HomeMy WebLinkAbout0851 CEDAR STREET - Health VCedar Street
nstable
58 001.003
00
- TOWN OF BARNSTABLE k
LOCATION K�I � Ac.r S�- SEWAGE
VILLAGE ''Je. ASSESSOR'S MAP & LOTOdf'00I—u-3
INSTALLER'S NAME&PHONE NO. &SVr,-,%nU
SEPTIC TANK CAPACITY /�
LEACHING FACILITY: (type) Gbt�. " size)
NO. OF BEDROOMS
BUILDER OR OWNER u'
PERMIT DATE:
a 1. COMPLIANCE DATE: 3 ��
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
Eige of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
_ TOWN OF BARNSTABLE
LOCATION , I Cs+u,"s, SEWAGE #
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILrTY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
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 of leaching facility) Feet
Furnished;by
r -
GAP
�-1- SA
r.
No. d s ( 7 6 Fee
TYiE COM;AONWEALTH OF MASSACHUSET,TS + Entered in computer:s
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
ZippYication for Mopogaf *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot�N(� Owner's Name,Add id Tel.No. �G
!�r/�5�" ��`�51`r�b�LG ��-(?7� .1�-Ff-✓�:/t Xi,�Ez=•. �l�tl o ��� ._.
Assessor's Map/Parcel 2-01
1�' Zo� � - 7 Z
InidanoeV�Ldjl No. Des' d�s�eGb�/G �
ers
�
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder
Other Type of Building 4/og� eNo.of Persons l Showers(V-) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date M*r& :3 0, :�—'004 Number of sheets Revision Date
Title$jk, f- �� Ze_,;j eAlO
Size of Septic Tank XS__dD _ Type of S.A.S.
Description of Soil o" `-'�" ' '� f"O ���jah�•f7_�.�1/� ra/:�-�/ _ Zd� f'i"D
/ZD
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction#<—mairglenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of Wt�heEnvi onmental ode and not to place the system in operation until a Certifi-
cate of Compliance has been issued y his Bof He
Signed Date �� d
Application Approved by Date
Application Disapproved for the'following reasons
Permit No. d - Date Issued &L U
f
70 ,i' i Fee
ID�J-
T E CO { ONWEALT�OF MASSACHUSETTS,,-,54'' / Entered in computer:"
CO Yes
PU�LIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
application for Migogal bpztem Congtruction Permit
s
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owaer's *me,Address and Tel.No. _
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. D ig er's Name,Ad_dr_e�s and-Tel.
Type of Building:
.Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building `d� /-r4' CNo.of Persons � Showers( Cafeteria( )
,Other Fixtures' .
DesigaFlow `� gallons per day. Calculated daily flow gallons.
Plan Date M A-rC. :3 ZOO 0, Number of sheets Revision Date
Title 5;ke' f7 5&,F i C, s:Q A/Ij
/,01_) T e of S.A.S.60aC 'c/`' erf
Size of Septic Tank�X ,/ ---Type /� / t.✓•�
Description of Soil 0 � �o 1'" f"O u .Z�i Z-111yy : _IG� CIA-X
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction agd maintenance of the afore described on-site sewage.disposal system
in accordance with the provisions of Title 5 of the nvi onmental ode and not to place the system in operation until a Certifi-
cate of Compliance has been issu d .y his Bow of Heal ° .
Signed / Date d
Application Approved by \ �/ Date
Application Disapproved for the following reasons
f
Permit No. •2 d Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
f (Certificate of (Compliance
THIS IS TO CE�TIFY, that the On-sit Sewage Disposal System Constructed ( ) Repaired( )Upgraded ( )
Abandoned(_ )by 5 3'/*"I r CU1s 0„_
t� at k P of Pf S • IN- D1 fl), has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. .)-U d y'�7d dated t L
r
Installer Designer
The issuance of ptth�i's pernut s all not be construed as a guarantee that the system it Tunctio s esignee .
Date -1 I O Inspector / Y�
l /
— -------------------------- -No. 2UO 1 �- Fee U
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Mi!5poga[ *p.5tem Construction Permit
Permission is hereby granted to Con truct(X)Repair( )Upgrade( )Abandon( )
System located at ��r. _
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of this(p� erm�t.
Date: =! �� / Approved by �. I/V•A ,
i
TOWN OF BARNSTABLE
r S�— SEWAGE #
LOCATION
VILLAGE
ASSESSOR'S MAP & LOTdf Off —ta
INSTALLER'S NAIL&PHONE NO.-
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) S7�
NO. OF BEDROOMS—,<;:
BUILDER OR OWNER o
COMPLIANCE DATE: 36
PERMITDATE:
Separation Distance Between the: Feet
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility
Private Water Supply Well and Leaching Facility (If any wells exist
Feet
on site or within 200 feet of leaching facility)
of W,tland and Leaching Facility(If any wetlands exist
et
WiNq 300 feet of leaching facility)
Furnished by i
P e Cad 3
•4 f (Oct
w
° C �-
Town of Barnstable .
o VNIE r°w
Regulatory Services
N Thomas F. Geiler,Director
.snKxx�r,�ste; • .
MEAS& Public Health Division
j�19' ���
�� Thomas McKean,Director
200 Main Street,Hyannis,AIA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date., 7,15
William Dinger
Designer: Arlvanrpd TPrbni c,-L S -U tio4staller:Agc„r?nnp Fyr2y2t;J Q }
Address: PO Box 99 Address:550 Willow St.
Sandwich. MA02537 West Yarmouth, MA 02673
On William T)ingpr/As s ura issued a permit to install.a
(date) (installer)
septic system at 851 Cedar Street W. Barnstable based on a design drawn by
(address)
Solutions
Earl Lantery/Advanced Tech dated 5/30/04
(designer)
r
I certify that the septic system referenced above-was installed substantially according,to
e design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
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.
" OF�ASsgcti a
HARRY
g EARL
�n�c LANTERY, 1R. v
(Ins ' er's Signature) No.26575 p 4
FSS/ONAI E
(Designer's Si tore) (Affix Designer's Stamp Here)
PLEASE RETiTRN TO ' ARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTIR THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE LU4LIC HEALTH DIVISION.
THANK'YOU.
Q:Health/Septic/Desiper Certification Form
LL
-----—---------
t. r
Fee-
BOARD OF HEALTH
R` TOWN OF BARNSTABLE
2pprication-*rVe[[ Cootruct ion Permit
Application is hereby made for a permit to Construct (tier ( ), or Repair ( )an individual Well at:
Location — Address Assessors 17-c'
d Parcel
/Ulu 1�1,, �� 1 Cam. ¢ ------------- --- - '-�Kc --
Owner ,� Address /y
'C,92U 1r 6�----�v)Ad e— -C,C�y -----l-�a-U_tD ----- �L�131�o V�I f-l/� `-o")clE
- ------ -------- -
Installer — Driller Address
Type of Building
Dwelling
Other - Type of Building ----------- No. of Persons----------------------------------------
Type of Well�-
YPeofWell�&- - U -- - -- -- - --- —- -- -------------------- - Capacity------------
Purpose of Well---- a--A it--------------------------_--
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 By-- - -------- -- --- —--—— -- -
n; date
Application Disapproved for the following reasons:--------------------------------------------------------—_________
----------------------- ---
-------------------------------------------------------
�� date
Permit No. -- —�=�-7 ----- Issued-------------------------------------------------------------------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( )
bY----------- ------ =—c-- - - —- ------- --------------------------------------------------------------- -------
taner
at- - — ---- —- — -- �� C..-�-1__--- -- �
has be 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. Dated---------_____________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------------------— - — -- - ------ Inspector-------------------------- ----—- --—-
.-'''��C7'}"^•'Z+J"f+�T'�- caw -y-�+"�''T"�(`.. Y�`.*nd�tf.�,'���t�'9 T''i!"4.'/f'�4^^'�M�+��.�7^��"'gy�; 5�1+'y'r'*� +T�'t}�'w'��v
No.- l- = Fee----�-b--------- ..
BOARD OF HEALTH
TOWN OF .BARNSTABLE
Application-Ar lVe1C-Contruction permit
�G. A lication is hereby made for permit to Construct V Alter or Repair an individual Well at:
tS PP Y P ( )- ( ) P ( )
Location — Address Assessors Ma and Parcel
--- .
. n�= =l .� �` �-- — - - S _®lc✓� .- a� �� l/e �'YI�9,
Owner Address
AEI - -- ------ - ----�1
Installer — Driller t r Address
Type of.Building y
Other - Type of Building-----------—-------------------- No. of Persons-----------------------
Type of Well �V Ca acit --------------------------------- -off
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 By—
date
Application Disapproved for the following reasons:-------__-------___------------------------------_--
----------
rr ----
date ;
Permit No. ---- Issued--- -- ---------------------------------
date - —
�a�rrc�b.�o_aas���.-�sn�vc-.Maass���i...:.r-o-...�+sr.o�+..,.,m.w�.-..�.�aar.+�..w.;sm.��=aew�:amc..�n...,v.i.�e�sau.•e..�.��.�- �.r�e�..�,.«..;:�'
BOARD OF HEALTH l
TOWN OF BARNSTABLE
Certifitate Of Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( . ), or Repaired ( )
by---------- ------ -c-- - - ---------------------------------------- -------- r
at — - - mow— 1 staller--g — — �— — — —
has be 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. �_?_Y,6-6--Dated ----------------------
THE ISSUANCE-OF THIS CERTIFICATE SHALL NOT 13 ,CONSTRUED A-GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------------------- ---- -------------------— -- a Inspector------------------------------------------ - "-----------
BOARD OF_ HEALTH
TOWN OF BARNSTABLE
�eC� �on�truct,on,�ermt
NO. Fee-----J---------
G
Permission is hereby granted — _____--------------_------------------------------____--
to Construct ( ), Alter.( ), or Re air ( ) an Individual Well at:
No. -------------- --- ---- --- -- ------- - %� _5 f
f — — street
as shown on the application for a Well Construction Permit
---- ---- — -- - Dated L
I I
------------------- �.-�--------------------------------------
Board of Health
DATE.----1-�---���"�f---------------- --- ,
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I HEREBY CERTIFY TO THE BE5T OF MY PROFE5510NAL
KNOWLEDGE, INFORMATION, AND BELIEF, THAT THE GRAPHIC SCALE
FOUNDATION IS LOCATED ON THE GROUND A5 SHOWN 0' 50' 100' 200'
HEREON, AND CONFORMS TO THE HORIZONTAL SETBACK
REQUIREMENTS OF THE TOWN OF BAKN5TABLE ZONING BY-LAW.
P-241-0� PLS ZZJU{. 04- ( IN FEET)
RICHARD . OOD, PLS DATE I" = 100'
FOUNDATION CERTIFICATION JOB No.: 031G9
IN DATE: 2 1 JUN04
WEST BARNYABLE, MA MA55ACHU5ETT5 SCALE: I° = 100'
PREPARED FOR
JEFFREY 50LLOW5
H S G HOOD SURVEY GROUP, L.LC;
LAND SURVEYORS - MAPPERS - CONSULTANTS
18 Old Kings Highway - P.O. Box 231 - Sandwich, MA 025G3
Ph: (508) 888- 10.90 Fax: (508) 888-7890 Z.2Ju1"4 �{
I
GROUp� OWTER Groundwater Analytical,Inc.
/J� P.O.Box 1200
A/, A�f YTICAL Bu Main Street
d 1� tom. Buaards Bay,MA 02532
Telephone(508)759-4441
March 5 2004 FAX(508)759-4475
www.groundwateranalytical.com
Mr. Ron Saari
Envirotech Laboratories, Inc.
8 Jan Sebastian Drive
Unit#12
Sandwich, MA 02563
LABORATORY REPORT
Project: Jeff Sallows/851 Cedar St
Lab I D: 70004
Received: 02-27-04
Dear Ron:
Enclosed are the analytical results for the above referenced project. The project was processed for
Priority turnaround.
This letter authorizes the release of the analytical results, and should be considered a part of this
report. This report contains a sample receipt report detailing the samples received, a project
narrative indicating project changes and non-conformances, a quality control report, and a
statement of our state certitications.
The analytical results contained in this report meet all applicable NELAC standards, except as may
be specitically noted, or described in the project narrative. This report may only be used or
reproduced in its entirety.
I attest under the pains and penalties of perjury that, based upon my inquiry of those individuals
immediately responsible for obtaining the intormation, the material contained in this report is, to
the best of my knowledge and beliet, accurate and complete.
Should you have any questions concerning this report, please do not hesitate to contact me.
Sincerely,
Jonathan R. Sanford
President
J RS/kal - s=
Enclosures
ENVIROTECHLABORATORIES,INC.
1VL1 CERT NO.:Af JVA 063
8Jan Sebastian Dr-Unit#12
Sawdnich, AIA 02963
908(888-6460) 1-800 339-6460
FAX(508)888-6446
CLIENT: Desmond Well Drilling LOCATION: 851 Cedar Street
ADDRESS: PO Box 2783 W Barnstable MA
5 Rayber Rd (Jeff Sollows)
Orleans MA 02653
COLLECTED BY., Desmond Well Drilling SAMPLE DATE: 2/25/2004
SAMPLE TIME: 2:00
WATER SAMPLE TYPE: Existing Well DATE RECEIVED: 2/26/2004
LAB I.D. #. 0402313
WELL SPECS.: 6"/126'/92'
RESULTS OF ANALYSIS:
Parameters Units Recommended Results Method Date Analyzed
Limits
Coliform bacteria /100ml 0 0 9222 B 2/26/2004
pH pH units 6.5-8.5 6.54 4500 H+ 2/26/2004
Conductance umhos/cm 500 84 120.1 2/26/2004
Nitrate-N mg/L 10.0 < 0.01 300.0 2/26/2004
Nitrite-N mg/L 1.00 <0.004 300.0 2/26/2004
Sodium. mg/L 20.0 8.1 200.7 2/26/2004
Iron - mg/L 0.3 0.2 200.7 2/26/2004
Manganese mg/L 0.05 <0.008 200.7 2/26/2004
Volatile Organics
Cloroform ug/L 80 2 EPA 524.2 3/2/2004
WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES
FOR PARAMETERS TESTED.
ND= None Detected.
<=less than
>=greater than
TNTC=too numerous to count
Date
Ro ald J. Saari
Laboratory DI for
GROUNDWATER
ANALYTICAL
EPA Method 524.2
Volatile Organics by GUMS
Field ID: 0402313 Matrix: Aqueous
Project: Jeff Sallows/851 Cedar St Container: 40 mL VOA Vial
Client: Envirotech Laboratories,Inc. Preservation:. HCl/Cool
Laboratory ID: 70004-01 QC Batch ID: VM7-1440-W
Sampled: 02-25-04 14:00 Instrument ID: MS-7 Agilent 6890
Received: 02-27-04 17:40 Sample Volume: 25 mL
Analyzed: 03-02-04 15:17 Dilution Factor. 1
Analyst: LG Page: 1 of 2
CAS Number. Analyte concentration Notes Units Reportingihmrt
75-71-8 Dichlorodifluoromethane BRL ug/L 0.5
74-87-3 Chloromethane BRL ug/L 0.5
75-014 Vinyl Chloride BRL ug/L 0.5
74-83-9 Bromomethane BRL ug/L 0.5
75-00-3 Chloroethane BRL ug/L 0.5
75-694 Trichlorofluoromethane BRL ug/L 0.5
75-35-4 1,1-Dichloroethene BRL ug/L 0.5
75-09-2 Methylene Chloride BRL ug/L 0.5
156-60-5 trans-1,2-Dichloroethene BRL ug/L 0.5
i 1634-04-4 Methyl tert-butyl Ether(MTBE) BRL ug/L 0.5
75-34-3 1,1-Dichloroethane BRL ug/L 0.5
594-20-7 2,2-Dichloropropane BRL ug/L 0.5
156-59-2 cis-1,2-Dichloroethene BRL ug/L 0.5
74-97-5 Bromochloromethane BRL ug/L 0.5
67-66-3 Chloroform 2 ug/L 0.5
71-55-6 1,1,1-Trichloroethane BRL ug/L 0.5
56-23-5 Carbon Tetrachloride BRL ug/L 0.5
563-58-6 1,1-Dichloropropene BRL ug/L 0.5
71-43-2 Benzene BRL ug/L 0.5
107-06-2 1,2-Dichloroethane BRL ug/L 0.5
79-01-6 Trichloroethene BRL ug/L 0.5
78-87-5 1,2-Dichloropropane BRL ug/L 1 0.5
74-95-3 Dibromomethane BRL ug/L 0.5
75-27-4 Bromodichloromethane BRL ug/L 0.5
10061-01-5 cis-1,3-Dichloropropene BRL ug/L 0.5
108-88-3 Toluene BRL ug/L 0.5
10061-02-6 trans-1,3-Dichloropropene BRL ug/L 0.5
79-00-5 1,1,2-Trichloroethane BRL ug/L 0.5
127-18-4 Tetrachloroethene BRL ug/L 0.5
142-28-9 1,3-Dichloropropane BRL ug/L 0.5
124-48-1 Dibromochloromethane BRL ug(L 0.5
106-934 1,2-Dibromoethane BRL ug/L 0.5
108-90-7 Chlorobenzene BRL ug/L 1 0.5
630-20-6 1,1,1,2-Tetrachloroethane BRL ug/L 0.5
10041-4 Ethylbenzene BRL ug/L 0.5
1 08-3 8-3/1 064 2-3 meta-Xylene and para-Xylene BRL ug/L 0.5
95-47-6 ortho-Xylene BRL ug/L 0.5
100 42-5 Styrene BRL u9 0.5
75-25-2 Bromoform BRL ug/L 0.5
98-82-8 Isopropylbenzene BRL ug/L 0.5
108-86-1 Bromobenzene BRL ug/L 0.5
79-34-5 1,1,2,2 Tetrachloroethane BRL ug/L 0.5
96-18-4 1,2,3-Trichloropropane BRL ug/L 0.5
103-65-1 n-Propylbenzene BRL ug/L 0.5
95-49-8 2-Chlorotoluene BRL ug/L 0.5
108-67-8 1,3,5 Trimethylbenzene BRL ug/L 0.5
(;rnilndwatPr Analvtiral. Inc.. P.O. Box 1200. 228 Main Street, Buzzards Bay, MA 02532
GROUNDWATER
ANALYTICAL
EPA Method 524.2(Continued)
Volatile Organics by GC/MS
Field ID: 0402313 Matrix: Aqueous
Project: Jeff Sallows/851 Cedar St Container: 40 mt.VOA Vial
Client: Envirotech Laboratories,Inc. Preservation: HCl/Cool
Laboratory ID: 70004-01 QC Batch ID: VM7-1440-W
Sa-npled: 02-25-04 14:00 Instrument ID: MS-7 Agilent 6890
Received: 02-27-04 17:40 Sample Volume: 25 ml
Analyzed: 03-02-04 15:17 Dilution Factor: 1
Analyst: LG Page: 2 of 2
CAS Number Analyte Cor centratton ": Nptes Units -:Keportin Limit:.::
106-43-4 4-Chlorotoluene BRL ug/L 0.5
98-06-6 tert-Butyl benzene BRL ug/L 0.5
95-63-6 1,2,4-Trimethylbenzene BRL ug/L 0.5
135-98-8 sec-8 utyl benzene BRL ug/L 0.5
541-73-1 1,3-Dichlorobenzene BRL ug/L 0.5
99-87-6 4-Isopropyltoluene BRL ug/L 0.5
106-46-7 1,4-Dichlorobenzene BRL ug/L 0.5
95-50-1 1,2-Dichlorobenzene BRL ug/L 0.5
104-51-8 n-Butylbenzene BRL ug/L 0.5
96-12-8 1,2-Dibromo-3-chloropropane BRL ug/L 0.5
120-82-1 1,2,4-Trichlorobenzene BRL ug/L 0.5
87-68-3 Hexachlorobutadiene BRL ug/L 0.5
91-20-3 Naphthalene BRL ug/L 0.5
87-61-6 1,2,3-Trichlorobenzene BRL ug/L 0.5
QC Surrogate Compound„ $piked 'Measured zRecovery QGlimtts
1,2-Dichlorobenzene-d4 10 8.3 83 % 70-130%
4-Bromofluorobenzene 10 7.9 79 % 70-130%
Me=.hod Reference: Methods for the Determination of Organic Compounds in Drinking Water,Supplement 111,US EPA,
EPA-600/R-95I131 (1995). Method Revision 4.1.
Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be
reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution.
Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532
Town:of Barnstable P#
pftHE l(3.� f4 x `A
o Department of Regulatory Services
�,ruvsTAHE 's Public Health Division Date
q�p 1b ... �e� t 200 Main Street!Hyannis M A 02�6GI � •�_. . � ;..� .'
rf0 MAt A t
f
yy Lp yy
Date Scheduled 2 v Time .
Fee Pd.
Soil;_$uitabiliV Assess±menu f oY'Sewage Dis osal
Performed By: Witnessed By:
1`l� Y LOCATION& GENERAL INFORMi'll
��
'f CZ
5 Location Address l l ' x' " Owner s Nam .4
Address �;j�C�'j' i ) if
Assessor's Map/Parcel � .. . ( Engmeer 2i
NEW CONSTRUCTION V REPAI _ Telephone# _ �
Land Use77 Slopes g (�Surfae Stones
Distances from: Open Water �r ft Possible Wet �rea> �A R'ft •prinking Water Well Sa ft
Drainage Way ft Property Line ft ~Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes)
Parent material(geologic)rLAZ,D"A-t �7�� D� Depth to Bedrock > —zoo
Depth to Groundwater: Standing Water in Hole: 1 Weeping from Pit Face
Estimated Seasonal High Groundwater I Zd
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles:
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST Dale Time
Observation
Hole# / Time at 9"
Depth of Perc Time at 6"
Start Pre-soak Time a Time(9"-V)
End Pre-soak
s
Rate Min./Inch ✓ �� ; .
Site Suitability Assessment: Site Passed Site Failed: , Additional Testing Needed(Y/N)
Original: Public Health bivisioit- OVse>jvatioii Hol '.)_a`ta'To Be Completed on'Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:HEALTH/W P/PERCFORM
f
Hole
DEEP OBSERVATION HOLE LOG
Depth from Soil Horizon Soil Texture= d r Soil Color a Soil Other+ _ I
P�. .
Surface(in.) (USDA) (Munsell) Moithng (Stucture'Stones,Boulders,
p p a
•+ � r { -' ""� �•Consis[eno "/o Gravel
i
f
DEEP OBSERVATION HOLE LOG Hole.#
Depth from r. �Boii,Honzgp- a<<i Soil Texture Soil Color Soil' d Other
Surface(m.) a, J (USDA) (Munsell) Mottlutg (Structure;Stones,Boulders.
P .9...,.t�,,.= ..
Consistenc ' %Gravel
[ice }
�. f v J, �.
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other -"
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,,%Gravel)
• ;fix.
DEEP OBSERVATION HOLE LOU*, =w, Mole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
,. J.
Flood Insurance Rate Man:
Above 500 year flood boundary No_ Yes
Within 500 year boundary Nov Yes
IT
Within 100 year flood boundary No ✓ Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious'material?
Certification _ ty
I certify that on' date)I have passed the soil evaluator examination approved by the
Department of virorunental Protection a d that the above analysis was performed by me consistent with
the require ing,expe ex�erie ce esc ed in 310 CMR 15.017.
Z ,
Signature Date_
Q:HEALTH/W P/PERCFORM
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/ /3 13 73 i \�� SINGLE FAMILY DWELLING W/ S BEDROOMS
BUILDABLE N32 20'58'E
/ N32°2054'E , NO GARBAGE DISPOSAL
13.G3' DAILY FLOW = 1 1 0 X
/ EXISTING
PORTION OF T 2
SEPTIC TANK(VOL. REQ'D)
_3m�t 1 P I NON-BUILDABLE / GRADE
PORTION OF LOT 2 r 93.1 -9 ,0 5 50 G.P.D. X 2 = I)) MAILS
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LEACHING AREA(S.A.5.) \`
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LOT 2�� 1, c� NOTES:
I - �`� r
\ r 70/ � D
J _ / / / \ ��\ 0 / 1 I 11 u. rnn
�j / 153 G96 ± SF I t \� -/ I .cD W � I . D15POSAL SYSTEM TO BE CONSTRUCTED IN STRICT ACCORDANCE WITH
/ (� / W cn z 0 COMMONWEALTH OF MA55ACHU5ET75 ENVIRONMENTAL CODE -TITLE V.
3.53+ ACRES �1V� - T 3' 1= \ � -, o
1 / L _ \ tx15Pt%)ro � � � 2. ASSESSORS PARCEL NUMBER (APN) : �3 €3 ` 8 Z
` ,
` V4�LL p ::E � 3. CONTRACTOR TO CALL DIG-SAFE 72 HOURS PRIOR TO BEGINING
I ( SHAPE FACTOR CALCULATION I I \ _ rTI CONSTRUCTION AND/OR EXCAVATIONG.
i (FOR BUILDABLE AREA OF LOT 2 j / , 7p 4. THIS PLAN DOES NOT, IN ANY WAY, REPRESENT AN ACCURATE, INSTRUMENT SURVEY OF THE
(149 1)(149 1) _ 17 1 / J o \ rn PROPERTY, AND IS NOT TO BE USED FOR ANY CONSTRUCTION, OTHER THAN THE ELEMENTS
Pa 129,783 �- / N o� / \ W OF THE SEPTIC SYSTEM AS SHOWN. THIS PLAN 15 NOT A RECORDABLE PLAN.
( \ 1 0 5. BENCHMARK IS BASED ON AN ASSUMED DATUM, AS SHOWN, UNLESS OTHERWISE SPECIFIED. E.LV. 93-4
Cu G. SUVREYOR: HOOD SURVEY GROUP, LLC
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� P.O. BOX 231
"EOT \\ I m ` SANDWICH, MA 025G3
7, SUP.V E- / DATA- F iR aIA PLY0,� if QaT�) SV RVF_V Pit d\N F
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2G.22' 1
1 205,80'
S3G°39'59"W 158,55'
53G I oo'34"W 103.G7',,, S3G°10'37"W 232.02'
GRAPHIC SCALE
w o
\ / 5 0' o' 25" 5 0'
I km
(IN FEET)
LEGEND
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FIRST FLooR SITE PLAN 24 �-- PROPOSED CONTOUR
EL. 97.0 _� 10 EXISTING CONTOUR
- DRIVEWAY
TOP OF WALL licit
EL. g�. o REMOVE 11 FIRM ZONE
MATERIAL 5'AROUND B
FIN. GR. EL. 9(b'0 EXISTING GK. EL.9 6.0 SYSTEM TO EL. 97.7 It
2%SLOPE 8 4 O
ACCESS W/ N 6 OF GR. / / \\ \\\\\\\\j\\\i\\\i\\i\\\i\\i\\\i\\\i\\\i\\\i\\\l /\\\\\\i\\\i\\\i/\�,\\\i\\i \ \\i,\i\\i\\i\\\i\\\i\ \\\i\\i\\\i\\i\\`\i\�i,
CE55 . .... .. .. . ,,�,, SITE AND SEPTIC DE51GN PLAN
\ 9"MIN. COVER
2"PEA5TONE ACCESS PORTS
C20TEST PREPARED FOR
FOR LEVEL 2'LEVEL
GAL 9a-Z JEFf KEY 50LLOW5
P.C. CONC. D-BOX 9). $e 8$°8 ��Sa°�° �ga°4
SEPTIC TANK(H 2� GASBAFFLE qq`� a 9,0 $bg0.
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6"MIN. r, 0Sobo8°bob T EL- »$Y8E :8
8sb o oa8os a 914 oA�osL f 0.8a��°a 3/4"TO I I/2"DOUBLE HEALTH AGENT APPROVAL DATE ON
L0TE 0EVIE�P\ ST_
�—G"CRUSHED STONE OR COMPACTED WASHED STONE ,�10'MIN— fin/ L' S i aAF-\N ST/-N6 LL-
5 'MIN- A'f �
20' MIN. -� � y ADVANCED TECHNICAL SOLUTIONS
DEPTH OF LIQUID-4' HARRY G .
Q L CONSULTING ENGINEER5
INLET TEE DEPTH - 10' 0 BELOW EA
,f ANT
OUTLET t ,, 1, a•
OUTLET TEE DEPTH- 14"
,575 P.O. BOX 99
PROFILE OF DISPOSAL SYSTEM k
E. SANDWICH, MA 02537
50 tAA
}� �� y� e.,; ATE: SCALE:
( DRAWING NOT TO SCALE ) RICHARD J. i 1 OD, PL5 H. EARL LANTE , Jr., PE 3 0 �A, Y ')— 6-0 ( .
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