Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0098 TURTLEBACK ROAD - Health
98-TURTLEBACK ROAD 092 TOWN OF BARNSTABLE , t OC-' `1!ION yirN�,Q SEWAGE # NVI LLAGE Qd.iy6Ar> Wt°� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY kO 0 0 Ccg LEACHING FACILITY: (type) i (size) Q 4_ ALA NO.OF BEDROOMS (� BUILDER OR OWNER 1 ' 9 PERMTTDATE: 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 �, _ � �. .,, t �,�. � � � . � . � � _�..� - _ . - _ X - ��� - �� �� ' .. ��� 1 e.. �. TOWN OF BARNSTABLE LOCtkTION 1 Q6UC �- (- Q-(� SEWAGE # VILLAGE =ASS�MS MOS ASSESSOR'S MAP & LOAQ INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY n < t nn 1M/\ LEACHING FACILITY: (type) I/����L�� I (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 Q6 t® 'n AAat Af a� Ac bc 3 q TOWN OF BARNSTABLE LOCATION SEWAGE# s2OJ 2 VILLAGE,, (s 14w J ASSESSOR'S M/AP&PARCEL '6 INSTALLER'S NAME&PHONE NO. Cle t,7 SEPTIC TANK CAPACITY 16,x LEACHING FACILITY:(type) Z 2- / lK-70(size) 41-7 17,K 2— NO.OF BEDROOMS 3 / OWNER . Al 7 !OF 4, PERMIT DATE: f /'-7 V 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 leachin crity) Feet FURNISHED BY e' s,77 19 C- 1 /7• G w c - � •`L�•7 No. DUI�y ✓ Fee 100 ) THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppliLation for Disposal .6pstim Construction permit Application for a Permit to Construct( ) Repair 4.4grade( ) Abandon( ) ❑Complete System <Individual Components Location Address or Lot No. 9.%vo-y"rt,& Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 0 Installer's Name,Address,and Tel No. Designer's Name,Address,and Tel.No. Type of Building: TI Dwelling No.of Bedrooms y3 Lot Size 01 Garbage Grinder(41,10 Other Type of Building 1c No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 7 7 2) gpd Design flow provided ? ? gpd Plan Date 1'i `�/ Number of sheets '7i Revision Date Title Size of Septic Tank 677- V Type of S.A.S. Description of Soil I? 1 Sf 3 Nature of Repairs or Alterations(Answer when applicable) .Q.. Z //^Z 0 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Sile_d���6R I Date Z G / Application Approved by Date Application Disapproved by - Date for the following reasons Permit No._� Date Issued No. ;. Fee ( ' C� THE COMM'NWEALTH OF SSACHUSETTS Entered m computer: Yes PUBLIC.HEALTH DIVI ,SION - TOWN OF B RNSTABLE, MASSACHUSETTS 2pplication for isposdf *psfP#m Cdns_truttion permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ;;Individual Components Location Address or Lot No. 9.7%A►.Y"A.,k Owner's Name,Address,and Tel.No. Assessor's Map/Parcel O Y Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: 1 y � Dwelling No.of Bedrooms f Lot Size � y 7CL_sq fi. Garbage Grinder Wi '&her Type of Building f F¢f No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) T 7 gpd Design flow provided �'1 gpd Plan Date I m f l/7 Number of sheets 71 Revision Date ' i Title Size of Septic Tank i.71 /oFgf d Sa#/U Type of S.A.S. 2 //`20 f�jl� g,ef CAQ,l+,�i et J Description of Soil 1? 1513 Nature of Repairs orAlterations(Answer when applicable) y 2,4& Z 41— Z 0 CJ G�^ e.•J LZ L/ r11 /1 X Z /P44,G� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Si ned Date Z G 7 Application Approved by Date Application Disapproved by Date 1 for the following reasons 9-21 i �• Permit No. F Date Issued THE COMMONWEALTH OF MASSACHUSETTS p 7 6_ Q di Z BARNSTABLE,MASSACHUSETTS 7 Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(61�Upgraded( ) Abandoned( )by 4�:(. --, t-• I- �''i hg-,(P-P' , te-f at 9 /yr-A6 k-Ae4 Oel A ,n/f(l has been constructed in accordance r with the provisions of Title 5 and the for Disposal System Construction Permit Ng�/?— q5 R&ated Installer Designer #bedrooms 75 Approved design flow 3 3 4: gpd The issuance of this pe it shall not be construed as a guarantee that the syst m will fund , as esigne Date C h Inspector J ; No. Fee / a� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS O �fl � Disposal 6pstrm Construction 3permit Permission is hereby granted to Construct( )) Repair(Jo< ,,,Upgrade(" ) Abandon( ) System located at c� IF /yv yoL0'e-'A 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. I Provided:Construction must be comple ed within t,' ee years of the date of this pe "• it. -- Date �T�� Approved by c. Commonwealth of Massachusetts z City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information AC L Owner Name Street Address Map/Lot# adv✓ y-e. ✓f/1� City. State Zip Code B. Site Information 1. (Check one) New Construction ❑ Upgrade ❑ Repair 2. Soil Survey Available? Yes ❑ No If yes: 41f to Source Soil Map Unit Soil Name Soil Limitations O y4 way G, Geologic/Parent Material Landform 3. Surficial Geological Report Available?x Yes ❑ No If yes: /OV"of aid Year Published/Source Publication Scale Map Unit 4. Flood Rate Insurance Map Zf OO/ Cps/ Above the 500-year flood boundary? K Yes ❑ No Within the 100-year flood boundary? ❑ Yes ❑ No If Yes,continue to#5. 5. Within a velocity zone? ❑ Yes K No 6. Within a Mapped Wetland Area. ❑ Yes No MassGIS Wetland Data Layer: Wetland Type U I, 7. Current Water Resource Conditions (USGS): 1 7 Range: El Normal Normal ❑ Below Normal Mon hlYear 8. Other references reviewed: t5form11.doc•rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 Commonwealth of Massachusetts _ City/Town of A � -� . Form I I Soil. Suitability Assessment for On-Site Sewage Disposal _ C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hale Number:' `/ Z? / ?=7 D 5'0 evIlY 1` Date Time Weather 1. Location Ground Elevation at Surface of Hole: Latitude/Longitude: / feet Description of Location: /��olc✓/� v e p� c� �?�� O per 2. Land Use 4a (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope Vegetation Landform Position on Landscape(SU,SH,BS,FS,TS) 3. Distances from: Open Water Body Drainage Way Wetlands feet feet feet Property Line 7— Drinking Water Well 10&-l Other feet feet feet 4. Parent Material: ���W Unsuitable Materials Present: ❑ Yes XNo If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes Rr No If yes: r Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater. inches elevation t5form 11.doc-rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage. Disposal C. On-Site Review (continued) Deep Observation Hole Number: Redoximorphic Features Coarse Fragments son Depth(in.) Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Structure Consistence Other Layer Moist(Munsell) (USDA) Cobbles Depth Color Percent Gravel (Moist) Stones Loac,.•.Y a -- 04 o Yp s/3 s � (7-7 7 c r to y� 6l ,41 � 'I. A4 eal-C �ristYi✓E' 03•-1si a 3 7—.5-Y Additional Notes: L j0-,4 t rJ Gv IG1�G4ZA, o. r7"�✓1 Cj�'l' Gv�G�l k" �''Y�� I^^A_�4.��a�� Gi''Cb�rs'-L �i+�� �i��.-, , l�(.d�l ✓¢�tv,v,/�,Q � C Z t5form 11.doc•rev.8/15 Form 11-Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts Cityrrown of Form 11 Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: Z ��Z`� i7 9` TIP 5-0°'r /fly H hr Date Time Weather 1. Location Ground Elevation at Surface of Hole: Latitude/Longitude: / feet 2. Land Use UPI:a-,'¢- GJardqCe Low �t/d e (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Vegetation Landform Position on Landscape(SU,SH;BS,FS, 3. Distances from; Open Water Body 7 Z o v Drainage Way Wetlands T /l'e feet feet feet Property Line 7•U Drinking Water Well �,/ Other feet feet feet 4. Parent Material: oy f c✓a,- Unsuitable Materials Present: ❑ Yes No If Yes: ❑ Disturbed Soil ❑ Fill Material Impervious Layers) ❑ Weathered/Fractured Rock ❑ Bedrock. 5. Groundwater Observed: ❑ Yes No If yes: > , 7 Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater inches elevation t5form1 l.doc•rev.8115 Form 11-Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 01 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Depth(in.) Layer Moist(flAunselQ (USDA) Cobbles Soil Structure Consistence Other Depth Color Percent ravel (Moist) Stones CvA.�y Q`, o /VY Ufa- r ld G I ut C 2 10 y w!/L P���� /0 F� J /v i'-i�o c 3 d s � Additional Notes: t5form11.doc•rev.8M 5 Form I I—Soil Siatabiliity Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of Form 11 Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hole Number: J-VA4^y Date Time Weather 1. Location Ground Elevation at Surface of Hole: Latitude/Longitude: / feet Description of Location: Feyvvy '414d(,-e- 2. Land Use WOCAC/ LvLe (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,bouiders,etc.) Slope(%) Vegetation Landform Position on Landscape(SU,SH,BS,FSjS) 3. Distances from: Open Water Body ? ZOO Drainage Way Wetlands T/. "o feet feet feet Property Line. Z- o Drinking Water Well _ tt�, Other feet feet feet 4. Parent Material: Dv"t'Gvv-- Im Unsuitable Materials Present: ❑ Yes No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes iTNo If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: > �? Inches elevation t5fonni 1 •rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts Cityfrown of _ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 3 Redoximorphiic Features Coarse Fragments Depth Soil Horizon/Soil Matrix:Color- Soft Texture %by Volume Soil (in') Layer Moist(Munselq Depth Color Percent Gravel Cobbles(USDA) Soil Structure Consistence Other S Stones " (o C0 t(9 Yi's, Lea.ifty pl.vrd (MQdovw+ Goak — C,3 z ld Additional Notes: t5form 11 •rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts Citylt"own of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: /f 7j f7: szo 0/YJ�H y Date Time Weather 1. Location Ground Elevation at Surface of Hole: Latitude/Longitude: / feet 2. Land Use Ly,-,A- (e.g..woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Vegetation Landform Position on Landscape(SU,SH, BS,FS, 3. Distances from: Open Water Body 7 Zoo Drainage Way Wetlands 7/Tv feet feet feet Property Line -/® Drinking Water Well w/� Other feet feet feet 4. Parent Material: Unsuitable Materials Present: ❑ Yes XNo If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed:. ❑ Yes No if yes: Depth Weeping from Pit. Depth Standing Water in Hole Estimated Depth to High Groundwater. > 13 inches elevation t5form 11 •rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts -- CitylTown of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number. Redoximorphic Features Coarse Fragments Depth in. Soil Horizon/Soil Matrix:Color- Sor7 Texture %by Volume Soil ( ) Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth ColorPercent ii ravels (Moist) o -6 % d es 3 s � 6- 7-0 13a� a�� % s d zo tas C-1 Jb y/2 G� 841 td r✓N.,, /cost -- /0 S'-/7l sew cr �O Z- f- le �i-- w eo(- 0 C J' Additional Notes: t5forml 1 •rev.8/15 Form 11-Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth .of Massachusetts City/Town of y Percolation Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal.DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form,check with the local Board of Health to determine the form they use. Important:When A. Site Information filling out forms on the computer, use only the tab ✓ '!` key to move your Owner Name / cursor-do not C?11 4— !N use the return Street Address or Lot# key. zj d d✓M-e- City/Town state Zip Code Contact Person(if different from Owner) Telephone Number B. Test Results li/2�'/7 q•`Jy Date Tlme Date Time Observation Hole# Z Depth of Perc Start Pre-Soak ICY ylv// End Pre-Soak /" Time at 12° Time at 9" Time at 6" Time(9°41 �• JJ WLdJ . Rate(Min./Inch) Test Passed: - Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Test Performed By: P Board of Health Witness Comments: tT /� /av✓�p�B,f t5form12.doc-08/15 Perc Test-Page 1 of 1 Town of Barnstable Regulatory Services g rY R, Thomas F. Geiler,Director MB Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: ZZ Sewage Permit# Assessor's Map/Parcel IYG �7— Installer& Designer Certification Form Designer: 6�1 . E 14p,ram- -&%n.,4?,S Installer: au Address: LQ.C4t_ Address: 4-Ln On was issued a permit to install a (date) (installer) septic system at `l w�fl�G✓��6_ 1Qa�, based on a design drawn by (address) 0 dated G P6C. Za/7 (design r) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) nspected.and the soils were found satisfactory. ���lOrA9q$ GMN— FRIG (Installer's i ture) ~ 0 HARRINGTON 8� No.1 070 b (Designe sSignature) (Affix De i —s Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. q:\office forms\designercertification form.doc I Town of Barnstable P# oFt� J� gyp` Department of Regulatory Services r/ 7 » sAxxsTAstr, » Public Health Division Date 9� MAW. . 039. 200 Main Street,Hyannis MA 02601 ATFO MA't A Date Scheduled 1/1 1 2'/ e7 Time / ® Fee Pd. Soil Suitability Assessment for S e Disposal e* Performed By: �D��✓p ► Witnessed By: _ ... LOCATION & GENERAL,INFORMATION Location Address p Owner's Name 4 Z®� Ail Address S p�_ti Assessor's Map/Parcel: Q d Z / Engineer's Name 4:6L �,`��dd�! 'l�/�•S► NEW CONSTRUCTION � 11`REPAIR Telephone# 7 7� —Z 3 r— ��3 Land Use d tl/X�w7 cy� Slopes(%) j Surface Stones Distances from: Open Water Body' ft Possible Wet Area 7 1" ft Drinking Water Well _aolnlAft Drainage Way ft Property Line O ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) no Parent material(geologic) Depth to Bedrock 7?o n Depth to Groundwater: Standing Water in Hole: 9 '+ Weeping from Pit Face ti0 Estimated Seasonal High Groundwater r to d, r � DETERMINATION FOWSEASONAL HIGH WATER TABLE w Method Used. So i �A(ypo{j�e-. Depth Observed standing in obs.hole: in. Depth to soil mottles: y Zn }f1' Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION Observation Hole# ^7 Time at 9" Depth of Perc )� Time at 6" Start Pre-soak Time @ d. Time(9"-6") ! End Pre-soak �d' d Z ` 9,e c ►p Rate Min./Inch L Z Site Suitability Assessment: Site Passed X Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP OBSERVATION,HOLE LOG Hole# }/,,,,'' +t .�r Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) —L-1j+✓ C®ate yf�,„d U 1`� 4�6 i✓ F. �G �". DEEP OBSERVATION HOLE LOG .. .. ., .. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 0-6 L� (�'�✓ L� f d�h e, tiu v. .alp G Z w Aire. - � Z`�"'Y 41,y tid DEEP OBSERVATION HOLE LO,G _.. ..... Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) "DEEP'OBSERVATION HOLE LOG `f Depth from Soil Horizon Soil Texture Soil Color Soil Other r Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No_ Yes { Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Envtron ental Protection and that the above analysis was performed by me consistent with the required tram in expertise an xpe ience described in 310 CMR 15.017. Si nature Date4�- Q:\SEPTIC\PERCFORM.DOC g t�l� Commonwealth of Massachusetts Executive Office of Enviromiental Affairs IN Dept. of Environmental Protection Jolm Grad One winter Street,Boston,Ma. 02108 D.E.P. Title V Septic Inspector P.O. Box2119 Teaticket, MA 02536 08) 564-6813 WILLIAM F.WELD v'� t Governor 49 ARGEO PAUL CELLUCCI Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO• M RED PART A CERTIFICATION fed 0 �' �-P (��m[[wNOFp 1998 Property Address: 98 TURTLEBACK RD.MARSTONS MILLS Address of Owner. NEAttr Date of Inspection: 918198 (If different) Name of Inspector: JOHN GRACI JOHN SCHLICHTE � I am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) Company Name,Address and 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: x Passes This Inspection Is based on criteria defined In Title V code 310 CMR 16.303.My findings are of how the system is _ COndIt10 all Passes performing atthe time of tlx inspection.My inspection does Needs ur er Evaluation By the Local Approving Authority snot eptic any and nty or yofIts components ents useful of the - septic system end any of Its components useful life. Fails Inspector's Signature: , Date: 9J8198 The System Inspector sha submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check,A, B, C,or D: A] SYSTEM PASSES: x I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: 8] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank,whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exhItration, or lank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04127)97) One Winter Street • Boston,Massachusetts 02106 is FAX(617)556-1049 is Telephone(617)292-5500 II � SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 98 TURTLEBACK RD.MARSTONS MILLS Owner: JOHN SCHLICHTE Date of Inspection:9l8f98 _ Sewaae backup or.breakout or high.static water level observed.in.the distribution box is due to a broken. or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced _The system required pumping more than four 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method usedto determine distance (approximation not valid) 3)Other D] SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: _ I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efflLlent to the Surface Of the ground or Surface waters due to an Overloaded or clogged cesspool. SAS is in hydraulic failure. (revised 04117)97) s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 98 TURTLEBACK RD.MARSTONS MILLS Owner: JOHNSCHLICHTE Date of Inspection:918l98 D] SYSTEM FAILS(continued) Yes No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds, arnmonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria: _ The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04f17)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 98 TURTLEBACK RO.MARSTONS MILLS Owner: JOHN SCHLICHTE Date of Inspection:918198 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: ,c_ — Pumping information was requested of the owner, occupant,and Board of Health. x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal — flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. x As built plans have been obtained and examined. Note if they are not available with N/A. x The facility or dwelling was inspected for signs of sewage back-up. x — The system does not receive non-sanitary or industrial waste flow. _c_ — The site was inspected for signs of breakout. x All system components, excluding the Soil Absorption System, have been located on the site. x The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge,depth of scum. x The size and location of the Soil Absorption System on the site has been determined based on The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. x Existing information. Ex. Plan at B.O.H. x Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is unacceptable)[15.302(3)(b)] (reylsed 04117)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 98 TURTLEBACK RD.MARSTONS MILLS Owner: JOHN SCHLICHTE Date of Inspection:918198 FLOW CONDITIONS RESIDENTIAL: d./bedroom for S.A.S. Design flow: 330 g.p Number of bedrooms: 3 Number of current residents: 2 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings.if available:(last two(2)year usage(gpd): nfa Sump Pump(yes or no): No Last date of occupancy: nfa COMMERCIAL/INDUSTRIAL: Type of establishment: Na Design flow:0 gallons/day Grease trap present: (yes or no) No Industrial Waste Holding Tank present:(yes or no) No Non-sanitary waste discharged to the Title 5 system:(yes or no) No Water meter readings, if available: nfa Last date of occupancy: nfa OTHER:(Describe) nfa Last date of occupancy.,- GENERAL INFORMATION PUMPING RECORDS and source of information: rda System pumped as part of inspection: (yes or no)No If yes,volume pumped:0 gallons Reason for pumping: nla TYPE OF SYSTEM x Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed(if known)and source information: SYSTEM IS 4 YEARS OLD Sewage odors detected when arriving at the site: (yes or no) No (revised 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 98 TURTLEBACK RD.MARSTONS MILLS Owner: JOHNSCHLICHTE Date of Inspection:919198 SEPTIC TANK:x (locate on site plan) Depth below grade: 2.6' Material of construction:x concreate_metal_FRP_Polyethylene_other(explain) If tank is metal, list age ma . Is age confirmed by Certificate of Compliance No (Yes/No) Dimensions: Le•6"H5'7•w4'10" Sludge depth:3" Distance from top of sludge to bottom of outlet tee or baffle: 31" Scum thickness:"' Distance from top of scum to top of outlet tee or baffle:6" Distance form bottom of scum to bottom of outlet tee or baffle: 17" How dimensions were determined: MEASURED Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS. GREASE TRAP:_ (locate on site plan) Depth below grade: rda lain other Polyethylene_ ex Material of construction: _concrete_metal_FRP_ ( p ) Dimensions: rda Scum thickness:r1a Distance from top of scum to top of outlet tee or baffle:rda Distance from bottom of scum to bottom of outlet tee or baffle: NO Date of last pumpingn, Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) rVa BUILDING SEWER: (Locate on site plan) Depth below grade: 3' Material of construction:_cast iron x 40 PVC_other(explain) Distance from private water supply well or suction llne:TOWN Diameter: nla rTve�mments: (conditions of joints,venting,evidence of leakage, etc.) (revised 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 98 TURTLEBACK RD.MARSTONS MILLS Owner: JOHN SCHLICHTE Date of Inspection:918198 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: rda Material of construction:_concrete_metal_FRP_Polyethylene_other(explain) Dimensions: nra Capacity: nla gallons Design flow: rva gallons/day Alarm level:_nra Alarm in working order?_Yes_No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) rda DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: nla Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box etc.) rda PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)No Alarms in working order(yes or no)_v,: Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) rda (revised 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 98 TURTLEBACK RD.MARSTONS MILLS Owner: • JOHNSCHLICHTE Date of Inspection:918198 SOIL ABSORPTION SYSTEM (SAS):x (locate on site plan, if possible;excavation not required, but may be approximated by non-intrusive methods) If not determined to be present,explain: n1a Type: leaching pits,number: 1000 GALLON LEACH PIT leaching chambers, number:We leaching galleries, number: rda leaching trenches, number,length: rya leaching fields,number, dimensions:rya overflow cesspool, number:nra Alternate system: nra Name of Technology:_nra Comments. (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation; etc.) THE LEACH PR IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.PIT HAD 6"OF WATER IN IT.PIT HAS NOT HAD MORE THAN 6"OF WATER IN IT. CESSPOOLS: (locate on site plan) Number and configuration: rJa Depth-top of liquid to inlet invert: rya Depth of solids layer: n1a Depth of scum layer: rya Dimensions of cesspool: rya Materials of construction: rda Indication of groundwater: We inflow(cesspool must be pumped as part of inspection) rJa Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) nra PRIVY:_ (locate on site plan) Materials of construction: nra Dimensions: rUa Depth of solids: rya Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) rda (revised 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 98 TURTLEBACK RD.MARSTON$MILLS JOHN SCHLICHTE 918198 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) 2^fie Gg FC04 AA 3 nC_ R�g (revlaed04/27197) Page ! of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 98 TURTLEBACK RD.MARSTONS MILLS JOHN SCHLICHTE 918198 Depth of groundwater 12 Please indicate all the methods used to determine High Groundwater Elevation: Obtained from design plans on record. Observation of Site(Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of Health Check FEMA Maps Check pumping records Check local excavators, installers X Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS MAPS AND CHARTS (revised0027197) page 10 of 10 r - COMMONWEALTH OF MMSACHUSETTS EXECUTIVE OFFICE OF IENVIRON- MENTAL AFFAIRS DEPARTMXNT OF ENrA�AL�'ROTI:C'i'I0�6 Vui 1 ONE WMEA STR IT, BOSTON MA 02106 (El?)292.55J0 TILUIP.COIF $B:rataty Du�.YiD B.8'1.'R.L'H3 AA.W20 PAJL CELLUCCI C ovanissioner Gavr+rnna RtIM1A1PACE SHWA=011SPOM s1ifTBU M GP1 C?1QsiS l=M PART A CURIWCATUM P►sverly,Adlinna: q -rV rf(c. 4?p,,G{G Mary 6f C w1r M /z t o -J!t C�nm Address of Owner: U, e bg Nletise d aaal�tosas: PtltaN 1 wit a IDIE ti.N/Q of IW B(310 CUR 15.0001 Congo"NoIes: r � KS�Lcd>7�1 Wi1n♦Addrtats. _ s7` .�l g Ooa6<71' 'TsiM�ieerra N;wtbw: _ i C*Ft;Ry that I have personally inspeeted the*swage disposal .at tlYs addreess and that the Information reported bellow Is 11 ue..ac cu irte� and comoato,as of the flute of inspectiori. The Inspection was'jpifformad based on my training and experience In the proper fun,:tion and -mrdiM:enence of on-site sewage disposal systems, The system: Pleases CWNWJ fishy Passes P Needs further Evaluation By the Local Approving Authority �. Pass bit;riser's Cloy im: -J% i / =�— (belle: The Vystem.neow:tor shall submit a copy of this Inspection report to the Approving Authority lieard of Health or DEP)Within thirty (310)days of e ar1phtting t•lls htspeotion, if the system Is a shared system or has a design flow of 10,000 gpd or greater,the inspector send th-t syst«n owner shidi submit ilte report to the sppropAlerto regional office of the Departmant of Envlronmentel Protocdor. The original shouhl be a-mtto dt+t system owner and copies sent to the buyer, if owksblo, and the approving Mithority. W01113 AND COMMENTS 1d3C1 dO H1�d3NMo1 318d1St4d QOOZ 8 63S a3N3�3� revised 9/2/98 Pass Ier11 • r. 1 Mend on swtiei.e ho., !. SUNSURFACE UWA®E DI$PtAL GVSTEM O SPECTMM FOM4 PART A CERT1l4CAT10ilb IaanNratedi OWNW: o.t.�e�irtap�sa Bert: 4 E t<oo 1111111111115 i9ttN OILWAARY: Check A. A. C. dw iD A. ES �/SYSM,/ASS : —X. I hevn not found any IniarwA len which indlcstss that wry of the f0hu„e cOmd1l ors dsseribad In 310 CMR 15.303 suirit. Any fellut s CA is not evaluated are Indicated below. COPItiYIiSfTs- S. SYSTPEtf 1;XIMI IDMALLY PASM: One rr mare system components as desoribed in the"Cemditional Pose"section need 'replaced or repaired, The sytitem,ulrami comp!stion of the replacemrent N repair,as approved by the`card of I4eath,wa Is. Mdleote year rra, or not determined(Y,W,Of ND). Describe basis of detarNmetio all instances. If"not detwmined",explain wl,y not. Th0 septic tank is mrlM,unless the owner or epwator hilk J00ovidod the system Inspector with a copy of s Certi:cpae of Carnplisnoe(attachsdl indicating peat the tank was I ad whhln twenty201 Years Mar to the dab of the ini. ( pectdori;of the es is I tank,whetter or not mapd, creek cturalhr unsound, shows subsrnetial infiltration or etflNrat:on, or"arsk Swatfailurs e i y the a gi a system wig peas In lien if the asieti a tic Lank is replsl:ed with a complying approved by the leer<I of Mealele. � � plylrey r�ey'le ti1Mt se .� Sewege backup or breakout high ttetie wets►level obasrwtd in eM distribution box a due to broken or obstra;cted Or due to a broken,w+:tle uneven dlsMbution box. TM system wlb tNl„ sI Hamm). � pass inspection!f(with approves oil tt�e li owes oil ken�d we rpdaood o0s WAGNOn Is removed distribution box in kitvelled or reputed -- The required Pr"riang nave than four times e Inapec if(whh Yew 6uo to broken or obstructed ape(s1• The system will Tess epprovM of tlhe Board of F(ee(th): broken p4wtsl we roplsced obslruetton Is removed revised !;/2;99 ivtaatis :01uo cs I"W wu wopsw peaft" '_._sa~p suluupsP W PNn f YY ! uuy3. real js ai .ls�o sl usfiafslu*'SJMu Pus weopfu sluounus is sausNJd 04 Pus A3plas;s�u+o4 uoWglod ua� 4�!pyM 041441 osas; fgtel vounaduoa olus6js opupp,pus sln3ssq�sNICZ aoi sp*us w3sM IISM s sssµial "!sM Alddes M s3ssnµd s If" vjlxu so W"0!sq sash 003 U243 gal si BVS s43 OUR UMSAs uapdissgs gas pus*0%alidss s WOWS OU AsM.+,ldiIr%�s3sM*wApd s to "OS UMM al SVs MR put Uft"s uopdrosgs lice Pus Vat al3dss s ws3sAs wU •1jam.114dtlnn MISM allgnd s 1s l swsZ s unplM sl Slfs W3 pus wettAs aspdasgs has pus*m*IW" ss4 usseAs s4.L '-'- •Alddns mem s as Ain"1� /H Alddns Ao:{IlA1 s9s�JM!jA bN8 OOl uPWiM sl SV!sys pus�'�)iugsAs uapdw+t40 ps pus*M*I *a a ss4 won"Stu •� _�!Ou am A affs am r 1'"MM JMrW*U 511 Walk d I cf31M1"V NI 1MlNMIZIMM st IMf9LLSAs 3111E LMI S3N 30 IANV A*Vgnddfls V ILLVIM*rWW ONVI KLIM is 3 HUL ssi'1N IW TV*MUSAs IZ •4usu We s,s P"9466"&"Pwg s Is�02 WWAA sl ANA to Ioodssh* AWa saspns Ss 384I 0!UM*N AApd As psdssso -- *1.I4I1I 10INAM3 3FLL ONVf7ug MV 1VW OMfW OU 19ElL.ON TV*HWW O M M V NI�:1 A;p3>M E� IMS 31t IVW.44XLI COe'!t 3ONIVOkU 0C1V Ns S3fl�I A3 M KOWN 90 a11V01I pg~"Wid TUM M,LSAf1 It aNil s:»so„ !cis t IN%sl uM"esulouu IUSUMOSM►'gs s43 pw A3s+ss•ytyssy Kprid 3sP Ot�s W 194"M A PM"04;Ag uapsn"MIP AOWM;sgftu 40i4M tsPas"ipw* "..o _. 'NiW*4 dO OYVO@ 3N1 AS 03ana311 M MOLLVfI'IrA3 do iL*%, '0 017J�7jD apissrwg;M woo ��c� ol�.�nl 8�► ::s�s�r�V A,ysdruV �MOM1 MOLL1►J13L1ts;! V IWd IgiOJ NML')U' !ONUAS 7VW4=30VMn 30VdW1gnv r S1lfSUMACE SEWAGE OMPOSAL SYSTM WBPWTM FOMS PART A CU"VRCAT900rf(oa!trrm" Prepesref AddM i�r�. `I 8 Tc'�e-6ir, t. QJL Ohrnar.: fx(. A14`Pkty oerau @tl b"M,tlar.: q( c (00 D. diet M IFALS: you'xrat indk:otr ddM "Yes"Of'No" to each of the following: 1 havn drtr�nrhkrd that one or Inure of the following follure conditions exist as described in 310 CMR 15.202. The bssli for i:hlv d@ - iji mtlon is iden" ed below, The Board of MoOt h shodd be eomuwod to daarnwne what Will be necessary to emmct tine lelmrre. Yes No Backup of*swage Irr o faellty or systern component due to a n od or clogged SAS or cesspool. Discharge or pig of etMuent to the surface of the grow waters due tb an everfoaded or Waogeii$AS u► ees*pool. Static I*dd level In Its distribution box above a Invert due to an ovorleaded or a,n"d SAS or cesspool. Liquid depth In eesspohot is loss than S" invert or evelable volume is less than I U day Now, Requir@d pumping more then 4 tlme the last.year JW due to clogged or obstructed pipets). Ni nhber of firth@@ pumped,_ .tl Any portion of tha Sol Abs on System, *@$spool or privy Is below the high groundwater elevation. .,. Aoty portion of a ee@sl or privy is within 100 fast of a Surface water supply or tribL,,tary to a surface water supply. /iool spool or privy is within a Zon@ I of a public WON. easel"or privy is within 50 feet of a private water supply well. �a M eo tool or privy is lose-than 100 fast but greater,than 50 feet from is private water supCdy well with$her r quality analysis, if the well has boon an@lysed to be acceptable, attach copy of well wrier sn,riysir for ,volatile organic compounds,ammonle nitrogen and nitrate nitrogon. L LdUWE ltl:!1 M PALS: You muh+t Indoute elth@r'Yes"or"No" to each of the folowbM. The k1lowing Criteria apply to large systems In addict the sultana above: The s,;stem serves a%W ty with a design f)o 10,000 gpd or greater ILarge System)and thet system Is a sfgMAe ent ti,real to public health and safety and the environment se one ar more of flit*following conditions exist: Yes No the system Is within fast of s surface drinking worst supply the system Is 21�0 test of a tributary to a surface drinkiing water supply the a located In a nitrogen sensitive ores(Interim Wellhead Protection Area it11PA)or a mapped Ysfwr UI of a pubis': wear well The corner Or ol:wat of any such system shall upgrade the system In accordamm with 310 CMR 1 B.304(21. Plosse consuft the fc,W ragi�Nwht ofNce tot the al ant for fwther Into..*Von. revived 9/2/98 f+er�e tt r tetliSYNFACE WWAOE ONFOSAL SYS"M 94PECTION FORM PANT S CHECKLOT OwmvFa+apatlt►A�s.af: r. G o,C Iq Daft isf bulp"iew: f (� to(, Checs If the foilowirn1 have been done:low must indicate either"Yes" or"Rio" as to each of the following: Yes No r Pumping Information was providsd by the owner,occupant,or Board of Heshh. - Nora of the system components have been pumped for at least two weeks and the etrstem hole been roealving warmed Sow rages during that period. Large volumes of water have not Iteen Introduced into the system recently or sit port of this Inspection. As built plans have boon obtained and examined. Note if thaty are not available with WA. "y a The hcft or dwelling was Inspected for signs of sewage beck-up. _ Via system does not receive non•sankary,or industrid westo flow. s Tito eke was Ins for signs of breakout. Y _ AN system coma wiants,excluding the Soll Absorption System,hove been located an+:hs else. The septic tank manholes were uncovered,opened,and the interior of the septic Yank was inspected for condition of befts om toss,material of construction.dimensions.depth of liquid,,depth of sludge,depth of scum. Tito alas and location of the Sell Absorption System on the site has been determined kesed on: -- Witting Nsfermation. f-or example,plan at S.O.H. Ditermtnsd In the fleld(11 any of the faBunt awlterie rslotsd to part C is at Issue,eppro,.(mtsbon of distance is unitaceptetNal 11 6.30213I(bl) Tito facility owner(and occupants,if diffm ant from owner)were provided with information on the proper inainti"name of Subsurface Disposal Ilystems. revived ?/2/98 f+grsoru UBSI APACE SEWAGE DN04MAL BYSTM NSPECTtON FORIM PART C SYSTBII wpoftul N o Do" btara�alMll: 9(r(bo FLOW CONIMM NN 110�.p.d.R.e►ea++. INurvd»r of bee raerna dpisn! 3 Numbw of bedroom$(sctuel): To"I DE "M.1low C;�/ Numbsn of our,ortt rseidarrb. awbass WMAi►(vee a nej. ; Lum(AMr 11001sts system) (yes or nol:,a If yes, *sparer*inspoodon required ► Laun�arr systarlr bopso'sd lrs6 or no) Seae�onai ua Imes of no):,�„• Water rrwwr 141ednve,If available(last two year's ussSs(9pol: Sump Pun»(vim or me): Lost dais of a oupsney:�� lei! Type of esWaaMn«tt: oeai4;ln low:-_____jgL I Sassd on I A. Sssis of door,Raw. Grosso osp prit"m(yes w no)__,_ bedwitrid Wwi s Mohlln0 Tank pros eras w no) Non•asnitsry Mace ilecharood Thds 6 system:(vas or no)w Wout mew moldings.If Last,pow of of suplowy: OTMIM:Mosel tie) ,.set date of 01 _ AIONFIAL SWOfMb%r PUNIP M MCIMM and rce of ini:er+ration: ��U�.- M� r-e- �Q e� pov $Volo++pumpad a part of Insoeadon:Ives or no If Vol, wokow pwnpsd: ,, puens Ress:rn far oumpl": T1/PP.�81T'�I ,_. Ssptl1:SwAddfaMEutlon box/soil ebeorption eyetern Sinn it oesspoei Over`low""Pam Shonid system Ives or no) Of 9`ee, attach previous inspsotkm reeerds,if any) UA Tiiahnolo v oft,Attach copy of up to data opsrstion and malmananoa comrset �._ Tipht Tsrdr Copy of DIP Approvel Odor APPROIVMATV:AN of ail compone►rts. Aete instoM Of known)and sowoe of Ift1wmatlon: tiswe r sdm detected when$riving at the site:Ives or no)e-v are�r:ised 9/:/98 hp6of11 BUMM FACE SIEWAOE SRSPOSAL SYSTM dmSVECT)ou FORM PART C SYSTM S+uaw"TIDN(annsm" l 48 Ti:rt(,-b.,:L jej ti�ee.er: tae.rn{`1 Dw or t�aa,iiosa: �{� laa� alalzdwln sdtlt�at: (Lea.te an tt jolenD Depth below ipede:37 INatMid of omeit u eon: cost iron 40 PVC a other(explain) DMtanoo*an�iveRa wotw Supply wep iu suction Hns DMmayot► 0,CwnntwKt:lea:;1dw'of joints, asttdrt0, evidence of Mokep.me.) (loasrbt on oleo iaetsl Depth belew MalwMal of ean+oruetkm.J-0onorate_natal —ass, _raysthNane_c*w(expMin) If tent Is metal.Ist"a s Is see ono Minted by Certificate of Compliance (Yes/No) DMlan+elsrlt:_,�O iDfetanose bans tt p of s#Wee to bottom of tutlat too w b&Ms:,Q 7 M •earn 1lMaknMs: a ON"""from to p of taunt to too of outlW:We OrbNM:S ,r Mm Dntre*0M bi;�of scum to bottom of outlet se or bt}f e: /6 few dbnaneions*we determined. �— �Cwssrstasts: freemsrrew"Is", for Pumpins.ao an of lnlot and outlet tees or tmfMlep,depth o} evidM& of I"kaof.e' D fati w c.6 So a c fluid f�ral�lrt �tion too et In ert.structural nteylr't i. K;�_ `t- ��s�„ fk*M(W eko p0m) Dooth below omie:,r_ Materw of eenstuctlen:`concrete_instal_.,.FVmg%ss —Polyethylene w(explain) Sown tMaknaes: Disco 0 l rom top of scum to top of oudst its or Dlstwroe horn bottom of sear+to bottom a+,outlet a baton: OM of newt outrp,ktp:-� — CemrtserRs: lreeemrr:ertdatlsn fa•putnplrp,e n of Inlet and outlet teas or beffMs,depth of Squid level in roladw to outlat invert, st►ucturld il.tebrity, evNbnos.of IMMIN•etc.) revised 9!2/98 File 7of11 SUUURFACE SIRWAU tXBPC A►SVSTBI NEFECTM"FORM! PART C SYSTRA MFCPMTIOM loondrOMM vj osflr��rwwao�wn: �,�! tGU TWIT OR NOIAMI TANK: (Tank nwst be purnped riot to, or at time of, Inspere:tlonl Omwe on eke plan) DW:h�befow 1naM:. M"wkd of oa ist willon:_comets s rnitel bergtsss_►oNyetAwene_ether{expleln) CMP1dtY:_. DOWN Design flow:_._a Nons Alarm sresa- Alarm In working order:Yes No Daetp of grevicas comrnmu: (Cardkiar of i dee condition of aht:n and Rost awkehes,*to.) D1i1f1AiW*101q wx domes on sees plan) Dao*of HOW Nvd above outlet invest Comments: (note If I"sand dstribution i saual,wildenoo of solids corryovaLavid e:e oil leakage into or ogre of b x, ate.) _ WLIL tev FfJNp ct►wslea does an ON plan) P~in wrwl:hg order:(Yes ar No)__ Ahern in waticing order(Yes w No)..,,__ Conr:nams: Into r:ondlthn of Pump ohwnbw.co" s and op u nwwwas,etc.) revised 9/2/98 rW,otil SUSSUnFACE SEWAGE DiSPOSAI SYSTEM NSKCTN M FORM PART C SYSTM�ifiOI1MATlON feesnlm.madf d�A.c,l�e�an,e.� OM lit b0pse/ien• CL t t too Sea iul11110111110'IOIra 6V81 lx 18"1-1. Ilooea,m on site 1:4wl,if possible:excavation not rwuifed,location may be sppfomdimnsted by nondntrusive methods) It not wood,ituplain: Typ. r 1Neilins pits,rr wdw- kwohing oh.srnbars,mpnbw:-- Maiahirg SderMs.number:_„_ hnohing tranchee,number,WMrth: losohing♦iehs.nt ndw,dimensions: overflow oesspoel,nuwAw,.—. Aism costive systorn: hens of Toehnol"y: Cenr>'msmmts: (note runMon of sag, np of tmydrsmAle f iiun,tev I of pending,da oamdition of va statlon,a .1 t ;------ (leeatu an slue plan) Mumtmbel-and ounNOurotion:_ lopth-top of Y:ndd to Not hwart: opth of*odds latte.: --6apth and scum Ieyer: Oimwlsions of,3osspod: M"Cliph)of serletMadon: (rldles l7n of S'OYndwaser. iMlow(caepool nmmmet be pu rd as port of inspection).,_,,r_ - Commrwou mote,131)" tlor of*am,si of hysiroukc feRnro,low!of pending, condition of voWation, ota.i MSiOY•hOusts,on_dM islen) Mete/leh of 0011"rwidon: DlfMneione: Depth of soft,;_,_ ConmMMM; 14, (noun mu>Ie~1 of$al],rip I of hyd!r iMure.level of pendng,oondhion of vogatafion.ate.l revised 9/2/98 per 9ofIt lcUO tMACE SWAGS DISM"L SYSTEM■ASPECTION FARM PART C *"TM WFOIIMIATION(1,004Vee4 Orr of weeP, lbW q (1 OR IMI OF OIMMU DINPOOAL O7OTOM: 11"We qee.to at least two pwwvwnt retKence laid As or,benchmarks locabio#A wets whhln 100'Mocate whets public water supply tenses,into house) .IY u � 5"7 rg �r revised 9/2/98 hptooriit SUBSURFACE SEWAGE OMMOS"SVSirM MPECTON FORM PART C SVSTM NPORMATIOM f4ma dtaadl -6"0 IV Add<«m Om«: f.c.dv`a�� Onto nl Mtairaotb;as NRCS now name Soo Tl,pe._ TV0691 depth to poundwssar_ USGS Date webalts vktitod Obowl&den Welt chocked Group lwater depth: Shallow Moderate _Deep $ITE EXAM 0*0 Surface water Chock C48V SheNow wens Estkmuted Do0i to Groundwster al�Feet , pleas,Indkote.iM the methods used to dotorrrmine Mgh Groundwater Eleva*m: DtRwinod item Uasipn Plan on roved Dtnorwd Sit*(Abu"property 46servation hole,basement wimp etc, Detamimid trom local condltlons Checked vkh kXeal Board of health Chocked :GMA Maps Chocked ;►umpkto records Checked scar oxoavators.InatoNe►u Used USC S Data Desadbo hOw ,vu osabllshsd the High Groundwater Elevation. (NO be comptsted) &__C-7 XLC)�� revised Itecu "1 1` TOWN OF BARNSTABLE LOCATION g 'V2"7Z a ��ck SEWAGE # -2 VILLAGE1 — 7 ASSESSORS MAP & LOTd9l p� INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ; (size) /o 0 ENO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BVI&DPER OR OWNER i ��ysJ; �'� T vg s , DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: -Z VARIANCE GRANTED: Yes No 4 THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for 11hipmal Workii Tonotrudion 11amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 7 _Tverz-6-A..oc� iz�• �f 4 ......_.._. ..._ -•--- -- - ------------- .....---------------.......--------------...------•....•-- Locati Address or Lot No,. ,s��vw.AF;2 �_70�3 _._....... - . lQ_..+.!V_!_a �:vc.C----' •'��✓1 '`..... Owner Address ---------... __�ia.JA------------C;y,e. '.... ......p-�--s (.ta9k �4QX_ ..... Installer Address Type of Building Size Lot....°__`{'-7 :-______Sq. feet Dwelling—No. of Bedrooms.................................___________Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures --------------------------------------••-•••-•-_...•- w Design Flow................................Y>�___gallons per person per day. Total daily flow----1!Ae'.............................gallons. WSeptic Tank—Liquid capacity_AA gallons Length__X7_4:__ Width__+-_'___ Diameter___'"_____ Depth_S^'_�_t_ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------/--------- Diameter_____//_......... Depth below inlet__!........... Total leaching area__ZN.'3 ____sq. ft. Z Other Distribution box ( vj DosingZ ( ) Percolation Test Results Performed by................ . ....................... Date...-'�"_3.'_. .............. Test Pit No. 149.15___4.minutes per inch Depth of Test Pit____-i�;� Depth to ground water......'........... Test Pit No. 2______________minutes per inch Depth of Test Pit____ :Z-___ Depth to ground water------- ............ �+ • •---••-••••--•--------------••--•-------•--.._....-•---•----------•-----•........_••-•---•---_-•----......................................................... 0 Description of Soil.... ............................................................................................................ x w VNature of Repairs or Alterations—Answer when applicable..........._.................................................................................... .......................-.................................................................................................................................... ........................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance khs b issued by the board of health. Signed ------------------------- ------- --------------.......--------------------------------...... ............---------- Dare Application Approved By -- .......< ...-----......_ ..................................... .........._---.--_-- Dace Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------------------------------------------------- ------------------------------ ----------------------------------------------------------------------------------------------------------------------- ---------------------------------------............ --------------------------------------- Permit No. -----� Ll:. `---..al.......................... Issued ........................ ----- --------------------_Date------ Dace r,. _1V .L-•_ l. _� rJ ..........��..: .... r J y . p THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applira#ion for Dispuml Work.5 Tow1rurtinn Vamit Application'is hereby-made for a Permit to Construct ( ) ror Repair ( ) an Individual Sewage Disposal System at: fi ..� Locatio Address or Lot No.�'/ .1/_�l�vr i�2 4 8,f !• lQ..l!�/p i?a a v4 ..��.J_...�P`'y : __*1 e.!:1.:!t.G?Zo43 ...--•--- __ .... --•---------------••--------•-----•---••....... a 2 - =� Ow ne `. �� Address (� �.�a�y9 �.. : .... .-----p.�., . --..-- .Installer Address d Type of Building Size Lot.... -Sq. feet U Dwelling—No. of Bedrooms..............�y........__....._.._..........Expansion Attic ( ) Garbage Grinder ( ) 'k Other—T e of Building No. of persons............................ Showers — Cafeteria Other fixtures ............•. f,rI --- . •--•-•••---•---•-•---•---•---......... WDesign Flow__________________________`._ SS-- gallons per pe'rsow pet'day Total daily,flow............................................gallons. WSeptic Tank—Liquid'capacity0_ gallons Length...Zl_D___ Width__:¢.-_"___. Diameter_- S_�Depth. ' ."__. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.....&__-....... Depth below inlet....'¢'_.......... Total leaching area...Zm!61.....sq, ft. Z Other Distribution box ( ✓) Dosing t nk ( ) '�' Percolation Test Results Performed by.... .... %�::....................... Date...`' _ _:-_-............... aTest Pit No. 1l0s._4 _minutes per inch Depth of Test Pit.....1;�......... Depth to ground water..._.------------- (s, Test Pit No. 2...........*:...minutes per inch Depth of Test Pit-_-�:z--_.. Depth to ground water-----_-....-•__---___-_- . ; 01 ----------------------- O Description of Soil--- ............ . ' V ------------------ •-------- •----------------------- ••-•----------- ------------------------------------------------------------------------------------------------------------ ..•_..-------------- W •---------•-----•-----------••-•---•--••--•---•-•-----•--••••------••--•----•••••-•-•••--•--•-••---•-----•---•--••-•-•-------•--••-•-•---•----•••--••---•••---••-•----••--••-•......-••-•--•---•---•-- VNature of Repairs or Alterations—Answer, when applicable...........................................•_•.........................._..._............_..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance Vsb en issued by the board of health. . Signed .......................' -- . .................................. l - Date ' Application Approved BY PP ----------------------------------------------------------------------------- ------- Application Disapproved for the ollowing reasons- -- ------ --- -------------------------- -----------------------------------------------_ ---------................ ......................................._---'------.-.-. ..............-.-q.-..........................._ - .......-'--------- --'-------.-..................-..- ................---.'............. " .......--- ---- -........------- Dare ' Permit No. -------- f �� -----� l.......................... Issued --------------------, te ------------------------ Da k THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cfez#tftratr of Cfontyltttnre THIS IS TO C�RTIP , That the Individual Sewage Disposal System constructed ( �—or Repaired ( ) by -1S T (t_),tkco-jA C ._. . . ................................. --------...................................................................................................---------------------------------- .---------- /� Installer at ........ - � . - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal'Works Construction Per tnittNo. ........... ... -'`dated .- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISEA,\CTORY. DATE-------- ' --------- ......... .... ................... Inspector .... .......... �... ... �4 THE COMMONWEALTH OF MASSACHUSETTS e- BOARD OF HEALTH s TOWN OF BARNSTABLE No.... 1�!-..,'��. FEE..... ...d...... . �t��r�a��tl nrk� ��an;�#r�tuan �ermi� Permission'is hereby granted__.._.� ........................................ . � T to Construct ( ) or Repair ( ) an Individual(Sea age Disposal System at No........£ �r.l ........... G4,tt!"�. p'I..,.�+5frebt t as shown on the application for Disposal Works Construction P '' No..7y!.2?°. Dated........................................... Board of Healy / DATE......... ........_. •....••--- FORM 36308 HOBBS Q WARREN.INC.,PUBLISHERS _ J n I a � r » l WC/ Ulu pa� oaua W-�'Vm oA P3 •fit, t7b-£-S 'a"h I Zz8-cl Z.kd -�wt 'gyp T2'X40n-Y 9 7.40 VW W07, I SZOWJ*,r Vo V(r vn 17Ot7 ?O" &f?la�7 v9oJ �a�.vuua� voE W T'j'j.w vo-"'�' (,l z+? P r r l o U-7(/ 'f'r�'a�� t 0W H.,t1 pvo\, zocpn p/ bt a d. $. v ,z = nb i:. •� OUOI :i o -" G v �. v ry A I - J --- - . nlv — 000/ � t,t7 rchj✓ N amS, °N a�'i °�j[l s �s £ T4u0ovpa9 -oN vn`bS SOh otr II ` 1 4a Ott ? 4 tor. for -- • OJC Lt,. s 170t7 1''J0� Q J d 0 1 a oov� 6'L* C'Cb C�> 55 05 i .SL L •°•� ZU£ Hof _.. . _ f, 6 N / PROPOSED SAS ; LEGEND 2 H-20 500—gal chambers with 4 stone all around in Tess Hole Lobation R 25' x 13' x 2' leach trench. tt 88.46' / :, 89.75' X:' °' } —GAS— Appr x saiinelocation a h l —W— Approwxafat8nleocation �QQ / 0 Qj 95,75' X.� 18— Existing contour / Cp 'Septic S O °j�� O O Eloadng se00gtank -10 eo SITE niayo R / � /� �/ QtbOC .� C•i � �xs j p �°• Existing Leach Pit g4 9a Rd 0 / o 04 j` qG� Ro O (to be pumped removed) ' 88.77' X s4: 08 AD MARSTONS MILLS 4. vent. 2, j3, ware LOCUS / © r / .. .•'X 9.9.18 � NO SCALE 44j / 98.4f1 101.15 9.73' GENERAL NOTES O 88.91' )E .W 10 O_ ' 1. ADDRESS: #98 TURTLEBACK ROAD, MARSTONS MILLS 2. ASSESSOR'S NUMBER: MAP 046 PARCEL 092 L mac/ io 3. DEVELOPER'S LOT: LOT #404 4 TOPOGRAPHIC INFORMATION WAS COMPILED FROM AN ON THE GROUND/ F NG OU D INSTRUMENT SURVEY. O�j 5. TOWN WATER IS PROVIDED TO THE SITE & SURROUNDING PROPERTIES. °/ 98.37 •:X / 6. NO WETLANDS ARE LOCATED WITHIN 150 FEET OF PROPOSED SAS. 7. REFERENCE PLAN: LAND COURT PLAN 30751-H o�/ 99 •• r Tip / /// ij REFERENCE PLAN: MORTGAGE INSPECTION PLAN FOR THOMAS A. MCINERNY & JUNE MILLIKEN DATED 9/23/2000, SCALE 1"=30' `9' eSmt h�/0 BY YANKEE SURVEY CONSULTANTS. 88.84 ^. 87 40 `S`/O O 6. // Q� C� 8. UTILITIES LOCATED BY DIGSAFE WITH THE EXCEPTION OF THE i tS� S // a� Q UNDERGROUND ELECTRIC. THE ELECTRIC LINE IS SHOWN APPROXIMATELY ::::• 9�' // / �o OQ ON THE SITE PLAN. THE ELECTRIC LINE SHALL BE LOCATED PRIOR TO X // i� COMMENCEMENT OF WORK. 93.1 : v 9. THIS DESIGN PLAN SHALL BE USED FOR SEPTIC INSTALLATION PURPOSES ONLY. " .... i o -co 88.90 0 F g o �. 0 LOCOI .................................... 9 : ' _ Upgrade Approval ...........................•........ ....................................... LOT 404 3 P� PP 927 04 _ 3 10CMR1 5.405 1 b A� v i r an 90yQ0 "'''' :••q AREA— 0.4� C9 O 3c )� ) requested to allow the proposed :' u e Q n8'••• LLD` 7 AC a SAS to be constructed approximately five feet from grade :.. �i'/VE :::; ':.;:.: .;:.:( ::`.:`. " �� ~ in lieu of the required 3 feet. H-20 chambers and a vent are provided / 9 X` Wq Y Q�` ' to mitgate the variance. f.H. #1 :. PROPOSED SEPTIC SYSTEM REPAIR PREPARED FOR 8' 4' 9� 49 £' T.H. #2 ROBERT ANZOLA ET UX AT 98 TURTLEBACK ROAD #IO2 T o � ,-��tcir q (MARSTONS MILLS), BARNSTABLE, MA o tOwnsw4g��c/r Ro o �� PREPARED BY: SITE PLAN ote, 40 { w Z0 Glen E. Harrington, R.S. .?s 9 Leda Rose Lane SCALE: 1 " = 20' o �O' m E'�'� Marstons Mills, MA 02648 �y T 'k� \P Tel: 774-238-1813 B.M. = 10 0.0 0' (ASSUMED) ON CORNER Email: gharr88®hotmail.ccm LANDSCAPE TIMBER SCALE: 1"=20' DRAWN BY: GEH DATE: 6 DEC 2017 DATUM: ASSUMED FILENAME: Anzolo SHEET 1 OF 2 1 I I Provide 4" SCH 40 PVC Existing Dwelling SYSTEM PROFILE Vent with screen or carbon filter 3DIST BOX Not Not to Scale D-Box cover shall be I Top Fndn Elev.= 100.65 = within 6" of finished grade I Existing Grade = 98.7't Finished grade over system=29 slope away Existing Grade = 91'-94'f Septic tank covers must be Provide 4 tee inlet „ S = 0.02'/ft, within 6" of finished grade due to slope 6a" provided One chamber cover shall be Min. 2"-1/8"-1/2" Double-Washed Stone variance re within 6" of finished grade or geo-textile filter cloth S=0.28'/FT q'd• BSMT. SLAB EL=97.0' 15' EXISTING Level for 2' S=0.01 ft/ft To of Peastone Elev.=89' 1000 GAL. 25' Invert Ele .=88. 0' SEPTIC TANK 9 P=88.63' 13' ® ® ® ca G C3 24" EXISTING O ® ® ® Install Gas IBof a Bottom f Leach Facility Elev.=86.50' 95.26' or equal = 8 80' 25 3/4"-1k" Double-Washed Stone 5' Min. 0.5' PROVIDED. 5' of pervious soil shall be confirmed below SAS 6" OF 3/4"-11/2" STONE at time of construction. Groundwater anticipated at 18' below grade at SAS. 6" OF 3/4"-11/2" STONE H-2 0 Bottomof T st Hole Elev.=86.00' CONSTRUCTION NOTES LEACHING CHAMBERS Design Calculations - 1 . Contractor is responsible for Digsafe notification Number of Bedrooms: 3 Equivalent to 330 Gal./Day and protection of all underground utilities and pipes. Garbage Disposal: Not allowed with this design 2. The septic tank and distribution box shall be set Septic Tank Capacity Required: 1,500 gallons (min. per Title V) Septic Tank Capacity Provided: Existing 1,000-gal H-10 septic Tank level on 6" of 3/4"-11/2" Stone. . 3. Leaching Capacity Required:- 330 gpd x LTAR= Req'd Area stones over 3" in Size.) should be clean sand Or gravel With n0 Long Term Application Rate for <2 min./inch = 0.74 gal/sq. ft. tones Proposed Leaching Structure: 1-25'x13'x2' Leaching Trench 4. This system is subject to inspection during installation Bottom Leaching Area Provided = 325 Sq.Ft. by Glen E. Harrington, R.S. Side Leaching Area Provided = 152 sq. ft. 5. The contractor shall install this system in aCCOrdance Total Leaching Area Provided = 477 sq. ft. > 446 sq. ft req'd. Leaching Capacity Provided =477 sq, ft X 0.74 gal/sq.ft.=353 gpd. with Title V of the Massachusetts Environmental Code SOIL EVALUATION & PERK TEST (P15539) and local Board of Health Rules and Regulations. 6. If, during installation the contractor encounters an Date of SOIL EVALUATION: November 17, 2017 y Evaluation Performed By. Veronica Warden, SE soil conditions or site conditions that are different Excavator: John Graci from those shown on the soil log or in the design, Percolation Rate:< 2 mpi, 24 gals applied in 10 min 00 sec. the installer shall halt installation and immediately notify Witness: Donald Desmarais, R.S., BOH Agent Glen E. Harrington, R.S. Test Hole Test Hole 7. No vehicle or heavy machinery shall drive over the No. 1 No. 2 septic system unless noted as H-20 septic components. DEPTH SOILS V. DEPTH SOILS ELEV. 8. Install Tuf-Tite gas baffle or equal on septic tank outlet tee. 0 96.00' 0 96.5' 9. All piping shall be SCH 40 PVC. A. Loam A, Loam PROPOSED SEPTIC SYSTEM_ REPAIR 10. No wells are located within 150' of proposed SAS. 4" 10YR4/2 95.67 6" 10YR4/2 96.0' 11 . Provide a 4" dia. SCH 40 PVC vent, as shown. Bw Bw PREPARED FOR gamy /6 10YRis ROBERT ANZOLA ET UX 12. Soils in the proposed SAS shall be confirmed prior to SAS installation 1oYR4 s 27" a 93.75 28" 94.1 T AT by the Designer and Board of Health. Any unsuitable soil shall be 30".� removed 5' horiizontally and filled with sand meeting 310 CMR 15.255. 98 TURTLEBACK ROAD 13. The existing leach pit, stone and leachate-contaminated soil shall be 48 a MEDCISAN 0 MED. liAND AA (MARSTONS MILLS), BARNSTABLE, MA removed and filled with sand meeting 310 CMR 15.255 specifications. 2.5Y#4 2.5Y6/4 "Or- MQ 14. Five feet of pervious soil shall be confirmed below the SAS at the time 120" 1 86.0' 1 1120" 86.5' PREPARED BY: tQ of installation. Groundwater anticipated at 18 feet below grade at SAS. No Observed Ground Water R.S. Harrington, 15. The existing underground electric line shall be located rior to I certify that I aA currently approved by the Department of I Glen E.9 Leda Rose Lane p commencement of work. Environmental Protq'ctlon pursuant to 310 CMR 15.017 to conduct ,lt . Marstons Mills, MA 02648 sail evaluations and, that the above analysis has been performed ® . by me consistent with the required training, expertise, and Tel:Tel: 774-238-1813 16. Provide 1 H-20 DB-3 distribution box and 2 H-20 500-gaL chambers theeresultsdof described oil evau10 aton, als Indcated on the at tha tached ��f�TAR Email: ghorr880hotmail.com by Wiggin Precast or equal. all evaluation forp, are accurate and In accordance with 310 CMR 15,100 through 15.107. SCALE: 1"=20' DRAWN BY: GEH DATE: 6 DEC 2017 1 Veronica Warden, SE DATUM: ASSUMED FILENAME: Anzola SHEET 2 OF 2 t cam- COLT) 'AA ov oaj 1KQ a 4l-1 t JYY r i it Ll '�1 i j .. r :, ill . 1. :)t Y: • Building Ske4ch -- -j /Client. An-_7-_018 Robert&Mar re 1:i e MA Code !I 6 Address 98 TURTLEBACK ROAD Caa BARNSTABLE . MARSTONS MILLS '' :ender PLYMOUTH SAVINGS BANK } t - ,-,- I I - I i - t j i - - - - i- - - -,; - . i 1 = ; ; - :. . , . . . ' _. . . 1 1. - - _ i .. • . . _ - _ - i - K 'C.L''7. i - - �Q J -- - I . . . . . . . . ..- - - -• jj . - } r r -.r I I a -- . • - `+ -/'_ e Q : ' = } . - -_ -r' - ;I, f � t t":- T!_-. =f �r nl, i_ �.' _--i + . . - ;�;;�; _ 1 E - - t - II{ _ _ - 7 - _ f - --_ - - - - __ - - _ _ - _ - __ _ _ __ - _ _ t I. _ _ _ _ . _ _ .f_ _ _ _ `jt{ . . _ _ ....•-- _ ..•.+. . . a.s....:-� _ _ 1 __ _ - - - _ _ ��y _ _ IVY .. . . . • _ , . - ) _ .. . . - 1 . . . . ./. .-,- 1 r. - - - » - . . _ _ :: - -- - - . - C_ - /. -- - - - "- - - .......-.- - -- _ _ _ _ • - - - - - -_• • - - - -- - -- - . .. - - I. - - - - - - _ - - _ - - - _ _ - - - - - - t - - _ - _ _ _ _ - _ _ - - -- - } . i •i- ...:......:"i.a_: .,:". a . . . . . ..-'-- . _�...-•.-.__.. _ _ _ _ .�. - r. •....... .........�.. _ - - _ _ _ S } 11 .� . . a _- - _ - - . ...... -- - f ..._.•.-.-......-.. • _ - _ _ _ _ ...v..a.i.!-. . . . _ _ ..-:....T:.:._s.._:.�.. - _ - - . _. . r _ . t _� li;t:C' �' ' - - -- - - 1 ..._..... ....". :.....-:.-. . .- , . . . r :�•:_' - t LL t. f.' II -- - j - - - ;.: - *-: ... y .... - " : , L. -,:;: . : .. - --1. :r - - 1 's F%:~ i - -.4• �_1 �. � � �_�,,y�, .- T iE __ -- i T;rc :__ r-;. -:. - - .- - i .� . - __ J•r _ _ _ _ __ __ _ - -- fI _ __ _ _ _ _ _ _ _ _ - .l_ - . rt. . - - - - - - - _ _ f :_ _ _ _ _ _ __ __ - _ - - - - _ - - 1...:- .�_ •.s.:. .T ................� r v r•.• .a.:._a-a........:. - - - - - - - - . . . . . . . . . . . . . . ........ .. ___ - - _ _ - - _ ' _ __S_S_ _ _ . . . .._. - ..._..._..__ ... _ - - _ _ _ __ _ _ _ __ _ .T. _ ..: . ... _ . • - - _ _ __ - - - - -- . - - - _ _ _ _ - - gg form SKT.B►dSk—-TOTAL 2000 for Windows'aPPraisal software by a ha mode,inc.—1-B00 ALAMODE I 1. N PROPOSED SAS LEGEND, - / 2 H-20 500—gal chambers RA / ro with 4' stone all around in Test Hole Location ' x 13' x 2' leach trench. `' �• _� � �ry 25 —GAS— Approximate9aslnelocation � e 88.46 :^ 89.75' X:' 0 —,N— ., ApproxiCnat� location .. obi try water Tine aD / �•OUj gi obi 18— Existing contour o, 95J5 x SITE / p p Existing 1,000 gal. H-10 �y �eboorr R / ^ $V tic loading septic tank c Setbo o � � oo #76 TV �, Ra Rd Q ...,::•'2 ck ^ RTCEe Existing Leach Pit s?::. i::;;_.:. 0 04 q Ck R O (to be pumped & removed) s ` ..,• MARSTONS MILLS 88.77' : : �O, ;: O X 94: '62 .. tOwn wot 6 LOCUS ,,:::;:,:''s>::'«:...... ;:<;:. g' vent.. NO SCALE / q X 9.9.18 Q p / r°X.:r✓ der / grin " .......... 68'' 101.15' 44,/ w GENERAL NOTES v 9.73 L 1. ADDRESS: #98 TURTLEBACK ROAD MARSTONS MILLS 0 88.91' � ._' W ,A'/0• �0r. 2. ASSESSOR'S NUMBER: MAP 046 PARCEL 092 vv 3. DEVELOPER'S LOT: LOT 404 4 GROUND PHIC INFORMANT TION WAS COMPILED FROM AN ON THE INS/�� �oF/ •�0���r/NG �0 5. TOWN WATER IS PROVIDED TO THE SITE & SURROUNDING PROPERTIES. CO j Nn 6. NO WETLANDS ARE LOCATED WITHIN 150 FEET OF PROPOSED SAS. v. :...98•;37' :X 7. REFERENCE PLAN: LAND COURT PLAN 30751—H °°/ g9 T � REFERENCE PLAN: MORTGAGE INSPECTION PLAN FOR THOMAS A. p F / / MCINERNY & JUNE MILLIKEN DATED 9/23/2000, SCALE 1 =30 98 �/ o BY YANKEE SURVEY CONSULTANTS. ol. ` 9 esh�t` dh\JOO / 0 / 8. UTILITIES LOCATED BY DIGSAFE WITH THE EXCEPTION OF THE Q� 88 84 S/0 .ss /// / •c Q UNDERGROUND ELECTRIC. THE ELECTRIC LINE IS SHOWN APPROXIMATELY 97.40 6�9 /a�/// ,c Q ON THE SITE PLAN. THE ELECTRIC LINE SHALL BE LOCATED PRIOR TO ) / o O COMMENCEMENT OF WORK. /;:'r : :`;; ;•;:••••.' �e�' // i° 9. THIS DESIGN PLAN SHALL BE USED FOR SEPTIC INSTALLATION PURPOSES ONLY '° o 0 Local U Lo I Upgrade Approval o / pa ova 8 8.90 .F T 4 4 P P LOT 0 C 1 4 04 310 MR 5. 05 1 b A variance is requested to allow the pr oposed osed •: 9�•7.••.. — C5 3 SAS to be constructed approximately five feet from grade '>. ...:::...... : >:;::; : AREA= 0.47 AC PP Y 90yQ0 q��•.•. ••••••.•.•••••.•••••••••••::••••••.••••• ro �° in lieu of the required 3 feet. H-20 chambers and a vent are provided lJ a nd : RIV; 4e: :!: ::4iC :^:':` r "� .................... ...................:: O� to mitgate the variance. / J X. f�1'A y : '•'t•H• #1 Ali� PROPOSED SEPTIC SYSTEM REPAIR / 0)0)N to d '� PREPARED FOR °' T.H. #2 . ;; ROBERT ANZOLA ET •UX 8. 4' 95'49 , p AT ro �oQ 98 TURTLEBACK ROAD rn #' o (MARSTONS MILLS), BARNSTABLE, MA 02 ^ o S' �/Rn I �/ 3 t•,,Q G`� to1v e4Ck O� 3� '" n IN ! PREPARED BY: R.S. SITE PLAN n w�f 3 R��� �, �® 91 Leo Rose nLg ane I �� Marstons Mills, MA 02648 SCALE: 1 " = 20' /TARO Tel: 774-238-1813 B.M. 10 0.0 0' (ASSUMED) ON CORNER Email: gharr880hotmaii.com SCALE: 1"=20' DRAWN BY: GE DATE: 6 DEC 2017 LANDSCAPE TIMBER DATUM: ASSUMED I FILENAME: Anzolq SHEET 1 OF 2 L _ Provide 4" SCH 40 PVC Vent with screen or carbon filter Existing Dwelling SYSTEM PROFILE 3 HOLE H-20 Not to Scale I DIST. BOX D-Box cover shall be -, within 6" of finished grade Top Fndn Elev.= 100.65 = ExIstin2 Grade = 98.7't Finished grade over system=2% slope away Existing Grade = 91'-94't . Septic tank covers must be Provide 4 tee inlet 36p Max. One chamber cover shall ibei Min. 2"-1/8"-1/2" Double-Washed Stone within 6" of finished grade due to slope 60 provided, within 6" of finished grad or geo-textile filter cloth S = 0.02 ft. variance req d. To of Peastane Elev.=89' ' S=0.28'/FT Level for 2' S=0,01 ft ft EXISTING BSMT. SLAB EL=97.0' 15' 25, Invert le = 0' 1000 GAL. ® ® ® ® �SEPTIC TANK P=ss.s3' t3, 24" EXISTING H-10 C3 ® 0 ® C3 ® Bottom f Leo h Facility Elev.=86.50' Install Gas �a a 25 95.26' or a ua =88, 0' 5' Min. 0.5' PROVIDED. 5' of pervious soil shalt be confirmed below SAS 3/4"-1'/e" Double-Washed Stone at time of construction. Groundwater anticipated at 18' below grade at SAS. 6" OF 3/4"-11/2" STONE -H-2 0 1 Bottom of Me t Hole Elev.=86.00' 6" OF 3/4"-11/2" STONE R LEACHING CHAMBERS CONSTRUCTION NOTES Design Calculations Number of Bedrooms: 3 Equivalent to 330 Gal./Day 1 . Contractor is responsible for Digsafe notification Garbage Disposal: Not allowed with this design and protection of all underground utilities and pipes. _ Septic Tank Capacity Required: 1,500 gallons (min. per Title V) 2. The septic tank and distribution box shall be set Septic Tank Capacity Provided: Existing 1,000-gal H-10 septic Tank level on 6" of 3/4"-1 1/2" stone. Leaching Capacity Required: 330 gpd x LTAR= Req'd Area 3. Backfill should be clean sand or gravel with no Long Term Application Rate for <2 min./inch = 0.74 gal/sq. ft. stones over 3" in size. Proposed Leaching Structure: 1-25'x13'x2' Leaching Trench Bottom Leaching Area Provided = 325 Sq.Ft. 4. This system is subject to inspection during installation Side Leaching Area Provided = 152 sq. ft. by Glen E. Harrington, R.S. Total Leaching Area Provided = 477 sq. ft. > 446 sq. ft req'd. 5. The contractor shall install this system in accordance Leaching Capacity Provided =477 sq. ft X 0.74 gal/sq.ft.=353 gpd. with Title V of the Massachusetts Environmental Code SOIL EVALUATION & PERK TEST P15539 _ and local Board of Health Rules and Regulations. Date of SOIL EVALUATION: November 17, 2017 6. If, during installation the contractor encounters any Evaluation Performed By. Veronica Warden, SE soil conditions or site conditions that are different Excavator: John Graci from those shown on the soil to or in the design, Percolation Rate:< 2 mpi, 24 gals applied in 10 min 00 sec. 9 9 Witness: Donald Desmarais, R.S., BOH Agent the installer shall halt installation and immediately notify Glen E. Harrington, R.S. Test Hole Test Hole 7. No vehicle or heavy machinery shall drive over the No. 1 No. 2 septic system unless noted as H-20 septic components. DEPTH SOILS ELEV. DEPTHI SOILS ELEV. 8. Install Tuf-Tite gas baffle or equal on septic tank outlet tee. 0 6.00' 0 96.5' 9. All g P.p I in shall be SCH 40 PVC. " A. Loam " A, Loam PROPOSED SEPTIC SYSTEM REPAIR 4 10YR4/2 95.67 6 10YR4/2 96.0 10. No wells are located within 150' of proposed SAS. PREPARED FOR 11 . Provide a 4" dia. SCH 40 PVC vent, as shown, aam 8w, ean aam wsan ROBERT ANZOLA ET UX 12. Soils in the SAS shall be confirmed ' prior to SAS installation 30" 93.75 28 94.17,OYR4/s " 10YR4/s AT proposed p 27 by the Designer and Board of Health. Any unsuitable soil shall be 98 TURTLEBACK ROAD removed 5' horiizontally and filled with sand meeting 310 CMR 15.255. 48 c ct (MARSTONS MILLS), BARNSTABLE, MA 13. The existingleach it stone and leachate-contaminated soil shall be M .5 6/4 M .5 /4 G� p 2.5Y6/4 2.5Y6/4 ��� removed and filled with sand meeting 310 CMR 15.255 specifications. , ``� +,�` � PREPARED BY: 14. Five feet of pervious soil shall be confirmed below the SAS at the time 120" I 86.0' 120" 86.5' s4 Glen E. Harrington, R.S. of installation. Groundwater anticipated at 18 feet below grade at SAS. No Observed Ground Water ; A ; 9 Leda . Rose Lane I certify that I an currently approved by the Department of 15. The existing underground electric line shall be located prior to Environmental Protection pursuant to 310 CMR 15.017 to conduct 0. 0 Marstons Mills, MA 02648 commencement of work. soil evaluations and that the above analysis has been performed Q by me consistent with the required training, expertise, and Tel: 774-238-1813 experience described in 310 CMR 15.017, I further certify that �q IST� �� Email: gharr880hotmail.com 16. Provide 1 H-20 DB-3 distribution box and 2 H-20 500-gal, chambers the resutts of my sail evaluation, as Indicated on the attached ITAft soil evaluation form, are accurate and in accordance with 310 " by Wiggin Precast or equal. CMR 15.100 through 15.107. Veronica Warden, SE SCALE: 1 =20 DRAWN BY: GEH DATE: 6 DEC 2017 DATUM: ASSUMED FILENAME: Anzolo SHEET 2 OF 2