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HomeMy WebLinkAbout0377 WHEELER ROAD - Health 377 Wheeler Road, Marstons Mills i \ A = '081 002 Lot E2 P v i I Commonwealth of Massachusetts - �N Title 5 official Inspection Form . Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd _. Property Address--- --------------------------------------------- --- _Fred Thimnr e Owner Owner's Name --- — — --------- ------------ ---- information for every on is required mills Ma 02648 4/23/15 required _— - — ------ --- page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the forma Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not .Michael_DiB_uon_o._ use the return Name of Inspector key. . _ - DiB�u.ono Sewer and Drain loci ' ran Company Name 8 Johns path Company Address ---------------...------------- ------ ��� S Yarmouth MA _ 02664 City/Town State Zip Code 508-364-9587 S113522 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,'accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP.approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Approving Authority _ 4/26/15 4r9pector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the.inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under h;posal tions of use at that time. This inspection does not address how the system will perf muture under the same or different conditions of use. t5ins•3/13 Titla 5 Official Inspection Form:Subsurface Sewagystem•Page 1 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a,•''v 377 Wheeler rd___ Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648' 4/23`/15 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/ always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system contains a 1500 gallon tank as well as a concrete Distribution box. All tees and baffles are in place. Outlet cover and Dbox are under driveway. There are two 1000 gallon concrete leach pits. pits are 8 ft below grade. Steel covers are to grade. At time of inspection pits were 1/3 full with no signs of breakout or ponding on site. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. 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. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 ' Commonwealth of Massachusetts Title 5 Official- Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills- Ma 02648 4/23/T5 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System.Conditionadly-Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd _ Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02643 4/23T15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety-and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: n ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3113 Tilie 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 f , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648 4/23/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No l-- ® Required pumping more,than 4,times_in the last.year,NOT due-to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with"a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D... Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd Property Address — - Fred Thimme Owner Owner's Name - information is required for every Marstons mills _ Ma 02648 4/23/15' page. City(Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 ---- DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 ISins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts N r - Title 5 official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 377 Wheeler rd Property Address Fred Thimme Owner Owner's Name -- ---- information is required for every Marstons mills Ma " O'2648' 4/23/15 page. City/Town State Zip Code Date of Inspection D. System Information Description: The system contains a 1500 gallon tank as well as a concrete Distribution box. All tees and baffles are in place. Outlet cover and Dbox are under driveway. There are two 1000 gallon concrete leach pits. pits are 8 ft below grade. Steel covers are to grade. At time of inspection pits were 1/3 full with no signs of breakout or ponding on site. Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Private well Detail Sump pump? ❑ Yes ® No Last date of occupancy: _ Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): --_ Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 377 Wheeler rd Property Address — Fred Thimme Owner Owner's Name information is required for every Marstons rvrflts• Ma 02648 4/23/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below); General 'Information Pumping Records: Source of information: Was system pumped as part of the inspection? ® Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)-and a-copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd M Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648 4/23/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 20 years Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: 18 "s feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): System is vented throught the roof Septic Tank (locate on site plan): Depth below grade: 1 ft feet — Material of construction: ® concrete ❑ meta.l ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 gallon If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gallon Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648 4/2371`5" page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 24 Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 42 Distance from bottom of scum to bottom of outlet tee or baffle " Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping history is unknown. And recommended Grease Trap (locate on site plan): Depth below grade: NA feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene El other (explain): Dimensions: — Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle - -----------. Date of last pumping: Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 i Commonwealth of Massachusetts W Title 5 official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd e Property Address — -- Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648 4%23%1"5' ✓ page. CltylTown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.):. Tank is at proper level. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan).- Depth below grade: _ Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: — - Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 377 Wheeler rd Property Address — Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02'648 4/23/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Normal 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.): Dbox is 8ft below grade. Both pits are receiving even flow. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): " If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills" Ma 02648 4/23%15 page. Cityrrown State Zip Code _ Date of Inspection D. System Information (cont.) Type: leaching,pits number- 2 ❑ leaching chambers number: — ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: — ❑ overflow cesspool number: — ❑ innovative/alternative system Type/name of technology: — Comments (note condition of soil, signs of hydraulic failure, level of pending, damp'soil, condition of vegetation, etc.): No signs of carry over. no si ns of h drualic failure Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert —_ Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for.Voluntary Assessments 377 Wheeler rd Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648" 4/23/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): No signs of ponding or hydrualic failure. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids — Comments (mote condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler,rd Property Address Fred Thimme Owner Owner's Name information is `Marstons mill.. " Ma 02648 4/23/15` required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Assessing As-Built Cards Page Laf_ 377 TOWN OF BARNSTABLE LOCA1k(1/ON E, -9_Z, mil/ SEWAGE d�� VILLAGEIVIG/ ASSESSOR'S MAP LOTf INSTALLER'S,NA.M.E.&,PHONE-.NO SEPTIC TANK CAPACITY LEACHING FACILITY:(c7pe) �, (size) X�U NO.OF BEDROOMS / _ RIVATE G'EL—L 4{L PUBLIC WATER BUILDER O OWNERS DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED; fir— r VARIANCE GRANTED; Yes— Sc, c� c 6Y http://www.town.barnstable.ma.us/AssessinQ/HMdisplay.asp?mappar=081002&sed=1 '4/227`2015 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 377 Wheeler rd M Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648, 4/23/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 35+ ft feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date --- ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation ® Accessed USGS database -explain: us s map You must describe how you established the high ground water elevation: Property sits 40 ft above nearest water venue. According to usgs maps system is approximately 50 + ft above ground water. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts W Title 5 Official inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M15 377 Wheeler rd Property Address Fred Thimme Owner Owner's Name information is required for every Marstons mills Ma 02648 4/23715`" page. CityFrown State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information — Estimated depth to high groundwater ❑ Sketch of Sewage Disposal.System either drawn on page 15 or attached in separate file l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 A�"$` CERTIFICATE OF ANALYSIS Page: 1 ` Barnstable County Health Laboratory ass cHys� Report Prepared For: Report Dated: 10/22/2009 Fred Thimme Order No.: G0955047 377 Wheeler Road Marstons Mills, MA 02648 Laboratory ID#: 0955047-01 Description: Water-Drinking Water Sample#: Sampling Location ,311 Wheeler Road Mar_stons Mills,MA Collected 10l21/2009 Collected by: F.Thimme Map 081 Parcel 002 Received: 10/21/2009 i j Test Parameters ITEM RESULT UNITS RL MCL Method# Tested i I Total Coli rm Present P/A 0 0 SM9223 10/21/2009 Absent for E.eoli Attached please find the laboratory certified parameter list. Approved By: (Lab Di tor) / o�2Llfl II l ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 3'77 TOWN OF BARNSTABLE LOCA', 'ION Lp yG � C,������i- DI�C/ SEWAGE # VILLAGE A" /',C? V2S /I/l' ASSESSOR'S MAP & LOT Q INSTALLER'S NAME & PHONE NCk SEPTIC TANK CAPACITY �� �� Q LEACHING FACILITY:(type) (size) NO. OF BEDROOMS RIVATE WELL PUBLIC WATER BUILDER O OWNE DATE PERMIT ISSUED: q DATE COMPLIANCE ISSUED: "` VARIANCE GRANTED: Yes No R p loc r . T a - �No.....C�..�--_..---..�s a 7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Divj-pv!3a1 Works Tunutrnrtiun Prrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: 3-)? ............... .......----�.......-•-------.....:........--•---..._..... ' Locat'on-Address or Lot No. ................��,,(M/�p........... .......... ................ Owner Address Installer Address U Type of Building Size Lot__1f�9l .7 q. feet �. Dwelling—No. of Bedrooms_______________________________.____..____Expansion Attic (4w) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a ---------------------------------------------------- ------------------_--_--_ d Other fixtures ________________ ____ _ _ _ i W Design Flow................ . .4 ...............gallons per person per day. Total daily flow.._el)(11�__.._ .__.__..__...gallons. WSeptic Tank—Liquid capacity,/ allons Length.,/4.'.'A_. Width.-,5.'-8--. Diameter-- Depth..,S'a�._ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....... sq. ft. Seepage Pit No.-_---.�.-----_ Diameter......./P-�__. Depth below inlet.... .......... Total leaching area..__.5. ` .....sq. ft. z Other Distribution box (x ) Dosing tank ( ) ........� 9� a Percolation Test Results Performed by._ ................................1 ------------------- Date----- ......__ ,a Test Pit No. I...i4Z-....minutes per inch Depth of Test Pit-- -S_______---- Depth to ground water..... 44 Test Pit No. 2---#05; ...minutes per inch Depth of Test Pit.....IY.!...... Depth to ground water....................... RS ......................W-1................................................................. -7...................................................... Description of Soil----------------. ------...........----------------- '-m3 e,- � ---------------------=------------------------------------------------#-------.-.-i"9 t ------------------------------------------------------------------------- -------------- U Nature of Repairs or Alterations—Answer when applicable--------------------------------................................................................ -•------------------------ -•--••--•-----------------------•-----------------------.....---•------------•---------------......----------------------------...------------------------------•--......---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h be n i sue ye board of health. .tea Signed ----- ....... .. -- ----- .....:_-�'................... / LT L Application Approved By .........�.Cn-- .. �. - - --- --------L./... --- --- - �f )are Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- Permit No. ....... ... ..-' 1. .- ........... Issued ........... �"..<>r ----- ........ Date �� iz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ' 1 Appliratiun for Dijpuuttl Works Tomitrnrtiun Permit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: 3 7 cE Z ----•----------------------•---•---....._..11 Location-Address or Lot No. ................) :.._.......... i'r•a=-1t[ /3'� Owner Address �✓2-' _)' c,urVJ; _7G j (�J >� -1 f1� �'V1 ✓VI i to Installer Address U Type of Building Size Lot.. D2.e 2•?USq. feet Dwelling—No. of Bedrooms........____--------------------------------Expansion Attic (;errs) Garbage Grinder ()ip aOther—Type of Building ------------------------------ No.` of persons---------------------------- Showers ( ) Cafeteria ( ) d Other fixtures .... W Design Flow___________________ 5............____gallons per person per day. Total daily;flow..._ X.__,!/.�?..=. ..........gallons. WSeptic Tank—Liquid capacityJ-9-'_OgalIons Length-A Width_-, '8.. Diameter-----'---_.-_ Depth..-S...ge... x Disposal Trench—No. .................... Width.................... Total Length----- Total leaching area....................sq. ft. Seepage Pit No..=-:�-:Z:_---.- Diameter......./!P...... Depth below inlet----G•.......__. Total leaching area_.-- ----sq. ft. Z Other Distribut/bn'box,(_X ) e Dosing tank Percolation Test Results Performed ._... 5.............. .... Date___-.�?,�-? 3.__._._.__.. Test Pit No. I...A?....minutes per inch Depth of Test Pit._f-.;..-......_. Depth to ground water---_.!v��.._...._. 44 Test Pit No. 2...4-. ...minutes per inch Depth of Test Pit------ -....__. Depth to ground water....... )l --_-_. -/...............................•--.....-•-•------•-----•-•..----- ••--•------••-----......-•--..........•••.......----- Description of Soil•-• .---------.. �� elf'i� SZr6.S07�- ----------------- ---b.`. = ; ...----------•----- U ------- --••------------------------------------••--------.........._.......-•------••---------------- U Nature of Repairs or Alterations I-Answer when applicable...._............................................... ............_..............._.. -- •---•...................•-•••---•-••-••--•-•-••-------•--..... Agreement: . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the'provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system,in operation until a Certificate of Compliance ha been i sue y th-'board of health. C f // c Signed :.._.:......v1.. ''� <..... -------- ✓/ ................Date.................. Application Approved BY -- ... -Lam.--------.. ........ f �Date�..�-'�.- Application Disapproved for the following reasons: ..................... . .................... . .... . ........... --------------------------------------------------- ---------------------------------------------- ........................................ Date Permit No. ...... .. . .. Issued ............... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of Tatulatianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( y( ) or Repaired (t ) �. L � S by - - -/ ... (—......_.............. >ti T... ........ .... - ... ............................. ... Installer at ................................ ,�I f��L L. Rd' 1 ... fF,��5? - 5........�! .._..._------------------------------------------ has been installed in accordance with the provisions of TITLE 5 of The State Environmental de as described in the application for Disposal Works Construction Permit No. _------ dated ...... ` ...7r._' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...... r,,7...............-- -------C4-- -------- --------- Inspector✓'--- ''._._.:.......... _......^... / f THE COMMONWEALTH OF MASSACHUSETTS BOARD` OF HEALTH TOWN OF BARNSTABLE No... ..l..��.�'..:�/ FEE---�< �......... Disposal Wrkii Tunutrnrtiun Permit Permission is hereby granted...............••-•••jUL(-�.> .............................................. -••-•--- to Construct (,�) or Repair ( ) an Individual Sewage Disposal System atNo...........................E-.t__ 1---L���_._. ''�_ST �.S.------- ./LG...........................................--------•----••-- rI `•---._ .._.._.. . Street / _7 / as shown on the application for Disposal Works Construction Permit NN�c_,4-4 Dated.._1.��' 7rrBo $~of Health / DATE--...... ,•......-f'----------------- JE FORM 36508 HOBBS dt WARREN.INC.,PUBLISHERS d 1 COMMONWEALTH OF NIASSACHUSETTS Z9 ExECUTIVE OFFICE OF ENVIRONMENTAAl AFFAIRS,-. DEPARTMENT OF ENVIRONMENTAL / Vy FEB 282002 TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION, Property Address. Owner's Name: ,� ^ Owner's Address: `7. r� �� ��1 Date of In s,pectton: "�p� �� /�cJ,Name of Inspector- lease print `- P �P P Company Nate Mailing Address- Telephone Number: ._-T7 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 ofthe time of the inspection. The inspection was performed based can my training and experience in the proper function and maintenance of'on site sewage disposal.systems. I am a DEP approved system inspector pursuant too.Section 15.340 of Title 5(310 CMR 15.000). The system: Passes -: Conditionally Passes __'JN bs.Further Evaluation by the Local Approving Authority.. Fa s � �' — Inspector.'s Signature: The system inspector shall submit a copy of this;i• y nspection report to the Approving Authority(Board of I3ealtli 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.con ditions.at the time of inspection.and under the conditions of use-at that time. This inspection does.not address,how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I y Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM•INSPECTION FORM ' PART A CERTIFICATION (continued) PropertyAddress:.4�7-7f,@.�.�lji.p.p �WC . Owner: L, Date of Inspectionc. d Inspection Summary: Check -AAC,D or'E/ALWAYS complete all,of Section D. A. ystem Passes: I'have.not found.any infbrmation which:indicates.that any of the.failure<criteria described in'l0 CMR : 1:5.303'or in 3.1.0,CMR.15.304 exist.Any failure<eriteria not evaluated are indicatedbelows Comments: B. Svstem Conditionally`Passes: One or more system components.as described%mthe"Conditional Pass"section need:to.be replaced or , repaired. upon p'The sysfem on comp letion ofthe.replacement orrepair as approved bythe Board-of Health;;-Will passe ° Answer yes,no or not determined(Y,N ND)in the for the following statements.:If"not determined"please explain. • I The septic tank is metal and over 20 years old* orthe septic tank(whether metal ornot):is structurally unsound, exhibits substantial infiltration or exfiltration:or tank failure is imminent.-System will pass inspection if the existing tarn:is replaced rvith.a complying septic ankas`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:a•vailable. 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)of dueAo 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.purnping niore.than•4 times a year due to broken-or obstructed pipe(s)..The system will pass inspection if.(with approval ofthe.Board of Health):. broken pipe(s)are replaced obstruction.is removed ND explain: _ 2 Page 3.of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM-INSPECTION FORM PART A CERTIFICATION(continued) Property Address: ILIA Owner: 0/Yrt�JP � d�22� Date of Inspection: �� %� �I i C. Further Evaluation is Required.by the Board of Health: Conditions exist which.require further.evaluation.by the Board of Health in order"to determine if the system' is failing to protect public health, safety or the environment: 1. . System will,pass unless Board of Health determines in accordance with 310,CMR 15.303(1)(b):that the system is not.functioning.in a manner.which w.ill.proiect,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 � . System will-fail unless the Board.of Health(and'<Pulil`ic Water Supplier,if an})determines that the system is functioning in a:manner.that protects the.public:h.ealth;-safety and:environment .._.._ _ The system has.-a septic tank and.soil absorption system(SAS)and the SAS is within.100 feet of a surface water.supply or,:tributary. to a surface water supply.. The system has a septic tank and SAS and the SAS is:within a Zone 1 of a public water:supply. The system has a septic tank and,SAS and the.SAS is within 50 feet of a private water supply well. _ The system has a septic:tank and.SAS and.the SAS is less than 100,feet.but.50 feet or more from a private water supply well.**. Method used to determine.distance .**This.system.passes if the well water analysis,performed.at a.DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of.ammonia nitrogen and nitrate nitrogen is equal to or less than 5.ppm,provided that.no other failure criteria are triggered.A•copy o fthe.aralysis must be attached to this form, 3. Other: 3 Page 4 of l l OFFICIAL INSPECTION FORM-NOT.FOR VOLUNTARY'.ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner: ,19/}y.A;1.q 11,1 c - y1`at Date of Inspection: M�aota�.c�lc�� e : . D. System Failure Criteria applicable to all systems: . You must indicate"yes"or,"no"to each of the following for,all inspections: Yes No/. i1 Backup,of.sewage into facility.or system component due to overloaded..or clogged SAS or cesspool — Discharge:or-pon.ding of effluent to th;eaurface:of the ground or surface waters due to an overloaded,or cloQaed`SAS'or cesspool / 5D p Static,:iquid level in the distribution.box above outlet invert due to an overloaded.or:clogged SAS or cesspool. /VV 'Liquid depth in cesspool is less.than 6"below invert or available volume is less than day:flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped: J Any portion ofthe SAS,cesspool or privy is below'high around water'elevation: _,/ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface An ortion of a cesspool or rig is within a Zone water supply Y p P privy � 1 of a public well - ' 1 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.a, eater than 50 feet from a private,water m supply well with no.acceptable water quality analysis. [This, :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 rio other_failure criteria. are triggered.A copy of the analysis' :in attached to this'fo.rm:] A(Yes/No)The system fails. I have determinedthat one or more`ofthe above failure criteria exist as described in 310 CMR 15.303,.therefore the system fails.The system"owner should contactthe Board of Health to determine:what will be necessary to correct the failure. E. Large Systems: - To 0 _ To b considered-,a*larbesystem the.system must•serve a facility with a�design.flow of'10 000:gpd to<15,000-.:; gpd. : You must indicate either or"no"to each of the following: (The followincr criteria apply large systems .in addition to the criteria above) yes no the system is within 400.feet ofa 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 nitro-en 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 sisnificant 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. 4 Page 5 of 1.1 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B . CHECKLIST Property Address: 2 77 A Owner Date of In pection: Check if:the.following have been done..You-must indicate"yes" or"no'.'as to each of the following: Yee'��o / Pumping:information.was JProvided by the owner, occupant,or:Board of Health V--,Were,any of the.system components pumped out'in the previous two weeks Has the system received.normal flows in the previous two week period ? _Z Have large.volumes of water been introduced to the`system recently or as part of this inspection? Were as built plans ofthe:system obtained and.examined?(If they were not available.note s:'N/A) j -. • �_ Was the facility or dwelling inspected:for si ns of sewage back up.? Was the site inspected for signs-of break out? Were all system component s,'excluding the SAS, located on site v` Were the septic tank manholes uncovered;:opened,and the.interior of the tank inspected-for the.condition. of the baffles or tees,material of construction, dimensions,depth of liquid,,depth.of sludge and depth of scum? Was,the facility owner(and occupants.if.different from owner).provided with information on the proper maintenance of subsurface sewage disposal systems? _ The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no Existing information.For example, a plan.at the Board of Health. Determined in the field(if any of the failure,criteria related,to Part C is at issue approximation.of distance is unacceptable)[310-CMR I5.3:02(3)(b)J _ 5 Page of 11 OFFICIAL INSPECTION-FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE-DISPOSALSYSTEM INSPECTION.FORM PART C SY8T- INFORMATION Property Address: 3-7-7 : Owner: PK11 Date`of In pection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(desianj `Number of bedrooms(actual) : DESIGN,flow based'on 310.:CMR 15.203 (for example: I I'O,gpdx#.of bedrooms): Number-of current residents . Does residence'have.a garbage grinder,( no)• Is laundry on a separate sewage system (yes or no) if.yes separate inspection regwred; " Laundry system inspected (yes or no Seasonal use:(yes or no):,-_",. Water meter readings, if available:(last.2 years usage(gpd)) Sump pump{yes ior no Last date of occupancy. 'G V /Z � 46ag COM.MERCIALIINDUSTRIAL1�, Type of:estabiishment:.. ;.. Design°flow.(based on 310 CMR 10.203): gpd Basis.of design.flow('seats/persons/sgftetc:): . Grease trap present(yes or no) Industrial waste holding tank present.(yes:or no): Non-sanitary waste discharged to the.Title 5 system'(yes or no)• `Water meter readings, if available: Last date of occupancy/use: . OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as:p ofthe inspec on.(yes.orno) If yes;volume pumped: ..gallons: How was:quantity:pumped determined .:,.Reason'for pumping: TYPE-OF'SYSTEM ;�Septictank, 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 a-e of all components,date insta led (i know )and source of information: Were sewage odors detected when arriving at the site(yes or no /,! 6 Pau 7of1.i : OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS _ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIOfi FORM PART C SYSTEM INFORMATION(continued) Property Address: q7 Owner: ,P Date of:Inspect°om. BUILDING SEWER(locate on site.pla Depth below grade: Materials of:coristruction:—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:, (locate on site plan) Depth below grade:C%f_9QgA-,; Material of construction:_1_yCbncrete_metal fiberglass_polyethylene other(explam) If tank is metal list age Is age confirmed by a Certificate of Compliance(yes or no —(attach a copy of certificate).. s Dimensions: /0"s °x (0 ` X Sludge depth:,Jn Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: °/ — Distance from top of scum to top of outlet tee or.baffle: G� Distance from bottom of scum to bottom of outlet.tee or baffle:_ How were dimensions determined: L&, y � �Atr/It� Comments(on pumping recommend tionn-s,-inlet and outlet tee or baffle condition, structural integrity, liquid.levels s related to outlet invert,evidence of leakage etc.): V A. GREASE T�)&L—oocate 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: "Cbmments(on pumping recommendations,inlet and outlet-tee or baffle condition, structural integrity, liquid levels as related to outlet:invert;evidence of leakage;etc.): 7 t Page 8 of 11 OFFICIAL INSPECTION FORM'-NOT FOR VOLUNTARl' A SSESSME1vTS - SUTBSURFACE SEWAGE DISPOSAL SYSTEM..INSPECTION FORM PART C :SYSTEM'INFOR MATION(c ontinued) Property Address. 7? Owner • Date of nspection: 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 Desicrn Flow: gallons/day Alarm,present.(yes or no): Alarm=:level:' Alarm in working order(yes or no): Date oflast pumping: Comments(condition of alarm and ifloat.switches,_etc:): YDISTRIBUTION BOX:Z(if present must be opened)(locate on site 1?lan Depth of liquid level above outlet invert:� �'�"` Comments(note;ifbox is level and distribution to outlets equal, any evidence of solids carryover,any.evidence of akage into or.ourof.box, etc.): PUMP CHAMBER (locate on.site plan) - Pumps it working order(yes or no): Alarms in working order es or no Comments(note condition of pump chamber,condition of pumps and appurtenances,etc:): 8 Page 9 of I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORVIATION:(continued) Property Address: q 7 Owner: Date of I6spection: � SOIL ABSORPTION SYSTEM (SAS): B (locate on site plan,excavation not required) If SAS.not located.explain why: Type _211eaching pits;.number: leaching chamber,number: leaching aalleries,number: leaching trenches,number, length: leaching fields,number.,.dimensions: overflow cesspool,number: innovative/alternative system Type/name oftechnoloQy.: Comments(note condition of soil, signs of hydraulic failure,level of ponding, damp soil;condition of vegetation, etc. • s ..w. .. -- /� _ - CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: .Depth—top of liquid to inlet invert: .Depth of solids layer. ' Depth of scum layer: Dimensions of cesspool: Materials of construction:` Indication of groundwater inflow(yes or no)'. Comments(note condition of soil,:signs of hydraulic.failure,level of ponding, condition of vegetation,etc.): PRIVY�(locate on site plan) Materials of construction:. Dimensions: Depth of solids:. Comments(note-condition of soil, signs of hydraulic failure, level-of ponding,condition of vegetation,etc:): 9 page l0 of I l OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM . PART C SYSTEM INFORMATION(continued) Property Address: ( J t � Owner:Q '-- Date of Inspection: 0�, '0 SKETCH OF SEWAGE DIS POSAL OSAL.SYSTEM Provide a sketch of:the'sewaae disposal system:includina ties to at least two permanent reference landmarks or benchmarks Locate 11 wells within.100 feet.Locate where.public water supply-entersfhe building. - - . . i 9� 5 o � , ,.10 , . i Page I 1 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART C SYSTEM INFORMATION(continued) Property Address: 7 Owner Date of I spection: ��wjpa / /, jC SITE EXAM: Slope Surface water Check cellar. Shallow wells Estimated:depth to around water 7,3 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 property/observation hole within 150 feet of SAS) Checked.with.local Board of Health-explain:- Checked with.local excavators, installers (attach documentation) Accessed.U:SGS database-explain: You must describe how you established-the high ground eater elevation: ? ' Ll 01 11 Permit.Number: Date: Completed by: Q< �d HIGH GROUND-WATER LEVEL COMPUTATION Site Location: J7 77 "�/ ��< / `��/�✓ %rj / �d/�` Lot No. Owner: /�� s✓�!.?Gl/� .. Address: 37? � ez2le�' J°l/7 Contractor: A!'�Ya�/' °111—i Address.: yJ� s lll,� i �`✓/`z4' Se�`l�j Notes .STEP 1 Measure depth to water table � � to nearest 1:/10 ft. .... ........: ........... .Date month/day/year STEP 2 Using Water-Level Range Zone and Index Well.Map locate site and determine- Appropriate 0 A Appropriate ndex well...0 OWater-level range.zone .................................... : STEP Using"monthly.repo-.t"Current Water Resources Conditi ons" ions" determine current depth to � water level for index well :.......................... - month/Year 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 2B) determine water-level adjustment...._....................... .:. :. ........................................ STEP b Estimate depth to high water by subtracting the water level adjustment (STEP 4) from measured depth to water ` level at site (STEP 1)".................................................. Figure 113.--,eprodu,libie eomoutatio:form _ .,__... of a��.lr.�i�'G� �i, tit;? �_ .�. ✓�...(,�..m:;.. • t ' EN VIROTIEC � LABORATORIES, INC. MA Cert. No.. M-MA 063 449 Rt(I- 130 ' Sandwich, MA 02563 (508)888-6460 • 1-800-339-6460 FAX(508)888-6446 October 31, 1994 i Quality Wells 246 Willimantic Drive G Marstons Mills, MA 02648 SAMPLE DATE: 10724 94 ( 1 1 i SAMPLE LOCATION: Kim Brown) i 'Wheeler Road Lot E-2 R Marstons Mills, MA SAMPLE I.D. NO. : WE-2 TIME: 11:00 A.M. SAMPLED BY: Ken/Quality Wells RESULTS OF ANALYSIS:* EPA 601 602 Volatile Organic Compounds) Units MCL** Reporting Limit Chloroform ug/L 100 2 Benzene ug/L 5.0 0.8 Toluene j ug/L 1000 2 meta- and para-Xylene ug/L 10000 1 ortho-Xylene ug/L 10000 0.6 * See the report enclosed. ** MCL = Maximum Contaminant Level BY: Ova Rona id J. Sa i Laboratory Director � I i : I GRO[!11 aWATER ANALYTICAL EPA P9ETH1®S .ill and 602 Volatile Organics (GC/PID/ELCD) Field ID: WE-2 Lab ID: 9064-01 Project: Brown/Lot E-2 Batch ID: VG2-0484-W Client: Envirotech Sampled: 10-24-94 Cont/Prsv: 40mL VOA Vial/HCl Cool Received: 10-24-94 Matrix: Aqueous Analyzed: 10-26-94 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) BRL 5 Dichlorodifluoromethane BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL I trans-1 ,2-Dichloroethene BRL 1 l, l-Dichloroethane I cis-1,,2-Dichloroethene * 2 BRL 1 Chloroform BRL 1 1,1 ,1-Trichloroethane BRL 1 Carbon Tetrachloride 0.8 1 Benzene BRL 1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichloropropane BRL 1 Bromodichloromethane BRL 5 2-Chloroethyl Vinyl Ether BRL 1 cis-1,3-Dichloropropene 2 1 Toluene BRL I trans-1 ,3-Dichloropropene BRL 1 1,1 ,2-Trichloroethane BRL 1 Tetrachloroethene BRL I Dibromochloromethane BRL 1 Chlorobenzene ! { ' BRL I Ethylbenzene 1 meta-and pare-Xylene * 1 1 ortho-Xylene * 0.6 BRL 1 Bromoform BRL 1 1,1 ,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene 1 1,4-Dichlorobenzene ! i BRL I 1,2-Dichlorobenzene I QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 27 91 % 87 - 113 % 1,2-Dichloroethane-d4 30 29 97 % 83 - 117 % L = Analyte detected below the Mo d!g limit.References A Method alyte result is an Purgeableimate. BRL Halocarbo s and Below Met od Reporting Limit, * Non-target compound. Purgeable Aromatics. 40 C.F.R. 136, Appendix A (1986). ENVIROTECH LABORATORIES, INC. MA Cert. No.: M-MA 063 449 Rte. 130 . Sandwich, MA 02563 (508)888-6460 • 1-800-339-6460 FAX(508)888-6446 CLIENT: Kim Brown LOCATION: Lot E2 ADDRESS: Wheeler Rd. Marstons Mills, MA SAMPLE DATE: 10-13-94 COLLECTED BY: Ken/Quality Wells DATE RECEIVED: 10-13-94 t _ TIME: 11:0AM SAMPLE I".D. : 61 JOB TYPE: New well WELL DEPTH: 65' RESULTS OF ANALYSIS: Parameters Units Reccuuended Limit Result Coliform bacteria/100ml (MF Method) 0 0 pH pH units 6.0-8.5 5.90 Conductance umhos/an 500 106 Sodium mg/L 28.0 11.9 Nitrate-N mg/L 10.0 0.04 Iron mg/L 0.3 0.21 Manganese mg/L 0'.05 0.042 COMM=S: Water shows moderate corrosive characteristics. Yes No WATER IS SUITABLE FOR DRINKING 4EES PARAMETERS TESTED xxx Datel /on ldiLaboratector LT = Less Than Fee-----�_�-------- BOARD OF HEALTH TOWN OF BARNSTABLE App[icationjorlVell Cootruct ion Permit pplication is hereby made for a permit to Construct ( ), Alter ( ), or Repair (j.,Wn individual W 11 at: Location Address Assessors Map and Parcel c tv A/------------- Owner Address SJ4L�`JI— G✓�LLf ------- --------------------------------------------------------------------------------- - _ - - - Installer Driller Address Type of Building Dwelling----------------------------------------------------------------- Other - Type of Building ------ No. of Persons---------------------------------___________ J U� Type of Well--------- - —- - - ------ - - Capacity---------------------- — - - ------------------- — Purpose of Well---- 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 Certi 'cate .of Compliance has been issued by the Board of Health. Signed-- - ---- -= - --__-- — --�d�_71 date Application Approved By-- -- -------—-- ---- —--—— ---_— ------------- date Application Disapproved for the following reasons:------------------------------------------------------------__—___—_____—_ ---------------------------------- --- --------- ----------------------------------------------------------------------------- t date Permit No. ---------- Issued ---- -- - - --- ------ ----------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO ERTIFY, That the Individual Well Constructed (ICY,' Altered ( ), or Repaired ( ) bY----------------- 1 d l�E'L C S __------ - f ---------- at - - - - - -------------------------------------- — -- -- —- st ler -- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE --- ------ —-- — --- -- Inspector---------------------------------------— - ---— 41. d Ate.+ r k" l f r hTfyTyr�✓+u F^�rr y.,�;,4�' #icR `n N ny. 1}„1"l cxr�r ,-y! 'r BOARD OF HEALTH ti + TOWN- OF BARNSTABLE Apptication_*rlVett Cootrutt ion Permit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( individual Wf 11 at: Location - Address Assessors Map and Parcel �J l -- -�`�!� `O- - - --- - -----—— - -------------------------- - - --------------------------------- Owner Address Lam: ' �� ------------------------ ----------------------------------------------------------------------------------------------- Installer- Driller Address Type of Building Dwelling------—------------------------------------------------------- Other - Type of Building---------------------------------- No. of Persons-------------------------------- --____-- Type of Well- --- -- - ---- - Capacity-------- ------------ ----------- -------------- Purpose of Well------/_k ��----fu,�x' ----------------- i Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The t Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in- operation until a Certificate .of Compliance has been issued by the Board of Health. . Signed- - L - ------- - 17 --� Application Approved By ---------- --- —- ----— --- -------------- date Application Disapproved for the following reasons: —-------------- ------------ -------------------__�__:—______—_ ------------- -- ----------------- ------------------------------ i` date Permit No. Issued=------------------------ - -- - - -- ------------------ date sm� .xs�.�.�...ec:m a®,®srr®..s..�.v��.e+�.�..�v..�.....s...,...+..�..+R.e.�i..ter.s.,.m,.�.�r.spa..a�..nnn....�t sa+.m�..mu�..d....,.,o.....m ms-•ma,... BOARD OF HEALTH TOWN OF BARNSTABLE ctC'ertcf icMr Of"'Comp[iance THIS IS TO CERTIFY, That the Individual Well.Constructed (L.y; Altered ( ), or Repaired ( ) by- -- -���'g�1 � - �`'E -f- ----- T ---------------------------------------= -----= --=--- ISistA7ler _ at---- —L- �''- �-£ — ------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ---- __ ated----------------------- 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 3pett Contruct ion Permit No. Fee _- Permission is hereby granted----�- ------___________________ - - --- - to Construct ( Alter ( ), or Repair3. an.Indi'i ual Well at: No. - - - -— - --- - ---------------------------------- Street as shown on the application for a Well Construction Permit iNo. ------ Dated---- =- =- ---------------------------- 1 ,Q and of Health DATE ii l � I i I i 1 � I I I I . 0 i 0 N i p i m i O W ------------- NEW BATHROOM LAYOUT .I TO BE FIELD DETERMINED EXISTING PLUMBING I W i I F I TO BE REWORKED I � � I EX. DR. EX. D EX. WDW EX. DR. i • z i 3 z a I a BEDROOM , POOL ROOMco o � r m 0 APPLY 1/2°•BLUEBD w/ - N Vl -------------I VENEER PL. (SMOOTH FIN) TO EX. STUD WALLS © EXISTING BASEMENT m a W a0 Y t� t Io n CLOSET 13 8'-O° C.O. I / I \ / NEW DROPPED FLOOR FLOORSEE FRAMING 0 ENTRY/ / t DETAILS _� IVIN EX..STAIRS TO REMAIN FIN. PER OWNERS / \ 0-1 NEW REMOV EN ALL RECOMMENDATIONS I // \\ i _ ! ; x O RAILING I // \\\ I ! Z UP // F z �3F C A W"� . I DATE oe/rr/or REVISIONS BASEMENT FLOOR PLAN SCALE:1/4°-r-o° '.DRAWN BY :DRAWING NO. A3 s/ /kq- � OD _ 11 � 77 i i L SCREEN PORCH j NEW STAIR EXISTING DECK LOCATION TO BE RAISED LENGTH t DEPTH TO BE DETERMINED j i . co i C co T DECK A BREAKFAST - F�4z UILT-INSF ER jj O I REMOVE EX. SHOWER IRECTIONRS II NEW KITCHEN �' p N REPLACE ./NEW II BY OTHERS FIBERGL, SHOWER II UNIT _ �. KITCHENco z �` LIVING Rm. REMOVE EX. EX 1 NEW PANTRY I I O W BEDROOM j 6' S d CG F/P REPAIR WALL , FLR L . �\ Q a I /EX w/FLUSH -_ _ AS NEEDED .I LLL1Jl���� HEARTH BATH •� NEW OPEN RAILING UILT-INS IREcr Nor i I EX. BEDROOM O i REMOVE WALL ® I .wRAP.n.TRIM NEW WOW TO EXPAND CL. I �,�4 CAp j. TREATMENT WRAPPED BEAM ABOVE REFRAME T Q g C.O. REMOVE EX. DR. 0 EX. STAIRS ON. w/ARCH TO REPAIR WALL AS NEEDED (y TO REMAIN .: ON. -nw _--_ -. NEW TUB FB NEW LIN REMOVE CORNER BIDS, EX WDW -F ADJUST SIZE Ex DooR SHOWER CABINET OF CLOSET WHERE NOTED TO REMAIN ��c p D® PER LAUNDRY RELOCAT .. j _q (FRONT ONLY) ____ — SINK LOCATION �T'! CUT BACK EX. W.C. SHINGLES NEW 0 AS NEEDED TO WEAVE CORNERS BALCONY ABOVE O I � o N a a j E2ENNOv_ z x .EX. OI D 2 R MUD PA EX. BATH W W W �-+ C) `CLOSET OFFICE/DEN ®1" EA. ENTRY ........ 4s° ', h-I' h�. ►� � p j I DINING RM. REMOVE E%.DR W OPEN RAILING REPAIR WALL A6 NEEDED I-a I REMOVE EX. FLOOR FRAME - � � w rL EX WOW I FOR NEW DROPPED FLOOR Q TO REMAIN SEE PARTIAL FRAMING PLAN I `.Z, o�ram+ H NEW STAIRCASE TO 2ND FLOOR cjllI U) 0.s ►r EXISTTNG SITOPNK t A w M To REMAINRCUT COUNTER MATCH LINE. I Q I AS NEEDED REMOVE CORNER BDS. EX WDW i 19�1 A I I TO REMAIN REMOVE EX WOW BIDET i W TO REMAIN CLO - REPAIR FLOOR Iz O AS NEEDED v� REMOVE Ex.W/D/WOMUP i 1 I o _ AND CABINETRY EX W r EX WOW REPAIR WALLS FLOOR ETC.j TO REMAIN I CENTER BETWEEN I I I I TO REMAIN REPAIR WALL AS NEEDED I FRONT OFFICE 4 I - DINING RM. WINDOWS CENTER ON GABLE i ——————————— T I I I------------- iI DATE DB//P/OI6.6 P POSTS WRAP wAx RED CEDAR I TRIM PRE-PRIMED iREVISIONS CURVE STEPS 2-COATS OF PAINT TYP. OF (4) ._____________ - .. - NEW BLUESTONE STOOP I ® © O I OSTONE RISERS NEW FRONT ENTRY OWNE TO MAKE , INDICATES NEW WALL CONSTRUCTION ADDITION FINAL STONE SELECTION EX , REMOVE EX. WINDOW FOR ;DRAWN BY REMOVE EX. BRICK WALK GARAGE NEW WINDOW TREATMENT _ :DRAWING NO. INSTALL NEW EX WDW i OABOVE BLUESTONE WALK TO REMAIN FIRST FLOOR PLAN SCALE:1/4'-I'-O" FFINALRSTONEASELECTION i /� w IST FLOOR ADDITION 75 S.F. I H4 2ND FLOOR ADDITION 89B S.F. (INCLUDING CEDAR CLOSET) MATCH LINE `------------- MATCH LINE I h ' II II II ' II i II II I t II II I i II Il I M i II II � o I ____________ I - I a I RNL JACU v IOR WH TUB ER SPECS. SKYL7 E = /O ___________fII'II _-______-_- VE ---------------- BRICK F/34° HIGH VANITY M. BATH LUSH PLUS COUNTERTOP EARTHO SIZE PER OWNER J JI,jIjIIIIIi �,I►WWWC-�"�ql1i QaaWOapzrwQ�� DIRECTION I CODE REQUIREMENTS AP TILE SHOWER w/GLASS M. BEDROOM ENCLOSURE TRAY CLG. OPTIONAL THOW p 9UIL -IN DRAWERS BAL-ONY/LOFT 36° FAIL] rK�T > E 'Ed�ra!�zOFl-- --- -- CE O PLANT ACCESS PANEL SHELF TO ATTIC ACCESS PANE TO ATTIC OPEN TO FOYER z STORAGE O ATTIC M---------------------O zQAZOU°fo.y ----------------------- V. ' I I II II i OE ABOVE II II i� II DATE oe/ir/ot :REVISIONS II I� :DRAWN BY Ij it DRAWING NO. II II LOOK PLAN iI If A5 SECOND F SCALE i/4' 1'-O° I I �I I� � W ` GENERAL NOTES : S AND S FOR DESIGN N I . THIS :.PLAN l THE E SS COVERS 92.40 ACCE SS MUST BE WITHIN N CONSTRUCTION OF THE SEWAGE DISPOSAL 12- OF FINISH GRADE FIRST 2' TO S M 0 YS TE NL Y. _.q -- BE .LEVEL - N - 4 PVC , AI/N 2 OF o METHODS AND. v 2.- ALL CONSTRUCTION M T SCHEDULE 40 PEASTONE S SYSTEM 89 `85 88 60 MATERIALS FOR E SEPTIC I C ARTERIAL R TH 8�.20 87.40 88. 5 6 8 3/4 - 8 0 I I/2 D CONFORM TO MASS. D. E. P. 7. lA. - SHALL N WASHED STONE : 0 3 8I. OUTL ET T 0 D 4F HEALTH E l L 5 AND LOCAL BAR E T T E 0 1500 ! MIN GAL . D-BOX RE GULA rl ONS. SEPTIC TANK L EACH PI T N 3 ALL A SEPTIC SYSTEM COMPONENTS LOCATED OF P_ R l E o 0 L . NTr SCALE E VEHICULAR UN D R AREAS SUBJECT T0" TRAFFIC OR GRE A TER THAN 3 IN DEPTH SHALL BE m CAPABLE OF Wl THS TAND I NG H 20 WHEEL LOADS. DS J . L SCHEDULE 40 4. UL AL SEWER .PIPE SHALL BE - 0 0R APPROVED V D EQUAL . _ D INVERT ERT V S ELEVATIONS : DESIGN GN CR ITERIA :TERIA 5: BEFORE CONSTRUCTION CALL DIG SAFE INVERT AT BUILDING:l N G 89. 85 DESIGN FLOW:D lG E 800 3 484 FOR LOCATION F 88 85- / 22 4 IN VERT N ER S , T IN SEPTIC A 4 I L0 TANK: , D ROOMS UNDERGROUND U L TIES .�.BE R A T G.P t? PER UT IL / S 4 0 INVE RT OUT ::SEPTIC TANK. ..BEDROOM EQUALS 4 L G.P.D. , 8 0 V 7. 4 -lN ERT ''IN DIST. BOX. 6. VERTICAL DATUM IS: APPROXIMATE NGVD V 87. 20 / S INVERT OUT DIST. BOX: YE GARBAGE GR I NDE R INVERT V 87. 00 7. FOR EN E T O BENCH MARKS SET SEE SITE PLAN. I N LEACH PIT SEPTIC TANK REQUIRED: BOTTOM OF LEACH PIT: 81 . 00 AA0G. P.D. X 200 880 GA L . ADJUSTED GROUND NA TER . iSEPTICTANKPROVl PROVIDED: 1500 GAL . ; OBSERVED GROUND D WATER:R N BOTTOM OF TE Sr HOLE 77. 00 SIZE OF LEACHING-F ACIL I 0 TY REQUIRED: = 50X -440 X I 660 G. P. D. DESIGN 2 P RC RATE M C / cE IN/lN H VACANT -, SO IL/ \ lL TES T PlT D A TA / /\ / \ PROVIDED: 2 6 PI TlS l W/ 2 _ S TN INDICATES PERCOLATION O;N O1 NDS EIRCAVE TE SIDEWALL . 377 S F.X 2. 5 _ 9 2GPD TES T GROUNDWAT ER /s7 `./ io\ 5\ / 7 0\ B TTOM/ 5/ .F.X GPD t \ \ EXISTING NG I ! / \ 2 1 5/ 3 �4 9 # \ s c TOTAL,. ... S 0 9 TP TP . / w EPTI � S.F. GPD 1 \ \ �LL 92.4 -92 A G D RN EL �GRND/ Md EL.F 1' 1 s \ (PER ER) N/A N/A 1 G.W.EL. G W_ 6 .EL. / 1 \ ! / 1 0 ] i / ! L 0 / / ! Y t ✓ / TOPSOIL 70PS0.• b I L I / i / ! / f / SUBSOIL BS lL t / SUBSOIL _ / BSOI/ L 1 I / 1 / / w o i. . . fit 1 I~ / / // f s- / e. r r / _ I / / / t I / e i l f 3 se 5 5 ENCt! AUfl''k 1 / � f 1 r / / I / / ,CB S FND , / i / , B WAR 4(� l / / ENCH K i / / B / _ d � 6 0 /EL 8 .3 C / U POLE L / .- erol x MED U/ M P / MED I U , 1 u 7 M r PJ+CE l AD - / / e L Y � S-ffB'_ �6 00 COA S. oh71r R E/ � COARSE I r/1 SA ND 1 SAND I / AN _ Iy I- _e I 0 0 WE _ / R P ,ED 1 _ P l i I r � _. I 1 N t 1 , / /l / / 9 ,taw 250 s a A B 5 TP N . � J 1 .R. / / / / l ,. u o ss9 N E POLE /17 I I � , r _ . .0 0 s R P ,.0 ._ P 2 R T � , P e P/ S ao T VE DRI _. �c _ O DIRT _ 1 EX/ T _ . / / k u � / o w ,- I /2 STN .. l / YdTER-t�1 a 1 _ 1 V 1 ! r+n TP l' 1 � l 1 _ 1 1 /r t , • . ih r 77 5 .0 78/ /4 I _ 0 J _ 1 / 1 l w 1 1 / r l rr a _ I' I _ _ o vw I ! _ \ T <) BAK l/ 1 N ! i D 1 DEC EMBER/ E / EM ER 28 /993 GARAGE \ R R D 1 - I AT A E N G , I / o 1 -v t / J 1 bo r v /60 1 ` r i 1 / m A• 5 r f / o Sr t EPH t EN HAA S o ,. S 1 a TEST B I i � Y v t 1 N 88 m 46 0 q� 1 I o 1 1 ,. BENCH K � r EN \ 1 I ,r �! P �1 _ . 1 1 1 0 o- r t 1 G R ERYDUN DUNNING_ t N 1 I SE �caroN 1 _ t WITNESSED _NESDB r I i o y A E Y r I \ 1 1 \ � 1 1 I , 1 m \ ,1 . V w d i 93� .alV � E 2S 7 I �O r r 1 r I _t � \t- \ v \ 1 \ 1 1 N C 2 PER 1 1 m J C RATE I 1 / ` MIN/INCH. i . / \I U 1 1 1 1 1 / /t ,5dd �tr • ,- I o , 1 I \ O i 1 1 m 1 a 1 1 1 t i $ETiC TNK /P , 1 1 r / t i 1 1 1 1 r t ca 1 1 i I I r I r J 1 \ \ Z 1 1 _ I 1 \ i 1 1 1 i 1 1 ` 1 I \1 1 t 1 1 t r 1 \ 1 1 i 1 1 I 1 \ m 1 1 1 l 1 1 _ N£ _ ,I $ : 1 1 1 1 1 1 ' , TbP AN \ 1 ' \ 1 1 1 1 \ ♦ 1 1 L \ l 1 1 \ 1 1 1 \ i 1 \1 \ 1 a• \ 1 I \ \ 1 a� \ 1 \ 1 1 1 1 \ N 1 1 \ 1 _1 \o ' \. It i \ 1 1 1 \ \ 1 \ r 1 1 \ 1 \ 1 ; 1 1 \ J 1 \ i 1 1 1 \ \1 1 \ \ 1 I \ \ \\ 1 1 1 \ 1 1 0 \ 1 \ o EXISTING WELL . \ \ O \ \ \ \ \ - A \ L \ \ \ \ \ I B.Kw, \vo Tv3 . \. LOT E 2 \ \ \ \ \ 1 \ l02.27o_ s.F. ____- S E� T C S YS T EM D ES G/V / atiw o \ \ \� r N\\ UP A D \L \ \ \ \ \ \ \ \ \ . . . ' 7 � R SL. am . M R S TO/V S M L L S M.4 k ,/ E`P,4 E F c� BV.W , \ T _ 0 .I~ 7, / v w E U/V J I S C:--,4 E L R E r of N G� ® L czn e d n n t s Ma . 2 J 2 N 1� 432 0 20 40 80 JOB 0:_'9 -0 N 3 39 6 F/ D C EL FW/ VB c c R AL S` W AH/CF C C .HE K C W F D RN S A H , , .• li