HomeMy WebLinkAbout0091 ANGELA WAY - Health 91 Anger Way, West Barnstable
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LOCATION:
VILLAGE: LA_9
LOT # : PERMIT
INSTALLER'S NAME: G�'niS� I >S
INSTALLER' S PHONE # :
LEACHING FACILITY: (type) a- le1j S (size) //X Ll g 1
NO. OF BEDROOMS:
BUILDER OR OWNER: GC✓t6
P_ERMI_T DATE:
'COMPLIANCE DATE: J ._ _ •-------�-I
DRAW DIAGRAM ON BACK
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 91 Angela way C
Property Address W
MURPHY, KEVIN P & JOAN 'm
Owner Owner's Name
information is CIA
required for every Barnstable �,{�� Ma 02668 6/1/16 s
page. Cityrrown State Zip Code Date of Inspection -4
t'+
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 forms A. General Information
on the computer, `
use only the tab 1. Inspector:
key to move your
cursor-do not Michael DiBuono
use the return Name of Inspector
key.
DiBuono Sewer and Drain
Company Name
8 Johns path
Company Address
S Yarmouth Ma 02664
Cityrrown State Zip Code
508-364-9587 S103522
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000). The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the-Local Approving Authority
6/4/16
,joector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface •Sewage Disposal System Page 1 of 17
P Y 9
kqjd V/s
Commonwealth of Massachusetts
Title 5. Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
91 Angela way
r Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
requedfo is Barnstable Ma 02668 6/1/16
required for every
pages City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
System contains a 1,500 gallon septic tank as well as a concrete distribution box and 6 flo diffusers.
System is currently leaching properly
B) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
* A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17.
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
91 Angela way
Property Address
MURPHY, KEVIN P &JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Y.
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
a
9 ea An I 1 way
Y
.f
Property Address
4u MURPHY, KEVIN P &JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. CitylTown 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 '/2 day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
tiM 91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
91 Angela way
Property Address
MURPHY, KEVIN P &JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
❑ ® Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field(if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 4 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
System contains a 1,500 gallon septic tank as well as a concrete distribution box and 6 flo diffusers.
System is currently leaching properly
Number of current residents:
2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ® Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d 378 Gpd
9 ( Y 9 (gp ))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
<cG
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
91 Angela
ea way
Y
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is Barnstable Ma 02668 6/1/16
required for every
page. 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:
None provided
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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
. Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
..,M 91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
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:
19 years
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2.5
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.):
System vents throught the roof
Septic Tank (locate on site plan):
Depth below grade: 1.5
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
1500
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
Sludge depth:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
7M 91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is Barnstable Ma 02668 6/1/16
required for 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 24
Scum thickness
3"
Distance from top of scum to top of outlet tee or baffle
42"
Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick
How were dimensions determined?
Tape Measure
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
No evidence of Ieaking,Tees and or baffles in place at time of inspection.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
Date
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
. Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M 91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. 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.):
Tees are in place and levels are normal.
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):
1500
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert Level and at normal level
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
Commonwealth of Massachusetts
v Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 91 Angela way
Property Address
MURPHY, KEVIN P &JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
® leaching galleries number: 6 flos
❑ 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.):
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
h Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
i 4.N 91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
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.):
No ponding no break out
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
91 Angela way
M
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
❑ hand-sketch in the area below
® drawing attached separately
M
t5ins•3/13
Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
° a 91 Angela way
Property Address
MURPHY, KEVIN P & JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
page. City/Town 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: 10+ ft
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: 10/15/97
Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers- (attach documentation)
II
❑ Accessed USGS database -explain:
You must describe how you established the high ground water elevation:
Test hole data on plan.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
6/27/2016 Assessing As-Built Cards
TOWN OF iZKST.a`
9iliPUAi@11'1JA 4S C (5—
LOCATION: 1�1/ (N`o
VILLAGE:
LOT 1: / PERMIT i 1
INSTALLER'S NAME: -c %° G�/s O•s '
INSTALLER'S PHONE N:
LEACHING FACILITY: (L e) (size)/�x�lg,
NO. OF BEDROOMS:
.. BUILDER OR OWn�,,:
�e,Vi�6
PERMIT D11TE � C
COMPLIANCE DATE: �nal�
DRAW DIAGRAM ON BACK
66K
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Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
91 Angela wa M
9 Y
Property Address
MURPHY, KEVIN P &JOAN
Owner Owner's Name
information is required for every Barnstable Ma 02668 6/1/16
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
TOWN OF 9�fI 5A RtsST�
LOCATION: ^� tv� --- -�_-
_ VILLAGE: L'-QSd I
an
LOT # PERMIT
INSTALLER' S NAME:
I NST A LLE R S PHONE # • .
(size �
- ows ) / X
LEACHING FACILITY: (type)
NO. OF BEDROOMS:
B DER OR OWNER: =--
P1RMIT DATE: 41 om Iq
Tr I
COMPLIANCE DATE:
DRAW DIAGRAM ON BACK
----- -
�j -
� 3
�(TJ 156K
No. Fee%���
THE COMMONWEALTH OF MA ACHUSETTS Entered in computer: 1
Yes
PUBLIC HEALTH DIVISION -TOWN OF BAR TABLE., MASSACHUSETTS
Rpplication for Digool *p.5tem Con6tructton Permit
Application for a Permit to Construct( LOepair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Alk Owner's Name,Address and Tel.No. . L Q,,�i�
Assessor's Ma /Parcel Lzk �%j �ov -^ �1_NU 15
Installer's ame,Address,and T 1.No. r ® Designer's Name,Address and Tel.No. Q 1
Type of Building: t, f61
Dwelling No.of Bedrooms_l Lot Size 9q000 sq. ft. Garbage Grinder( )
Other Type of Building yA—, �¢.No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow L gallons per day. Calculated daily flow Y L40gallons.
Plan Date 1 9 Number of sheets ( no- Revision Date
Title
Size of Septic Tank ISO Type of S.A.S.
Description of Soil
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 Enviro ode and not to place the system in operation until a Certifi-
cate of Compliance has been issued by d of e _
Signed Date /d
Application Approved by Date
Application Disapproved for the fo owing reasons
Permit No. o Date Issued
o, - " Fee
THE COMMONWEALTH OF MA ACHUSETTS Entered�in computer: 1
PUBLIC HEALTH DIVISION —TOWN OF BARN TABLE, MASSACHUSETTS <• , es
UB
,. 01p�prication for nioogar *proem Congtruction Permit
�
+ ... I; a�pplication for a Permit to Construct( LPFepair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components
%
Location Address or Lot No. F' (� [�Aft W Owner's Name,Address and Tel.No. L
Assessor's Map/Parcel ., W��� � w�� � �• 3
Installer's Mune,Address,and Tel.N!tohs
O Designer's Name,Address and Tel.No. rr` � l P,C) fan
O Type of.Building:
Ir t�1
is Dwelling No.of Bedrooms _ Lot Size 99000 sq.ft. Garbage Grinder`( )
�• Other Type of Building {Uv" �,.O=WANo.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow L) gallons per day. Calculated daily flow 4 gallons.
k '^4 Plan Date Number of sheets .. Revision Date
Title
Size of Septic Tank ISOO (;t J1 A, Type of S.A.S.
40
Description of Soil
Nature of Repairs oc Alterations(Answer when applicable) A `
Date last Ainspected: �.
` Agreement: a -
' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system.
An accordance with the proyisions of Title/5'of the Envir al de and not to place the system in operation until a Certifi-
cate of Compliance..has been issued by a0of e .
Signed €" Date �� 7
Y� Application Approved by _ Date
Application Disapproved,for the fol owing reasons `
Permit No. gr !>_-!r l Date Issued
----- —"=— —------ --- ----- ----- —
'i THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(` )Repaired( )Upgraded( )
Abandoned( )by
at \1 has been constructed in acco dance
with the provisions of Title 5 and the for Disposal System Construction Permit No. ated
Installer Designer
The issuance of this permit shall npot be jconstrued as a guarantee that the system w 11 function as4esigned.
Date fie) 11 I 0 fl Inspector yi AI ��'• v � l /A/ '-tk
- ---------------------------------------
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Migpogal *pgtem Congtruction Permit
Permission is hereby grailted to Construct( 'Repair( )Upgrade( )Abandon( )
System located at V� 1 �.�s�o�� , \A-J
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 permit.
Date: Approved by
No.- - 7- -7
BOARD OF HEALTH Fee----- --
— �
TOWN OF BARNSTABLE
0(ppCicationArVell Con0ructioupermit
Application is hejeby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at:
pp _
�--�----�---_j 2-.� CO— G/h7 — — — --------------------------------------—p-----------—— —— ———
/ Location —/Adddress Assessors Ma and Parcel
e'= 9 --- -- -- -- -— 2 --4�`11"L---c.:�-' - �--`-----------------------
Owner f(ddress
- - ----- - - -= ----------------
Installer — Driller Address
Type of Building
Dwelling 14 o u S C
Other - Type of Building -------------------- No. of Persons--------------------------------------------------_-
- ------------ -
Type of Well-<<- ------------ Capacity--------------------------------------------
Purpose of Well rkte-el--------------------
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in operation until a Certificat .of ompliance has been issued by the Board of Health.
Signed /
g 4reans.:
3J 7/ 17—_---- date
Application Approved Bydate
.Application Disapproved for the followin --------------------------------------------------------------------------------------------------
------------------------ -----------------------------------------------------
----/d.1
----------------
-------- -----------
date
Permit No.- - - -------- Issued ---- - - --
BOARD OF HEALTH
TOWN OF BARNSTABLE
(Certificate (Of Compliance
THIS IS TO^CERTIFY, That the Individual Well Constructed ( Altered ( ), or Repaired ( )
bY----------AA )' —-------------------------------------------------------------------------------------------------------------------------
lnstaller
has been installed in accordance with the provisions of the Town of Barnstable Board Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. '- .--Dated--- ------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------------------ - --- -- Inspector------------------------------------——-- -----
j .r"��. s�,• + �� ..:+ �. � � +� � .-tea--• .r.-� .. .,. ..'..R.. . . ,......�.y+'— .''�'.S`trS'7�.w•
4! J �
I .
No.=- - - --- ----- Fee----- ---------- -
BOARD OF HEALTH
TOWN OF BA'RNSTABLE
App[icat ion for Ve[r C.ongtruct ion Permit
Application is hereby made for a permit to Construct ( ), Alter ( ), or Rpir ( )an individual Well at:
q1' J - - k' -� --- ---- -- ---------------------- --- ---- -- -- -
/ Location —/Address Assessors Map and Parcel
I t
t L J�.—G �o e —t J G`-1� — J-/r / — -- ---
Owner Address
Installer Driller Address
Type of Building
Dwelling-----u 2_� 5---------------------------------------------------
4
Other - Type of Building ----- No. of Persons------------------------------------------------
k / 1
Type of Well L---------------------- - ------- Capacity----------------`--
Purpose of Well-- -ti' a '�- -�'`"- ------------------
1
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in operation until a Certificat .of ompliance has been issued by the Board of Health.
Signed -- --- - -- -------- 9IJ�/�'
1 0 9 date
Application Approved By date
Application Disapproved for the following rea ns:----------------------------- —---------------------------}-- - -
-- --------------------------------------------- ----------- ------------------------
date
Permit No. -- -��----- ------ —-------- Issued—=------ - -- -
— — = —
da?e
.. __�.r.r n:.oer� -._ .._� -._..-�-.- __�a+�. -----'.,...v.-'�y�..ww�.�;,w.1...n.yr:ar.w.nr+t,.w+-rM.-cars.-ee�a-w.w!.�•x4s+rYea.r.i+�.. - _ .._ �,...�.m—
BOARD OF HEALTH
i TOWN OF BARNSTABL''E
-_ Certificate Of !Comphance -
=THIS IS TO CERTIFY, That the Individual,_W..ell Constructed( "J, Altered ( ), or Repaired ( )
i - ---- - - - -- -
Installer
JG -----------------------------
has been installed in accordance with the provisions of the Town of Barnstable Board j4 Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. -- ---,/�- ---Dated-=----------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
1
SYSTEM WILL FUNCTION SATISFACTORY.
DATE---------------------------------- --------- Inspector----------------------------------
----------------------------------------
i
BOARD OF HEALTH ,
TOWN OF BARNSTABLE
Yell Con5truct ion Permit
No. - r r --= Fee ----- ---------
..✓' ,..-
'Pe hission is hereby granted-AAS-u-'-"`—�^-`-�
to Cog9ns/truct (✓/), Alter ( ), or Repair ( ) an Indiividual Well at:
------------------------------
Street
as shown on the, a P lication for a Well Construction Permit
---------- Dated -r---
No. - -� --
I
--------- _4----------
- Board ealth
DATE----- j
i
ENVIROTECH LABORATORIES, INC.
MA Cer...No.: M-MA 063
449 Rte.130
Sandwich, MA 02563
(508) 888-6460 1800-339-6460
FAX(508) 888-6446
CLIENT: Bill Lento LOCATION: 91 Angela Way
ADDRESS: 229 Percival Dr. W. Barnstable, MA 02668
W. Barnstable, MA 02668
COLLECTED BY: DA Scannell SAMPLE DATE: 4-7-97
SAMPLE TIME: 12:OOPM
WATER SAMPLE TYPE: New Well DATE RECEIVED: 4-7-97
LAB I.D. #: 974-082
WELL SPECS.: N/A
RESULTS OF ANALYSIS:
Parameters Units Recommended Results Method
Limits
Coliform bacteria /100ml 0 0 9222 B
pH pH units 6.0-8.5 4.72 4500 H+
Conductance umhos/cm 500 154 120.1
Sodium mg/L 28.0 13.4 200.7
Nitrate-N/Nitrite-N mg/L 10.0 0.40 4500-NO3 E
Iron mg/L 0.3 0.40 200.7
Manganese mg/L 0.05 0.338 200.7
Volatile Organics ug/L See attached report. ND 502.2
COMMENTS: Low pH indicates high corrosive characteristics.
Iron level is not a health hazard, but may cause taste and staining problems.
Manganese is not a health hazard, but may cause aesthetic problems.
YES WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED.
Date # /G/�
Ronald J. Saa i
Laboratory Director
<=less than
>=greater than
TNTC=too numerous to count
FROM TOXIKON PHONE NO. : 6172757478 Apr. 16 1997 04:17PM P
Page 2 TOXIKON CORP. REPORT Work Order 0 97-04-158
Received: 04/09/97 Results by Sawte
SAMPLE ID 97,4082 FRACTION 01A TEST CODE 502 2 NAME VOC IN H2O 8Y PUk6E & TRAP
Date & Time Collected 07 category RATER
Dichlorodifluoromethane ND 0.50 1,1,1,2-TetrachLoroethane NO 0.50
Chloromethane _ NO 0.50 1,1-DichLoropropene NO O.SO
Vinyl Chloride NO 0.50 Bromoform ND 0.50
ND 0.50
Eromomethane NO 0,50 1,1,2,2-Tatrachloroethane
Chloroethane NO 0.50 1,2,3-TrichLoropropane NO 0.50
Trichlorofllloromethane _ 0.50 promobenzene �IN D 0.50
1,1-Dichloroethene NO 0.50 2-Chlorotoluene NO 0.50
Methylene Chloride ND 1.5 4-Chlorotoluene ND 0.50
trans-1,2-Dichloroethene ND 0.50 1,3-Dichlorobenzene _4D 0.50
1,1-Dichloroethene NO 0.50 1,4^DichLorobenzene NO
cis-1,2-Dichloroethene NO 0.50 1,2-Dichlorobenzenc NO 0.50
2,2-Dichloropropane NO 0.50 1,2-Dibromo-3-Chloropropane ND 0.50
Chloroform Ng 0.50 1,2,4--Trichlorobenzene ND 0.50
Bromochloromethane ND 0.50 MexachLorobutadiene ND 0.50
1,1,1-TrichLoroethane NO 0.50 1,2,3-Trichlorobenzene NO 0.50
1,1-DichLoropropene ND 0.50 Benzene ND 0.50
Carbon Tetrachloride ND 0.50 Toluene ND 0-SO
112-Dichloroethene NO 0.50 Ethylbenzene NO 0.50
Trichloroethene ND 0-50 m-Xylene NO 0,0
1,2-Dichloropropane _ND 0.50 P-Xylene ND _ 0.50
Bromodichtoromethane ND 0.50 o-Xylene ND 0,50
Dibromomethane ND 0.50 Styrene _ NO 0.50
cis-1,3-DichLoropropene NO 0.50 Isopropylbenzene NO- 0.50
trans-1,3-DichLoropropene . D 0.50 n-Propylbenzene NO 0,50
1,1,2-TrichLorotthanr ND 0.50 1,3,5-TrimethyLbenzene NO 0.50
1,3-Dichloropropane NO 0.50 tert-8utylbenzene NO 0.50
Tetrachloroethene _-_NO 0.50 1,2,4-TrimethyLbenzene NO 0.50
Dibromochloromethane NO 0.50 3ec-8utylbenzene _^,u 0.50
1,2-Dibromoethane ND 0.50 p-IsopropyltoLuene ND 0.50
Chlorobenzone ND 0.50 n-8utylbenzene ND 0.50
Napthalene ND 0.50
Notes and Definitions for this Report:
DATE RUN 04/14/97
ANALYST
INSTRUMENT � B
UNITS ua1L
DILUTION 1
ND = NOT DETECTED AT DETECTION LIMITS
Dettartment of Environmental Management/Division of Water Resources
its . WELL'COMPLETION REPORT 'W q 7 —
WELL LOCATION. GEOGRAPHIC DESCRIPTION
Address
N S E W of
(reetl (circle)
City/Town
Well owner/ (road)
Address
N S E W of
Imi.in eenthsl (Circle!
Board of Health permit obtained: yes •no❑ intersect. w/ (road)
WELL USE WELL.•DATA ,
Domestic u Public❑ Industrial ❑ Total well depth ft.
Monitoring❑ Other Depth to bedrock - ft.
Water-bearing rock/unconsolidated material:
Method.drilled EC a L✓ r
Date drilled
,h /s 7 Description
f •
Water-bearing zones:
CASING
Type Sc 4 '1 O /a r ( 1) From To
Length—It. Dia(J.D.) in. 2) From To
3) From To
Length into bedrock—ft. Gravel pack well: dia.
fProtective well seal Screen: dja.
Grout-0 Other Slott` length3 from-J toJs
ISTATIC WATER LEVEL(all wells)' = ,
Static water level below,land surface .ft. Date
WELL TEST(production wells)
Drawdowil .3 ' ft. after pumping 3 hr: min.at gpm
How measuredX-,,4 °pLRecover* `fft�after_hr. min.
LOG of FORMATIONS COMMENTS S
Ma
te
riels' .9 From To
Nl r L•t J4 -A
Driller.
/tit r Firm CG Nye �f'fN e/l✓��t f�u
i
Sa., j• J r
Address Paw �6 c�
City/Town
r
Supervising Driller Reg.# J S�
Si nature of supervising registered well driller
Mew print firmly
• BOARp OIF HEALTH COPY
,sd,•2µ,:.«i.t.,r,'�..r.an.a�;fin,.wx 5,h,:x«.d�..<rn.'f..,.{`�"'.w•��i�'.
BENCHMARK SOIL TEST
TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR _
3. 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE OF SOIL TEST Q �'' P '. ,,�"'Qf7
ELEV.
= 4 CLEAN SAND SOIL TEST DONE BY � ,Y`[ � °�'^��">'���
(ASSUMED) CONCRETE WITNESSED BY
COVERS LOAM AND SEED OBSERVATION HOLE 1 ELEv= 27� f OBSERVATION HOLE 2 ELEv.- 33
4' SCHEDULE 40 PVC PIPE PERCOLATION RATE 2 MIN. NCH AT INCHES PERCOLATION RATE < 2 MIN. NCH AT 9G y INCHES
MIN. PITCH 1/8 PER FT. 2' LAYER OF
1/8' TO 1/2' DEPTH HORIZ TEXTURE COLOR MOTT. OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER
2 .8 M x WASHED STONE VENT w o 0 0 _
/ p 4' CAST IRON PIPE 2 �' z c, �3 m, ✓ NOT REQUIRED g ,9 <o y �, v` � �/vs u,rFsp� 8 A L OA1%4 .� vnisai rA33G�
(OR EQUAL MINIMUM -" '
PITCH 1/4�PER FT. 2 z 1 CU. FT. OF
S FEfQ 5 CONCRETE
FLOW LINE L�-V 1 M ,b�3 a ANCHOR 3 0` ..`. _. _. �4 jKj
ELEV. s MIN. p
� /.7s..� 22. . a e � " �p a - 614 � � _.SF)�.!La �. � 2 O.S t 719 � ' .E L. Z
V• ' LEVEL o a ELEV. _ ___.. __-..._. _
ELEV. _ -� .4b BAFFSLE ELEV. = 3/• � 6' SU ELEV. _ �/•34 _ _DISTRIBUTION ELEv. _ H / C� C R C 1 r, C� M � , — z M Fa/utv, --
LIQUID OUTLET BOX 2 �'M3 INFILTRATORS WITH STONE IN AN -ram p rAAd_z)
DEPTH TEE 4 FEET 14 INCHES (TO BE PLACED ON FIRM BASE) TO BE WATER TESTED
5 FET 19 INCHES IF MORE THAN ONE OUTLET I �' / TRENCH FORMATION
6 FEET 24 INCHES � 500 GALLON 1,�� WELL N' r/Q WATER', ENCOUNTERED AT t 4'f ELEV. _ /�' NQ WATER ENCOUNTERED AT / G 8 ELEV. _ 9
7 FEET 29 INCHES (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION `, ZONE
8 FEET 3.4 INCHES SEPTIC TANK 3/4' TO 1 1/2' INDEX
WASHED STONE SYSTEM (SAS) ADJUST
LEGEND: DESIGN CALCULATIONS
NUMBER OF BEDROOMS
_ DISPOSAL UNIT
80TTOM OF 'LEST HOLE - ff ELEV. _ •�•w EXISTING SPOT ELEVATION 00%0
SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. _ EXISTING CONTOUR ----00-. -- GARBAGE DI
�x NOT TO SCALE FINAL SPOT ELEVATION TOTAL
G MA ED FLOW
R./DAY X 'f BR. `�" C GAL AY
VO7"E 1 2 NA Y319 Z t f 1✓s'c f�to r.'+ e F 7'C] Z, S T 3 i''t' �j FINAL CONTOUR ( ) ID
SOIL TEST LOCA710N REQUIRED SEPTIC TANK CAPACITY � .GAL
Y P mac. 3w_ a r1 d f,W,� h, �r /VS 7 9 4 �.. L� f�l8 s qt ACTUAL SIZE OF SEPTIC TANK /So a GAL
S UTILITY POLE -�-
7'"c� / 7"" y. �. r`T / ctr„! « ! ` j^ F'"" Z. w q T"�IZ TOWN WATER —WSW® SOIL CLASSIFICATION (nitEDI✓nit ��
" � �,,�� ®vim tt ,^ -- `" 1'A Q L i S�"19 SE ^✓ r / " CATCH BASIN t� DESIGN PERCOLATION RATE S � MIN./IN.
+o✓z, t 0`,�n°', T'A 4 4� I7 Al✓ I ( _ :c , , GAS LINE G LEACHEFFLUING AREAING RATE,� h t t 6 x G"'� GAL/DAY/S.F.
��� c.�,,��!Z)�l firt /7` ?"d a 1!'F ,t't i9 C�.G? .9 T.7��'I�'N4""1J �./�v�;" � b_ � � L �lt C i L SQ. FT.
.� ,r f.
'! •? `� �' , n, J J {� - LEACHING CAPACITY (AREA X RA-7) 443
GAL/DAY
/ 1 2 4443�' g �, RESERVE LEACHING CAPACITY GAL/DAY
r
(7-0W" 1 Z'x 49, , 7r 44 � GA4 c7,�y
NOTES:
1. ALL WORKMANSHIP AND MATERIAL��LL�CONFORM TO D.E.P.
• ._ T�' \ k �' TITLE 5 AND THE TOWN OF Z3 A RULES AND
REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE.
-
• 9 e 2 ALL GONERS TO SANITARY UNITS SHALL BE BROUGHT TO
WITHIN 6' OF FINISHED 'GRADE.
3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
aP WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
..
F O,
10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS.
4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL.
`��`—•-•. BE MORTARED IN PLACE.
► .�, j �,1-�---. - h -y -�' 5. NO CETERMiNATION HAS BEEN MADE AS TO COMPLIANCE WITH
1"yc 1C r __ }�4= .s,.. ..<.. D�FFRFSl AR _7f)AIjNC., RFt.;l_1! AT1f?AfC,-nlMtacq !.d PPL1L`1►dT_L�_T[�-_-__-- � -
OBTAIN SUCH DETERMINATION FROM APPROPl21ATE AUTHORITY.
6. UT1Lf11ES SHOWN ARE APPROXIMATE ONLY. EXCAVATION CONTRACTOR
IS TO CALL "DIG-SAFE" AT 1-800-32-2-4844 AT LEAST 72 HOURS
f . �, — r �-" •. �ji ,.y y ���' ' - ^�, PRIOR TO COMMENCING WORK ON SITE.
/• e' Y ""�-�• .� ``• �. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS
1)eCk• SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE }
/ �y, f --i `'`'•,� .-. ! 8. PARCEL IS IN FLOOD ZONE CG I
1 q ... Gel'
j 9. LOT 1S SHOWN ON ASSESSORS MAP / AS PARCEL
R 12 C P G s er)
x JO. A G.L VNLSu i TA Q L.�' �•r.�7 T:l='R i+a L C•G -+'G�) .S N�q J.E- 9
� a �. ,: * �". _,..�. ....._ }...,..,,,.,.,....,� �•� `:.. ``�,,. � L't E' (<iris 4 V,�'Z? F�A� ^✓?.��l�'. �1 MD �'0:2 !?
M�NJMuM of A [ t ATZQW40 S19.3' >�" 43E
`f . � �
r J - S 7—am tin. 0t-t_
y
AEU Aa z'7Z 0.r e r vr.�v� Y �2 J �
... f ...,w. � .......m /".-.a�,,[4'�.. `� - - , � '�rl� at��}�• �t.%.d5!��✓ �` i ;,; ,`. � •S.
�; �k�a s' ! ii Gj r'hJ VV'I L c Q JC ,
,gas �: RT
�;�wL APPROVED: BOARD OF HEALTH
4
Y
/ /yn
Y J{) .._... ,fit e / ,,�r/
+•" ;. J _..�.. .. A t�„�'q:.. At �
. ►./t3 -0 /
DATE GENT
PROPOSED SEPTIC DESIGN
FOR
! +
_ - MOP $ f t7
--'- �y 14 PROJECT LOCATION
_ _, _�
" _.
j 1 W� 8Li
'lei o
-�- ��~-�- "� ,����� � .k ,--- ,� CRAIG R. SHORT
��e��t,� PROFESSIONAL ENGINEER508- �
P. 0. BOX 781
` ,o ' j.: � �'�" _A s , . gyp 'f ?s # �; 385-6530 DENNIS, MASS. 02638
r � `"`'•*. °�,,.,,,� � ,�'` DATE SCALE ►+ �
,� REVISED � I�� / c�, � ( JOB N0.
f REVISED
LOCATION MAP 3,/f i/9 �' SHEET / OF l
0 1996 CRAIG R. SHORT, P.E.
BENCHMARK
TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR SOIL TE T ELEV, = Q3• 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE Y DATE OF SOIL TEST _2 Q P �'� -f-0
CLEAN SAND SOIL TEST DONE BY -D 0,--e �' �; �'/ -��'-/� /N -
(ASSUMED) CONCRETE WITNESSED BY Tor" M
COVERS 4' SCHEDULE 40 PVC PIPE LOAM AND SEED OBSERVATION HOLE 1 ELEV.. 27's
OBSERVATION HOLE 2 ELEV, �3
MIN. PITCH 1/8' PER FT. 2' LAYER OF PERCOLA71ON RATE e a MIN.ANCH AT 614, t INCHES PERCOLATION RATE < L MIN./INCH AT 9G-' INCHES
1/8' TO 1/2' DEPTH HORIZ TEXTURE COLOR MOTT. OTHER DEPTH HORIZ TEXTURE I COLOR MOTT. OTHER
3 2 8J M x WASHED STONE VENT wo oD _ _ V_./o c)Z)
G 4' CAST IRON PIPE - * � c 3 p, �?M,.✓ NOT REQUIRED �
(OR EQUAL1 MINIMUM �^�'2- 8 /r? L Of3 M UNS v�,AFL 8 L p�g� "' v,,,su,rA��•
PITCH 1/4"�PER FT. @ Z 1 CU. FT. OF _ �~^
SPEf �� CONCRETE S u�3 soil "' ��' S vp z opt - -
FLOW LINE e Cf,c9.1' oa ANCHOR
/'� 3 p�
ELEV.
3. 10' '
Y _ _ i i�/z
_ _
MIN 2 p C<'q
. /.7,5 LEVEL oo. „� 1 � n / 10 " Z8-is �"� C ' `S�.v L- L 2p'.;. 7 8 ~r � L z G
-i 'YKS ,k ELEV. - FF
ELEV. .�2,DO B GAA� ELEV. .� 31,Sp 6 SUM P ELEV. s J/,3c � t E / — - - --- L A r:.
DISTRIBUTION _� G H / GN C.4 RA C t 7-Y Cz M�Ij/LIM MED/ten —
LIQUID OUTLET 2 .�"'� INFILTRATORS C
DEPTH TEE4 FEET 14 INCHES (� BE PLACED ON FlRM BASE) TO BE WATER X TESTED _�- WITH STONE IN AN Z 14 s a
5 FEET 19 INCHES IF MORE THAN ONE OUTLET / X n Q TRENCH FORMATION
6 FEET 24 INCHES 1500 GALLON - !f, a 2f n/p WATER ENCOUNTERED AT / .r 9
e FEET
39 INCHES SEPTIC TANK (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION to WELL NO WATER ENCOUNTERED AT ELEV. ELEV. _
ZONE
3/4' 1 1 1/2'Y SYSTEM (SAS) INDEX
WASHED STONE ADJUST
BOTTOM OF TEST HOLE oars � may, n ,�,s- LEGEND: DESIGN CALCULATIONS 4,
SEWAGE DISPOSAL SYSTEM PROFILE L--r-- EXISTING SPOT ELEVATION 00,0 NUMBER OF BEDROOMS
NOT TO SCALE OBSERVED WATER TABLE ( / / ) ELEV. - '`!E _ EXISTING CONTOUR ----00---- GARBAGE DISPOSAL UNIT ti/�
FINAL SPOT ELEVATION 0 ,0 TOTAL ESTIMATED FLOW
I�/O 77.E / 'LHA Y��l t�'v�/' k Z ' F. TO a ST"f3 f't�D FINAL CONTOUR 0 (Ir 2 GAL/BR./)AY X BR.) GAL/DAY
J f P 1'c^.0„ 4v,..7" E nJl.,-f Ai e tr lem-",F_ �' S n/;,c ;'�7 A �,� U F�20 SOIL TEST LOCATION REQUIRED SEPTIC TANK CAPACITY A:;-c GAL
T"p WELL- .7 0'.,,- ?"`*"j 1. t. ") /f,7 o ,. ,�s f�" ."'^ �1 �'s'R 7-4-Z- UTILITY POLE -O- ACTUAL SIZE OF SEPTIC TANK /Soa GAL
�� ��E D �� � � � � w✓ TOWN WATER -�W \�W SOIL CLASSIFICATION ;t•i -Zt I�,^�7-.tr?AJ13,) S
•' �' cc;? V oUr_� Cc P-�Lt�t 'J�ZI -S�`� �'!� a'��` o CATCH BASIN ®� DESIGN PERCOLATION RATE SS MIN./M.
'� �• GAS UNE G " EFFLUENT LOADING RATE •7 GAL/DAY/S.F.
AL.E/�QIZ^'C/ow" i7' 7-.:Z - rpG,,'3C�_,0 r7.7-_,,�?JHr.D AIAJ-A' /"a
/ �, �? I �VV LEACHING AREA (� I'x q f3 x 4 _ SQ. FT.
r t� �/ nV '� ' n� 1'P 2 ` - LEACHING CAPACITY (AREA X RATE) C° GAL/DAY
7.>A 2.�' RESERVE LEACHING CAPACITY �G" GAL/DAY
7,r 4 1 G.9 4/ Y
`�, -' --•_ , c'B v -`" '" ,�' 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P.
TITLE 5 AND THE TOWN OF � RULES AND
REGULATIONS FOR THE SUBSURFACE.DISPOSAL OF SEWAGE.
2 ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO
WITHIN 6' OF FINISHED GRADE.
3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
THSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
-�\
WI
�410 *•.�� 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
4, ti \ �` '` .. K "� USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS.
f ff '�j,' �.,` . ems, r 4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL
rG r ',� BE MORTARED IN PLACE
``R
NO u� RM1tv,hTOv HAS BEEN MADE AS icy COMPLIANCE NTH
4 u---'2�F- , DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO
ram,'
7~ '' r "~" `�;zz
--.,�► ^" .,,,� ` �'`7 J j OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR
IS TO CALL "DIG-SAFE AT 1-800-322-4844 AT LEAST 72 HOURS
PRIOR TO COMMENCING WORK ON SITE
7, CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE.
�� `C F O 8. PARCEL IS IN FLOOD ZONE® -
I 4 � ^h:
9. LOT IS SHOWN ON ASSESSORS MAP AS PARCEL '
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� ,L IL �. ... �..:, APPROVED: BOARD OF HEALTH
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DATE AGENT
PROPOSED SEPTIC DESIGN
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k1 4�1' PROJECT LOCATION
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" ' ,�,,�'' ,'�` < � ' .'� - - _r •_,.. , {j� d C C v s CRAIG P SHORT
PROFESSIONAL ENGINEER
�i 7'�t� �. l �. ,�,f' 4 I w.* ,✓ „~�. P. 0. BOX 781
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508— DENNIS,
,✓°� ' a , 385-6530 MASS. 02638
DATE.� �+.....+'''+ \j
SCALE
! 4 .1 2 f 1Q/'fT 1►► _ j
`�''.� - Z�• _Q } REVISED 2! ' 7 JOB NO.
' REVISED --�
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LOCATION MAP SED //,F 7. SHEET / OFI rw
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• 01996 CRAIG R. SHORT. P.E. _