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0068 WATERFORD DRIVE - Health
68 Waterford Drive 3 Marstons Mills P 056 002X30 i 1 TOWN OF BARNSTABLE LOCATION 67ti�r� SEWAGE# VILLAGE 1Mu+T-;L,.,S )n',\�S ASSESSOR'S MAP&PARCEL rla t £�S.NAME&PHONE NO. zarnv SEPTIC TANK CAPACITY k!FDO® LEACHING FACILITY:(type) (size) e. NO.OF BEDROOMS OWNER C`cj,® PERMIT DATE: 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 � K-7 p� �v = L(o r rr ©5(v 0017- Y30 Commonwealth of Massachusetts opl, _yW, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - 'r 68 Waterford Drive Property Address ----- -- --- --- ---- ---------------- Geor e Newton Owner Owner's Name information is Marstons Mills MA 02648 March 8, 2018 required for every T _._ _ _ _ page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When General Information <SI# a 13&U filling out forms A. on the computer, use only the tab 1. Inspector: key to move your cursor-do not Patrick T Sullivan use the return - ---— - ------ -- - -- - — key. Name of Inspector Ready Rooter Excavting r� Company Name -- -- --- ---- - - --- PO Box 89 Company Address - -- ----- - — - Forestdale _ MA _ 02644 City/Town State Zip Code _508-888-6055 _ _ S112843; Telephone Number License Number. B. Certification I certify that 1 have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority _March 8, 2018 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system 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 IDEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc•rev.6/16 l itle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 4011M V5 Commonwealth of Massachusetts Title 5 Official Inspection Form l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 6 Waterford 8 aterford Drive Property Address George Newton Owner ---------- --- -- -- - ----- — -- Owner's Name information is required Mills _ MA___ 02648 March 8,_2018 required for every _ __ __-_...---------- page. Clty[Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/ always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes:- ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. i The septic tank is metal and over 20 years old for the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspecti if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is ess than 20 years old is available. ❑ Y ❑ N ❑ N (Explain below): t5ins.doc•rev-6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 68 Waterford Drive Property Address ------ --- - -- George Newton Owner Owner's Name -- - ----- -------------- information is Marstons Mills MA_ 02648 March 8, 2018 required for every -----------------____-- ---- - _ page. City[Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced © Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or repla ejd ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumpin more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection f(with approval of the Board of Health): ❑ broken pipe(s) ar'e replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further eval ation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is no If in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is vrv' hin 50 feet of a surface water ❑ Cesspool or privy Irs within 50 feet of a bordering vegetated wetland or a salt marsh t51ns.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form _ 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive ------ ------ ----- ---------- - Property Address George Newton _ Owner Owner's Name information is Marstons Mills MA 02648 March 8, 2018 required for every - _-_- _ page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) — 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption sy m (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surf ce water supply. ❑ The system has a septic tank and SAS and the AS Is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water a lysis, performed at;a DEP certified laboratory, for fecal coliform bacteria indicates absent and t e presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that n other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts _►= fF� Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 68 Waterford Drive _ Property Address George Newton Owner Owner's Name information is Marstons Mills MA 02648 March 8, 2018 required for every ______ page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is wit h 400 feet of a surface drinking water supply ❑ ❑ the system is yvithin 200 feet of a tributary to a surface drinking water supply El El the systems/located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well a significant threat If you have answered "yes" t an question in Section E the system is considered , Y Y 9 Yq Y9 or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts y _ W title 5 official Inspection Form A Subsurface Sewage Disposal System Form - Not for Voluntary Assessments \ems; y 6_8 Waterford Drive Property Address George Newton Owner ----�-- -- -- -- — — -- Owner's Name information is M_arstons Mills MA 02648 March 8, 2018 required for every _.— —_ _ page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of breakout? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual). 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 GPQ t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Imp l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address George Newton Owner Owner's Name informat required l for on levery Marstons Mills _ MA 02648 March 8, 2018 page. CityrFown State Zip Code Date of Inspection D. System Information Description: Number of current residents: - --- Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No 660 GPD* = Water meter readings, if available (last 2 years usage (gpd)): 2012016 581 GPD* Detail *Water usage during summer months high due to irrigation on meter. Recommend removal of garbage disposal. System not designed to handle._ Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: --- —- Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft-, etc.): - ----- -- Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: ---- - -- -t5ins.doc•rov.6f16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 f o , Commonwealth of Massachusetts l _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4t 68 Waterford Drive _ Property Address George Newton Owner Owner's Name information is Marstons Mills MA 02648 March 8, 2018 required for every — page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Ready Rooter records_Pumped 08/09/2016 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? ------ ---- Reason for pumping: --- — --- Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc•rev.6/16 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts <<N 1 Title 5 Official Inspection Form rt - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments _ 9 p Y Y. t � 5 68 Waterford Drive ------------ --------------- — --------------------- Property Address George Newton Owner Owner's Name information is Marstons Mills MA_ 02648 March 8, 2018 required for every — -- — .— page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Pits installed approx 1991. Tank and d-box moved and replaced 09/09/2009 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer (locate on site plan): Depth below grade: 224 — --- _-- -- feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): ----- - Distance from private water supply well or suction line: N/A __- - feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): 20 Depth below grade: -- — - - p g 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: 10.5' x 5.5' x 5.5' 1500 gallons 2, Sludge depth: — -- 15ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Fi, Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments P� ~ 68 Waterford Drive Property Address George Newton_ _ _ Owner Owner's Name information is Marstons Mills MA 02648 March 8, 2018 required for every _ _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 33'_ Scum thickness 2" at inlet, 1" at outlet Distance from top of scum to top of outlet tee or baffle 61 Distance from bottom of scum to bottom of outlet tee or baffle 14"_ 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. Inlet viewed with mirror. Under block patio. Liquid level at outlet invert. Risers brinoutlet cover within 6" of grade. Pumping not needed at time of inspection. Grease Trap (locate on site plan): Depth below grade: ----------------- - feet i Material of construction: i ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: ---- Scum thickness - -- — - Distance from top of scum top of outlet tee or baffle ---------- --- -- Distance from bottom o. scum to bottom of outlet tee or baffle --- Date of last pumping ------ Date t5ins.doc•rev.6116 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W� Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address — - George Newton Owner Owner's Name — -- information is required for every _Marston_s Mills MA 02648 _ _March 8, 2_018 _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: ' Material of construction: ❑ concrete ❑ metal fiberglass ❑ polyethylene ❑ other(explain): Dimensions: -- ---- --- -- Capacity: — - ----- -- --- gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: - ----- Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): ' Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address — — ---- George Newton _ Owner Owner's Name information is required for every Marstons Mills MA 02648 March 8, 2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): 011 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.): One inlet, two outlets w/speed levelers in place. No solids carryover. No sign of leakage. No high water staining over outlet inverts. Riser brings cover to 10" below grade. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order. ❑ Yes ❑ No' Comments (note condition of pump chamb r, condition of pumps and appurtenances, etc.): " If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins,doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts 1ritle 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 6_8 Waterford Drive Property Address _George Newton Owner Owner's Name information is Marstons Mills _MA 02648 March 8, 2018 required for every _ — _ _ _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2-600 gal w/2' stone ea. ❑ leaching chambers number: — ❑ leaching galleries number: - --- ❑ leaching trenches number, length: --- - ❑ leaching fields number, dimensions: -- ❑ overflow cesspool number: -- ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Pit#1: Liquid level 2' below invert at time of inspection. Light staining 2" above current level. Pit#2: Liquid level 18" below invert. High water staining 6" above current level. Clean stone visible in sidewall. Both pits located and inspected with camera. No sign of past hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration i ---- i Depth -top of liquid to inlet invert - --- Depth of solids layer Depth of scum layer — Dimensions of cesspool — - Materials of construction --- -- Indication of groundwater inflow ❑ Yes ❑ No 15ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 n s Commonwealth of Massachusetts Title 5 Official Inspection Form — Subsurface Sewage Disposal System Form - Not for Voluntary Assessments /< 68 Waterford Drive _ Property Address George Newton Owner Owner's Name information is required for every Marstons Mills _MA_ 02648 March 8, 2018 - _-___-- page. CitylTown State Zip Code Date of Inspection D. System. Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.).- Privy (locate on site plan): Materials of construction: ------- -- - Dimensions ---- -- Depth of solids /sigof Comments (note condition of soilulic failure, level of ponding, condition of vegetation, etc.): t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,•'"r 6_8 Waterford Drive Property Address George Newton _ Owner Owner's Name information is Marstons Mills MA 02648 _March_8, 2018 required for every — _ page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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 r� W� I; j �� V S t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 i Commonwealth of Massachusetts qa Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address Geoor a Newton Owner Owner's Name information is Marstons Mills MA 02648 March 8, 2018 _required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >5teat Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: Pervious Title 5 Inspections _ ❑ Checked with local excavators, installers - (attach documentation) ® Accessed USGS database -explain: m�a s.massgis.state.ma.us/oliver.php You must describe how you established the high ground water elevation: Slope to front of property drops 10'+-. Base of leach pits 7' below grade. Accessed local ground water contours and topo mapping, property elevation over system at 62+-'. No high ground water in area of system.__— _-- ------------- Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ( 68 Waterford Drive _ Property Address — Geor e Newton Owner Owner's Name information is Marstons_Mills MA 02648 March 8, 2018_ required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE v/ LOCATION V4q SEWAGE VILLAGE ASSESSOR'S MAP.&PARCEL."o-O INSTALLER'S NAME&PHONE NO. . SC. �ti /�o G®d►f! SEPTIC TANK CAPACITY 4 0ae f1Q/oc4°feel -roll y LEACHING FACILITY.(type) (size) NO.-OF BEDROOMS OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet. Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY S 0 d M nA O } / N �g TU QLt � No. �� f = 1. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for 33igoat �&pgtem Cougtructiort permit Application for a Permit to Construct( ) Repair(vUpgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. (���� � � Owner's Name,Address,and Tel.No. Vvl P41ZS70)1 V ►tit t t:C4 Assessor's Ma [Parcel ��� ���� p 114,0 /� 6 l��f'�cEZ 009 3 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. vbt 2 t Type of Building: Dwelling No.of Bedrooms Lot Size q 4. ►Est f sq. ft. Garbage Grinder (0) e � Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) V gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) F I��L Tj�. `Tr4/✓.fi g 7F_ 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 n place the system in operation until a Certificate of Compliance has been issued by this Board of Health. /Signed _ e ��7 �p�_ Application Approved by Date Application Disapproved by: Date for the following reasons Permit No.� — 2 c Date Issued ," Sty �� k ' No. .2wc(' 268 Y' 1 b �;� . Fee in computer: ,,,,THE,COMMONWEALTH OF MASSACHUSETTS EnteredYes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 12t"pficatiou for Migo!6aY 6p!tem Con5tructi6u Permit Application for a Permit to Construct( ) Repair(VUpgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. &C6 U/,4%R Owner's Name,Address,and Tel.No. Vet 4,2e�7?' /S VW iLZ4 Assessor's Map/Parcel ^� 7Ott-( �i (/9i UG' Q �O'W k4+n/1'6WA UU i ,14 W(1 CC S Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. VS`5/O—,75731/ ,7.C. 44e7-0 L1943-1500 5,—/�NE-v ►'p�v9/�Srvi< i L( �!! T F /_.ur�..r.✓ .r� Ga S3� Type of Building: Dwelling No.of Bedrooms Lot Size t-/ / lq sq. ft. Garbage Grinder (c7) Other Type of Building No.of Persons-, Showers( ) Cafeteria( ) Other Fixtures .-_,Design Flow(min.required) A/ A gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) f?F a91E_ 5 F�Tif 7v9'/✓�. ^� ��/ai arTi—'. F-..t l�C�"'¢LE 171'r••iT/I���T.vr� C�n1C 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 Environ ental Code and n o place the system in operation until a Certificate of Compliance has been issued by this Board of Health. _ Signed Application Approved by Date Application Disapproved by: Date for the following reasons ' Permit No. C�,6 Date Issued THE COMMONWEALTH OF MASSACHUSETTS ��AA 7 i T —ro BARNSTABLE, MASSACHUSETTS ,vw v St rl,c Certificate of Compliance `� k 7�- Gy ` t THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ((,- ) Upgradd e ( ) Abandoned( )by 6&44c /(/6t„i?0A./ r at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer d CeMz T� Designer oy Lf #bedrooms Approved design flow gpd The issuance of this permiitt-- hah not b construed as a guarantee that the syst m will uicfFo_- sdesigne d=. Date Inspecto _� n No. Q� �L Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS jDi!6po!5ar 4p5tem QZ..on5truction Permit Permission is hereby granted to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) System located at �� -✓f���oG. Yb Ao D0 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: Const ctio must be completed within three years of the date of this perrA. Date 5Z l3�/ Approved by ,S 7 / i Comm t onwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System,Form - Not for.Voluntary Assessments, 68 Waterford Drive Property.Address Catherine Benoit ` Owner Owner's Name informatics is required for Marstons Mills MA .02648 March 12, 2009 every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. WhenImportant: When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name r� 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code _ 508-428-1779 S112855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in'the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑. Needs Farther Evaluation by the Local Approving Authority March 12, 2009 Ins ector's Signature �. Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Lo 1—► 101 09-33 Benoit.cloc-08106 Title 5 Official Inspection Vorm Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills MA 02648 March 12, 2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Tank was pumped following inspection, leaching pits have 1-2' of effective leaching. Recommend annual pumping of tank with use of garbage disposal. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup 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 09-33 Benoit.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface - ace Sewage Disposal System Form Not for Voluntary Assessments 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is Marstons Mills required for _MA 02648 March 12, 2009 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 09-33 Benoit.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is Marstons Mills MA 02648 March 12, 2009 required for every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than_day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or � ® tributary supply. ributa to a surface water su I . 09-33 Benoit.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name informationis Marstons Mills required wir for for MA 02648 March 12, 2009 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large considered system y de ed a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 09-33 Benoit.cloc•08105 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 L ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills MA 02648 March 12, 2009 every page. CitylTown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ® ❑ Pumping information.was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 09-33 Benoit.doc•09t06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills MA 02648 March 12, 2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 5 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d N/A Irrigation g ( y g (gp )) system. Sump pump? ❑ Yes ® No Last date of occupancy: Currently Occupied Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste Folding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): 09-33 Benoit.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills MA 02648 March 12, 2009 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Tank pumped April 2007 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1989 Were sewage odors detected when arriving at the site? ❑ Yes ® No 09-33 Benoit.doc-08106 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is Marstons Mills required for MA 02648 March 12, 2009 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer (locate on site plan): Depth below grade: 1 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 1'feet Material of const,uction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene El 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: 10.5' long x 5.8'wide- 1500 gal. Sludge depth: 4 Distance from top of sludge to bottom of outlet tee or baffle 26 Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 101, How were dimensions determined? Measured 09-33 Benoit.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills MA 02648 March 12, 2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank scheduled for pumping following inspection. Liquid level was found at bottom of outlet invert, tees intact and clear. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ 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 bottom of outlet tee or baffle Date of last pumping: Date .Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 0933 Benoil.cloc-08,'06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills MA 02648 March 12, 2009 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): No solids or high stains present. Liquid level at bottom of both outlet pipes. PumpChamber wer(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 09-33 Benoit.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills MA 02648 March 12, 2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: Two 600 gal pits. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching pit#1 has 2' of effective leaching with no evidence of surcharge, pit has sufficient effective leaching for system to pass leaching pit#2 was not opened. 09-33 Benoit.doc•08/06 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 68 Waterford Drive Property Address Catherine Benoit Owner Owner's Name information is required for Marstons Mills _ MA 02648 March 12, 2009 every page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 09-33 Benoit.doc•08,106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts _ Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 68 Waterford Drive _ Property Address --------- Catherine Benoit Owner Owner's Name -- -- information is required for Marstons Mills ___ MA 02648 _ March 12, 2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. . \ \ \ \ \•. \ \ r r r / ♦ \ ♦ ♦ ♦ \ ♦ \'\ \ \'\ \ ♦ \ \ \'\ \ \ ♦'\ \ \ \ \'\'\ \ \ \ \ \ \ \ \ \ \ \ \ f ! 2 26 5 45 ni /Jy�J r'r 59 \ \ \ \ \ �+t•NV11\.l [iy �9 l 1'�1i. S�l 1� r r r r r'•/ / ! l 'II•• :•\,\!•,/,:\. 36 \/\/\/\J L i Commonwealth of Massachusetts Title- 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 68 Waterford Drive Property Address Catherine Benoit _ Owner Owner's Name information is Marstons Mills MA 02648 March 12, 2009 required for _ � every page. Cityrrown State Zip Code Date of Inspection D. System Information cont. Y (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to ground water: 20+ 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: pate ❑ 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: USGS topb map and town GIS. You must describe how you established the high ground water elevation: Town groundwater contour map shows water below el. 20 and topo map shows property above el. 50 09-33 Benoit doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 1 FILE DOPY �- COMMONWEALTH OF MASSACHUSETTS . EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED MAP PARCEL ®p��Jo AUG 17 2004 LOT TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 68 Waterford Drive Marstons Mills,MA. 02648 Owner's Name: Robert Brennan Owner's Address: Same Date of Inspection: 5/28/2004 Name of Inspector: (please print) Brad J White Company Name:Windriver Enviromental Mailing.Address: 107 N.Main Street Carver,MA 02330 Telephone Number:(508)-866-2576 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority l Fails Inspector's Signature: / Date: 5/28/2004 The system inspector shall submit a copy of s 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 System Passes. ****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. Title 5 Inspection Form 6/15/2000 page 1 t Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 68 Waterford Drive Marston Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X 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: System passes.Recommend regular service. B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. 'The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup 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: T:at„ c T..�......♦:,.., r... �11 c1'lnnn 2 I Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 68 Waterford Drive Marston Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health and Public Water Supplier,if an determines that the Y ( PP � Y) system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50.feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: ' 'r:a,., c r—.,o,.+ ...,v,.— 411 ci1)nnn 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 68 Waterford Drive Marstons Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 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 a cesspool or privy is within a Zone 1 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 form.] _NO_(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 68 Waterford Drive Marston Mills,MA.02648 i Owner: Brennan Date of Inspection: 5/28/2004 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 this inspection? _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 sign 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? _X_ _ 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 the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 68 Waterford Drive Marstons Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual):4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):440gpd Number of current residents: 2 Does residence have a garbage grinder(yes or no):Yes Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required] Laundry system inspected(yes or no):Yes Seasonal use:(yes or no):No Water meter readings,if available(last 2 years usage(gpd)): not available Sump pump(yes or no):NO Last date of occupancy:Current COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/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: Pumped after Inspection. Was system pumped as part of the inspection(yes or no):Yes If yes,volume pumped: 1,000 gallons--How was quantity pumped determined?Sight tube on truck Reason for pumping: Check tanks structural integrity. TYPE OF SYSTEM _X_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) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): / Approximate age of all components,date installed(if known)and source of information: System was installed in 1989 per as built plan of system. Were sewage odors detected when arriving at the site(yes or no): NO Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 68 Waterford Drive Marstons Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 BUILDING SEWER(locate on site plan) Depth below grade: 40" Materials of construction:_cast iron X 40 PVC_other(explain): Distance from private water supply well or suction line:N/A Comments(on condition of joints,venting,evidence of leakage,etc.):Building sewer is in good conditon. SEPTIC TANK: X (locate on site plan) Depth below grade: 26" 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' x 5'-8" x 5'-2" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle:31" Scum thickness:3" Distance from top of scum to top of outlet tee or baffle: 12" Distance from bottom of scum to bottom of outlet tee or baffle: 18" How were dimensions determined:Measured Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): tees in good condition.Tank is structurally sound.No evidence of leakage in or out. GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass__Solyethylene_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.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 68 Waterford Drive Marston Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain): Dimensions: Capacity: gallon Design Flow: gallon/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)(36"below grade) 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.):Distribution box is level and distributing evenly.No evidence of solids carryover.No evidence of leakage in or out of the box. PUMP CHAMBER: (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.): Trio f T.,—,+,*—L'....,, 4/1 1z/1M(1 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: 68 Waterford Drive Marstons Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 SOIL ABSORPTION SYSTEM(SAS):X (locate on site plan,excavation not required) If SAS not located explain why: Type _X leaching pits,number: 2@ 6'x 6' PitA 36"from pipe to water PitB 39"from pipe to water leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: _overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): Soil is dry.No evidence of hydraulic failure.Vegetation is normal.No ponding on the surface. CESSPOOLS:_(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 68 Waterford Drive Marstons Mills,M.A.02648 Owner: Brennan Date of Inspection: 5/28/2004 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. A 4 � af 2 y 3 10 a r Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 68 Waterford Drive Marston Mills,MA.02648 Owner: Brennan Date of Inspection: 5/28/2004 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 81+ feet Please indicate(check)all methods used to determine the high ground water elevation: . Obtained from system design plans on record-If checked,date of design plan reviewed: _X_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:No indication of groundwater at 81. Per local topography.There is a slope in the topography in the neighboring properties.Probably closer to 10 but no indication of groundwater at 81. T41. c r.,,.+;, T7-4/1 ri,)rnn 11 0 G 1✓iN�- �ao� N/r�G 2 ooM a r J { J a " 0 r7 0 U) II LL T.O.F. = 50.5' W W FINISHED GRADE EL, 50't Q } � 6" 6" jf PRECAST DISTRIBUTION BOX NOTES: W = W l�ZM FINISHED GRADE EL. 50't INSTALL ON A STABLE COMPACTED BASE �., MINIMUM WALL THICKNESS = 2" Cr = J 0 Q v EasnNc 7RISER MINIMUM INSIDE DIM. — 12" ` Ld In TO REMAIN MINIMUM SUMP = 6" INV EL 10"Min. 14"Min, INV EL OUTLET INVERTS SHALL BE EQUAL TO EACH OTHER AND AT t Q 46.6' Below Flow Lin f 46.36' INV EL INV EL 2" MINIMUM BELOW INLET INVERT. O �O Liquid Level 48" MOD 0" 46.16' 45.96' THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX SHALL 6" Stone ALL HAVE EQUAL INVERTS AS DETERMINED BY FLOODING THE FP L A N L E G E N LL J DISTRIBUTION BOX DISTRIBUTION BOX TO THE HEIGHT OF THE DISTRIBUTION LINE O REQUIRED CAPACITY — 440 GALLONS AT 20090 INVERT AFTER ALL LINES HAVE BEEN SEALED IN PLACE. Q RELOCATE EXISTING 1500 GALLON TANK INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH LP EXISTING LEACH PIT z z F— DURABLE AND NONDEFORMABLE MATERIAL PERMANENTLY J 00 0 FASTENED TO THE LINE OR RECONSTRUCTING THE LINES V 0_ F— Tees shall be constructed of Schedule 40 PVC and shall extend a ` UNTIL ALL INVERTS ARE OF EQUAL ELEVATION. 49,3 EXISTING SPOT ELEVATION Of minimum of 6" above the flow line of the septic tank and be on `� O Q Q the centerline of the'septic tank located directly under the y�Yof EXISTING HYDRANT W T F R clean—out manhole. W The inlet pipe elevation shall be no less than 2" nor more than 3" �O` Q above the invert elevation of the outlet pipe. Septic tank shall have a minimum cover of 9' Two 20"manholes with readily removable impermeable covers of durable material shall be provided with access ports The outlet tee shall be equipped with gas baffle. Install on a level, stable compacted base onto which six inches of crushed stone has been placed. N�,,4� L_ O C _ J !E> M A P 0, cQ GENERAL NOTES: `.� `-0 1. ALL THE WORKMANSHIP AND MATERIALS SHALL CONFORM TO DEP AND �`. ASSESSORS MAP 56 PARCEL 002/X30 THE TOWN OF BARNSTABLE RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ACCESS PORTS OVER TANK TEES SHALL BE ACCESSIBLE WITHIN 6" cSy6,`•�` REFERENCE CERTIFICATE: 189,016 OF FINISHED GRADE. a� 3. SEPTIC TANK AND DIST. BOX SHALL HAVE NOT MORE THAN 36" OF COVER. �`.���j ; 4. THE EXCAVATOR/CONTRACTOR SHALL CALL "DIG SAFE" AND VERIFY THE LOCATION cQ.`� �`� A REFERENCE L.C. PLAN: 23747-B OF SITE UTILITIES PRIOR TO ANY EXCAVATION, AND SHALL BE RESPONSIBLE FOR ALL MATTERS RELATING TO ELECTRIC AND/OR GAS EASEMENTS. 5. SEWER PIPES SHALL BE SCHEDULE 40 PVC. (4" DIA. UNLESS OTHERWISE NOTED) LOT 21 ZONING DISTRICT: RF 6. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE `.` `�` 1. Z 7.MORTARED SHALL HAVE A MINIMUM SLOPE OF 0.02 FT, PER FOOT. j� 44 1841± S ft.IN PLACE. `�`. `�'`✓�� (A q BUILDING SETBACKS: 8. THE EXCAVATOR/CONTRACTOR SHALL BE RESPONSIBLE TO CONTACT DOYLE ti 5 AND ASSOCIATES 24 HOURS PRIOR TO ANY REQUIRED INSPECTIONS. FRONT — 3O'SIDE & REAR 15' z . o N°, OVERLAY DISTRICTS: Ln AP RPOD & MA ESTUARY Z.O.C. CL o ,- z PROPOSED LOT COVER BY STRUCTURES = 7.5% d C1_ . . . I zl ADD PAT10 AREA .. PROPOSED 1500 GALLON SEPTIC TANK LOCATION REMOVE EXISTING DECK FOCUS DOES NOT LIE IN A FLOOD HAZARD ZONE BM: TOP OF FOUNDATION 0) ELEVATION 50.5' DATUM: ASSIGNED EXISTING 1500 GALLON SEPTIC TANK LOCATION 32 1' 50.0' 50.0' PROPOSED DIST. 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