----•--------•-•----.....---•---•--.-....................-----•---------•-----.........._....--••••--•-------; ------------.•-•-••--•---••---•--•---•--•--•-•-------•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS 'A'4 BOARD OF HEALTH ......................................CV ....O F...........HAIlf`iBTABLE ............................................ (9rdifiratr of Tuntplianrr THIS I$14G RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY----•--•-•--------•-_-......11 ._.:.kt� - -----..._.. ...... ----------•-----------•--•--•------------------------------------------------------------------- b_ ---- rt stal t has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS RUEP AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-----=---••-••-�------.Z ........ -- Inspector THE COMMONWEALTH OF MASSACHU ETTS f BOARD OF HEALTH �.t'". '/ 7•- .........................................OF.......................No......................... FEE........................ Disprrsqj ,, #s Tnns#r uan rrnti# 'reb � • � -------------•-•• -•---------••-•••••----••••••--•-••-•••--•--•----•-••-•...-•-•-•......•--......----.........-•----......... ermiss> > hereby gran to Construe r4 o �i;an I iivid�ewage Disposal System at No. --- - ! Street r ..�+w! �... i as shown on the application for Disposal Works Construction Per 't No..................... Dated...._:;.._._{{{._ _____..____...___._.... --------•------------------•-----------------•--------------------•....---------------•--..............•. 3 _ Board of Health DATE. ------••-•-•-------•••••-----••---•--•--------- FORM 1255 A. M. SULKIN, INC., BOSTON 4/1/2021 ShowAsbuilt(1700X2800) LOCATIRK 5EWACE PERKIT NO. V I U A C E fMt t Vs INSTALLER'S NAME & ADDRESS N A U I L 0 E R OR OWNER _-'so{�h KeT� h QO In g0ATE PERMIT ISSUED OAiE COMPLIANCE 15SUED S- Zg - gam_ 'to f v Y3 ' I https://itsqldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=047083&sq=2 1/1 J 6-, OFFICE LABORATORY 1498 HIGH STREET 176 PLYMOUTH STREET BRIDGEWATER, MA 02324 BRIDGEWATER, MA 02324 1 Y OLIVEIRA ENVIRONMENTAL LABORATORIES, INC. FOOD DAIRY PRODUCTS-WATER-WASTEWATER 'CHEMICAL&BACTERIOLOGICAL ANALYSES 697-26W December 21, 1984 Pilgrim Pump Company 272 Long Pond Road Plymouth, Mass. 02360 Source: Well Water - Bored Well with well point - 56.feet deep - producing 20 gals./min. Located on the property of Mr. David Ward - Lot 305 - Turtle Back Road - Marstons Mills, Mass. Coliform Count /100 ml @ 35 C 0 Membrane filter S.P.C./ml @35C 85 Color (APC units) 30. Sediment moderate Turbidity (NTU) leg Odor none Taste metallic pH 5.5 Specific Conductance micromhos/cm 260. mg /liter Total Alkalinity (CaCO,) 9.00 Free CO, 55.6 Total Hardness (CACO,) 70.0 Calcium (Ca) 9.60 Magnesium (Mg) 11.2, ! Sodium (Na) 14 Potassium (K) 1.35 Total Iron (Fe) Manganese (Mn) 0 Olq Silica (SiC,) 9.00 Sulfate`(SO,) 42.0 Chloride (CI) 19.,0 Nitrogen - Ammonia 0.2s Nitrogen - Nitrite 0 00R Nitrogen - Nitrate 0.50 Copper (Cu) _ On site collection made by Mr. George Bishop of the Pilgrim Pump Co. - 12/18/84 at 4:00 P.M. Sample delivered to laboratory by Mr. George.Bishop - 12/19/84 at 9:00 A.M. Bacteriologically,' this well water is of a satisfactory sanitary standard and is suitable for drinking and domestic purposes. Chemically, this well water is corrosive, high in iron content .and.medium hard. The color, sediment, turbidity and taste are affected by the high iron content. All other chemicals tested meet the standards. Director F C `ndard-Plate Count indicated the general bacterial population of the well at the time of collection. C. Group Bacteria: S' uficance The coliform group bacteria includes organisms found in the intestinal tracts of warm blooded animals, birds,decaying orgar. -matter(hay, leaves, wood, etc.), the top 2 to 3 feet of the soil, lakes, ponds, brooks, rivers, drainage and types of vegetation. Because the organisms can cause some illness; because the presence of coliform organisms in the water suggests that other more harmful organisms may be present, water containing one or more coliform group bacteria per 100 ml of sample should not be used for drinking or cooking purposes unless boiled 5 minutes or disinfected by other means. This bacteria is of animal origin(intestinal tract)and may be considered as closely associated with disease causing organisms. On this factor, none should be present. Color — APC Units- Ground water ought to be practically free from color. For attractive water - color should not exceed 15 units. Turbidity — NT Units- Recommended limit not to exceed 5 units. Odor Et Taste — For water to be of high quality, the water should be odor free and taste good. pH — The pH value defines the concentration of free hydrogen ions in solution. Expressed on a scale extending from 0 or very acid to 14 or very alkaline with 7.0 being neutral. Specific Conductance — Conductivity is a good criterion for measuring the degree of mineralization and assessing the affect of diverse ions on chemical equilibria. Total Alkalinity — The alkalinity of this water represents its content of carbonates and bicarbonates. Free Carbon Dioxide — Well water having a low pH and a Free CO, level in excess of 50. mg/I will be corrosive to iron, bronze, brass and copper tubing and fittings. Total Hardness — Standard not to exceed 50. mg/I. Waters having a hardness level of 50 to 100 are in the medium hardness range, over 100 very hard. Calcium -- Calcium contributes to the total hardness of water.Appreciable amounts of calcium salts break down on heating and form scale in boilers, pipes and cooking utensils. Magnesium — Magnesium is a common constituent of natural water. Magnesium and calcium ions are principal contributors to water hard- ness. Concentrations in excess of 125 mg/I can exert a cathartic and diuretic action. Sodium — Recommended limit not to exceed 20 mg/l. Potassium — Potassium concentrations in drinking water seldom exceed 20. mg/l. Total I Iron —_ Standard not to exceed 0.3 mg/I. Manganese — Standard not to exceed 0.05 mg/I.The principal reason for limiting the concentration of manganese is to reduce esthetic and economic problems. Silica — Silica content of natural water is most commonly in the 1 to 30 mg/I. Silica in water is undesirable because it forms difficult to remove silica scales. Sulfates — Standard not to exceed 250 mg/l. Chloride — Standard not to exceed 250 mg/I. Nitrogen — Ammonia is present in variable concentrations in many surface and ground waters. Its occurrence in ground water is generally a result of natural reduction processes. Nitrogen - Nitrite — Nitrite in water poses a health hazard, but fortunately seldom occurs in high concentrations. Waters with a nitrogen - nitrite concentration over 1 mg/I should not be used for infant feeding. Nitrogen - Nitrate — Standard not to exceed 10. mg/I. Nitrate, in high concentrations can and do cause methemoglobinemia or so-called nitrate poisoning in infants. Water with 10 or more mg/I of nitrate is unsatisfactory and is not considered safe for drinking or cook- ing. It is especially dangerous to children and should never be used in infant formulas. Copper — Standard not to exceed 1.0 mg/I. L i; A f 1 Q F S E W A G E PEAMIT, PiD. �dSe A LLER'S SAME ADDRESS NIt U I L 0 1 R OR OWNER Y D-di-E CoVPLiAMCE ISSUEDA '``aS9 17�c+� ��o� �f� Doti`�F ��� r 1 " , BASIS . OF DESIGN r�.,. I % Number of Bedrooms 3 (Design Daily Flow 330 G.PD l 2. Garbage Dlsposol Unit NO / J. Leaching Capacity Re wired 330 G.P. D. 296 Art _ g p y gg Proposed 188.5 5 4. Side Area Prop Sq uare Feet. VACANT) I I �\ 5. Bottom Area Proposed 78.5 Square Feet. / 6 \ 6. 'Proposed Leaching Copocity549.86 P. D. 7. Water 'Supply Well 8 Precast Reinforce oncrele Units H-/0 Loading I \ / Exist. Leaching L EGEND �./ . Pit BENCHMARK 94-3 Existing Spot Elevations I Spike up l.0 6 >wrn oak 94.0 Proposed Spot Grades Elev. ` /16.P4 (Assumed) ng Contours 297 —94— Proposeds r Contours — — tl¢ , Proposed Water Service ' /o' r—� L Exist Leaching RAreoV e Pit -o T,Pam'?'\ { - D-Box ti \� o -/�� GENERAL NOTES I �6 is TP N°P ! / 1 3► \ - / � ✓ 5a � /. •Property Line /nlormolron from o Plan of Land by Barnstable Survey Consultants, Inc. ladia Z. Topographic Survey by Me transit s method. Elevations refer to an assumed dotum. O POSED ,ti \ % J. Percolation Tests performed in accordance with 'Title 5of the � c _ a r¢ N DWELLING p 304 Massochusells Stole Environmental Code. 4. All construction to conform to the Stale Environmental Code and the Board of Health requirements for the Town of Barnstable; 104 ,O which ore port of this plan whether or not specifically indicated herein. 5. The Contractor shall,prior to bockfilling the system, notify both the Exist. xi Leaching l Design Engineer and the Board of Health Agent to inspect the e D Pit roe system as constructed ( �9 9 " 6. R,A.S. Associates will not be responsible for the performance or 306 h �� "' o ero>ion of/he ro proposed system. Any deviations from this 9a o0 o P P p ' vB `„ design sho/l be approved in writing.by R,A.S. Associates prior to their incorporation 1•o n into y the system. 7. .The NORTH ARROW indicated on fhis plan was token from the mentioned Plan of Land and maynot indicate TRUE NORTH above House r v Xist- 6 .o i > , E l � and should not be used for locating SOLA R PANELSand lor � ..— STRUCTURES. 4 I L - 8 Flood Hazard Zone C , Community Mop N 250001. I I ' 92 43 TEST P/ ' L O G so ti 8G 4 9 `. T.P. N. /. T.P. N. 2. f 25 EX/ST. X T Doles /I/6 84 Dote"///6/84 WELL / £LL + I � WELL. Grotnd Surface E/ev /09.9 "Giound Swlace E/eY /09./ l f t b o 125 woad/oom,roofs woodloom, roots to rued, brown, sue- ru rhed. brawn,5aB- r d o exis>* wo , 2 SOIL, aorr=e 9roye/ 2 Jo/c, sure grgrer L5 2 T!� TL E BACK ROAD D 5+� ry � 4 4 r g3 gy gyX 0 Perm%lion Test 6 Loose coarse l0 6 Loose,cars e T!o � - Medium, t`4n medium, >'4n SAiVD, SAn/o, ! B some 9rzave/ B some gravel SITE PLAN /o to . _ Bo/fom o //a/e Bo/fom o f/o% SCALE / - 40 / No %va fez 97.9 / No Wa hr' 97.l . Enco un le red ENcoun t`eted ✓ /4 i i/NiSN GRADE ABOVE AND AO/ICENT T07Nf SYSTEM SHALL SLOPE A MINIMUM Or 2% AWAY MOAT SYSTEM. 4'D/AM£TER CAST IRON OA SCHEDULE 40 P.Y.C, PIPE (lNSTALLEO WITH T/GNT✓O/NrS/ Top of Foundation 20'M/N/Ml/M DISTANCE FROM BUILDING TO EDGE OF LEACN=NG SYSTEM. /09.50 ... /0'MINIMUM. 1\ ► : 108.5 '. 4'Riser ►:. 1000, 2ta' SLOPE f SLOPE+0.020-- � ?'LAYE�Y OF //e'Tb Zoning District: RF performed By Stephen W. Cartwright 'Outtof =� //2�WASHED STONE. ►' v MIN. Toe Tin (M/K ► 4'0 Percolation Rafe 2min. /inch: Witnessed By Ronald Gifford Distribution co B,O.H. Agent ':.► /000 Gallon 0 6'o'Errnc i►. /02.0 BOX DeP/A 3/*' TO / //2' WASHED P-3B22/ q Septic Ton r` STONE ALL AROUND.m a a N ° W. :.. L 0 T PLAN © P o OF iz PROPOSED SEWAGE DISPOSAL SYSTEM 6�o•Loo Prase P Cease. ' FOR 2 LnocAin P!1 2 n : /O- O Effective dometer ���OFk4 Homes by D. M. Ward , Inc. 4'Minimum Woler Tob/e =O STEPHEN M S� IN .r• �R� . y BA RNS TA B L E MA SSA CHUSE T TS A ,¢Na.30497 p S Y S T E M PROF L E 9a FGrsTE�` `�� Scale - As Noted Dote = December 3/, 1984 not to - scalessi a ON L Re istered Professional Engineers CISSOCICit2S . g Rof S and Land Surveyors 13 Carolyn- Drive _. .- . ., ,... mouth Mosaacnusette 224 3758 Sheet 1 . Ply ,. awn'. :S,{t�C If -._� 's /46 _ sfoh B S W.C. Checked 8 S MB. Or 8 _ F e_N. _ , , , , 1 "•....... , r -ram., - i.