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Home My WebLink About0092 WATERS EDGE - Health 77 192 Waders Edge (Marstons 'Mills P --- - 062 044 - \ 2- � Ll 85- sop, ✓ LO CATION g2 SEWAG E _PE_RMIT NO. LOT , 51, w oieq 3 EbGc- D R °VILLAGE I N S T A LLER'S NAME A ADDRESS (� R, ERE tr AcK L-!o F 5 V5�U Lc C fs B U I L D E R OR OWN ER DATE PERMIT ISSUED cl_ 95' DATE COMPLIANCE ISSUED 1 �,� a � -� �� r� i F 0 , b .�� `r a �� M o .�. O y� TOWN OF BARNSTABLE LOCATION 9 bASALS &Oe 6,261 falne!�,Ion A EWAGE # V VII.LAGE. t /�� ASSESSOR'S MAP & LOT ./`��.,fun, 1��i ROE NAME&PHONE N0. �Q Sh SEPTIC TANK CAPACITY 15®017RI16 LEACHING FACILITY: (type) J/ D-4�e,t el-r (size) NO.OF`BEDROOMS BUILDER OR OWNER tilG�ir��Q�� PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist / on site or within 200 feet of leaching facility) A1/1' Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Cg h 's CA al Da-331 'Dq=CAI' F3- ' �3:-417 51. Z. l `� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION FRECEIVED MW At t � 200 AUG 0 9 2004 v1'T' TQVVi,,OF c3ARNSTABLE,,,, TITLE S H"EALTH DtPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS =m SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A ;; C, ti_, CERTIFICATION E5 > d R Ed t aers Edge Road Property Address: 92 W � Marston Mills co Owner's Name: Lort.Johnson v Owner's Address: 92 Waters Edge Road Marston Mills Date of Inspection: August 5,2004 Name of Inspector:(please print)Timothy E.Cash Company Name: Cash's Trucking Inc Mailing Address: PO Box 7 Yarmouthport Telephone Number:_(508)362-Ml 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-W of Title 5(310 CMR 15.000). The system: xx Passes Conditionally Passes _ Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature:( . �� Date: August 5,2004 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 ****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 some or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of t 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) property Address: 92 Waters Edge Road Marston Mills Owner: Lort Johnson Date of Inspection:August 5,2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: XX I have not found any information which indicates that any of the failure criteria described in 310 CUR 15.303 or in 310 CUR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: I have found nothing accordinq to state or local rules that this system will fail in anv way. 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: Title 5 Inspection Form 6/15/2000 2 r Page 3 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 92 Waters Edge Road Marstons Mills Owner: Lort Johnson Date of Inspection:August 5,2004 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 CNIR 15-W(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 I 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: Title 5 Inspection Form 6/15/2000 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:92 Waters Edge Road Marston Mills Owner: Lort Johnson Date of Wspertion:Auaust 5.2004 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for aIl inspections: Yes No xx Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool roc Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool roc Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool xx Liquid depth in cesspool is less than 6"below invert or available volume is less than%2 day flow xx Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped roc Any portion of the SAS,cesspool or privy is below high ground water elevation. xx Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. xx Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. xx 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.] 1 6 (Yes/No)The system fails.I have determined that one or more of the alcove 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 now 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 xx the system is within 400 feet of a surface drinking water supply _ xx the system is within 200 feet of a tributary to a surface drinking water supply _ roc 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. Title 5 Inspection Form 6/15/2000 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 92 Waters Edge Road Marstons Mills Owner: Lort Johnson Date of Inspection: August 5,2034 Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes No roc _ 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? xx _ Has the system received normal flows in the previous two week period? xx Have large volumes of water been introduced to the system recently or as part of this inspection? xx _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) roc _ Was the facility or dwelling inspected for signs of sewage back up? roc _ Was the site inspected for signs of break out? roc _ Were all system components,excluding the SAS,located on site? xx _ 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? xx _ 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 xx _ Existing information.For example,a plan at the Board of Health. xx _ 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)] Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address•. 92 Waters Edge Road Marston Mills Owner: Lod Johnson Date of Inspection: August 5,2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 1 10 gpd x#of bedrooms):440 Number of current residents: 2 Does residence have a garbage grinder(yes or no):l) Is laundry on a.separate sewage system(yes or no): U-a [if yes separate inspection required] Laundry system inspected(yes or no):Ub Seasonal use:(yes or no):M b Water meter readings,if available(last 2 years usage(gpd)): 2002-87000 2003-99000 Sump pump(yes or no):JA Last date of occupancy: 8/04 CONHHERCIAL/INDUSTRIAL Type of establishment. Design flow(based on 310 CMR 15.203): Sri Basis of design flow(seats/persons/sgfl 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: OTTIER(describe): GENERAL INFORMATION Pumping Records Source of information: Home Owner Was system pumped as partt of the inspection(yes or no): If yes,volume pumped:_gallons—How was quantity pumped determined` Reason for pumping: TYPE OF SYSTEM xx 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(i€known)and source of information: System was installed 9/17/85 by Merriam Backhoe Service Were sewage odors detected when arriving at the site(yes or no): 1u® Title 5 Inspection Form 6/15/2000 6 Page 7 of It OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 92 Waters Edge Road Marston Mills Owner:Lort Johnson Date of Inspection: August 5,2004 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(bate on site plan) Depth below grade:2'5" Material of construction:roc 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: 1500 gallon septic tank Sludge depth: V Distance from top of sludge to bottom of outlet tee or baffle:35" Scum thickness: 0 Distance from top of scum to top of outlet tee or baffle: 0 Distance from bottom of scum to bottom of outlet tee or baffle: 0 How were dimensions determined: measured Commems(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): fs are in good condition,tank is sound and shows no sign of anv leakage,liguid level is stood in relation to the fs GREASE TRAP:_(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.): Title 5 Inspection Form 6/15/2000 7 f Page 8 of 1 i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 92 Waters Edge Road Marston Mills Owner: Lort Johnson Date of Inspection: August 5.2004 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: 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: (if present must be openedXlocate on site plan) Depth of liquid level above outlet invert:even Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-box is level and show no sign of leakage,or carrie over. 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.): Title 5 Inspection Form 6/15/2000 8 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 92 Waters Edge Road Marston Mills Owner. Lort Johnson Date of inspection: August 5,2004 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: xx leaching chambers,number: 4 leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: _overflow cesspool,number._ innovativelatternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): siol is dry,no breakout,or hydrualic failure,stone is clean and free,vegetation is normal,feils is woridng 000d. 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: (bate 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.): Title 5 Inspection Form 6/t5/2000 9 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 92 Waters Edge Road Marstons Mills Owner. Lort Johnson Date of Inspection: August 5.2004 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. L)A 3` F= fro&W orgoos _U A �i CI 1 ti O 1 G v Title 5 Inspection Form 6/15/2000 10 Page It of It OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 92 Waters Edge Road Marstons Mills Owner- Lort Johnson Date of Inspection: August 5.2004 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: _Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting propertylobservation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) xx Accessed USGS database-explain: Capr Cod Commision You must describe how you established the high ground water elevation: No water at 1Y,results on next page. Title 5 Inspection Form 6/15/2000 1 l Permit Number: Date: 8/5/04 Completed by: Timothy E.Cash 1•IIGH GROUND-WATER LEVEL COMPUTATION Site location: 92 Waters Edge Road, Marstons Mills Lot No. owner:Johnson Address: Same Contractor: Cash's Trucking Inc. Address: PO Box 7,Yarmouthport 02675 Notes No water encountered STEP 3 Measure depth to water table 8J5/fl4 13.0 ` tonearest 1/1Oft. .............................................................................. Date month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: aAppropriate index well............................... .......... sdw25c �B Water-level range zone..................................................... B STEP 3 Using monthly report"Current Water Resources Conditions" determine current depth to 7/04 51.0 water level for index well........................... monthJyear STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A),current depth to water level for index well(STEP 3), and water-level zone (STEP 26) determinewater-level adjustment............................................................................. . .... 5:2 STEP 5 Estimate depth to high water by subtracting the water- level adjustment(STEP 4) from measured depth to water 7.8 levelat site (STEP 1)..................................... .. .................................................................. Li i -o�� o No ...Rs...........—......5)-2— Fimic ........... . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................... ....................OF........I......I..,..............I........................................................ Appliration for Diapasal Works Tomitrurtion "truth V Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: 95r-* q9_ jb.R .......... .......... ............................... ................................................................... Location-..A4dr,ss or Lot "'o. mptr,3 IV ------ ......... ............. _OT ...�n.. ..... . ......f.,,0�4.euj........................ .... Owner Address ............................................................................................ ......................................... ...... Installer - Address Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms..........A.11.......................Expansion Attic Garbage Grinder (VO) Other—Type of Building ............................ No. of persons.......5................. Showers (.3 Cafeteria (o) P4 Other fixtures . ...... . . ................................... ---------------------------------------------------------------------------------------- Design Flow..........3 .....................gallons. W j9d gallons per person per day. Total daily flow____._..... .*.... Depth...'........ 1:4 ; Lin .... meter................ Depth....A/........ Septic Tank—Liquid capa�ity,44�...gallow �h... Width,4/..,.o Diameter..... . 4. A' Disposal Trench—No. ........... Wiath.l__. ....... Total Length...Zi- Total leaching areas.? Y.:t..Z...sq. ft. Seepage Pit No_____________________ Diameter.._......_....__.._. Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box Yd Dosing tank 0-4 Percolation Test Results Performed by................................................*........................ Date---------------------------------------- aTest Pit No. I................minutes per inch Depth of Test Pit.__.._._........_... Depth to ground water.._............,::...__. 0-4 44 Test Pit No. 2................minutes per inch Depth of Test Pit................... Depth to ground water.............2......... P4 ........................................................................... .......................... 0 Description of Soil......ia--"--4'L ...........j.............. -------------------------*------------------------------------*--------------- --------- .......----------------------------....... ------- ---------------- .......................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable---------- ..........0.... ......................... ...........................P.4:&L C-0 , j,- i. ................ ........ ................................................I..........................�...................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in.accordance with the provisions of TL I TL LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beenAsstfed by the b of health. PP 5_7 e .... ........................... ... .................. 11 Date Applic ion Approved By....................................... ......)......L I ... ................... .... &A.5----- Date Application Disapproved for the following reasons:............................................................................................................... ................................................`.........—............................................................................I............................................................................................... Date Permit No......r..j _j.4 _ Issued....................................................... Date ----------0 ——-------------------------------------- ........ FEB�� ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF.................-....-......-......... Appliration for Disposal Works Tonstrurtion thrutit Application is hereby made for a Permit to Construct!'( ) 'or Repair an Individual Sewage Disposal System at: ......L) ......... .................................................................................................. Location .4dress. �jo or It. lei)................... ...........................�rsr.)11.r J� .... ...... ................................. Owner Address ................................... ..................................... .................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..........#.J/............... .....Expansion Attic Garbage Grinder 0/6) P4 Other—Type of Building ............................ No. of persons......4 ................. Showers Cafeteria A4 Other fixtures ., ................................................................................................ I .................................. p Design Flow.........3.11. . ..... y-pfy gallons per person per day. Total daily Now.._.........................................gallons. Liquid capacityi40----gallons d f ,/ L.f n ... .... Widt49....49.�.. Diameter._.-.______.__. Depth....Y 11:4 Septic Tank jth_.X.' 6. 4 ........ x D'isposai" Trench No,. ... ....... Widthl..... ........ Total Length..4/.......0.".. Total leaching areapf�Yt.l...sq. ft.. Seepage Pit No---------------------- Diameter.................... Depth below inlet................._.. Total leaching area..................sq. f t. . Z Other Distribution box Dosing tank ( ) Percolation Test Results Performed-by-------------------------------------------------------------------------- Date------------------------------.....•-- 1.4 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......................... .....................................I................. .... ...... ................................1—............................................. 0 Description of So .27U_4a��. .....Q.....4-d ......................................................I.................... U ....................................................................................... ............................................................................................................. ..........................................7............................................................................................................................................................. U Nature of Repairs or Alterations—Answer when applicable-------- --------- ------------------------------------------- 11 ..........................................A�..................................................................................................................................................... Agreement: Th'e undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been .ssued by the b", of health. Signed..............................thee L................... ... . Daty4L Application Approved By, � � _._. . .....P "UX ................... ...... - ... ------ Z7.... ,ha Date Application Disapproved for the following reasons:................................................................................................................ . ......................................................................................................................................................................................................... Date Permit No.......F.........),-e. ........................ issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................OF............. ....................................................................... Tntifirate of Toutpliatur THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by.......................C.44.,01'.4.e............... .ass.,. ................................................................................................................... ............ ... .... .... .. ........ at........ ......lt. ..... ....... ....................................................................................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Co described in the application,for Disposal Works Construction Permit ... dal -- - --------510:5............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..... .. ............ Inspector..._._.._ ---- ......... ......................... ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................0 F..................................................................................... Nozs� -------------- FEE Disposal Yorks OUInstrudion "prrutit Permission is hereby granted....... tcj "//-fx/.,;" ............................I...................I........................................................................ to Construct . or Repair an Indiviftal Sewage Disposal System atNo...._5A.... . ........................................................................................................ Street as shown on the application for Disposal Works Construction Permit No........ ...O.."Dated........ ........... . ..........., ......................... ....................... ...U_ ............................ DATE............1- -------------------------------------- -- Board of Health p FORM 1255 A. M. SULKIN, INC., BOSTON I. J .K. HOLMGREN & ASSOCIATES INC. Civil Engineers and Land Surveyors 1308 Belmont Street, Brockton, Massachusetts 02401 (617) 583-2595 July 23 , 1985 Mr. and Mrs. Kent Powell 172 Jones Road Marstons Mills , MA 02648 Dear Mr. and sirs . Powell , Kindly except my sincere apologies for the manner with which your project has been handled by my office. Unfortunately , due to our severe work load , a job occasionally does not get the attention it deserves . In our effort to accommodate you as quickly as possible , our standard "checking" procedure was omitted , thereby , causing you all the consternation . I fully understand if your opinion of my firm is less than anticipated. But I would hope that you would not hold Ms . Bohannon in the same regard. She obviously had no part in this fiasco and I would sincerely hope that I have not tarnished her reputation as a professional. Again , I am truly sorry and hope that the remainder of your home construction goes well . Very truly yours , / John K. Holmgren , P . E. JKH/lad Land Surveys Subdivisions Septic Design Wetland Filings Site Design } _ - o 4 O Cl � d O a �O PRECAST LEACHING CHAMBER X\ � \k 4 REQUIRED > DISTRIBUTION h ; 'BOX NOTE //'_Q S DESIGNED SYSTEM CONSISTS OF 4 OUTLETS REQJIRED BEACHING CHAMBERS SURROUNDED ` BY 3 FEET OF 314 - I /2, O �� I I I \ ( \ WASHED STONE CAPPED BY 2 \/ ISoo GALLON SEPTIC TANK PEASTONE WITH 6 STONE U 1 I I I I Q o LEACHING CHAtIOBEF' V ° J AREA DESIGN SCHEDULE ELEVATION` . 1 \ / ) TOP---OF FOUNDATION 76.50 C-A-L.-CUL A T l O N S 1 FINISHED BASEMENT FLOOR---,------- - . 69:OL� - , 04 I u` / LEACHING AREA REQUIRED: FINISHED GARAGE FLOOR 75.50 4 0 r Q� �\ -- -- — �o ' ``� �✓g�' a � 7 Bedrooms at /lO GPC/BR = ��— �Pn / T.H 2 SEWER INVERT AT FOUNDATION 69./0 50 for Disposal- -N/A GPD SEWER INVERT INTO SEPTIC TANK 68.90 SEWER INVERT OUT OF SEP7I C TANK 68. 74 TOTAL = 440 GPI s , / 1 0�' SEWER INVERT INTO DIST. BOX 66.OEE_rTc RATE- 2_o MIN.iINCH - ono` / �o . , p SEWER INVERT OUT OF DIST. BOX 67.92 bo, TCM AREA 440 S.F. x /. 00 - 440 9PG SICEWAL.L AREA = /92 S. F. x 2. 5 = .4$0 GPG SEWER INVERT AT LEACHING PIT 67.62 � � WATER TABLE LEACHING ASE = �32 SF, w/capocity o 00 f2ZUGPf 62. SOIL L 0 GAS SCALE - I 3� e PROJECT BENCHMARK: CATCH BAS WA IN RIM STATION 9a 50 TERS BAXTER YE- lNG. F��' �, EDGE ( PRIVATE WAY) ELEVAT/ON=7/.60 NGVD. DATE April 10, 1955 ENGINEER PETER SUL/I VAN BOARD OF,,.HEA LTH AGENT ,/AMFs CONLON TEST PIT I TEST PIT 2 TEST PIT 3 TEST PIT 4 TEST PIT 5 60 c� OFb �A GRETEM. cyG,o ELEVATION=78.00 EL EVATIO.N = 78.85 y�`�\A\k OF Mq � v BOHANNON JOHN K. G w H ti LOAM LUA M HOLMGREN �-, �o� G►S E / & / & CIVIL H �s�� L LAND O 2 SUBSOIL 2 SUBSOIL NO. 308" r fG1ST 3 3 _ PERK_L EVEL 4 cL EA N 4 _ I CERTIFY THAT THE SEWAGE DI SPO S SYSTEM PREPARED FOR .' KEN T B L ORI PO W EL L - CLEAN ( SHOWN HAS BEEN DESIGNED IN ACCORDANCE WITH 172 ✓ONES ROAD 5 — 5 TITLE 5 OF THE STATE ENVIRONMENTAL CODE IVARSTONS MILLS MA. 02648 MEDIUM MEDIUM AND THE RULES 8 REGULATIONS OF THE LOCAL 6 s BOARD OF HEALTH.7 7 ON SI TE SA NI TARP DISPOSAL SYS TEM SAND SAND L O T 58 8 8 9 g. { DESIGNED BY : LEGEND A DR WHI STLEBERRY, MA RSTONS MILLS , M A • 02648 ID EIs TING cororouRs !oI -- - - - DRAWN BY CHECKED BY: J.K. HOLMGREN 8 ASSOCIATES, INC. PROPOSED CONTOURS —!O! T H E J K H I2 NO WATER I2 NO -WATER EXISTING ELEVATIONS /0/x00 SCALES DRAWING No. REGISTERED ;PROFESSIONAL Q!oi / = 40 ENGINEERS AND LAND SURVEYORS PROPOSED ELEVATIONS 1308 BELMONT ST. TsT HOLE DATE: BROCKTON, MASS 02401 5122185 9 ' I