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0027 WINDING COVE ROAD - Health
27 WINDING CdVE R6A4,;-�-7 r7- Marst6ns Mills A = 076 — 031 I Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Winding Cove Rd. Property Address U-1 N� Power } Owner information Owner's Name is required for a every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection 4,. Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 Cityrrown State Zip Code 508.272.6433 13010 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10/11/17 Inspecto Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 CitylTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Existing septic tank, new d-box and chambers 2013 B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ��< 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M �r 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Occupied Date Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped 2013 per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc-rev.6/16 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Original septic tank per age of home, new d-box and chambers 2013 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2'6" Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) H-10 tank, inlet cover raised to 12" of grade If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000g Sludge depth: 3" t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle '12 Scum thickness trace-1/2" Distance from top of scum to top of outlet tee or baffle >21. Distance from bottom of scum to bottom of outlet tee or baffle >2" 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.): Pumping suggested evry 3 years to prolong the life of the system Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.cloc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): H-20 D-Box 2'10" below grade, cover raised to 3"of grade, very good condition Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): H-20 Chambers per compliance on file are approximately 3' below grade, they were video inspected and are damp at this time, cover raised to 6"of grade, no indication of past fail conditions, maximum adjusted groundwater to the bottom of the SAS 5+ft. per compliance on file Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Soils are compact and dry Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately a a � I I t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,• �r 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >12'feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date permit Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: Per compliance adj. GW to bottom os SAS+5' ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: Home is at elevation 66' and nearby surface water at 4' You must describe how you established the high ground water elevation: .see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Winding Cove Rd. Property Address Power Owner information Owner's Name is required for every page. Marstons Mills MA 02648 10/11/17 Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file l5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF B"NSTABLE /LOCATION a") Ol t-,f�i kt6 C-T"-(%7 SEWAGE# i VILLAGE Zt j e!, [ 44ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �7OaZ;d[.t�"�"i C0_9M, SEPTIC TANK CAPACITY C-*1 C7�9 t44�, (ere) 4�,,(t LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: —(,�r- P_` COMPLIANCE DATE: 0 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) rr Feet FURNISHED BY D�ri� C�Pa �r..���•,y 1 h r 3 y-7V O ,�, 0 �Df No. J. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH.DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes \01 4phration for Nsposai *pstrm Construction J)ermit Application for a Permit to Construct( ) Repair(/S Upgrade( ) Abandon( ) ❑Complete System [Individual Components Location Address or Lot No. 9°7 o>- Pj. Owner's Name,Address,and Tel.No. 50 Assessor's Map/Parcel '74. 3r A! Installer's Name,Address,and Tel.No. �j 6 8-I)71-9 399 Designer's Name,Address,and Tel.No.F'121Y �i .L. CUY�S1'fLCr�'Y d9'1�=i1C. e j0 M 1Aee1i�^a�X�C Q�'/-kO7 S '• a� � Type of Building: Dwelling No.of Bedrooms Lot Size 3,6 Q sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) y 4® gpd Design flow provided c�� gpd Plan Dat e_M Q .ap l Number of sheets s' Revision Date Size of Septic Tank ° Type of S.A.S., rx►o L eU ����,tp�,D � 9/ Description of Soil Nature of Repairs or Alterations(Answer when applicable) ° leael C6m{� i n o&_ is FC.3�W X � ��X �,e P.� tj cClq® reYnout-d + rpn 1amjvw►e4& S, -j / 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 Co to place the system in operation until a Certificate of Compliance has been issued b Board of Health. nS' e a Date Application Approved by 0 Date Application Disapproved by Date for the following reasons Permit No. "� Date Issued No. Fee / r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: %-/ PUBLIC HEALTH DIVISION.-TOWN OF BARNSTABLE;`MASSACHUSETTS Yes ftPiication (pr OisposaY bpstem Construction J)ermit Application for a Permit to Construct( ) Repair(/) Upgrade( ) .Abandon( ) ❑Complete System krIndividual Components Location Address or Lot No. 2") LJ i r:'dt ..� (20iJ� 1 a• Owner's Name,Address,and Tel.No. S087- a'>�- O q6S- d�tcx,r.�J or,s 11 i 115 c1 Poc�1' Q19 �1'/)d,'n5 Gt�ve Ad Assessor'sMap/Parcel ?4 31 Mars4rn- U;1�� ti:j�L[Ja4o � Installer's Name,Address,and Tel.No. 50 8- 7 I?(-9 39`7 Designer's Name,Address,and Tel.No. ( ,F_6. �v� Cvf►�5+rc +i t ,Zi,c �f) �nn. E�ill eer;►�,-rrc 93 i M `a/ 7 Sf f Y n,�d P M0241-9 Type of Building: Dwelling No.of Bedrooms Lot Size ?J 5 U sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) j Other Fixtures Design Flow(main.required) 4 t4e) gpd Design flow provided y 5 gpd Plan DateSp,(),�_m L Q aO 13 Number of sheets 1 Revision Date Title`TsI+I, `J 151de.., R0, e4 __ 7 zl, A�g/5kh_SN/115 Size of Septic Tank eA;SitA= Jorr "(i Type ofS.A.S.,S+„-x, 'Description of Soil _4 Nature of Repairs or/Alterations(Answer when applicable)'( cj,,) F1 ao ri f�1 rr 47 an/vi. u ECA (:.}}�'YA U'll M-rS 1 i1 Cc 12,,}} Sr 3 1w(A S' X -2 r,C ti. 1'.-M6QeP_0_I" 1'�,�C�,N@ YY3'1!_.tiX Date last inspected: F 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 b, this \Board of Health,. Signed'n �4 r - 19 d pn Date _/ Au ��� i !, �L e Application Approved by ` ,E�/ I ® /� _ Date Application Disapproved by h / l Date for the following reasons y Permit No. ", Date Issued � � • - o r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(}11) Upgraded( ) Abandoned( )by � �b Ic irr , t l)r)4r4_)J--t or) 7Lpe- at U)I rAj /vim (2e,tw A41i,re bfyK,&/`4�,Sas been constructed in accordance with the provisions of Titjl�the for Diss osal System Construction Permit No. dated Inc- 9 Installer &f�11 l r nc><✓i,Cl`/C��1 . .Ly�C Designer O,(�/�.�/� n lsltn _nsi� ��1 , bedrooms _ Approved design flow gP d ,a i The issuance of this permit shall not be clons�ed as a guarantee that the system w��ction as designed. / d Date 0 (! Inspector L YI �/ No. Fee - �J A/ THE COMMONWEALTH OF MASSACHUSETTS US TS OUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS 4 1 Misposal *pstem Construction i3ermit Permission is hereby granted to kin/Construct( )�7 Repair(),� Upgrade( )/ Abandon � ( ) System located at / �1 .I 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:Constructq* ust be completed within three years of the date of this permit. Date % 7/)�/ Approved by f W i 1 i I h a J ` r �� � ' ., A ` rY'� I I OCT-15-2013 11:24 From:60RTOLOTTI CONST 5084289399 To:15087906304 P.1/1 »9 Town OR BarnstAble Regulatory Sep-vices Tbomas F.Gefier,Director moo; publfC Health Division 'Thomas McKean,Director b ' r 200 Mfliu Street,$yamma,KA 02601 Fax: 5o6-190-6304 office: 50s•862»4644 rmstaner&Desiomer Certification Date, Ap Sgwagc permit# 2 D 13 "!W Assessor's MapWarcet �6 IAesigmer: �IJA - U A.ddxesa: Adilreas• i On �� s issued a p to install a d e (xus 'Jlcr /1 e septic system,at „� J �a/[ based on a design drown,by addle ) I dated. I cert7fy that the or system xefetewAd above was installed substardiallp according to I tha design,wbic'h ulay inclWe minor approved changes saCh as lateral relocation of tie distribation box sandlot septic tack. I I certify that the sep6.0 system rcfam' ed,above was installed with major changes (i.e. greater than l0'I.gttcra agtioa of the SAS or any vertical relocatim ofPl MY MPO mr of the septic system) m accordance with State B�Loca112egvlati ceded U-built by d ,ira to follow. Ili Oft Af OANIRLA OJALA o5tall '9 Signatae CNIL er N , No 48602, c rsrBa l le ���� I ,s$i�at e:'flgeer's tamp Hone) RIC'TiJRii x0 T3AZtNSrARX,X+ PCyYiLIC AL1h? 1. R �w YANCR Wfl.�. t40T Da�._IS�iJE:� �1�IL BOTS���R��.AEYID A�-13LTiX�T �� +MR �tytv�'� SrAtil.E CJ�L AL fiIDN I 1R��Cp�LY�17 AY'THIa D1AR�i �, ��,�. --�— • '-. Q.gGnitl�sr�t[�1Desiauer Carpficodon Fong 3-26-04.doo h f 5- r I'mc oA1E rnu�r �o� D;sMW A16-W must r2�PAiYL Town of-Barnstable Barnstable Regulatory Services Department wtcac 1 + r Public Health Division I• 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012 1010 0000 2850 9934 August 19, 2013 Judith Power 27 Winding Cove Road Marstons Mills, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 27 Winding Cove Road, Cotuit, MA was last inspected on 7/09/2013 by Patrick M. O'Connell, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Septic system is in hydraulic failure. • Must remove garbage grinder or design a new system for one. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH i i Thomas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\27 Winding Cove Rd MM aug 2013.doc ° Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address — Judith Power Owner Owner's Name --- ------------------ _ information is required for Marstons Mills --- _-- —_ MA -- 02648 _July 9, 2013 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not use the return Name of Inspector — -- --------------- ------- --- ---------- key. Septic Inspection Services Co. Company Name r� PO Box 1487 Company Address — Marstons Mills _MA_ 02648 rnnm Cityrrown ----------------- -- State—..----- -—— --- — —.__ Zip Code 508.428.1779 _ _ SI_1_2855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this adt ,-ess and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 MR 15.000). The system: . ❑ Passes ❑ Conditionally Passes ® Fails i ❑ Needs Further Evaluation by the Local Approving Authority tiJ July_9 2013 Jgbr 13-59 Insp ctor ignature Date r "j �-- The system inspector shall submit a co of this inspection report to the A rovi Authority. Board y p copy P P PPg Y.� of Health or DEP) within 30 days of completing this inspection. If the system is a shared system 60 has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the03 report to the appropriate regional office of the DEP. The original should be sent"to the sysfeb o%pr and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. 15ins•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 1 of 17 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .• 27 Winding Cove Road Property Address ----------- ----------- — — Judith!Power _ Owner Owner's Name — --- — --- information is required for Marstons Mills _ MA 02648 _ July 9, 2013 every page. Cityrrown State Zip Code Date a of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E /always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the followin statements. If"not determined," please explain. The septic tank is metal and over 20 years old" or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address — Judith Power Owner Owner's Name ----- ------- - ...-- --- ---- - --- - information is required for Marstons Mills _— _ _ _ _ MA - 02648 July 9, 2013 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ PumpChamber p um ps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approva! of Booed of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address Judith Power Owner Owner's Name --- --------- — information is Marstons Mills MA--- 02648_ Jul 9, 2013 required for ___--._._- _ __ _ _ y every page. City/Town State Zip Code Date of Inspection B. Certification (Cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 fes it of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No".to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool El ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than_day flow 15ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address Judith Power Owner Owner's Name information is required for Marstons Mills MA 02648 July 9, 2013 _-_ _ _ every page. Citylfown State— Zip Code Date of Inspection B. Certification (Cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the follolving, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 15ins•3113 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,w 27 Winding Cove Road Property Address Judith Power _ Owner Owner's Name information is Marstons Mills _ _MA 02648 Jul 9, 2013_required for _ _ y every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following. Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria rela'ed to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3---- Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms). 330 15ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address -- -- - Judith Power Owner Owner's Name information is required for Marstons Mills _ MA 02648 July 9, 2013 _ every page. CitylTown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 123,000 gal. _ 9 ( Y 9 (gP )) 168 gpd. Detail: — Sump pump? ❑ Yes ® No Last date of occupancy: Currently Occupied. Commercial/Industrial Flow Conditions: Type of Establishment.- Design flow (based on 310 CMR 15.203): Gallons per day�gPa) Basis of design flow (seats/persons/sq.ft., etc.): ----- Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: -- ---- — 15ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Se wage Disposal System Form Not for Voluntary Assessments 27 Winding Cove Road Property Address — ---" "----- -- Judith Power Owner Owner's Name -- information is required for Marstons Mills _- — MA _ 02648 July 9, 2013 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Tank pumped 3l30/12— Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: ---------_.-------------_-.-- gallons How was quantity pumped determined? --- ------------- Reason for pumping: --------__—_-__ _ Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): I 15ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address --- --- ---- ------------ -- Judith Power Owner -- ------ -- -.. ---- -- - --..------------ - Owner's Name information is required for Marstons Mills --- MA _ 02648 _ July 9, 2013 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of Information.- Compliance date: 5/3/88 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2' _ feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): - — Distance from private water supply well or suction line: — feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 16" — feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: -- years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8 5' long x 5.2'wide - 1000 gal. Sludge depth: 4__-__ 15ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments A,. 27 Winding Cove Road Property Address ---- ------------------- Judith Power Owner Owner's Name information is Y required for Marstons Mills' _MA 02648 Jul 9, 2013 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle - Scum thickness 4" --- Distance from top of scum to top of outlet tee or baffle -- - Distance from bottom of scum to bottom of outlet tee or baffle - How were dimensions determined? 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.): Liquid level was found over inlet and outlet pipes, tank had been full to top i:idicating hydraulic failure. �, --- --------.._..------ Grease Trap Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ co-icrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: --- Scum thickness -------- Distance from top of scum to top of outlet tee or baffle — --- Distance from bottom of scum to bottom of outlet tee or baffle ---------- — Date od last pumping: - Date t5ins•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 10 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address Judith Power Owner ------------------ -------------- -- Owner's Name information is required for Marstons Mills _--_ MA__ 02648 July 9, 2013 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: ----------_-- --. Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: -- --.----- — Capacity: gallons--- Design Flow: -- -----.-_.--- gallons per day Alarm present: ❑ Yes ❑ No Alarm level: -- ------ Alarm in working order: ❑ Yes ❑ No Date of last pumping: ---- ------------------------ — — Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 15ins-3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments «„a,.•'� 27 Winding Cove Road _ Property Address —---- Judith Power Owner Owner's Name information is required for Marstons Mills _-- MA 02648 _ _ July 9, 2013 _ every page. City/Town State Zip Code Da!�of Inspection D. System Information (cont.) Distribution Box if present must be opened) (locate on site plan): Depth of liquid level above outlet invert --- ----- ------ --- - Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No' Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): " If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 12 of 17 i ,1 Commonwealth of Massachusetts = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address Judith Power Owner Owner's Name information is required for Marstons Mills -_ MA 02648 ____ JL''y 9, 2013 _.— _ every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: One 6x6 pit. ❑ leaching chambers number: - — ❑ leaching galleries number: ❑ leaching trenches number, length: ---- ❑ leaching fields number, dimensions: — ❑ overflow cesspool number: - ❑ innovative/alternative system Type/name of technology: --------- - -- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching pit was probed to locate. Probing of area found stone and soils surrounding leaching pit to be saturated. Pit is in hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration -- - - Depth-top of liquid to inlet invert ----- -- Depth of solids layer -- -- -- Depth of scum layer ---- -- - — Dimensions of cesspool ------- -- Materials of construction - Indication of groundwater inflow ❑ Yes ❑ No l5ins•3/13 1ice 5 Official Inspection Form Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 27 Winding Cove Road Property Address ---- ------------ Judith Power Owner --- ---- ---- ----------- ------ Owner's Name information is Marstons Mills required for _- MA_ 02648 July 9, 2013 _ every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction.- Dimensions -- ----_ _—__-. Depth of solids — - ---- ------------ -- Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 15ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts U Title 5 Official Inspection Form i l Subsurface Sewage Disposal System Form Not for Voluntary Assessments - 27 Winding Cove Road Property Address Judith Power Owner Owner's Name information is required for Marstons Mills MA 02648 lly 9. 2013 every page Cilyitown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System. Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public r p c Ovate supply enters the building. Check one of the boxes belr•N: ® hand-sketch In the area below ❑ drawing attached separately Front Yard 1 rac t` 33 i1i' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address Judith Power Owner _—...--- --- -- ---- Owner's Name information is Marstons Mills MA _ 02648 Jul 9, 2013 required for � ._ y every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: N/A--- feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record I If checked, date of design plan reviewed: pate ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: -------------- ------------ Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 16 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Winding Cove Road Property Address --- Judith Power Owner Owner's Name information is required for Marstons Mills _ MA _ 026 -July_48 9, 2013 __ _ _ every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information - Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 17 of 17 171 61, /1VLX1-- (3 Town of Barnstable P# ' Departineut of Regulatory Services Public Health Division Date /v 200 Main Street,Hyannis MA 02601 Date Scheduled ime ]F (&/O Q• ��//��,, ee Pd. Soil Suitability .Assessment for S e Ibis Performed-By: �truM c�•�a " C A 0,) �c �/ Witnessed By: LO CATIOI L&GENERAL INFORMATIO Location Addregs l /�f /,, Owner's Name f,��M Address Assessor's Map/Parcel• 1�"/ /A ©�4 Bngincer's Nan NEW CONSTRUCTION ! REPAIR Telephone Land Use: ^XP - Slopes Surface Stones Distances from: Open Water Body ft Possible Wet-Area {t Drinking Water Well ft Drainage Way ✓✓t ft Property Zinc Z r ft Other ft y SIM'TCH:(Street name,dimensions of lot,exact locations of test holes&pore tests,locate wetlands!n proximity to holes) f n ell —' z, r r • ti Parent material(geologic) 0(1WA-01-- Dep q edrgck >3 Depth to Groundwater. Standing Water in Hole:__gv Weeping from Plt FAVc .a Estimated Seasonal Hlgh Groundwater- � z2. DETERMINATION FOR SEASONAL HIGH WATER TABLE €; Method Used: Depth Observed standing in obs.hole., iyl,4 lu, DnP th to soli mottles., 1tL Depth to wccpiug from side of obs.hole In, Groundwater .Ad)uslrnt!nt' fr. Index Well# Reading Date: Index Well love[ �_ Adj.factor Adj.CrfVundwater Leval Observation PERCOLATION' TEST Date_*-�—x'ln e //1 jo Hole# Cl Timo at 9" S Depth of Perms Time at G" Start Pre-soak Time @ I D; 1® Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Sitr Fallcd: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back--------- ***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:\S EPTIC\PERCPORM.DOC DEEP-OBSERVATION ROLE LOG Role# Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, CoTisistelicy,%'Gravel) -s— Ins o ,yam • • . DEEP OBSERVATION ROLE LOG Hole# � Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, on is en. %Grave _s /'7J IYW e_1� DEEP OBSERVATION ROLE LOG Role Depth from Soil Horizon Soil Texture Soil Color Soil Other I Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. -cptigiotency.Ya O e DEEP OBSERVATION HOLE LOG If[ole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,St ties',Boulders, Co si ten Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No._^ Yes Depth 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? `lid If not,what is the depth of naturally occurring pervious material? Certification I certify that on 6,5 4 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in�10 CNM 15.017. Signatur Date . Z� • Q:15.L1'T1C1T'L�12C1�01iM.I70C • r TOWN OF BR RNSTABLE = n � � 1�4 ® LOCATION 1 v"� � SEWAGE # 0 "760 VILLAGE M AI-J�; L1 M CU-6ASSESSOR'S MAP & LOT YIS INSTALLER'S NAME & PHONE NO. (G: q2,b SEPTIC TANK CAPACITY i Uv-o LEACHING FACILITY:(type) (size) l� NO. OF BEDROOMS _PRI VATJ WELL OR PUBLIC WATER FU BUILDER OR OWNER DATE PERMIT ISSUED: l DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No C/ � 1 67A Q, f, 7 �� 7rl -716 E0LOFT- THE COMMO WEALTH OF MASSACHUSETTS \ BOAR® OF HEALTH ®V.-j.. ................ 0F.....9 4,{ 5. .......... Appliration for Disposal Works Tonstrurtion Frrutit Application is hereby made for a Permit to Construct (V,) or Repair ( ) an Individual Sewage Disposal System at: 0 .... .� �> ...ep.. --.--------------------------•-•-------•--------•--•--------------------•--••---_-------------- Location-Address or Lot No. ....-................_............---...----..................---•--............................ ..........-----------------•----•---._.......••---- n Address....-.......................................... Installer Address d Type of Building Size Lot. 3 © __Sq. fget U Dwelling—No. of Bedrooms__Z......................... .Expansion Attic 40 Garbage Grinder Q�p aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ............................ . W Design Flow......s5t;........................-------gallons per person jper day. Total daily flow-----n.0...........................gallons. WSeptic Tank—Liquid capacityI� �. ...gallons Length ____ Width A.. Diameter................ Depth__5_�_ ..� x Disposal Trench—No. .................... Width.................... Total Length..............-...... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.... Depth below inlet.....6........... Total leaching area...Z.G.7_..sq. ft. Z Other Distribution box ( ) Dosm ank ( ) i '-' Percolation Test Results Performed by... AU?%>_,�i.N.Y _.! G................... Date._�� .. ......... a Test Pit No.*?.....A ..minutes per inch Depth of Test Pit.....A :�...'Depth to ground water.._ (14 Test Pit No.3.... per inch Depth of Test Pit_____ ttJO... Depth to ground water-_l..............`...` p _ , �� -......_._.. Description of oil.0- .... ! L2� .! ?. .P9 in U ...-•------•---•-•----•----------------•----•--------------------•--------•--•--•-••----•--•---._...-•--------------••------------..._. U Nature-of Repairs or Alterations—Answer when applicable......................................................................................0........ --...................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. I n S' ed...... :... ....................•......................... /..�..!. ,1. ._....._ t Application Approved By... Date Application Disapproved for the following reasons_..............•......................................................__....................................... _ ........-•-••-•••••.........-•-••---R/':'�: ...............•----•------------........--.--••--------•--•----------------------------------•--•-----•--•------•---•----•--•Da....0.-•----•--- 17 :�Permit No.. . . .... .. ---•-•-----------•--. Issued....................................................... Date UoT 3 J_/.... .. ..6. . . F�s No .. .�/ o\ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 O V�1 +.J1... OF.............. 4:S A .C: _......................._. ,Apure#ion for Disposal Works Tonstrnrtion Prrutit Application is hereby made for a Permit to Construct (V)`or Repair ( ) an Individual Sewage Disposal System at: ` Location-Address or Lot No. Wa ................................................................................................. --•-•-•••--•--_...__....•-•••-•---........•--•---•--•...••--•--•-••-......•....................._. Address ...... ............. ..................................-`� YL. Installer Address dType of Building Size Lot. ... .....Q..... fget V Dwelling—No. of Bedrooms.. .....................................Expansion Attic ('t� Garbage Grinder (�(' Other—T e of Building No. of persons............................ Showers — Cafeteria dOther-fixtures ------------------------------------------------------..........--------------------------------..........--•------.........................•••...-•-- W Design Flow......SS..............................gallons per person per day. Total daily flow__...�30..........................gallons. or WSeptic Tank—Liquid capacityti -gallons Length.8. __... Width..".). .... Diameter_"... .... Depth.5..:0.. x Disposal Trench—N`..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...1�.......... Depth below inlet..____.......... Total leaching area.:.U?_7....sq. ft. z Other Distribution box ( ) Dosin ank ( ) Percolation Test Results Performed by.... cT _ .-_Y.5..�0.L.................... Date.AQ/.3�.. _ __..._. ,.a Test Pit No. .___. _..minutes per inch Depth of Test Pit.....�p.:U... Depth to ground water.. T-�.S S-Off IE32CQ GT4 Test Pit No.:3....4- ..minutes per inch Depth of Test Pit...._ A..0__.. Depth to ground water..!'.................... P4 ------------� 1 - -----.r................•r-•-•c--.------•---.-1--1•-------•------••--t-'•••...._. Des O 1 . T.,�. a..?.� !- _----------------------------------- --------------------------------------------------------------------------------------------------------........---•------•---•-•------ 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 TITIL- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed..................................................................................... . •.--_-• �f Application Approved By ... ------ r l A� ----------•-----------•------ --...-_.. __..___..f-�?._..__._.___�z__l�; . _�_.�,_. _�� Date Application Disapproved for the following reasons-----------------------------------------•------------------------------------------------......•--......_----- / Date PermitNo..!. ..g+..-.76-.6-------------------- Issued--•-----------•---- ............................... Dattee THE COMMONWEALTH OF MASSACHUSETTS ft� BOARD _ O IEALTH � ................. ..........................................OF......: ......... !.......1.1? .. Trrtifirair of Tomptianrr THIS S TO C T Y, That/fhte) di/vi� al Sewage Disposal System constructed ( or Repaired ( ) byv� ...li,:a l<.. \\--------------------------•-•---------•-•---------.----•-r9 at......L(.r__'__,1..__..... --•-/......W�1 � / ... O V ... .1J__ ...1`.`��_L.1.!_. ..& ..1--........................................ has been installed in accordance with the provisions of TI LE 5 of Th State Sanitary Code No. side ribe in the application for Disposal Works Construction Permit - .'_.f 1 Z_ ___...... dated__...-11/1_ �.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE T AT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................t .`. .—f..................................... Inspector-- ._.......... .� ............................................... THE COMMONWEALTH OF MASSACHUSET:TS OARD F MA TH ' -- -- �' /�,�j ! ........ OF................. ................ .1 .... ...... FE ..... No......- v.-4/ E. '- RoVooal Vorka Ton o#rnr#' n rrnti �f Permission •s hereby granted---.- Al ..... -V = to Construct or Repair ( ) an Indi i ual Sewag'e/D•spos tem .� at No. 1 �i�41l i��a� �`� .._ V.. { ?... l �. ..-. .................... .... Street as shown on the application for Disposal Works Construction Permit No�� ._..�,4-7��? Z Dated.. �.�...... .......... ,,.L'^� `•. Board of Health DATE-------- ...................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS • 3 T 44 t /vz � -- Mk 103 47 �__ 8yCd 0 eDY 3 7,77J —� �/ �C,�,GUL.•4-..T�o,�/ l�i••�--ram / '°/n/ 2 /V//�✓, �r� LEA_ . , ;., �-,�, ..,; r y%Z If ►.acoc�N,rE:2�� AU- le- 76 :TER :< SULLIVAN No. 29733 1� ' cI. � ,/ c,�/.✓ .��eEUs�� c�r�fi��y'S I it/T�. n 'MRS;� L cam'-��T/�i� 1Y4e_57ai✓S /' IL/ wL.LIAM /-, /`16 T .:,.c.� Y E t No. 1933:1 Lac TES ��✓/r///�/ 7 rr%= L��'��/ ?1�/ A. �� / ALL SHALL TE SYSTEM PROFILE MARKEDS WITHC MAGNETIC TTAPE OR BE PROVIDE MIN. 20" DIAM WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. NOTES ACCESS COVERS TO WITHIN 6" OF FIN. GRADE WATERTIGHT C.I. COVERS TO GRADE 1. DATUM IS APPROX. NGVD o o� TOP FOUND. EL. 69.5' 2" PEASTONE OR GEOTEXTILE 2. MUNICIPAL WATER IS EXISTING FILTER FABRIC OVER STONE MINIMUM .751 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 69.2 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. PIPES LEVEL 1 ST 2' BLOCKS OR 4. DESIGN LOADING FOR ALL PROPOSED PRECAST Route 28 4"OSCH40 PVC MORTAR ALL PRECAST RISERS UNITS TO BE AASHO H-20 Rd. 66.8' H-20 5t( Loc s H-20 D'BOX COMPONENTS d� ° 4 (NP) EL 4 5. PIPE JOINTS TO BE MADE WATERTIGHT. ENDS SIDES 65.8 10" EXISTING 14" ➢000000 00°00000° TEE SEPTIC TANK** TEE 65.4E*' ° ° ° �Eee0 ®OCR'® 0Me0 -F2El�IEN 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE 0 0'o.o o•o 6" MIN. SUMP ,o°o 0 0 oa®ao��ao�.a oa®oaaa�aao°000°o° WITH 310 CMR 15.000 (TITLE 5.) o� a ° ° ° ° 0 0 0 0 0 o O GAS BAFFLE .90°o�o�a0 0 12" MIN. INT. DIM. o ®F ®ODaDa��® QeI---°o 0���00����® eo t_ Do 00®�0 0��o 000ag000 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND 65.12' 64.95 62.8 NOT TO BE USED FOR LOT LINE STAKING OR ANY C.� OTHER PURPOSE. H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 8, PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (3) UNITS REQUIRED ALL AROUND PRECAST STRUCTURES 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 33.5' X 12.83, 9. COMPONENTS NOT TO BE BACKFILLED OR COMPACTION. (15.221 [2]) 5.4 CONCEALED WITHOUT INSPECTION BY BOARD OF Baxter e Rd HEALTH AND PERMISSION OBTAINED FROM BOARD $ o a ( 1 % SLOPE) ( 1 % SLOPE) - OF HEALTH. LEACHING 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP FOUNDATION- EXIST SEPTIC TANK 28' D' BOX 12' 57.3' BOTTOM TH-1&2 CALLING DIGSAFE (1-888-344-7233) AND FACILITY OUN D VERIFYING THE LOCATION OF ALL UNDERGROUND & *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT --- OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF NOT TO SCALE UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE WORK. PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE INSTALLER SHALL CONFIRM MIN. 4' SUITABLE SOIL 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 76 PARCEL 31 CONDITIONS IF NOT SUITABLE PRIOR TO INSTALLATION OF ANY PORTION OF SYSTEM SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY BE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED IMMEDIATELY GRANTED BY THE BOARD OF HEALTH AGENT OR AND REMOVED. BY HEALTH INSPECTOR PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED �JI BY THE BOARD OF HEALTH REVISED DURING A PUBLIC 7q \ O'�HEARING HELD ON AUG. 4, 2009 1.39 G 1 3) FAILED SYSTEMS ONLY : SOIL ABSORPTION SYSTEM Ov INSTALLATIONS PROPOSED MORE THAN THREE FEET BELOW �.05 0 \ F GRADE WITH PROPER VENTING (PIPED TO THE ATMOSPHERE) x 72.I 6 \ AND TH H-20 LOADING, BUT IN NO CASE SHALL THE SAS - / �O SYSTEM DESIGN. WI BE LOCATED MORE THAN SIX FEET BELOW GRADE. 5' REMOVAL OF UNSUITABLE SOIL REQUIRED c� 72 7� ��9.6 � AROUND PERIMETER OF LEACHING FACILITY, I DOWN TO SUITABLE SOIL LAYER. REPLACE ylso T 70.64 70.52� 7 ?0 WITH CLEAN MED. SAND, TO MEET GARBAGE DISPOSER IS NOT ALLOWED ® 2.5 ` 9. /1.28 \ 3� 13 SPECIFICATIONS OF 310 CMR 15.255(3) c� O oh 72.75 70.�3 70• J ,;o � � \ 56 DESIGN FLOW: 4 BEDROOMS @ 110 GPD = 440 GPD TEST HOLE LOGS `� �� 67 ., � // _ _ _ USE A 440 GPD DESIGN FLOW 65.✓z GRAVEL PATH � l 69A0 7"I.15 70 7� 69-94 � ` -- ` - /- - - ccPT'C -''.'�I`:!�: 4s n rPD ( )) - gR0 ARNE H. OJALA PE, SE c� x \� ENGINEER: c 1.73 - 69 HIS AREA 69.91 9.68 -�' a o.4� \ 130. o0 0.90 **RE-USE EXISTING 1000 GAL. SEPTIC TANK WITNESS: DONNA MIORANDI, RS 69.41 .39 ' LEACHING: DATE: AUGUST 22, 2013 LOT 77 09 GRAVEL PARKING - 20" IDA 0 17 �\ X 7z48 43,560 Sq. Ft. x 62.87 \ s9 SIDES:2 (33.5 + 12.83) 2 (.74) = 137 GPD PERC. RATE _ < 2 MIN/INCH 45 %� 7 g BOTTOM 33.5 x 12.83 .74) = 318 GPD GRAVEL PARKING CLASS I SOILS P# 14109 \ THIS AREA .7��, q .1 TOTAL: 614 S.F. 455 GPD TH ` 129 ELEV. ELEV. 6 .85 82 X 6' . .09 rn� USE (3) 500 GAL. H-20 LEACHING CHAMBERS (ACME OR EQUAL) 0'° 69.0' 0" 69.0' \ GARAGE ` �f 0, WITH 4' STONE ALL AROUND 12 AREA DRAIN (t, gyp' R AVN) " FILL 14" FILL c, � ��v 6��5 6g \��`���` � / TO BE MOVED /�/B ALS/B PITCH DRIVE TO DRAIN LS BENCH MARK - TOP OF _ 65�\� / TO NEW LOWPT. 10YR 2/1 16 „ „ BRICK STEP AT LANDING I 9.44 JAP. MAPLE (SAVE) h 14 10YR 2/1 ELEVATION = 69.5' 6 .47 6 x 72.33 RIM 68.0 Bw BW 68.96 91 �L INV. 67.0 LS LS EXIST. DWELL.. / / / V.I.F. 32" 1 OYR 6/6 32" 1 OYR 6/6 TOP FNDN. _ ( 10FF 1y• C1 C1 ELEV. 69.5' o X MA 73.3o Sas APPROVED DATE BOARD OF HEALTH PERC MS MS 8.9 / 84" 10YR 7/8 84» 10YR 7/8 68.73 C X 72.36 TITLE 5 SITE PLAN C2 ,C2 j J FSL UNSUIT. /FSL UNSUIT. OF 100" 10YR 7/1 60.6' 100" 10YR 7/ 73 1/ 60.6' 68 9� x 72. 27 WINDING . COVE ROAD C3 C3 PVC AT"1 MARSTONS MILLS MS MS 132" 7.5Y 6/2 132" 7.5Y 6/2 0 PREPARED FOR ENT WITH C4 C4 INV. 66.0't X 70.66 ANDPBUGSCREEN (FNARLCOAL PLACEIMENT BY LTER BORTOLOTTI CONSTRUCTION/POWER MS MS I F' 8 S.F. TRAPROCK p CONTRACTOR WITH HOMEOWNER 140 0 1 OYR 6/6 57 3' 140" 1 OYR 6/6 57 3' LEVEL SPREADER ti° CONSULTATION) SEPTEMBER 12, 2013 O GROUNDWATER ENCOUNTERED jNOFMAs oFt off 508-362-4541 � Sqo qs1� fax 508-362-9880 N HILL/WOODS ti �o DANIELA �s %�° DANII L ti�Nty downcape.com s o O VIL A down cape engineering, inc. CIVIL OJALA No. 403R0 GIsrE�'���`` ` � °FEs `' a civil engineers Scale: 1"= 20' 9 '12) ONAt E � land surveyors 1 939 Main Street ( R to 6A) 0 10 20 30 40 50 EEr DATE DANIEL A. OJALA, P.E., P.L. YARMOUTHPORT MA 02675 13- 179