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0235 WHEELER ROAD - Health
235 Wheeler Roads II LI Marstons Millsrt .P:p A 082. 008 II TOWN OF BARNSTABLE LOCATION 23- SEWAGE #,F� Ar VILLAGE //!.!�/�f�j ASSESSO/R'S MAP & LOT — U INSTALLER'S NAME&PHONE NO. Yh•1�/df�, CS7isLf �I?�''Z9.7f SEPTIC TANK CAPACITY l,apd G L i LEACHING FACILITY: (type) 57d C. (size)/3 X Ref `--;7' NO. OF BEDROOMS Ll BUILDER OR W R PERMIT DATE: S��/�0 2 COMPLIANCE DATE: i • 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) /rQ Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) 131 Feet Furnished by l7W-J ,e/% 417 (�pg,�tMN s I 0 TOWN OF BARNSTABLE U-X—AT10N .3,��/ ��G<.�,�— RD SEWAGE -VILLAGE_ ///i��, ASSESSOR'S MAP & LOT — U s INSTALLER'S NAME&PHONE NO. 64,,574c/-,, V 491� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) rAO (size)/3,y NO. OF BEDROOMS BUILDER OR WNER PERMITDATE: S��/�0 2 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) /r0 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 131 Feet Furnished by l7a�r� '��3 s �r�� � � � . /f �7=- s. ��!' q' �� 0 �3 �o�,C � ���f✓ r ��t��aL (9 No. " a ;v A`" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[pplicatiou for �hzpooal bpgtem Conztruction Perron Application for a Permit to Construct( , )Repair( )Upgrade(1/Abandon( ) ❑Complete System T Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. J / [J Designer's Name,Address and Tel.No. bi-M/,ol )ions 7-.., 7 ?/93Q Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building e o No.of Persons Showers( ) Cafeteria( ) Other Fixtures l Design Flow 69 gallons per day. Calculated daily flow `� � gallons. Plan Date Number of sheets Revision ate / D Title v�/ <�� r� 3 5 e e el Size of Septic Tank /G�UO 9lI'� �KXZ57'_ Type of S.A.S. — 57cy 61-r C Description of Soil l Z e 3 -?,_57_� Nature of Repairs or Alterations(Answer when applicable) tj— cz?%1�-Pi2Y e ,�q [: SIGNING ENGINEER MUST S ' 7 " Date last inspected: INSTALLATION AND CERTIFY IN t " THE SYSTEM WAS INSTALLED IN Agreement: r"=0RDANCE TO PLAN. The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b s o of Health Signed Date Application Approved by Date 7 L—Zr Application Disapproved for the following reasons Permit No. �7491w_ Date Issued 1, . +." f` �"rite..� r'^ r � ,.... m� ...�_y'')/_,q��.,-; .� F • . J _ .. �! ! ..�.��r��, � �, ,ram �4 w` -,_® /y"� ... /'/1/ � l '� • Na^,/, �i I➢; f' t/ �' Fee 'i� � THE,.COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ; (PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE S MASSACHUSETTS h ZippYication for 30igo5al *p!5tem Construction Permit Application for a Permit to Construct Repair Upgrade(e/)Abandon ❑Complete System U Individual Components PP ( ) P ( ) Pg f/ ( ) P Y P Location Address or Lot No. P � Owner's Name,Address and Tel.No. Z33- U4e l l r Assessor's Map/Parcel, y. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. kf 10/0911 Goes 17% eewe eVe Z?!�?, -7 7/-e7 Type of Building: ` e r Dwelling No.of Bedrooms I Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) '( Other Fixtures 'J 'y Design Flow A�l gallons per day. Calculated daily flow 7 Q gallons. Plan Date /� _ Number of sheets / Revision ate 5 /�-- 7 _ /� - Title 1'"`"/,7` .$/7''� � d Z .�..7 C�Ll�i�'� /^ Size of Septic Tank F X'/..ST` Type of S.A.S. 3 - 5`de f9 C X&,0 Description of Soil 1�- �i3 X J 45 � ell Nature of Repairs or Alterations(Answer when applicable) i i Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system f. in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued byl.-this o of ealth. Signed A Date _5 Z01z Application Approved Date Application Disapproved for the following reasons w Permit No. Ades ► /�-'� Date Issued 'r '' �""'' i THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CER ,:that t}e On-site S wage Disposal System Constructed( )Repaired( )Upgraded Abandoned( )by 01/ �'`di2? / r at Z- has been constructed in accordance w, with the provisions of Title 5 and the for Disposal System Construction Perr 6�.�i-2/. dated .01 -g406- r.'1t,-;,. Installer Designer The issuance of this permit shall not be construed as a guarantee that the sys eeriri will f ction as de ig ed. Date �r J �;. Inspector �✓ '' t t, �liib�G- '�s�l ----------------------- No. Fee '"^17 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ligpool *p!gtem Construction Permit Permission is hereby granted to Construct(/ )Rep it( )Upgr�e( d�Abandon( ) System located at �!" �y 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:Construction mustbe completed within three years of the date of thi p it. Date: Approved UY tel.(508)362-4541 939 main street rt 6a - fax(508)362-9880 yarmouth port mass 02675 down cape engineering civil engineers& land surveyors structural design Arne H.Ojala P.E., P.L.S. Daniel A.Ojala, P.L.S. land court Timothy H.Covell,P.L.S. surveys June 7, 2002 ` Thomas McKean, R.S. site planning Barnstable Board of Health 367 Main Street " sewage system Hyannis, MA 02601 designs Re: 235 Wheeler Road, Marstons Mills inspections Dear Tom: permits Down Cape Engineering, Inc. performed inspections of the newly constructed septic system at the above-referenced location. The septic system is hereby certified to be installed in substantial compliance with the approved plan (see sketch) . If you have any questions, please do not hesitate to call me. Yours truly, , Arne H. Ojala, PE, PLS Down Cape Engineering, Inc. REC cc: Bortolotti Cons ruction 4 Town 0z, CFI'/E)1 1 ZUU�H� pTAB�E A 22 rg 23 + 24 ?O 25 ?� 26 27 28 ?3 `1\8 (3) 500 GAL LEACHING 24 CHAMBERS WITH 4' \30 STONE AROUND 3� 40 RFT, �'A� 3? ?g 27 i P1 2B no r oC-- 29 j DECK EXIST. ```� 30 DWELL 9 31 j SLAB EL. '--__ 40.5 32 33 4 34 g 35 rn 36 xr 37 38 m 39 1 ¢O -10 F� 0) o I' l If \ 0,2-092 SEPTIC AS-BUILT LOCATION : 235 WHEELER ROAD (MARSTONS MILLS) BARNSTABLE PREPARED FORT SCALE : 1"= 40' DATE : JUNE 7, 2002 BORTOL0TTI CONST. REFERENCE : ASSESSORS MAP 82 PCL 8 I HEREBY CERTIFY THAT THE SEPTIC SYSTEM SHOWN ON THIS PLAN IS LOCATED AS SHOWN HEREON, ARNE LA OJA -4 off 50H—a�2--4541 o CIVIL `� fax 5M 362-SM c� 7s2 � down cape englneering, Inc. 41//ff ']1v� 'ppF f ►S CIVIL ENGINEERS LAND SURVEYORS 939 MQIn st. yarMouth, rya DATE REG. LAND SURVEYOR COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS--- DEPARTMENT OF ENVIRONMENTAL PROTECTION ° ONE WINTER STREET, BOSTON MA 02108 (61,7)292-5500 �. (9 Q TRUDY COXE Secretary U'. ?OD ARGEO PAUL CELLUCCI ��yQ DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIONFORM PART A CERTIFICATION �` `"`✓�+ Property Address: 235 Wheeler Road, Marston Mills, MA Name of Owner: Leo Burns ` Address of Owner: Sante Date of Inspection: August 17, 2000 name of Inspector: (Please Print) James M. Ford I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: James M. Ford Mailing Address: P.O. Box 49, Osterville, MA 02655-0049 Map: 082 Telephone Number: (508)862-9400 Parcel. 008 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Passes Conditionally Passes _ Needs Further Eval tion a Local Approving Authority ✓ ils Inspector's Signature: Date: August 20, 2000 The System Inspector shall submit a py of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. NOTES AND COMMENTS revised 9/2/98 Page 1of11 Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 235 Wheeler Road, Marston Mills, MA :"�•' Owner: Leo Burns Date of Inspection: August 17, 2000 - . INSPECTION SUMMARY: Check A, B, C, or D. A. SYSTEM PASSES: I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 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. Indicate yes, no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank,whether or not metal, is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health: e` `Sewage backup or breakout or high'stand water level observed in the distribution box is:due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced" obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Burns Date of Inspection: August 17, 2000 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b) THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND.PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The:system has:a septic:tank-and soil absorption system(SAS)and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply:, The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART A CERTIFICATION (continued) Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Burn Date of Inspection: August 17, 2000 D. SYSTEM FAILS: You must indicate either"Yes" or"No"as to each of the following: ✓ I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No ✓ — Backup of sewage into facility or system component due to an 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. ✓ 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 Soil Absorption System,cesspool or privy is below the high groundwater elevation. ✓:, Any.portion.of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is"within a Zorie 14 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 ni�'_ acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for_ coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No feet of a surface drinking supply the system is within 400 ng water PP — — Y the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Burns ' Date of Inspection: August 17, 2000 �•,- ,r ', 1;Y a Check if the'following have been done: You must indicate either"Yes" or"No" as to each of the following: Yes No ✓ _ Pumping information was provided by the owner,occupant,or Board of Health. ✓ _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ✓ _ As built-plans have been obtained and exanuned. Note if they are not available with N/A. ✓ The facility or dwelling was inspected for signs of sewage back-up. ✓ _ The system does not receive non-sanitary or industrial waste flow. ✓ _ The site was inspected for signs of breakout. ✓ _ All system components,excluding the Soil Absorption System,have been located on the site. ✓ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for conditions of baffles or tees,material of construction,dimensions,,depth of liquid,depth of sludge,:depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: -- -'- . ✓ Existing information. For example,Plan at B.O.H. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [15.302(3)(b)]• ✓ _ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Page 5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Burn Date of Inspection: August 17, 2000 "+ t-� <<+ '-.�':�_•4'..,- . '. FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom. Number of bedrooms(design): 3 Number of bedrooms(actual): 3 Total DESIGN flow 550 Number of current residents: 3 Garbage grinder(yes or no): Yes Laundry(separate system)(yes or no):No; If yes, separate inspection required Laundry system inspected(yes or no): No Seasonal use(yes or no): .No Water meter readings, if available(last two year's usage(gpd): Private well Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gyd(Based on 15.203) Basis of design flow 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: t t :r: ,:3_ . ,:.:•s. OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Never pumped-per owner. System pumped as part of inspection(Yes or no): No If yes,volume pumped: gallons 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) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other. `APPROXIMATE AGE of all components,date installed(if known)and source of information: Approximately 1986-per design plans. Sewage odors detected when arriving at the site: (yes or no) No revised 9/2/98 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Burns �..r •i.;. ` 0 Date of Inspection: August 17, 2000 BUILDING SEWER: _ (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints,venting,evidence of leakage,etc.) SEPTIC TANK: ✓ - I (locate on site plan) Depth below grade: 3' Material of construction: ✓concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal,list age_ Is age confirmed by Certificate of Compliance_(Yes/No) Dimensions: 1000 goal. Sludge depth: — Distance from top of sludge to bottom of outlet tee or baffle: -- l . 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: -- ' How dimensions were determined: — Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) The tank was located but not dug up. The tank was 3'under a brick walkway. Recommend installing risers. GREASE TRAP: None (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: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, _ evidence of. eakage,,etc.)`' revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Bums Date of Inspection: August 17, 2000 TIGHT OR HOLDING TANK: None (Tank"must be pumped prior to,or 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: Alarm level: Alarm in working order: Yes_ No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: ✓(per design plans) (locate on site plan) Depth of liquid level above outlet invert: — ;. ;,n Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) The D-box was not dug up. The leach pit was in failure PUMP CHAMBER: None (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.) revised 9/2/98 Page 8of11 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Burns Date of Inspection: August 17, 2000 `A SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan, if possible;excavation not required, location may be approximated by non-intrusive methods) If not located,explain: Type: leaching pits,number: 1-6'x 6' with 2'of stone(per design plans) leaching chambers,number: leaching galleries, number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.) The pit had 5'6"of water on the bottom and the scum line was above the inlet pipe The leach pit was in hydraulic failure. The bottom to grade was approximately 9' CESSPOOLS: None (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow(cesspool must be pumped as part of inspection). Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) PRIVY: None (locate on site plan) Materials of constriction: Dimensions: Depth of solids: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) I revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION :(continued) Property Address: 235 Wheeler Road, Marston Mills, MA Owner: Leo Burns Date of Inspection• August 17, 2000 Map: 082 Parcel: 008 SKETCH OF SEWAGE DISPOSAL SYSTEM: . include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 3A� ` C3 A O t3a- - A3- sa 3 zl list:., 7k KC' '.2 r revised 9/2/98 Page 10ofII i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 235 Wheeler Road,Marston Mills, MA Owner: Leo Burn Date of Inspection: August 17, 2000 ct, ;- ;�;,;;-,•; , a, NRCS Report name Soil Type Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 30 +/- Feet Please indicate all the methods used to determine High Groundwater Elevation: ✓ Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions ✓ Checked with local Board of Health Checked FEMA Maps Checked pumping records Check local excavators,installers ✓ Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) The bottom of the pit to grade was approximately 9'. Using the Barnstable topographic map and water contours map, the maps were showing approximately 30' +/- to groundwater at this site. This report has been prepared and the system inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. revised 9/2/98 page 11of11 I Page: 1 CERTIFICATE OF ANALYSIS ' - Barnstable� County Health Laboratory rJ 4 Report Prepared For: Report Dated: 04/28/2000 Order Number: G0005680 Ronald DeYoung 26 Seth Goodspeeds Way Osterville, MA 02655 Laboratory ID#: 0005680-01 Description: Water-Drinldng Water Sample#: 05680 Sampline Location: 235 Wheeler Road, Marston Mills Collected: 04/20/2000 Collected by: Ronald DeYou 82/8 Received:. 04/20/2000 Routine ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates 0.4 mg/L 10 EPA 300.0 04/25/2000 LAB. Metals Copper 0.3 mg/L 1.3 SM 3111B 04/25/2000 Iron <0.1 mg/L 0.3 SM 3111B 04/25/2000 Sodium 8 mg/L 20 SM 3111B 04/25/2000 LAB: Microbiology Total Coliform Absent P/A Absent P/A 04/20/2000 LAB: Physical Chemistry Conductance 102 umohs/cm EPA 120.1 04/20/2000 pH 6,1 pH-units EPA 150.1 04/20/2000 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. Approved Bys (Lab Director) L7��d u Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 e',, Commonwealth of Massachusetts Executive Office of Environmental Affairs 1 Department of Rd Environmental Protection I 0 W111m F.Weld r Cox A r Paul Cellucci ��D vldd u a. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 8 PART A _ CERTIFICATION . 4 propeetyAddress; 235 Wheeler Rd, Marstons Mills Address of owner. Leo Burns Date of Inspection: aL —f 0` (If different) Name of Inspector. W.E. Robinson SR Company Name,Address and Telephone Number. ( 5 0 8) 7 7 5-8�7.7 6 W.E. Robinson Septic Service P.O. Box 1089 ' Centerville MA CERTIFICATION STATEMENT 'I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _V passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: e-0 Date: 02"- I v `c! The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. a INSPECTION SUMMARY: Check A,B, C,or D: Al SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y,N,or ND). Describe-basis of determination in all instances. If"not determined",explain why not) The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street • Boston,Massachusetts 02108 a FAX(617)556-1049 • Telephone(617)292-UN �A1 Printed on Recycled Paper 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) property Address 235 Wheeler Rd, Marstons Mills Owner. Leo Burns Date of Inspection: A—/a e,�, ? BJ SYSTEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution boa is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution boa is levelled or replaced The system requite pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed C1 FUR ER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) YSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) EPERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3) THER (revised 11/03/95) 2 o I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinued) Property Address: 235 Wheeler Rd, Marstons Mills Owner. Leo Burns Date of Inspection: ;v 16 D) SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 16.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what*will be necessary to correct the failure. Backup of sewage into facility or system component due to an 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 1/2 day flow. _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for conform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. El GE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 Pion Area(IWPA)or a mapped Zone II of a public water supply well) The o r or operator of any such system shall bring the system and facility into hill compliance with the groundwater treatment program require ents of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.. (revised 11/03/95) 3 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PropertyAddresx 235 Wheeler Rd, Marstons Mills Owner. Leo Burns Date of Inspection: a,_/6,q 7 Check if the following have been done: Pumping information was requested of the owner,occupant,and Board of Health. one of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. barge volumes of water have not been introduced into the system recently or as part of this inspection. h/As built plans have been obtained and examined. Note if they are not available with N/A. he facility or dwelling was inspected for signs of sewage back-up. Phe system does not receive non-sanitary or industrial waste flow ,/The site was inspected for signs of breakout. fi/All system components,excluding the Soil Absorption System, have been located on the site. 'he septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction, dimensions,depth of liquid,depth of sludge,depth of scum. 1 he size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. =4/z facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 I, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PropertyAddrese: 235 Wheeler Rd, Marstons MIlls Owner. Leo Burns Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: `Z/ / gaff lions Number of bedrooms: 'K—'-/ Number of current residents:41625 9 Garbage grinder(yes or no): 'cam _ Laundry connected to system(yes or no):X5 Seasonal use(yes or no):_ Water meter readings,if available: N/A well water Lest date of occupancy: —1 O a 4 COMMERCIALANDUSTRIAL: Type of establishment: Design flow:_gallons/day 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: OTHER(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORD and source of information: System umped as part of inspection: (yes or no)L o If yes,'volume pumped: gallons Reason for pumping: TYPE YSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yea or no) (if yes,attach previous inspection records, if any) Other(explain) APPROIQMATE AGE of all components,date installed(if known)and source of information: !� S Sewage odors detected when arriving at the site: (,yes or no)Li O (revised 11/03/95) 6 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) property Address: 235 Wheeler Rd. Marstons Mills Owner. Leo Burns Date of Inspection: 1-4..Pt. SEPTIC TANK_ (locate on site plan) 14 Depth below grader Material of construction:=�ncrete_metal_FRP_other(e:plain) v► Dimensions: A4C 0 Sludge depth: V-G• ► Distance from top of slings to bottom of outlet tee or baffle:3�, 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:- Comments: (recommendation for pumping,con,�d'tion of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) _/ s 6 '0 ti 2 s Wo i/al b zr-of► Gal E TRAP:_ (k�ca on Bite plan) Depth low grade: Mate ' of construction:_concrete_metal_FRP—other(explain) Dimens no: Scum from top of scum to top of outlet tee or baffle: Distance m bottom of scum to bottom of outlet tee or baffle: Commen (recomme tian for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence leakage,etc.) (revised 11/03/95) 6 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 235 Wheeler Rd, Marstons Mills Owner. Leo Burns Date of Inspection G-S n TI OR HOLDING TANK:_ (locate site plan) Depth low grade: Ida of constriction:_concrete_metal_FR.P_other(exp)ain) - Dime no: Capaci gallons Design flow: gallons/day Alarm evel: Co nts: (condi n of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX:L (locate on site plan) Depth of liquid level above outlet invert:_ Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box,etc.) 6 PUMP HAMBER:_ (locate o site plan) Pumps ' working order:(yes or no) Comme ts: (note oo tion of pump chamber,condition of pumps and appurtenances,etc.) 14 (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 235 Wheeler Rd, Marstons Mills Owner. Leo Burns Date of Inspection: ;L_/d,q -) / SOIL ABSORPTION SYSTEM(SAS):C/ (locate on sits plan,if possible;excavation not required,but may PP be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching pits,number:1 leaching chambers,number:_ leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Comments: (note conditio of soil,signs of hydraulic failure, level of ponding,,co ition of getation,etc.) n- L �O G C POOLS:_ (loca on site plan) Numbs and configuration: Depth- p of liquid to inlet invert: Depth f solids layer. De of scum layer: no of cesspool: Ma riala of construction: of groundwater: inflow(cesspool must be pumped as part of inspection) Commi tits:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) P _ (1 on site plan) Mate ' of construction: Dimensions: Depth o solids: Comme ts: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) (revised 11/03/95) g SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) ProperVAdde+ees: 235 Wheeler Rd, Marstons Mills Owner. Leo Burns Date of Inapeotioo: Z,1 6 A I SEETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at lit two permanent references landmarks or benchmarks locate all wells within 100' L 11 \4 ,I - s DEPTH TO GROUNDWATER Depth to Vmndwater. jL`- feet a G� method of ddernination or approaiimation: (revised 11/03/95) 9 L0CATCoN SEWAGE PERMIT NO• VIIIA E INSTAL 'S NAME i ADD ESS U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED � t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Application is hereby made for a Permit to Construct (X-) or Repair an Individual Sewage Disposal System at: Location-Address or Lot No. Owner Address Installer Address Seepage Pit No......./........... Diameter----/J------- Depth b/elo inlet...... Total leaching area._2,! Z....sq. t. Z Other Distribution box Dosing tank 1010 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTIL 5 of the State further agrees not to place the system in operation until a Certificate of Compliance has been is u d t d lie Date pp ---`-`--`------------'—'----`--------`------------------`---`---`------`--`---'—`—`------ No......... 2 - Fizim ............ THE COMMONWEALTH OF MASSACHUSETTS F BOARD OF HEALTH .......... OF.......... ' ApPratiou for Diapuiial Workii Cron,51rurtinn ramit Application is hereby made for a Permit to Construct (X.) or Repair ( )-an Individual Sewage Disposal System at: f...� sfi•...s �1c. .. .................................................... Location-Address or Lot No. ....."13AI_?Z-3 -��`"'a"''"�`. --•---•--•-•------------------------------------------------------•---•-----•-------••---..._..... Owner Address -_t 144 rg------------------------------------------------- ---------------------------------------- ---------------------------•---•----------- Installer Address of ST V TypeDwelling in No. of Bedrooms________________ Size Lot______ +__ ��'._.. ___.._...__•--___-,___-Expansion Attic (No$ Garbage Grinder (AJ4 '11 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ______________________ ___ Design Flow........_ "`"_________________ allons per person per day. Total daily flow_---__.. ,,,5_ ................... W g �-•- P P P Y Ygallons. WSeptic Tank Liquid capacity .lallons Length................ Width-----------_--- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width______.____._._._.. Total.Length______.___._____.__ Total leaching area................ ._sq. ft. Seepage Pit No........ ..--------- Diameter_... ....... Depth belo inlet_._........... Total leaching area_.�__.��.�_.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) y, Percolation Test Results Performed by.-".'. _________________________ Date..r' __f `_' aTest Pit No. 1.. .._minutes per inch Depth of Vest Pit____________________ Depth to ground water........................ (% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water... Oj .. ! - ... Description of Soil-----•-C ---- r e `` _�. _ ,-- --------------------------------------------------------------------------------------•------------------.....--------------------------...---•------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable:.............................................................................................. --------•-------------------•------••-----------•--------------------------------------.._.:.._.....------------------......------=-----------------------=------------------------------..._........... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f'1T rrl"+• the provisions of TTL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is udd.y tbe-bo 'd oll he th. tSi e (� / Date A A ' Application Approved B Y----._l. ..___ --•- -�--- ---- � � �.:.�--•=---------------=- ---�✓�--�--�--7•` Date------ Application Disapproved for the following reasons------------------•---•--------••••--•-•-•----•------------•----•------•-•••---••---•----•............•--••-•••- ....................•----:-----------•---•-------------------•-----------•-•------------------------........------•---------------------------------------------- ---------------------------------- .. Date r Permit No.................. 7 •----•--------------------------------- Issued.-------`=--- •----- -- ...................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL ....G ..........OF............ .: .. .....:. ................_... �rdifiratr of Tompliattrr THII I TO CERTIFY, t th yidual Sewage Disposal System constructed ( or Repaired ( ) by ! ......--- - lr has been installed in accordance with the provisions of T ` of T e State Sanitary Code as desc;ib d in the �} application for Works Construction Permit N .`V .___ ':L._.......... dated-_-_ .__ *_. __. ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST D AS GUA TEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ < �.. Inspector d� -• --•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NO......................... FEE.......................... Rapn Permission ss ereby granted_.._. : 1'....._:._ _...........................��r to Con u " .( ' or e r ( ) an d i nal Sew ge ts� ytern j�, at No6J;t -'" +��d4`t-.. � yd' �rLis Street as shown on the application for Disposal Works Construction Perm-i'" o t � "�' �J ated ---••••-•- /D Board o Health' DATE..........----- :.. -,t FORM 1255 HOBBS & WARREN, INC., PUBLISHERS No. comm Fwt4 50 LrA--*IHG PIT ru .000 r W 70 r to It be t Ftm 11tt i t E / +'k P.M F'4'+or*i'a try a Ha4^5r• MRCS aA'?E:3= '7 OZ71n 10 7'S ALAN 1 u Jo yI oN wt c-Rom:P jo rslQ+vAl Fes, . �t7NF=' �x�tsi�TG13 7 ,�,.y 19�.+..� � ��,,y• pi tom► ♦.7� ��,. �''"'"'j. w , p15paM� yycMtA V=1644. RTZ 0 -M4 W• ?ON Ws 4 ACS--AIM' + ...�.�a���li_TI 1 (,,� F.r1'�f '�"+"�►� /�JL�'"5 .. r?s,�.�� Sf�t tiKi1N tcF� /�• '- -c m -r' "1 19ma 5 a&VWM4.4 A6 yr/2'/e�.13,++ N d�P�,6 4r,VP -rawc f = 3 Itozz330�,p p• 3C>fnc "N4K - 33O AN-ev. -ye I.5= 495 6q.,c•- use Ia5n -r e,"< LZV4941H& PIT - ::, ' rr./ RE3 o 3.34 6�d ry• - U58 �'d' yc 7't tlg P PIT + 2 p_ a G.�' Pt-,wT.- G,A N--I-N = i f I i� K fv A 2.'S)-4- (lTX C�,2- I,0) = iF,50 4,64- 1 S_ 31•[i O STE3JVl 4KL I IN3`CI�L�e 1J tN�t7 l�AINTf+1N>:,� �^TL'1 �N ta}IG� V-l� f14 �71�/Jc�P1v .C-T}F MffsS/►."�•11,ME3'T'tz5 �+Jtt�NN�g►NT1-L• 6Ct� -"i'ITt-� �'",�' VPW ,9*w-cr: 6pt.M.. - _ iL 1 5. W4N 'rZv M tUUN� `' y� m FAR 14M t�s7 �4-' v 5r`` ti 6�• O !r4 `Mir F ow&. \A0 1 fur 6i4MlAA- ,qµb 1`t0 W^.7SfL :D�rllLe�t-! 13 frOO434 I`,)ac, MW46 F��r = I "1 oP +L8ta6 1;4k4 2 Ntir#!1-i' S 0- 0,. St,o, yam, �`.• ; r�rl,�i� 63,!5 oKf, A", 4- r -7 iswr GsrToFF i If A•?t!s. TrP_t_U7t Ea T 1NYR�IZ'C. 08 INv• - �� 1 COO 6�M�• P.a,Gc�Rt3T% � .�. i I G TPNK to`t'' 7 !v UNG tt pfni) ,. f f?L.t1F><• d f'Ac-cfWs Prr + IN7�. i •G' 10 l4o.- ---- --- -- - fe' ----- --------------_-- BOARD OF HEALTH TOWN OF BARNSTABLE Applicat ion-for Vell Con!5truct ion Permit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ("Jan individual Well at: LA e�/ �j M c.t S%yr s /\"t 4-- __7 Jli/h.S Location Address — —— _-- --— _07 3 -f./l C C r j Assessors and G tI S S Tt� S 6u i G is Address / - �} p /rv. o /-�bluc�S�� Q A Owner- - - --f------------------- ---------.tom-------------- - Installer — Driller Address Type of Building Dwellin Other - Type of Building---- ------------------------- No. of Persons------------------------------------------------------ Typeof Well- --------------------------------------------------------- Capacity------------------------------------------------------------ ----- Purpose of Well--�o- S_�'C_____cJey l►-P/ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate f Compliance has been issued by the Board of Health. Signed ----------- - -- ---a- - �01)1 i 7_ -- -' date Application Approved By —___-------___-- __-__-- __-- ----___-_— --- ------------- date Application Disapproved for the following reasons:----------------------------------------------------------------------------------- - - - ----------- -- - ------------ - -- __— - - --- -------------- ------------------------------------------------------- date Permit No.--- --- ------------------ Issued - - - - - - — - - te BOARD OF HEALTH TOWN OF BARNSTABLE Certif irate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired by------ -----------------------------------------------Insta ller-------------------------------------—-------—----------—---------------—---- - - - -- ----------------------------------------------------------- at- -------has been installed in accordance with the provisions of the Town of Barnstable Boar of HealtbTrivate Well Protection Regulation as described in the application for Well Construction Permit No. - - -- ---X-Dated------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE Inspector--------------------------------------------------------------------------- C owl ,;� �. » • �- __ V Fed---- ----------------- BOARD OF HEALTH TOWN OF BA=RNBTABL,E p CicationArlVe[C Cooft,Yfott ermit + 1 a ..,'i+ y.y.,,irk Application is hereby made for a permit to Construct ( ), Alter ( or Repair ('Ian in ividual Well �t: r Location Address �' Assessors Map an Parcel - � ----------------------- --- . -------------------- Owner � �•__ Address�s -,s_/l '-��� -- /c'' °------r`----``---- `-'--- - -F Installer — Driller Ad ess Type of Building i Dwelling }/o s¢------------------------- ----------------------- Other'- Type of.Buildin t�k Typeof;WeII-' /---- -- ------- - -— " Capacity---- -- -- --------------------------------------------- Purpose of Well--flo_Mc Agreement: The undersigned agrees to,i stall the aforedescr'bed individual well in ;dance with the provisions of The Town of Barnstable Board of H alth Private Well Piotection Regulation — y'dersigned further-agrees not to place the well in operation until a Cert•ficate of Compliance has been issued by the"Board of Health, Signed- - ------=---------- - ------ - date Application Approved y ---- -- - —- -— —= = ------------- ate._`` Application Disapproved for the following reasons:--------- - ------- - ------------------------- -- - - date ORPermit No.-- - Issued —,� - ---- ----- ----------------- to v ° S �J e- I y` �� P 1 BOARD OF HEALTH t TOWN OF BARNSTABLE Certifitate &,COMPUante THIS IS TO CERTIFY, That the Individual Well Constructed (-_.), Altered ( ); dr"Repaired + SSG N --- ------------ — ; Installer -- - — --- r� • � at-33S -- --- r - - has been installed in accordance with the provisions of the Town of Barnstable Boar of Healtbprivate Well Protection Regulation as described in the application for Well Construction Permit No. --- --- j--Dated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- --- -- - --—- Inspector--------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Yell Con5tructionVermit � No. --.— ---- Fee---- ------------- dJ �t t.tir.`!/ - ------------—--------------------------—-------------------------------------------- { - Permission is hereby granted---� -�-- ------------- --- to Construct ( ), Alter ( ), or Repair an Individual Well at: No. - 3 S P�� '— =- —n'" 5 - -`�'�°--� s ---------------------------- Street as shown on t rqa Alion for e11 Construction Permit -- ------- ---- -- ------ ------No.-------- - — --- -- Dated Board of Hea DATE----- — ,- l - -------------- I i I puo� 1 '► - ENVIROTECH LABORIJORIES, INC. 7—if — _ MA Cert. No.: M,MA 063 - a . 449 Rte.130 ---- Sandwich, MA 02563 - — (508) 888-6460 1800-339-6460 FAX(5.08) 888-6446 � " 4 CLIENT: ` -' Mr:Bums LOCATION: 235 Whheeler Rd. ADDRESS: 235 Wheeler Rd. Ma"rstons Mills MA 02648 Marstohs"Mills MA 02648 COLLECTED BY: D. Pennini/DA Scannell SAMPLE DATE: 10-10-97 SAMPLE TIME: 2:00 WATER SAMPLE TYPE: New Well/repair DATE RECEIVED: 10-10-97 LAB I.D.#: 9710230 WELL SPECS.: 58, RESULTS OF ANALYSIS: Parameters Units Recommended Results Method - Limits Coliform bacteria /100ml 0 0 9222 B pH pH units 6.5-8.5 5.67 4500 H+ Conductance umhos/cm 500 104 120.1 Sodium`= ' mg/L 28.0. 8.75 2007 Nitrate=N/Nitrite-N Lmg/L'' " ' 10.0 .0.52, .: 4500-NO3 E Iron mg/L 0.3 < 0.02 200.7 Manganese mg/L 0.05 0.004 200.7 COMMENTS: Low pH indicates high corrosive characteristics. YES WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. I ` Date ..Q I� Ro ald J. Saar Laboratory Di ector <=less than >=greater than TNTC=too numerous to count a Department of Environmental Management/Division of Water Resources =` WELL COMPLETION REPORT III i WELL LOCATION GEOGRAPHIC DESCRIPTION Address Al 11Ai� o.o N S E (-of !!earl '. (wrc/el City/Town Well owner a "'S (road) Address.�I 3S L,A-11 NCS) E W pf. (ml in tenths), !circle) Board of Health permit obtained: yes ❑'"", no ❑ intersect. w/ �GGe��ae WELL USE WELL DATA Domestic ®'"Public❑ Industrial ❑ Total well depth Sg ft. Monitoring❑ Other Depth to bedrock h. Method drilled 6(A(0°L Water-bearing rock/unconsolidated material Date drilled/G'/�°�� Description/-4 G� �Jsa- .`a`�• ./ ;, Water-bearing zones:. CASING Yb .n�� 1) From To s Type ry 2) From To LengthC 5 _ft. Dia(J.D.) in. 3) From To Length into bedrock ft. Gravel pack well: . dia. Protective well seal: Screen: dia. Grout_© Other. Slot 00S,length 3'`from rg to�� STATIC WATER LEVEL(all wells) Static water level below land surface_!ft. Date WELL TEST(production wells) Drawdown`�'—ft. after pumping W.—min.at 3 gpm How mea'sured 'T►ne Recovery ft after—hr.. min: LOG of FORMATIONS COMMENTS Materials From To Driller r� r/1 1C1 Itir•e � . Firm�-.� SGt<,,•v t.�.r /Ji, � t , . Corti Address City/Town /t ,uC 6.;I ? All 006 � Supervising Driller RegA ►)SJ • l�i,�,,..,.=,tit` + Si nature of supervising registered well driller vleeseprrnrnrmly BOARD.OF HEALTH"COPY. LEGEND SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) SYSTEM PROFILE TEST HOLE LOGS ACCESS COVER To WITHIN 6 c 4DT TO SCALE)-OF FIN. GRADE ENGINEER: AH OJALA PE DESIGN FLOW: 4 BEDRO❑MS ( 110 GPD) = 440 GPD ACCESS COVER (WATERTIGHT) TO 100.0 PROPOSED SPOT ELEVATION USE A 440 GPD DESIGN FLOW WITHIN 6' OF FIN. GRADE MINIMUM .75' OF COVER OVER PPECAST /* 2% "LOPE REQUIRED OVER SYSTEM 35.0' - 36.0' WITNESS: DAVID STANTON 100x0 EXISTING SPOT ELEVATION SEPTIC TANK: 440 GPD ( 2 ) = 880 00 USE A 1000 GALLON SEPTIC TANK (EXIST) ELEV. 37.0't FjR FIRST 2' i2' DOUBLE WASHED PEASTON DATE: 4/23/02 � RACE LANE PROPOSED CONTOUR ---- 3' MAX. < 7- MIN/INCH Locus - EXISTING 1000 PERC. RATE _ LEACHING; rr- 100 EXISTING CONTOUR 2(33.5 + 12.83) 2 (.74) = 137 GALLON SEPTIC t 35.6' CLASS I SOILS P# 10223 SIDES: SLAB 0 40.5' TANK (H- 10 > GAS 33.$3 33.5 x 12.83 (.74) = 318 RE-U5E RAFFLE 34.0' -- [� D CD CS 0 LO F O C] a BOTTOM: o MYSTIC w 615 455 6' CRUSHED STONE OR MECHANICAL � 32.17 0 [� [] � C] O [� O O TOTAL: S.F. GPD CO O E O" 0 o a a a LAKE W COMPACTION. (15,221 1211) ��$ 2' 0 0 0 0 C7 a M 0 E] 0 30.17' Q ELEv. � USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR DEPTH OF F OW = __4'_ 0' 36.7' EQUAL WITH 4' STONE ALL AROUND < 6.4 SLOPE) , TEE StzEs: 3/4 TO 1 1/2 DOUBLE WASHED STONE 0&A INLET DE TH = 10" LOAM OUTLET r"PTH = 14' 6" 10YR 2/1 LOCATION MAP NTS FOUr DATION-- EXIST. SEPTIC TANK LEACHING B 25' D� BOX 16' FACILITY 4 47' 21't LOAM ASSESSORS MAP 82 PARCEL 8 BOARD OF HEALTH 36„ 1OYR 5/6 33.7' MA APPROVED DATE 2 5.7' C G-W EXPECTED AT EL 9'f MED/COS + 8.44 2.5Y 5/4 +' I .\N Ik NO WATER 17 ENCOUNTERED ;3.90 79 NOTES 10 + ASSUMED 17.4 3 1. DATUM IS 2. MUNICIPAL WATER IS NOT AVAILABLE / '+�29r7a 23 + 2 %? 3. MINIMUM PIPE PITCH TO BE 1/8' PER F'❑OT. / _ - -.~ i 0 / \ \` -4 5' REMOVAL OF UNSUITABLE SOIL \> REQUIRED AROUND PORTION OF 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASH❑ H- 10, _ 26 ..__. ' PERIMETER OF LEACHIING FACILITY, 5. PIPE JOINTS TO BE MADE WATERTIGHT. 27_ '~ t! J ?? DOWN TO SUITABLE SOIL LAYER. EXIST. +227.56 REPLACE WITH CLEAN MED. SAND. 6, CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. ' LEACH PIT � '� - � ?�T ENGINEER TO INSPECT AND ENVIRONMENTAL CODE TITLE V. - +.26.0 CERTIFY REMOVAL. (PUMP AND - 29 ? PROVIDE APPROX. 54' OF 40 MIL LINEN AT LIMIT OF REMOVAL, - 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE s OX a - REMOVE) 3p TOP AT ELEVATION 33.0' USED FOP LOT LINE STAKING, 40 34 RFT 3r 8. PIPE FOR SEPTIC SYSTEM TO S .H 0 4 PVC 40``� Wq�� �`\� `I �.�?6 8 _ ; 0 b*E BA(IKr IL.LEP OR i.IIIVI`. �LLJ 11-10-11 / + 44 a.. -ab. 2 I `'r 4 INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 28 - FROM BOARD OF HEALTH. --29 r7o"t"' 10, CONTRACTOR, SHALL BE RESPONSIBLE FOR VERIFYING THE l / 0 ---- 61 Ya tJ DECK EXIST. \�` + 3L72 LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR DWELL. TO COMMENCEMENT OF WORK. 31 + 31.33 SLAB EL. \ 40.5 ----33 TITLE S SITE PLAN / 4 .3 4 04, 33.34 OF 4 --35 235 WHEELER ROAD IN THE TOWN OF: r 7.26 045.9( 44 (MARSTONS MILLS) BARNSTABLE 7 28 '787 �..._ ~, 39.58+ PREPARED FOR: 47 5 Aq �` 76 46.4� + 44.77 �o BORTOLOTTI CONSTRUCTION/DeYOUNG 6 VF + 47.62 7-� . 46.77 o �n1/fj� l 47. 1 40 0 40 80 120 1�4 7".7 47.72 447'aA o SCALE: 1" = 40' DATE: MAY 5, 2002 4 o REV. 5/15/02 4. . '4 .011 +109.38 is �150.0' v \ k/8.70 a 2 \+ 8\ 1t1 OF Hqf �1H OF �,� \ ��\ �o ARNE yc ARNE H. ti �\ H. ✓ v, \ \ 7 q ALA OJALA / .2634A IST 49.42 AR JAL 0 rnt E . �,.S. DATE \ -®4-7-64 Q \\ + 9.5 \+ 0. 8 L=14. '5' - + �O. R=30. )0' �1 51.63 AND wP�TC14 WAS INST CERTr-y r, I �N8�TO PIAN..4Ll.tA r:a a _ R=' 5.00 -+-SR + 50.00 off 508-362-4541 .92' `�9.41 ''''L=45 4' ROAD fax 08 362-9980 7 L,��Z ra6.7 R=879.30' wHEE down cape engineering, inc, + CIVIL ENGINEERS BENCH MARK - TOP OF CONCRETE LAND SURVEYORS BOUND. .ELEV =.--49.4 (ASSMD) , � 939 moin st, yarmouth, mo 02675 02-092