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Home My WebLink About0805 CEDAR STREET - Health - 805 CEDAR STREET, =W�.TBARNSTABLE0007-010 � h I r } s 1 n .- t i ,0 •: 4 i f t No. 4210 1/3 BLU ESSELTE 10% TOWN OF BARNSTABLE LOCATION S ��, .� r SEWAGE# DQaO -D 1 S VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.' SEPTIC TANK CAPACITY I'Sti\'ti/C"� V LEACHING FACILITY:(type) �y)�r US©bA��d�1[ �q(size) UK 17 NO.OF BEDROOMS> q .OWNER jp( c)G Ors PERMIT DATE: ` A V ' COMPLIANCE DATE: Separation Distance Betwe n the: /yp*&,% ouni�TTeo Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 11/-17 t 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 ocxs c.,c)a,c y� cvwMbc �oil glsl�^+r No. . Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes TippYication for Misposai *pstern Construction permit Application for a Permit to Construct( ) Repair())Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. O©�'-Cet)a P 5f- Owner's Name,Address,and Tel.No. wmv /�// Assessor's Map/Parcela' l✓(/N 105 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms d/ Lot Size _ 11�{(07 sq.ft. Garbage Grinder( ) Other Type of Building /'�/�"det/Ffe No.of Persons 2., Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Alile gpd Design flow provided 7�j r 3 gpd Plan Date C) Number of sheets / Revision Date Title ` Size of Septic Tank s/h{f/y Type of S.A.S. 60 et v " U /'i/li((yf Description of Soil NaturF of Repairs or Alterations(An�swer when applicable) `'4 C t� ,�(�rJ �' tq1' E- tf/ — / p oy TT 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. S Date Application Approved by c Date `— Application Disapproved by Date for the following reasons Permit No. J O i.5 Date Issued J t C) t� 5 No. C/ C a o ,5 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION —TOWN OF BARNSTABLE, MASSACHUSETTS ftplication for -Misposat 6psteut Construction i3ermit Application for a Permit to Construct( ) Repair(l) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. &�-ceda t 5- Owner's Name,Address,and Tel.No. vjt-v �/ Assessor's Map/Parcel�SsSle .., /tdtV to Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms II,I Lot Size s/ ,607 sq.ft. Garbage Grinder( ) Other Type of Building "'o //,/4LfrG No.of Persons 2., Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided S 76 ,I gpd Plan Date /�/�I2r �d Number of sheets / Revision Date Title ! y Size of Septic Tank y/!J1/iu) Type of S.A.S. / 4()0 44I i1'nJ Description of Soil Natu,r`e of Repairs or Alterations(Answer when applicable) l k)*4l (' SCO -foIl XJ �dtsdt,jW %� jC S}-1 tfy fJhoy 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. Sigrie Q /� - Date Application Approved by tJ, Date r " :21 Application Disapproved by Date for the following reasons Permit No. o�o a C) ! (=� Date Issued 1 I 0q 0 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Comptiance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by-29/f 1- 10 1 A e- at _Pl)z, 6Zk/ 4 bj4 fn rla/ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a/5,,d��atted 1 ^ 0 1 Installer -//�/u/N I //V G.- Designer �,r/,rd /2[6 s%✓. #bedrooms Approved design flow /a/4/c) god The issuance of this permit shall not be construed as a guarantee that the system wil1*1unctiofi— -designed. Date /r f/ Inspector L -^- -------- --------------------------------------------------------------- I d" +.5 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposat 6p8tem construction permit Permission is hereby granted to Construct( ) Repair—( Upgrade( ) Abandon( ) '. System located at Ql f �"� ,( �'} Lc� i`7Q( 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 �- o�d Approved b �� Pp Y ^' i Town of Barnstable ;Regulatory Services + Richard V. ScaU,Interim Director NAM+ BASNSfABt.E. • Public Health Division r ' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form .Date:i��(��sewage Permit# 91 01 Assessor's Map\Parcel Designer: Installer. t Address: y"jT V C d 1 Address: On I dot ' L was issued a permit to install a _'_( ate) (installer) septic system at \4Vt . based on a design drawn by (address) -. dated 1 �� (designer) 10 I certify that the stem referenced above was installed substantially according to septic the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the-septic system) but in accordance with State & Local Regulations Pl an revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. 1-certify that the system referenced above was constr�c��+�__.��liance with the terms of the IAA approval letters (if applicable) `' fit`OFrt�q�lrr o? DAVIp �y t vMASON 'rn'' sta er's Signature ,� No.Yoss a �+, is r S (Designs s Signature (Affix Designbr s Stamp 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:1Septic�pcsigner Certification Form Rev 8-14-13.doc i Commonwealth of Massachusetts 088--ODD--Oj IMMM Title 5 Official Inspection form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Property Address '_ Peter& Kristin Nu nes K c Owner Owner's Name information Is x required for every West Barnstable Ma 02668 10/23/2019 page. Cityfrown state Zip Code Date of Inspection r 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 a, filling out forms Inspector Information 013on the computer, Sean M. Jones use only the tab key to move your Name of Inspector .cursor-do not S.M.Jones Title V Septic Inspection use the return key. Company Name 74 Beldan Lane Company Address Centerville Ma 02632 Cityrrown State Zip`Code n 774-248-4850 smjonestitle5@gmaii.com, SI4522 _- sean@smjonestitle5.com License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Titie`5' (310 CMR 15.000); I 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 inspectionI have determined that the system: 1 Passes 2. ❑ Conditionally,Passes 3. ❑ Needs Further Evaluation by the Local Approving.Authority 4., Q Fails 10123/201"9 Inspector'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 has a design flow of 10,600 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. jPlease 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. tfimsp:doc rev.-7/26P1018 Tuts 5 Official Inspection Form;3utrsurfaoe Sewage Disposal Syafem Page t.of:18 :-Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary;Assessments 805 Cedar.Street Property Address Peter& Kristin Nugnes Owner Ownpes Name rs inforrdon'Is West Barnstable _;. w Ma 02668 1.0/23/2019 requlfed;fir®very _— 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: The property located at,805 Cedar St West Barnstable is served by a Title septic system consisting of a 1500 gallon septic tank,distribution box and 4 Cultecs.The system was found lobe in proper working condition at the time of inspection. 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 exflltration 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 eaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below)'. A t5u ,dot•rev.7/26P2018 Us 5 Official Inspection Form.Subsurface Sewage Disposal System•Pegs 2 of 18 Commonwealth of Massachusetts Title 5icial Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Property Address Peter&Kristin Nugnes Owner Owner's Name: Information 1s West Barnstable Ma 02668 10/23/2019 required for every Citytrown state Zip Code Date of inspection Page. 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. f sewage backup or break out or high static water level in the distribution box due, ❑ Observation o s g p g to broken or obstructed pipe(s),or due to a broken, settled or uneven distribution box.System,wiil pass inspection if(with approval of Board of Health)'. ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): li ❑ 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 a 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(e)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 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' that the oyotem is not functioning in a manner which will protect public health,, }- safety.and the environment: tb�8p Vic, rev 7 2fifZ078_„- --_ Title 5 Official Wispection form;3ubswf ee Ssmage'1340sal System•;Pam 3' 18 Commonwealth of Maasachusett ' Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form-Not for Voluntary Assessments 005 Cedar Street Property Address W` Peter:&KristM,Nugnes Owner Owner's Name information 16 required for every west Barnstable Ma 02668 10/23/2019 page. cityrrawn' State Zip Code Date.of Inspedion C,. Inspection Summary (cont.) m ❑ 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 fall unless the Board of Health(and Public WaterSupplier,If any) - determines that the system Is functioning. n 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 sup ply. ❑ 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 prwate water supply well. ❑ The system has a septic tank and SAS:and the SAS is less than 100 feet but 504W 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 certified1aboratory,for fecal col'lform 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 Y 4 1 System failure Criteria Applicable to All Systems: y$ PP y You must indicate"Yes"or"No"to each of the following for allInspections: 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 GhSp,*o-r6.1 19' Trite 5 offdal Inspadion Form,Subsw1aoe Sewage Oisposo System-Page 4 of'18' I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Property Address Peter&Kristin Nugnes owner Owner's.Name irrformation i>3 West Barnstable Ma 02668 10/23120.19' requited for every !Town State Zip Code Date of InspeWon C C. inspection Summary (cunt.) = 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 El Z 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 0 ® obstructed pipe(s).Number of times pumped: ❑ CD 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 0 well. Q Any portion of a cesspool or privy is within 50 feet of a private water supply well. El 0 Any portion of a cesspool or privy is less than 1.00 feet but greater than 50 Beet from.a private water supply well with no acceptable water quality analysis. [This system passes if the well wateranalysis,performed at a bEP certified' laboratory,for fecal colifonn 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 la facility with a design flow,of 2000 god- r 10,000 gpd. 0 The system IMIs.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 stems: to be considered a large system the system must serve a facility with a rg systems: 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 SectionCA. Yes No E1 ❑ 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. g' the system is located in a nitrogen sensitive area(Interim Wellhead Protection " El El! Area-IWPA)or a mapped Zone ll of a'public water supply well t5insp: c r®v.7l P 1 B Tim 5 official Inspection Form Subswraae'Swap Disposal System•Pall 5:ar 1 Comrnonweatth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form,-Not for Voluntary.Assessments 805'CedarStreet Property Andress Peter& lCrWimNugnes Owner F t Owners Name reoulred, West Barnstable Ma; 02668 10/23/2019 • ��equlred�Or,edery; pe9e Cityrrc wn State- 210 Code Date of inspection C. Inapection Summary(cunt.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered dyes"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 C.4 shall upgrade the system in accordance with 310 CMR 15.304.The.system owner should contact;the appropriate regional orrice of the Department. 0, You must indicate"yes"or"no"for each,of the following for all Inspections: Yes No Z ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑, Z Were any of the system components pumped out.in the previous.two weeks?- z ❑ Has the system received normal flows in the previous two week period? 0 ® Have large volumes of water been introduced to the system recently or as partof this inspection? aWere as built plans of the system obtained and examined?(If they,were not available note as N/A) Z ❑ Was the facility or dwelling.inspected for signs of sewage back. up? . Z D 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?. 0 Was the facility owner(and occupants if different from owner):provided with information onthe proper maintenance of subsurface sewage disposal systems? The size and,location of the Sol Absorption System(SAS),on the site has been determined based on: 'M ❑ Existing information. For example;a plan at the Board of:Healfh Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] Min- •rev.7128120f8 _ TRIB 5 Oftlal hgwdlon Fan:Subuffface Sewage 01sposal System•Page 0 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Property Address _ Peter& Kristin Nugnes - owner Ownees Name i0iredion s fcrevery West est Barnstable Ma 02668 10123f2019 Page; CityErownr state Zip Code Date of Inspeaion D. System Information 1. Residential.Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): I DESIGN flow based on 310 CMR 15.203(for example:110 gpd x#of bedrooms) 334 9 provided - Description: 3 � Number of current residents: 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 El Yes, Z. No information in this report.) Laundry system inspected? ❑ Yes, Na Seasonal use? ❑ Yes No Water meter readings, if available(last 2 years,.usage(gpd)) Detail: Sump pump? ❑ Yes, 0 No Last date of occupancy: current Date t6inap rev 7126Y201t3 " T199 5 OBidal fted on Form:Subadaw Swage Disposal System Pap 7 419 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Property Address Peter&Kristin Nugnes Owner's Name in�rmatlon`k�� ; requlredtfor.every West Barnstable Ma 0266,8 10/23/2019 Cityrrown state Zip Code Date of'inspedion, Di.System.Information (cont.) ;$ .2. Commerciallindustrial:Flow,Conditions: Type of Establishment: Design flow(based on 310 CMA 16.203): Gallons per day(gpd); Basis of.design flow(seats/persons/sq.ft, etc.,): Grease.trap,present? ❑r Yesr ❑ 'No Water treatment,unit present? ❑ Yes ❑ ,No. If yes, discharges to: Industrial waste holding tank present? ❑: Yes ❑ No m Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ :No Water meter readings,,if available: - - - Last date ofoccupancy/use: Date Other.(describe below): :a 3. Pumping'Records: Source of-information: Was system-pumped as part of the inspection? ❑ Yes; No If yes, volume pumped: gallons How-was quantity pumped determined? ` Reason;for pumping: 3 tSUtrp,dw•rev.;TOM Me 5 Oftai hgmc M Form Subsurfim Sewage Dtsy".Symm.•.Pep of 13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. 805 Cedar Street Property Address Peter&Kristin Nugnes owner Owners Name information Is West Barnstable Ma 02668 10/23/2019 required forevery page. Citytfown State Zip Code' Date of lnspedion D. System Information (cone.) 4. Type of System: Septic tank,distribution box, soil absorption system ❑ Single cesspool Overflow cesspool Privy El 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: system installed 5-6-1996 - Were sewage odors detected when arriving at the site? ❑ Yes• 0 No S. Building Sewer(locate on site plan): 1;5 _ Depth below grade: feet _. Material of construction: ❑cast iron ®40 PVC [].other(explain): Distance from private water supply well or suction liner test Comments(on condition of joints,venting, evidence of leakage, etc..): Joints in good condition, no leakage,vented through roof. t5insps c rev,T,l2Bd2At8 We 5 ofH W ImpeaRm F rm:subsuwace;S"W Dispose!System Psge 9.01 IS. ' Commonwealth of Massachusetts Title 5 Officiall Inspection Form I Subsurface Sewage Disposal System Form-Not for Voluntary Assessments: 605 Cedar street a ..: Property Address Peter 8 Kristin Nugnes Owner Owner'a-Name o"t°r"'aUon�s West Bamstable Me 02669 10/23/201,9 .�ulredhtr:eaery .. - pe9e pEc�i pityrrown Stater Zip,Code Date of 1r�aon D. System Information (cont..) ". 8. Septic Tank(locate on site plan) Depth below grade: feet Material of construction: Z concrete ❑-metal ❑fiberglass ❑ polyethylene ❑other(ex fain) If tank is metal, list age: years i Is age:confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallons 'Slud9e depth: ;Distance-from top of sludge to bottom of outlet.tee,or baffle 3' Scum thickness 211 711 Distance from top of scum'to top of outlet tee or baffle Distance from bottom of scum.to bottom of outlet`tee or baffle 10" How were dimensions:determineV Opened covers and-took; measurements Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural Integrity., liquid'levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should be done soon and again every 2'years for proper maintenance. Water level was even with outlet, tankwas not leaking and was structurally.sound: Ibinsp.doc•rev:7rj&xIs rdle 5 0H'MW k4E01bn Fwm:'3ul9ialwm Sewage Disposal system•page 10 61 18 F , Commonweafth of Massachuseft - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Property Address Peter 8 Kristin Nugnes owner Owner's Name information Is West Barnstable Ma 02668 10i2.3/2019 i"Olred for every Paige. City/Town State Zip Code Date of irspedon D. System Information (cunt.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: 0 concrete ❑metal ❑'fiberglass polyethylene C]other(explain):; Dimensions: Scum'thickness Distance from top of scum to top of outlet tee or baffle. Distances from;bottom of scum to bottom of outlet tee or baffle Date of last pumping: Data _ 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: Matey at-of construction [I`concrete El metal ❑fiberglass ❑polyethylene E];other(explain); Dimensions:,= Capacity: gallons Design Flow:. gallons per day i3lrtsp doc rev,.71�f2018 rd*9 Of(rial tnspedion Fe m 8ubsurece Dispasal Syeiem•Pais 11 of le Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1 80.5,Cedar Street . Property Address -` .. Peter'& Kristin Nugnes owners owners Name requaticn5is` West Bamstable Ma 02668 10/2372019 nequlred for every- C !Town state, Zip Code: Date of Ina page:, � .. aY p pedion M System Information (cont) 8. Tight or Holding Tank(conf) Alarm present; 0 Yes ❑ No Alarm level: Alarm In working onler.: ❑ Yes 0 No Date`of last,pumping: Date 'Comments(condition of alarm and float switches, etc,): *'Attach copy of current pumping contract(required). Is.copy attached? 0 Yes 0 No 9. Distdbutlon'Box(if present must be opened)(locate on site plan),-- Depth of liquid level above outlet invert Comments(note if box Is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box was level.and in good condition with no.rot. Water level was.even with outlet invert with,no signs of past backup. . . it 151n d=c W-'Tn812m8' Me 5.01RCial msDe�len Form:Subswfa�_ Sewage Disposeliystem,Paga.t2ol18. I , Commonwealth of Massachuset .UTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Propertyt Address Peter&Kristin Nugnes owner Ownees'Nam information is est Barnstable Ma 02e68 10/2312019._ required for every Cityrrown State Zip Code Date of Inspecion" Page; D. System Information (cunt.) 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` l Type: 13 leaching pits number leaching chambers number _ 4 Cultecs ❑ leaching galleries number leaching trenches number, length;; leaching fields number, dimensions: TY ., , ❑ overflow cesspool ,numbee. rr(6 t D innovative/altemative system Type/name of technology: t5(nsp,doc•rev.. f28fZb18` To 5'Oftial in on Form:Subsurface Swepe Disposal Syetem•Pape 13 d.16 `Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Notfor Voluntary Assessments 8.05 Cedar'Street Property"Address: '..„ ,Peter'&Kristin Nugnes "own®r Owner's Name rego lr af'b West Bam'stable Ma 02668 10/23/2010 required for every a e City/Town, state. Zip Code that®of Inspection -p� 9. �_� D: System Information. (cont.) -' 1;1: Soll;'Absorption System(SAS)(coat:) Comments(note condition of soii,signs of hydraulic failure, level of ponding, damp soil,condition,Of vegetation, etc.;): s,a.s,.consists of 4 Cuitec chambers. Leaching facility was video inspected and found dry with no signs.of,past overloading. 12. Cesspools(cesspool must be pumped as part of'inspection)(locate on site plan); t s Number and configuration Depth—top of liquid to inlet invert Depth.of solids layer 'Depth of scum layer Dimensions of,cesspool Mi terials of construction _ Indication,of groundwater inflow ❑ Yes 'No - Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation; etc:): r lSirtspAoe•rev 71Z6i2o18 We 5 Offidel troectO Form:Subsu:iaoe Sewsp t)iap n1ZYstem•Pie 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 805 Cedar Street Property Address Peter&Kristin.Nugnes. Owner owners Narne tMortnatlon West Barnstable Ma 02668 1"0/23f2019 '800ed'for"every — page: CdyfTowm State, tip Code Date of 1qSpecUon .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 V ----� 0 z Z 'W'16 A3 3° r' l9in�; revi.TTdEJ2018 TRIO b OilieW Irispactron Form!Subsudaae Sewage Disposal System,Pape 16&1S 'Commonwealth of Massachusetts y' Title 5 official Inspection Form F-- Subsuiface Sewage Disposal System Form-Not,for Voluntary Assessments 805Cedar Street Property Address. Peter& Kristin N Agnes `Owner Owner's Name mtnrinetion`is West Barnstable Ma 02668 10/2312019 required;for every :Page;. City/rown. State. Zip Code Date of Inspection D. System information (dbnt.) 13; Privy tlocate on site plan);° Materials of construction: Dimensions. y. Depth;of solids Comments(note,condition of soil,signs of hydraulic failure, level of;ponding, condition of vegetation,, .. t q : t5tnsp i� !rev.711 20ifr' 'Me 5 Offidei hayeftn Fam:& tdwe fiawa p Ois)"`3 Awn•Pape is,of 18' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary.Assessments 805 Cedar Street Property Address Peter&Kristin Nugnes owner Owrnees Name informAtion West Barnstable Ma 02668 10/23/2019. required for every -� page• t ity r"n State Zip Code Date of Inspection D. System Information (cont.) 15. Slte Exam: ® Check Slope Surface water 0 Check cellar a (] Shallow wells Estimated depth to'high ground water: feet Please indicate all methods used to determine the high ground"waterelevation: I� ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feetof.$AS) [a Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) El Accessed USGS database-explain: You+must describe how you established the high groundwater elevation: Groundwater was established by accessing town of Barnstable groundwater contour maps. Before filing this inspection Report,please see Report Completeness Checklist on next page:= t5b15p Bois iev:7 98 Two s omcim mspectimFow.subsufm sowage o#ow 9.4stem-page 17'or"tg .t z,as , •••_ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '805 Cedar Street Property A4dmft Peter&Kristin Nugnes Owner Owner's Name information West Barnstable Ma 02668 10/23l2019 ►iequi�Btl,torevery page: Cityrrown State Zip Code Date of lnspedion E Report Completeness Checklist Complete all applicable sections of this form Inclusive,of: A. Inspector Information:.Complete all fields in this section: B. Certification:Signed&Dated and 1, 2, 3,,or 4 checked �. C. inspection Summary: 1,2, 3,or completed as appropriate 4,(Failure:Criteria}and 6.(Checklist}completed D. System Information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15`: Explanation of estimated depth to high groundwater included ti r .9uta•ree 71Y8l2�1® TRIO 6 Oftal ftpWim Form:6ubsm&*Sawepq D*miai$ysiem•Pepe 19 or18 I - CERTIFICATE O µ ANALYSIS Barnstable County Health Laboratory (M-MAo09) ikwpieft Order Na: GIOI17396 Peter Nugnes Report Dated; IG24f2018 805 Ceder St Submitter. Peter Nu9nes . West Samstabie, MA 02868 Description: Lab Anatysts Laboratory Ift 19117326-01 matd) water=orinkMg Waat ; Sample#• Sampled: 10t1dwo 8 30 By: mtomer ColieGion Address. 005 Cedar GL,West BaMw8b19 Received: 1 O1012019 W02 SY: Peltne►P Sampb-Low#ions Tum Around Standard Routine Nitrate>as Nitrogen 3.0 0.10 10 EPA 300,0 CL 1011.,0019 14:02 copes 0.11 mgfL 0.10 , 1:3 EPA 200.8 CL 10111=9 14 Iron ND mgk 0.10 0.3 EPA 200.8' GL 10/111201.9 14:M PH 6.5 PH AT 25G NA 0.641.5 SM 450044-8 'CL 10/90%284 14:14 Sodium 24 MOIL 2.5 20 EPA 200.8 CL 1011112019 WN Total Conform Absent PIA 0 0 SM 92238 RG 10/1012019 1018 Conductant ?AO umohslan 2.0 EPA 120.1' 6Ce 10/1012018 14;18 Sodh ►level is above the m aulmum c Warntneni level. Thane one raw sodkm diet may wish to`0nsadt a physinten. AQached.pWmfmd the mom"ca rafted parametsrUt r Approved By:, ©c7 70 ttab Nlartag®rj } i - i 3I NO=NOO Detect _"Rt. _Re"p w1v Limit --,. ., — MCL=Ma)dmum Contaminent t ev+el r 3495 Main Sheet, PA,Box 4a7, Barnstable, MA 02630 Ph 508-376.6M � PMW r of.1 ' • r, CERTIFICATE OF-ANALYSIS sarnstable County Health Laboratory(M-MA009j 7. . Order No- 019117326 t?�er Nub, Relwrt Daied: 10/24/2019 805`C ar St Submitle: Peter Nugm west Bamstable, MA 02668 DespipElon: Lab Analyst 1 r 19117326-01 i0atft: 'WOW•pM*ng Water :Sample,#: Sampled. 10/10no19 8:30 BY: axww :t?otfa Awn e05 calla"Ll West Barnstable' iteantvedp "10/10/2019_- 902 'By: Ks3old S'ena�la°Lo�on3; Turn Af=ndt Standard LAna�!�, yn Method- EPA"524.a; F DUona 1 DabeMalped: '10/17/2019 @ 12 53 EPA 5242- V018#10 o rrganfcs by GC/KS Resuft MRMRParameter �, �c�ug/L IUWL Parameter u9n oinditluorcrr rang NO 0.50 thtor bane NO, oso: ror NO 0.50 Ghtorafionn Vh1yf tldOrtde .« NO 2.0 OSoJos1,2t NO, ZOc 0.50 Bromomethera 1. NO Aso ds 1,3+D 1911opropene ND 0_9 Ji 1,1,1,2-T*8dtlot+E eftne NO am 1;11-TMti mane NO 0m NO 200 am Dibromometham NO am 1t1'2'2- , _.ane NO also Fityibennene NO 700 OjD 1;1,2-ltf�no NO 5.0 030 5w, robutadtene' NO 0.50 1,1=Dlatlor tfiane ND om neND OSO: 1 1 -Dfdllomethwe NO 7.0 0 50n*ctttotide ND• SA 050' ND OSO rt-butyl eth NdND 0.50 ene ND 040ND" OSOa0'eite ND,,2,+Tttdttcrabemw ND z0 OSO' entene. NDND 0.50 pyttotuer� ND os'o ND a:50 lben�ne NO Uo Ir,2-Dftomoettwrie(®B) NO also Styrene NO am. 1,2 o e NO 600 0.50 tent-t3utyi mnwe NO 1,2-0[dit0toefliane. NO 5.0 ` am T&achloroethwie NO 4.0 0. 50 1,Z-0t +ior r NO also Toluene ND 1 0-5o 1,3 5-Tbemene NO asoTotal'xyt NO :000 0A, j,_3-Dktdoroberwm NO 0.50 traiwIA-Did broethene NO 100 am 1;3-Dtai�OreP NO 0.50 1;3-D� e NO am I 1,4=Did�llarcbeniene NO 5.0 0.50" rthene NO 5.0 Oso 2,2-Did#aroPr0 NO o.s0 tarnflunromethane ND o.� 2-QtI�Caluerte: NO p.5p _ 4-t7iEoromlu NO 0 50 Compound %Re QC Lbn@s"O �r NO 5.0 0.50 1�2-D1chMrobertsene-d4 8895 TO 130. ftmobwene NO as0 p-Bromoflu0robenzene 83% To 130: �. B nacfitararietl>ar:e NO 040 Bromodid�toromesfte` ND 0.50 BromofOrtn NO 0.50 rlaur.tahrlatde NO 5.0 0 0 NO 100 0.5o 0 Attaches pl a find the Womry wtlAed parameter W. Approved By: - (Lab, Dissector) NO.=None Detected RL = Reporting Limit ° Mt3.=Maximum ConWminant level i 3195 Main Stoeet,, PO.BOX 427, Barnstable, MA 02630 Ph:508-�375-6605. -?age i of TOWN OF BARNSTABi F 2 Op LOCATION SEWAGE # 9Z �ASSESSOR'S MAP &Vn:LAGE �J O 44D!� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY f ft LEACHING FACILITY: (type) (size) / NO.OF BEDROOMS ..:0 3�4 BUILDER OR OWNER 0 dk-<S PERMIT DATE: 'r" �+� COMPLIANCE DATE: ''' -'"` dal t Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and:Leaching Facility(If any wetlands exist within 300 feet oflchingjacility) Feet Furnished bys� .� q N`2 •� 3E A . /s®og ST = ~�' AKESSORS AW Na No. �L� " PARCEL V0= a, / Fee ,N THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS 0[ppYication for Migpaal *pgtem Congtruction permit Application is hereby made for a Permit to Construct(i/jor Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. e es► Owner's Name,Address and Tel.No. 7 7`^- et�� e/ yo,- lr?f -k J/!'�.t� � f++�"'92 /SY>f�i//tr AlGa p A le f O s-6 Alavk.,s s toa >t Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. .TO4 try 5/, M6.j lt", /i/��f � ,�4�r. f 7 ✓J�L Type of Building: Dwelling No.of Bedrooms Garbage Grinder(Al#> Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow .1-3 0 gallons per day. Calculated daily flow y gallons. Plan Date .2-21- 96 Number of sheets Revision Date z-7/- Title o Description of Soil ChAr" /Vs��+, SA-e/ Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo r n - Signed Date �' ` Application Approved by Application Disapproved for the following reasons Permit No. Date Issued J, �� Suers♦'1�'• �'�' "pg �+::�.t„ Y .�kr� '.-fvY �,:,_ � �.sw..''��<:�s.„eT:.:...!+T rs �„.S ��S=.ice... r, � n... .. .., •-�. .. c :�''R.f..W�vr,Y "•�W ..,..;=a,<"Y.��"-: I�a, No. � ��./ Fee� I •. THE COMMONWEALTH OF MASSACHUSETTS PUBUC HEALTH DIVISION -TOWN OF=BARNSTABLES.MASSACHUSETTS Tipphratton for�MtgPo,5a[,*p!5tem Con5trurtton vermtt Application�is hereby made for a Permit to Construct(1�or Repair( )an On-site Sewage Disposal System at: Location Address or,Lot No. Owner's Name,Address and Tel.No. 7 71_ c.1e $O S C-Id a�. ,s�./..e t ��"t/' ►`'"'d�°'�/. �r�S t,a ,,/I��ticfh r S O f�/� S-6 11/vvvi s S7 c,..h:r Installer's Name,Address,and Tel.No. 1 Designer's Name,Address and Tel.No. Tour h ,rl Au Me Pow, C�1 oti / SuG{/NIHN f St lve.4,f7".S 1 I/s S Type of Building. t Dwelling No.of Bedrooms Garbage Grinder(Al�p Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures t Design Flow 3 V gallons per day. Calculated daily flow 3U gallons. Plan Date Iffy. 1-21- 96 Number of sheets Revision Date 2- 2 K« Title 0 �/ Description of Soil M��. SANv� Nature of Repairs or Alterations(Answer when applicable) - Date last inspected: Agreement: f The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the'Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo H lth. Signed Date 4 , Application Approved by or Application Disapproved for the following reasons Permit No. ` ��° Date Issued THE COMMONWEALTH OF MASSACHUSETTS 4' PUBLIC HEALTH DIVISION - BARNSTABLE-. MASSACHUSETTS oil, Certtftcate of Compliance' THIS IS TO CERTITFY,that the On-site Sewage Disposal System installed or repaired/re laced( : )on ��i by for as .� has been constr ted i accordance with the provisions of Title and the T605isposail System Construction Permit No p dated"' Use of this system is conditioned on compliance with the provisiorz et orth below: ----- No. "'� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1=tgPota1 P!6tem Comaructton Vermtt Permission is hereby granted to 10 g7 rC _. to construct( )'repair(. )an On-site Se ,age Sy stem located at - and as described in the above Application for Disposal System Constrtct n Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within/two years of the date below. i Date: 9 !� Approved by 1 1 i i r AAIE REPORT' t�M Efi!':.: AA77: ! . ItICAN E ' ' 720 h�rnonrn .- 2 LABORAYORIE.S IIVCURPUIiA?'ED •LAB ID#!MA076- I : .n . DATE RECEI. t ,VED• 04 11:`9'-/96 . .. 'DATE COLLE . . : CT6A 04/19/96' OOLLECTEA• BY S • ME ��1f�77;>�:N;ttMxtE••,�:: :.; c�� • • .•MkTR•IX. t Water siyiPL scp ion` :.• : C.etlr.•St.. W. .Bar 's.t$bY�: ' - ANALYTICAL RESULTS C . ..ir _ .._._ . '� ._ " ` :�, L';;REaUL�•� I-.:UOM_j DA � � • � ..I �' •—....�....-- LEST mE COLirortiM DACT8RIA MIRTHOD __ ph NEGATIVE ORG/100ML 04/19/86 0/100 CONDUCTIVITY 6.65 S.U. 04/19/96 0- SM Ire 9222E SODIUM 240 UMHOS/CM 04/19/96 019 EPA # 150.1 . YRON 10.0 MG/L 04/1910 EPA # 120.1 NITRATE ND MG/L /96 0.04/19/96 0.05 EOA # 200.7 14ARGANESE 0.15 MG/L 0A 6 200.7 04/19/96 0.02 ND EPA MG/L 04/19/96 0.001 20000. EPA 4 7 .7 i II ' I i ANALYZE 0Y: these results apply on1y t0 tilt actual wimple as tested. 711e tote rr of results is JcpenJcnl upon Ilse quaho�the�� plutt;technique and suhsequent IwnJl►thg. Actual Jttcctinn Itm�if l the t iN d e ore 9iluti0n factors,if any.,lrnerican Pnvironmer►ahl Laburatoritx,Inc. sAall nfrt be held I pblcCir,M L;ntrr Ire lied by analytical,res ults. p tation ul ••Ficttda EPA G!jIdeUnoa bL C)0 Elm.Hill Avenue, Leonliusicr, Mussar'huseits 01453 y .b�ctltn4 Dct�edun L+m1t (d).534-1444 • 1 (80())322.0094 • F , Nu N . (108)537.6252 of Detected Please Rtcycle M UOM U1111 o(&leosut•e REPa T NiTMgERs .�iPi77,2.02 AIT11;'RIC ENVIRONMENTAL 1,4 t3ORATORIES, INCORPORATED . LAB 10#r:MA076- D� mar�d Weil bra lligi fin''.. DATE :RECEIV:ED 04:�.19%96 Amber fid. , PCB Box 27.83 ... DATE 'COLLECTS;n: . C0LL9CTED:.sit : . , !� y MA'1'R'IX' ` � . ' 's water N:IJM�tER._.... M-312i0.2 {:. t`. „r r'PT; O >t :uc zi ..: 8.A:5 . . d.4r. St:. BArn'%tab j' .-MA- C TM w. . ..I ANALYTICAL RESULTS - A5M.yrgR _ _ 'RESULT _iJdM 'TEST DATE i MDL C METHOD _J D ichlorodi f luorc-A'methane ND UG/L 04/22/96 0.50 r. fiPA # 524.2 rhloromethane ND UG/L 04/22/96 0.50 EPA # 524.2 Vinyl Chloride ND UG/L 04/22/96 0 S'0 3:tEPA # 324.2 3tromomethane ND UG/L 04/22/96 0.,50 EPA # 524.2 ^_Hlcroethane ND UG/L 04/22/96 0.50 EP.A # 524.2 ichlorofluoromethane ND UG/L 04/22/96 0.50 t EPA # 524.2 1 , 1-Dichloroethelne ND UG/L 04/22/96 0.50 EJA # 524.2 Mitthylene Chlori;,de ND UG/L 04/22/96 0.50 E,A # 524.2 'icans--1,2-Dichloroethene ND UG/L 04/22/96 0.50 EOA #• 524.2 :, a.-taichlorc5ethane ND UG/L 04/22/96 0.50 EPA # 524.2 ?,.I-nic.hloropxopane ND UG/L 04/22/96 0.50 E�A # 524.2 t.{s-_,'l.-Di.chloroethene ND UG/L 04/22/96 0.50 EPA #1 524.2 Cril.oro£orm (THM): ND Ufa/L 04/22/96 0.50 Ef)A # 524.2 nromochloromethaiae ND Ua/L 04/22/96 0.50 E A # 524.21 �r1,1-Trirhloroe,thane ND UC/L 04/22/96 0.50 EiA # 524.2 1.,1-Dichloropropene ND UG/L 04/22/96 0.56 -EPA # 624.2 Carbon Tetrachloride ND UG/L 04/22/961- .O-50,. EPA # 524.2'` Benzene ND UC/L 04/22/96 r"' 0 50 E$A # 52.4.2 1.,2-•Dlchlcroethene ND UC/L 04/22/96 0.50 EPA # 514.2 i'richlcroethene ND UG/L 04/22/96 0.50 EFA # 524.2 2•-Dichloropropane ND UG/L 04/22/96 0.50 E�J,A # 524.2 nromodichl.orometlhano (THM) ND UG/L 04/22/96 0.50 EPA # $24.2 :,tbromomethane - ND UG/L 04/22/96 0.50 E A # 524.2 :i.3•-1,3-Dichlorofpzopene ND UG/L 04/22/96 0.50 EPA # 524.2 - 7,.luene ND UG/L 04/22/96 0.50 E;A # 524.2 ` "-unu-•1,3-Dichloiropropene ND UG/L 04/22/96 0.50 EPA # 524.2 : 1, 1,2-Trichloroettaane ND UG/L 04/22/96 0.50 EPA # 524.2 : 1; 3-Dichloroprop'an® ND UG/L 04/22/96 0.50 EPA # 524.2 Tet.rachloroethen!e ND UG/L 04/22/96 0.50 EPA # 524.2 ' Dibroatochlaromet�hane (THM) ND UC/L 04/22/96 0.50 EPA # 529.2 - '.,2.-Dibromaethane ND UG/L 04/22/96 0.50 E�A # .524.2 Chlorobenzene ND UG/L 04/22/96 0.50{''.E." '.E A #'t5, 3,1,2-Tetrachloroethane ND UG/L 04/22/96 0.50' '' t"EPA # 524.2 Ztaylbenzene ND UC/L 04/22/96 0..50 ,�. EPA # 324.2 60 Elm.Hill Avenue., Leominster, Alassachusecrs 014.53 (508)534-1444 - l (800) 522.0094 - Yax: (508) 537.6252 I - - m THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA Lr.t,._nll CI v,,1 r wi U'ICI 1!lit_ " II_i i�!_:. 14 a - I REPORT-NUMBER: AA77202 1 AMERICAN ENVIRONMENTAL_ ..1 LABORATORIES, INCORPORATED PARAMETER RESULT UOM TEST DATE MDL METHOD Xylenes ! ND UC/L - 04/22/96 , A..503;F a.. Ep ._ 524.2 .yrene ND UG/L 04/22/96.- r,0.50 �� i iEpA-# 524.2 _Y 7r,,mofora\ (THM) ND UG/L 04/22/96 0.50 EPA 1) 524.2 sr,prcpylbenzene; ND UG/L 04/22/96 0.50 I' Epp► 6 .524.2 1,1,2,2--Tetrachloroethane ND UG/L 04/22/96. 0.50 "y...EPA 0 524.2 1.,2,3•-Trichloropropane NO UG/L 04/22/96 0.50 EPIA 4 524.2 Drcmobenzene ND UG/L ' '04%22/96 0.50 IVA # 524.2 'si••koropylbenzene ND UG/L 04/22/96 0.50 EPA t $24.2 tlticrotoluene ND UG/L 04/22/96 0.50 524.2 1, ?,5-•Trimethylb6nzene NO UG/L 04/22/96 '. 0.50 EP Ep;h A 524.2 1-Chlorotoluene ND UG/L 04/22/96 0.50 EPA 1 524.2 '.Vrt-Butylbenzene ND UG/L 04/2.2/96 0.50 EA. A 524.2 1 . 2,4-Trimethylbenzene ND UG/L 04/22/96 0.50 EPA # 524.2 '@c-Sutylbenzelle; ND UG/L 04/22/96 0.50., EPI # 524.2 ,. -'nopropyltoluehe ND UG/L 04/22/96 0.50, EZ# 524.2 1, 3--Dichlorobenz�ne ND UG/L 04/22/96 0-50 EP' A 524.2 1,4-Di ND UG/L 04/22/96 0.50 EP # S24.2 r-Bntylb'enzene !' ND UG/L 04/22/96 0.50 EPA # 524.2 _;2-Dichloroben26e ND UG/L 04/22/96 0.50 EPA # $24.2 1,2-D:ibromo-3-Chloropropane ND UG/L 04/22/96 . 0.50 EPA # 524.2 • 1,2,S.LTrichlorOben2ene NO Ua/L 04/22/96 0.50 EPA► (I 524.2 >aa:�hlcrobutadi�ne ND UG/L 04/22/96 0.50 EPA # 524.2 Nq)thalene ND UG/L 04/22/96 0.30 EP # $24.2 1, ::,3-Trichlorob4nzene ND UG/L 04/22/96 0.50 cp� N 524.2 I I bir3L MULTIPLIER: P rRCENT RURROGAT1s RECOVEIM i 4- romoflu.orobenzene 1188 1,2-Dichloroben26e D-4 82% V3� ': 3 t*; ;. .. I . 1 1 • , S y L' • '' 1 • r. w'' } T1 ��x•1. y • ,. 1. �t �r . �. ifAll n rr E I.` ' REv1B t D BYt ( ) Meese to Its afply only to tht actwil sample as tested. The integrity or rrsulm is depondcnt upon the quality'of the t 4 ., F 33nipling technique and subsegocni handling. Actual detection limits are llle;ibove reported MDV.s multiplied by dilution factors,if any.Amcricmut avironmcmal L•,bumoties,Inc. 011d1 not he held liable for any interpretation of j analytical reiults. 1 ` .c aeds EPA Guk)ctines 60 Eint Hill Avenue, L.eominsrer, Afuysurhu errs 01.153 - c.ho�netectinn Umit (.508) 534.1444 • ! (800.)522-0094 • F(Lt; (508)537.62.52 UOM�Unl�of m"nure LOCATION Lor•&'eC,0s425f2E�T l 'rcr¢.e o5do�.te7wr t y NO. 7_ VILLAGE_! Tz�ysfiaB�E DATE /L o APPLICANT Z ba&146 FEE 75 ADDRESS 7-/E,P4T,4&E,25u/ u rc lem.,� �,�:r W ELEPHO p, 778_¢?� (Non-refundable) ENGINEER_�w,v Csi Enuit g, ins TELE O NO.Juz- DATE SCHEDULED JAnluAR-cl 1 . Applic signatur • • . • • • O O O O O O • O • O O O O O • • O O • • • O O O • O O O • • •.• • • O • . • O. • • O • • • • O O • • . . . . . .O • O . . , SOIL LOG SUB-DIVISION NAME FTc7L JzEo_%0 4 Es? -s " DATE I I Z TIME EXPANSION AREA: YES NO _CAWi- you 6- /L r cave ENGINEER TOWN WATER PRIVATE WELL to BOARD OF HEALTH /-AcKG y- SPV5 EXCAVATOR SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and . percolation tests, locate wetlands. in proximity to test holes) NOTES: Z6 LOt; � nn 7� F• �' �f°,-r��.r/y Cat I$� �� a 'n M 2jg, I ' F �r 1• .. PERCOLATION RATE: G ZIn/jhcG, w TEST HOLE NO: /Z ELEVATION: TEST HOLE NO: ELEVATION: 1. Tv f sL, . � 1 1 2 2 3 3 4 4 _ 5 5 6. 7 T1 ec(lu/pn 7 8 Scj 8 10 �../ 10 �H Of 11 Co644?, 12 12 13 132 15 •.. a WQ '�/ AI 15 n 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES JNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: 40TE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION )RIGINAL: COMPLETED IN ENTIRETY BY P. E . AND RETURNED TO BOARD OF HEALTH _'OPY: RETAINED BY APPLICANT � I Fee BOARD OF HEALTH TOWN OF BARNSTABLE AppricationforlVell Con5tructfoupermit Application is hereby made for a permit to Construct ( j), Alter ( ), or Repair ( )an individual Well at: -e tfet r 1'7re&T% - --------------------- Rf�/J --�/ - - �L A--DzO--,j--=�-��a- -- - /� �i� Location - Address Assessors Map and Parcel/ f'l 2/s T/a) d r is lr ej JL •�'� O t'a/2 /S 'ed- --------------------------- /------------------------------------------- --------------------- ------------------- Owner Address ell �0( - ----------------------- ---------------- --- - Installer — Driller Address Type of Building Dwelling GQe� `��' ------------------ Other - Type of Building ------- No. of Persons------------------------------------------------------ sci 9o- n� --__ Type of Well-----------------`----------------------- --- Capacity----------------------------------------------------__------- Purpose of Well 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 Certificate of Compliance has been issued by the Board of Health. / Signed ---------- date Application Approved B — —— date Application Disapproved for the following reasons: ----------------------------------------------------------------------------—----------------------—----------------------- ------------------------ date Permit ------------------------------—-- Issued----- -- - - " ---- - -- date BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate ®f Compliance THI I T CERTIFY, That the Individual Well Constructed Altered or Repaired ( ) S S O C �i), ( ), p ----------------------------------- Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. - -7------Dated-------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE---------------------------------------------------------------------------- Inspector------------------------------—-- -— ------------------------ _ter^ 4 No /�------- - Fee------ =------ ........ BOARD OF HEALTH TOWN OF ' BARNSTABLE zip-plitAtids.forVelf Con!5truct ion Permit Application is hereby made for a permit to Construct (X), Alter ( ), or Repair ( )an individual Well at: .STa° -------------- - - — OAP—PIP - .ol'/-_4z /_dim_ - -____ Location — Address Assessors Map and Parcel /� as Tilt/ �/YCi1�P —— —— — --------------------— -------`f �'------ /U 'R s a� `—�— — —t'l}_ i(//�/i< ��1 E1 4aCJj�Y � ��? _—_ _ Owner Address r_Abr----- '� '--�-------------- -------- Installer — Driller Address Type of Building Dwelling -_JS f�1t a1 ------------------- Other - Type of Building----------------------------------- No. of Persons------------------- TYPe of Well ------------------ ------------------- __— Purpose of Well---CA-41 6 i,1&IL —-------------- 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 Certificate of Compliance has been issued by the Board of Health. Signed-- ©rr!D< a , ^-��` ------ —_31 � _� / — - - aate Application Approved By—_ date Application Disapproved for the following reasons:-------------------------------------_-------------_---------__-__________________ _ --_—_ _---- --- -- -= — --------------------------------- date Permit'No. - t - � -- =�-/---------------------------------------- Issued —- — -- —1—�� — - - ---- - date— BOARD BOARD OF HEALTH 1 TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) v-r----------------------------------------------------------------------------- ---------------------------------- �j wy� / Installer p /�/, 75 (a ,y-.. Q ! 6 1 / m.__�!A 3�_s�lit/Jt ——— -- ---------- a at--a— I-vc—,z�iro '1———= r —: -- ........... .— has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No.k?-4 -=-- --- ----Dated-------------�-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL_ SYSTEM WILL FUNCTION SATISFACTORY. ; DATE-_—_- - - --- -- -- -- - Inspector__- —--- --------— --- —- -- BOARD OF HEALTH TOWN OF BARNSTABLE Vern CootructionPermit No. -t-----------------= _ --�------ r Fee---------- Permission is hereby granted--------— ----------, - = --- to Construct (� Alter ( ), or Repair ( ) an Individual Well at: Street as shown on the application for a Well Construction Permit No. �LJ Q_ n_—_� 1s4 Dated - --- � /-- --- --- ------- r-- ---- ----------------- - —----— ----------------- Board of Health DATE-------------------------------------------------------------------------- Department of Environmental Management/Division of Water Resources 7Address__,?0 WELL COMPLETION REPORT OCATION GEOGRAPHIC DESCRIPTION vie ST•pet_ CJU?- aiO M'g P 8rF' N S E w or peed (eJrcle) wn !.0. ,s ,rl R ws7WA '6er /°� � s��t''s%� / u4N�5 (road) Address + /le'e'e/5 JT, N S E W of (nit in tenths) klydel ,f Board of Health permit obtained: yes Er no El (road; w/ (road; i WELL USE WELL DATA I Domestic (©'Public❑ Industrial ❑ Total well depth fad ft. Monitoring❑ Other Depth to bedrock, ft. �s e Water-bearing tock/unconsolidated material: Method drilled Date /�_ Description drilled "`f� `! Water-bearing zones: CASING 1) From To Type JCh �D f�!/� .2) From To Length/4-1 ft. MaO.D.):—in. 3) From To Length into.bedrock ft. Gravel pack well: dia. P Protective well seal: Screed: dia: a Grout.❑ Other Slot"-4- length - from to/ u STATIC WATER LEVEL(all wells) ��,,,,,�// Static water level below land surfaced ft. Date WELL TEST(production wells) Drawdown ? It. after pumping hr.-- min.at /D gpm How measured?otl/�/''L'q'°4:T- � ,.—ecoveryk,.,f4.- �rr. min. o LOG of FORMATIONS COMMENTS 4 P 0'0- 8 Materials From To - ��►'b © Driller / KJE'b/l9o�lGQ i cJ`� FirmS/Ylarld �� SrafiG. QO //O Address F'"-�1N/) '3 /.fit ' City/Town ��'��`S /fJ•4 �vLG�� Supervising Driller Reg* ' y� G.. Si nature o/nrpervisln re istered well driller . Please print trrmly BOARD OF.HEALTH COPY r v=;.-_ - ,• zi --- _.___ _-- �._. .. •..... r �r..�r n ...r w�n..�r n r�r v r n�. I V L:�YJGG4eJ1tIk0_l 1"'.l'll 4 W-1 �^ AMERICA�.N E1�Y'IlfOli�11��NTAL RE'�?:ORT. NUMBER': AA.7`72.0,2 LABORATORIES INCORPORATED y ASSMSORS MAP 07 :yv: •LAB ID# M.1ti1G• pARCO.Na - ....::..: .::. DAT1r REGEI:VED : .>•::Po' •'BMX_.,2 ; 04/1`9/96 'earl ;.0:�: COLLECTED 6; ;3;,• •.;' DATE CaL 04/19/96 COL'•LECTED' BY SA1�Ei •MA a MA IX W .te•r (( St�iPZ1~::at)1rS �. _.��..�..:_�-:R;I-p�'1c�t�� :..`N.u; riffs;;;: ••• $.p5••�. . aaz'natable MA ANALYTICAL RESULT, • L':REa:LiL'X!•J I .:UOM_ ' EST __•...—. __......-- CoLirwzI j BACT8RIA J LT DA'SEl MAL ph NEGATIVE 04/19, 96 U/lU0 — ORG/IoOML CONDUCTIVITY 6:65 S.U. 04/19/g6 SM # 92228 SODIUM �40 UMHOS/CM 04/19/96 0_14 EPA # 150. 1 rRUN 10.0 MG/L 04/19/y6 10 EPA # 120.1 ^;.L RATE ND MG/L 0.05 ESA # 200.7 MANGANESL• 0.15 04/19/96 0.003 EPA # 200.7 MG/L 04/19/96 0.02 ND MG/L 04/19/96 EPA # 353.3 0.001 EPA # 200. 7 i ANAME6 i nil 'fhrs¢iesuits a Iv onl•t ItJrViR1YEG� Pp. y O'IIIC At ual Sn�h�lle A.i tested. �lyle 1ntC�rliy O[results is dt'pendCnt upon the quality of the I,lu,t;tednl;que and suh3cyuei)t Iwndling. Actual dctectiun limos ate the above reportccl M1aL's multiplied by dilution factors,it Any.American 1 nvironmeArnl Uburntoritx,Inc. shall ntlt be held li:,blc for un intrr ti i. ', analytical results. p auLn ut ".E'"'teds EPAGuidetin,% 60 Elm.Hill Avenue, Leonti�tsccrrr UuSsa(:huse(t$01453 .yDL.-Mc:D,ed Detecyun L+mit (508)S'34-14951 1 (800 ) .S2)• OUy4 • Fiji: (508) 537•62S2 NJ),Not Detected Pleme Rtcycic® V01M•Unit of,Mcusure REPORT NUMBER: .AA77.2.02 te Al ESECA IVENVIR'O�'�'M NTALL AM)k4TORIE.S, INCORPOR ITED LAB 1:1,)# MA070'- TC•. p >Trc�> d �1 ]7Y Z1�ricTv rn� � 'DATE ..RECEIVED i'. . S -avherci E BOx, DATE 'CO L,EC'1 ED; . .0.4/.19. 9 6: CO��ETE Y C s S �; •. AI�iE . ;. IX s Watt : VOfIE1 fitlt2FsEFt AA7.7202 .' w , Barnstabl'e, 'TEST 'DATE-! MDL � �__METHOD J i L cl:lorodifituor,•cxnethane ND UG/L 04/22/96 0.50 EPA # 524.2 C'hloromethane 14D UG/L 04/22/96 0150 EPA # 524.2 Vinyl Chloride ND UG/L 04/22/96 0.50 EPA # 524 .2 3r.:�momothane ND UG/L 04/22/96 0.50 EPA 4 52.4 .2 'Icr.-oethane ND UG/L 04/22/96 0.50 EPA # 524.2 'I.J i.olilorafluoromPthane ND UG/L Oo/221,96 0.50 E?A # 524 .2 1., '-Dichlo.roethene ND UG/L 04/22/96 0.50 EQA # 524.2 tJ.?th.vlene Chloriade ND UG/L 04/22/96 0.50 E�jA # 524.2 ` ci hns-!,2--Dirhloroethene NIA UG/L 04/22/96 0. 50 EP?A R 524.2 ., .L-Dichloroethane ND UG/L 04/22/96 0.50 EPA # 524.2 ?;1-1)ichloropr_opane ND UG/L 04/22/96 0.50 EPA # $24.2 1,'l.-Di.ch),oroethene ND UG/L 04/22/96 0.50 EPA R 524.2 C•;�l.uro�oxm (7'FiP9) ND UG/L 04/22/96 0.50 EPA # 524.2 :`rclutoch].crometh&Tie ND UG/L 04/22/96 0.50 EPA 524.2 1-Trichloroethane ND UG/L 04/22/96 0.50 EPA # 524 .2 1., 1-1)ichloroprope,ae ND UG/L 04/22/96 0.50 EPA # 524.2 Carbon Tet.rachlvride ND UG/L 04/22/96 0.50 EPA # 524.2 enxene ND UG/L 08/22/96 4. 50 EPA # 52-4.2 , 24):4chloroethAnA ND UG/L 04/22/96 0.50 EPA # 524.2 d'.ri.ehlrroethenE ND UG/L 04/22/96 0.50 EPA # 524.2 2•-Dichloropropane ND UG/L 04/22/96 0.50 EPA 4 524,2 _i_lomodichloromethane (THM) ND UG/L 04/22/96 0.50 E1.A 4 524.2 2:i..bromamethane ND UG/L 04/22/96 0,50 EPA # 524.2 'i.:s•- ,3-Dichlor6propene ND UG/L 04/22/96 0.50 E1A # 524.2 :t-.luene ND UG/L 04/22/96 0. 50 EPA # $24.2 ans-1,3-Dichl6ropropene ND UG/L 04/22/96 0.50 EPA # 524.2 . 1,2-Trichlc%roe;thane ND UG/L 04/22/96 0.50 EPA 4 524.2 ?; 3-Dichlorcprop;ane ND UG/L 04/22/96 0.50 EPA # 524.2 let.tachloroethene 111D UG/L 04/22/96 0.50 EPA # 524.2 • DibroriochloromiaC:hane (TH14) ND UG/L 04/22;� 6 0.50 EPA # 524.2 -p2-Dihxamoath,atLe ND UG/L 04/22/96 0.50 EPA # 524.2 Chlorobenzena ND UG/L 04/.22/96 0.50 EPA # 524.2 -Tetrachi'oroethane ND UG/I. 04/22/96 0,50 EPA # 524.2 ?ylbenaene ND UG/L 04/22/96 0.50 EPA # 524.2 60,Ein1.Hill Avenue, hfon►inatE r, j19assc7chusetts . 01r4 :53 (.508I 534-1444 m I IY0() s?2-U(94 far. (5fb 53ry-6: 52 � ' Plrncr Nrrr,fR MIJI`ll•ICl`i I ML I REPORT NUMBER: AA77202 AMERICAN ENVIRO,IrMENTAl_ LC60RATOR1RS, INCORPORATED' ArtAP4ETER RESULT UQM TEST DATE MAID : METHOD :)r01 Xylenes ND UG/1. 04/22/96 0.50 EPA # 524.2 ":.v.rene ND UG/L 04/22/96 0.50 EPA # 524.2 "e u,ofornt ('TfiM) ND UG/L 04/22/96 0.50 EPA # 524.2 c�prapy?.benzen? ND UG/L 04/22/96 0.50 EPA # 524.2 1,1,2,2--Tetrtach16roethane ND UG/L 04/22/96 0.50 EFA # 524.2 1 ,2,3-TriGhlOrop�opane ND UG/L 04/22/96 0.50 EPA # 524.2 Bromrbenzene ND UG/L 04/22/96 0.50 EP'A # 524.2 .,Vropylbenzene ND UG/L 04/22/06 0.50 EPA # 524.2 .; •chicrotoluene ND UG/L 04/22/96 0.50 EPA # 524.2 1, �, 5--Trimethylben2ene ND UG/L 04/22/96 0.50 EPA # 524.2 I-Chlorotoluene ND UG/L 04/22/96 0.50 EP1#. # 524.2 >•t-Butylberi ene ND UG/L 04/22/06 0.50 EpA # 524.2 '. , 2,4-Trimethylbnzene ND UG/L 04/22/96 0.50 EPA # 524.2 Butylben2e;lel ND UG/L 04/22/96 0.50 EPA # 524.2 ?<opropyl:o3uette ND UG/L 04/22/96 0.50 EPA # 524.2 !,3--richlorobenz�ne 1dD UG/L 04/22/96 0.50 EP:A # 524.2 1,4-Dich.loroben2ene ND UG/L 04/22/96 0.50 EPA # 524.2 ?e-BUCy?ben«ette ND UG/L 04/22/96 0.50 EPA # 524.2 '-;2--Dichloroben2ene ND UG/I, 04/22/96 0. 50 EPA # 524.2 1,2-Ilbromo-3-chloropropane NJ) UG/L 04/22/96 0.50 EPA # 524.2 1,.2,S. Trichlcrob�-nzer»e NI) UG/L 04/22/96 0.50 EP1a # 524.2 y>ha;:hlorobutajigne ND UG/L 04/22/96 0.50 EPA # 524.2 : w..pthalerte ND UG/L 04/22/96 0.50 EpA # 524.2 1, :!O3 Trichlorob6nzene ND UG/L 04/22/96 0.50 $24.2 t•.- I, RULTIPILTEN: 11 "-RCI D1iT SURROGATE RECOVERY- 4-.;fir o,nof luorobenzene 18 i ',2-Di`hlc7robenz�ne- D-4 82% I i i I i i i i I i i I 1 mat,'Y?,FJ D By, } "These results apply only w the.setwil sample as tested: The illte-ity of result~iS dopoildcot upon the quality of the i sattipling technique and subsequcnt1 ht3ndling. Actual detection limits are the Bove reported MDV.�multiplied by diltitiUll factors,if say. atlalytical Amrrirn11 FAvltOtimcil[al LabOral6rits,rltc'. shalt I,(.), he hr.id liable for any inrerpretati4n of I results. a �z reds EPA Guerlctines 60 Elm Hill Avenue Leominsreo,, Mussaclllcseus 01453 •� � :c•i,a��netecuon Umit (508) 534-1444 • 1 (800) 522-0094 Fat: 508){ NV•loot I) krted 537.6Z.�� UONI•Uni�or measure ' Plaato kncvcic ff® --_ _-_ I . W!ee'.Ai7K,a>;'tt�R'a..:Apt['A1v.Y.'..�Rrtx'S�IY.�T.A3C/2•V6'�=::Lh'a'i.41�r`.L1p .4,8.'TS7f3E'S>�::✓.isiCKR!1N'_Srll7•LC"Qn^xc3,b aAN.Y ""'•:# _iapttF'��9t14�.995rSti�'..^i•bs • .:_. .. •.t`� ry;- :-'N'w='ri. 'tlnE�'lKN:KI'0.Tmr� .7G�fQ.'�^" .-..� ,. :t'"r•::_3Yrpat9@p>.�.^..,_';..::yam-J:../1•,'i. +--.'u•A3F.""aa!sR+�yISL'T'w`.'r,.'L�7M,YT.-"�.r"9.'TiO�itd8n. i'I�6"�4�w+w�r.a.3a'if�'17u:^9• .:i^Niw.'•^yr.a"Y'^.... _.. t z '� { he installation shall campy f_h the State Environmental Cod n, Town o -f �� .. 1; T I t 't e Title��and f 3 8nard of Health Rfygulations. A _%T. �� ^�/ 2' The e ro oSGd an this Flan shall not be installed until a iitensed town insta let I;I f�{? D r�}. �l,��J� ��1�,,�,p�, ' � ... t� _ , septic system as�' p ---- --_- r _ ._ ""�. _ _-- �l i TRESS W j �j ,- _ receives approval and an installation permit from the applicable town. U �/ I�t(o✓� � .`V .V-. _. --�'�'_�-�.�t. .. .,..._.-_-__.. �, Prior to installation,iFa installer` r shatl verify the location of vtil: aes,s?ire inverts, sewerer lines FLr R� "' � " .• 4 % .�E ` ) +_ " J_ ._._ww_. arid existing septic Ct�r-nponents prior'to installation. t �-_ -- .._.. .. _ _._ _..__._- ¢_; ,,- �� « Al gravity piping i to be 4 inch schedule�10 PVC at 1/8" per fort. The first Z feet out of ( %D I gr Alp u�;;: � 4 .•,-- avrt, sewer r„ S 1 ►_ .--_ _ ._� I- T - i g 2 the distribution box shall he level_ All piping connections to be g!ued, r j _ 5J This septic design play,is not to be ut=lized for property line determ!nation or for any other " trr ose other tti_-n the proposed septic s stem installation. � All Title V comporents are to meet Title V specifications, �.•.•�`` ,�t� ��t�'(,�t ;) Parking shaft be p(ohitliwec? over Title it components unless._^rnpenenfis are M24 loaded. {��i I t„�� .�r 8} The existing teaching or Cesspool-,- shall be pumped and filled with material per Title V � • �,, abandonment procedures, Leaching and cesspool(s)and contaminated soils within the /r lip, - / 1 proposed SAS shall be removed and .replaced with clean sand per Title V specifications. � Cr t a• '� ! 3) Septic components are to be I('from a water service line.Sewer ilnes crossing a water line slpt St , /L ; f be sleeved with an appropriately sized schedule 40 PVC with Qnds grouted. The water service r !_ - , r �75�� - t �7 lisle or the septic line can be scent=ed ri;h flee Sleeue being a distance cf 1�`' o- both sides rs'r crossing the line. 1^; ff a garbage grinder exists In.the structure, it is to be.removed -he septic system is not designed to accommod«te a garbage grinder. �Yj — ---_ x1) The installer is responsible for care of excavation around al,utilities cn the property and Uv i � s i-•• _ -�. )k N ter on process of the septic ;>c µ +- - protecting the structural integrity of all structures during;the installation ' �.__��.I „,__ � ,� s•;rs+ern. �s gyp . ,,'_,�� ,. o ` ," 12 Tlzi plan only�epresFnts that a septic system can be install+:si on the property meeting Title V requirements. >: r:r, P�;�i r 1 t t+t�; :n`' t .1� :Gpf, „ ��V /DAY 13j The property owner Chu#i reviar��de�rgf criteria to approve the total nut,bpr of bedrooms and N •�,�, _iJ. L r- - _ -_ _ __ design flow.Installation of the sciatic system as proposed and receipt of payment for the design. 1JBJ17 shall be deemed approval of the de xign criteria by the property ad�rner or agent of. 14)The validity of this plan stall expire with the expiration of tl-ie towr+installation permit issued for ;�rY tt , this plan or the validity of this plan shall expire on the expiration of the Certificate of Complit ncr, �I �3A1, O ...s, N issued for the irrstalta• ,. i • 9 Lr �VJ ° '� �.1�� D Chi., t .' c �} �. t�iD l �j M _ , so, � / i 1. =B-06 [��p� t/{^{' [/�f ;• �i, �!��. .♦�,^f)117 ,, - - ` ' �,..-......-. ; �'�C�.X (�V�`•'S r i p i t,t�1 1 t ' �.. ..r-•''` `r.. t � �+ r,.s `' •' ,J.. r�. ,.s _ .l .,9r1 y„� y^""e.'c*. _�">=t.� �.%.="_'i( ram.-k h�j �,.```m..+e�.y, 3 / 7 _ i TANK 4 �- - IDS 12+ W✓t l t - - OrrI�4 �t;g. �C�� .# ______.._.__�� .�._ _.. �✓t✓v tfin DAVID i ate! f i1s r'Si1 t..s 1^�\.J f i � �_7c ^� JI J .,:._.... -...'.. ` ryJ f} ��tltldd) jib j .yam--�_"u"+ "`M��,✓. y`r-, .y.rr✓..— ; .ai � 'fi� fC! �� _ _y./' .' _t = ._I.� _ ar i..�AV ;' '✓ S,-: a if d•.`.,-..1'�t f.y !'1,'� i .. ...k,»'*� `a6l - _ p2 s`Y•-r;:' r"�...I,T!;i.�. 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MUNICIPAL W USE :0 'GP L M INIMUM PIPE.,PITCH To BE 1 IT, Z� 'SEPTIC joK: GALLONS , PER F OT, D 3. T RTI0HT._'- �US LON SEPTIC'� TA K 4, DESIGN LOAD N CAL N �ECAST LfNrrs o BE "AASHO-H V I G FOR ALL JOINTS M MADE_,WATE 5 PIPE vv� MASS. DETAILS-�'JOL E-� IN ACCORDANCE:VITH. ONSTRUCTION; LEANI 6 C' �GPD TITLE SIDES -:tNVIRONMENTAL-CODE� E IS 'PLAN 4S FOR P1 [3 GOD 7. TH BOILTOM L STAKING.':", qOPOSED: WORK �ONLY AND :NOT,JO :,USED,FOR LOT,1INE % GpD '1 40 S. PIPE FOR SEPTIC S F 0' SCI `:PVC, TOTAL. V SYSTEM T A'J'; CONCEALE T L E D OR _\j 2L -3 �!H EALTH AND'L NED 9 COMPONtWS' NOT 0-',BE 'BACK INSPECTION ]3Y'.BOARD OF, ,"08TAI FROM HEALTH. �,BOARD LEM PROPOSED` SPOT, EL EVATION EXtSnNo .SPOT'."ELEVAM0 ooxG N A PROPOSED C - E "AND S EWAGE '0 F SLIT i6 ... ... S n CONTOUR �j 7 Di TM :TO'" Of- V 7f�V%t, DATE "PROM FOR it .................. S C DATE. e Cape, Ing, Inc., ca D 0 dd r DL Y, % 1) S tjAVEY, RS 'At PH Nf: S013 2-4541 A Fo . 62-9880 t 1�',,yekrrno FtA 0 4 %wop rn ek! 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