Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0011 CARLSON LANE - Health
FA=133-1030 ARLSON LANErnstable J TOWN OF BARNSTABLE LOCATION I Car Is of\ Lri SEWAGE# 201IR - 3S`1 �-VILLAGE (.rJ c. ASSESSOR'S MAP&PARCEL %3 30 INSTALLER'S NAME&PHONE NO. A 4 B EXCayaA i O,n y`)rl-D G S 3 SEPTIC TANK CAPACITY 1000 LEACHING FACILITY:(type) sppQa,) (4c(Z) (size) 13 X 2S yt 2 NO.OF BEDROOMS 3 OWNER Lc_AooX / PERMIT DATE: g 1-Z L-0$ 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 I` AI- �l Zo'� Az' 33�1 0�" c L'Froni Cy = .y,7'L" CC rr11 No. b I 3J -7 Fee V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zippfitation for Disposal *pstrm Construction 3permit Application for a Permit to Construct( ) Repair(vJ'*Upgrade(") Abandon( ) ❑Complete System ndividual Components Location Address or Lot No.11 r4SCyN Lane Owner's Name,Address,and Tel.No. col00 X Assessor's Map/Parcel 133 30 WS} (t 34g6l,i 11 C�a r-1 so n Ltd L` - O A Q-0 Installer's Name,Address,and Tel.No.43j,�13 Ex �O Designer's Name,Address,and Tel.No.,Do vc Fla cr 4 V4-rcaSe"tj L D Forc54,A<klc Oa6y P.O BOX 331 H-ruJIM-1- Type of Building: Dwelling No.of Bedrooms 3 Lot Size $$ 000-- sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided 34/3 gpd Plan Date - 2.0 - 1$ Number of sheets 1Z_ Revision Date Title Size of Septic Tank /000 Type of S.A.S. 00 9<0 Wc- Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1420 2. 14 ZO 500 44< - 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 Enviromnental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. , Si Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 9 o 19-3 r-7 Date Issued ��--------------------- No. L b T1 Fee V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: fT Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for Disposal .pstem Construction joe mit Application for a Permit to Construct( ) Repair(vI"'Ag ade-(4) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No.II ��`.� ^ Owner's Name,Address,and Tel.No.K,cn L �(©o X Assessor's Map/Parcel -3 \44(4 �jat fiS ��_ ! L rJ LJ. O A-Q O Installer's Name,Address,and fel.No. 0 s. .a t XC.a k.�10 w Designer's Name,Address,and Tel.No.D,,vc Fla H�t r 4 4 IWT'c:�,Scrr L� L►i. C7a6_/q P.0 ROX 331 Hor, -�,cL, Type of Building: Dwelling No.of Bedrooms �'� Lot Sized sq.ft. Garbage Grinder( ) ~ Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided gpd Plan Date Number of sheets 'Z. Revision Date Title 1 Size of Septic Tank 1000 Type of S.A.S. Qr. �<_ �2 i Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1.120 �{7 ,(-�7�c . � �2© 500 L.IC. ,. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sig d Date - Application Approved by Date /J 7�(,_•r 4 Application Disapproved by Date for the following reasons Permit No. 2 o I Y r 3 S' ` _ 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 *N at // �n rI ��Q ��,t) has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.,')0(,-3,;-Zated Installer 3 3 :X Z�a Designer _D a j 2r #bedrooms .13 Approved des}.g• ow 3 gpd The issuance of this permit shall not be construed as a guarantee that the system will4unctio desigpea�~�" Date I 1 S 'r - Inspector Y. No's d l Fee B o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(t/ Upgrade( ) Abandon( ) System located at 11 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date 11 "Z G Approved by t j,., Town of Barnstable 0F1HE Tgyy Regulatory Services Thomas F. Geiler, Director MASS. _ Public Health Division MASS. 1639. 1% Thomas McKean Director fD MPS `200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: ' 12- I`t- 18 Sewage Permit# Zo18 - 35`1 Assessor's Map/Parcel 133- 30 Installer & Designer Certification Form Designer: -DmQc- F lei)%cr-4 sA Installer: S3 eytco vaA Iof% Address: -90 BOX 331 Address: I!I T Scrt-c - LQ E6no i ck FO rc sl cL a.Ic. On l 1- Z G - 18 8 ie i3 EXe-aLyv,--A was issued a permit to install a (date) (installer) septic system at I I ()a r-15or\ LiQ based on a design drawn by (address) J� o��t Flvtier-��{ dated 11^ o-18 (designer) _ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distri4ution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. DWD D. staller's Signa e LAHERTY,JR. No. 1211 T fW (Designer' Sigriatur ) (Affix-Desig J p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.. THANK YOU. q:\office forms\designercertification form.doc Town of 9701 tDeQartyaeat of 13egatafory�ervvices ��� 1+ pElblc Health u9'DSltE3E t?7` 200.Mom Strrot,Hyannis MA tl2541 rw r l l ,.. =0 0 Data y y� 1 Tsme F� - ° � ken PerCaemrdBy .' r or. y s s it J, witncn � IL, TION&GENEhALIINEO i iTYCDiV I,oc�nan Addres � q - ' i Asscsuss3laFlPmce6 ,;���f�� , � EvetpcorsNnme .� �� � J'� NL•W CONSMUCRYDN.. imd iTae - d �-;gialxS(%y a ��' SenF,EStastcs _ Dismnzesftom. tVatariiod ,.• R 1'aast6k Wet IUtA' �... R Drirykta Wat.^!W .•, .� g sEs G tr'R - DraiaaEc otei_ .R . 'i' :(SAnsmc.r>tdtoasioisafiai,easlaannofrsiiwtis�&'psireases.lamte.avFtlsrntsi�spi++ximigr,tohoseaj . W } Al. . PstrasmaaxfaltPfid? 7 �' .��, '� DepiLeoNesyrocGe..,,r:....�. t)e�lh to G cvadwaSer..s aiiiiitg.Water m"flair� `'(y •LViceping fim pi[�Eace - - Fsfiamw Scaswd.H41b-ckbnm�ikiwr ` IIDETEitidi�?dAT�®N t"OXBEASONA� i+E�R'i' NEWT I,E' u«aaa uo . Deptn,f>hsavedsumdhtg-inohs7mte:;, ..: m•D�yuntusoiimatttas:� :Ckpilttovreepieg4romsidcyfobs.holr:�_��- a ia.:Gt�mSv�'�cAd3usimetlt -�. � R. tadaelticttg i?SDatr." IodasWalltare): AGE Wa r AdJ.6i+miiwaxrLai l C� ® ST 7t►sta�� Y4nr J Ohservaiat e I ptt+afi?Csec � F Yuueat6 ,���� Ssai►Pre 3aak i5mr-a(y.; ", Time:(7'G j tauii?ce�k _ Sua 5tdtntiitky Aatest aaa 5tx Yosstid 5i4a Faitd Addslanat Ycsciag Noe fW(YiNy On�nei r,�t�c Hrat�hDtwsiau t7hservat�oa Hoye Data Ta Bc�gmpteted oa Sack If mom east to tieeaia:3>aCtcd 'iQt►La 90ti' aveti�ead;:pa►n.eti2ti tiI $aastairye+Cntirv�tte $DivisEDm aflet ane�(l}'week ga9or'to'Rt egin�i$g LSiaTTIG5P8ttCFORh1iD0,G V r DIMEP 'Role# tkpfhfmm:. "Soifliax0m, SaMtrwoic,. wcWar 3oel Qihes, sarfaae{ia)'�.. " (17SDA�,� (ffim 714�4a& istmcknc,Swtxs,8uuidtts. 77776 IA- ea lD ®B VAllbbi l�OL LAG +' SHahaea Soil`7oiwro 'Sw!Cdor Sm!- aver 5w1§cr�i' 3i tIJ9DrU.; tt9 � h3on7ln� (SaviiuY�fficaes;Eastdcnx.77 ty ; �•'. 9DltEl°DMERVA'§ og HOIZ LOG halet tkpth „ Sat liot3aai Soil Teisaie Sail Cotar Sot Diner 771 ti.t. - ry� rti �•®Ail15]R��'A lYlLV YEOL{.J •> p.l'Y7l - - . _""Y�ROs17•�. SOLI}IOIIrA)a � ,SWI"CCF11tDC SOIS COIeS, .: ¢"" ... ;a�SIC .. „ - ' '3dcfauC+al tUSDA} �(tiunxU). Mdtttai3 t8wqum,swans.8autdns. fnasistentu_mJaUraa�2! - 10 - �+ 1oi59faa�C#`Ra i4dfitlA "F AbeSeSWgoariW«t�;Mom WithWs ogetrto�m�[y Yoe_ yes'. Ivuhm 1ltDpe6rYiloadtaaadsry ido �Ycc Does at leastpa r'£eet of natato occucriag p ai*iw exist Mail awes ohserverf thmughl the area proposed for die sot!absospaon system' itos If not,what is the depdt o£,natuixatly occturng��i material?. � r t cartit�r that on, C DZ yz Navepassed the s�,y%vs]tlator examiwm approved by dte o£ Una the above a»alysis was hpsne cansistemt untli" the requ$cd tra Lace descnlxd m zi0 CMR l5 t)!7: tk�s�Eh��citt�oitta� R _ COMPLETE • ■ Complete items 1,2,and 3. L. Rece&ecl%y(Pdked Signature ■ Print your name and address on the reverse ❑Agent so that we can return the card to you. ❑Addressee 0 Attach this card to the back of the mailpiece, Name) C. Date of Delivery or on the front if space permits. 1._Article Addressed to: D. Is delivery address different from item 1? ❑Yes YES,enter delivery address below: ❑No I LEDOUX, KENNETH F &ANITA =FRS f 11 CARLSON LANE Ii WEST BARNSTABLE, MA 0266-b -r II rvice Type ❑Priority Mail Express®I IIIIII IIII III I III I III I II I I I I IIII I Ii I I II I III o Restricted Signature ❑Registered Mail TM Signature Restricted Delivery ❑Registered Mail Restricted Certified Mail® Delivery 9590 9402 3630 7305 4464 83 ❑Certified Mail Restricted DeliveryReturn Receipt for ❑Collect on Delivery Merchandise 2._Article_Number_[Transfer_from_service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation'm ail ElSignature Confirmation I' 7 015 ' 1730 0 0 0V 1 4 9 9 0 6 6 3 0 ail Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt USPS mAcwNG# First-Class Mail Postage&Fees Paid ': •' USPS g Permit No.G-10 9590 940�t"AkX1'7305 4464 83 United States •Sender:Please print your name,address,and ZIP+4®in this box• Postal Service I-own n1`f;m nstaGle Health Division 'C� 200 Main Street Hyannis,I,;1A 02601 M I -0 —0 O 0 '.,' 0, Certified Mail Fee .- Er S $ Extra Services&Fees(check box,add fee as appropriate) �('• rq ❑Return Receipt(hardcopy) $ 0 ❑Return Receipt(electronic) $ �P_Dstmark q�;t? r ❑Certified Mail Restricted Delivery $ G F�ere 0 ❑Adult Signature Required $ �q ❑Adult Signature Restricted Delivery$ O Postage rn $ S'°S Total Posh $ LEDOUX, KENNETH F &ANITA L TRS, � Sent To 11 CARLSON LANE N Streetanil WEST BARNSTABLE, MA 02668 Ciry•Sfate Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate •Electronic verification of delivery or attempted return receipt for no additional fee,present this , delivery. USPS®-postmarked Certified Mail receipt to the. ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides n for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the = ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified, ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the •To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,R should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on=t ■For an additional fee,and with a proper. this Certified Mail receipt,please present your _ endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for u� the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion. of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy.retum receipt, 7 complete PS Farm 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Forth 3800,April 2O15(Reverse)PSN 7530-02-000-9047 SENDER: COMPLETE:THIS SECTION COMPLETE TH18 SECTION ON DELIVERY 0 Complete items 1,2,and 3. A. Signature 0 Agent N Print your name and address on the reverse X 0 Addresses so that we can return the card to you. y(Pti E Attach this card to the back of the mailpiece, Re'e ceked'Ey(Priked Name) C. Date of Delivery or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item I? E3Yes ------It YES,-enter delivery address below: 0 No LEDOUX, KENNETH F &ANITA QRS 11 CARLSON LANE WEST BARNSTABLE, MA 026(r8 �rvice Type D Priority Mail Express® It Signature 0 Registered MailTm [3 Rive y lstrered Mail Restricted 5Adult Signature Restricted Delivery Certified Mail® Delivery o, Cartified Mail Restricted DeRvery Retum Receipt for 9590 9402 3630 7305 4464 83 0 Collect on'Delivery �Merchandise Collect o ivery U Signature ConfirmationTm 2. Article Number(Transfer from service label) 0— n Delivery Restricted Dtg Edl 0 Signature Confirmation 7015 1730 0001 4990 6630 sil Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt C3 M —0 C3 0 F _ U Er Certified Mail Fee Ir Extra Services&Fees(check box,add]fee as appropriate) ❑Return Receipt(hardcopy) 17:1 r3 ❑Return Receipt(electronic) $ RZstmark C3 ❑Certified Mail Restricted Delivery r 3 []Adult signature Required $ Adult Signature Restricted Delivery$ Ay 2, C3 Postage M I r— Total Poshrq $ LEDOUX, KENNETH F &ANITA L TRS LrI Sent To 11 CARLSON LANE rq C3 WEST BARNSTABLE, MA 02668 Town of Barnstable Barnstable Regulatory Services Department AFAmedcac j SARMAHLE. 9� 039. ,�� Public Health Division 200 Main Street, Hyannis MA 02601 2007 6 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 6630 August 27, 2018 LEDOUX, KENNETH F & ANITA L TRS 11 CARLSON LANE WEST BARNSTABLE, MA 02668 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 11 Carlson Lane,West Barnstable, MA was inspected on 07/26/2018 by Michael J. DeCosta,Jr., certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Backup of sewage into the house due to an overloaded or clogged SAS or cesspool. 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 BOA OF HEALTH C. Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\1 I Carlson Lane West Barnstable.doc i �Try ram, Town of Barnstable + EARN3TABLE, Regulatory Services Department ptfD MA'S A Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. e. �ackup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well portion f a cesspool within 50 feet of a private water supply well with no ❑ An o ono ppy Any p P acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc c Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Carlson Lane u- Property Address Kenneth Ledoux Owner Owners Name information is West Barnstable required for every V MA 02668 07/26/2018 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 forms A. Inspector Information S/*r�- 13a3� on the computer, use only the tab Michael J. DeCosta, Jr. key to move your Name of Inspector cursor-do not Wind River Environmental use the return Company Name key. 46a Drive �y Company ny Address Marlborough MA 01752 City/Town State Zip Code (508)400-8083 SI 13230 Telephone Number License Number B. Certification I certify that: 1 am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. Fails spectors Sig ture 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pa7 1 of 18 c Commonwealth of Massachusetts i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 P Y Y 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts �A Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments /n 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page.e. City town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 below (Explain ) 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 11 Carlson Lane V Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ® ❑ 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. 5) 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 CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 11 Carlson Lane v Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 350 GPD Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: 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 Well Water 9 ( Y 9 (gPd))� Detail: Well is 127'away. Sump pump? ❑ Yes ® No Last date of occupancy: CurrentDate t5insp doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Carlson Lane v- Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information:. Wind River Environmental -See attached record. Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1,500 gallons How was quantity pumped determined? The quantity was measured by the pump truck. Reason for pumping: To check the structural integrity of the septic tank. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Work Order# 0217066607 Cust# 1996610 Customer Since: 2 017 Tax: 6 .2 5 0 0 Job Comments Tech Comments 07/26/2018 T5 customer is aware of all the forms that need Cover(s) secured. Start work after July 24th 9:30am. to be on site we are pumping as well. unknown gal. cover in 20182910779. the back yard . might have to dig . customer will be there on site with diagrams . cc on file . cm System Owner System Location Kenneth Ledoux Primary Home 11 Carlson Lane 11 Carlson Lane West Barnstable, MA 02668 West Barnstable, MA 02668 (508) 362-9874 Kenneth Ledoux (508) 362-9874 Service Date: Txu 07/26/2018 os:oo AM Frequency: Call to Confirm: Service Type: Standard Previous Service: 07/19/2018 Approx. Gals: 0 CCLS: Location Details: Depth Below Grade: Custom Clean Cust Home: NO Filter Township: _In5{ ct)on,lT5-' County Barnstable Butld Ups M. DE'SCr7jl 7{JfS � « mall", Inspection Title 5 (ribt i�nclud2ngpumpng 1 $ 365ODOOr �364�00 ,x Inspection Title 5 BOH"sees 1�0* $ 25 0000 :0 2 0 is Inspection (Labor/Exposure Feea�Yper'hr� U $ 84�990 Pumping 1001 - 1500 1 00 $ 110 $ 31 A 12- r Environmental Compliance Residential 1.00 $ 21.9500 $ 21.95'N" Y � e We suggest keys steps to keep y Subcotal a$ 951.07 �� t these 3 k Y P P Your system healthy Tax $ 0.00 • Regular servicing • Use CCLS bacteria additive Total $ 951.07 . Use a filter Disposal Site: Disposal Volume: Payment Detail: Waste Code : 0.0000 Amex xxxxxxxxxx3006 04/2022 Sales Rep : CSR : Crystal Marshall Due on Receipt Truck:S77 Technician : Michael Decosta Jr. On Site : 09:52 AM P 0 Number: Tech Notes : System not Operating Fine. Normal water level. Light top solids. Moderate bottom sludge. Outlet baffles are intact. Main line Clear. No filter is present on the tank; current tank can be outfitted with a filter. Recommended No Recommendation. Cover(s) secured. Title 5 inspection Fails, leach pit completely overkill in hydraulic failure. Liquid level in pit over invert and X traveling back into dbox, system will not pass, tech to pump later today 1000 gals, full report will be mailed to customer, all set thank you. Customer Signature ENVIRONMENTAL Remit payment to 46 Lizotte Dr Suite 1000,Marlborough,MA 01752 cam, Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1 � 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known)and source of information: 1985 per plans Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. 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: 127' feet Comments(on condition of joints, venting, evidence of leakage, etc.): All the joints are sealed. There are no leaks. The vent is on the roof. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c Commonwealth of Massachusetts ,p Title 5 Official Inspection Form I, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 18"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'x 5'x 4' Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" 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.): The covers are 18" below grade. Good tees, no filter installed on the outlet. The liquid level is normal with moderate solids and sludge. The tank appears to be structurally sound and not leaking. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments C � 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 c Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments < � 11 Carlson Lane v Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. 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.): The distribution box is 3' below grade and 16"x 20". The box has one outlet. The liquid level is normal with moderate carryover into the box. The box is showing signs of deterioration but is watertight and not leaking. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 f c Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ® Teaching pits number: 1 @ 6'x 6' ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS)(cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The pit is completely overfull and in hydraulic failure. The liquid is above the inlet invert and traveling back into the box. There is wet, saturated soil around the pit. Showing signs of hydraulic failure. 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments < � 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 l_ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments (Y �I 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is West Barnstable MA 02668 07/26/2018 required for every � page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 AsBuilt Page 1 of 1 LOCATION L ' SE AGE PERMIT NO.. to('O.3a VILLAGE — �- w- 13ARA�y#,6L c INSTA LLER'S NAME ` ADDRESS GUILDER OR OWNER N�a � :1 Co sr DATE PERMIT ISSUED DATE--: COMPLIANCE ISSUED tp��sl o i it O. r .e \ http://issgl2/intranet/propdata/prebuilt.aspx?mappai=133030&seq=1 7/18/2018 Commonwealth of Massachusetts i� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �n 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: + 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: 1985 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) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Obtained from original design records. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 e � r--- r tna.,e c�z�rs t r'��.�»r oa° a 'ra► 5 �. 'r.. ;� ram, � ,r ., - ,ra.• •.-:'.�- t^-rzu--*�-��----t�+^-a- _�"_.:..�_�" - s.o 5. 'S�p -.. w{o s 1 ., •.. }#�4•i'fE;�,�„". » u. A11 'air, ., r',siy� .- .. , lot 00 .� scN- § s t � ? y � �9 A •£4 33 it 4Ci, Y lk�d�.R A'� • >. 34.0 ski � �nnt xz � tin i - a d• Y: 4s',"' .» I,E„ of x v �la w v �. v w ;fir v z -n t • .. - 11 6�� - l _, §3 € » Ca �' ra a3i aY R.. w "'^gx� ZS•G> - ...«.�.-.-..�.....F44U`- - , - - _..m... Y +i' .a�„-•Maa Gco«a.aD Y.�wr6'. - • Y o mom 8� RIA V �- `t4 Ft ;wiY�:A'{a,+NoreiKal t a_ - ,.-.��.,n.-.a-....: "" ",e..e.,M?2 aat; ,.wa_.-r,a,•we. " Er-$v. +,�,_o 'ems CL£s+ 4.o r ¢>aed� LXAcHwC F44-fi- 'Y ANYa { p "�'a�°i,,..J��.,�,�'..!� �=r• ,„.a.x �.,.+ �..,�.^,. _ € `',,...-. ,� � i a - f ar "y* f� " " .— now" -opu e; L`.r rtatf 4z is"5'S ` i , F 41 € s } a Al 00 h Ju jqaL It a fi �a,r a bGwr�a mar =mm,.,, r, i L K;s€ i oi'eca s� � awsrau Fec aHcr ,; wsr •c[ x IM rrz%CC£aN ACt't{4`OMW W1rH 7,rue � 9F THQ SYi7 � , L< l� -H- w ❑oi n8u €. Ltl€arL 2utE� 6- i 4 9_ '� t4C •i1.5_a �a 5 dX S.3.oAk�LNJL ;k .Sf C t < t a � ���ya 1 �s s, r.ch:::rZ.1��..€` ;E'9Crt$:..shay.1,�......_...f�"vt�.8„C�.t�+u`-•z s Q - s Rrx.r as c E 44,.E S F•'3 x F`� �a�N.1 _ _ -r� - 7atMra,r -lu-G2.,..�. t _ C? � � t+ 6ritsMua x.... _ F tp ss: .5 •,�'�Z,,2 f.q "ajpv _ \ ." ,�. : r�� \ r ➢vf Az. ttfE I LC ba'7.' tc,, C,fj,v2 -�....... �tFFCCTIvF 0 Y,4 3 >. M All , + ti (: �a SEWAGE OISPOSAL SYSTEM r; v t, New,G" q F.-#. # t3ir .xc;�eua�te sTcut,rugkv DAN"Fw t' akcrorsa e+rc rs, +�. c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments e � 11 Carlson Lane Property Address Kenneth Ledoux Owner Owner's Name information is required for every West Barnstable MA 02668 07/26/2018 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist j Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 Failure Criteria and 6 Checklist completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 18 of 18 % t L0 CATION 1- j S A C E PE RMIT NO. L 0 30 �11 tt s kAO-SoIr V I L L A G E --�--- urGAOL c INSTA LLER'S NAME A ADDRESS , �yO ME 0,7*51'4' �k�bw lei( R UILDE R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 3g p M l� '. U�-���!� ��--� �C���M No................ ,-- r'�8. �............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH "; liratiou for Dtspas al Works Tomtrurtion ramit E Application-is_-Hereby made for a Eermit to Construct (V) or Repair ( ) an Individual Sewage Disposal System at -r , # # Loc t on Address or 4t No. ...._ 1��Y' ....-•--- ............. """...."" l�L� TGIF/_...----- -' • -......... ..�- Owner •.•__ •____•Address ........................................................I�6.?�als./.d'3�-----•--•-�---•-�" ---...__._.._._..._..._. .--------•-•-•-•--._...---------•-•--•--- Installer Address d Type of Building Size Lot___ •.l�l�j't'I _ -feet Dwelling—No. of Bedrooms______________ _Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ------•-------------•------- No.� of persons____________________________ Showers Cafeteria ( ) a d Other fixtures .........................................-................................................---------------------..._...--•--•-•-----------------------• -Design Flow.............. __`,.�!__....................gallons per person per dv. Total ally flo gal WSeptic Tank—Liquid capacity O.OAgallons Length_____."A!__ Width_ _______LO" Diameter__-_- Depth_ __-____. x Disposal Trench—j . _ ____________________ Width u.__._._ Total Length_____._�___...__.ifTotal leaching area....................sq. ft. -- 3 Seepage Pit No_________ ___________ Diameter.) Depth below inlet_,5._-.,0.._. Total leaching area..................sq. ft. Z Other Distribution box ()<) Dosing tojik_( ) p '-' Percolation Test Results Performed by...... .5__E!!�Ei�:__ GsIIIJC Date___M4Y...��..�.....-4 a � y Test Pit No. 1------- '....minutes per>nch Depth of Test Pit...... _�r. Depth to ground water_._.._r_r �_!v.�. fs, Test Pit No. 2........Z:__minutes per inch Depth of Test Pit----/APO______ Depth to ground water.M./V C_...... WO q�" j 7i .�------® """""""""""""""""------ :/-"" •_�r- n / Description of Soil__.- � _..�./�.�.Vst4l 1 Z x /1�End>G��zJ•-' it-"""COALn G U ..•._.____ _____________________________________________________________________________________________________ W V Nature of Repairs or Alt rations—Answer when app iTble.__...P�..> /_ __:u_r_' --�� __ � ._._._..1Z?.�i_� 144I5_ ....... ... . ? ......._... orb ;G`____._ .�..... r� ...._ . Agreement. � �o r The undersigned agrees to install the aforedescribed Individual Sewage DisP Y osal S Z in accordance with the provisions of TITLE 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 _.-- .......... --•- -------- D e Application Approved BY E ------- ----_----•- ........ ` € --------- Date Application Disapproved for the following reasons: -•...............................••-•________________________________________•--___---._...._...________-.._....._...._.._______________.___..___.,___._.________._.___-••-----------___._.___----------- L' � Date PermitNo.... 2..- ......................................... Issued_.........."....... ............. Date No------------- .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF All firatiou for Uispnia1 Works Tomitrurtion Vamit Application is hereby made for a Permit to Construct ( Y) or Repair ( ) an Individual Sewage Disposal System at: l ................_.... ................................p. df..................................... ° .................................... ...................................... Lo ton Address "> or Lot No. f G r~'6 1''rC_;C.1cl!1..4?_!�!.1- .-•-•- �- ' '�.........._..... ......................-----....._..-•-_. .....-•--•••--_. ._ .__.._... _-- Owner Address ...................................................... --•-•----------------------•---------•----...................--•-••-•-•---......--•--------------• Installer Address Q Type of Building 3 Size Lot.....—_w G. !` _S et U Dwelling—No. of Bedrooms............... ________________________Expansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4Other fixtures ------------------------•-----------•-•--------•-------------------------------------- -----------------•-----------------------•-------_----------- d W Design Flow............... `. ....................gallons per person pr day,. Total daily flow.............. .0 .................gallons. WSeptic Tank—Liquid capacity}0M 0gallons Length____.__....(_. Width_ =/0Diameter__---- :_. Depth_.-6__--:_-�'�-_ x Disposal Trench—No..................... Width_�....... ...... Total Length.... ......,Total leaching area....................sq. ft. Seepage Pit No......... .......... Diameter.W._.._.�.. Depth below inlet..._.. ./.._ Total leaching area..................sq. ft. Z Other Distribution box (K) Dosing to k ( ) Percolation Test Results Performed b ... �" 1 ' } rR"3..•1 Date..._ _k _ __ - Test Pit No. I........"_•_.minutes per inch Depth of Test Pit....... �Via.+_. Depth to ground water------ 11 A&) (r, Test Pit No. 2................minutes per inch Depth of Test Pit----- ...... Depth to ground water.W4_/J_f------ ................ ---•.....:.............•--• ----_------•----•----_---- x Description of Soil...... _w f ---------------------------------------------------------------------------------------•--------------------•-----------....._..--•---•--•----------------•-----;•••------•----•----•---•--•-•••-_..... U Nat re of Repairs or Alt atio s Answer wh n applicable------pe re / t. ._VA ...... .&491- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sysarn in accordance with the provisions of TI=- 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 hea h. Signed......................... •-------- ---- .. ... ........... --------•----•--•---••••--- t Date Application Approved By *- =`"':. --•---- -•-- . Date Application Disapproved for the following reasons:------•----------------------------•-•------•-----------------•--------...------•---•---------------....._---•-- -•...................•----•--••--•--------•-•------•-----•-•---...---•-•---•-•---•-•........-•---....----'----•---•-•--...--------•-••--------•---------•----•--•------------••-•-•---------•--........._ Date PermitNo..... `....._.. ................ Issued_...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS �� ("" BOARD OF HEALTHAl B +�� v-• Trrtifirab of 'Utpliattre THRY IS TO CERTIFY, T4at the Individual Sewage Disposal System constructed (t/) or Repaired ( ) by.............W.Z-!?•V V..... ......----•---•-------------- --•---•------_-_----________-_____._____-____----------_•_____-_-________-___--_________-•--•-----•--- Installer at -•------- -------- has been installed in accordance with the provisions of TITLE r of The State 'Sanitary Code s d cribe i the application for Disposal Works Construction Permit No.__ ..._....... dated_:........ ..... PP P T `' [557 =� THE ISSUANCE.OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL fUNCTION ATI'SFACTORY. DATE......C..f_- ........................... Inspector................................................................................... THE COMMONWEALTH OF MASSACHUSETTS s BOARD OF HEALTH =�►%` t�. -e� �. pQ5 ? "..W..'AJ............OF....... Z......... ................2...................... d� 0 NO.i..............•........ FEE........................ DispiY',� t Worho Tonstrttrtiatt rantit f Permission i.sl. hereby granted. X.ff . "4......--•--•---••------•...............•--•----...........--------- f°to Construct ( (/ or Repair ( ) Inr�ividual Sewage Disposal System atNo.._ -.a.F_ _3_. ..,- f•= - --------------`-----•----•----•--___--•-------- -------------------------------------------------------------------- Street as shown on the application for Disposal Works Construction Pe Dated.._�� ly__ yp� g t 4 Board of Health DATE.................. L o I ....... ::.:....---•........ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS, � HOS ENGR. ASSOC. INC. P. 0. BOX. 156 RAYNHAM CTR., MASS. 02766 617- 624-036Z TO .__ _ _. ..t%s _ SUBJECT�.�AL-4:i� _ t!i (�ti MESSAGE T .. I _I _Lt f SIGNED- s `W REPLY Q1. DATE CJ2 INSTRUCTIONS TO RECEIVER: QUICK REPLY LETTER FORM ORHb)•QUILL CORPORATION•3200 ARNOLD LANE•NORTHBROOK,ILLINOIS 60062 ,.WRITE REPLY. 2.OETACH STUB S CARBON.KEEP WHITE COPY,RETURN PINK COPY TO SENOER. J TOP OF FOUNDATION COVERS TO BE WATERTIGHT AND BROUGHT TO WITHIN 6" OF FINAL GRADE SEPTIC SYSTEM PROFILE Flaherty Environmental Services EL. 60.0' EL. 58.0' jnot to scalel INSP. PORT W I 3" OF GRADE / CLEAN SAND P.O. Box 331 2" of e" to b" DOUBLE WASHED rO PROP. EL. 58.0' Harwich, MA 02645 4" CAST IRON or EQUIVALENT PEASTONR GEOTEXTILE MIN._ PITCH 1/4" PER FOOT FILTER FABRIC 774.994.1166 4^SCHEDULE 40 PVC PIPE 4" SCHEDULE 40 PVC PIPE FLOW LINE '(first 2'to be le VENT IF REQUIRED vell 60' 1% �• ?,• 5' 1°/a r • .: ' L'EXIST. i4 00000°o°c EL. EXIS . o 0 0 0 0 0 0 Y. EL 55.6' °o°o°o°o°p o o°o° 0 omm ooa0000c EL.55.0' EL.54.83' Op°pp op°pp°0000oo per"'®� �, o°o°000pc LLB-11 'rr�ii p ��J L� °0000°oo°ooe 2.0' GAS BAFFLE EL.54.8' o°c°o°o°o°°°o°o°o ®mil' y�J o°o°0000c-- t o 0 0 0 0 0 0 .. °000CO0OC EL-52.8' ;3 (H 20 D-BOX) •S:'';, •; 6"CRUSHED STONE OR SOIL AB. � SORPTION SYSTEM MECHANICALLY COMPACTED 1000 GALLON SEPTIC TANK (2) 500 GALLON H-20 CHAMBERS DATUM: ASSUMED (EXISTING) 5.8 � � WITH 4 ST to 1�" DOUBLE WASH ONE AROUND IN A 4 WASHED STONE , - - 12.83 X 25 X 2 CONFIGURATION BOTTOM OF TEST HOLE EL. 47.0' EL. 47.0' ^' hicysr USGS ADJUSTMENT: N/A LOCAT/ONMAP R � 68•y7 GROUNDWATER E LEV: N/A LANE- — 3g7 N TH CARLV 6a3p. 150' TO WELL I SB Q 60 8 \ 1 e h Sit Rt.6A � H�9 LOCUS T * d, w EXIST. 62'S H I TH-2 : O O 9 �O !� DRIVEWAY 40.2' NTS \ \ EXISTING '� �\jHOFMgs 0 \®� 3 BR sq DWELLING \\ f �o D VID O LOT I 2 ACRESt BENCHMARK; —'- — 1Z MAP 133 LOT 30 TOP OF FNDN BECK EL.60,01 Q S8 f /STS S'N/TAR% 56 ` DATE.'1112012018 REVISED: 56 r f SZTE AND SEWAGE PLAN FOR B & B EXCAVATION, INC./ { KEN LEDOUX 11 CARLSON LANE (WEST) BARNSTABLE, MA SCALE : 1 " = 401 REF PB 254 PG 65AND HOS PLAN DATED 1112611985 PAGE 1 OF2 ......................................................................................................................................................................................................................................................................................................................................... ...................................................................... ..................................................................................................................................................................................................................................................................................................................................................................... x7 GENERAL NOTES DESIGN CAL CULA TIONS S YS TEM DETAIL Flaherty Environmental Services P. 0. Box 331 1. ALL PRECAST COMPONENTS TO BE H-1 0 Harwich, MA 02645 RATED UNLESS OTHERWISE SPECIFIED. NUMBER OFACTUAL BEDROOMS 3 DISTRIBUTION BOX(ES)AND ANY 774.994.1166 COMPONENTS WITH ANY ANTICIPATED r. GARBAGE DISPOSAL UNIT NO VEHICULAR TRAFFIC TO BE H-20 RATED. 2. THE DESIGN OF THIS SYSTEM DOES NOT TOTAL ES TIMA TED FLOW ALLOW FOR THE USE OF A GARBAGE (I 10 GALIBRIDA Y X 3 BR) 330 GAL./DAY GRINDER. 3. MUNICIPAL WATER IS NOT AVAILABLE, REQUIRED SEPTIC TANK CAPACITY 660 GAL. 4. ALL CONSTRUCTION TO CONFORM WITH 25' SIZE OF SEPTIC TANK 1000 GAL. (EXISTING) 310 CMR 15.000 AND ALL OTHER APPLICABLE LOCAL, STATE AND FEDERAL SOIL CLASSIFICATION CODES AND REGULATIONS. 5. INSTALLERICONTRACTOR TO REVIEW& DESIGN PERCOLATION RATE <2 MIN./INCH VERIFY ALL ELEVATIONS AND DETAILS . . . EFFLUENTLOADINGR4TE AND REPORT ANY DISCREPANCIES To 0 74 GAL./DAY/FT' YIFT2 12,83' DESIGNER PRIOR TO CONSTRUCTION OR LEACHING AREA ASSUME ALL RESPONSIBILITY. (2)x(25.0'+ 12.83)(2) = 151 SF 6. INSTALLER/CONTRACTOR IS 25.O'x 12.83' =320 SF RESPONSIBLE FOR MAINTAINING SAFE 471 SF x 0.74 =348 GPO WORK AREA, VERIFYING ALL UTILITIES AND NOTIFYING "DIG SAFE" USE(2)500 GALLON H-20 CHAMBERS WITH 4'STONE (1-888-344-7233) 72 HOURS PRIOR To IN A 12-83'X 25'CONFIGURo4 TION AS DIAGRAMMED CONSTRUCTION. Z ANY CHANGES TO OR DEVIATIONS FROM RESERVE LEACHING CAPACITY NIA GPD THIS PLAN MUST BE APPROVED IN WRITING By FLAHERTY ENVIRONMENTAL SERVICES AND LOCAL BOARD OF HEALTH. 8. FINISH COVER OVER COMPONENTS IS NOT TO EXCEED 3'PER 310 CMR 15.000 (NTS) UNLESS SHOWN PER PLAN 9. ALL ABANDONED SEPTIC SYSTEM COMPONENTS TO BE PUMPED DRY AND SOIL EVAL UA TION FILLED WITH CLEAN SAND OR REMOVED AND REPLACED WITH CLEAN SAND. TESTHOLE#1 PW 15826 TESTHOLE#2 PW 15826 OF 41,,qq Evaluator David D Flaherty Jr,RS,REHS Evaluator. David D.Flaherty Jr.,RS,REHS 10.ALL COMPONENTS TO BE PROVIDED SE#2755 SE#2755 A WITH WATERTIGHT ACCESS PORTS BOH Witness: Don Desmarais,RS BOH witness Don Desmarais,RS a D Date. Novembar20,2018 Date: November 20,2018 WITHIN 6"OF FINISH GRADE. U F E 11.ALL SEPTIC TANKS, DISTRIBUTION 11 TH-I EL EV.58.0' TH-2 ELEV.58.0' BOXES AND PIPING TO BE INSTALLED WATERTIGHT. 0%15* OIA L S 10 YR 312 S T S- 0"-15" OIA L S 10 YR 312 TAR 12.NO KNOWN WETLANDS OR WELLS WITHIN 100 FEET OF PROPOSED 15"-35" B LS I0YR516 15"-35" 70 B LS I0YR516 LEACHING. 13.THIS Is NOT A CERTIFIED PLOT PLAN AND UNDER NO CIRCUMSTANCES IS THIS PLAN TO BE USED FOR ZONING OR (41-) Pero 'i car*that on November 12,2002,1 have passed BUILDING PURPOSES. the examination approved by the Department of SITE AND SEWAGE PLAN Envlfonmenial Protection and that the above analysis 14.LOT IS SHOWN AS ASSESSOR'S MAP 133 FOR has been Performed by me consistent with the LOT 30. required training expertise,and experience described 8 & B EXCA VA TION, INC. 15.LOCUS PROPERTY IS NOT LOCATED — 35"-132" C MS 2.5Y616 35"-120" C MS 2.5Y 616 In 3 10 CMR 15.018(2). KEN LEDOUX WITHIN AN AQUIFER PROTECTION 11 CARLSON LANE DISTRICT(ZONE II). G.W.ELEV.NIA G.W.ELEV.NIA (WEST) BARNSTABLE, MA BOTTOM TH-IELEIV. 47.0'1 BOTTOM TH-2 ELEV. 48.0' PAGE20F2 ................................................................................................................................. ......................... ...................... ...................................................................................................................................................... ......................................................................................................................................................................................................................................................... ....................................................................... ........... .... . ........................ . .............. .................................... i I I� f i i I 1 i i t I - • 8 57 � e �� DOi�•` Z3 A 7 °/6' /! — "f`" '---A r A � 1�"L` _ .Q'4� _`j i`f►; � ./ i j61��1,,�• �6fTo SrC ,�/ 2 N,J.., 42- 'tJ Va Zy�- - -- ✓,,. r i i� -►y t'�v5� � ,,,o ts f r i f i S f i 1 1 i 3 i ©E AQ i L ^} LA I NpL -ls-r�cJ �-� f:� � �s oc �� -�C +�c.a'`��ti3�_��r E✓' 1 Piz f -, .g _. r-. 9F : JAY •: -._ -. , .#+•.. rr{01•!,. Sys .. , .: :.._. .p,... .. -, . .. I - _ ti. CacaJrJD LO VrtO.LNti i. Covelq S -z-0 ctRAOG OP Sett -Too k- j� T 5vg 'Soli I, hoc. 2' 'E \,,,,� Fr• L`fa M:jo.0 t ! `�CJl�' (-f(H rr}i FJt 1 L Y INR 5 HEA ASTON AA Q S E' s o.ya►„ B�'T rtr� �I 2 t5 'C p t �A 6 �o T T o00 a D r-�i ��; `� 17 a l vy `J i L�+�. 3 4,cJ—__-----— - �.ER C i A 177 k POE 'dA(�+0� F �, r� E D 1 V✓�1 .� ,� s- S A c o A e f PLAN V IEw: , 30, - I¢4 CONC- COVER TO C32ADE Z r-3" Of yay ;le" WASHED STONE 5 T -T 7 t elare -o4[wvt -. ------------ i G , J E012TH ,.._T�_.,�T SACKF ILL \- I I ' l o 0 o o c Y i / �� �►/e i O O o r'ib R -- 4' PjPE FROH T rLfj; P +T I i f CBoxt 4 I U O p o ci a p y G - Dlsrll8unoM 0 p O O O WAS�tED � a a 'Q a 'NASf1ED 5 TONE I D O n _ STONE i 1 3r Itt O O O O p P«CAST 1 Per L,KER REfNFORGING t 1 -, CONC PIT Top 104 ewas itt �IHER SIDES 'IOWIQE Uv �vf7n3Lt IMATERY+L To � � Ex ;: � •� >^ QED P�oM _ I i o 0 0 0 E / I p -7 E�-t- ✓. 3 4.0 J g,. f ! I O O O U O 1 0 O o 0 0 I o o e o o :. -Z-1--- - - — -- -- L r -, - H o ►mil D R o 6�0 E T� L F A G -1 er 1 v-p- o 0 0 ov �P � GFILI- � D W1Tr-' LL� FKJ M�v :o' 4' CTo� R,vC. 4 c �. �r N Lr 7)40P IT 1 EACNING ._PIT NO SCALE K HOtA OUTS KNOCK OUTS - f PIPE Q .. ? 1 Ni LIQVCL FitfT L[NbTM �s - -� q n SECTION A'A C,p N C G U �/ t R T b 6r E -` - - v!-i,+Rr T7TTttt�J1 J A11 `y am"7T7N'ZN TTTT« 711 (�I-S T R I B U T1•�N 0X= -- nb'CovrRs N _ ------- -_ ----�*,�' x - _ - � - `' - CD PON N SHALL BE CONST T'cUC1-ED AND NO 5CALE _. INSTALLED IN ACC012DANCE WITH T tTL.E S OF THE STATE A r R S oAcE 16' Couc PIrE + E_w\II pc)MENT-Atr CODE ( 1917) ANO ANY APPLICABLE LOCAL QU!-ES. DESIGN DATA- • I 40, p i ="•- /� '� -� - — 3 (3f_nlcOMs X I (Q GAL�04.Y_—_ 3 3 0 -- 4 —�� 't tfKE Q t- L 14%wo a9� _ L 39r75 l.o �� :S/OG Z •S C } 3' c T 1 -_ 2, 1!1 . T�/,( 4 _ ( (] r`TAP i Bo0 TOM d f CQ .ti _ ,Q L ra'^��_ } O i � b � R c I N c Bests i , I 'lJI , 5 STEEL E GL MESH 5 N ` r' � ( Q X 5 x 2. s � 9 Z . 7 4"(1 0.PYc --- -= - __ - -- -- - 11 4"C Z►r PV! ALL' WALLS, 4 7� - ti Z. r[[ ` Sen. � Ilif T><[_ U5r —� E�, ��,' >•',-�� 1© ' p ► gn/7 __ -5 ;EFFECTIVE DEPTH __ - ----� i ®FBAs SEWAGE DISPOSAL SYSTEM � ', '► ®���° cyG�� �A L F - C AP E. . . G o y_sT, tom_- 4 z_I 3-- 3 N oTE: ALL CONCRETE STRUCTURES TO BE I_ —_.-___�-oT 4. 1' RoT'oNC)o CONCQErEA�oo+� - --� - -4_1t-__�__ _�__ . _ ____�1. SMMI,JR.CIVIL AANS-TA$L.E �A5:5 _ _ - --- -.- - oeEQUAL• ! OX GALLON C v*+c eFTe To BE: 4000 �jEPT IC - �.� ��s��� ��•� # --_—_----------------- --- --- _- -_ loNA1.�` NOS ENG Assoc 1NC, RgYNHAM NO SCALE r SCALE. NO ATE' �'Jv zr 19Sf A E• AS $