HomeMy WebLinkAbout0016 CEDARCREST LANE - Health w .
;16 Cedercrest Lane
A=,1311013-005
W.Bam`s6 le
n
0
t
B
y
I
�1
J, J 64t
Y°F ai'• CERTIFICATE OF ANALYSIS Page:
Barnstable County Health Laboratory
Report Prepared For: Report Dated: 5/7/2007
Charles Harootunian Order No.: G0740174
P O Box 266
West Barnstable, MA 02668
Laboratory ID#: 0740174-01 Description: Water-Drinking Water
Sample#: Sampling Location _IVCedarcres[LN W.Barnstible M, Collected: 4/20/2007
Collected by: C.H. O Received: 4/20/2007
Test Parameters
ITEM RESULT UNITS RL MCL Method# Tested
Lead 0.0022 mg/L 0.001 0.015 EPA 200.8 4/25/2007
Routine +Ammonia
ITEM RESULT UNITS RL MCL Method# Tested
Ammonia ND mg/L 0.20 EPA 350.3 4/23/2007
Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 4/20/2007
Copper 0.13 mg/L 0.10 1.3 SM 3111B 4/20/2007
Iron ND mg/L 0.10 0.3 SM 3111B 4/20/2007
Sodium 30 mg/ 1.0 20 SM 3111B 4/20/2007
Total Coliform 0 CFU/100mL 0 0 MF-SM 9222B 4/20/2007
Conductance 300 umohs/cm 2.0 EPA 120.1 4/20/2007
pH 6.5 pH-units 0 EPA 150.1 4/20/2007
Sodium level is above the maximum contaminant level. Those on a low sodium diet may wish to consult a physin
Approved By:
Director)( )
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
THE COMMONWEAL'{H OF tiMASSACHUSETTS
Y, BOAR® OF HEALTH
'
1` . .0"-----------..........OF..........J
Appliratilan for Uiipviia1 Morkii T antitrnrtinn ramit
Application is hereby made for a Permit to Construct ( t_ or Repair ( ) an Individyq I&we Pisjosal
System at:
..... ' Din.co ..... : .................. ......................................................
Location-Address or Lot No.
Owner Address
,-� ...........................• ..--
Installer Address
" Q Type of Building Size Lot.................... .....Sq. feet
U
., Dwelling—No. of Bedrooms................. --_---.._-_.__-_-___-__-Expansion Attic ( ) Garbage Grinder ( ��
Pk Other—Type of Building ............................ No. of persons................------------ Showers ( ) — Cafeteria ( )
PL, Other fixtures ..........................................
W Design Flow--�' _ �?....._._l�®....gallons per person per day. Total daily flow------- �0_-:-_-_gallons.
� Septic Tank Liquid capacity./$9�q.gallons Length-------------_ Width................ Diameter---------------- Depth................
Disposal Trench—No. .................... Width____......__........ Total Length..______.._._.-•_• Total leaching area--- __... sq. ft.
Seepage Pit No---------/......... Diameter_......-&-r...... Depth below inlet---` ---.a.._ Total leaching area-I- 6 sq. ft.
z Other Distribution box ( ) Dosing tan
'~ Percolation Test Results Performed b _ .__._ _,..! �.................. Date____ _... .. .......
............
Y ;
aTest Pit No. 1__ ...minutes per inch Depth of Test Pit____________________ Depth to ground water--______-___________-._.
(i Test Pit No. 2................minutes,per inch Depth of Test Pit_________---____-_- Depth to ground water........................
----•.........................................................................................................•---.........._........---------••-•---•.•-•--
Descriptionof Soil v !'� a' Rv_t3_.: .lz - Gl't AVE— £3T E�',5�'9.
x
-- ...... •----••---
W `--
x •- � ---- - - --- - �---�------ --. �------ �f-1-�----�------------------------------------------------
-n-
�-wry-
U Nature of Repairs 'or Alterations—Answer when app 'cable................ ........................... ...................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TL 11 T." y g g p y
5 of the State Sanitary Code— The undersigned further agrees not to lace the system in
operation until a Certificate of Compliance has been is ued Vyhe b ar of health. ��
Sig d._ ......•• . . -•-•.-- •... . ....................' �.../_9�r0
Date
Application Approved BY-------- �- --- :_.. . - --.L�✓d!f- --...................... ---- �2--_7Z-�/-�--r3-�.
Date
Application Disapproved for the following reasons________________________________________________________ _.._
---------•----
-------------------•........----------•----------•-------------------------•-----••-••-•-••--•-----•••-•_..
- -----•-•••••..................
Date
Permit No Is e
sued
r `
.r t 1
THE COMMONWEALTH OF MASSACHUSETTS •
,
BOAR® OF H AL H
..........OF ..................................
� Iirtt#ii� t ur i u �a� Hlorkii Tnnitrnrtion "permit
Application is hereby made for a Permit to Construct •( ) or Repair ( ) an Individ Ofe Dis sal
System at:
..... ._.Y.................... ............................................. ..................................................................................................
}r Location-Address or Lot No.
W
JI Owner 5 Address
P„ Installer Address +
U Type of buildirng Size Lot---.'.
...................... feet
Dwelling—No. of Bedrooms.___....__.v_______________________________Expansion Attic ( ) Garbage Grinder ( )
aOtlier=Type of Building __ _____________ No. of persons............................ Showers ( ) — Cafeteria ( )
Design Flow Other��fi`ktures .---_..: ---_ allon- ---------------------------------------------------------..--------------------------------------------.._.._......---•
W g g s per person per day. Total daily flow------ _____gallons.
t� Septic Tank Liquid capacity............gallons Length................. Width................ Diameter................ Depth.................
Disposal Trench—No_ ____________________ Width.................... Total Length.......______..... Total leaching area__ ff_ sq. ft.
Seepage Pit No_____________________ Diameter.................... De th below inlet__ _. �v
p / .......... Total Total leaching area_ -».sq. ft.
z Other Distribution box ( ' ) Dosing,tank,( ) d ��" .
Percolation Test"Results. i r. Performed by:jf Y_ ._._. �.. ,���__________________ Date_.__f" _'�..
%.._minutes per inch Deptl-C of Test Pit____________________ Depth to ground water_.___.__._.._...__..._..
Test Pit \To. 1_.
Lr., Test Pit No. 2..................min4es per inch Depth of Test Pit..............._..... Depth to ground water........................
94 ..___._ '....................................... ____.__.________..........._______.........................................................
Description of Soil
W - � �....... = ---- •------------------------- - =-
U Nature of epairs or Alterations=Answer when app able_..............................................................................................
...................................................____________________________________________________________.........................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of:TT `5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Co npliance has Keen issued by the board of health.
Sig d •----- -
-- •-------------------------------
Date 's
Application Approved B
PP PP Y --
4
A L�!17•. f Da �� .
f
Application'Disapproved for the following reasons-...........................................-...................................................................
---------------••---...--••-•----•--------•-----•-•----------•--•----------------------------•-----------------------------------------------------.-.-------------------------------------------._.._.
Date
Permit No. :::' :::::..:.......................... Issued......................................................
Date
THE COMMONWEALTH!OF MASSACHUSETTS
BOARD OF HEALTH
............�Q'f 1..........O F..9.... ad'. /�' .......................
w1rrtifiratr of Toutplianre
THJ IS TO CEE
IFY, That the Individual Sewage Disposal System•constructed '(Ioj�or Repaired ( )
by .................................... --- ----- •----...............:------------------•--..........---•-----==
y slauerf _
��------ - mod?-•------ --
has been installed in accordance with the provisions of T + ` of The State-Sanitary de as described in the
application for Disposal Works Construction Permit No. - �r d Lted_.
PP r-11 ,. P � _.s2
THE ISSUANCE OF THIS CERTIFICATE SHAL OT BE CONSTR-gED AS ., GUARANTEE THAT THE
SYSTEM WILL FUNCTION 'SATI ACTORY.
DTE......-- `� -- ------------ Inspector • _
r
THE COMMONWEALTH :OF MASSACHUSETTS
BOARD Of HEALTH
No.......... 1p .... .... �'' FEE....�1..o.
Disposal nrkl w otrudwit rrmff
Permission is hereby granted...w----} ......... • •-----.•--------------------------------•----------....----•-----•---••-•--•
k to Construct �r Repair ( ) an ndivid Se age Dis s stem
atNo._ .. _ ......_... } _ ...............
r et
as shown on the application for Disposal Works orks Construction Pit __/__'_�_______ _______ Dated_._
__________________
oar" -d of th
DATE-------3:: '
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
� �✓►i.���"i rr Lill/l 1 L�( � � M �- r ' �
l N � Cs�AQBitC.Jc Gr41�JD�-Q �
+501o'�t�-PD I
�' }
5EPI1G TAt.1K �t\�15 X200%.= = I�
u E ►SDd GAL TA��X. J 5�,
P t7 v r E & !cG
'at S PoSAt_
S 1 DE�/A�.L AEEA s 105 "Sp -
`.r
t3oTTo� ARC- --�� t '•V 1 •' � 4►t�
ToT"a%-- VESk6t-4
A � X►�
PE oLdT to►.i 2AT� t•1 u 7. ftW oe Lam: ; _. _ _ kA zs - --
' r
OST
t,�s 7., At
� , . £aU �cS rru�� "" ¢��vE ISOo 4 �sE e tuu •gl•5
' Lt�
P
SV�7Sc+►�. 4~ v� VKT ruvc mat.. �•-�,'3
a b S�PfIC `:
toeo 9t„q
SRuD'f 90
d
Lp t
VJ 41 1
3/4
WAStJr� '
F� CTb W is '
L
I
Leo F► �..� t�gG,e„T►0�.1 W,�Q�.���•\:,t�t.-�4 a
� {.!D S�c4►t.E SGAI..t_ ;,��}` DATA \ ,"�, ��
1 CEALTtF`f T"AT 'r"t-- �1�, v\ ZJ. 1►,��54�0►�U
"EQE.o s•J GOM PL-Y S
AwD ¢<rMr="Tji' OF 'C'WE. S
Tetlu" of �Q �.15 �-C �C_A►) Qjt r-cl, PO
I
QS�tSTt= ezecv IAtJD yvQVEYO�� '
T"44, PLs&J Icr UOT $A5ED ou Au 11,W&WE"T OSTE.QVtu.6. RAaSOS.
TO& OFF9ET; •5"ouLD uoT $E uSEn �
APPL►G A t•t T ��►Y-C�-1 I�a+f � � �
L,G �' f f�uSe�v. /.d /�t�� 131 G/ 3-OUS-
LOCATION SEWAGE PERMIT NO.
VILLAGE
INSTALLER'S NAME i ADDRESS
3 UILDEIII OR OWNER
L/�/1/�
L
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
i�
I�-
Mo
p A
i P
1
v� flo