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HomeMy WebLinkAbout0435 WHISTLEBERRY DRIVE - Health 435 Wli,scieberry Drive I Marstons Mills r ' \�A= 062 —.023 }* \ i F M l C '1 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . M s 435 Whistleberry Rd Property Address ND McKeown Owner Owner's Name LL` information is required for Marstons Mills MA 02648 4-24-18 -r every page. City1rown State Zip Code Date of Inspection i10 Inspection results must be submitted on this form. Inspection forms may not be altered in any »"t way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. D.A.BROWN INC Company Name P.O. BOX 145 Company Address CENTERVILLE MA 02632 ' Cityrrown State Zip Code 508-420-4534 S14297 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 ❑ Falls ❑ Needs Further Evaluation by the Local Approving Authority Csc 5-24-17 disposal disconnected April of 2018 Inspetfors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. .."This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 I t, T. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 4-24-18 every 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: This is a revised page 2 stating that the garbage disposal has been disconnected only. The actual inspection was done in May of 2017. 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 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 4-24-18 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: according to as-built card system consists of a 1500 gallon tank d-box and 2 500 gallon chambers. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available (last 2 years usage(gpd)): Detail: house has irrigation system h20 2015----------376 2016--------303 gpd Sump pump? El Yes ❑ No Last date of occupancy: currently occupied Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste 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 TOWN OF BARNSTABLE G V^ LOCATION SEWAGE# /, VI LLAGEA0;W1+S/"®e5,,W1l1S ASSESSOR'S MAP&PARCEL.��2 ly�� INSTALLER'S NAME&PHONE SEPTIC TANK CAPACITY jSDD / LEACHING FACILITY:(type) —,�O,O �`I�ts/yJl� /'S' (size) ? 'X /3 NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY rro14> y L` u-I •f • m -o o E' Certified MEr- ail F e Fxdr erviCeS&Fees(check box,add fee as appropriate) �~N IS', Return Receipt(hardcopy) $ O ❑Return Receipt(electronic) $ Postmark - ..'- 0 ❑Certified Mail Restricted Delivery $ .r Here Q ❑Adu@ Signature Required $ K) _5—A I.l.l. ❑Adult Slgnature Restricted Delivery$ J�' O Postage,/ Q N $ GS ra Total Postage and Fees dos � Sent To-- nI�GN1N/ l,l.[WS ------�rJ.1L ------�J-....- fO Sire d L o, rpO x li 6a& Certified Mall service provides the following benefits: IN A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this- delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. ,I signature)that is retained by the Postal Service'" Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the - ■You may purchase Certified Mail service with® signee to be at least 21 years of age(not -7j First-Class Mail,First-Class Package WOW, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified i m Insurance coverage is not available for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retaill. of Certified Mail service does not change the ■To ensure thatyour Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a r certain Priority Mail items. USPS postmark.If you would like a postmark on a For an additional fee,and with a proper this Certified Mail receipt,please present your �. endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion, of delivery(including the recipl`ent'esignature). - of this label,affix it to the mailpiece,apply You can request a.hardcopy return receipt or an ;,appropriate postage,.aod deposit the mailpiece.—j electronic version.For a hardcepy.retum receipt, 1 t �: +r •, +•% complete PS Form 3811,Domestic Retum kj ,.1 k y fi" i tv tti, t Receipt attach PS Form 3811 tb your mailpiece; IMPORTA 'Save this receipt for your records. PS Form 3500,April 2015(Reverse)PSN 7590-02A0Q-904f ■ Complete items 1,2,and 3. A. Sign • Print your name and address on the reverse Z' Agent so that we can return the card to you.. dressee ® Attach this card to the back of the.mailpiece, B. Received by(Printe.Name) C. Date of Delivery or on the front if space permits. 17-1-17 1.Article Addressed to: D. Is delivery address different from item 1? O Yes If YES,enter delivery address below: p No %5 GU►1rs+leb& A i, IK7 14 oa�µ8 3 Service Type ❑Priority Mail Express® 103Adult Signature gedIII mill 111IIII I II Ii I II I 1111111111111111111111 ult Signature Restricted Delivery ❑Registered Mail Restricted Ified Mail® � Delivery , 9590 9402 1934 6123 0978 14 ceRreed Mail R�trlgted Delivery cc�+etum Receipt fir O Collect on Delivery / Merchandise" 2._Articie_Niimber .(Transfer thorn servicA 6hPl)--_ M Collect9_n_D_elivery Restricted Delivery 0 Signature Confirmation"" ❑Signature Confirmation 7 015; 17 3 P; 0 011.�4 9;9 0 6T357. j i t 1 Resticted D iv Reistrlqted Delivery PS Form 3811,July 2015•PSN 7530-02-000-9053 Domestic Return Receipt it USPS TRACKING# i j - First-Gass Mail Postage&Fees Paid USPS t ' Permit No.G-10 I 9590 9402 1934 6123 0978 14 United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service Town of Barnstable `Oa Health Division . 200 Main Street Hyannis,.MA 02601 it I I I I I 1111't�fiiil�ll���l�Il�1t���1��������t,�„ji11►��1i1,��1�111�1� j I. e TF4E Tp� Town of Barnstable Barnstable .�.~ Regulatory Services Department iIa1 j tARVbTABM I '"39. ,�� Public Health Division 200.Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 6357 July 5, 2017 MCKEOWN, THOMAS J & LINDA J 435 WHISTLEBERRY DRIVE MARSTONS MILLS, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 435 Whistleberry Road,Marstons Mills, MA was inspected on 05/24/2017 by Douglas Brown, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Garbage disposal must be removed with permit. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH �oms McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Conditionally Passes Letters\435 Whistleberry Road Marstons Mills.doc ti Town of Barnstable flSM �,�� Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA-02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) _ An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground . ❑Pumping more than 4 times during the last year not due to clogged or obstructed � g Y gg pipe. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA q Single Cesspool ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components, etc) ❑Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) ❑Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER -Ar" 6me1 6 �' r d Repair deadline: Q:ISEPTICIDEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 435 Whistlebegy Rd Property Address t I4.7 McKeown ° k 5 Owner Owner's Name - information is Marstons Mills MA 02648 5-24-17 X required for CD every page. Cityrrown State Zip Code Date of Inspection r'..0 Iw�l Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important` A. General Information �/ When filling out (�/ /a 3 9 forms on the computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. D.A.BROWN INC Company Name OkA P.O. BOX 145 Company Address CENTERVILLE MA 02632 City/Town State Zip Code 508420-4534 S14297 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 Local Approving Authority a/#I& /'�� jf"��, 5-24-17 Ins ecto s gnature ate The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•313 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �v i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M , r 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ® One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. 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): Garbage disposal need to be disconnected t5ins•3113 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 M 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. CityrFown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owners Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption 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 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 El ® 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 Y2 day flow t5ins•3i13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form WE Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owner's Name informatics is required forMarstons Mills MA 02648 5-24-17 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® 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. ❑ ® An portion of a cesspool or privy is less than 100 feet but greater than 50 feet YP P P Y 9 e 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•2113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown 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): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '< 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: according to as-built card system consists of a 1500 gallon tank d-box and 2 500 gallon chambers. Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage (gpd)): Detail: house has irrigation system h20 2015---------376 2016--------303 gpd Sump pump? ❑ Yes ❑ No Last date of occupancy: currently occupied Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(9Pd) 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 Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown 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: 1500 gallons How was quantity pumped determined? Reason for pumping: maintenance 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•3/13 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 435 Whistleberry Rd Property Address McKeown Owner Owners Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: s.a.s installed in 2012 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast ircn ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 1.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Sludge depth: light heaviest at tinlet t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 II Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown 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 Scum thickness light 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 were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was pumped at time of inspection for maintenance. Grease Trap(locate on site plan): Depth below grade: feet 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: Date t5ins•3,13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every pace. City(rown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °M ,• 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required)for Marstons Mills MA 02648 5-24-17 every page. Cityrrown 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 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.): box level no signs of failure or solid carry over. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): There were no signs of failure at time of inspection system was functioning properly. s.a.s was functioning properly as well with no signs of failure or surcharge. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/.3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is recuired for Marstons Mills MA 02648 5-24-17 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owner's Name information is required for Marstons Mills MA 02648 5-24-17 every page. Cityrrown 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: none at time of perc feet Please incicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 5-22-17 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: You must describe how you established the high ground water elevation: design plan 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 435 Whistleberry Rd Property Address McKeown Owner Owner's Name: information is required for Marstons Mills MA 02648 5-24-17 every page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 17 of 17 Po Y • 9 Assessing As-Built Cards ' ' Page 1 of 2 TOWN OF BARNSTABLE LOCATION lL-e_,F-gr,,4 L0/-SEWAGE# 2012-�a/7 VILLAGE i4'/ltrSTO�1S 119il1S ASSESSOR'S MAP&PARCEL j94 2 INSTALLER'S NAME&PHONE SEPTIC TANK CAPACITY /5a0 LEACHING FACILITY:(type)2—,!rV�Y 6-s- (size) NO.OF BEDROOMS owNER I%awes fyI ��Eo�ydJ PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetlaxid,and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY all i I �rav�f to c�/hi"s�/E h�crr y Or. http:[!www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=062023&seq=2 5/29/2017 ..-• �_ ...�..wi.uba-r-v..M... _ ,�..+^�`i'�«.,yn+n..r•^-�---' •r-r '°""'Er+."p.-.....n. _.. ,.. ,„-sy_,.#,.. ,Yrv.+. ..,. ..TY ...���^.,_t ,,�- ...y.Y.�,✓•"...v.%�?w.v+�a No. _ / Fee THE COMMONW ALTH OF,MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF,BARNSTABLE, MASSACHUSETTS Yes Zipplitation for Migozaf *p5tem Con.5trurtton Permit Application for a Permit to Construct( ) Repair( ) Upgrade CIII/Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.435— 04, l,c Oa" Dr- Owner's Name,Address,and Tel.No­1&,k kk 'L e ewJ.n Assessor's Map/Parcel 00Z az 2 3 ►� 4g Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. (�Loy� "arrl m Type of Building: ,�{{ Dwelling No.of Bedrooms Lot Size �(p� sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons t`p Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) llO gpd Design flow provided 3�� gpd Plan Date Number of sheets 1 Revision Date Title0.1ICZ� Size of Septic Tank Type of S.A.S. � Description of Soil 0 _11, t VV 14" Vy-.A _5 ?-.L`_ 1 Nature of Repairs or Alterations(Answer when applicable) Pko ioLu_ �/1 i✓l d Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. gn Date Application Approved b Date -7 q ' Application Disapproved by: Date for the following reasons Permit No. _IINO `�- " a , Date Issued 8 u. .. - ....;�—• Y�'W+..��'�1+.. syiNr•... X .- .y ... ,� R` .w�'.r-'Yw+.`vw r 'Y_ No. t Fee l Q THE COMMONW9ALaT C F..MASSACHUSETTS Entered in computer: - PUBLIC HEALTH DIVISION - TOWh..O BARNSTABLE, MASSACHUSETTS Yes ZIppYication for Mioo!5al *patent Con.5truction Permit Application for a Permit to Construct O Repair O Upgrade Abandon O ❑ Complete System ❑Individual Components Location Address or Lot No.455 .owner's Name,Address,and Tel.NoZc?t(1 C V,-,<'UU)(g Assessor's Map/Parcel 0tvZ 0Z 3 48 Installer's Name,Address,aruf Tel.No. Designer's Name,Address and Tel.No.�Ut�✓� Via rn fa), t Type of Building: Dwelling No.of Bedrooms Lot Size `l i,(o35 sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons t 9 Showers( ) Cafeteria( ) Other Fixtures ,Design Flow(min.required) `�o gpd Design flow provided �j�� gpd Plan Date �O Number of sheets Revision Date .� Title �RAU_I'Lliv } J Size of Septic Tank 00 Typeof S..A�.S. &Lt jdQ s 2 a Description ofSoi1 0 - IZ�r �.��� �Z.t-��� OJ-� SA�c( �Z-Li"- 'IS'" M-?8 S041,�_ VYAD Ira vti .Iq AWA V 5ql"I P (4 applicable)0X 0(&(f,, U c C)A,n GI 1 (.C'�. Nature of Repairs or Alterations Answer when a licable Date last inspected: < Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate'of Compliance has been issued by this Board of Health. Signe Date Apphcation Approved 6y- Date 7 Application Disapproved by: Date for the following reasons Permit No. 1�t t,s- ,rr - Date Issued R 8 :. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (certificate of Compliance THIS IS TO CER Y,that the On-site Sewage.Disposal System Constructed ( ) Repaired ( ) Upgraded. ( ✓) Abandoned( )by S. at 455 L,,)kt4LcoL,-n t ick m6 bms wqt , has been constructed in accordance 1 with the provisions of rtle 5 and the for Disposal System Construction Permit No.,;)C''/3' A a 1-7 dated Installer " �' S Designer 61 COAL,-,. �" #bedrooms 3 Approved design flow �J - gpd The issuance of this permit s all not be construed as a guarantee that the system(Irfu-nefi-6 as designed. Date /1f1 i I r� InspectorA a , —— Fe r No. o r1',7 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Mi!6po5al *p!gtem Construction Permit Permission is hereby,granted to Construct ( ) Repair ( ) Upgrade ( �/) Abandon (. ) System located at 436— k_)VL(.S W be,rrz,t .�, Marshm S Mdl S and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Constructi mu t be completed within three years of the date of this p• its Date 7 c Approvedb�� _ f Town of Barnstable P# 3 g Department of(regulatory Services MAK t, E Public Health Division Date set p' 201)Maier Snee4 Hyannis MA 02601 b 1 Date Scheduled (/i / Time Fec Pd. 1 0c— C[(Z ZT tr Al Will Soil Suitability Assessment for S �e V JDisposa Performed By _i r"'e- 1 r p_M►h-ty`"' W•7 Witnessed By: LOCATION&GENERAL INFORMATION Location Address Owner's Name ,/ Atkhess l��S'(,,4 JA(44err.Qr Assessors MwPued: ti 6 d—d Z� anginec's Name 4:644 fllz"� V�nn1 � NEW CONSTRUCTIONN /\ REPAIR 'telephone o JT D 'q Z py—_T,16 Z Lind Use &;�& o�( Slopes(%) �—r Suffice Stones �y Distances linen Open Water Hady-`�Zy n Possible Wet A o�ft Drinking Water Well Drainage Way ft Property Une .ft Other ft SKETCH:(Street name,dimetnions of la.uaet("cations of test holes&Pen:tests,bate wetlands in proximity to holes) V3S Parent malerinI(geologic) "- ""' Depth to Bedrock POO Depth to Groundwater.Standing Water in Hale! Weeping bom Pit Price Ectimatd Seasonal High Groundwater > Z r DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Deptli Observed striding in obs.hole In. Depth to foil mottles: in. Depth to weeping from side of obs.hole in. Groundwater Adjustment fr. Index Well R Reading Date: Index Well level Adj.Actor Adj.Groundwater Level PERCOLAT-ION TEST— Observation Depth d Pere l h L_ Time at 6" Start Pre-soak Time 0 J J `64 Time(91'4") End Pt-swk ♦ Rate MinJlnch ``x Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y!N) Original• Public Health Division Observation Hole Data To Be Completed on Back— ***If percolation test is to he conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. QAS EPTIGIPER CFORM.DOC DEEP-OBSERVATION HOL$LOG Hole# OMM Sail Hod= SalTaelam So7Cabr Smi Other (USDA) (Mvasdq Mfg Mn=10%Stonex BMW eet allydi O— Z i4 S l • Z Nv t2�Z w tA.rd 4E .cam -sa as. Z.T V r tier+•0 1 I'�L �* are DEEP OBSERVATION HOLE LOG Hole# Dclub samba m �7O� ° Un Tauum Soil Cofer Sat Qum tU (trlonselU rbaoffift (Saocane.&&a.RWA*M raw r� te Yes = do l Z a, -t rand J#YO 2- 1 A I::j craNd a-S-Y d A otiv . s -C To.hd 71 #s4 -rv' rtoti el DELP OBSERVATION HOLE LOG Hole# Mpth front Sail Horizon Soil Taalae Soil Color Sal Odra Sarfacn(io.) (USDA) (a 13103M moctung (Stroaana•Stasis Da wcm Gmyeh DEEP OBSERVATION HOLE LOG Hole# Depmeom Sao Haim SailTeNme Sa'1dolor Soil 0dw (USDA) Obw�iD Iriaala6 (SOaetom Stoaev BortWos t Flood IrturnncC�ate Mao• Above 50oyra tload boundary No._ Yea V ._Y"n=yrr b&-dary No— Yea within too yearfwd i.aladuy.No— Yes , Death of Nndtrnlly t]rctra'i�,.p�y�ar M,�nl Rocs at least four few of uaturzh otxntting Pervhros mtiterW exist in ail m=s observed dwoughout the avert proposed for the mil absorption system? _�� If trot,what is the dcPth of itatum0y ct c mring pervious mawW? rfitano I testify that oa 0. 11T(dam)I have passed ft soil evaluator examination approved by the Deparm i of amwomeotat Pmte*on AW that the above walysis was Perforated by me eouidstft with . "o"e,���3expertise and eX txibed' 310 CdMlt 15.017. • Sigma • Date - - -- - nrrL•1,\-j.LJVar rVA rL'W-ULH11V1V 111.G'1 r\rey Vl.1L1L'.1<Vf1T1U114 elYJ - An- LOCATION LOT' 48 S�JN 15TLEBERM 'D(g NO. VILLAGE M.A(LS?oNS MILL. DAT, •¢-Z 8(o APPLICANT �oM MC KGowJ FEE - F,DDRESS WIMOC7►//'WC (A MARSY�IIS MIA'ELEPFIONE NO. (Non-refundable) ENGINEER SM6t.� �1(�11S�cQ/t�G (NC TELr NE NMi'll CATE SCHEDULEDPP ,c. ts s' na re) . .. ......................................... . ... ... ... .. ... ASSESSOR'S DtAP & i.UT NU: SOIL SUB-DIVISION NAMI; � LL.EB DATE —Z3�6� TIME IXPANSION AREA; YES NO ENGINEER ' TOWN WATER PRIVATE WELL r�n� �� (� BOARD OF HEALTH '!�17ZIe aZ6W,,f EXCAVATOR SKETCH: (Street name,etc.,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) _ NOTES: N Q NNo 1 �pp �® y I 'S i V�`-•�y 3 7 -- Ito 9S' PERCOLATION RATE: TEST 'iBDLr, NO: EL VATION: TEST HOLE NO 2 ELEVATION: 1 1 i­71P Sve67-,& 2 _ 2 118" 3 3 7p 4 - GLEiO� 4 5 �YIE1J/vrh 5 --- ,c�0/ra�7 B y,�Juo a 9 9 10 10 12 12 _ 13 13 -- - ---- 14 14 r 15 16 Ald &W rim.\ 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FICLD_LEA NG PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST.S11OW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN f NTIRE,r L1Y P F AND Rr._TURNED TO f32ARD 01:' HEALTH' COPY: RETAINED 13Y APPLICANT Town of Barnstable Regulatory Services Thomas F. Geiler,Director • swatvsrestE. 9 MAM Public Health Division s63A �� " Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: )Z )v Sewage Permit# Assessor's Map\Parcel DIOL 025 Designer: ' nstaller: 0 Sal ! :6111+ Address: 0 d C Address: was issued a permit to install a (date) (in ller) septic system at based on a design drawn by '(address) �Y1 l( ( i� dated 'Zp 1'L 0 2`�,2a IZ / (designer) i/ I certify that the septic system referenced above was installed substantially g accordin to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. H OF MASS GLEN gcyN ER1C , (Ins ller's Signature) HARRINGTON No. 1070 c7r�,,M /V/TAB\ (Des' a ign re) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTH. BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU Q:Health/Septic/Designer Certification Form 3-26-04.doc AsBuilt Page 1 of 1 TOWN OFBARNSTABLE LOCATION 413,5_Wk1. TL-e_D I7/SEWAGE k 2o/2-,0,/7 VILLAGE kkjt?-_Srg .S ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.S.?�'7 2a-l738 SEPTIC TANK CAPACITY 1500 LEACHING FACILITY:(type) 2-,-00 �T'�A/HgJ 5' (size) NO.OF BEDROOMS ] OWNER _r,.7�0WHS «aG(/�'I PERMIT DATE: -g-/Z COMPLIANCE DATE: -a ' Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility Of any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Vry I II rrON 7' !c, �4 http:,'/issgl2/intranet/propdata/prebuilt.aspx?mappar=062023&seq=2 9/14/2017 !�" 5PR- MAP NO. �' PARCEL 2-3 LO_C.AT10N SEWAGE PERMIT NO. VILLAGE I ST IEIt S NAME i ADDRESS R U I L D E R 0R �ER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 7,7.- gL y � T lc� i THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTHD - �� ......OF...�a!;i51 .. - ............................ Appilra taan for Ilispos al Works Tonstrurttnn 1hrutit Application is hereby made for a Permit to Construct 6�.j or Repair ( ) an Individual Sewage Disposal System at: .W h. 1� �.:... ��..... f ? 6US.... �- .--•--.._..-- '® 4-a....................................................... I C�ocation-Address / _or t No. t fl o— ---— . ..- .................................... h�-�,.....---�.....0�`=-".L.:n_ZQ1 ............... w 1 l i Address n ........•-----••.............•_. Installer Address Type of Building Size Lot.47 ..Sq. feet U Dwelling—No. of Bedrooms....................................Expansion Attic ( ) Garbage Grinder ( ) e of Building ( ) a Other—T yp g -••--•-•-------------••-•--. No. of persons.----.---.---------.---.__-- Showers ( ) — Cafeteria dOther fixtures ----------------•-------------------•-----------------....------•-------__-•......--•••-_--•--••-• ------•...........-•------.....•-•--•.....-------- ; w Design Flow.......... ........................gallons per person day. Total daily flow...... .... ..............................gallons. W Sep c Tanl 4,iquid capacit/50.6.gallons Length.lu_° �` •- De t L !� ._. Width Diameter P 1 = .. Y x —No. .................... Width._l4?._._...__._ Total Length...? .____.._ Total leaching area. °._ZRI_.sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box K) Dosing tank ( ) '-' Percolation Test Results Performed by. �, lF1� 1� �� a••�.�'/ Date.._42__V-e<, --- ---------------------- Test Pit No. 1----2.........minutes per inch Depth of Test Pit.. _ j------- Depth to ground water./���_....... f=, Test Pit No. 2.... --......minutes per inch Depth of Test Pit---/P.......... Depth to ground.water---<'?.x2m.._..... 9 ......--•----•_•_•_____--_•--•••.............. •-- ••--....---••............-----•••_•_..._ O Description of w V Nature of Repairs or Altgr 0•o�ns,—Answer w en applicab 1 ^n° �z � � Agreement: o n The undersigned agrees to eta ll tie a refescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code—Ahe undersigned further agrees not to place the system in operation until a Certificate of Compliance has be f health. Sined._:. ... ........ . ...::. ........ - - ate Application Approved By_........ .. --•----- ............................ ----.....--.. 1$ Date Application Disapproved for the following reasons---------------••-•----•----•--•---•-----------------•-------••-------------...----••......---•--..._.....------ -----•---••-...•----•.......--•-••...--•...•--•••----••-----•----•--•-•--•----•-•-•------•-••----..........--•---•---......---•-•--..._-•••---•_•---••.................................................. Date Permit No................................ -• Issued. Date No .... Fps... ...._.... THE COMMONWEALTH OF MASSACHUSETTS �. r 7 �._.TZooz. BOARD OC71/ 1 EALTH .... OF.....� ' .:.:..... . - •............................. Application is hereby made for a Permit to Construct 6Q- or Repair ( ) an Individual Sewage Disposal Sys em at: VJ 4-1 ................_.._.. i .....t...1 ... ................�..:....._... -- - ----.....---..L .46...----..............................------------..... ocatioa-Address ` or Lot No. Address ... ................... V.... .. .- ----------------------- ------------_---------••----•-------•-----•-•----------•--•---•----••----------------------•-----• Installer Address Type of Building Size LotA 7<._S.0t?..Sq. feet U Dwelling—No. of Bedrooms.....................................Expansion Attic ( ) Garbage Grinder (114 ) '14 Other—T e of Building .............. No. of persons..........._................ Showers — Cafeteria QI Other fixtures ............................ W pesign Flow........: ........................gallons per person per day. Total .T✓`�_ , daily flow......3.3 ................................._...._.._.._.glons. WSe I uid ca acit : AP. allons Len th.14'4..... Width.�=8..... Diameter................ DePtb&�S"--- x r —No. .................... Width.-/�?. _._.. Total Length... ._._...... Total leaching area .. t_sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box K Dosing tank ( ) / _ Percolation Test Result Performed by. Ul�t_: Oe6� .............1��.. Date._.; _ .. ............... Test Pit No. 1...Z........minutesperinch Depth of Test Pit•_....T..._.__ Depth to ground water.�'ll.�A _�_._. fi Test Pit No. 2....�t---........minutes per inch Depth of Test Pit-__f-_-........... Depth to ground water... -�7._.._... a --------------------------------•-•-----....------......------...._................----- •--.---.-•......................................................... 0 Description of Soil-_'��._rr'r�!----7 P y .s�v/.�'Se/C J .< -� � ��("• -CL �.1 / _.G�® f •rs '04> v ' Z......... ' W •---••----------------------•------•-------•--••-•----••-------•----•-----•-----•-._._..................--.:•--- -------••-- ---••------•---------••••-----......------•-•---•--•-----•--- U Nature of Rcpairs.or Alt rf ion Answer when applica -� . . -- I "t� Agreement: t n `s,_-4-� ,CC -'�`�Y 4 V% The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL- 5 of the State Sanitary Code— he undersigned further agrees not to place the system in operation until a Certificate of Compliance has b of health. Wined •......... ...... �. -�. ... ...............:.........._..._ Date Application Approved BY .,=.:._ ........... f ate Application Disapproved for the foflowing reasons:........................................................................................................... . ...............................••----••-......_.....-•-•••----------••••---••---•-----•-•-•-••-••---•---••--••-•••--•-••----•-•-•......-•-•-••-•-••--------•......................................... F �••-,r Date Permit No.....--.�.`�'....------ /f Issued-•...................................................... ,c L................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD.-Of HEALTH ...... - .T.'911M. .T........................... •4 (9rdifiratr of Tomptianrr , THIS IS TO CER _ FY, That the I ividual Sewage Visposal System constructed ( '),'or Repaired ( ) by------------------------------------ ------ .'..1 .. 'o►' ---------......----•-•-------.....---------.....--------------•--..........._..--------.... InstaRe,-_, at------------L -------.` l ... � . 5 ................. has been installed in accordance with the provisi TITLE 5 of the State Sanitary as d scribed i the n application for Disposal Works Construction Permit No.___--- __�_� ..... dated._.. /� -----. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FU CTI N SATISFACTORY. DATE ) ............. Inspector .._.1/ yr� .................................... THE COMMONWEALTH OF MASSACHUSETTS J��, yfi �,.--•^' BOARD OF HEALTH' . 41�tSS?" ................................I... OF.-- ��'( -ate..... j FE .-. -- Raposal orks Tons#rnr#ion amit Permission is hereby granted... �.1_.-'���........ ' ' ---------•--.......--•------------------------ ....... to Construct ( ) R p it ( ) an Indiui ual Sewage Disposal System +� l y i in Street yf �� b as show6 on the application for Disposal Works Construction Permit N�,E'__/ffjjy�_:__. Dated......I _._�Vv� ............... ............ .. .. 1 arj � ��^ Board of HealthDATE______ !( 6 t(� FORM I25 HOBBS & WARREN. INC.. PUBLISHERS R q Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: \L/AI5TL.C—sE 1Y _iZ . 'NIA2SJ-WJS 1-AILLS Lot No. Owner: 60-AC MC �ECW ii Address: Pa. 136x (y 0-*J-E1?_v L4_Z Contractor: Address: 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: OA Appropriate index well...................................................... 9�vJ'253 OB Water-level range zone ....................................................... STEP 3 Using monthly report"Current Water Resources Conditions" determine current depth to 3 8� 50•3 water level for index well ........................... mon h/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 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water 2/O levelat site (STEP 1) ...................................................................:......................................... Figure 14. Suggested computation form. 131, APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS AM LOCATION Lror 48 LJ N 15TLF sSg(z T R . VILLAGE MA(Z T01�1 S 11-S _ DAT •¢43.6(o APPLICANT `o" MQ Kea wj FEE .ADDRESS �I9flG/ 0E_yky"A U� ELEPHONE NO.' ' d (Non-refundable) ENGINEER ARrtoca rGmCq&js;R.1w.I6 Imc. TELE NE N S DATE SCHEDULED_ ( pplicant' s s= na re) • • • • • • o 0 0 00 0 0 • o • o 0 0 0 0 o e o o • • • o 0 0 • o 0 0 • • • • • • o • • a • • •.• • • • o oo o • • • • • e 000 . . . o • o • • • • • . ASSESSOR'S NiAP & LOT NO: SOIL SUB-DIVISION NAME DATE 1 A TIME ')' 30 EXPANSION AREA: YES NO __�Aaaa&.&CW&ItINSP jj ENGINEER TOWN WATER PRIVATE WELL / BOARD OF HEALTH EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) , NOTES: kr / � of . N C N. N ,P �k Z � SS 1 �y 13 7 Ito 9S' PERCOLATION RATE: Z- wtvi,►. TES T,,OLE NO: EL VATION: TEST HOLE .NO Z ELEVATION: . 1 / Ta So6501c5 i' '2 2 i 's 3 3 — rp, 7D 4 4 - 8 S 9 9 10 10 12 12 " . . 13 13 ------------ ---- - 14 1415 a i 6 Alt) 4W� � 15 16 ; SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD _LEA NG PITS _ LEACHING TR HESENC UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST-SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P. E . AND RETURNED TO .BOARD OF HEALTH COPY:, RETAINED BY APPLICANT � `" 4 engineering inc. civil engineers & land surveyors October 24 , 1986 Town of Barnstable Board of Health Town Hall Hyannis , Ma. 02601 Re: Tom McKeown Lot 48 Whistleberry Drive Dear Members of the Board This letter is to certify that the septic system for Lot 48 Whistleberry Drive was installed in accordance with the design plan. Respectfully, r Robel E. Raymond, .E. & R.P.L.S. i 60 east falmouth highway, east falmouth, ma. 02536 (617) 540-0354 SYSTEM PROFILE TOP OF NOT TO SCALE FOUNDATION FINISH GRADE OVER FINISH GRADE O FINISH GRADE OVER EL. 75.90 EL. 74.5 DISTRIBUTION BOX 74.9 EPTIC TANK 74.9 FINISH GRADE _ CARBON r 00 o- OVER TRENCHES 74.1 75.8 FILTER RISERS TO 6 A' = OF FINISH GRAD a o I r r 6, PRECAST CONCRETE � s ,^�: o, r� e, i' - 500 GALLON DRYWELLS 3' 111N. RISERS TO 6 -''"; H-20 REINFORCED LOADING ��_ a M1N.SLOPE I% OF FINISH GRADE OUTLET PIPE(S) LEVEL 13" o FOR 2'( MIN.1% SLOPE TRENCH LENGTH = 25'-0" 6" ° MIN.SLOPE 1% BEYOND - �'- o MIN. DRY\IVELL LENGTH = 8'-6" i r-p�\o_ =� 13"MIN. 14�� 172.90 72.70 MIN. 6"SUMP r �,o:r �`• , •r �,O:r �, o;o r 'x%,'r �r o �-o� PVC OR CAST IRON TEE < 72.45 72.30 •r o,o:r 72.13 ~,. *. r ' , r ` r rop0,I rr I , rr - _ _� '�` '.y r. a i-t� ® 1p r.',,1 y,0: 4, ,a' p,O�.r1T�r ^� .rrd-��r'•r'bp �`�Tbo.; ,;b ,br b Or•� ko ,� r, GAS BAFFLE DISTRIBUTION BOX 71.50 ; , ., ':, • ��. w , OTTOM OF DRYWELLS EL.69.50 1500 GALLON � MINIMUM INSIDE DIMENSION 12 3/4 -1-1r2 DOUELE 3J4"- 1-1/2" DOUBLE _, I� .•o w ,r , 0 0 A OUTLET INVERTS 2 BELOW INLET INVERT WASHED CRUSHED 4 •�: PRECAST CONCRETE -Q MINIMUM CONCRETE WALL THICKNESS 2" STONE 72 WASHED CRUSHED BSMT.FLR. STONE H-10 REINFORCED INSTALL ON COMPACTED LEVEL BASE ELEV. 68.80 °o ' �6 0 -' 7' :1 ; NOTE: EXCAVATE TO =C= STRATUM IN ORDER TO BOTTOM OF TEST HOLE EL.62.30 REMOVE ALL =A= & =B= IMPERVIOUS MATERIAL WITHIN S OF THE SAS. REPLACE WITH CLEAN TRENCH SECTION .• �' �o p r -.; :r , r f` CLAY-FREE SAND SEPTIC TANK ll`. INSTALL ON COMPACTED LEVEL BASE ��` "� � � 9" MIN. DOUBLE WASHED PEASTONE o r 4"'DIAM. 36" MAX. OR GEOTEXTILE FABRIC o ^r'° L, g'' 3/4" 1-1/2" DOUBLE WASHED CRUSHED rr „ 4 + ` �f 51 2 STONE . . TRENCH WIDTH 1 rr ,p• ' '_...�w n.y.,•.~•.~'� GENERAL NOTES: NUMBER OFTRENCHES 1 ' 1. ELEVATIONS SHOWN ARE BASED ON ASSUMEDNUMBER OF DRYWELLS 2 a, 2. ALL P?PES IN THE SYSTEM MUST BE CAST IRON OBSERVATION PIT j o N6.?o OR SCHEDULE 40 PVC. P 5478&P 13Fr68 o_ ,, 3. HEALTH AGENT/CAPE& ISLANDS ENGINEERING _- c u�xRTN _ �189 l� OTrON,SOIL FVALUA rOR MUS�i BENOTIFIt�WHEN CONSTRUCTiONlb •i/'`�/ + + + : < 2 MIN./IN COMPLETE PRIOR TO BACKFILLING: PERCOLATION RATE / 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED WITNESSED BY: D,,kANTON BY CAPE & ISLANDS ENGINEERING AND THE BOARD BARNSTABLE BOARD'OF HEALTH �G / // I �`�, OF HEALTH. DATE: JUNE.1 5,2012 DESIGN DATA ��•� 5. MATERIALS AND INSTALLATION SHALL BE IN TH#1 \ . . _ COMPLIANCE WITH THE STATE SANITARY CODE EL.74.3 TH#2 + ��G�• / , // .�- [TITLE V]AND LOCAL APPLICABLE RULES AND or, oll NUMBER OF BEDROOMS 3 REGULATIONS. =A= LOAM 6. NORTH ARROW IS FROM RECORD PLANS AND IS 10 YR 3/2 GARBAGE DISPOSAL NO �• / ��p0 Op 6� LOT 48 \ j I,AND NOT INTENDED FOR SOLAR ENERGY PURPOSES. 12" 6 DAILY FLOW 330 GPD. 1W�' 47,635 Sf. \ 7. WATER SUPPLY: MUNICIPAL WATER SYSTEM. SEPTIC TANK REQUIRED 1500 GAL. / + I VGATIO 8.THE SOIL ABSORPTION SYSTEM SHALL HAVE A MINIMUM =Bw=MED.SAN© SEPTIC TANK PROVIDED 1500 GAL. OF ONE INSPECTION PORT CONSISTING OF A 4" PERFORATED 10YR5l8 LEACHING REQUIRED 330 GPD. PIPE PLACED VERTICALLY DOWN INTO THE STONE TO 24 12 + THE NATURALLY OCCURRING SOIL OR SAND FILL BELOW THE =C1=MEDIUM SAND � SOIL ABSORPTION SYSTEM CALCULATIONS: �• .� STONE. THE PIPE SHALL BE CAPPED WITH A SCREW TYPE 2.5Y 6/4 ti ,r � GRADE.CAP AND ACCESSIBLE TO WITHIN 3 OF FINISH G 15/° F-M GRAVEL + / \ 1 + ��O 9. THIS PROJECT DOES NOT INVOLVE ANY LAND DISTURBANCE SIDEWALL AREA = 152 SF. 88 WITHIN 100' OF A CONSERVATION RESOURCE BOUNDARY 152 SF. X .74 G/SF. = 112 GPD. + / PAVED ,- �� BOTTOM TO X RE= 329 243 GPD. DRIVEWAY =C2= MEDIUM SAND SF.\ / _ 2.5Y 7l2 / i �-' - � 5%STONES LEACHING PROVIDED = 355 GPD. ?� --+ / + 0 O LEGEND NO GROUNDWATER 144" -�1� 52 PROPOSED CONTOUR 144 EL.62.3 g9 + SEPTIC SYSTEM REPAIR w� + 0 �,�° �,'' Q ---•52---• ,�-•- - EXISTING CONTOUR 'Coe p + PROPOSED SEWAGE DISPOSAL SYSTEM I ^ /k-OW-DIFFU � ��,l OBSERVATION PIT PREPARED FOR �r 1,500 G LON O Q �• & Lll rlJ� lY1C 0 I'I l r s rrlc ANx h.. ,;ti �} El DISTRIBUTION BOX ; THOMAS � / �, / b 23, ti . � HSE.NO. 435 WHISTLEBERRYDR. o0o F ¢ . zI / o ,;�h 'NV1 TAR _ "STONS MILLS,MASS. 61° �(s , \ 6 o r 0 SOIL ABSORPTION SYSTEM z PLAN NO. 061812 SCALE: AS NOTED r \ ti° / / RESERVE RESERVE AREA CD �lt�`01;�A FILE NO. 259BA DATE: JUNE 18,2012 \ \< tn •'••� •• SEPTIC FILE NO.77 PCS FILE: whistlebe"435 C\ \ \ N ` ° llAVlll •••° PK NL 22.26 PIPE INVERT ELEVATION CHARLES EL.77.0 / NOTE: EXCAVATE TO =C= STRATUM IN ORDER TO SANICKI CAPE & ISLANDS o 28085 D ENGINEERING \ _ _ S ENGIN RING IMPERVIOUS M z - B �' z \ b REMOVE ALL A & z PLOT PLAN �2 ' / WITHIN 5' OF THE SAS. REPLACE WITH CLEAN, 435 o o '' , 800 FALMOUTH ROAD, SUITE 301 C _ r SCALE. 1rr - 30' / CLAY-FREE SAND 062 023 048 5 5 5 MASHPEE,MA 02649 (508)477-7272 MAP SEC PCL LOT HSE • - GENERA 4, NO TES P4AN V/Eyl'• % ,444 E4E"Y.4TIONS SHDGYN ARE p�S�tp . 72 i sotsa g �f .4$ tJti1E"�? • �-- ! ,;:._�J� �C.L EAN 4U7` 4 1�1/SPECT/ON COYE'R a t `� r + {{ ! . P/TCH A4� .LINE A ! , , , � S MIN//i�1Uhl OF /e Fr. 1 NZ SS OTHERWISE S EC/F/EP, ! tAC? Ewa __ I � � f i! } � ; � �,� � S � t1 ��= 'U 3. 4k4 P/PES TO ANP /N THE SYSTE.�N SHAtj �.� BE CAST IRON OR SCH OU E !•-i�,t3tu�-i �s.�a- � # �?• E' �!, -4•Q PVC. { i ! , ,•! 4 A4�, SEPT/C TAN,,,V O/STRIBUTIO B X -- -- -- _ _ .4N© E.4Ch/JN(3 PIT SX.4 B or-ttr ? 1 , S /L�, E PESIGNEO OR X-ZO `1'h�EE.t, .0 OAO/NG S J'trh/EN UNDER P,.�4Y//1JG. , Q UNSUJTAB�C,E' �11.4TER/A4, ' --- - �.. ,.:.. .� - `BENE'ATX HE %/YYE�'T E4,EYATIOJYS a „' O /C _, OF THE DIFFUSORS FOR A O!S TANGE OF 12a ?.�.rc _ Z 4 1. SANITARY TEE , 9 -}�-► 3G)2 51z dPfNINGS , 1*" t: 9 ., h'NOCkOUTS FOR ' l8 S,LOT.S /o ANO BACKFII-k !N/TH C4A Y-f'9,CE r . ., BEO rNSTAL,(..4T�4N 8 8 z/z -* 2 S.4/VO,4IVh GRA t✓E�, XAY/NG A PERCOLATION , 3►xo TYPIC,44 ,045TR1,611TIG7/i� B�,� � � � � � � .. � � - --, o R,4TE OF 2 .�r�IvurEs PE I H _ s_. R NCH OR�.ESS. Uo we,TF Yid 2 @ G'c� NOT ,d �_ .. . ,r.. ;' a 6. 7RE 154-,V577 BOARD OF HEALTH MUST , Ta �5C �.E' ;� t, BE IVO TIF E' WI-IS-IV ,,- - I1/r:,$TE' f��7`/`�fB'UT/4N' BOX�tNl�/GYJ4 G;4�... � �� .� �t f ,. 7- / O THE" SYSTEM IS NEAR . SEC /ON 8 B O SE 't/,4TION PIT" ` SECTION .Jlfz FILO rt' >NE Re1NroRcEO SEP7 TANK 8Y CONP,GETroNANO PrQ/Ord TO BACk I��iNG. TYPICA.C, i�oo G.�l�l,. E IC TA1V F'Efr'Cc`3.G,4TI41V RATE Mt t C - A.4lER104N• IO-W4 "CAST 4f EIQI-IAA PRECAST • .EACHING CHAII�BER ?. UN.LESS JTNERW/SE NOTED,AI,I SYSTEiG/ NOT SCAJ E COAfPOMFNTS SX.4d,k BE /NST,444EO /N O,SSEeV-4TJUNS BY--�-t MC V-CA.J F© 4 xB-O F�C.t�W Df�FUSER R /tlOTE= TANKS REIN, ORCE TXIM41GROUT NOT TO %X41 E .9000WP,,4NOE' WIT TIT E OF T:. ��te�c!fir' �O�ev of ��-,4�,rX _ t N �. �' HE STATE' W1 TH.,E'G�C r/?/C f4'E J PK`P ImRz- m I Tf! ��" S.4Nl TAR Y COOS ANO A/V Y 4,O �. U ENG,�N-54'R ARROW 'E•NG/fYEERfN+G INC CA R 1,ES E tBEPG'E© L.STEF4 ROP,5 I t 7`OP B T• oaf TE: ��2`3-�•� O TOf .; i�YYH/Cy 6tAY APP.t,Y. .. ��NeRErE Is �,r�aC psi� �Es T . y � , F/NISH Gh'Af�E OYErY �.EACH/NG - v. . .. - AREA E4 El - 9 3+0 EII,EY, =45t FINISH GRAPE F/NISX G AOEOYEr4 N F/NlS'h/Gfi'.4f�E Fn, TA K PRECAST LEACH/NG cl-umBERS --- _ !)YEYr O BOX �, €GEY. g3to E,C EY 1}2�2� _ F�Ot4' ©/FFUS'ERS v F'EASTONE - /Zvyr ;• oe� 1/r v I "f,GOIVGlNE /NYC 110fo 7; /� /N .=fir-75 r,o►n>3Sioq CA,L. FIST, 8DX i ' _::,,... d, ." , .... 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