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HomeMy WebLinkAbout0559 WHISTLEBERRY DRIVE - Health 559 Whistleberry Drive Marstons Mills F/R A = 061 043 / t �t 1 `moo s c.___ �I �_ it No. FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, �Ci ticS�C�� MA. APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) RepaiIX Upgrade( ) Abandon( ) - ❑Complete System';'<idividual Components Location *5 - 1` Y Owner's Name ���� (+- Map/Parcel# (� (Ql ��C y�1 Q Address Lot# -* 17 1 Telephone# 4D 8 ao,-,3 Installer's Name ". aDesigner's Name' opy t Address '"�1 12 CX,, Address 1 Telephone# %�>S-L f a t Telephone# 70 (� Type of Building � -\ewr�t,ON Lot Size 46dca sq.ft. Dwelling-No.of Bedrooms Garbage grinder Other-Type of Building No.of persons !!Ic Showers (Cafeteria Other Fixtures 2 Design Flcw (min.required) J� gp Calculated design flow 30 Design flow providedJG gpd Plan: Date 0'' Number of sheets g Revision Date `- Title �� T�5e A �z.'����ce � s �S�sc:.� �Q kg-n Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned a to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to t9o4ce th5>ystim in operation until a Certificate of/Conyliance has been issued by the Board of Health. Signed Date 5 2103 Inspections 23_ 33 No., 6 - FEE -COMMONWEALTH Of-MASSACHUSETTS ( Board of Health, G\z�\P_ MA. Y�: APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT : , Application for a Permit to Construct( ) Repaid ( (Upgrade Abandon - ❑Complete System') l�individual Components Location *,5,Sq W#4t .jj i3r jk y jX. M.(A I I Owner's Name Map/Parcel# �� �(�1 � � Q(�3 Address RN1 Lot# "} ` Telephone# 4D 8 •- j '3 Installer's Name ' \Q Designer's Namelj> nV Address � "'�� '� Address Telephone# 8$3-413 s99 Telephone# �Sy !!, Type of Building �` �C s�0.� Lot Size 46,500 sq.ft. t.A Dwellir_g-No.of Bedrooms C{R- Garbage grinder (� � Other-Type of Building 1 G No.of persons '�Showers (goKCafeteria Other Fixtures �� Ckle r1 `5w4<1 ,. x Design Flow(min.required) J gpd Calculated design flow �J�� Design flow provided gpd Title gpd Plan: Date 5 ILA t C Number of sheets 1 Revision Date �wi r�� sQ c't ��c1SJC �cc� �c �.� `J 1..��s•�e� Description of Soil(s) _ l �� Soil Evaluator Form No. Name of Soil Evaluator C_buyxul SWW Date of Evaluation S i 12-N0 3 DESCRIPTION OF REPAIRS ORALTERATIONS The undersigned 7e4s to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees tosfi t/torplac��cyst m in operation until a Certificate off,Compliance has been issued by the Board of Health. Signed 1 !/ p' Date Inspections e i 20o3- 23 3 0 No. COMMONWEALTH OF MASSACHUSETTS FEE Board of Health, I YES �ISL MA. CERTIFICATE OF COMPLIANCE Description of Work: U Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired),Upgraded ( ),Abandoned ( ) by: at has been installed in accordance with the pro 'siorls of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 2W3--Z dated 5 22103 Approved Design Flow (gpd) Installer .�n Designer: Inspector: ..� _ Date: The issuance of this permit shall not be construed as;a guarantee that the system will function as designed. No. G"`'1 2 73 FEE 576 COMMONWFA T14 OF MASSACHUSLITS Board of Health, Rot�3 MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby ranted to; Construct( Repair(epair( Upgrade( ) Abandon( ) an indi-6dual sewage disposal system at 5�SS TIYc/ -"' �-! as described in the application for Disposal System Construction Permit No. 2w?—233 , dated S 22 a3 w 4, �- Provided: Construction shall be completed within three years of the date of this m Al 1 conditions must be met. Form 1255 Rev.5'96 A.M.Sulkin Co.Boston,MA Date 22�Q Board of Health i BORTOLOTTI CONSTRUCTION, INC. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address Prop Date of Inspe�o/ 9sMap % arce0L13 Own:—h PART A — CHECKLIST CHECK IF THE FOLLOWING HAVE BEEN DONE: PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH. /NONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND THE SYSTEM RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE NOT BE THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. 1Cb J L/-AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE W /A. \2 &-IHE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. ffHE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. O C 199 r/ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. > r� "c� r , � f. V THE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF THE SEPTIC TANK'WAS INSPECTED FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH OF LIQUID,D`EPTH.OF SLUDGE DEPTH OF SCUM. THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION ORpT APPROXIMATED BY NON-INTRUSIVE METHODS. v THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSDS. PART B — SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL No of Bedrooms No of Current Residents /1/ Garbage Grinder S' Laundry Connected to System A/ , Seasonal Use NON RESIDENTIAL: Calculated flow WATER METER READINGS,IF AVAILABLE: GALLONS P in,g Records and Sou ce of Information: SYSTEM PUMPED AS PART OF INSPECTION? © IF YES,VOLUME PUMPED = GALS Reason for Pumping: TYPE OF SYSTEM: Septic tank/distribution box/soil absorption system Single Cesspool Overflow Cesspool Privy Shared system (if yes,attach previous inspection records, if any) Other(explain) Approximate age of all components. Date installed,if known. Source of information. At SW � . SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? Q SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SEPTIC TANK: Depth below grade:a)uEms' /��� Dimensions: g-s X / Material of construction: J,�Concrete Metal FRP Other} �A Sludge Depth Distance from top of sludge to bottom of outlet tee or baffle Scurn Thickness Distance from Top of Scum to top of outlet tee or baffle Distance from bottom of Scum to bottom of outlet tee or baffle Comments: F6 Q. 160n S G C'�c DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT Comments: i PUMP CHAMBER: FPumps in working order? Comments: i SOIL ABSORPTION SYSTEM SAS : IF NOT PRESENT,EXPLAIN: TYPE:/- O✓J I ; Comments: / 66C,121- CESSPOOLS: 6 Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimens'on of cesspool Materials of construction. Indication of groundwater inflow(cesspool must be pumped) Comme-ts: PRIVY: Materials.of construction Dimensions Depth of solids Comments: f 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM I PART B — SYSTEM INFORMATION (Continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: :INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS. LOCATE ALL WELLS WITHIN 100' I II I 30 DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER METHOD OF DETERMINATION OR APPROXIMATION: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C — FAILURE CRITERIA (I (Indicate Y—yes N—no ND—not determined.Describe basis of determination.If"not determined",explain why not) IV Backup of Sewage into Facility? !� Discharge or ponding of effluent to the surface of the ground or surface waters? /V Static liquid level in the districution box above outlet invert? / Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? Ir I Required pumping 4 times or more in the last year? Number of times pumped iAl Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfl tration? tank failure imminent? Is any portion of the SAS,cesspool or privy, below the high groundwater elevation? /y Within 50 feet of a surface water? �— Within 100 feet of a surface water supply or tributary to a surface water supply? IAI_ Within a Zone I of a public well? Within 50 feet of a private water supply well? Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools &privies only, not the SAS)? _ Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water j quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for cofrform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen. ! PART D — CERTIFICATION ;':INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399 CERTIFICATION STATEMENT �!I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY RECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE II IN THE PROPER FUNCTION AND MAINTENANCE OF ON—SITE SEWAGE DISPOSAL SYSTEMS. 11 CHECK ONE: li I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. �i I HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN 310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. I INSPECTOR'S SIGNATURE: DATE: ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(d applicable),APPROVING AUTHORITY f TOWN&BARNST E , LOCATION SEWAGE #��— 35 VIL & LOTLAGE ' '( INSTALLER'S NAME&PHONE NO. ✓ �� Q� SEPTIC TANK CAPACITY I000 6 Fx3,��9 i LEACHING'FACILITY: (type) 3^ fin (size) NO.OF BEDROOMS '3' BUILDER OR OWNER J � PERMIT DATE:�� .L 03 COMPLIANCE DATE: �LD 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 Feet within 300 feet of leaching facility) ` Furnished by 6� 3. y3'7`� J� 3 . 17'l/ �. s. 17�b1' y TOWN 0 BARNSTABLE `LOCATION - SEWAGE # w 3-5 \;; .-CAGEYjASSESSOR'S MA F & LOTo ` 7� INSTALLER'S NAME&PHONE NO. � IIC( DV� SEPTIC TAN CAPACITY 1000 6 _F_X-3 LEACHING FACILITY: (type) 3^ ®n (size) NO. OF BEDROOMS BUILDER OR OWNER_ Q Ea PERMITDATE:,!t5 ,2Z— — COMPLIANCE DATE: 5,�3 63 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 C9 3. y3 7 y 3 . 17 #/1 17'6 P' y FC� MUr��' n `GR 4, `fir , . ,,: xis�� M1, .- � � R •.•e.{' � � ,�}:� •fU�°� y 4j `� } J f, � +t� EU • •E \VN F r �� Mw � '� ���'IIDF"`` " 'h' 1.• e ��Y�, 1 a r W � n , ' r Y. xa 8 , f ' .J r ^ Y ° y - j r x � 1 a. r 46. f Um v .2 cp a +rJ MY R .. � .•_.�' -� �, �N - � v.�y� �a any a '4 u y�y � W w' t k¢ a Y�i y p •'sy,,c 1 lk, lt) `p f M1 s P t e f AL a"s s t7YY', dry A• '"><�` � lu NX µ 4=,,, � � e�"`a�.�� .d,,..a •�'�� _���`' a3 e s+ ���^ �..,. �w ,�e� 1�.,,8 P. 'k ���Nr1' �� y, '+' �% ♦• s .�'� �� .Y..�� 'I@F°J�'exia -- :µ iM � # � t t "1,7 aY, � #. COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS 2 DEPARTMENT Ok ENVIRONMENTAL PROTECTION FAILED 1NSP ECTION MAP PARCEL TITLE 5 LOT _ OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 552 Whi ci soborry drlve —Ma�s tens mills, tt�a Owner's Name' ,sue T Owner's Address: Date of inspection:4,1 Name of Inspector:(please print)_Wi 1 I i am E_ . Robinson Sr. Com,panyName: William E. Robinson Septic Service Mailing Address: P 0 Box 1089 Centerville, MA Telephone Number: (508) 775-8776 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section.15340 of Title 5(310 CMR 15.000). The system: Passes Co9ditionally Passes eds Further Evaluation by the Local Approving Authority ails Inspector's Signature: ��� Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health*m 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 once of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the appro.ving authority. Notes and Comments ****This report only describes conditions at the time of inspection and tinder the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 .i' t , T COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION s y,, R41 1401T , TITLE 5 OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 50 Wh; }i eborry ,� `;;_ � ,..,=s����=-�--„rive --?4arstensue,i1l�-, m-a Owner's Name• Owner's Address: Date of Inspection: LT— ,— 62 Name of inspector: (please print)-Wi 11 i aim F_ . Rcjhi nson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville, MA Telephone Number: ( 508) 775-8776 CERTIFICATION STATEMENT 1 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.15340 of Title 5(310 CMR 15.000). The system: Passes C094itionally Passes eds Further Evaluation by the Local-Approving Authority ails Inspector's Signature: <12 Date: _ —6 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heatth•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 Commen ts nis ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page] Page 3 of 11 OFFICIAL INSPECTION FORM`-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 559 rasa ti ..t-.,....ry Dr -e Memsisans-1 mills,1 A Owner: Date of Inspection: 6 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 fail' to protect public health,safety or the environment. 7.1 1. S stem will pass unless Board of Health determines in accordance with 310 CMR 15.303(l)(b)that the sy tem 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 esspool or privy is within 50 feet.of a bordering vegetated wetland or a salt marsh. 2. Syste will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is nc,tioning in a manner that protects the public health,safety and environment: _ e system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surfa a water supply or tributary to a surface water supply. e system has a septic":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 ltbact te water supply well*,.:.Method used to determine distance is system passes if the well water analysis,performed at a DEP certified laboratory,for coliform ria and volatile oiganic compounds indicates that the well is free from pollution from that facility and the p rcscnce of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other tail a criteria are triggered.A copy of the analysis must be attached to this form. 3. Oth r: 3 Page 4 of 11 , OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY.ASSESSMENTS , SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Drive Owner- Date of lnspec 'on- D. System Failure Criteria applicable to all systems:. You must indicate"yes"or"no"to each of the following for all inspections: Yes No/ v ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool t�ischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool bution box above outlet invert due to an overloaded or clogged SAS or, Static liquid level in the distri cesspool ✓_ Liquid depth in cesspool is less than 6"below invert or available voluggme.is less than'/2 p P(j . ;Required pumping more than 4 times in the last year NOT due to clogged or obstructed i e s .Number of times pumped elevation. Any portion of the SAS,cesspool or privy is below high ground water Any portion of cesspool or privy is within too feet of a surface water supply or tributary to a surface water supply. y portion of a cesspool or privy is within a Zone 1 of a public well. y 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 160 feet.but greater than SO feet from a private water supply well with no acceptable water quality analysis.(This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds P presence of ammont indicates that the well is free from pollution from that facility and the prese 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.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be nsfdercd a large system the system must serve a facility with a design [low of 10,000 gpd to 15,000 gPd- You mus indicate either"yes"or"no"to each of the following: (The foll ing criteria apply to large systems in addition to the criteria above) yes . no e 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 11 of a public water supply well if you ave answered"yes"to any question in Scztian E the system is cOnstdered a significant threat, or answered "yes"i Section D above the large system bas failed.The owner°T for of>�large system considered a sign under nt threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304_ he system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM'° ' PART B CHECKLIST Property Address: 559 Whistleberry Drive Marstons Mills, MA _ Owned _.. . Date of Inspection: 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 7 _ 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 7:. ,Z Were as built plans of the system obtained and examined?(If they were not available note as N/A) v Was the facility or dwelling inspected for signs of sewage back up 7 Was`the site inspected for signs of break out? _ Were all system components,excluding the SAS,located on site 7 _ 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 7 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:. Ye. 1L_ 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 CI AR 15.302(3)(b)) 5 r Page 6 of 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 559 Whist-1 PhPrry Drive Marstons Mi 1 1 a,:— MA Owner _ Date of Inspection: — —G S FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design) Number of bedrooms(actual) DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x N of bedrooms):,3,�y Number of current residents: Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no [if yes separate inspection required] Laundry system inspected(yes or no)Ae 0 Seasonal use:(yes or no): /ti'V Water meter readings,if available(last 2 years usage(gpd)):2 0 01 =1 4 5, 0 0 0 2 0 0 2=2 5 5, 0 0 0 gallons Sump pump(yes or no): .41 Last date of occupancy: GAO 3 COItIMERCIA NDUSTRIAL Type of establis ent: Design flow(base on 310 CMR 15.203): Qvd Basis of design fl„. (seats/persons/sgft,etc.): Grease trap prese t(yes or no):_ Industrial waste olding tank present(yes or no):— Non-sanitary A, ste discharged to the Title 5 system(yes or no):_ Water meter r dings,if available: Last date of cupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: /v Was system pumped as part 6f the inspection(yes or no):_ If yes,volume pumped:_ Qallons--How was quantity pumped determined? Reason for pumping: TYP�OF SYSTEM C Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool —Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: S- Were sewage odors detected when arriving at the site(yes or no):,�i U 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM'.` PART C SYSTEM INFORMATION(continued) Property Address: 559 Whistleberry Drive Marstons Mills, MA Owner: John 4artarian Date of Inspection: BUILDING SEWER(I to on site plan) Depth below grade: Materials of constru ion:_cast iron 40 PVC—other(explain): Distance from privXte water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: z ocate on site plan) ) Depth below grade:�_ Material:of construction: ✓.concrete metal fiberglass—polyethylene _other(explain) — — If tank is metal list age:— is age confirmed-by a Certificate of Compliance(yes or no):_(attach a copy of certificate) t r i Dimensions: Sludge depth: Distance from op of sludge to bottom of outlet tee or baffle:,d Scum thickness: Distance from top of scum to top of outlet tee or baffle: 7 , Distance from bottom of scum to bottom f outlet tee or baffler T, How wee dimensions determined:.(I �� Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of.leakage,etc.): GREAS TRAP:_(locate on site plan) Depth belo grade:— Material of onstruction:—concrete—metal fiberglass_polyethylene—other (explain)- Dimension Scum this ess: Distance fr m top of scum to top of outlet tee or baffle: Distance m bottom of scum to bottom of outlet tee or baffle: Date of I-, pumping: Comment (on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related o outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM' PART C SYSTEM INFORMATION(continued). Property Address: 559 Whistleberry Drive M r tnn� Mi11 �� MA Owner: ?"— Date of Inspection: TIGHT or I LDING TANK: (tank must be pumped at time of inspection)(locate on site plan) . Depth below c: Dep t'� - other ex la'ut): , Material of cons t ction: concrete. metal fiberglass___polyethylene ( P Maten Dimensions: Capacity- Design Design Flow: allons/day Alarm present es or no): Alarm level: Alarm in working order(yes or no): Date of last p mping: Comments( ndition of alarm and float switches,etc.): 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.): --------------- PUMjii (lo ate on site plan) Pumpr(yes r no): Alarr(ye or no): Comion f pump chamber,condition of pumps and appurtenances,etc.): 8 • Page 9 of I 1 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_559 Whistleberry Drive Owner: s Marstons MT11 _ MA am Date of Inspection: SOIL ABSORPTION SYSTEM(SAS):-1ZI/oocate on site plan,excavation not required) If SAS not located explain why: Type aching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): f p CESSPO S: (cesspool must be pumped as part of inspection)(locate on site plan) Number and nfiguration: Depth—top o iquid to inlet invert: Depth of solids layer: Depth of scum yer: Dimensions of c sspool: Materials of con traction: Indication of gr dwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (ocate on site plan) Materials of co struction: Dimensions: Depth of solids Comments(n a condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): Y _ 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY A M SUBSURFACKSEWAGE DISPOSAL SYSTEM INSPECTION FONTS PART C RM SYSTEM INFORMATION(continued) Property Address: -- --�-ry Drive MarGtnnG M_ T�1�� Owner: MA_ Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. g dJ T rk 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 559 Whistleberry Drive marstnris Mills, MA Owner- John an Dale of Inspection: y —&G ' SITE EXAM Slope Surface water Check cellar Shallow wells Estimated'depth to groundwater 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: :Zbse.rved site(abutting property/observation hole with' 1 SO feet of SAS) Checked with local Board of Health-explain: Checked with local excavato rs,installers-(attach documentatio n) Accessed USGS database-explain: You must describe how you established the high ground water elevation: O 11 Health Complaints 24-Dec-03 Time: 1:15:00 PM Date: 12/23/2003 Complaint Number: 17205 Referred To: DAVID STANTON Taken By: DAVID STANTON Complaint Type: Article X Detail: Business Name: Number: 559 Street: whistleberry Village: MARSTONS MILLS Assessors Map_Parcel: Complainant's Name: Address: Telephone Number: Complaint Description: septic has new leachpit and d-box. Original tank. Had plumber come out and said water level in tank above inlet, and below outlet. Either installed backwards or not level? Actions Taken/Results: DS WENT TO SAID LOCATION. READY ROOTER WAS PUMPING OUT THE TANK. THE TANK IS DOWN DEEP AND HARD TO GET A GOOD OBSERVATION, BUT IT APPEARS THAT THE TANK WAS INSTALLED CORRECTLY IN 1983. THE RECENT REPAIR INSTALLED A NEW PVC TEE ON THE OUTLET OF THE TANK. IT APPEARS AS THOUGH THE OUTLET TEE AND PIPE WAS INSTALLED AT A STEEP PITCH DOWNWARD, CAUSING THE TEE TO BE TOO HIGH INSIDE THE TANK, OR THE PIPE SETTLED DOWN DURING THE BACKFILLING PROCESS CAUSING THE PIPE TO PITCH DOWNWARD (UPWARD INSIDE THE TANK), OR THE OUTLET WAS PUT IN TOO HIGH ON THE SIDE OF THE TANK. HOMEOWNER CALLED INSTALLER. ONLY WAY TO TELL THE TRUE ELEVATION IS TO USE A TRANSIT ON THE INLET AND 1 „h Health Complaints 24-Dec-03 OUTLET PIPE. READY ROOTER SAID THAT THE INLET TEE WAS BELOW THE LIQUID LEVEL, AND THE OUTLET TEE WAS ABOVE THE LIQUID LEVEL. HOMEOWNER WAS TOLD TO CALL BOH IF THEY HAVE ANY PROBLEMS WITH THE INSTALLER. Investigation Date: 12/23/2003 Investigation Time: 4:00:00 PM 2 i r — Se,; - 20- 01 13 : 52 BARNSTABLE HEALTH DEPT 5087906304 Sr�s;o� ;NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLA.TI.ON 'TEST AMJ SOIL EVALUATION EXEMPTION FORM —Ap—.A,'3 by hereby certify that the engineered plan sip ed by m^. urtec n5114VO concen-Ling the property located at �sgt-ks'R2R Y �v� meets all of the fci,ow;n0 cnceria • This failed system is connected to a residential dwelling only. There are no :or-tmztrzia.! ,.,r business uses associated with the dwelling. • 'F.e soil is ciass:;ied as CLASS l and the percolation rase is less than or equai to -Ti.nutes per inch. The applicant may use histoncal data to conclude this fsc: or may :onduct xe!irnwary tests at the site without a health agent present • T here .s no ;ncrelle in Flow and/or change in use proposed • T hcre are :to variances requested or needed. • The bottom Df the proposed leaching facility will not be located less than founeen %.et aoove the mwYirnum adjusted groundwater table elevation. (Adjust the -nundwatcr cable using the Frimptor method when applicable) Please complete the following: Gmune Surface Eleyation (using GIS informauon) �O___ F!cvat:or, � �� :;d;ustment for high G.W. 4s BETWEEN and B --Y--�— I S.(;'VE D — D ATE. yr�l a-0� ..._._..---------- -- -- NOTICE � 33sec j,-r)n tie move :rfonnation, a repair permit wil! be issued for �cdr^erns bedrooms are authorized to the future without en,tncerec r !I 3 P . Permit Number: Date: Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Location: �LS� �ti�� � � r '"I �� `�S Lot No. � Owner: Address: 4as'_A`n2 Contractor: L �C-\Address: b -. C `1�lttcsl�d� (2✓Jb Notes: STEP 1 Measure depth to water table ,{ tonearest 1/10 ft. .............................................................................. .Date ` c) mont /day year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: 50W Appropriate index well.................................................... oZ6 OB Water-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to O� 1 water level for index well ........................... Alimonth/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) a determine water-level adjustment .......................................................................................... STEP 5 Estimate depth to high water by subtracting the water• level adjustment (STEP 4) I from measured depth to water level at site (STEP 1) Figure 13.—Reproducible computation form. 15 ,Cape Cod Commission: USGS Well Data- April 2003 Page 1 of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties, the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources Office. The water level measurements shown below are taken monthly from United States Geological Survey (USGS) observation wells and compiled during the last week of each month. They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to be used with Technical Bulletin 92-001 to predict high groundwater levels. For your convenience, we've also provided links to USGS national and state data. See the last column in the table and the footnotes below. For further information, please contact Hydrologist Gabrielle Belfit at the Commission offices (508-362- 3828). April 2003 (.1 SUS Site Water Record Record Departure from ':Number**** Location Well No. Level* High* Low* Average** (links to t.1SGS Monthly Overall national water-level 11 database) Barnstable 230 22.3 20.5 26.6 0.4 1.4 413956070164301 Barnstable 24W 23.2 20.5 28.6 0.6 1.3 414154070165001 Brewster BMW 21 10.7 6.9 13.6 -0.8I -0.5 414518070020301 Chatham CGW138 21.4 20.9 26.6 1.7 2.6 414100070011101 Mashpee MIW 29 6.2 5.6 10.0 1.4 2.3 413525070291904 Sandwich SD2 46.3 45.9 48.2 0.6 1.0 414418070241601. Sandwich SDW 51.0 45.8 55.1 -1.4 -0.9 414124070265901 Truro TSW 89 10.7 10.2 13.0 0.9 1.3 4202060700459O1 Wellfleet WNW 17 8.5 7.3 12.8 1.1 1.9 415353069585401 http://www.capecodcommission.org/wells.htm 5/15/2003 TOWN OF BARNSTABLE U.)tATIQN ��' G�/7 i`S�� OYt� �(�P SEWAGE# VI ;LAG / ' •,e8 ASSE§SgR'S MAP&LOTS � ZNsf�E47 CFW'S /P S NAME&PHONE N ( /(/GD SEPTIC TANK CAPACITY / LEACHING FACILITY: (t/y�pe' �/ / (size) NO.OF BEDRO �7` BUILDER R OWNER Cyr PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility G / 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 Facili (If any wetlands exist within to 1 chin faci ' / I/V Feet Furnished 0` C. o - y W- s1�� V-� 36 ` 9, r - 1-OCATION - SEWAGE PERMIT NO. VILLAG I N S T A JJER'S INE i ADDRESS 44a ,on s �; I U I L D E R OR OWNER DA T E PERMIT iSSU E D DATE COMPLIANCE : ISSUED 7 ` � 1 ��\ � .k �' II t� - .. � - . �� t�, i ���c �� � �� ����` 4 � i.• J .T-....v� N f THE COMMONWEALTH OF MASSACHUSET,TS BOAR® OF HEALTH ..................OF........... .6+-MI -TAU- ..... ApplirFatiun for Dispuual Works Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..... �.....;r�s.......................�- . ....................................................... ocat n-Address 7�w�r Lot No. �> y..S i.ta -..: .1 ......�a �.--------------•-. -----.....-----------�� ....................•......................... r ess w 4J<.S_ ��3.i. L ...................... :........ - Installer Address d Type of Building Size Lot............................ fee U Dwelling—No. of Bedrooms..........3---_--•--------------------Expansion Attic (�i1d) Garbage Grind `4 Other—T e of Building No. of persons......1/ Showers — Cafeteria Ga Other fixtures -----------------------------•-• . . _ ---------------------- --------••---.......... ,- --...... . W Design Flow......... �............................gallons per person per day. Total daily flow....... ........... •.......gallons. Septic Tank—Liquid*capacityl&tO.gallons Length.....� ...... Width..... .._..__. Diameter..---�------ Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------------_-- Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-•-•••••-•-•--•---------••--•-••-•••-••--••-••-••••••-••-.........-•-•-•........................•--......................................................... ODescription of Soil..........................................................................--------------------------.•...-----------.....--------------------------.......-•------...... x W x -•••-------------------------•--------•---------•-----------------...------------------.....--------------------------------------------------------------•-•----------------------.....-•-•-••---.-•--- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------------------------------------•.--••-- Agreement The undersigned agrees to install the aforedescr ed Individual Sewage Disposal System in accordance with the provisions of SITS- 5 of the State Sanitary Co e—The undersigned further agrees not to place the system in operation until a Certificate of Compliaijce has bee sued by the board of health. Si ed - , -----•- ----- t ---------•----.:...... ate Application Approved BY c ••. - - ,�-.. .... Date Application Disapproved f o the following reasons:.............................................................................................................. i� --•-•-••...................•-•-•-----•••••••........-••--••••......•-•-•-••-•••-•-•-••---.....-•••-•••... Date PermitNo......................................................... Issued....................................................... Date Fps. _•.._............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 3 �I ...... ';...+ ..---....OF......... .tE..................................... Allp ira#ion for Diopooal Works Tomotrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: i ... r ..�......_.... .�.................. •............................ --••--------------------.........._?_�....... - - ......---- Locat}on-Address r or Lot No. s�h'. .t.'1 i. 4 a ' .{ : e b ' Address t .s ` ...........Installer Address Type of Building Size Lot............................Sq. feet aDwelling—No.-'of Bedrooms..........3.............................Expansion Attic (1)6 Garbage Grinder (A(&) p, Other—Type of Building ............................ No. of persons-_.•_Y.................. Showers (L,/) — Cafeteria ( ) Q' Other fixtures -----------------------------------••-•........ W Design Flow........:: .5 ......................---gallons per person per day. Total daily flow._....UPI...........................gallons. WSeptic Tank—Liquid"capacityOIJ .gallons Length___-)Q_._.... Width....4........ Diameter----_f-0__........ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•••------------•-•----------•-•----------•-••-•-----••----------•--------------------•.....----•----...---..______...._..--=----•=•....-•----........... _.. 0 Description of Soil-•-••--------------•--...------------.._...-•-•-•------------------•----------------------•-•----------------------...._......-•--------------------•---....._•-••----•- x U -•-•-•••-------•--••--•----------------•------•••--...•------•-•-•--••-•----.................-•-------•----•-----------------•••----••••----••------•-•-•----•--•--•--•-----------------•--...•-•-••---- W --------------------------------------- ••----..._........------.... UNature of Repairs or Alterations—Answer when applicable..........:.................................................................................... Agreement: The undersigned agrees to install the afo;edesc�ibed Individual Sewage Disposal System in accordance with the provisions of.ITTIE 5 of the State Sanitar Co e—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee sued by the board of health. �-- . A. �'?` Si ed .......... -?' o (Date . /!. .. 7 ✓ Application Approved BY------- �'--------------•----------...-----------•-----.._...---•----------•--•---•--- ------------- - �---*�-�--•-- Date Application Disapproved f o the following reasons------------------•-----•---•----------------•----------•---•--...-----------•--•--------------------------•..._ ............................................•----------------•--•---------••---------.....-•-------•-----I••---------•-•......-•---••---------•----•---•---------••----•-•-•-----•--••---•--•-•-••-•----- Date PermitNo.......................................................- Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................I.........OF................................................................................. Trrfifiratr of Tomphanrr IS I O CER.,,� Y, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by .._.. .. ...-•-•-- -=�................................................................................................................. i _..__✓!..» f....... - •.- ?""�3. Installer +� as been installed in accordance with the rovisions of TITLE' 5 of The State Sanitary Co e as escribed in the application for Disposal Works Con ru tion Permit No... .3 __3_-�2-3----•:-_------- dated.5--- _ - _________________________ THE ISSUAN E OF THIS C TIFICATE SHALL NOT BE CONSTR ® AS A, UARANTEE THAT THE SYSTEM WI NCTION SATISFACTORY. DATE....7_/..ZIP........................................................ Inspector. .. ....:_.-•--••..............--..............-----•---•---•------•----•--..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 13 OF............................................... f FED £1.........- Dfopo a 0 , Qlonotnuton rrmit Permissio ,•s ereby granted__ -•--......-•--••-•---------------------------•-••--------•---------------..........: --•----....._.......-•---•- to Constr ) or Repair a Ind*: . `. a Sewage Disposal System at No "�j' t .....__..... _ ..��.: i ....._•---•--.----- ------. ••--------•••----•••-----------•---------•..ZXZ. ... T Street `as shown on the application for Disposal `�ork nstruction Permit No.__.._....•..... __ ed. .._ .........::.:...... o'. f .Hath... ..... o e DATE.._... /'r�-•----------•---•--•-•.................•-•-----•-- ...... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS zo.tea, I , I s 1 FLLNf r�,�Po law/. Zo. (:;AZ. '1\ 5 i1 v ,4 e \ lotgZ"� Z •�� 3• - N ' � � 3 •I \ G \ \ 1� �� Z•S 9 •y � � � 0. 3 Idl �' _o, z•a 11 � o� 3 .fit G� Sc'o UD Sc� D,47-A SI�GLG- FAMI BC- OM GAIZBAGE 69it-1062. D�It.Y Flow .: .IID X 3 = 33oG.Pv I SEPT►G TA►JK =�330x15D% = �}9 yG.P. usc- 1000 GAL. 1 o15Po5AL. PIT v5E 1000 GAL. s�D>`vJaw p�ZEp = 13£35fF 13 f3 S.F. X 2.5 = 3 4 5 G.P lc:>. (30'C"ToM Qe6A = �o SF. G PD. -r�TA��- v t✓��N -39 S G P -('oTAL pA I LY FLOV4 = 330 6RD. o T►p RATE I''IN ZMIN ot�LESS � � FL�Q/✓ D�t/ ��� /�E�'c�►'--�, PEtZG LA N � 1.T � •. ,• yam— of OF ►!�' ��. 4�� MSS I. ZRICHARD >, AIAN G� A. QAXTER h JONES • `' {'1o.24048 Na '5100 O h0 SUR" N c / Z, NNw LA4N 1000 lN�• /. �r,F35avL DIST. INS• C,SA%-. /O Z - I ppo INV TANK PIT INV.. INV. WITW I I 1'/25/4'I Vz WAS" D 6TaNE CG,5A I i Sid ti/17 C �i4G7i. G E R.T I F 1 G D P 1.o T P L A w T' .Va PRUFTL� 14,4�:5,v=:;,y� LocATiOt-r 1 NO• SCALE �jCALEAll 3 p>r P.I`1 R E P S V-S 11 GE 1 C E R-f I F Y T N AT 'T H ROc0li7swz;, f/S?51A0 w0 NEKTON CoMPLYS WtTN-cHE AND SETEAGK V-GQ012!✓M'6N'T•l�' 'Ta W N O F a.4lLI/ST<!Z3 c_E AND I S /t/oT1" ��/S-7-1 (3 �J,t Y ,Sf1• g LOCATED -W�ITNt "t' E GLo/o�p PLo.IN D AT I✓='LL-`�` ( 8 AXT E tL C Wye:y E I u� �Z.EG I S't>c26V ►-AND 5 "TI115 PLQ•hl I�j MOT f3n5Fp oa AN OSTE2VILt..ESs. 1w5•T-R•uMENT SVZVeY �-Ti, P- oFFSE"t5 6t.lou0 NOT D E v g E D-TO D ET E fL1�11►-I E L cT 4 I►-1 E�j A QP L-I E A r-1 T �'OAi/� ,� SA�Gk?7— No Gacze,o.�E 6��oECL vAI�Y F esw z 'I iv x 3 = 3306.Pp I5EP-T1r, -tAIjK = 330x15c>% -- A956.PQ U5E- loon J o15Po5AI- PIT v4E IUOD GAS. S�nlcvJau- peEp = 13,a5fF I 13t� S.F. X 2•. 5 = 345G.Pl• poY-roM, aeeA SF. 50 S.F. X 1. O 'So 6 P.D. 9 5 G�' -TOTAL pA I L.Y FLC>W = 330 PSZC0LA'flo4 GZATE : 1"IN ZMIN 4_-3 wmtt�:ao,t Of it �t OF ii^ a:�� 4P� M J J r�ICHARD orb ALAN G' BAX7ER H c�i JONES ' No "5100 P1o.24048 .410, ST¢� NT h0 SURV w c ^ � LGL4N ►oov INV. /. SvF�Swc- DIST. INJ. GAL. BOX SEPTIC. {ODO Ao U -rp NK I N`�• CAI... 9 �• t_Eacu ,�,yiw,t� PIT I N Y. I N Y. I C12A✓ WIT" r 9 li 9.8 II —WAsuc-a-- . 3.9 GERTIFIGP PI-oT PLAN e17- /,4G,CEA n y� 1_o G A^c I o tJAeSTo,%s /1'/L,GS /✓STALL�D N O S C A I.E �j GA I.E /':yp ' --�- ATicAll /Z / 3 R G F G cze N GE j. 1 CERTIFY 'tNAT TSNoIr�JN µER6oN GompLk 5 1nlITN-THE �,IoE►-It�� ,CST �/ �I.lD SET5ACK 2.6Q019-EM>cN'f� OF 'CN� -(c>W►•I O F:: _15344A45-rA Z3�E A N V I 1_OG TED -WIT NI T E GLoop PI.D.IN DAT =�%= c P BAXTE cL e 101M INC. R.EG 1 sT 6IZ.6.U1►-Aw 0 5 u 7—v EYoes Tull Pt_AN 15 NOrr E3nSFt> o AN osT'E9-vILLB- - M100.S ell. I��j-I-R.uMENT SV2V1�`( �r"f•!-IE DI=FSETS �e.�IEAnIT NoT DE VSEDTd DETER-/^INS l cT III-lE�j T 'yi� AO S ITT _ 2-18' dAM. ACCESS]MANHOLES Tu!^f(eb �r 10' min. from 4 1 ark d tank "NOTE: ALL PIPES ARE TO BE 4' SCHEDULE 40 P.V.C. $ c9 Existing Foundation Septic tank corers must be house to septic - T.O.F. elev. 59.50 within 6 in. of finished grode ��� �h'S( C� Goee over Septic Toni - 54.50 Grade over D-Box - 49.50 Grade over SAS - 5000 to e9-00 SECTION A -A A; _ •�+ :,._ '` PROFILE VIEW OF LEACHING SYSTEM W'( S 0 02 3 HOLE TOP OF SAS - 47.25 THE ACCESS COVERS FOR THE SEPTIC TAW, 7a o \ (H-20) DIST. BOX 3' Moximum Cover a�•to r r re.A.e CYtid�td SYm. INLET DISTRIBUTION BOX AND LEACHING COMPONENT O „) W r/d'- r/i' r..A.A P.+.t.- 10 ` f Cu ET SET DEEPER THAN 6 INCHES BELOW FINISHED d . S=0.075 / /_' EXIST. PIPE `• EXIST. 1,000 J .010' foot a 70' "I - I" FINISHED GRADE. FROM FOUNDATIU•, O O �YieM.. _ �- �- GRADE SHALL BE RAISED TO WITHIN 6" OF Jt SEPTIC TAN H•-1 O �+ :n 20 0 0 a tl m ��rn ^ �J o o INSTALL TUF-TITE GAS BAFFLES OR EQUALS CONCRETE FULL FOUNDAT ��• ab- -- ., ..,v y :•.•�,,.may• 'r-.Ti:�.1: •' a M a " s.a 0 o c3 - .:,.. .. •:...;•. .r.. ) SYSTEM PROFILE > a o =o CM 0 o STEEL REINFORCED PRECAST CONCRETE SITE lE = 2000' +/- f2' d 3 L"ts '* tone I'l etwe 29.5' PLAN VIEW Not to Scale - - EPf ective tiraen 2.75 2.7 29.5' e e 3-24' REMOVABLE COVERS Z GENERAL NOTES 6 mp 3/+'-t e $ Effective Length � 1. Contractor is responsible for Digsofe notification compacted stone <' .•• ;.: .. 'j.•- a .,. . ,. .,•• •; 4'j - .r;•,, Bottom of Test Hole 1 Elev=39 50 SOIL ABSORPTION SYSTEM (SAS) _ __3" min. elsoronce and protection of all underground utilities and pipes. --------- -------- -- -- -- -- - INLET B' min.T 2' min. inlet to outkt ^. t3• ,NLET r•'• 2. The septic tank and distribution box sholl be set 500 C H-20 LEACHING UNITS / WIGGINS PRECAST '""-' �"-" °mom. OUTLET Jevel on 6" Of 3/4"-1 1/2" stone. m-T- G;juid level �r 3. Bockfill should be clean sond or grovel with no Not to Scale stones over 3" in size. 5' -7" ---- �--- !5' -7" sY 4. This system is subject to inspection during installation E41 w.d>~ I• 41q<,u e ptn by Carmen E. Shay - Environmental Services, Inc. NOTE- ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE 5. The contractor sholl install this system in accordance '* with Title V of the Massachusetts state code, the approved plon If and Local Regulations. 8._0. 4:..l10. 6. If, during installation the contractor encounters any soil Conditions or site conditions that are different CROSS SECTION END-SECTION from those shown on the soil log or in our design installation must halt & immediate notification be made to Cormen E. Shay Environmental Services, Inc. I USE EXISTING 1000 GALLON H- 10 SEPTIC TANK 7. No vehicle or heavy machinery shOR drive over the FOUNDATIION 0 - SEPTIC TANK 70'-�- D-BOX w----20' a- LEACHING FACILITY septic system unless noted as H-20 septic components. NOT TO SCALE 8. Instoll Tuf-Tite gas baffles or equals on all outlet tee ends. 9. All Distribution Lines shall be 4" diameter Sch. 40 NSF PVC pipes. �IP.t) �' �� ' 10. All solid piping, tees & fittings shall be 4" diameter PERCOLATION TEST Schedule 40 NSF PVC pipes with water tight joints. 11. SITE and Surrounding Properties are Connected ' 1r �� <40 F �� Done of Percolation Test: MAY 12, 2003' \ � Test Performed By. CARMEN E-SHAY- RS., C.S.E. to Municipal Water. Results Witnessed By. WAIVER I 1 Excmvotor: SHAY ENVIRONMENTAL SERVICES, INC. \50 i 1 ^\ Percolation Rote: Less Than 2 min-/inch 6 38" BELOW GRADE. t NOTE- TestHole THE PROPERTY LINES ARE APPROXIMATE AND ----- I R , N�. 1 COMPILED FROM THE SURVEY PLAN GENERATED BY 64 i L'------' BAXTER & NYE, INC. OF OSTERVILLE, MA 60 ------------------- - 0 DEPTH SOILS ELEV. ENTITLED " CERTIFIED PLOT PLAN OF _ \ LOT g71 WHISTLEBERRY DRIVE, MARSTONS MILLS, MA" - -- -- �\ \�L_ ------ Sandy Loam 51.so DATE JUNE 20, 1983, AND IS NOT INTENDED TO BE A SURVEY 10 IR 3/2 Q \ PLOT PLAN. IT SHOULD BE USED FOR NO PURPOSE OTHER THAN A. 5067 THE SEPTIC SYSTEM INSTALLATION. �N , Sandy loom I Failed �` �\ '� 62 torn 5/6 WETLANDS LOCATED WITHIN A 200' RADIUS ARE SHOWN ON PLAN. 58 10'- 28' Bw 49.17 Leach Pit \,.-.\� ��� eo ��\ l �\ \\ Med-Coorse - ,\\ '/1 \ \ \\ 1 \ \\ Sond 56 - ��\ 'Ao \\ `\ I 2.5 Y 7/4 NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE 28'-84" C, 44.50 FROM THE EXISTING SEPTIC SYSTEM TO BE DISPOSED scptc Ta 000 gal \`\``�\ \`�� \`,' ��Ar !j \\\\ `�\ OF AS PER BOARD OF HEALTH SPECIFICATIONS. `. . ` 60 �� Medium _ � zs r 8/6 EXISTING LEACH PIT TO BE PUMPED DRY & 84'-144 C, 3950 FILLED 1N PLACE. IN \ , 52 ---- `� EXISINC CARACE \\,1 '�' 11' ASSESSORS MAP - 61 PARCEL - 043 � 3 BEDAOM DECK , ,\ `�-, ZONING - RESIDENTIAL HOUS i \\ �O Perc �/1 FLOOD ZONE C 4 Depth to Perc. 28" to 44" , # ! Perc Rote=<2 min./inch 1 i (WALK-OUT ,\ 1 Groundwater Not Observed - - - - i _ -- ------- - - --�--- -- T +- -- --- - - -- --- _ --- - _ _ ON i \ _ �YE,iAiJG$ LOCATED WITHIN A cvv RAJiUi ARE Sk1GWty v,v PLAN. BOTTOM OF TEST HOLE Elev. = 144" TEST HOLE #1 � BASEMENT) , ELEV = 51 50 ,r':>.� ADJUSTED H2O Elev. _ No Adjustment Required. 35' I \ 0 i �` DECK \1 l \` ----- -\ I . ^ 1 1 ALL CUTLET PIPES'FROM THE LEGEND SCREENED PATIO AREA , , tt 1 DtSTRtBUT,ON Box SHALL BE 12. I \ CONCRETE CODER ROOM SET LEVEL FOR AT LEAST 2 FT. n Sonotubeb \��\ \, { t` KNOCKOUTS ET 'ir'..w•+: .i..• 2• DEN ES rick Patio ! t • , -\vt` OUTLET tY INLET 8X0 SPOT OTGRADE 46 OPOSED 2 DENOTES EXISTING / I ► I ,s-5- Y x 104.46 SPOT GRADE 1 4' - SCH. 40 Te 1,75' PLAN SECTION CRGSS-SECTION ' i � 4' - I'L PROPERTY LINE \+/ / 3 THOLE DISTRIBUTION BOXH-10 LOADING 7 PROPOSED CONTOUR ,44-- \ , ; i \ i ; + NOT TO SCALE 97-- - - - -97 EXISTING CONTOUR i 1 in o o D tt 1 es a Co cu a� , f l DEEP TEST HOLEPERMIT REQUESTED FOR THREE BEDROOM OILY - SEPTIC OVERZIZED AT CLIENT'S REQUEST. PERCOLATION TEST LOCATION \ l0T #7 Number of Bedrooms: 3 Bedroom Permitter due to Property is Within a Zone ILo l----� FENC` L e ci TaGrinder o E -------- _ \ � 46,50 Square Leaching CopocitylRequired 330 Got./Doy 0tW. PER TITLE V) 40' --_-'- ---___ - `� `� p x 330 Gal./Day = 660 ! USE NEW 1,000 GAL. Septic Tank. SOIL ABSORPTION AREA: Using percolotionrote of-<2 min./inch - PRIVATE DRINKING WATER WELL Bottom Area: 0.74 gol/sq. ft. x 400sq. ft. = 420 gallons REVISIONS `________ __________ `\ , \ � Sidewall Area: 0.74 gal./sq. ft. x 20i sq. ft. _. 188 gallons \\ Pwiding: = 450 gallons Use: (3) PRECAST 500-C UNITS, HAVIP A 2' EFFECTIVE DEPTH, NO. DATE: DEFINITION PROJECT BENCH MARK \\ \� \\ ' TO BE USED WITH 3.5' OF WASHED STOWS ON THE SIDES AND TOP OF DOOR SILL FROM WALKOUT, BASEMENT �' 2.75' OF WASHED STONE ON THE ENDS.! ,\ \\ \ \\ \ UNITS TO BE SEPARATELY PIPED AND T( BE SEPARATED 2' APART. ELEV. = 52.00 (NGVD) .\ \ \ \ \ _ OFCTLA 42 ND tt PROPOSED t \ \ t \ t \ oG� t PREPARED FO R . of TLAND SUBSURFACE SEWAGE DISPOSAL SYSTEM 42 `_-_ � - ___ _ `t `� tit ,t ` ` / \ --- II � -` , , t 0 F sr T O Ns t t t I t _ 54 JOHN 8c -PA�MERLA ZARTARIAN #559 WHISTLEBERRY DRIVE 1 1 y-� 559� WHISTLEBERRY DRIVE _�./. MARSTONS MILS, MA 1 I + N L 1 1 dui �i o �NDFn� :� , PREPARED BY: ti t I { A MARS MILLS, MA' 02648 S CID C.A PHEY E. SHA I' ENVIRONiffENTA L SERVICES, INC. I 0 34 THATCHERS LANE by at s T-e fV 0 20 40 54 SnnTAti �P� EAST FALMOUTH, MA 02536 i" TEL/FAX 508-548-0796 41 SCALE: 1 "=20' DRAWN BY: CES DATE: MAY 14, 2003 1 PROJECT#SD-421 FILENAME: SD421 PP.DWG SHEET 1 OF 1 T I