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HomeMy WebLinkAbout0050 WILLINGTON AVENUE - Health 50 Willington Ave. Marstons Mills J/-- - -- -- --- - \ A = 103 030 069 - - -- - --- 1 TOWN OF BARNSTABLE LOCATION S�( 1�, J!V �� SEWAGE# o2®Cl(y VILLAGEAA&6*M !Uo��� ASSESSOR'S MAP&PARCEL/'01-03(0 INSTALLER'S NAME&PHONE NO.10w0�A Z c�N Lc SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) 12 8 X 3 S X'Z NO.OF BEDROOMS Lf OWNER�c)P GK4 PERMIT DATE: 7/a'/G COMPLIANCE DATE: -7- 91 G Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4- 10elc 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 IJ-1,.% (DLy AJ - tbAC14 f , VJ LU i oot Arno--& cz-2S,2 `)D -- 39,E vlct tool--z® 1 .26,G i - Lit .- 2 - yam 2 - —3 - No. a(iY © Fee �� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitatlon for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(:Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. SCE w i 1 1 NS�v,,) A v-e Owner's N me,Address,and Tel.No. Assessor's MapTarcel 3 In^staller's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. iJC»p1CcS1`Z `J�C�'v.!!V ,�—NC �^�IvCmPd\N"j C:c�Vd�C � Type of Building: Dwelling No.of Bedrooms H Lot Size 16'CO sq.ft. Garbage Grinder( ) Other Type of Building VLfSt0 e,-,,S�iC.�` No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) LALAO gpd Design flow provided gS-4I y gpd Plan Date -7. t — I G Number of sheets Revision Date Title i Size of Septic Tank Type of S.A.S. .5-00 Q��le 1 () C VICJit '{S Description of Soil Nature of Repairs or Alterations(Answer when applicable) \Q S VcAk Cc • N c� C� C��<) "� 5-00 r aAlcvo 11•— E-0.n) C-(-% SLR c�� 1p lc�v 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. Si ed Date - l> Application Approved by Date / 4 Application Disapproved by Date for the following reasons Permit No. �� ��� Date Issued 7 ., 0 �- No. �U/ t�!�`� v Fee �Q T THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -' SOWN OF BARNSTABLE, MASSACHUSETTS Yes 0(pplication for Disposal *pstem (Construction Permit Application for a Permit to Construct( ) Repair(t//upgrade.(a,) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Sv cv l 1 n►S}V,,,) A Owner's Name,Address,and Tel.No. AAc­rsi,r,-�% AA,))-, r Ur^e�e Ic Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Zo\\ c,-S A �JfC�,�rJ LNG �= .� �ti��r�NS GJcti✓IC Type of Building: l Dwelling No.of Bedrooms?' Lot Size LI`1 sq.ft. Garbage Grinder Other Type of Building V PSI Pc,�1�-'1 G` No.of Persons Showers( ) Cafeteria( Other Fixtures Design Flow(min.required) gpd Design flow provided C�S Ll, �� gpd / Plan Date 7— 1 " I G Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) S \\ ,t l 2 C) (-t4 c,,+-,t��4S iq 15 tD&),P CC-S S1.AC�DS? 6 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. Si ned "' - Date -7 Application Approved by Date ry Application Disapproved by s Date r for the following reasons Permit No. ��✓�(y �"� Date,Issued 7 111n11,16, --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS `- BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site SewageDisposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by �� L� T�_ )r at c,n (,J, M r, t.gas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NoAl,(, - dated 7// �� �► Installer z�)C'( S 1 7tr� r.f n, Designer ��-AN c.er ,�,� wry fl✓ #bedrooms t,I Approved design floe LI L((� , gpd The issuance of this per 'it shall not be construed as a guarantee that the system will nc'o as designed. Date ,�� Inspector fl n I �. t .-'No. ���0 � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem construction 3permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at (:�() wk h n }rj,J ve /j G r--,�-r s Aj � and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of thye mit. Date '� f�) ^" �, Approve(deb �j Town of Barnstable Regulatory Services Richard V.Scali,Interim Director KAM Public Health Division 1659. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: (2i 1 Ge Sewage Permit# 2016—,2 50 Assessor's MapWarcel 6 Designer: 1=r�q:o,2 a,^ the^L1s in_`` Installer: D.A, Address: t Z i y, s s��; i2e•4 Address: ►?6, t� i a cta l r Mri hz `f on 7 Zb")L D.A 't3 cd--- �` was issued a permit to install a (date) (installer) septic system at s0 W- nS i-Gh Avg based on a design drawn by (address) pe�e� 3'1 Lt;�t-tC fL dated (designer) 2L I certify that the septic system referenced above was installed substantially according to the design,which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip'out(if required)was inspected and the soils were found satisfactory- 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. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in co liance with the terms of the I\A approval letters(if applicable) �P`Z� of �SS9<y PETER T- staller's Signature) McEN TEE CIVIL No. 35109 f (Designer's Signature) (Affix Desi ere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION CERTIFICATE OF C.VtVIPLIANCE WILL NOT BE ISSUED UNTiL BOTF[ THIS FORM AND AS- BUILT CARD ARE RECEIVED BY TIDE BARIVSTABLE PUBLIC HEALTR DIVISION THANK YOU. QASePticWesiavcr CeitiEcation Form Rev 8-1413.doc Town of Barnstable n# "v Department of Regulatory Services >At!8rrA"B� Public Health Division Date � MASS. - �p i639 �p� 200 Main Street,Hyannis MA 02601 lFC µAT , 1 Date Scheduled Time i ' o M d t CIO me— � _ Fee Pd, Soil Suitability Assessment,for Sewage ;Disposal Performed By: eele/ C.L,r"t -(— -St /.s�Z ��nv,`/, y. Witnessed.By- W/. OCATION & GENERAL INFORMATION Location Address Owner's Name `- "�S �'� 0p �crx 5'G2 t"1+' } Address � ✓Vt� U 1M(+a Z—G Z Assessor's Map/Parcel: i i\ O 2 D Engineer's Name ;n Q ei( �h t NEW CONSTRUCTION l Vi REPAIR) Telephone# Land Use Slopes(qo) l ��— Surface Stones /vd Distances from: Open Water Body t A, ft Possible Wet Area NB� ft Drinking Water Well=0 `'�ft Drainage Way IV)/"' ft Property Line (06 +- ft Other ft i SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) a 0 Ci Parent material(geologic)®�' !` Depth to Bedrock Depth to to Groundwater. Standing Water in Hole: (j/4 Weeping fYOm Pit FAce Estimated Seasonal High Ground I ater DETERMINATION FOR SEASONAL HIGH WATER TABLE, Method Used: Depth Observed standing in obs.hole: In, Depth to Sol mottles: in. Depth to weeping fromiside of obs.hole: in, Groundwater Adjustment a. _ ft. Index Well# Reading Date: Index Well level Adj.fhetor— Adj.Groundwater Love!.,T... PER+COLA.TION TEST Date .._� .0110e H If Observation Hole Hole# Time tit 9" Depth of Pere 3 y. S'Z.. Time at 6" .a Start Pre-soak Time @ _ $ Time(9"-6") i _ \ End Pre-soak Rate Min./Inch. Site Suitability Assessment: Site assed -->L Site Failed: Additional Testing Needed(Y/N) Original: Public.Health Division j Observation Hole Data To Be Completed on Back----------- I ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:\SEPTfCTERCFO R M.D OC DEEP.OBSERVATION HOLE LOG Hold# Depth From Soil Horizon Soil Texture .Shcl Color Soil I Other Surface(in,) (USDA) (Munsell) Mottling '(Structure,Stones;Boulders, o i to rave C- DEEP OBSERVATION HOLE LOG Hold# '� Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) U S i4 � — 34 a YY?-Xz iM--C. S'Wt 'Z"S`r 411 DEEP OBSERVATION HOLE LOG Hole#1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(iu.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenov. b Gravel)— ? � ,c Ste. 2-SY 6l6 DEEP OBSERVATION HOLE LOG Hole: Depth from Soil Horizon Soil Texture Soil Color, Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. • on i en a - Tr jVX Flood Insurance 1R.ate Man:. Above 500 year flood boundary No— Yes Widen 500 year boundary No Yes Within too year flood boundary No Yes Del li of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? CS If not, what is the depth of naturally occurring pervious material? _ Certification I certify that on _ 1 4 (date) I have passed the soil evaluator exarruna ion approved by the Department of Environmental Protection and that the above analysis was perforr}ied by me consistent with . the required trai xpertise and experience described in 310 CMR 15.01?. Date /l� Signature J Q;ISEPTtCTERC:FORM.DOC f FROM : FAX NO. May. 30 2002 12:42PM P2 Pnge 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN Date of Inspection: 11/6/01 OW CONDITIONS IDESIGN NTIAL f bedrooms(design umber of bedrooms(actual): 3 flow ba 0 CMR 15.203(for example: 110 gpd x#ofbedrooms):440 ck>current residents: 3 Does residence have a garbage grinder(yes or no);NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use:(yes or no):NO Water meter readings,if available(last 2 years usage(gpd)): n/a Sump pump(yes or no):NO Last date of occupancy: n/a COMMERCIALANDUSTR]AL Type of establishment: n/a Design flow(based on 310 CMR 15.203), n/agpd Basis of design flow(seats/persons/sgR,etc.): n/a Grease trap present(yes or no):NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no):NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X 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) _Tanovative/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): n/a Approximate age of all components,date installed(if known)and source of information: 15 YEARS OLD Were sewage odors detected when arriving at the site(yes or no): NO F FROM FAX NO. May. 30 2002 12:42PM P1 .John Grad-Septic Inspections,Inc Dox2]19 1'catickV.Mu.02536 Barnstable Phonc 508-SG4-6813 Prix 508-564-7270 �RnNSM S(,SION TO; ATTENTION; FAX NUMBER: � Cl� � 2j0"A Jr FROM; ��� C.l � REASON; 7 Ya COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS a " SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION $ Property Address: 50.WILLINGTON AV MARSTONS MILLS,MA 02648 fQ 3®QQ s(09 �. Owner's Name: CHISTOPHER EORDEKIAN " Owner's Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 =_' "' Date of Inspection: 11/6/01 R.ECE ED ; Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS DEC 0 5 2001 " Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 1 Telephone Number: 508-564-6813 FAX 508-564-7270 TOWN HEALTH BARLTH DEEPT.PT.NSTA E " CERTIFICATION STATEMENT x I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is_4,�- K�; true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and rY ,' 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: ' ,'q X Passes vu _ Conditionally Passes _ Needs Furpe valuation by the Local Approving Authority Fails Inspector's Signature: Date: 11/6/01 The system inspector shall submi•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 now 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 bC5 i sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. `. . r. Notes and Comments " THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE , SYSTEM'S USEFULL LIFE. f> 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�. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Yt PART A .i. CERTIFICATION (continued) ' :e Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN Date of Inspection: 11/6/01 a Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: S X 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: _d,: THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG * THE SYSTEM'S USEFULL LIFE. q 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. �t Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain n/a The septic tank is metal and;ove'r 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 t with a complying septic tank as approved by the Board of Health. r� *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating _:Iy that the tank is less than 20 years old is available. ' f p ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed, ; 4 pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of j` z Health): .z _ broken pipe(s)are replaced `° _ obstruction is removed x _ distribution box is leveled or replaced , ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if with approval of the Board of Health): _broken pipe(s)are replaced obstruction is removed ND explain: n/a z S 1 S , Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS ay ° ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 a Owner: CHISTOPHER EORDEKIAN Date of Inspection: 11/6/01 1-y 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,;Z ,: not functioning in a manner which will protect public health,safety and the environment: 4" _ 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 ' 1 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the , system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water, supply well". Method used to determine distance n/a "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammoniaFw nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy: =t•t of the analysis must 6'attached to this form. 4 s a tF i fi i 3. Other: n/e a '' J! . t. Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) r- z. Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN x `, Date of Inspection: 11/6/01 D. System Failure Criteria applicable to all systems: x , ' You must indicate"yes"or no,+to each of the following for all-inspections: r Yes No ¢� - X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ° i - X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool - X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool r ; - X Liquid depth in cesspool,is less than 6"below invert or available volume is less than''/Z day flow ` - X Required pumping more than 4 times in the last year NnT due to clogged or obstructed pipe(s).Number of tunes pumped n/a. gF:: X Any portion of the SAS cesspool or privy is below high ground water elevation. + - X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply X An portion of a cesspool or privy is within a Zone 1 of a public well. t - Y P P P �'Y P �> X An portion of a cesspool or privy is within 50 feet of a private water supply well. - Y P P P �'Y P PP Y - X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with . no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP I r certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free ; from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or_F;, _ less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be T � . attached to this form.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in310 CMR 15.303,therefore the`sytstem fails.The system owner should contact the Board of Health to determine what will be gam= 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. ' You must indicate either yes or no to each of the following: g (The following criteria apply to large systems in addition to the criteria above) . `.., yes no ` X the system is within 400 feet of a surface drinking water supply le. _ X the system is within 200 feet of a tributary to a surface drinking water supply _ X 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 anyquestion in Section E the system is considered a significant threat,or answered�Y " " "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` E should contact the appropriate regional office of the Department. 1 F� f t d j Page 5 of 11 °. 3 k5 d 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B , CHECKLIST Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN Date of Inspection: 11/6/01x" `^ Check if the following have been done. You must indicate"yes"or"no"as to each of the following: ?. ! Yes No . X _ Pumping information was provided b the owner,occupant,or Board of Health P g P Y � _ X Were any of the system components pumped out in the previous two weeks? �x X _ Has the system received normal flows in the previous two week period? .... X Have large volumes of water been introduced to the system recently or as part of this inspection? r . j X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) 00, . X _ Was the facility or,dwelling inspected for signs of sewage back up? ` X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS,located on site? X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the �44, baffles or tees material ofnrucion dimensions depth of liquid,depth of sludge and depth of scum ' r� ; , VA X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance` ' r of subsurface sewage disposal systems?, '` The size and location of the Soil Absorption System(SAS)on the site has been determined based on: W. . .F6 I Yes no ..`� X _ Existing information.For example,a plan at the Board of Health. 9 X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is # j unacceptable)[310 CMR 15,.302(3)(b)] a r'. t rt, C Page 6 of 11 + OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Al e,�T PART C SYSTEM INFORMATION - ; +, Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN xl:: Date of Inspection: 11/6/01 ..i. r i FLOW CONDITIONS RESIDENTIAL r :y 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)�M CO\CW ir Number of current residents:3 �� w\ Does residence have a garbage grinder(yes or no):NO T� Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required] ] Laundry system inspected(yes or no):NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO ) , Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd 4 Basis of design flow(seats/persons/sqft,etc.): n/a Grease trap present(yes or no): NO I Industrial waste holding tank present(yes or no): NO Non-sanity waste discharged to the Title 5 system es or no NO t j Non-sanitary g Y (Y )� Water meter readings, if available: n/a l; Last date of occupancy/use: n/a 1 OTHER(describe): n/a sikr ; GENERAL INFORMATION « ` Pumping Records Source of information: n/a. ar Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a ' Reason for pumping: n/a 'm ;; TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system . ' _Single cesspool ' Y _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) Vu ,� �; _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) .;M• � tV. Tight tank Attach a copy of the DEP approval ,Ia . Other(describe): n/a z'} Approximate age of all components,date installed(if known)and source of information: M= 15 YEARS OLD r . Were sewage odors detected when arriving at the site(yes or no): NO ', r � 1 � i .. .. 14.E rt�'�i.r....- Page g 7of11 } 44 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORMO.= ;, PART C Y SYSTEM INFORMATION(continued) Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 3 '3 Owner: CHISTOPHER EORDEKIAN _ Date of Inspection: 11/6/01 BUILDING SEWER(locate on site plan) y` Depth below grade: 22" r Materials of construction:_cast iron X40 PVC_other(explain): n/ah Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) ems. Depth below grade: 14" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a r If tank is metal list age: n/a is age confirmed by a Certificate of Compliance es or no): NO attach a copy of certificate ' Dimensions: 1000G L 8'.6".H 51711 W 4' 10"" Sludge depth:2" Distance from top of sludge to bottom of outlet tee or baffle:32" x Scum thickness: I" Distance from top of scum to top of outlet tee or baffle: 6" k:' Distance from bottom of scum kto bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related ` ^_ to outlet invert,evidence of leakage,etc.): `. ` THE SEPTIC TANK AND ALL COMPONENTS APPEAR TO BE STRUCTURALLY SOUND AND ; FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEMS+"' USEFUL LIFE nT" f p55Rr rR ,� I GREASE TRAP:_(locate on site plan) Depth below grade: n/a n. Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a ' Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a + Date of last pumping: n/a ! Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related` 'd ' to outlet invert,evidence of leakage,etc.): i n/a z r 'P i Page 8 of 11 :,t OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS '£t` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C r k SYSTEM INFORMATION(continued) Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 F Owner: CHISTOPHER EORDEKIAN Date of Inspection: 11/6/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) '"'` Depth below grade: n/a Material of construction:_concrete_metal_fiber lass _other ex lain : n/a g _polyethylene ( P ) Dimensions: n/a ' Capacity: n/a gallons "'` Design Flow: n/a gallons/day, r= Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO ; Date of last pumping: n/a *`� Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) , Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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 IS STRUCTURALLY SOUND. u i,N' n: PUMP CHAMBER:_(locate on site plan) ' Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments note condition of pump chamber,condition of pumps and appurtenances,etc.):n/a `i >r :' S i1 y n T 1 f Page 9 of 11 k: tom. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C -'' SYSTEM INFORMATION(continued) Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN Date of Inspection: 11/6/01 a= w R• SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type w*. 1000 GAL 6' X 6' leaching pits, number: 1 3 A:. n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a ' :.. n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a ; y �y. Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): THE LEACH PIT APPEARS TO BE FUNCTIONING PROPERLY AND SHOW NO SIGN OF HYDRAULIC . FAILURE.PIT HAS NOT BEEN MORN^HAN 1/2 FULL-BOTTOM AT 9' 6" , 4 4OLS:CES (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a .{R Depth of solids layer: n/a Depth of scum layer: n/a ` Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no):NO �ib Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): . PRIVY: (locate on site plan) { . Materials of construction: n/a Dimensions: n/a :`x Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): , n/a jit sr' 4 t Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN Date of Inspection: 11/6/01 g 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. `y 4 O�x bc ;r s a o }y� 14 s P— I W 1+ a-'r } J` Page 11 of 1 t { OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS A , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM _- PART C r t 7rh SYSTEM INFORMATION(continued) Property Address: 50 WILLINGTON AV MARSTONS MILLS,MA 02648 Owner: CHISTOPHER EORDEKIAN k•,--` Date of Inspection: 11/6/01 SITE EXAM �Y Slope _Surface water :i _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a ` \ YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators,installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: s' GROUNDWATER IS DETERMINED BY AUGER-NO WATER AT 12' �+ El x r Fq, � - Y o.s ' V t n r Y 1 -..xhY kT r I Al, 9�Y DATE:?/20/99____ PROPERTY ADDRESS:_ 50 L111in Lon v g _ � A- ----Marstons—MIl _—_--y�" , Mass . 02648------------------------ 0 On the above date, I inspected the septic system at the above ad . This system consists of the following: 1 . 1-1000 gallon septic tank. .. 2 , 1—Distribution box . 3 . 1-1000 gallon precast leaching pit . Based on my inspection, I certify the following conditions: 4 . This is a title five septic- system. ( 78 Code ) 5 . Pumped 1000 gallon septic tank . 6 . 'Replaced broken distribution box . 7 . Waste water is only 12" below the invert pipe of the leaching pit . 8. Automatic failurw is 6" . 9 . The septic system is in proper working order at the present time . —� SIGNATURE: G _ Name:_J_P--_ Macomber Jr_______ Company: Joseph_P. Macomber_& Son , Inc . Address: Box 66 -------------------- Centerville , Ma . 02632-0066 Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY P. MACOMBER & SON, INC.Tan ks-Cesspools-LeachfleldsPumped & Installed Town Sewer Connections(JOSEPH P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 yM COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF DNVIRONmE.NTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292.5500 TRUTDY COX Secrets ARGEO PAUL CELLUCCI DAVTD B. STRUI-; Governor Co:r_:,ss:oa SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART A CERTIFICATION Pyopa<tyAaae>s: 50 Willington Ave NarnaotOwrw Rjcpr A Barres Marstons Mills ,Mass . 02648 AddreuofOwrw: 9n Wi11inot-nn Ave Dau of Inspection: Marstons Mills , Mass . 02648 Nary» of Inspector:(Pla"e Prirro Joseph P. Macomber Jr. I am a DEP approved system kupector purwam to Section 15.340 of Thie 5 (310 CMR 15.000) company Nam.: Joseph P. Macomber & Son, Inc. µ-Tas9Ad&au 2632-0066 T dephorse Nwr.bef: 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 Lupection. The Inspection was performed based on my training and experience in the proper h,nction and maintenance of on-site sewage disposal systems. The system: Passes Condidonally Passes Needs Further Evaluation By the Local Approving Authority _ Fails I Inspector's Sign=te: Date: The System Inspector ell submit a copy of this Inspection report to the Approving Authority (Board of Health or DEP)whhin thirty 00) days of completing this Inspection. If the system Is a shared system or has a design flow of 10,000 gpd or greater, the Inspector and the system owner shall submit the report to the appropriate regional office of the Department oh£nvkonmeraal Protection. The original should be sent to tree system owner•and copies sent to the buyer, If applicable, and the approving authority. NOTES AND COMMENTS revised 9/2/98 Page IofII Prmled on Rccy0ed Prpce ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (con6nuod) Prop-WAckk—: 50 Willington Ave . Marstons Mills ,Mass . Owner: R►corda B a r r o s Date of Inspection: 7/2 0/9 9 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: 1 have not found any information which Indicates that any of the failure conditions described in 310 CMR 16.303 exist. Any failure criteria not evaluated are Indicated below. coMMEIm Waste water is only 12" below the invert pipe to the 1nprhing pit _ Fai1tiro is at 6" hpinw the i vprt- pipe . B. SYSTEM CONDITIONALLY PASSES: U4 One or more system components as described In the 'Conditional Pass' section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health, will pass. Indicate yes,-no, or not determined(Y, N, or NO). Descrlbe basis of determination In all Instances. If `not determined', explain why not. The septic tank Is metal, unless the owner or operator has provided the system Inspector with a copy of a Certificate of Compliance (attached)Indicating that the tank was Installed within twenty (20) years prior to the date of the Inspection: or the septic tank, whether or not metal, Is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure Is Imminent. The system will pass Inspection if the existing septic tank Is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box Is due to broken or obstructed pipe($) or due to a broken, settled or uneven distribution box. The system will pass Inspection if (with approval of the Board of Health). broken pipes) are replaced obstruction is removed distribution box Is levelled or replaced • The system required pumphig-more than-four-times to yeardue to broken or obstructed pipe(s). The system willyass— Inspection if(with approval of the Board of Health): - - broken pipe(s) are'replaced obstruction Is removed revised 9/2/98 Page 2of11 Ji i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 50 Willington Ave .Marstons Mills Mass . Owner: Racordp Barros Date of Inspection: 7/2 0/'9 9 C. FURTHER EVALUATION IS REQUIREID BY THE BOARD OF HEALTH: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH.AILL.PRQTECT THE PUBLIC HEALTHAIIID SAFETY AND THE BWHONMENT: JLb Cesspool or privy is within 50 feet-of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING W A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: A0 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS Is within 60 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance A1R (approximation not valid). 3) OTHER LIDAM u� A revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM e PART A CFRT1F1CAT1ON (continued) Prope,MAddre": 50 Willing ton AVe Marstons Mills Mass Ownee: R4car,:foBarros Date of irupecdon: 7/2 0/9 9 D. SYSTEM FAILS: You must Indicate either"Yes' of 'No' to each of the following: _V I have determined that one or more of the following failure conditions exist as described In 310 CMR 15.303. The basis for this detarmination Is Identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup oFsewags Into 4eci4"r—stem componenCduetto an overloaded orelo99ed-SAS-or-c0aspool. 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 `��t Invert due to an overloaded or clogged SAS or cesspool. Liquid depth In cesspool Is less than V below Invert or available volume Is less than 112 day how. Required pumping more than 4 times In the last year NOT due to clogged or obstructed pipe(s). Number of times pumped I. Any porvon of the Soil Absorption System, cesspool or privy Is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. i/ Any portion of a cesspool or privy is•within a Zone I of a public well X Any portion of a cesspool or privy Is within 60 feet of a private water supply well. Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, anaeh copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen•and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must.indicate either 'Yes' or 'No' to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) end the system is a significant threat to publi( health and safety and the environment because one or more of the following conditions exist: Yes No the system Is within 400 lest of a surface drinking water supply the system•ls-wltkin 200 leatol�t.iLutery to a wrfaoadr:nJcirsq Ovate+ suPPIY -- !' the system Is located In a nitrogen sensitive area (Interim Wellhead Protection Area -IWPA) or a mapped Zone If of a puor,c water supply well) The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further Information. I revised 9/2/98 Peee4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: /iD g.p.d.lbedro m. Number of bedrooms design)- Number of bedrooms(actual):_ Total DESIGN flow ,y Number of current residents: Garbage grinder(yes or no): Laundry(separate system) s or&A4 If yes, separate.lnspection.required Laundry system Inspected ye or no) Seasonal use(yes or no): jJ ,p Water meter readings,if available(last two year's usage(gpd): " Sump Pump(yes or no):_Atl Last date of occupancy: J C O M M ER CIA UIN D U S TR IA L: Type of establishment: o,4 Design flow: 1-14 PPd ( Based on 15.203) Basis of design flow Grease trap present: (yes or no) Industrial Waste Holding Tank present: (yes or no)422� Non-sanitary waste discharged to the Title 5 system- (yes or no)_41219 Water meter readings,if available: Last date of occupancy: Wl' OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING JM source of nfAFImat ,L, �J- Z System pumped as part of inspection: (yes or no) ��N,�f y ¢ss If yea, volume pumped: ga ns Reason for pumping: �Y sal y ��Cr �v* �'• TYPE OySYSTEM V Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes, attach previous Inspection records;if any) I/A Technology et .Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date Installed{if known)-and source c44Aformation: d'S- Sewage odors detected when arriving at the site:(yes or no)_ revised 9/2/98 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM WFORMATION (corrdrnuoC) C� NogoMAddr.s.a: 50 Willington Ave Marstons Mills ,Mass . Owrw: R►ccy-rdu B a r r O.s, Dru of ln4pecdon: 7/2 0/9 9 BUILDING SEWER: (Locate on site plan) Depth below grade:� Material of construction:_cast Iron 40 PVC_,other(explain) Distance from prlvau water supply wall or suction line ZEE— Diameter q!1 Comments: (condition of Joints, venting, evidence of leakage,-etc.) Joints apnPar tight No &v-4denee leakage . s L Ile Ouse van . (locate on site plan) Depth below grads:-& At MaturLal of construcJon: conweteA!Amet&W&fib•(plas44Polyethylsno,�M_othWexplain) If tank Is (natal, list ape • J4.aps.conrvmed by Certificate of Compliance (YeslNo) Dimensions: Sludge depth: Distance from top cf�udge to bonom of Outlet tee ortraffls: Scum thickness: Distance from top of scum to top of outlet tee or batfls:�_ Distance from bonom of Icum to bo m of cull t tea or baffle: How dimensions wets detsrmined: Comments: (recommsndstlon for pumping, condition of Inlet and outlet tees or•batflse, depth of liquid level In relaJon to outlet 4 .eR, �vucture::nt•; evidence of leakage, etc.) Pump the tank PyPr3j gears . inlet n outletstructuraliy sound and GREASE TRAP: (locate on site plan) AA Depth below gtsde:AL,4 Material of consuuctl n:4concrste{/metal,&FlberglessAPolyathyieneother(explain) Dimensions: Scum thickness: A Distance from top of scum to top of outlet tee or baffle;•_ Distance from bonom of sum to bonom of outist tee or battle: 4110 Date of last pumping: Comments: (recommendaUon for pumping, condition of Inlet and outlet tees or baffler, depth of liquid level In relation to outlet in,en. rtruccvral int. evidence of Isaksgs, etc.) r revised 9/2/98 Pser7of11 A SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM t� PART C SYSTEM INFORMATION (continued) I1o9-1YAd&—: 50 Willington Ave Marstons Mills ,Mass . f Data RgCa�do Barros o Irupection: 7/20/99 TIGHT OR HOLDING TANK' ,L' Tank must be pumped prior to, or at time of, Inspection) (locate on site plan) Depth below grade: 4)h Materiel of construction:/J#concrete,!AmetalW FiberglassAAPolyethyleneAi4othar(explain) AJA Dimensions: Capacity: gallons Design flow: gellonslday Alarm present Alarm level: Alarm In working order: Yes4A No,0 Data of previous pumping: dA Comments: (condition of Inlet tee, condition of alarm and float switches, etc.) Tight or holding tanks arp not nrrasoat DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet Invert: 410 Comments: (no4o.11 level and distribution Is equal, evidenoo of solids carryover, evidence of leakage Into or out of box, etc.) — — Distribution hnx hag nne latesai ; ng evideaee 5814:ds t PUMP CHAMBEFUlkNQi (locate on site plan) Pumps in working order:(Yes or No) 104 Alarms In working order(Yes or No) kw Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) uMD chamber i c not present . 6 revised 9/2/98 Page 8of11 y 1�1 t 1 • • A SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (condnued) propemAd&—:50 Willington Ave Marstons Mills ,Mass . DWnw: R46:aco Barro Deu of Inspects r- 7/2 0/99 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,If possible; excavation not required,location may be approximated by non-Intrusive methods) If not located, explain: Type: leaching pits,number.,, leaching chambers,number: leeching galleries,number:_ leaching trenches,number,length: leaching fields,number, dimen Ions: overflow cesspool,number: Alternative system: Name o1 Technology: Comments: lure, level of ponding, damp soil, condition of vegetation,,etc,) (note condition of soil, signs of hydraulic fai o ine san rau is a ' ry , egetation orma . cFssPOOLS: (locate on site plan) Number and configuration: v Depth-top of liquid to inlet Invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: Inflow (cesspool must be pumped as part of Inspection) Cass o0 Comments: failure, level 01 ponding,condition of vegetation, etc. Inots condition of soil, signs of hydraulic Cass oo s a . PRIVY:&(y (locate on site plan) �� � __Dimensions: Materiels of constructJgn: '✓ Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, ravel of ponding, condition of vegetation; etc.) Priv , Paec 9 of Il revised 9/2/98 SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM h PART C SYSTEM WFORMATION (continued) NopcyAckk"4: 50 Will�hgton Ave Marstons Mills . Owr.o: Ricar-do Barros D`u of 4up.ct>on: 7/2 0/9 9 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells wlWn 100' (Locate where public water supply comes Into house) Qp<h � � 1 \ 1 4 revised 9/2/98 Pact 10of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAd&—:50 Willington Ave Marstons Mills ,Mass . Owner: Ricardo Barros Date of Inspection: 7/2 0/9 9 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep _ SITE EXAM Slope Surface water Check Cellar Shallow wells �^0 Estimated Depth to Groundwater-lv Feet Please Indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed.Site (Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps --k—/Checked pumping records _zchecked local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) Used water Contours Map . Gahrety & Miller Model 12/16/94 revised 9/2/98 Page 11of11 a•r"nr.a-nirsr.�-s+�rmr•n.n.s-nnrerrs.mn-n+�rr»r�*m.rrmrw,rtn��n are .. 1I 'TOWN OFBARNSTABLE BOARD OF IIEALTII � F^Tt7�T'•.^.1.-*,,"_*�4ISURFACR SEWAGE-I,i I'USAL SYSTEM IN�9i'F,CTION FORM - PART D^� CEIZTJ F Cr1TION r1 - -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 50 Willington Ave Marstons Mills ,Mass . ASSESSORS MAP , BLOCK AND PARCEL # Los 1 ('67),Q) fl OWNER' s NAME Ricado Barfos PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber : Jr. . COMPANY NAME Joseph P. Macomber & Son, Inc. COMPANY ADDRESS Box 66, Centerville, Ma. 0263.2-0066 Street Town or City Stat• 11P COMPANY TELEPHONE (508 )775 -3338 FAX ( 508 )790 -1578 R q 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 recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : ystem PASSED _zS The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public hea1Lh or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conc�icted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date One copy of this certification must be provided to the OWNER, the BUYER ( Where applicable ) and the BOARD OF HEALI'll. * If the inspection FAILED, the owner or",operator shall u Within one year of the date of the inspection, unless allowed dort required he m otherwise as provided in 3.10 CMR 15 . 306 , partd .doc TOWN OF B STABLE ,1 r ,T' T ijN W��`l SEW G # 'I r V l TLLAvE ASSESSOR S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER 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 Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Ad- it --f- I , ) _ At b �® 13 ` TOWN OF BARNSTABLE A LPCAT 6N 'f�B j 4 �,�,y� SEWAGE # VILLArr. ASSESSOR'S MAP & LOT INSTALLER'S NAME& PHONE NO- SEPTIC TANK CAPACITY , �/�/ J� LEACHING FACILITY: (type)�'� (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 fee f leac ' fa ,ty Feet " c Furnished GIIil�iiYn/ �l/ -j'ylAr�fb� 1 'fps Ar QA<h Tif vl� 0 3� sa 5� � 1 . APPLICATION FOR PrRCOLATION TEST AND ORSERVATJON PITS .ATION Loi c ci - '-7O W 111 ,Y1, NO. P_-43 IQ jLAGE So — DATE_ 'LICANT W,4z1,?%/ a'Eje'?'ate FEE_ b TELEPHONE NO. Non-refundable) )RESS /��i `{ Aj-,.ry ;INEER A',t Li TELEPHONE NO. 'E SCHEDULED (Applicant' s signature ) • • • • 0 0 o 0 *to • o • o 0 o o o . • u o • . • o 0 0 • 0 0 0 • • • • . • 0 • . • u • • • • . . • . • • • • • • • • • • • o • o • • • o a • u . • . . • • SOIL LOG Ilo 3-DIVISION NAME � .c/� C 1% ' p/-� ly DATE_ �¢ s Z���jS� TIME 'ANSIbN AREA':^ YES fo'NO 2)=, ENGINEER IN WATER PRIVATE WELL Z iy �/VL_piy BOARD OF HEALTH EXCAVATOR :TCH:; (Street name, etc. dimensions of lot, exact -location of test holes and percolation tests ,- locate ..wetlands in-.proximity to test holes ) NOTES : G 7:0 � l �AL AIT?jgA-JI - �/ Goo �• j L L i 1,1-L 7--b/.,r 4d T 6�w COLATION RATE: 2 `4 f iy 1�fE i2 I T HOLE NO: ELEVATION : TEST HOLE NO: ELEVATION: 2 _ 10 2 3 3 -- 4 Gj�fi✓ L 4 ------ 5 - SAN v 5 6 6 --— - 7 7 8 9 9 10 10 _ 11 7v®•✓may 11 12 -- 12 - 13 13 _ 14 — -/�o i�iFaY�2 14 1.5 15 16 16 / TABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD i/ LEACHING PITS r/ LEACHING TRENCHES UITABLE FOR SUB.:-SURFACE SEWAGE. REASONS: E : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION NAL: COMPLE"pF1) TN PN7'I RPTY 13Y P . F. AND RETURNED TO BOARD OF 1IEALT11 Vw ' bc Io'n 5d A G E PERMIT 49. Ld L -�-1 7o WZ-O-L(--� /Le - V1L LAG E IHS7ALL 'ER'S NAI"AE ADDAESS B U I L D E R DR OWNER 0/t- DA T E P E R M I T I S S U D o/ 13—T5 - DATE C0MP . IAHCE lSSUED� � �� 6 I � �� �.� � T ' +`. ' �. 5` a�� � �� ;. i� j`� ,� �J 9 �I r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ----�t... ......................OF........�. .............................................. Appliration for Diopoii al Works Ton,strnrtion runfit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal Sys jt. "�.cationddress ° Lot No. ....................................P-7--- k&tVL7._. Address W V a-ro-Qt ev 0 ! E) a ....... Pq Installer Address Type of Building Size Lot._yl_(a.0_Q_........Sq. feet Dwelling—No. of Bedrooms........-1................................Expansion Attic ( ) Garbage Grinder ( ) aa Other—T ype of Buildin g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures W Design Flow...................67................gallons per person per day. Total daily flow----- a._...__...._..._........._gallons. W Septic Tank—Liquid capacity/5 .gallons Length..A���e_'' Width._-5'.�`'._ Diameter__^__. Depth..�___�"-. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.........I.......... Diameter.__....4 Depth below inlet......L.......... Total leaching area..Z.4.7....sq. ft. Z Other Distribution box ( ' ) Dosing tank ( ) Percolation Test Results . Performed by.... 1. . .�"�� ____... Test Pit No. 1_--_- �. _....._minutes per inch Depth of Test Pit-__-� 'A... Depth to ground water.. o N_1�---- fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --•--•------••---------•-----•--•----•--------•-•--------•-•---------------------- Description of Soil------ ......ro?--.--- ��!rc.! l7 �' '� s ' y! _ ... ^J W U ------•--•----------------------•-•--•--....------..........•--•------.....•-------------.......-•------...-------••••-------•--•-•-------•---•....--------•-----........._....------...--------------•- W UNature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------------------------•-•----------------•------•---------...-----....------.....-•------•-•------------------------•----------------•------------•---------------......_............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLi; 5 of the State Sanitary`Code—The undersigned further agrees not to place the system in operation until C�h to Compliance has been is ued by the board o health. r , O Signed ....... . .. '1-------------------- .' : .... / Date APP c n Approved BY =' .. V ( r�`- ......................................................•-------..._..Date Application Disapproved for the following reasons______________________. ......• � _ -,--_ ..-•-•-•--•----------------------------•----•---...------------•-•-----------------.....--•---•------•---•-•....-•----.....-------•----------......--••-•---•----•--•------•••----•••------------•--•--- Date . PermitNo......................................................... Issued_....................................................... Date � •h s THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................---............-.OF......................................---------------.....--•---I.........._.............. ,2 ppliration for Disposal Works Tonitrnr#ion rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................................................. ...............__..........------........-----.. Location-.Add..e.._s... --------- ...... r t N-o.. - ---------------- Owner ...Adiress .......................................... oLo ..................... ......... ... Installer Address d Type of Building Size Lot----------------------------Sq. feet U Dwelling No. of Bedrooms....... ................... .._..Ex Expansion Attic a g— --•------ p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -----------------•-----------------------------------.-•----•------••----•---••-•••-••--•-•-----------------------------.....----....----------- W Design Flow.................. .................gallons per person per day. Total daily flow----- ...........................gallons. WSeptic Tank—Liquid capacit}d3.�?..gallons Length..�d'! _` Width.: _.g...._ Diameter_-_-'"..... Depth_ ."-'S-. -_. x Disposal Trench—No--------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........._.......... Diameter...._.► Depth below inlet..... .......... Total leaching area."Z".4.7.._._sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0-4 Percolation Test Results Performed by._..A.L_.�..__�r'��;...4.^l. t.w11=�.!Lt.��_ Date_' _-.�?S- -------- 14 ® y 14 Test Pit No. I......Z.......minutes per inch Depth of Test Pit.__J __/_.._ Depth to ground water_�!v.i,1.._.__. rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ----------------------------------------•-------••---------......-•----......---•-------....._..._ O Description of Soil.....Z1. U ---•-•---------•---••----------------•-------••-----•------------•--•-•--•-•-------••----•-----•------------•---•-•---------•-...----------.---- W -----------------------------------------------------------------------------•-----•------------•-------------------------------------------------------------------------------------......---------- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------------------------------------------------------•-------------•--•---••-•-----------•------------•----------------•-•--•----------••-----••••------•----•-••--•-----•-••-•------.......--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE; 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation#nApproved ' Certifi to f Compliance has been issued by the board of health. V �---�-- Signed...................................................................................... ------------nace...----....... .__ - Ap I By...... --- ----------------••--•--•--•----•-- .s� r. `� ---------- Application Disapproved for the following reasons---------------------•-••---••-------------------------•-------•------------------------------••---------•-•---•- ..............................................................----•---•---•-----.....-----•---------.....••------........-----------•-•----••-----•--••-----••------•-----------••-----•••--•---•------. Date PermitNo......................................................... Issued--------------------------------------------------------- Date Y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................................................ 01rdif iratr of Tomplittnrr THIS IS TO CERTIFY, That he Individual Sewage Disposal System constructed ) or Repaired ( ) Installer at----- " -------- -�Ls�._. _�..- v has been installed in accordanc2th the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__...�.5__"_S_rS •----•---•--- dated--------4'.-13..'•-�.5--....... ----•---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................ .a14.J..$ 2`.--------•--.............---........... Inspector.-•-- ------ -----._ ................................... THE COMMONWEALTH OF MASSACHUSETTS ._. BOARD OF HEALTH ...........................................OF.................------..._._..........................._.__...................--.... ' No._ .......�._.. 1_.? FEE.-F _ _.::�............ . Bisposal Workv Tono#r ion rrnti# Permission is hereby granted.... ...--.._.&.R to Construct ( k) or Repair ( ) an Individual Sewage Disposal System at No..... �2_ �V\M street as shown on the application for Disposal Works Construction Permit N it ram.... Dated...... _: 'c#z-----....,..- Board of Health DATE. r " ............................................ FORM 1255 A. M. SULKIN. INC.. BOSTON ,7/ ,.__.. - r ! i. i ( _ 30 1 � , -75 w�2 .NONE j 2 zz 1 ..r ( t 1 , 1 3r.g50 W Q P/T; - N ' � 1 H rcn 30. �o o T,L:AA/ SCALE - 0 I } _ 3z4"' COTS' G97D { - O ��•5 - I ' - { � J..ii11j. � TOTQ�,t ���,q � I � ; k• � , 2r73 ! zS•? : N Q` i { Ca S.7. { , ( 1 1 �9 I 32.0 ; E �!?OFILE -AEG _ALL C�t�, _LNG_/ f,' _ 1 Ra, ' SKETCH PLAN OF Wk) IN 10,05TONS MILLS ' i } = Hyfaivnyis, Nlws� .i 0 2 GO/ : FoR NA t? Y ! t ! r! I ( ' I ' B�/r�9 'Ions 'G9 r 7t�jS : Sho4��/-, o.r c /��•, Iaf 9 i ! i i i. , _TEST I t I I wi 1� a T d/7fOr� k II ' 3 f�f NQ ,Wf7T / � En�v�ancrrc% ..........._L 30�9 28�3 1 ( I I f � 1 I 1 t + � � ( � 2Sr�1 r 1 �,._r ' i j. :-t ' .? -• ' ! .-- - 1 , ( �pP . , Or 1�h�4 1 { ..�.u!Se t 7 k , f 1. _ t ; z/o WILI_IAM H. FARDIE w: /'wneY k 1 i I p No. 8995 O 1 S�O.NAL .12 IiI i , aopt I 1 , , ` CONTOUR LOCUS � x 100.98 EXISTING SPOT GRADE o� �ii• <� °� o Wy EXISTING WATER SERVICE N 'C EXISTING SEPTIC TANK ® � Ro TOP OF TANK, EL.=85.50 ->9.H.bt>`--- OVERHEAD WIRES �oJ Tee�ooy e�Pe N INV.(OUT)=84.15± TEST PIT now on BENCHMARKQ. o EXISTING LEACH PIT BENCHA4AReorr. STEP LEGEND OUTSIDE CONTRACTOR SHALL PUMP, Lakeside Dr FILL WITH SAND & ABANDON EL.=87.61 c� m it m c [ (fio +87.10 X��PwJ wl5b r C0 A ✓,-d U'40 N 84'56'00" E "^ a '•• z Shubael II 260.00' � o � ° a ° Pond l.nj•{i.l t�T +e7.ao LNOCUoSSMAP .1 CALE LOTS 69 & 70 41,600±SF 87.17 PARCEL ID: 103-030 - 8 x 87.3 x 8680 .'I 1 ' ' 7.19 + 6.20 C,��� TP-4r,�'[p_3-- --- 1 GENERAL NOTES: �S x a7.zs a RESERVE AREA I 87.11 x �-- I 1 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL x 87.10 ..-"••••-•, 14- 48' 2BOARD OF HEALTH AND THE DESIGN ENGINEER. �ao 1 . ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 0 0 873s TP-2ol ,,; O 0 ' OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE BM x < LOCAL RULES AND REGULATIONS. ~~ � 87.38 87.61 fL�.a�� 3 � ' e 2a (---33.5--I '. N 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR t A7.08 87.37 0 _�-0- TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DECK x FENCE x 86.50 DESIGN ENGINEER. DECK f s7so +e7.z9 0 0 I 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING �� b + FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN .Cp (OD �\ 8587 86.91 87.25 WA 8743 86.95 Cs ENGINEER BEFORE CONSTRUCTION CONTINUES. Ct 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. ' m x 87.14 ` 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 87:as;F: "O' 86.83 EXISTING �.�a-- :?'` ' .....:..- THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HOUSE(#50) FENCE =•'= `• `"' HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. I 81.20 i i86.59 + l / ( x T.O.F.=88.3f 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 66.72 DRIVEWAY:c;.:1:: �- 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. FLAGPOLE 86 / 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS CID1 I 86:95: .66 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 3e 86,88 ` DIRECTED BY THE APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY x 86.73 x 87,19 X e 6.75 I'..w`''.a; l i 1 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 86.43 � J �t 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 1 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). SHELL LA'MP ir.;r.; ' : 85,56 I 821 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE RIVE; 260 00' es,62 x s5.19 : .:;''. x e5.6a INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. +'e6.lo 6- S 84'56 00" W \ ^` :` 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 86.08 85.91 85,43 edge of pavement 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC 84.01 83,45 83.01 SYSTEM COMPONENTS NOT SHOWN ON THE PLAN M 1 rrifPETER qs WILLINGTON AVENUE s PROPOSED SEPTIC SYSTEM UPGRADE PLAN T. sa.00pK SET TEE CIVIL 50 WILLINGTON AVE. MARSTONS MILLS MA "' o•oo o. 35109 Prepared for. D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 OWNER OF RECORD G/SjER�` �� Engineering by: SCALE DRAWN J08. N0. ENG� EORDEKIAN, CHRISTOPHER S & WENDY L Engineering Works, Inc. 1"=30' P.T.M. 165-16 P.O. BOX 592 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (o CENTERVILLE, MA 02632 (508) 477-5313 7/1/16 P.T.M. 1 Of 2 ^ NOTE: TO PREVENT BREAKOUT, THE PROPOSED Y, . FINISH GRADE SHALL NOT BE < EL:83.5 SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE SHED PERIMETER OF THE S.A.S. INSTALL RISERS & COVERS OVER INLET PROPOSED S.A.S. AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX PROVIDE ACCESS TO GRADE OVER OUTLET COVER INSTALL WATERTIGHT RISER g� PROVIDE ONE ACCESS MANHOLE TO WITHIN 3" OF FINISH GRADE FOR INSPECTION PURPOSES T.O.F.=88.3+ COVER SET TO 6" OF GRADE �S• o F.G. EL.=87.Of F.G. EL.=87.Of �, 8, F.G. EL.=87.1 t F.G. EL.=87.2f 33.5___ 1 MAINTAIN 2% GRADE (MIN.) OVER S.A.S. = PROP. S.A.S. Co. 1558 1� L = 58. L = 23' ® S=1% (MIN.) @ S=1% (MIN.) ' -53.2 T 4"SCH40 PVC 4"SCH40 PVC 6" io I 6" aaBaaaaa DECK EXISTING 4s" LIQUID RESUMERESUMELEVEL ADD 4' 4.8' 4' GAS BAFFLE INV.=83.40 PROPOSED INV.=83.23 EFFECTIVE WIDTH = t2.8' INV.=84.15 D-BOX (EXIST./VERIFY) INV.=83.00 3-500 GALLON LEACHING CHAMBERS HOUSE(#50) EXISTING SEPTIC TANK SURROUNDED WITH STONE AS SHOWN :L- H-20 RATED TOP CONC. ELEV.=84.1 t BREAKOUT ELEV.=83.50 SEPTIC LAYOUT NOTES: INV. ELEV.=83.00 aaea Baaaa aaaaa 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE aaaa ---aa INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=81.00 4' 3 x 8.5'=25.5' 4' m ) 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' MIN. OF NATURALLY OCCURING EFFECTIVE LENGTH = 33.5' ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION FE3 ®® 0 3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTT. OF TP-2, EL.=75.3 - ®®®® ® ®®®® 37" 4) CONTRACTOR SHALL INSPECT EFFLUENT FILTER ON 3/4" TO 1-1/2" DOUBLE w OUTLET TEE AND REPLACE IF NECESSARY. WASHED STONE N z ®®®® ® ® 3" LAYER OF 1/8" TO 1/2" SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE (OR APPROVED FILTER FABRIC) 1 02" SOIL LOG 4" KNOCKOUT DESIGN CRITERIA DATE: JUNE 6, 2016 (REF#15,066) 20" DIA. COVER SOIL EVALUATOR: PETER MCENTEE PE(SE#1542) NUMBER OF BEDROOMS: 4 BEDROOMS WITNESS: DAVID STANTON IRS HEALTH AGENT 4" KNOCKOUT 4" KNOCKOUT 58" SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74 GPD/SF) 0 DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP-1 DEPTH ELEv. TP-2 DEPTH ELEV. TP-3 DEPTH ELEV. TP-4 DEPTH DAILY FLOW: 440 GPD 86.8 A 0" 87.0 A 0" 86.8 A 0" 86.9 A 0" 4" KNOCKOUT DESIGN FLOW: 440 GPD SANDY LOAM SANDY LOAM SANDY LOAM SANDY LOAM 86.1 10YR 4/2 8" 86.3 10YR 4/2 8" 86.1 10YR 4/2 8" 86.2 10YR 4/2 8„ GARBAGE GRINDER: NO-not allowed with design B B B B 500 GALLON CAPACITY, H-20 LOADING LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF SANDY LOAM SANDY LOAM SANDY LOAM SANDY LOAM.74 GPD/SF 83.8 CHAMBERS 1OYR 5/8 10YR 5/8 1OYR 37" 83.9 5/8 10YR 5/8 36" EXISTING SEPTIC TANK: 1500 GALLON CAPACITY C1 36" 83.8 C1 38" 83.7 C1 C1 N.T.S. D-BOX: 1 INLET, 3 OUTLET (MINIMUM), H-20 RATED PER/ PERG 34"/52" 36"/54" PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 3-500 GALLON LEACHING CHAMBERS IN SERIES M-C SAND M-C SAND M-C SAND M-C SAND 50 WILLINGTON AVE., MARSTONS MILLS, MA SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 2.5Y 6/6 2.5Y 6/6 2.5Y 6/6 2.5Y 6/6 SIDEWALL AREA: 2(12.8' + 33.5') X 2 = 428.8 S.F. Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 BOTTOM AREA: 12.8' x 33.5' = 185.2 S.F. Engineering by: SCALE DRAWN JOB. NO. TOTAL AREA:........................................... 614.0 S.F. Engineering Works Inc. NTS P.T.M. 165-16 75.3 138" 75.5 138' 75.3 138' 75.4 138' � � � DESIGN FLOW PROVIDED: 0.74 GPD/SF(614.0 SF) = 454.4 GPD NO GROUNDWATER, PERC RATE: <2 MIN./IN. 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 7/1/16 P.T.M. 2 Of 2 I