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HomeMy WebLinkAbout0272 WAKEBY ROAD - Health 272 WWk by-'Road Marstons Mills A= 043 - 048 ' i i I li | � ����K����� m�a� ��� �mf����� ��� ������������� ���~��0 �� Official N Inspection �� ^1 / � � � Title � ��UQN�N�� N��������H��� ������ � K.��� ~ ~~ ���°�° wm���p���~ m��mm Form Subsurface Sewage Disposal System Form Not for Voluntary Assessmentsfit �l � 272 WakebV Road Property Addre~~ *0 Lars Jensen Owner Owner's Name information is required for every MarshonsMU� �___ MA Q2648 ougo City/Town /��e-- Z �---- -------__��' � Code Date ofInspection ' Inspection results must be submitted on this form. Inspection forms may not be altered in any � way. Please see completeness checklist at the end mf the fVnn � . � /mpoftant:When A. Inspector��^ " " ~ on the computer, use only the tab Patrick T. SuUivan key m move your Name vfmupocmr ��----'----- ------------------- cursor do not Read Rooter E d usome,em� _------------------------'--------- key. Company Name PO Box 88 4�A Company Address ---'----------------------------------'--'--- � Fnreshdale MA 02844 City/Town ------------------State Zip zipCudo 508-509'0802 S112843 Telephone Number License Number '��-------- -- ' B. Certification ---------- | certify that: | ammaDEp approved system inspector in full compliance with Section 15.34Oof Title 5 (310 CkOR 15.000); | have personally inspected the sewage disposal system at the property address |iobaU above; the information reported below istrue, aCuunaha and complete aoofthe time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance ofon'site sewage disposal systems. After conducting this inspection | have determined that the system: 1. Passes 2. Fl Conditionally Passes 3. Fl Needs Further Evaluation by the Local Approving Authority 4. F-1 Fails | Nnvember28 2018 The system inspector shall submit a copy of this inspection report to the Approving Authority (Boa rd of Health or DEP) within 30 days of completing this inspection. If the system has a design flow ofow 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to | the buyer, if applicable, and the approving authority. | Please note: This report only describes conditions at the time of inspection and under the � conditions of use at that time. This inspection does not address how the system will perform in the future under the same mr different conditions ofuse. A^ Commonwealth of Massachusetts _IP Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 272 WakebV Road Property Address Lars Jensen Owner Owner's Name information is required for every Marstons Mills MA 02648 Novenber27, 2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Sumrnary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: ------ 2) System Conditionally Passes: F-1 one or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Z) Check the box for"yes", "no" or"not determined" (Y, N,/ND) for the following statements, If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltrafion 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 1 s than 20 years old is available. FJ Y F-1 N El ND below): --------------- ............ t5insp.doc-rev.7)'26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 • i Commonwealth of Massachusetts Title 5 Official Inspection Form �— rJ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Wakeby Road Property Address Lars Jensen Owner Owner's Name - -------- — - ---- — ------- ----- information is required for every Marstons Mills -- -- -- MA — 02648 Novenber 27, 2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high,static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken';settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced /% ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will,pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further/evaluation by the Board of Health in order to determine if the system is failing to protect public/health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment.- f5insp.doc-rev.,/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts -,p Title 5 Official Inspection Form t� 1/1 r: Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Wakeby Road Property Address Lars Jensen Owner -------------------------------------------- — ------ --------------- ----- Owner's Name required for is every M_arstons Mills — — —_ required for eve —__ MA 02648 Novenber 27, 2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cessspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorp�ron system (SAS) and the SAS is within 100 feet of a surface water supply or,tributary tct a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. / ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well*`*. Method used to determine distance *" This asses system if the well water analysis,y p ,performed at a DEP certified laboratory, for fecal coliform bacteria indicates absenYand the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided t6t no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: -- ---------- - -- -- - --------- - -- --- ----- ----------------- ------- I 4) System Failure ISriteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systern•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form :) Subsurface Sewage Disposal System Form - Not for Voluntary Assessments II 272 Wakeby Road _ — --- ---- - - -------------- Property Address Lars Jensen --------------------------------------------------- Uwner Owner's Name --------------- --- ---------------------- information is required for every Marstons Mills MA 026_48_ Noyen_ber 2_7, 2_0_1_8_ ----------- ____------------------------- page. CityfTown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ z The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems. To be considered a large system the system must serve a facility with a design flow of'10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yps` or"no" to each of the following, in addition to the questions in Se!:tion CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply the syste,M is located in a nitrogen sensitive area (Interim Wellhead Protection ❑ ❑ Area- I PA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts ~�~~��8�� �� �°�����~��"��8 N������������~���� ����N~N�� NN�W�� �m �^�U0N��N�m0 Inspection Form ��m mmm Subsurface Sewage Disposal System Form Not for Voluntary Assessments 272VVakeb R d -- Property Address ---------------------------- '------- ---- LoraJenson Owner -------------------------------- —--------------- Uwnor'owamo --�-----�--------- information is required for every yWoratonsMi||o MA 02848 Novonber27 2018 nvQ*. City/Town State Zip Code Date of Inspection------�------ C. Inspection Summary (cOOt] If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered asignificant threat under Section C.5orfailed under Section C4 shall upgrade the system in accordance with 318 CPNR 15.304 The system owner should contact the appropriate regional office uf the Department. 5. You must indicate "yes" or"no"for each of the following for all inspections: Yes No M 0 Pumping information was provided by the owner, occupant, ur Board ofHealth | | Ej Were any of the system components pumped out in the previous two weeks? N El Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? � Were as built plans of the system obtained and examined? (If they were not � available note asN/A) � �� Fl Was the facility or dwelling inspected for signs of sewage back up? M El Was the site inspected for signs of break out? M 1:1 Were all system components, excluding the SAS, located nnsite? N El 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 ofscum? Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue �~ �~ approximation of distance is unacceptable) [31OCK4R 15302(5)] Commonwealth of Massachusetts w,,, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 272 Wakebv Road Property Address Lars Jensen Owner Owner's Name information is required for every Marstons Mills MA 02648 Novenber27, 2018 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): 4------- DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 446 GPD Description: Number of current residents: 3 Does residence have a garbage grinder? El Yes M No Does residence have a water treatment unit? F] Yes M No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) El Yes Ej No Laundry system inspected? El Yes El No Seasonal use? f-] Yes H No Water meter readings, if available (last 2 years usage (gpd))-. 2017= 117 GPD Detail: 2018=,94 G-PD Sump pump? F1 Yes M No Last date of occupancy: .-Current Date t5insp.doc-rev.-7/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 / Commonwealth of Massachusetts l.4p Title 5 Official Inspection Form Y! Subsurface Sewage Disposal System Form Not for Voluntary Assessments Property Address Lars Jensen Owner Owner's Name information is page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.)� Grease trap present? El Yes No � Water treatment unit t/ n Yes El No Industrial waste holding tank presen.f? El Yes [:1 No If yes, discharges to: N e Title 5system? Yes Fl No � Water meter readings, ifavai| : Last date of000upancy/uee: Date Other (describe bo|ow)� 3. Pumping Records: No i record found Gourceofinhormotion� | Was system pumped os part of the inspection? Yes �� No | ~~ |f yes, volume Pumped: 1000 ga|wns How was quantit 5be �beon truck ~~^ Heavv Solids | Reason for pumping� Commonwealth of Massachusetts w, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 272 Wakeby Road Property Address Lars Jensen Owner Owner's Name information is required for eVffy Marstons Mills MA 02648 Novenber 27, 2018 page. CityRown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract El Tight tank. Attach a copy of the DEP approval. El Other(describe): Approximate age of all components, date installed (if known) and source of information: Septic tank installed 1984. D-box and leach system installed 06/06/2007. Certificate of Compliance on file at Health Dept. Were sewage oclors detected when arriving at the site? El Yes N No 5. Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: n cast iron M 40 PVC El other (explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): —-------------- t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 y Commonwealth of Massachusetts - 0_ Title 5 official Inspection Form ! i) Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Wakeby Road Property Address Lars Jensen Owner ---------- --- --------Owner's --_---------------------------- Name — information is Marstons Mills _ MA 02648 _ Novenber_27, 2018 required for every _ _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: --- — feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5' x 4.5' x 5' 1000 gallons ----------- 01, Sludge depth: 1 --- - ----- ------- Distance from top of sludge to bottom of outlet tee or baffle 22>12" at inlet-------- ----- ------ Scum thickness ------------------------- 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 011 -- -- -- -- -- -- How were dimensions determined? Dip tube and tape measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet and outlet tees in place. Liquid level at outlet invert. Heavy solids at time of inspection. Risers bring covers within 6" of grade under brick patio. Tank was pumped and cleaned after inspection. Recommend maintenance pumping every two_years. - 15insp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 6aV 272 Wakeby Road Property Address Lars Jensen r Owner's Name information is required for every Marstons Mills MA 02648 Novenber 27, 2018 page. State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction'. [:1 concrete El metal ❑ fib eyglass ❑ polyethylene El other (explain): Dimensions: Scum thickness / ------ -- - - - Distance from top of Scum to top of outlet tee or baffle ------ Distance from bottom of scum to bot* of outlet tee or baffle Date of last pumping: Date Comments (on pumping recomn?6ndations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outletjnvert, evidence of leakage, etc.),. 8. Tight or Holding Tank (tank must be pumpe/d at time of inspection) (locate on site plan): Depth below grade: Material of construction: El concrete El metal fiberglass ❑ polyethylene E] other (explain): -------------------- ------ Dimensions: Capacity: gallons Design Flow: ------ gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 ® fficial inspection Fora — i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Wakeby Road Property Address Lars Jensen ------ ------- ------ Owner Owner's Name --------- --- —-------------- information is required for every Marstons Mills MA 02648 Novenber 27, 2018 ----------------------------------- ---- - --- --- ---------- — page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: q' Yes ❑ No Alarm level: -- --- - Alarm in working order: ❑ Yes ❑ No Date of last purrtping: Date Comments (condition of alarm and float swii ches, etc.): ------ -- -- --- ---- ---J--------._..-_------------------ --- - - - ---- -- --------- - Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): 11 Depth of liquid level above outlet invert 0 -------- -- ----- Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): One inlet, three outlets. Speed levelers in place. Light solids carryover not affecting system operation. H-10 D-box is 3' below grade_ No high water staining over outlet invert_ t5insp.doc•rev.7/:26!2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth. of Massachusetts 1= ; 7 Title 5 Official Inspection Form t� - �a 1�1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Wakebv Road Property Address — - Lars Jensen Owner -- ---------------------- ------------------------- -------- Owner's Name -----— -- - information is Marstons Mills __ MA 02648 Nov_enber 27, 2018 required for every _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber (locate on site plan): } Pumps in working order: ❑ Yes ❑ No' Alarms in working order: ❑ Yes ❑ No` Comments (note condition of pump chambe condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption. System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ------ -- ® leaching chambers number: 3 -500 gal ea. w/4' stone ❑ leaching galleries number: --- — --- ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: -- ----- ❑ overflow cesspool number: -- ----- ❑ innovative/alternative system Type/name of technology: ------ -- ----- ----- ---- t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 � Commonwealth of Massachusetts ��~��N�� �� �����'~��~��N N������������~���� ����0°0�� Title �� ��/� � ����mm� Inspection �-��mmmm Subsurface 8axvaQe Disposal System Form ' Not for Voluntary Assessments 272 Wakeby Rood Property Address � Lars Jensen Owner Owner's Name information is required for every K8arntonsW1i||s MA _ 02848 Novanber27 2018 pago City/Town State Zip Code Date ofInspection D, System Information /cUnt.\ 11 Soil Absorption System (8AS) (oonL) Comments (note condition of soil, signs of hydraulic failure, level ofponding. damp soil, condition of vegetation, etc.): Camera used to locate and inspect chambers. Liquid level 1f[' below invert st time of inspection. High water staining >1' below invert. No sign of past hydraulic failure. Clean stone visible in aidewaU. Leach sVstem is, 3.5 below d No ventfound. � � � 12. Cesspools ( | must be pumped as part of ahep|on)� Depth top cx liquid ro inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool ------- Materials of clanstruction Indication of groundwater El Yes 0 No Comments (ncte oondition/ofooi[ signs of hydraulic failure, level of ponding, condition of vegetation, e0:): | ------ ----- ---- ------- --'--------�— t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 16 � | Commonwealth of Massachusetts Title 53fficial Inspection Form 1, Subsurface Sewage Disposal System Form Not for Voluntary Assessments 9 py - �� ter; 272 Wakeby Road Property Address --- - - - — ----- -- Lars Jensen_ Owner Owner's Name------- ----- -- -- -------- — information is Marstons Mills _ _ _ MA 02648 Novenber 27, 2018 required for every _ _ _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate-on site plan): Materials of construction: =�--- -- --- ---- — Dimensions 7L— -- -- -- ---- ---- Depth of solids -- -------- ---- Comments (note condition of soil, signs,zf hydraulic failure, level of ponding, condition of vegetation, etc.): --..------------------- -- - ----- ' t5insp.doc•rev.7/26/2016 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth: of Massachusetts -; ? Title 5 Official Inspection Form - — .'l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Wakebv Road Property Address ---------- ----- --- -- — - -- Lars Jensen Owner ---------___------- ------_-------- Owner's Name information is M_arstons Mills MA 02648 _Novenber 27, 2018 required for every ----------------- ------- -- -------- page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately N I i I i I i -0 i t J J .i 0 1 � 15insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System• age 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form - 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Arr.- 272 Wakeby Road ------ -- -------- `ate v%a. Property Address -- - -------- _--- -- ---Lars Jensen Jensen Owner Owner's Name information is Marstons Mills MA 02648 Novenber 27, 20_18 _required for every — _ _ _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed. 06/27/2006 - Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers -(attach documentation) ® Accessed USGS database -explain: maps.massgis.state.ma.us/oliver.php_ You must describe how you established the high ground water elevation: Test hole in 2006 found no ground water at 126" (elv= 77.6). Base of chambers at elv= 82.25. Seasonal adjusted ground water level is at elv= 48.3 per engineered plans_ ----------------------- ------------ ------------------ --- Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts ��~��N�� 0� ��.���~��~��N N������������~���� ����N°��� Title �� ��y� � ��~���� Inspection ����mmmm Subsurface Sewage Disposal System Form Not for Voluntary Assessments 272 Wakebv Road Property Address Lars Jensen Owner Owner's Name information is required for every yNaretonsK8iUs MA 02648 _ Novenber27 2O18 page. city[/own State Zip Code Date vfInspection E. Report Completeness Checklist ~ Complete all applicable sections of this form inclusive of: A. inspector information: Complete all fields in this section. B. Certification: Signed & Dated and 1. 2. 3, or checked C. inspection Summary: 1, 2. 3. or 5 completed as appropriate 4 (Failure Criteria) and G (Checklist) completed D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Oiapoao| System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included -- TOWN OF BARNSTABLE LOCATIONo97 aZ lJd cQ SEWAGE#,ele—IAI 'VILLAGE fwr, Mi (l S SSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY J Osue 4 c �4r 10 _ LEACHING FACILITY:(type) 5-00 LC (size) I Z,s X 1-E NO. OF BEDROOMS 3 " y OWNER �e0. �Teh2Uoe 1-t= PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Ay t- Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) aG Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) w Feet FURNISHED BY a C9 0 A5, 63 ,g� 4S �0 ° No.. "' Fee V A D Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zip plication-for ai.5 pont *_ p.5tem Cow5tructiou Permit Application for a Permit to Construct( ) Repair a Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 21Z Li 4) ' 4)16A Owner's Name,Address,and Tel.No. e,4t j� �� 4, MAas.Tur►J Ntitl 2-71 Wa/(e,6LI lead Assessor'sMap/Parcel L13 qi il2�iS mr<<S Installer's Name,Address,and Tel.No. C OP40 v tc 6h k/f-7 g Designer's Name,Address and Tel.No. C-c,o - T'Ec% �.�. r3,-9-Z63 43 141-4--fl< cr`PC./e So�yLZ qd_LX (_ept -evQ► tl-e rv44 Saki 6(( oTly Tfpe of Building: Dwelling No.of Bedrooms _t Lot Size �5 t t sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' L Design Flow(min.required) `-[ 40 gpd Design flow provided 1446-0%3 gpd Plan Date Jyv.d' '2-00Co Number of sheets 1 Revision Date Title "Z11 i.J4LA1,1 (L Size of Septic Tank i ID eL­� Type of S.A.S. S� S 1� �.• w� $I&Lc Description of Soil S2k, O lam Nature of Repairs or Alterations(Answer when applicable) !lam 5 W I ^1 a L.C. 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 Health. Signed _ Date S Application Approved by �r _ Date . 7 Application Disapproved by: Date for the following reasons Permit No. "2 ( Date Issued y No. Fee DA � L THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYicatiou for Migaat �&Vmem Cou5tructiou Permit Application for a Permit to Construct( ) Repair a Upgrade( ) Abandon(�f) ❑ Complete System ❑Individual Components Location Address or Lot No. e21 Z W 4l 1 W Owner's Name,Address,and Tel.No. �.•<i,k.J , Y �����,�I - M42STL0J Ilnill Z-71 (.Wail<10y (?,Ad �Assessor'sMap/Parcel t13 i Installer's Name,Address,and Tel.No. C4r-&,)i& Designer's Name,Address and Tel.No. tco L� C�KT-���:�lt ✓vim So�36Y o�5y s�,.,��„�,�o, � Type of Building: 11 _ Dwe"]ng No.of Bedrooms `t Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures '' EE Design Flow(min.required) `4 q gpd Design flow provided 44t'0•V 3 gpd Plan Date J ��� 2<:yatc Number of sheets Revision Date Title Size of Septic Tank (iD 03 Type of S.A.S. C3 ) Soo S KY(, L• C.• Description of soil %-eR (P)fin _ n II+ Nature of Repairs or Alterations(Answer when applicable) �-. ��. l 3� S pcS Q, a� 1{4 a t C_ r 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 Health. ,+ Signed� 'late Application Approved b - to � Date d� - - PP PP Y Application Disapproved by: Date �. for the following reasons r Permit No. y Date Issued U/� 4 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site ewage Disposal System Constructed ( ) Repaired ('�) Upgraded ( ) Abandoned( )by l,4AAA.-)J1 eXt-< P'()f3 �•�,c at 1112- k4�oti 12..e A..) ?*(S f uu S If/1.1115 has been constructed in .c ordance with the pro//v ��isions of ��Title 5 and the for Disposal System Construction Permit No.�w� /—4 dated Installer &,a"t� �'�/��' ; �'� LPL Designer �CV �2C.ln L, #bedrooms Approved de,�ign+flow DTI /.� gpd a The issuance of this permit shall not b e construed as a guarantee that the system gill unction as designed.(v� U . Date l„ 1/_ 1 ii� ' 1 Ins ector �/(/��_ /L' � . P J L/ ————————————— —————————————---————— —————— No. NX7- L� �% Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Oigogal i§p!5tem Coon5truction Permit Permission is hereby granted to Construct ( ) Repair (U' ) Upgrade ( ) Abandon ( ) System located at -2- Li a 11s.L AA,11i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5'and the following local provisions or special conditions, Provided: Constructiokrnpst be completed within three years of the date of _ th erit. Date dl Approved bym Oc_� w.. / 1 j € i i 1 l j d C 1 i i I 4 i i ins �o f I i I i i } f � V I' oN 3 .._........ if E i t t i 1 t i I o � I I f N r : t i ---------- ----- 1-..------ i { 7 i M I S�CoN�n �rc� Town of Barnstable lui '°' � Regulatory Services : Thomas F. Geiler, Director SAWMADUM ''UL ;9. � Public Health Division �E0N1 � Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Juke �, W 07 Designer: 4V 1 D CO U G K A 06 WIZ Installer: Address: 43 A-406 LC (f-11; Address: On (p -C) Co _(D`7 CCne w 1d.P 'Z g >r3n 1 Qwas issued a permit to install a (date) (installer) �— septic system at 62 2c9 64J0-1Q4q /4/ based on a design drawn by (address) Icy TeC�, Cnv,ro nnev-ht 1 dated ( a? --Ot9 (designer) i/ 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. 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. �1! Vk OF iygssq ZH OF ASS moo`' DAVID oyGN o`'� DAVID q�yG o D. D (Installer's ignature) COUGHANOWR N " COUGI NOWR No. 1093 r Q/S7E��4 s0 �ICENSE� Q CLm4z• co,�� P's 1 1� SgNITAR\NN /� EVALO (Designer's Signature) (Affix Designer's Stamp 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. Cif C A T ION 2 / SEWAGE PERMIT NO. Lot #24A Wakeby Rd. in :'84-197 PILLAGE Marston Mills V� INSTALLER'S NAME & ADDRESS T.W. Nickerson, Inc. 160 Mill Hill Rd.R.R.#2 Chatham Steve Huntoon � tUILDER OR OWNER ,DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED G� � �f; � \C 1 7 � J / �f ��yA p- No—Q_. ... ........................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 1 � AV.V trFatiun for RsVooFai Works Tonutrurtiun Vamit "AppI' tion is hereby mad f r a r to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sys a �( ess ..........................................� _....----•-----•--•.......................or Lot No. t Owner Address W Installer Address Type of Building Size Lot____________________________Sq. feet Dwelling—No. of Bedrooms............. ......................Expansion Attic ( ) Garbage Grinder 160) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d Othtl h'�" xtur ref W Design Flow_____ _ _-____ ! _ _________________gallons per personer day. Total daily flow___..___._.___®____.______.__.__._______ Ions. c WSeptic Tank—Liquid cdpacity��gallons ength____ __........ Wid h___..�___._.._ Diameter__ ___ Depth_._ __.__..... x Disposal Trench—No.__ _._ Width_._:__.___ Total Lengtld.________________ Total leaching area___`�_Z_ ___....s.ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2.............___minutes per inch Depth of Test Pit.................... Depth to ground water........................ L� ==----------••-•----•-----•---•-•-----••-•-•-••--...-•••-----•--••..................................•--••-••••••------- ODescription of Soil..................................................................................................---------------•-------------------------._...---------..........._.. x V ...•--•----••-•----••-•----•---••-•---•••••--------------------------------------------------------•-----•••-•------------•-----•--------•----•-•-••-------------•-••------....••--••----•--•------------ W -------------------------------------------------------------------------------------------------------------------------------------------------------------------•-----------------•-------------•--- V Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ a ---------------------•------•------------------------------•------------•----•-•----•----...--•--...----•-----------------------------------•-•--------------•---•--•--•---•-••••------•-------•----••-• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI't U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. igned---- .....................•-•-----•---•-------._....---------..__ ........_.... ApplicationApproved By--- ------------•-•••--•----------._.......-----------•••-•-...__............._-----__---•- 2 t 7 ate Application Disapproved f t e following reasons:.----•--------•----------------•--------------•••-----------•--------------•--•-----------.._..--- •••-••-••- -----------------------------------•--••----•---.....-------....---------......_..-----•--...------........_.._.__....----------------••-----•----•----------•----------------------------•------•------- Date PermitNo...................................................--•- Issued........................................... at .Date THE COMMONWEALTH OF MASSACHUSETTS J BOARD OF HEALTH =---...................................O F........................................ Appliration for Disposal Wore Tonstrurtion rrmit Appli tion is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sy i' ss or Lot No. = �. f ........................................ ..........--...................................................................................... �,,o� Address I-,� ----•-f%'- L`- -Pl%................... ` zr a -` ---...............---------------•--......•........................ Installer ,: Address UType of Building Size Lot............................Sq. feet .., Dwelling—No. of Bedrooms.............. ..................... P ( )Showers g W44 Other—Type of Building No. of persons Attic Garbage Grinder ( ) ayP g ••----••--•----------•...--- P ( ) — Cafeteria dOther fixtures ----------------•---------.---•---•-----•------•---•--------------------••-•-•---•--•-••----- w Design Flow_ -------------gallons per person per day. Total daily flow.......'/`--.t-!p........................g llons. WSeptic Tank—Liquid"capacity-? *allons Length._--....... Width....�/._.._.. Diameter._______.-_ Depth......... x Disposal Trench—No. ../............. Width....K.......... Total Length................ Total"leaching area--_Vie.2 y.-:...sq,ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-___-_---__-__---____. } 0 Description of Soil......................................................................................--------------...----------------------------------------•-•--•••--•-----•-.-•-•- x 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 TITL i� 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. gned --.-,•-----•--.....-•--•-----------•-•---•-----------------•--•••--• ------�---.. o--•----------- following ... Application Approved BYc ......... te . -Application Disapproved reasons---------------------•----------•----•-------•-------•---------•-------------------------._...--•------•--------. ...........-•••--•-•--•---••-•............ ...------...------•-•---------•--•----•-----••-- ----------------------------------------------••........_...._Date PermitNo.......................................................- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trrtifiratle of f ompliaurr TS IS f0 CERTIFY, That the Individual Sewage Disposal System constructed ( r epaired ( ) f by-.. "4 e-.:, ---..... ......- ---- -- ----- - ----- ------------- ----- .Installer.. atfit.. �r -�.-t/-- --� --- ................................................ has been installed in accorda ith the provisions of TITLE 5 of The State Sanitary Code s desc ' ed in the application for Disposal Work Construction Permit No t/CONSTRUED ................. dated_ ,� , THE ISSUANCE OF THIS CERTIFICATE SHALL NOT AS KG"UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACT RY. p DATE....................................................... , 1 Inspector------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.................................................................... .............. No9........-• F � FEE ---�.......... Permission is hereby granted.--- •.. ---• -- . .......................................................i................................... to Construct ( Repair ( nf In vl ual Sews sposal System 1� atNo....... .. .!.......... ...l. . ............ -- ................................................................................................... Street as shown on the applipgrlon for Dispo rks Construction Permit No................. . ated.......................................... Board of Health DATE... --.._-_ FORM 1�58 A. M. SULKIN, INC.. BOSTON r r •. SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. yy� ❑Agent ■ Print your name and address on the reverse "l' fl% ❑Addressee so that we can return the card to you. B. Ke.eived by( ri ted Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on.,the front If space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: enter delivery address below: ❑ No Mr. &Mrs Richard Griffith 272 Wakeby Road ! Marstons Mills,-NIA 02648 3:.Service Type` ❑Certified Mail ❑ Express Mail ❑Registered- p Return Receipt for Merchandise " ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Nymber 7005 1160 ; 0000 0191,;1284 ; 7i (Transfer from service label) 7 Ps Form 3811,February 2004 Domestic Return Receipt 1025 5-02-M-5540 UNITED STAT L@� • Sender: Please print your name, address, and ZIP+4 in this box • PUBLIC.HEALTH DIVISION TONNTN OF BARNSTABLE 200 MAIN STRF_,ET HYANNIS, MASSACHUSE'TTS 02601 rla rf !t j { C�r_,;� t ,f+t,}?_ IIItt;;;�r�r1�:=li,rrrrslJr3�rlit;sr�ia�f;rilr�llrri��;te;�a�rt U.S:"Postal SeruiFeTM _ CERTIFYYIED MAIL.TM RECEIPT�� 'i � " �`�� (Domestic,Matl,Only;No Insurance Coverage�Provided) ° lF,o�,delivery,iriformationviiit our�website at www.usps:com®" _ i PS Form 380Q June 2002 See Reverse forinstructionsj Certified Mail Provides: (asianey)Z00Zeunr'008EwJod Sd n A mailing receipt , o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. Town of Barnstable FINE Tp� o Regulatory Services ,atuvsrnst Thomas F. Geiler,Director '039. •� Public Health Division QED MA'S A Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 22, 2006 Mr&Mrs Richard Griffith 272 Wakeby Road Marstons Mills, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 272 Wakeby Road,Marstons Mills,MA,was last inspected on June 121h, 2006 by, Sean M. Jones, certified septic inspector for the State of Massachusetts. The inspection of your,septic system showed that your system has "Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Septic system is in failure No available leaching in pit. You have 2 years from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HEALTH D PARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health — t .a Commonwealth Of Massachusetts Executive Office Of Environmental Affairs Department Of Environmental Protection TITLE 5 Official Inspection Form -Not For Voluntary Assessments Subsurface Sewage Disposal System Form Part A Certification Property Address: 272 Wakeby Rd.Marstons Mills Ma.02648 Owners Name:Richard&Genevieve.Griffith Owners Address:272 Wakeby Rd.Marstons Mills Ma.02648 Date of Inspection:6/12/2006 Name of Inspector(please print)Sean M.Jones Company Name:S.M.Jones Title V Septic Inspectors Mailing Address:74 Beldan Ln. Centerville Ma.02632 � Telephone Number:508-778-4597 -7 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the inf rmation reted por :. below is true,accurate and complete as of the time of the inspection.The inspection was performed-based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: Passes Conditionally Passes Needs further evaluation by the Local Approving Authority X Fails Inspectors Signature Date: (o a 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:Septic System fails because at time of inspection leach pit had 0 inches of available leaching. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 1 i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION lcowiww Property Address: 272 Wakeby Rd.Marstons Mills Ma.0264,8 Owner:Richard&Genevieve Griffith Date of Inspection:6/12/2006 Inspection Summary:Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes:N/A _I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B.System Conditionally Passes:N/A One or more system components as described in the"Conditional Pass"section need to be replaced or Repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the_for the following statements.If"not determined"please Explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally Unsound,exhibits substantial infiltration or exfiltration or the 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 structurally sound,not leaking and if a Certificate of Compliance Indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or Obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with Approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(S).The system will Pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION tcowmuw Property Address:272 Wakeby Rd.Marstons Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection: 6/12/2006 C.Further Evaluation is required by the Board of Health:N/A Conditions exist which require further evaluation by the Board of Health in order to determine if the system Is failing to protect public health,safety or the environment. 1.System will pass unless Board of health determines in accordance with 310CMR 15.303(1)(b)that the System functioning in a manner that protects the public health,safety and the environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a Surface water supplyor tributary to a surface water supply. _ The system has as eptic tank and SAS and the SAS is within a Zone'1 of a public water supply. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a Private water supply well**.Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform Bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other Failure criteria are triggered.A copy of the analysis must be attached to this form. 3.Other: OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(cowwAD) Property Address: 272 Wakeby Rd.Marston Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection:6/12/2006 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X 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 '/z day 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 cesspool or privy is within Zone 1 of a public well. X Any portion of cesspool or privy is within 50 feet of a private water supply well. X Any portion of 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 pp,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] X (Yes/No)The system fails,I have determined that one or more of the above 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:N/A To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd- You must indicate either"yes"or"no"to each of the following: Yes No the system is,within 400 feet of a surface drinking water supply — _ the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you 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 CM15.304.The system owner should contact the appropriate regional office of the Department. r OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:272 Wakeby Rd.Marston Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection:6/12/2006 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 system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X_ _Were as built plan of the system obtained and examined?(If they were not available note 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 SAS,located on site? _ X_ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tee,material of construction,dimension,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 the Board of Health. X_ i Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance Is unacceptable)[310 CMR 15.302(3)(b)] OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:272 Wakeby Rd.Marston Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection: 6/12/2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):-5— Number of bedrooms(actual):—4_ DESIGN flow based on 310 CMR 15.203(for example): 110 gpd x#of bedrooms):_550 GPD`_ Number of current residents:-4— Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no):—No—[if yes separate report required] Laundry system inspected(yes or no): N/A_, Seasonal use:(yes or no) No_ Water meter readings,if available(last 2 years usage(gpd): Sump pump(yes or no): No Last date of occupancy/use: Current COMIERCIAL/INDUSTRIAL:N/A Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/person/sqft,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: Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was this 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 Obtained from the 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: 1984 Were sewerage odors detected when arriving at the site(yes or no): No f OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:272 Wakeby Rd.Marstons Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection: 6/12/2006 BUILDING SEWER(locate on site plan) Depth below grade: 2`+i- 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.): Joints were in good,condition no sign of leakage. SEPTIC TANK: X_(locate on site plan) Depth below grade:_18" Material of construction: X concrete metal Iiberglass_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"X5`6"X4`10"= 1000 Gallons Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: N/A Scum thickness: N/A Distance from top of scum to top of outlet tee or baffle:—N/A Distance from bottom of scum to bottom of outlet tee or baffle: N/A How were dimensions determined: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels As related to outlet invert,evidence of leakage,etc.): Septic Tank was located but not excavated because leach pit was full of water.resulting in a failed inspection. GREASE TRAP: N/A (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.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:272 Wakeby Rd.Marston Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection:6/12/2006 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inpection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain) 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: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:,X_(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 carryover,any evidence of Leakage into or out of box,etc.): Distribution box was not located or excavated because leach pit was full of water,resulting in a failed inspection PUMP CHAMBER: N/A (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.): f OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - SYSTEM INFORMATION(continued) Property Address: 272 Wakeby Rd.Marstons Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection: 6/12/2006 SOIL ABSORPTION SYSTEM(SAS)_X (locate on site plan,excavation not required) If SAS not located explain why: Type X Leaching pits.Number:- 1-Leaching chambers,number: Leaching galleries,number: Leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternitave system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Leach pit was full of water at time of inspection. CESSPOOLS: N/A (cesspools 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: N/A (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.): f OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 Wakeby Rd.Marstons Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection: 6/12/2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 5+/- feet P Please indicate(check)methods used to determine the high ground water elevation: _X_Obtained from system design plans on record-If checked,date of design plan reviewed: 3/19/1984 Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Design plan dated 3/19/1984 on file at Town of Barnstable Board of Health showed no water encountered at 12' OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:272 Wakeby Rd.Marstons Mills Ma.02648 Owner:Richard&Genevieve Griffith Date of Inspection:6/12/2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent referencelandmarks or Benchmarks.Locate all wells within 100 feet.Locate where water supply enters the building REAR OF HOUSE A B TANK 1 A-1=25' B-1=28' D-BOX A-2=37' B-2=38' LEACH PIT ❑ 2 A-3=35' B-3=46' 3 *(septic tank and d-box measurements were not confirmed, leach pit measurements are correct) YOU WISH TO OPEN A BUSINESS? I� For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main-St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is -required by law. 3f DATE: 39 Fill in please: APPLICANT'S YOUR NAME/S. L2S 7�tif � y BUSINESS YOUR HOME ADDRESS: `� Z ( Sr,4VIM ° TELEPHONE # Home Telephone Number Sam—2zi— Stiri 5 NAME'OF CORPORATION: I� FSE " NAM, E'OF NEW BUSINESS zflw TYPE OF,BUSINESS iNc< ,CJ�s� IS THIS A HOME OCCUPATIONS'. YES, NO ADDRESS OF BUSINESS.'= 'i 2 G✓. i2(g � � �� �� �`''�c S ,MAP/PARCEL NUMBER Y [Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.. 1. BUILDING COMMISSIONER'S OFFICE MUST COMPLY WITH HOME OCCUPATION This individual has b�.e in rmed of permit requirements that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO C ` COMPLY MAY RESULT IN FINES. A thorize Signa ure* COMMENTS: � � 0 St 2. BOARD OF HEALTH This individi ial has hPen f rmed of the per i re item tot at pertain to this type of busii less. r d�Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual h s e ' formed of the licensing requirements that pertain to this type of business. Authoriz Si nature* COMMENTS: i CONVERSION ;e . �= DISTANCES INCHES DISTANCESCONTOURS c?Ir TO LEACHING GALLERY DECIMAL FEET 3 N LOCUS Il T w ALL DISTANCES ARE IN DECIMAL EXISTING - - - - - - - 50 00 ❑_j< FEET NOT IN FEET AND INCHES. In et MINIMAL GRADING PROPOSED m �ZO A B C 1 •08 ROAD 0<w (noz 1 46.5 30.3 31.6 3 2 .1 WAKE6Y 'z (n ,, _)<0 2 53.1 42.0 48.9 2 3 .25 84 `` o cwn 0 3 64.3 51.6 57.7 4 .33 m cn m 5 .41 es Aosr n �' 6 .50 8� f�� 7 .58 g0� MARSTONS MILLS. MA 65 LOCUS MAP m 10 .83 m. ^ 6N 0 c 11 .92 /ram \ NOT TO SCALE 89 m c) CD w ae 33.5 f t x 12.5 FL x 2 FL < .J Z 3 '� �.a LEACHING GALLERY W u 3 U _1 >W �' o W4 W} o N Am.00j'' LOT 24-f� ��z e F� L�ljZ s X a❑ Z Z f' w amo mF (� W ❑ ~ �.. 0�15���` AREA = 45161 sf+- 22 W ❑ w �EP 00 m : : ;;?::;.: cwn D \ �a ' 84 LEGEND ui W Z I :ii i' \ O `� /�� 'A120 EXISTING 86 000 GALLON Z \ ! OJ 2 SEPTIC TANK U l~i1 L X N OLL 0 O m m \ e Z 00 .q�T 5 / 88 TEST PIT J � c �j �O ti9� G // EXISTING Z� _ (n} ❑ °� a \ 3 F PIPIN/ LEACH PIT O Q U Z Qfw \ /'95�2 -NUMBER REFERS TO TREE W Z J rco�cn \ / , DIAMETER IN INCHES. J LETTER DENOTES TYPE. 16-P p< �pc y`\ WATER �I� ' /\/ O-OAK M-MAPLE P-PINE -X\ CONTRACTOR MAY ELECT TO USE _l Z U W� / ALTERNATE PIPING ROUTE TO W a Z \ \ \ p� / MINIMIZE DISTURBANCE TO LAWN Lu� 3 Z U W Ld O w w w N �3 `ul oil00 0Rzl J X � OJ p�F' PPJEB / e W W ± F m n \ / g� O� cox J Wu mw < O / w \ � BENCH MARK \ i PK NAIL IN DRIVE '—' � z O / ELEVATION BARNSTABL GIS 0.00DAT SEWAGE DISPOSAL SYSTEM PLAN w J CD O < �we �� ��. -TO SERVE EXISTING DWELLING 0 J << Z I `� EST. RICHARD & GENEVIEVE GRIFFITH 0 0 L7 m U OWNERS OF RECORD Z 0 � X SNOFnlgss 272 WAKEBY ROAD W s o�� DAVID �cyG �/ 1995 `��- MARSTONS MILLS. MA + s cn FLAN ' p� D. �� ®NV��� PROPERTY ADDRESS COUGHANOWR CA ASSESSORS MAP 4 3 PARCEL 4 8 43 TRIANGLE CIRCLE SCALE. 1 in = 30 f t �No. 1093o SANDWICH MA 02563 PLAN BOOK 317 PAGE 85 z z 30 0 30 60 SO/sTE� 508 364-88J4 DATE: JIJNE 28. 2mPJ6 O F T � i q N 17AR N JOB #E T E-2 3 8 5 JPAGE 1 OF 2 VERSION: O W x w w 0 10 20 30 w THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED } _ Q p SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM + J `�►� ING �U �D b CHANGES TO PRERTY PLAC MEDNT OFHER ADDITIONS. SHON. FOR ANYOEDS,THER FENCES OR SWIMMING POOLS. OWDNER ' SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. ;r SOIL TEST LOG. , - DESIGN CALCULATqGNS DATE OF TEST: JUNE 27. 2006 DESIGN FLOW: 4 BEDROOMS X 110 GPD = 440 GPD SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. SEPTIC TANK: 440 GPD X 2 DAYS = 680 GALLONS NO GROTUNDDWAT R ENCOUNTER LD OUTWASH USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL TEST PIT 1 +- PERC 60 to 2 MIN/INCH IN C SOILS CONDITION. IF NOT, INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) ELEVATION = 87.57 DISTRIBUTION BOX: USE 3 OUTLET D-BOX. DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SOIL ABSORBTION SYSTEM: A 33.5 FL x 12.5 f t x 2 ft LEACHING GALLERY CAN LEACH (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 8'�.5� Abot = (33.5 x 12.5 ) = 418.75 sf Asdw = ( 33.5 + 33.5 + 12.5 + 12.5 ) x 2 = 164.0 sf O O LOAMY SAND 10 YR 2/2 NONE FRIABLE A t o t = .602.75 s f 3-9 A LOAMY SAND 10 YR 3/4 NONE FRIABLE V t 0.74 x 602.75 = 446.03 G P D 9-32 B LOAMY SAND 10 YR 5/6 NONE LOOSE USE A 33.5 f t x 12.5 F t x 2 f t GALLERY. Vt = 446.03 GPD > 440 GPD REQUIRED 85.00 32-120 C CMEDIUM TO OARSE SAND 10 YR 6/3 NONE LOOSE LEACHING GALLERY CONSTRUCTION DETAIL 500 GALLON DRYWELL 77.57 SHOREY PRECAST CONCRETE DIMENSIONS AND DETAIL 500 GALLON DRYWELL USE H-10 UNIT NO GROUNDWATER ENCOUNTERED LEACHING UNIT OR TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH EOUIVALENT 2 MIN/INCH IN C SOILS STON INSTALL ONE INSPECTION ELEVATION = 8 8.12 +- ^ RISER TO WITHIN SIX INCHES OF FINAL GRADE AND INDICAT 33.5 Ft ON AS-BUILTECARDATION m DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 4J m `' (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING m Q 34 68.12 In O O O N OQD In 0-6 Ap SANDY LOAM 10 YR 3/2 NONE FRIABLE N I m oa0000000000 ����0 6-44 B LOAMY SAND 10 YR 5/6 NONE LOOSE 84.45 8.5' 8.5' 44-126 C MEDIUM TO 10 YR 6/3 NONE LOOSE A 6 10Z In COARSE SAND 33.5 Ft 77.62 LEACHING GALLERY NOTES CROSS SECTION VIEW USE SHOREY PRECAST 500 GALLON LEACHING DRYWELL (H-10 LOADING) 2 In PEASTONE 2 In PEASTONE 11 GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER . FOOT MINIMUM. 0 0 28 3/4 In T 24 E f 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS In EFFECTIVE 3/4 in TO 26 OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) -1 2 Tn GRAVEL DEPTH 1-1 2 In GRAVEL In 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. 46 In 58 In 46 In 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 150 In 7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0- BEFORE ;PITCHING DOWN 6) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF L-OW FLOW FIXTURES GROUNDWATER ADJUSTMENT SEWAGE DISPOSAL SYSTEM PLAN AND APPLIANCES. AND BIANNUAL PUMPING OF THE., SEPTIC TANK 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULR LOADING.. DO -NOT EXISTING GROUNDWATER LEVEL -TO SERVE EXISTING DWELLING PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM.' BASED ON TOWN OF BARNSTABLE 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. GIS DEPARTMENT RECORDS. RICHARD & GENEVIEVE GRIFFITH INDICATED GW 46.00 272 WAKEBY ROAD MARSTONS MILLS. MA 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL INDEX WELL SDW-253 STABLE BASE THAT HAS BEEN MECHANICALLY ,COMPACTED AND ' N TO WHICH ZONE e EEO-TECH ENVIRONMENTAL SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE.' UNEVEN SETTLING READING DATE MAY. 2006 12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED READING 48.1 FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. ADJUSTMENT 2.3 43 TRIANGLE CIRCLE SANDWICH MA 02563 ADJUSTED_ GW 48.3 ETE-2385 JUNE 28, 20061 1212 T P , max__ : 44 AV . .. , ,qQ ��••yy pj , n I h� F� ,. u t L 4 , e z w , �3 40 3 © L— L./G X7 J4 RL L R F'P SLR w e� � E T G�.I TNr r t \ AFL V i�S v _ z ..�. �.. _ i ,-- rc�tir-t a Je P P u : 5 E L) 4 t7 P. V. C. if? rr-r r r-,i mu r -.-Co erg- 2 e /2 G o _ U �/ o o f - - fff WGL O !o d b o , , , G , 4ZD -46 0 //j 0 (�/'�''^� i jam^'' . Is \...." I °....+ a dctl .� t�{2 use fa t'�- . ....�'�._�..�:,.� .�. �s 7- 6�•-� �,.�._. �`.. � �. ,_ 4 _ i�'C.; TL- f ' f r 8. F' 'r9 M J N. iV of r y � G, c� r x _ Za�7v 4 s_ ` a. c M 5 7` c T� i!ll !. 5 5 4 3 i 51.C7 j s G� C a" LOr4M 1 ,EFF P , -t 49.0 S B 50! 4 z A or-r A 0 t E , a , r o _ 5,9hJU , / ^ l - f _ F , 3 39.0 s S i T, -i�' �nJGG?c.j _ !N rl "J'" S FAG Rw P _-z. ��� . LOT 2 �' 1�.1 OCJ k� ram' � 5 - 4 C..r4 � 3 /� Fes'G E• .. i ` t�NG> M O N U/L sET E3 9 8 �- _.. -5. F Ad WN Aj ., EYE � 3 r t�EaF I ,H. v , t ,t EY r to N , ^ 13 T8 7 130 'A A __crvr �I , E , < _ � 4 r� Str s r _ C s � _ ! l L. 1�to S�-r`f3 , vr�-�-rc3 B o� e� M © U T 9 .. � �c� YAK P d �^/ cc fin `' V ; . t' ct:t" 1 c._