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0176 WAKEBY ROAD - Health
L WAI�EBY ROAD,MARSTONS MILLS 043 056 I No. 1,043� ^ ®5_0 Fee to© THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 21pplitation for 30isposal *pstem Construction permit Application for a Permit to Construct( ) Repair a Upgrade( ) Abandon( ) ❑Complete System [i]'Individual Components Location Address or Lot No. 17 b (��{ Owner's Name,Address,and Tel.No. A -re c>,,(cJS Assessor's Map/Parcel O q3Jos-(" S Installer's Name,Address,and el.No. Cr{p.w;,,L �� p� j Designer's Name,Address,and Tel.No. C 1�0- 138x ?b3 Cr lvd4K./ Type of Building: Dwelling No.of Bedrooms Lot Size 30 62-1 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Ljq o gpd Design flow provided -3 gpd Plan Date 3-tv—200 I Number of sheets Revision Date Title C ?G L_ k Size of Septic Tank [Qes .1L IQ :)i� Type of S.A.S. �2� S Ikft_&6) '1~/fie(,.j Description of Soil —n Nature of Repairs or Alterations(Answer when applicable) 55 12 ►L 330LA k Date last inspected: Soda 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 Hea . Signed Date -3 Application Approved by Date 3' Application Disapproved by Date for the following reasons Permit No. ?_®®q—Q.5 0 Date Issued I . _ .. ,.�"' ���"'------�r•��.�.��..:n. -•-�.�,,,+„�-�,;..q...._ a-ram+,.-..... ,t,,,;:.r�,r"`+-.s�,.-, ...." _ �� ...�„R--,-1► No. 0 U Fee t Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpIication for Misposal *pstrm Construction permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System 21ndividual Components Location Address or Lot No. 1 -7(0 Owner's Name,Address,and Tel.No. ((j t rJs r'�•a�51z+-s �'�+ � s Assessor's Map/Parcel p q 3 c S Sit Installer's Name,Address,and Tel.No. Cq Plark) Designer's Name,Address,and Tel.No. G J�v• )30x 7b3 C�4+, C a,►Cs 1-i a MV oZ(,3t Type of Building: Dwelling No.of Bedrooms Lot Size 3 bI 62 it sq.ft. Garbage Grinder( ) Other Type of Building S;,,.,r �ar, ;�, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) LAI 0 gpd Design flow provided Z•3 gpd Plan Date 3.1 a-2p0 q Number of sheets ( Revision Date „ Title I?cam L_.)Ln� 4. Size of Septic Tank j po o 5 A L `e+l {t Type of S.A.S. cs Description of Soils Nature of Repairs or Alterations(Answer when applicable) CrX i S j ,h 1 U oo c/G 1 n 1-iZ TY1M 1n 7) -<3 ox t y (�> S Tcmas(es T re ` .,� c Date last inspected: 7,001E t Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date 3 I - 2004 Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ZO O g-0 j 0 Date Issued 1' 1 I-Z O O`j --- ----------------------- ------------- -•------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(VQ Upgraded( ) Abandoned( )by C.d per,,,,;c tom. 6`1,14r p. '�e� LL k , WV at t 3 L / has been constructed in accordance with the provisions of Title and the for ;i osal System Construction Permit No.Zco9.o S'o dated - I j - ZO$g Installer L l.L 'Designer 3• L. t t�i t or,#bedrooms l.j Approved design flow y(o Z • f �1 gpd ,The issuance of this permit shall not be comtruedtas a guarantee that the system will tion as designed. Date _ Inspector (f v i - - No. 10,0q-0 S;0 Fee (0p THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal Opstem Construction permit Permission is hereby granted to Construct( ) Repair(7L) Upgrade( ) Abandon( ) System located at j la (�J A 1�a 1,, (Z yj�S roo,) (� r and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. - Date -I(- 20 O 9 Approved by f 'I own of Isarnstame Regulatory Services -1• homas F. Geiler, Director "IR Big, M"U' Public Health Division ' hOrnas McKean, Director 200 Main Street,Hyannis, MA 02601 Officr.: 508-862.4644 Fax: 50190,f,304 Installer & vegzjagr Cgrtificatto Form Gesirier: SL �t1c�iY�E'ec i n_ y�c __.._. bast-- slier: C.<•?�h��•u,�_ �,� �c° r(s•�.,� Address; z�`�it Cc � _. �becc Address; ., on 3- l kl-"Z6a C , was issued as permit to install a (�a1e)�� (instal3er) septic system at �Z�t,,�,>a1,i �.�� based on a design drawn by address) , elated ► 6fCVN 10 1001 ,__V__ l certify that the septic system referenced above was installed stibstantially accorciin t.the design, which may include rninor approved changes such as lateral relocation of'Itht. distribution box and/or septic tank, I certify that the septic systelri referenced above was installed with major changes (t.e greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic systems) but in accordance with State.& Local Regulations. Plan revision cis certified as-built by designer to follow. (lnstal.ler's Si afore) JR W ICJ 11. S (Designer's Sid-__,_,,._�- Affi '" (� esi`gner's M azs�p Hire) kLEASE RETV - —To TABkE PUB C H I SI iV. E FI 'A'I'L U E ILL N B SS BU `r. TT4rV YOUIHANK . Q: Health/Septic/Desisnex Certification Form i0 -d 2-920 2LZ 809 DNI2133NIDN33r WO 9i : 60 600Z-6T_NUW Town of Barnstable P# 2. Department of Regulatory Services �oFtME,, Public Health Division Date 200 Main Street,Hyannis MA 02601 � BARNSTABLE,019. � rfotur� Date Scheduled �D Time Fee Pd. `/(/ (v Soil Suitability Assessment for Sewa a Disposalg Performed By: VtG�IRC.( ��1yl 2v�K�1, E Z�, C S E Witnessed By: ' f :..::.:. 11 L::..:... ......r....� ..Y(I ........... ,. ....... ......:r. fT..1.f�.� .T�...7.1�y.T.. f1.1i::....: .. :.,..,i��nis,:u:'.:.:'� .. ..:'ri' � I:.:�._ .,..rll:.l._......:...,..r,...r,�7.^.^..:.II,.,,:..,,::u:rA��:..:,rr....,,.:ru....^'i'^"^:...:r��:,r,r,:.r,.,..:;:.?!�: ...::a:•::;(;r Location Address 1, ��[�e /^ (� �'y�m J Owner's Name I/yL�L M 1 1 Cal Ilu /11�vr.�7 Address t 7(, GJri�Z �a� / A� Assessor's Map/Parcel: 10 4 3/bsfo Engineer's Name �J';G� / P✓i)S NEW CONSTRUCTION REPAIR ✓ Telephone# 3,br K(A,Y0 Cab Land Use S,45ie- Carnt(y /d es+J¢M' ,J Slopes(°/a) 1- 2- Surface Stones — Distances from: Open Water Body — ft Possible Wet Area — ft Drinking Water Well — ft Drainage Way ft Property Line >(O ft Other — ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) Parent material(geologic) dU�wrai�/t Depth to Bedrock 7 (3 0 Depth to Groundwater:. Standing Water in Hole: `� 3 6 Weeping from Pit Face 7!3 0 Estimated Seasonal High Groundwater 7 /200 .. ............................._.._............._......._...._...:........ ........_.......:.:.._�......,...............:.................r:^:::�::..:::r::r-n:::�:,,:•::,::.::�::::.::::.:...:::r::r.:r.:::::.:::n.,r, — — !"I!;i!I::ii !il!li':11 I�:F.f — .......:.:....L..::i..�.....i...i....::4:I:,:......;vy.:.i....,.....,i...�,r.....r..y;r..�:.:.i......... .. ... .. :1 ... ...v..........._......:...u: :: u:: .. ..... ...... .... ... ........... ....... v�Hy� ,�1 :...::.:...:.. ,. :Ll� � :�ii.. ���:J ��:���::��.�'� Y:l ;!! � �i:l..: :.._1......�.1.......: ........_..._...........u...................__._......:..._,...c Method Used: a�E�.( b(o52rvAtt6v. Depth Observed standing in obs.hole: "(30 in. Depth to soil mottles: y 3() in. Depth to weeping from side of obs.hole: -, 13 0 in. Groundwater Adjustment ft. Index Well# r Reading Date: Index Well level Adj.factor Adj.Groundwater Level= ........... ...... .....:....:..........................................................................................:.:.........:..:....::.::::::::,::::�::..;..,...,::::c:.:::::::�::::::::::::�::::.::::�:::::::::::::::::::.:�..-::.:::�... :,:::::::::.:::::.::::r::i:.!..::;.i:':i:.'.::I�':I::.ii:i:i!iri�iie�_;ii;i�:i:ic:':!!!:!::i�:!v:•!;:!::::ri::!!::ii::;!.:ii{:e'::i:°:!�::::_ ............................._..........................................:.:.:.... r.......,....,,. Observation Hole# Time at 9" Depth of Perc y Time at 6" Start Pre-soak Time @ o%/0 A Time(9%6") ' End Pre-soak Rate Min./Inch e- Z- - Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division _ Observation Hole Data To Be Completed on Back----=----- Q:HF,ALTH/WP/PERCFORM • t mum Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency ° Gravel) 1/6 36 -lad G Cs 2: 5Y6%6 /dose, .LAG............ ........H.ol�..#.:..... .:........:::::::.:... ..::.....:. :...: Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Fill 22,-1Y A L5 j0`i( ''// 2 y'3W L S j O Yt -Y6 �'6-13d L C S •2, 5 /doS-e— :: :• t:: ............: .................. ()L .. �. ::.::.:.:.:::::::::. . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. �onsistcncy.o Gravel) - Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ° r e Flood Insurance Rate Mai;. 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? Y f 5 If not,what is the depth of naturally occurring pervious material? Certification 1 certify that on )�-21-C/9 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experiene scribed in 310 CMR 15.017. Signature c Date 3/a-d 9 L O ION SEWAGE PERMIT NO. .VILLAGE INSY � LE 'S N E i ADDRESS 2 0 OWNER DATE PERMIT ISSUED, 2 .� 4 DATE COMPLIANCE ISSUED _ � �. -__---=----c .r.r �, .,, �' .,� � �-� ��, - � `� r. '� i �a�"' f `l s� �. i�,. . �; ��&/ 1 - TOWN OF BARNSTABLE 1:06.ION 11(0 SEWAGE # t '✓ILI<AGE I3S ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY l LEACHING FACILITY: ( pe) "chm p (size) I non NO.OF BEDROOMS BUILDER OR OWNER b U G it C. -MS 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 <a R. r J TOWN OF BARNSTABLE LOCATION I7(o LJa (2 3 SEWAGE# -001-0570 VILLAGE 1r�e �, �t S ASSESSOR'S MAP&PARCEL '/3 INSTALLER'S NAME&PHONE NO. ( 'an,wtd( PA V2,�1' S/U 2 SEPTIC TANK CAPACITY /ODb /7 /6 LEACHING FACILITY:(type) Ito) ffiC�� l�cu >.(�G (size) N4 !j 0 NO,OF BEDROOMS OWNER _ --1' afC PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility No // feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and L aching Facility(if any wetlands exist within 300 feet of leaching facility). l feet FURNISHED BY -f U C.. / /s, �3 o R� 34-1 3-x>,o 8(o�0 THE COMMONWEALTH OF MASSACHUSETTS BOARD 0 I-IEALTH ------ .---.....OF.......... .....1 .......................................................... Appliration for Diipusaal Works Tnnstrnrfinaa runfit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: t � .... �.t�� ...?P..... / ,s.... ........................A/6Ar - --•--•-----------------•------•------••----•-- '�Imo' �----- Loca'/ -�A,d/d�re/ss_ _ �/� �e%•a%lM- !- o No.. _ � Owner Address a •---••-•----. /7Z�... �!( &.4.................................. ....�-� !i/-....R .' . �s_.. 9{..... Installer Address Type of Building Size Lot.......... ................Sq. f t U Dwelling—No. of Bedrooms......1.................................Expansion Attic (i.-) Garbage Grinder ) 44 Other—Type of Building No. of persons............................ Showers ( ) � Cafeteria ( ) a Other fixtures --------------• -••-----------• . W Design Flow............. _//0..........gallons per person per day. Total daily flow......._23C.......................gallons. WSeptic Tank—Liquid capacity/#V#..gallons Length-------_------- Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length......... Total leaching area....................sq. ft. Seepage Pit No.................... Diameter....t.> . Depth below inlet... ........ Total leaching area..,2.f./...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ��) Percolation Test Results Performed by....:................ _:.!7p-._ ./h ....� Date_._ ._a...___'7.7�.... aTest Pit No. 1_. ....minutes per inch Depth of Test Pi .................... Depth to ground water........................ Test Pit No. 2----- i utes perinch epth of Test Pit.................... Depth to ground water........................ o Description of Soil_________ ____ U W ------------------------------------------------•---------------•----•------------------•-•---...--•--------------------------------•-•-------•---•------•-•----•-••----•------------------•.._...-••--- UNature 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 iITi 1E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is d the boar f health. Sign .. ... ............................... ... _�7'� 1 Da Application Approved By-•-••--- r- •. . ..... ... .. ..�- ••• .. Date Application Disapproved for the following reasons-----------------------------•------------...-----------•-..................................................... ......................................................-•--•--•--••----•-••--••-•-------••-••••._.....•--•--•-•-----..........•--•---•--•-•----••-• -•-•--•--•----•---...-•----............---•---- Permit No........................................................ Issued....I� %2 ....................... ' 7. A NFim............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD Qf HEALTH OF.......... .......... ............................. ............................................................................... Appliration for Bispasal Works Tonstrudion 1hrmit Application is hereby made-for a Permit to Construct or Repair an Individual Sewage Disposal System at: .................................................... ...E.14 .... ......................... L -Add es No. . ....W; ...5 low, .... W . ...... .......................... ..........7-------------------- ---- -------------------- Owner Address;; -------------------------- s~, )VAs 40"s ........ .... ................ Installer .......Address ........"---------------------------- Type of Building Size Lot.............................Sq. fi4et Dwelling—No. of Bedrooms......1%.................................Expansion Attic (4e) Garbage Grinder-00 04 Other—,Type of Building PP.404/ No. of persons............................ Showers Cafeteria 114 ''Other fixtures .............................................................. el "*---------*--------------------------------------------- ------------*------------ W Design Flow............. ...........gallons per person per day. Total daily flow.......10001 .......................0 Ions: 1:4 Septic Tank—Liquid capa.cityo.#O..gallons Length................ Width................ Diameter-___--_--_______I Depth................ Disposal Trench— o. .................... Width Total Length.......... ......__ Total leaching area.......... ...sq. f t. 1: ON W/--------- Seepage Pit No--------------------- Diameter.... .. Depth below inlet.:.. . ...... Total leaching area._4.?�.......sq. ft. Z Other Distribution box Dosing'tank.( ................ Percolation Test Results Performed by:-__ V ...... Date___7-0 Test Pit No. I--I __._minutes per inch ..Depth of Test Depth to ground water_.___.._..........._.__. Test Pit No. 2................MI. utes e nch"][ epth of Test Pit.................... Depth to ground water......................... .................................... ------------------- ....................................... - __-__-_ 0 Description of Soil........ ---- --------- U 41- ... 4.......... ...... 0 A--- U .......m............................... .................................. ............................................................................................................................................................. U Nature of Repairs or Afterations—Answer when applicable---------------------- .......................................................................... . ..................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T LL4 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has; been/is the board'of health. Av, ............ .. ... . ......... Jg.n ___ .... ---- ............ i 9 Date • Application Approved By........�, a4j .... . . ...... . ..... ......d. ................... Date Application Disapproved for the following reasons:.............................................. ................................. p ...................... .........................................................................................................................................Z..................................... ...................... -Date PermitNo........................................................ IssuecL....................................................... Date THE COMMONWEALTH:,OF11MASSACHUSETTS L BOARD HEALTH ............ ........................ ..........) . .. ......OF....... ...... Tatifira of Tontpliatta 1 0 1 hat the Individual Sewage Disposal System constructed A�®rRepaired Ljh� of by......... .... .... ............ ............-------------------......... ...... ........................................................... tallA at......... . ..... . ...... ........ Y. j L........... A...:.k) ........................ has h6n installed in accordance wit the provisions of n the 5 of The State Sanitary Coe as describe application for Disposal Works,Construction Permit No. . .. ....I.40_4411*lqo......... dated-------4-'. �1.......... THE ItSbAkE OF THIS CERTIFICATE SHALL.HOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................................................................I.............. Inspector................................................................................... t THE COMMONWEALTH OF MASSACHUSETTS 4 , BOARD 06 HEALTH ............ OF.......... X. ........................................... No..................... FEM....................... pt isposal 3X k V n rmit .. .......... Permission is hereby granted...""'_... . ...i!...... .................................................................................. a, !�� - . V. 4(Z to, Construct or pair an Ind I i i *,age bis 0 S :!!t. ....... ...die........4--- at WWe"4. V,0 - - - _4... ;t:rAeet as shown on the application for Disposal Works C6nstruction P t No D ted.... ...... ... .. ... ... ...... ...................... Board of Health �j/'ZDATE_-M...... ........... ............... FORM 1255 HOSES & WARREN, INC., PUBLISHERS t _ IG -rA�4 150 dQS n a 'J vA n i(T � al 43 G 4 TE57' l-InLL: Top �'•ts� La,o.n /COG -S�ds'b i� /cr�o �M✓ r ��,;.rw. 9S TS 9b.o GA4 j i u j�,tc N J11- /C p �G TsT Per LA JCS I A/! - CEZI- V--Iaf-3 PLO-" 1=>i_ Lo%_AT1ot-J 44TO /4'L.6S 1 CGRTt�Y T"AT- T14F-- v✓t`A Tt-Lr= 'S1a� mot►-�� ,�- I A1.t� '�ETf3ticIL i.'[4utczE��cuT-4 ar- TNi-._- rlrk-r1:-. c2c.GtSn�-+Z�n t._n.uc� au2���-�o�s p57( Qv1l_ /4r�S��- 1t•1�'(;-'t �.�.t .tJi" �?�� v:'-�f T��L c�Fc ,�-rS �i�Jcw►t� APPL.I <_l�.F-�lr_ t. ► ,c' �;��c� rc> l t :t { .C/�1ta.It", l.vT L ►�!�S -' - ,' s DATE 10/21105 PROPERTY ADDRESS 176 Glakegy Road Naastoaz Niiez (razz 02648 On the above date, the septic system at the address above was Inspected. This system consists of the following: 1.. 1-1000gaUon tank 2., 1-Dizta.igut.ion Box 3, 1- 1000ga2ion eeach.ing p it., Based on inspection, I certify the following conditions: 4. 7h.i,6 .i.6 a 7.it ee T.ive Septic. zyztem (78Code) 5.- Septic zystem .iz .in paopea woak.ing oadea at .the paezent time., SIGNATURE9 - Name: Robert A. Paolini Company: Joseph P. Macomber & Son Inc Address: P. O. Box 66 Centerville, Mass 02632 f d 1 Phone: 508-775-3338 or 508-775-6412 c -..r Co OWN p c�, JOSEPH P. MACOMBER & SON, INC. ^a Tanks-Cesspools-Leachfields Pumped &..Installed Town Sewer Connections P.O. Box 66 Centerville, MA 026.32-0066 775-3338 775-6412 • COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM,.NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PARTA CERTIFICATION Property Address:176 ldake&y Road aaz onz 1qi.E.Ez Owner's Name: 132 y a n .6 Owner's Address: .. .3 a m e_ Date of Inspection: 10121105 Name of Inspector; (please print) - Ro .ut :A Pao1ini Company Name: �, l.11 c. om9palt X .S:o.n Inc. Mailing Address: en eavi e, 4,3.6..02632 Telephone Number: 5 0 8-7 7 5-3 3 3 8 CERTIFICATION STATEMENT I certify that I have personally inspected the.sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in:the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to-Section.15:340 of Title 5(310 CMR M000). The system: XXXPasses Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fail Inspector's Signature: Dater The system inspector shall submit a copy of this inspection report-to the.Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner.shall submit the report to the appropriate regional office of the DEP.The original should be sent to-the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments "" a ort only describes conditions at the time of ins ection and under the conditions of use at that This r y P P time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 I Page 2 of I 1 OFFICIAL INSPECTION;FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORK PART A CERTIFICATION(continued) Property Address:17 6 ld a k e.e y Road Owner:D/t an Chiid s Date of Inspection: Inspection Summary: Check A;B,C,D or E/ALWAY85complete;all of Section.D A. System Passes: qES NO I have not found any information which indicates#hat 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: Septic zystem ib in. paope2 wo2king oadea at the /2aezea-t .time.- B. System Conditionally Passes: _O 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 leaith,will pass. Answer yes,no or not.determined(Y,N,ND)in the for the following statements.If"not determined"please explain. NO The septic tank is metal and.over 20 years old*or the.septic:tank(whether metal ornot)is?structurally unsound,exhibits substantial,infiltration or exfiltration or tank failure is:imminent. System will pass inspection if the existing tank is replaced with a complying septic tank;as approved by.the.Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: NO. 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 pipes)are replaced obstruction is removed distribution box i$leveled or replaced ' ND explain: NO The system requited pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY SS FORM. TS SUBSURFACE SEWAGE DISPOSAL SYSTEM PART A CERTI.FICATION(Continued) Property Address: 17 6 ldc� l�a2—a- t onh (7 Owner:. B2yan Ch iid s Date of Inspection: C. Further Evaluation is Required by the Board of Health: NO Conditions,exist whichrequire further evaluation by the Boar&of Health:in_order to determine if the system is failing to protect public health,.safety or the environment. ( )( ) 1. System will pass unless Board of Health determines.in accordance with 310 CMR 15.303 I b that the system . not functioning in.a manner which will protect public health,safety and the environment: no Cesspool or privy is within 50 feet of a surface water n o 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 an determines that the system is functioning in a manner that protects the public health,safety and.environment: �. n o 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. 'c tank and SAS and the:SAS is within a Zone 1 of a public water•supply. stem has a septic n o The system- P n o The system has a septic tank and.SA&and the SAS is within 50 feet of a private water supply well. no 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 v.ihu¢.2 performed at a DEP certified laboratory,for coliform water analysis,p **This system passes if the well1 is free from pollution from that facility and indicates that the well bacteria and volatile organic compounds5_ m provided that no other the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than pp ,p failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: 3 I Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR:VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION_FORM PART A CERTIFICATION(continued) Property Address:17 6 Qa k e g a2.stoni iez Owner:B2 an Ch-iidz Date of Inspection: 10121105 D. System Failure Criteria applicable to all systems:. You must indicate"yes"or"no to each of the.following-for all inspections: . Yes No _ Backup of sewage.into facility or:system component due to overl:oaded.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 _ X Static liquid level in the distribution box.above outlet invert due to an overloaded or clogged SAS or cesspool _ X Liquid depth in-cesspool is less than 6"below invert or available volume is less than 1/zday flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of the SAS,cesspool or privy is below high ground water elevation. _ X Any portion of cesspool or privy is within 100 feet of a surface water supply.or tributary to a surface water supply. X Any portion.of a cesspool-or privy is within a;Zone.i.,of a.public well. _ X Any portion of a cesspool or privy is within.50 feet of a private water supply well. �• _ X Any portion of a cesspool or-privy is less than 100 feet but greater than 50 feet from a private water , supply well with no acceptable water quality analysis.[This system passes.if the well water.analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates.that the well is free from pollution,from that facility and.the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5.ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached.to this forT.] N0 (Yes/No)The system fails.I have determined that,one or mord?pfthe above.failurc,criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner.should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve.a:facility with a design flow of 1.0100.0 gpd to 15,000. gpd• You must indicate either"yes"or`to"to,each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ X the system is within 400 feet of a surface drinking water supply X the system is within 206 feet of a tributary to a surface drinking water supply _ X the system is located in a nitrogen sensitive area @nterim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section,E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.504.The system owner should contact the appropriate regional.office of the Department. 4 Page 5of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAT,�SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 17 6 V¢k e& i2 o a d Q2b onz i b Owner�32y¢rz C 7..-d 6 Date of Inspection: 10121105 Check if the following have been done.You must indicate'yes"or"no"as to each.of the following: Yes No X Pumping information was provided by the owner,occupant,'or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of thus inspection? N1 R Were as built plans of the system obtained and exarnined7(If they were not available tote as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ 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? X _ 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: Yes no X Existing information.For example,a plan at.�he Board of.Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)J S Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISP,OSAL:-SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:176 ldake&u Road Owner: B zuan Ch.i edz Date of Inspection: 10121105 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): .4 DESIGN flow based on 310 CMA 15.203(for example: 110 gpd x#of bedrooms): 4 4 0 Number of current residents: 2 Does residence have a garbage grinder(yes or no): rz o Is laundry on a separate sewage system.(yes or no):n_o [if yes separate inspe..ction.required] Laundry system inspected(yes or no): a o Seasonal use?(yes or no): no . 200.3=60, 000ga eons GP D=164.� 38 Water meter readings,if available(last 2 years usage(gpd)).2 0 0 4 5 6, 0 0 0 ga i 2 o n.6 G D=15 3.4 2 Sump pump(yes or no): rz o Last date of occupancy: /2 2 e-6 e n i COMMERCIAL/I -bUSTRIAL NCR Type of estabohm nt: Design flow(b. on 310 CMR 15.203): gpd Basis of design-'flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system-(yes or no):_ Water.meter readings,if available: Last date of occupancy/use: . OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: N1R Was system pumped as part of the inspection(yes or no): n o If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X 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 ob_tained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 20 f yea2� Were sewage odors detected when arriving at the site(yes or no): n o 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR-VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:1 76 NakePly Road Naastonz Owner:13ayan Chi edz Date of Inspection: 10121105 BUILDING SEWER(locate on site plan) Depth below grade: y Materials of construction:_cast iron X 40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): ao.intz a/2/2ea2 light.- No eeakage., Vented thzough hou.6e vent. SEPTIC TANK:V e-3(locate on site plan) 10 0 0 ga te o n Depth below grade: 18" Material of construction: X concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ 'Is age confirmed by a Certificate of Compliance(yes or no):_.(attach.a copy of certificate) Dimensions: 8 6"X 5 ' 8"X 4 ' 10 Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: 10" Scum thickness: Z" Distance from top of scum to top of outlet tee or baffle: 5' Distance from bottom of scum to bottom of outlet tee or baffle: 5' 4" How were dimensions determined: m e a 3 uIL ed Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of.leakage,etc.): P um/? tank eveay 2yea2z.- In-get 9 outiet teen a¢e .in peace. iank ch 2uc u2a�2y pound Liquid .eeve ez ate no zma e., GREASE TRAP:n 0(locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Gaeaze taa/2 .is not 1211o.3anI -- f Page 8 of l 1 OFFICIAL.INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM.INFORMATION(continued) Property Address:17 6 Oa k e&y Road Na2z.t on 6 Mi P_.P_.s owner: l32yan Ch-iP-d-6 Date of Inspection: 10121105 TIGHT or HOLDING TANK: NO (tank must be pumped at time of inspection)(locate on.site.plan) Depth below grade: Material of construction: concrete metal fiberglass _ .:polyethylene other(explairi): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes.or no). Alarm level: Alarm in working order(yes.or no): Date of last pumping: Cwwn%nts(condition of Alarm and float switches,etc.): cg t oz f/ro.Pding .tankzs aze not /22eZen•t,! DISTRIBUTION BOX:Y e-3 (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,.any evidence of solids carry.over,any evidence of leakage into or out of box,etc.): Box i.6 eeve e.- Kays. 2 2a•te za.Pz.! No ieaka_ge oa zo eid caa¢u ove z.- PUMP CHAMBER: n o (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition.of pump chamber,condition of pumps and appurtenances,etc.): PumI2 ehamgez i. not P¢eaent 8 Page 9 of 11 OFFICIAL INSPECTION FORM—'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:176 blakegu Road Naazt onz /'].ice Owner:.132yan L77 d= Date of Inspection: 10121105 SOIL ABSORPTION SYSTEM(SAS):_{locate on site plan,excavation not required) If SAS not located explain why: Located zee- page 10. Type• leaching pits,number: X leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/altemative'system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,-condition of vegetation, etc.): Loamy to medium zando No z.inga 0, 7-04ol2uae.• So.iiz aae day. eg . a .ton .tz noama . CESSPOOLS: no (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration:' Depth—top of liquid to inlet invert: s Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes nr no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): ce,6.3/20016 aae not RaeZent PRIVY:no (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.): Pa-ivy P/L-ivy is not paezent 9 Page 9 of 11 OFFICIAL INSPECTION FORM—'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address-'I 76 V a k e e, Raazs _ones Owner:.Bayan c d Date of Inspection: 10121105 SOIL ABSORPTION SYSTEM(SAS):_{locate{locate on site plan,excavation not required) If SAS not located explain why: Located zee Page 10., T_ype X leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): -� Loamy to medium zand.� No zingz o� So.ies aae day. Vegetation .cz noam¢ . CESSPOOLS: no (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 br no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): ce.3.e/2ooiz aae not /2ae6ent 7. PRIVY:n o (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.): PltjVy i.e not ae,5eat 9 f Page 10 of 11 OfFCCIAL_INSPECTION FORM-NOT FOR VOLUNTARY:ASSESSMENTS SUB A.CE`SEWAGE DISP.OSA:L SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION(continued)' Property Address: 176 Gl a k e y /2 o a cl Owner: Bayan .c -6 Date of Inspection:.10/2.1/0 5 SKETCH OF SEWAGE.DISPOSAL SYSTEM Provi a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100.feet.Locate where public water supply enters the building. a i 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY FORM ASSESSMENTS - `. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION PART.0 SYSTEM INFORMATION(continued) Property Address: Naaztons lit 3 _ Owner: Ba yan e h Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water � feet Please indicate(check)all methods used to determine the high ground water elevation: ign plans on record-If checked,date of design plan reviewed: N 0 Obtained from system des u e.s Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board afHealth-explain:a.i Rum Of rnnr/ no . Checked with local excavators,installers-(attach documentation) Accessed USGS database explain t oWn.'�aan�ta�fie. ma. u.s �—. You must describe how you established the high ground water elevation: Cl.sed. : Ca e Cod Commi�s�on 1datea 7agie Co itoua� ,4nd �u�2ic IJatea Su�/s�y ldd aotect�on aaea.L ma Se t 999 ej,e hea Uatea ae•souace•s 0.44ice ca e cod eomm.i�ion. Leaching Pit �. I I"eet Groundwatereet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore,the vertical separation distance between the bottom 3'y of the leaching pit and the adjusted groundwater table is feet. 11 •rmnr+r,—rs,•r•�--T.,,.ra...n,esr.s-++.+serarr.ar.:•,.T+,very'.,,r.•w•rm,:.rr,-a..•a•rrrrs+smen •. .r+r,.z--r-.,,•ne-- >sr.r—••F TOWN OF 1341RIi.S7Ai3I F BOARD- OF JIEALTII SUIISUItFACF SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTtFICATION ••Zt'S-T'.-t:T�T.l I�^l..TTe T>•RII'TT.'1Tf T7R'.RS7fr1�.'•7T1 rYrnrre�.am�Tv*rnever mertn _ .:Tv-rr•r.--er•—•.� -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 176 Nakegy Road ASSESSORS MAP, BLOCK AND PARCEL # 043-056 OWNER' S NAME Bayan Ch.iidrs ire mRver.JseierePm'Yfi. ^�'�� T . PART D - CERTIFICATION NAME OF INSPECTOR Rogeat l aoiin.i COMPANY NAME aoseph ! flacomgez•�&` Son Inc COMPANY ADDRESS i3ox 66 Cgnte2v4_We Na z 02632 Street Town or City State LIP COMPANY TELEPHONE ( 508 ). 7:75 3338 FAX ( 508 .)790 -- 1578 R T.S7 C7T1,•9lL11CRSTei7 CERTIFICATION STATEMENT I certify that I have personally. .inspected the sewage disposal system at this address and that the information reported is true , accurate, and omplete as of the time of •inspection . The inspection was performed and any recommendations regarding upgrade , . maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . r Check one: XXX System PASSED j The inspection which I have conducted has not found any information which indicates that. the system fails to adequately protect public health or the environment as defined in 310 CMR. 15 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this. form. System FAILED* The inspection which I have con t;reted has found that the system fails to Protect the ilublic health and the environment in accordance with Title 5 , 310 CMR 15 . 30.3, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form N. Inspector Signature Date One copy of this certification must be provided to the OWNER, the. BUYER where applicable ) and the BOARD OF HEALTII, * If the inspection FAILED., the owner or operator shall upgra►de ' the system. within o'ne year of the date of the inspection, unless allowed or requi,re:d otherwise as provided in 3JO CMR 15 . 305 , ___�-2 � .. t� t JUL 6 1995 DATE:_ 6/30/95 y� CC-- -- — MW 176 Wakeby Road PROPERTY ADDRESS:________ ________ 1 j 9 5 ©t�3 Marstons Mills, ------------------------- Mass . 02648 On the above date, I Inspected the septic system at the above address. This system consists of the following: 1 -1000 gallon septic tank. 2 . 1 -distribution box. 3 1 -1000 gallon leach pit packed in stone,: I Based on my Inspection, I certify the following conditions: 1 . This is a title five septic. ( 78 Code ) 2. The system is in proper working orddti at the present time. RECCOMENDATIONS 1 . Covers raised on the tank & pit. 2. Tank should be pumped. 3 ._4clditional leaching pit. j 4-bedrooms 78 code ) SIGNATURE: _ N a m e: J`P.Macomber Jr,_______ i i Company:_J_P_Macomber &_Son Inc j Address: Box 66 Centerville,Mass , 02632 Phone:_508_775_3338 --------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tan ks-Cesspools-LeachfIolds Pumped & Installed Town Sewer Connectlons P.O. Box 66 Centerville, MA 02632-0066 775.3338 775-6412 i 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION •FORM Address of property 176 Wakeby Road Marstons Mills owner's name Beth Morrill Date of Inspection 6/29/95 PART A CHECKLIST Check if the following have been done: Yes Pumping information was requested of the owner, occupant, and Board of Health. No None of the system components have been pumped for at least two weeks 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. House empty YPR As built plans have been obtained and examined. Note if they are not available with N/A. Yes The facility or dwelling was inspected for signs of sewage back-up. YeR The site was inspected for signs of breakout. Yes All system components, excluding the SAS, have been located on the site. Yes 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. Yes The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. Yes The facility owner (and occupants, if di.fferent from owner) were provided with information on the proper maintenance ,.of SSDS., 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential 4 number of bedrooms 0 number of current residents o garbage grinder, yes or no' , Yps laundry connected to system, yes or no NO seasonal use, 'yes or no If nonresidential, calculated flow: 1993 66, 000 gallons GPD=180.82 1994 68, 000 .gallons=GPD-186. 30 Water meter readings, if available: Residential auk Last date of occupancy GENERAL INFORMATION Pumping records and source of information: Pumped septic tank 6/30/95 NO System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Type of system XXX Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy NO Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components. Date installed, if known.. S.ource of information: 1979 Source Board Of Health Town Of Barnstable NO Sewage odors detected when arriving at the site, yes or no I ' f 9 . SUBSURFACE SEWAGE DISPOSAL 8YsI"FM INSPECTION FORM PART B SYSTEM INFORMATI:�: �,tinued SEPTIC TANK: Yes =1000 (locate on site plan) depth below grade: 20" material of construction: XXX concrete .rr-tal FRP other(explain) dimensions: L-8 ' 6" W-4110" H-517" 1.0" sludge depth 24" distance from top of sludge to bottom of outlet tee or baffle 16" scum thickness Over distance from top of scum to top of a'. :' et tee or baffle below distance from bottom of scum to bott^r:: .,f outlet tee or baffle Comments: (recommendation for pumping, condition of i 2t and outlet tees or baffles, depth of liquid level in relation to out-a-,;., 'avert, structural integrity, evidence of leakage, recommendations for : irs, etc. ) tooutletInver ut.la ons—Qx Liquid level Tan s struc Ural y sound. -No'signs of leakage; Covers on tank should a raised. 2-collars DISTRIBUTION BOX: YES (locate on site plan) NONE depth of liquid level above .t invert Comments: .(note if level and distribution is equal , ' :'ence of solids carryover, evidence of leakage into or out of box, --:!ndation for repairs, etc. ) No evidence of solids carry over. No evidence of leakage, no'. repairs' needed on distribution box. PUMP CHAMBER: NONE (locate on site plan) pumps in working order, yes or r- Comments: (note condition of pump chamber, condit .,. pumps and appurtenances, • recommendations for maintenance or repai _. . ) 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : Yes _ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits and number 1 -1000 gallon leach pit leaching chambers and number packed in stone. leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool , number Comments: (note condition of soil , signs of hydraulic failure, level of ponding condition of vegetation, recommendations for maintenance or repairs,etc. ) No signs of hydraulic failure No Ponding,vegetation fine Cover should be raised. 4-risers CESSPOOLS (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) PRIVY: (locate on site plan) materials of construction dimensions depth of solids Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) . • 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION •FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L=SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' Town Water 77 lG � L \� ±176 Wakeby Road Marstons MI11s,Mass. DEPTH TO GROUNDWATER 25+ depth to groundwater method of determination or approximation: 'See Attached plan. Plan Book 309 , Paae 75 Baxter & Nye Inc. No Water at 84 .9" THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA t _ _! :.�. '• ,fA , • � , • :� �1! `•'1.,�a1�i7�,.T�n f A.%"{ �,• �r �{ ° � r. 3 • `' a ax , �., ' `?•�h;•{yiS�V r•.�T��� ! � •�� ,���"1y� �j��y � 1 } � � ` 4! r � 7 { + � � ,"•r �i t� �. t' y,,F'• �•"l•,� 7,'r, d� I MMILOW • a��. o ,si ��t. , i r�%R�•4frfl�,y.,.•�:1. ? ��• ;iy.'��'�,�.t rsA���yC�j'�'�'.t '3 �.�:r ' "WA �J a # WE faK y.• ''g �t , !y �'A � fir"N,r?7 r�-, J'�'Var IV' • ..>� $•'' °. PN' a y� y...��"i.1�� rrr�r�1Te �/•� 4 �t1 1 ���J !,.;:.:i1`�: �'l ks r `t'y�•'!!{�1r�,rY"�k,�'v'i'�`i v" 1� ry'� r �jr t• � i i 1 *{� ,:/` 1' •*'��tgy:�tS#�IYir 1�� �.r��•f„�,l011,�y+ryQ",�4a•,. � �"� � 1 s �'ri:"'r�Pi ♦ y,F` ,, Y `r 'r(�• it '� •� � i31'is ? 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NO Discharge or ponding of effluent to the surface. of the ground or surface waters? NO Static liquid level in the distribution box above outlet invert? YES Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? NO Required pumping 4 times or more in the last year? number of times pumped - No Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? ) Is any portion of the SAS, cesspool or privy: NO below the high groundwater elevation? No within 50 feet of a surface water? No within 100 feet of a surface water supply or tributary to a surface water supply? NO within a Zone I of a public well? NO within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS) ? Nn within 50 feet of a private water supply well? .No 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 anal, . for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION fu' -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDVf§S 176 Wakeby Road Mafstons Mills ASSESSORS MAP, BLOCK AND PARCEL # 43-56 OWNER' s NAME Beth Morrill - `--v PART D - CERTIFICATION NAME OF INSPECTOR J.P.Macomber Jr. COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Street Town or City State ZIP COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one: XXXX System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conducted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature . Date One copy of this certification must be provided to the OWNER, the BUYER (where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd.doc I Water =. Conservation SAVE Tips ME! CHECK FOR LEAKS : Water Loss in Gallons Due to Leaks Leak this Loss Per Day Loss Per Month Size • 120 3,600 ' 300 10,800 • 693 20,790 • 1,200 36,000 • 1,920 57,600 e 3,096 92,880 .0 4,296 128,980 ® 6,640 199,200. 6,984 200,520 8,424 252,720 9,888 296,640 11,324 339,720 12,720 381,600 14,952 448,560 Ccmmcnweaffn ct Masscc^userts Executive Office of Environmental Affc:rs Department of Environmental Protection Water Pollution Control Tecnnical Asslsrance and Training Sections W UM F.Weld Gormor Trudy Cox@ S•mmy,EOEA Thomas&Powers Az"C«mr•r«w 06/12/95 ATTN: Joseph P. Macomber, Jr. Joseph Macomber and Son PO Box 66 Centerville, MA 02632- Dear Joseph P. Macomber, Jr. , I am pleased to inform you that you have attended training, met the experience qualifications, and have passed the Title 5 System Inspector exam, pursuant to 310 CMR 15.340. The passing grade for the exam was 39/52 or 75%. Your grade was 81%. This is an official notification that you are a Certified Department of Environmental Protection System Inspector pursuant to 310 CMR 15.340 . You will receive a System Inspector certificate at a later date. If you have any futher questions, please write to me at the following address: Kimball Simpson D.E.P. Training Center 50 Route 20 Millbury, MA 01527 Thank you very much for your time and consideration in this matter. Sincerely, Kimball T. Simpson, DEP Training Center Director (2 4 0 5) Route 20 9 Millbury, MA 015V • FAX 508-755-9253 • Telephone 508-756-7281 PROVIDE PRECAST CONCRETE GENERAL NOTES fT.O.F. EL.= 88.6' ±' EXTENSION RISER WITH CONCRETE INISH GRADE OVER D-BOX= 88.6'± 4"SCHEDULE 40 PVC MIN. SLOPE 1 % ' _ ' COVER TO WITHIN 6"OF F.G. OVER FINISHED GRADE OVER DIFFUSERS= $$,7 $$,rj INLET AND OUTLET COVERS. REMOVABLE COVER OVER RISER TO SLOPE @ 2% MIN. 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE WITHIN 6"OF FINISHED GRADE INSPECTION PORT WITH ACCESS BOX TO METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL WITHIN 6"OF F.G. (ONE PER TRENCH) CODE AND ANY APPLICABLE LOCAL RULES. @ END. EL.= VARIES FINISHED GRADE OVER TANK EL. _ $$,j ± 5"DIA. OUTLET(S) 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 36 EXISTING 4" PROPOSED 4" 3 "M 9IN. 9" 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE _ -y PVC SEWER PIPE I "MIN.MAX. TOP OF SAS B.O. $5.73 SYSTEM UNLESS OTHERWISE NOTED. .- - - / _ --� 6� 3^ 3" DROP MAX 3^ 9^ PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN - 2" DROP MIN MIN.SLOPE @ 1% JOINTS (TYP.) ELEVATION =85.73' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 10" 4" PVC IN FROM 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" ��` �i "+ SEPTIC TANK 4" PVC OUT TO 1.33' nl" " THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 8,._ � ._. O 6 TYP LEACHING FACILITY p90, (NP') 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. CONTRACTOR CONTRACTOR SHALL 12" I 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 85.60 MIN. 85.43' 85.30'1 84.40 (LAID FLAT) 2.875'(34.5")--I----5.75'� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES 22"ZABEL FILTER - (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE ASS 6 CRUSHED STONE MODEL#A1801-4x22 � � OVER MECHANICALLY (TYP ) 1150' NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH . TANK NECESSARY COMPACTED BASE 5'MIN. . AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 40.0'(TYP FOR BOTH TRENCHES) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 91.00' ESTABLISHED - - TO BE INSTALLED ON A LEVEL STABLE ON A NAIL SET IN A TREE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 77.87' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW BIODIFFUSER (PROFILE) BIODIFFUSER (END VIEW) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES SEPTIC TANK PROFILE 16 - ARC 36HC #3616BD BIODIFFUSERS TO THE DESIGN ENGINEER. CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR DISTRIBUTION BOX DETAIL \ 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. O ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE -- - -�� - - 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING r.^ l y REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM NOTE: ENTIRE PROPERTY IS LOCATED WITHIN A DEP ` , *, �� �� TEST PIT DATA APPROPRIATE AUTHORITY. APPROVED ZONE 2 AND THE ESTUARINE WATERSHED. _ PERC NO. 12491 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS INSPECTOR: Donna Z.Miorandi, R.S. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. MAP 43 EVALUATOR: Michael Pimentel, E.I.T. ! • �.__ �.- i , l� DATE: March 6, 2009 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. PARCEL 1 TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE J ' MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. -Y_ ELEV TOP= 88.70' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, MAP 43 " 45 !1 ELEV WATER= <77.87' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). PARCEL 55 Nag°08 E t 0 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 57 38 LOCUS f PERC RATE _ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. 0 APPROXIMATE LOCATI( iv ui L_As� -ING n LEACHING PIT TO BE PUMPED AND N78°p8��"E - o °l _ DEPTH OF PERC = 36"-54" M FILL. ^ ,,,,T; ft �� r � SAND 34.4 5' \� O 16. PROPOSED PROJECT IS LOCATED WITHIN: TEXTURAL CLASS: 1 ASSESSOR'S MAP 43 PARCEL 56 O I 1 � - m L_$p_31 __- OWNER OF RECORD: MARC D. CHILDS Z :213$ !� ADDRESS: 176 WAKEBY ROAD Benchmark ; ,,, Q f 0^ 88.70 Q• � MARSTONS MILLS Nail in Tree � ) Fill SHED OD Elevation =91.00' i II / 1 � A rox. M.S.L. � � 22" 8T Loamy Sand 86. MAP 43 $ ��� 1 24„ 10Yr 3/1 86 70, FEMA FLOOD ZONE C I ) I PARCEL 56 LP \9p ~ I O Loam Sand 44 COMMUNITY PANEL# 250001 00015 C CO 00 p �: B Y 30,029 S.F. ± 9 2' 88 7 PROPOSED TOTAL 16 ARC 36HC B IODIFFUSERS 4 +`� I 85.70' TP 1 10Yr 5/6 17. DEED REFERENCE: BOOK 20420, PAGE 69 \ (8 BIODIFFUSERS EACH TRENCH) • 1, \ ,� Perc 6 18. PLAN REFERENCES: 1.) PLAN BOOK 309, PAGE 75 I I I 88 7' o x r_ 88.5 . 19O -_ ` 54" "� 84.20' 2.) PLAN BOOK 366, PAGE 42 (31 C PROPOSED INSPECTION PORT V'VITH 1 ' . "' .°� - ,. I 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. � ACCESS BOX TO GRADE (TYP OF 2) APPROXIMATE LOCATION OF EXISTING I I_ 5 - --' - ` I `' - 7"?. PROPERTY LINF INFr'RMATIO-I IS ONLY APPROXIMATE. THIS PLAN IS TO BE!'SED ONLY DISTRIBUTION BOX TO BE REMOVED - I T p = `-�; Coarse Sand FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY q y C 2.5Y 6/6 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. O 88.5 X-� _, ri /` (Loose) PROPOSED DISTRIBUTION BOX ) O KENNELOD EXISTING 1000 GALLON SEPTIC TANK TO / � - X'X�X, � �`'- MAP 43 LOCUS PLAN BE UTILIZED AS PART OF THIS DESIGN / B.H.DECK X'X� w � PARCEL 58 SCALE: 1" = 1000' 130" 77.87' #176 / No Mottling, Standing or Weeping Observed \ 4 EXISTING i DESIGN DATA TEST PIT DATA LEGEND \c96 DWELLING y 50x0 EXISTING SPOT GRADE \8, TOF - 88.6'± cn PERC NO. 12491 r NUMBER OF BEDROOMS(DESIGN) 4 INSPECTOR: Donna Z Miorandi, R.S. - - 50 - - EXISTING CONTOUR MAP 43 CP. \ PORCH / \o DESIGN FLOW 110 GAUDAY/BEDROOM EVALUATOR: Michael Pmentel, E.I.T. PARCEL 55 Zo \ \ ( TOTAL DESIGN FLOW 440 GAUDAY 50 PROPOSED SPOT GRADE _ ti '� DATE: March 6, >.009 \ \ / DESIGN FLOW X 200 % = 880 GAUDAY r, PROPOSED CONTOUR � � ---, TEST PIT#: 2 USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP = 89.20' ❑/H/W EXISTING OVERHEAD WIRES / ( - ELEV WATER= =78.37' -X-X-X-X-X- EXISTING FENCELINE PERC RATE = W W EXISTING WATER LINE BIT. DRIVE y N7B-08 4"E INSTALL 16 - ARC 36HC (#361613D) BIODIFFUSERS DEPTH OF PERC= TEST PIT LOCATION / �7� 625i SWING-TIES TEXTURAL CLASS: 1 EXISTING LEACHING PIT CO� ° 8'AA',W ' HC-1 HC-2 SYSTEM CAPACITY LP S7g 0 DESCRIPTION -_ 19 67, BIODIFFUSER CORNER�1) 53.7' 27.2' I (TOTAL L.F. OF BIODIFFUSERS)(7.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD O EXISTING 1,000 GALLON SEPTIC TANK UP#118/10 L/ "105.33. i BIODIFFUSER CORNER(2) 60.6' 38.5' I (80.0')(7.8 SF/LF)(0.74 GAUSQ.FT.)= 462.3 GAL. LEACHING/DAY 0 89.20'! Fill PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE 0 ! 84 R �3p5 BIODIFFUSER CORNER(3) 94.5' 50.6' 22" 87.37' TOTALS: A Loamy end Q PROPOSED DISTRIBUTION BOX - P 10Yr 31 BIODIFFUSER CORNER(4) 90.3' 42.6' I 24" 87.20' TOTAL NUMBER OF BIODIFFUSERS: 16 B Loamy Sind PROPOSED ARC 36HC(#3616BD)BIODIFFUSER W P YpUTI 3 TOTAL NUMBER OF COUPLINGS: 0 10Yr„6 pGE OF PAVEMENT �40'w�D ) TOTAL LEACHING AREA: 624.7 SQ.FT. 36" 86.20' - --- - - REV. DATE BY APP'D. DESCRIPTION E o TOTAL LEACHING CAPACITY: 462.3 GAL./DAY 2) PROPOSED SEPTIC SYSTEM UPGRADE 0 PREPARED FOR: 4) NOTE: CoarseSand CAPEWIDE ENTERPRISES 1) EFFECTIVE LEACHING AREA OF 7.80 SF/LF OBTAINED FROM THE C 2.5Y6/6 DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER (Loose) LOCATED AT "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO NOTE: ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003(LAST 176 WAKEBY ROAD MODIFIED JULY 23, 2008). TRANSMITTAL NUMBER=W000052. MAR,STONS MILLS, MA 1.) MAGNETIC MARKING TAPE SHALL BE PLACED B H HC-2 ---.-. - ---- DECK SCALE: 1 INCH = 20 FT. DATE: MARCH 10, 2009 ALONG THE TOP EDGE OF EACH SEPTIC SYSTEM 130- 1 78.37' 0 10 20 40 80 FEET COMPONENT. #176 No Mottling, Standing or Weeping Observed TIi OF 44 REPARED BY: 2. CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN HC-1 EXISTING - _ __ ___ __ _-_ �.��rr JOHNL. cy � ENGINEERING, INC.THE LOCATION OF THE PROPOSED LEACHING FACILITY RESERVED FOR BOARD OF HEALTH USE o cH R(,HI�L ,JC G 4-BEDROOM TO ENSURE CONSISTENCY WITH TEST PIT DATA DWELLING o f 2854 CRANBERRY HIGHWAY SHOWN ON THIS PLAN. REPORT TO ENGINEER AND TOF =88.6'± EAST WAREHAM, MA 02538 LOCAL BOARD OF HEALTH IF SOILS ARE NOT SITE PLAN PORCH 508.273.0377 CONSISTENT WITH TEST PIT DATA. SCALE: 1"=20' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.1574