HomeMy WebLinkAbout0071 WOOD DUCK ROAD - Health 71 Wood Duck-Road
,t Marstons Mills. a
A = 030 045
,f
l
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
M
�r
i
5<e
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 71 Wood Duck Road
Marstons Mills MA 02648 ��0
Owner's Name: Robert Wyatt
Owner's Address: Same
Date of Inspection: February 20,2007 Job#07-38
Name of Inspector: PATRICK M.O'CONNELL
Company Name: SEPTIC INSPECTION SERVICES CO.
Mailing Address: 189 CAMMETT ROAD
MARSTONS MILLS MA 02648
Telephone Number: 508-428-1779
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
�k
_X_ Passes
Conditionally Passes
Needs Further Evaluation by the Local Ap oving Authority �' '•,,
,1. .
Fa
Inspector's Signature: Date: 2/20/07
47
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of H alth or-`
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments: Tank has liquid only and is not in need of pumping at this time. Leaching chambers
were empty at time of inspection,a high stain line indicates chambers have never had more than 6"of
standing water.
****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 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
_XX 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.
Answer yes,no or not determined(Y,N,ND) in the 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.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)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
obstruction is removed
distribution box is leveled or replaced
ND explain:
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:
Page 3 of I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
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
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 I 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 1,00 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPO
SAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
_X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
—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
X Liquid depth in cesspool is less than 6"below invert or available volume is less than_day flow
_X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
—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_ Any portion of a cesspool or privy is within a Zone 1 of a public well.
_X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
_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 certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.)
_No_(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be 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:
(The following criteria apply to large systems in addition to the criteria above)
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.
i
Page 5ofII
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
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 by the owner,occupant,or Board of Health
_X_ Were any of the system components pumped out in the previous two weeks?
_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?
_X_ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
_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 baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of
scum?
_X _ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has been determined based on:
Yes no
_X_ _ Existing information. For example,a plan at the Board of Health.
X _ 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(3)(b)]
• Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 4 Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x 4 of bedrooms): 440
Number of current residents: 1
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):
Seasonal user(yes or no): No
Water meter readings, if available(last 2 years usage(gpd)): Two years total: 72,000 gal.=98 gpd.
Sump pump(yes or no): No
Last date of occupancy: Currently Occupied
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system (yes or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records: None
Source of information:
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped: gallons-- How was quantity pumped determined?
Reason for pumping:
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)
_Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Compliance date: 5/8/02
Were sewage odors detected when arriving at the site(yes or no): No
• Page of 11
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 71 Wood Duck Road, Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
BUILDING SEWER: XX (locate on site plan)
Depth below grade: 1'
Materials of construction:_cast iron _X_40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints, venting,evidence of leakage,etc.):
SEPTIC TANK: XX (locate on site plan)
Depth below grade: I
Material of construction:_X_concrete_metal_fiberglass_polyethylene
—other(explain)
If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of
certificate)
Dimensions: 10.5'long x 5.8'wide—1500 gal.
Sludge depth: 0"
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness: 0"
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: STICK WITH HINGE FLAP.
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
Tank has liquid only. Liquid level is at bottom of outlet invert and tees are intact and clear.
GREASE TRAP: No (locate on site plan)
Depth below grade:
Material of construction:_concrete_metal_fiberglass_polyethylene_other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
• Page:8 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
TIGHT or HOLDING TANK: No (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/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date cf last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: XX (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.):
No solids or high stains present,liquid level at bottom of both outlet Pipes.
PUMP CHAMBER: No (locate on site plan)
Pumps in working order(yes or r:o):
Alarms in working order(yes or 70):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:
_X_leaching chambers,number: Three 500 gal drywells.
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.): High stains in chambers indicate chambers have never had more than 6"of standing water.
CESSPOOLS: No (cesspool must be pumped as part of inspection) (locate on site plan)
Number and configuration:
Depth—top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
PRIVY: No (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.):
• Page 10 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
I
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
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.
Wood Duck Road
Water
Service
38 43
44
53 63
68
a �
0
• Page I I of I 1
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 71 Wood Duck Road,Marstons Mills
Owner: Robert Wyatt
Date of Inspection: February 20,2007
SITE EXAM
Slope None
Surface water None
Check cellar Dry
Shallow wells None
Estimated depth to ground water: More than 15 feet
Please indicate(check)all methods used to determine the high ground water elevation:
_Obtained from system design plans on record- If checked,date of design plan reviewed:
_Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
Checked with local excavators, installers-(attach documentation)
_X_Accessed USGS database-explain: USGS topo map and town GIS
You must describe how you established the high ground water elevation:
Town groundwater contour map shows water below el. 55 and topo map shows property above el.70.
r 1
T N OF BA TA LE
T,OCATION (/ SEWAGE#
`VILLAGE i�� ASS SSOR'S MAP&PARCEL 000 o S�
LL �
�.S NAME&PHONE NO. da ll/ �e&ro me/I 6 - 779
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)2/ 0 U
NO.OF BEX02�74 '"-V-f
MS
OWNER
PERMIT DATE: C A/TE: 6 0�/o2D d-7
Separation Distance Between the: —,�r1S,Q(G77a�W
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
Wood Duck Road
Water
Service
i
r ;
fi
\ 38 4
• ti
a 44 k
53
63
i
68
TOWN OF BARNSTABLE CC
LOCATION 7f GyD®D I)L cx xp SEWAGE #
VILLAGE ASSESSOR'S MAP & LOT Qe U-DyS
INSTALLER'S NAME&PHONE NO. Oon-TO L® nZ
SEPTIC TANK CAPACITY 7 0�
LEACHING FACILITY: (type) t10 f9 Ll C C-s (size) /O> 41 O oL
NO. OF BEDROOMS �� r
BUILDER OR OWNER
PERMIT DATE: 2 COMPLIANCE DATE: .S
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
��� ���
,� � � � - �
� � �,�
�_�
?•,�
a � ^�
., gs
.. �� �-�
�` � � � �` V
2U d_��� Fee
No. /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: -✓
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
ZIpprication for 10iopool *potent Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( y)Abandon( ) L�J Complete System El Individual Components
Location Address or Lot No. Owner's Name Address and Tel.No.
Assessor's Map/Parcel
MOM acotl •cel 4a16'7-P135/a``//(�,/9 15
Installer's Name,Address, d Tel.No. Designer's Name,Address and Tel.No.
7 7/ 7 7/--�
Type of Building:
Dwelling No.of Bedrooms Lot Size �8&737sq.ft. Garbage Grinder("0
Other Type of Building of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow ® gallons per day. Calculated daily flow 00 gallons.
Plan Date Numbey of sheets Revision Date
Tile 7� � l! ® ®r� a_a
Size of Septic Tank Type of S.A.S. 2 — G D
Description of Soil 3/., J�/r l Z,�✓
Nature of Repairs or Alterations(Answer when applicable)
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 Certifi-
cate of Compliance has been issued th's Bo d o ealth. Of
Signed Date 7 / B
Application Approved by Date d 2-
Application Disapproved for the following reasons
Permit No. a y U a -/ram Date Issued L 0
———————————————————————————————————————
No. 2U d--2—)Sr ,Fee
Entered in computer:
_ THE COMMONWEALTH OF MASSACHUSETTS fes
7 to PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zipp ication for )Diopooar 6pztem Con6truction Permit
Application for a Permit to Construct( )Repair..( )Upgrade(V)Abandon( ) LJ Complete System El Individual Components
Location Addressor Lot No. Owner's Name,Address and Tel.No.
�j
/Assessor's Map/Parcel ��,,/�-•�•-fps ,/`//5 Maw 40114 ,
Installer's Name,Address,and Tel.No.." Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size �,7 7sq.ft. Garbage Grinder(/O
_. 1 Other Type of Building r.° neC o.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow A01 gallons per day. Calculated daily flow gallons.
Plan Date O Number of sheets Revision Date
Title /7h P / �GTI�
Size of Septic Tank �.`7 l�� Type of S.A.S. 3 �Od Q�i' G' of
2 �
Description of Soil 33. /}���
Nature of Repairs or Alterations(Answer when applicable) to
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 Certifi-
cate of Compliance has been issued by this Bo d ofHealth. /
Signed �.-t Date
Application Approved by Date y /l a 2-
Application Disapproved for the following reasons
Permit No. ? f)U t-;r� Date Issued �b D�
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTI Y,that the pPn-sit Sewage Disposal System Constructed( )Repaired( )Upgraded
-f Abandoned( )by 0/' ,`,�/D ; lo!nee��`"•
r at �/l/DD✓) I��LIr' I/e. /�O/"f�`4�S�Ji��has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. _�:S- dated / G?
Installer Designer
The issuance of s permit shall not be construed as a guarantee that the sy t m will function a de 'gned.
Date � 4 rn Inspector &I). h-
---------------------------------------
No. o —/ Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Mtzponl 6pgtem Coneutt tion Permit
t Permission is herebyranted to Construct Re r Upgrade Abandon
g ( ) ( )UPg ) sS
f System located at 7.3 1il eVz2 epC
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes 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 this mmut.
Date: `�k6Z61�- Approved by_ �wf �,✓ _
a
TOWN OF BARNSTABLE L" L
j LOCATION 7/ a aap nc cx xp SEWAGE # ,24®ot-
VILLAGE +AnsTOn-s TLC 5 ASSESSOR'S MAP & LOT 0-0g55
o L
i
INSTALLER'S N44ME&PHONE NO. � 2T0 � 1 M
SEPTIC TANK CAPACITY 7�®
LEACHING FACILITY: (type) lo�CL a�-, ' size) /O> 410 ,aL
NO. OF BEDROOMS
BUILDER.OR OWNER 64, 95
PERMTTDATE: �6 2 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
A ../ Z
A � 3
13 JL
TOP FNDN AT EL. 84.6' SYSTEM PROFILE TEST HOLE LOGS
ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT TO SCALE)
ACCESS COVER (WATERTIGHT) TO ENGINEER:ARNE H. OJALA, PE
WITHIN 6' OF FIN. GRADE
83,0' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM WITNESS: DAVID STANTON I "SA ue+GS ao.
82.3' s RUN PIPE LEVEL 2' DOUBLE WASHED PEASTONE DATE!_ 3/27/02
FOR FIRST 2' PERC. RATE = S ?_._MIN INCH > �
PROPOSED 1`01) 3' MAX.
81.7 GALLON SEPTIC I 10204
80.85' TANK (H- 1O > GAs 80.0 CLASS SOILS P# W
BAFFLE 79.44' 79.27
0 0 0 0 WppO DUCK
MIN o 79,17' F M C] o Q o 0 0 0 4' AROUND ELEV.
( 2 % SLOPE> �6' CRUSHED STONE OR MECHANICAL
COMPACTION. <15.221 C2]> � ED a 0 0 o 0 o o
2' o 0 0 0 0 0 0 o a o 77.17' 00 Q 82.8' Locus
DEPTH OF FLOW =�_ SLOPE) < 1 % SLOPE)
TEE SIZES 3/4' TO 1 1/2' DOUBLE WASHED STONE-""'
TONE FILL
INLET DEPTH = 10„
6"
OUTLET DEPTH _L� A LOCATION MAP NTS
=
LEACHING 5.37' •• 10YR 3/2 L
FOUNDATION--- 42 SEPTIC TANK 53 14
D' BOX 12' FACILITY ASSESSORS MAP 30 PARCEL 45
MAX 6
SL
BENCH MARK - TOP OF CONCRETE BOUND
ELEVATION 84.9' 71,80' Cl
LS
60" 10YR 5/8 77.80'
„) + 84.9 C2
/ NOTE: SILT LOAM VARIES
84.9 SILT LOAM FROM t4' - t7'
85
84 2.5Y 6/2
+ 85.3 75.8'
C3
MED/COS
_I + 83.1 132" 2.5Y 7/4
71.80'
GREEN HOUSE 5' REMOVAL OF UNSUITABLE NO WATER ENCOUNTERED
(QUONSET HUT) SOIL REQUIRED AROUND
PERIMETER OF LEACHING NOTES:
r FACILITY, DOWN TO SUITABLE
83.3/ \ SOIL LAYER, REPLACE WITH ;
CLEAN MED. SAND. SEPTIC DESIGN: (GARBAGE DISPOSER IS NIOT ALLOWS > 1. DATUM IS APPROXIMATED FROM QUAD
NOTE: UNKNOWN LOCATION OF 2ND + Ba.3 ` ,
FIR SAPLING \ >>
CESSPOOL NOTE: SILT LOAM VARIED IN F"_DN . ` Pf 7�rRCCMS • ` -p n� -
DEr:It��� 1.: _ .gin GnD e. MUNICIPAL WH i ttk I t_hiJ iiiyG
+ .9 C � TEST HOLE FROM *4' TO 7`t _+ t
DOWN USF A 440 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8' PER FOOT.
\ -. . SEP'TIC TANK: 440 GPD ( �) = 880 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 1n .
<9 1 1500 5. PIPE JOINTS TO BE MADE WATERTIGHT.
+ 1.9 USE A _ GALLON SEPTIC TANK 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
LEACHING: ENVIRONMENTAL CODE TITLE V.
a"o SIDES: 2(33.5 + 12.83) 2 (.74) = 137 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
ao + 83. USED FOR LOT LINE STAKING.
+ C000. BOTTOM: 33.5 x 12.83 (.74) = 318 g. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4' PVC.
12" AKS
TOTAL: 615 S.F. 455 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT
+ USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED
+ 80.0 FROM BOARD OF HEALTH.
°D EQUAL) WITH 4' STONE ALL AROUND) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE
+ 84.2 DECK 84.5 a LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR
V. Bz.s' INV. 81.7' fi 4 TO COMMENCEMENT OF WORK.
EXIST.S DWELL. j
N D TITLE 5 SITE PLAN
84.4 100.0 PROPOSED SPOT ELEVATION OF
g 84.1 83.9 100x0 EXISTING SPOT .ELEVATION 73 WOOD DUCK ROAD
/ I GRAVEL DRIVE / PARKING IN THE TOWN OF:
IW s 1 2.7 � 00 PROPOSED CONTOUR (MARSTONS MILLS) BARNSTABLE
.
LOT 34 ��� / 00 cge�F / 87.0 100 EXISTING CONTOUR PREPARED FOR: BORTOLOTTI CON STRUCTION/HAWES
38,737t SQ. FT.
3.8 { 24 82P \ /
1 82.1 /
� 30 0 j0 60 90
/ 1 81.5 + BOARD OF HEALTH
IJ \ G 82.7
MA SCALE: 1" = 30' DATE: MARCH 30, 2002
APFROVED DATE
ff 80.5 / G fax '362-9880
�- 6080.0 N f 1N OF
79.7 down cope engineering, inc. ° � � � �` �y
o NE y ARNE H. c
6.0 E wl QAD CIVIL ENGINEERS s o,H. 3 OJA� N
F��
R�2.67 ` ,.. .. ` � `�'�N CI{ LAND SURVEYORS ° Zssao °
6 `95.53 - ss a� �� ,r FC1STEa,OJALA J?
% __ F
- - - - lT2 /o
.5 W-Q 939 vain st. yarmouth, ma 02675 AR N s s
02--060 .s. DATE
r