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HomeMy WebLinkAbout0104 DEER JUMP HILL - Health y 04 4 a 1 i tl r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road, West Barnstable, MA Property Address Barbara A. Bean Owner Owner's Name information is required for every West Barnstable MA 02668 07/17/2014 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When computer, A. General Information on the c filling out I 7 _ use only the tab 1. Inspector: key to move your cursor-do not RIED C. ELLIS use the return Name of Inspector key. ELLIS BROTHERS CONSTRUCTION Company Name 23 ENTERPRISE ROAD Company Address loam YARMOUTH PORT MA 02675 City/Town State Zip Code 508-362-6237 S 121891 Telephone Number - License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of Title 5(310 CMR 15.000).The system: . asses ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority � a 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 is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,-and the approving authority. This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. I t5ins-3113 Title 5 Official lnspection F ulneace Sewage Disposal System-Page 1 of 17 I ` Commonwealth of Massachusetts Tile 5 official Inspection Fo'FM Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road, West Barnstable, MA Property Address Barbara A. Bean Owner Owner's Name for e information i every West Barnstable required or eve MA 02668 07/17/2014 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: V-11�4 /W1 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: I I I B) System Conditionally Passes: I ❑ One or more system components as d scribed in the"Conditional Pass"section need to be replaced or repaired. The system, upo i completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not deterr iined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 year old'or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or LaWtration or tank failure is imminent. System will pass inspection if the existing tank is replaced m ith a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(ExplE in below): I f � i � � I I �irts 3/1 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 f Commonwealth of Massachusetts Title 5 official Inspection Fo'rm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I 104 Deer Jump Hill Road, West Barnstable MA j Property Address Barbara A. Bean j Owner Owners Name information is required for every West Barnstable MA 026681 07/17/2014 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) � ❑ Pump Chamber pumps/alarms not opera ' nal. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): I ❑ Observation of sewage backup or break o it or high static water level in the distribution box due to broken or obstructed pipe(s)or due to z broken, settled 'or r uneven distribution box. System will pass inspection if(with approval of Board f Health): I i ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or re I d p ❑ Y ❑y N ❑ ND(Explain below): `i I i I i i ❑ The system required pumping more than times a year due to broken or obstructed pipe(s). The system will pass inspection if(with appro al of the Board oflHealth): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): I ❑ obstruction.is removed ❑ Y ❑I N ❑ ND (Explain below): 4f i I C) Further Evaluation is Required by thO Board of Health: ❑ Conditions exist which require further evE I'uation by the Board of Health in order to determine if the system is failing to protect public heath, safety or the environment. 1. System will pass unless Board of ealth determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: i ❑ Cesspool or privy is within 50 feet of a surface water I I ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 j Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road West Barnstable MA Property Address i Barbara A. Bean Owner Owners Name information is West Barnstable required for every MA 02668, 07/17/2014 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board o Health (and Public Water Supplier, if any) determines that the system is functioi ling in a manner that protects the public health, safety and environment: ❑ The system has a septic tank ands I absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tri tary to a surface water supply. ❑ The system has a septic tank and S S and the SAS is within a Zone 1 of a public water supply. i ❑ The system has a septic tank and S S and the SAS is(within 50 feet of a private water supply well. I ❑ The system has a septic tank and SAS nd the SAS is less!than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: i **This system passes if the well water anal sis, performed at a!DEP certified laboratory, for fecal coliform bacteria indicates absent and the resence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no oth r failure criteria are triggered.A copy of the analysis must be attached to this form. i 3. Other: I i I I i f I D) System Failure Criteria Applicable to All Systems: j i You must indicate"Yes"or"No"to each of the following for all inspections: Yes No El clogged of sewage into facility or system component due to overloaded or / clogged SAS or cesspool ` ❑ L-�„J/ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6° below invert or available volume is less than '/day flow ' t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 104 Deer Jump Hill Road, West Barnstable, MA Property Address Barbara A. Bean Owner Owner's Name information is required for every West Barnstable MA 02668, 07/17/2014 page. City/Town State ZipCod'e Date to of Inspection B. Certification (cont.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ Any portion of the SAS, cesspool or priv yl is below high ground water elevation. ElAny portion of cesspool or privy is within 1100 feet of a surface water supply or tributary to a surface water supply. ❑ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This sy stem asses if the well water P analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attachedI to this form.] The system is a cesspool serving a facility P 9 y with a design flow of 2000 - ❑ � 9 d 10,000gpd. 1 gP ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15'303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct theasyem e E) Large Systems: To be considered a large the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. �? For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No I I ❑ ❑ the system is within 400 feet of a surface drinking water supply I ❑ , ❑ the system is within 200 fec t of a tributary!to a surface drinking water supply f the system is located in a n trogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large s stem has failed. The owner or operator of any large system considered a significant threat under Sec ion E or failed;under Section D shall upgrade the system in accordance with 310 CMR 15.304. Th system owner should contact the appropriate regional office of the Department. t5ins-3113 Tile 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 5 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road, West Barnstable, MA19- - I Property Address Barbara A. Bean i Owner Owner's Name j information is required for every West Barnstable MA 026681 07/17/2014 page. City/Town State ZipCode Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ! ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Were any of the system components pumped out in the previous two weeks? i ❑ Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained!and examined?(If they were not available note as N/A) yz ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑ Was the site inspected for signs of break out? /'IV i ❑ Were all system components,Oxcluding the SAS, located on site? i ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank i inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)j'[310 CMR 15.302(5)] I D. System Information I Residential Flow Conditions: i Number of bedrooms(design): Number oft bedrooms actual : ( ) DESIGN flow based on 310 CMR 15.203 (for example: 110 gpdjx#of bedrooms): t5ins•3M 3 Title 5 Official Inspecdo�n Form:Subsurface Sewage Dis posal sposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 official Inspection FoIr Subsurface Sewage Disposal System Form-Not for Voluntary i ssessment 3 ,.• 104 Deer Jump Hill Road, West Barnstable, MA Property Add ress dress Barbara A. Bean Owner wners Name information is O i required for every West Barnstable MA 02668� 07! 7/2014 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes No Is laundry on a separate sewage system? (include laundry system inspection X information in this report.) ElYes C( No Laundry system inspected? ❑ Yes [/No Seasonaluse? ❑ Yes No Water meter readings, if available(last 2 years.usage (gpd)): i Detail: f Sump pump? � ❑ Yes No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system ❑ Yes ❑ No Water meter readings, if available: � t5ins•3/73 To 5 Official Inspection Form:Subsurface a Dis posal sposal System•Page 7 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection F®rm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road, West Barnstable MA j Property Address 11l Barbara A. Bean I Owner Owner's Name ` informaton is West Barnstable required for every MA 026681 07/17/2014 page. CltyrFown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): a 1 J i General Information I i Pumping Records: Source of information. Was system pumped as part of the inspection? _ I Yes ❑ No If yes, volume pumped: gallons I How was quantity pumped determined? C� Reason for pumping: ' Type of System: Septic tank, distribution box, soil absorption system I ❑ Single cesspool I ❑ Overflow cesspool ❑ Privy I ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Altemative 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 operato under contract ❑ Tight tank. Attach a copy of the DEP approval. , ❑ Other(describe): i! t5ins•3113 1 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road West Barnstable MA j Property Address Barbara A. Bean Owner Owner's Name information is required for every West Barnstable MA 026681 07/17/2014 page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: f Were sewage odors detected when arriving at the site? ❑ Yes ft No Building Sewer(locate on site plan): j,.e Depth below grade: feet Material of construction: ❑cast iron 40 PVC ❑other(explain): 11 Distance from private water supply well or suction line: feet Comments(on condition of Jeints, venting, evidence of leakage!etc.): " or ace �- i Septic Tank(locate on site plan): Depth below grade: / ` 6-11 ewll'- l' feet Material of construction: concrete D metal ❑fiberglass Di polyethylene ❑ other(explain) i E If tank i met , list age ` years Is a con, et by Certificate of Compliance?(attach a/Py�of certificate) ❑ Ye ❑ lVo / Dimensions: j / "�r� Iv �g9 I'Sludge depth: i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 7 Commonwealth of Massachusetts Title 5 official Inspection Fo® m Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I 104 Deer Jump Hill Road, West Barnstable MA Property Address Barbara A. Bean Owner Owner's Name 1 information is required for every West Barnstable MA 026681 07/17/2014 page. CltylTown State Zip Code Date of Inspection D. System Information (cont.) ID Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle j Scum thickness 1 Distance from top of scum to top of outlet tee or baffle i Distance from bottom of scum to bottom of outlet tee or baffle i How were dimensions determined? j Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid le el's as roat to out et inv rt, eviden a of leakage, etc.1): r� � -A JI ®. I I i Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal fiberglass polyethylene ❑ other(explain): Dimensions: Scum thickness I I Distance from top of scum to top of outlet tele or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 N Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y4 104 Deer Jump Hill Road, West Barnstable, MA wb Property Address Barbara A. Bean Owner owner's Name information is required for every West Barnstable MA -02668 07/17/2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structuralintegrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pem/`pd time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal E 1 fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float swit hes, etc.): "Attach copy of current pumping contract(r uired). Is copy attached? ❑ Yes ❑ No t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 or 17 Commonwealth of Massachusetts I Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i 104 Deer Jump Hill Road, West Barnstable, MA Property Address Barbara A. Bean 1 Owner Owner's Name information is MA West Barnstable 8 required for every 0266 07/17/2014 page. City/Town State Zip Code Date of Inspection D. System Information (coot.) Distribution Box(if present must be opened)(locate on plan): Depth of liquid level above outlet invert I �2 Comments(note if box is level and distribution to outlets equal, any evidence of soli rryover, any evidence of leakage into or out of box, etc.): i PCs 5MIlll" I AIp .� E ` l N Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ! ❑ Yes ❑ No* i t Comments(note condition of pump chamber, ondition of pumps and appurtenances, etc.): I i C I i i i *If pumps or alarms are not in working order, ystem is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: I i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Forts Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i 104 Deer Jump Hill Road West Barnstable, MA Property Address Barbara r A. Bean i Owner Owner's Name information is West Barnstable MA 02668 ! 07/17/2014 required for every St page Cityfrown ate Zip Code Date of Inspection D. System Information (cont.) Iz-rZ^<-, a, Type: eo ❑ leaching pits number. , leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: I ❑ leaching fields number, dimensions: ❑ overflow cesspool number: t i ❑ innovative/alternative system Type/name of technology: I Comments(note condition of soil, signs of hydraulic failure, level;of ponding, damp soil, condition of vegetation, etc.) �v � � X�� � �� ILI t ►� 7 t r O i Cesspools(cesspool must be pumped as pa of inspection)(locate on site plan): C Number and configuration i I Depth—top of liquid to inlet invert Depth of solids layer { Depth of scum layer i Dimensions of cesspool { i Materials of construction r Indication of groundwater inflow C ❑ Yes ❑ No i t5ins•3113 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road West Barnstable, MA Property Address 1 Barbara A. Bean ! Owner Owner's Name i information is West Barnstable 02668 07/17/2014 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level lof ponding, condition of vegetation, etc.): j i -14 i i Privy(locate on site plan): Materials of construction: Dimensions Depth of solids j Comments(note condition of soil, signs oi hydraulic failure, level of ponding, condition of vegetation, etc.): i i I t i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i 104 Deer Jump Bill Road, West Barnstable, MA Property Address Barbara A. Bean i Owner Owner's Name i information'is West Barnstable MA 02668 07/17/2014 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate 7whe public water supply enters the building. Check one of the Ioxes below: hand-sketch in the area below I ❑ drawing attached separately � �6• '9�M fVy�i e � 37'?'-' :3• 50r e ( I 1 I i 1 I i 1 i I { t5ins•3/13 Title 5 Official Inspection,Form:Subsurface Sewage Disposal System•Page 15 of 17 i i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,..� 104 Deer Jump Hill Road, West Barnstable, MA Property Address i Barbara A. Bean i Owner Owner's Name information is West Barnstable MA 02668 ii required for every f 07/17/2014 page. Cityrrown State Zip Code' e Date of Ins ction � p D. System Information (cont.) j Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar 04'�' ❑ Shallow wells /10 v I >n s Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground Water elevation: ❑ Obtained from system design plans on record j If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: i ❑ Checked with local excavators, installers-(attach d+cumentation) Accessed USGS database-explain: F You must describe how yo established the high ground water elevation: = I Before filing this Inspection Report, please see Report Completeness Checklist on next page. I t5ins•3113 Title 5 Official InspectionlFonn:Subsurface Sewage Disposal System•Page 16 of 17 r Commonwea th of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 104 Deer Jump Hill Road, West Barnstable, MA Property Address Barbara A. Bean Owner Owner's Name information is West Barnstable MA 02668 07/17/2014 required for every page. Cityrrown State Zip Code Date of Inspection E. 7,;, spection ort Completeness Checklist Summary:A, B, C, D, or E checked I spection Summary D(System Failure Criteria Applicable to All Systems)completed i S tem Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Aug. 19. 2013 3: 34PM No. 1427 P. 1 CERTIFICATE OF ANALYSIS Page: 1 of 1 9 Barnstable County Health Laboratory (M-MA009) Jl�CHU�^' Report Prepared For; Report Dated: 8/19/2013 Reid C. Ellis Ellis Brothers Construction Order No.: G1376366 23 Enterprise Road, P 0 Box 59 Yarmouthport, MA 02675 •----------•--- Laboratory ID#: 1376366.01 Description: Water-Drinking Water Sample at: Sample Location: 104 Deer Jump Hill Rd,W Barnstable Collected: 08M512013 Collected by: Received: 08/15/2013 Bold$fne ITEM RESULT UNITS RL MCL METHOD# jjjTED Nitrate as-Nitrogen 2.5 mg/L 0,10 10 EPA300.0 8/15/2013 Copper ND mg/L 0.10 1.3 5M 31118 8/19/2013 Iron ND mg/L 0.10 0.3 SM 31118 0/10/2013 pH 6.9 PH AT 25C NA 6.5.8.5 SM 4500•H•B 8/15/2013 Sodium 7.6 mg/L •2.5 20 SM 31118 6/19/2013 Total Collform Absent PIA 0 0 SM9223 8/1512013 Conductance 230 umohs/cm 2.0 EPA 120.1 8/16/2013 Water sample meets the recommended 11mits for drinking water of all the above tested parameters. Allached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508.375.6605 TOWN OF BARNSTABLE LOCATION 4,Qq fir_ JLu4 D f{e/l SEWAGE # 2 00 3 - ���1� VILLAGE (�� l��vhI L24�/fi ASSESSOR'S MAP & LOT 2 " "'1 INSTALLER'S NAME&PHONE NO. ILL Y-00- 2710 SEPTIC TANK CAPACITY /12© / �j LEACHING FACILITY: (type) 5,90 fgPI U�g -l/�j�� (size) NO.OF BEDROOMS f i BUILDER OR.OWNER PERMITDATE: COMPLIANCE DATE: e�= Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet i Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) 1 SD. Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �� °✓s�-t/ _....T..__---- f�•jT_f FiO..f o. Po;ci No �^ TOWN OF BARNSTABLE 1110,0e LOCATION 4 17�,Qq g N JU�,to �1 i�� SEWAGE #�00 VILLAGE 22, ASSESSOR'S MAP & LOT 132 " "'1 INSTALLER'S NAME&PHONE NO. Soy- 5'20 SEPTIC TANK CAPACITY /S00 LEACHING FACILITY: (type) 5-5'DO 4 //1,41 Z ry(Z (size) 3 7' x l NO.OF BEDROOMS !7' BUILDER OR OWNER PERMITDATE: - /05r COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by tZm_ v� �pp a rONG� No.!r� —2 Feev THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes + PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0ppfication for 30igpoga1 *pgtem Construction 3Permit Application for a Permit to Construct( . )Repair(✓SUpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 0,Y 001trr JaWla //i// Owner's Name,Address and Tel.No. ur. lao"wit�b/� Deaf ljs�rl Assessor's Map/Parcel Installer's Name,Address,and Tel.No.,SD$— q.QU— %' _48 Designer's Name,Address and Tel.No. .1o.)clod.I)./34w-,vs / 9938 � �y� L�na✓,4�r✓ie�9 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) roll -,zgo � h t y,rl, 11, 5 notice I�N.�y�, 2 6r.4 xjw 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 Board of Health. Signed Date Application Approved by Date 0 Application Disapproved for the following reasons Permit No. 6 3s27 Date Issued THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A m / �C(�� IL DATA . v--- No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 4> Yes PUBLIC HEALTH,DIVISION -TOWN OF BARNSTABLES-MASSACHUSETTS f Apprtcatton for M gpogar *paem Con.5tructton Permit Application for a Permit to Construct( )Repair( v)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. f(]�/ U l /=/^ f�/✓y�j% f y.!! Owner's Name,Address and Tel.No. ✓. _3/ � t/mob/� o� ate? Assessor's Map/Parcel 1 ! ,f, /-7 />/r <� (/Gti� /1 . i. Installer's Name,Address,and Tel.No. }O�, - y2<> �L' Designer's Name,Address and Tel.No. �tq 17' 2-a�4a /P1, Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons 1 7Show,wer`sj( ) Cafeteria( ) Other Fixtures Design Flow, gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 2'n/S T.4 / t 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 Board of Health. Signed Date r Application Approved by ..S Date Application Disapproved for the following reasons Permit No. 60 _2 Date Issued t� . t -------------------------- THE COMMONWEALTH OF MASSACHUSETTS - BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(,_- _)Upgraded( ) Abandoned( )by r>Ie,/,4 /J, S at /U y cv, L?4y/�S T�4�/t; has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated 6 Llk 5 Installer Designer /V 6" The issuance of his perrrfit shall not be construed as a guarantee that the syste 1 A/ddh tied. �^ Date & d3 Inspector _ ;�� ------- - ---------- ---------------- No. Zcti3 F FeeCJ t THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS liopogat *pgtem Con5tructton Permit Permission is hereby granted to Construct( )Repair(t.)-Upgrade( )Abandon( ) System located at /U and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title/5 and .e following local provisions or special conditions. Provided:Co//nss ri cttiio must be completed within three years of the date of thi�-:R Date:_ (L��`� Approved by r ASSESSOR'S MAP NO. u PARCEL f L 0 CATION _ : - lama_ - S_E W A E. _ p.E_R-M-1-T--N_0.-3 VILLAGE -INSTA LLER'S NAME' A ADDRESS Cd ?yiT S U-I L D E R OR OWN ER DATE PERMIT ISSUED l9 „ � DAT E COMPLIANCE ISSUED "glow _ —� 3 h A 34 ( s V Lk � Get V� b1 S� 43 s® -low- • r � No.a THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH r /U L Th-- ---- ...-----.OF.. �� C________________•__---....--------- Appliration fur Disposal Works Tonstrnrtion Prrutit Application is hereby made for a Permit to Construct �) or Repair ( ) an Individual Sewage D,issosal System at: (� .G`o?�.c e C�\ 6V 4 Z ation- ddress or Lot No- ,.�' .lr�.................. ��s'�✓ � T/ rst..L!'�r.,lla� . —� Own Address Installer \ Address Type of Building - Size Lot... O_ 3...Sq. feet Dwelling—No. of Bedrooms-------....... ..........................Expansion Attic ( ) Garbage Grinder �Wo aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------•-------------- Design Flow______________________1.1-_Q_........___.gallons per n per day. Total daily flow--------- ___._._._........................gallons. W � w WSeptic Tank—Liquid capacity�d.gallons Length_,9__-�t. __ Width.....�e_#.____ Diameter________________ Depth_S_....... x Disposal Trench—No.------ ............ Width.....1Z. ..... Total Length...... Total leaching area._?4D.....sq. ft.�;f Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tX* ( ) _ Percolation Test Results Performed by.-_____JS. iQt1 ,n1�'i_ _____________________ Date__ _ -S._____.... Test Pit No. L__.<_->�---minutes per inch Depth of Test Pit.___.9., � __________ Depth to ground ater....B................ Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water_-_____________________- O Description of Soil..a �3_._ -u'l Q.. f� -- /i 9C '� dF x ........................� CL�E4../ �e"�/d'AN�_.fir- TON, -- �'`�9T �. ------------------------------------••-----•----- U W x ---------------------------------------- -----------------------------------------------•-------------•---- V Nature of pairs or Alterations—A ewe when applicable___ ..__.. ... Q l+ .f'-_ ..-._-_. 4- f�(4-0 Agreement: � �� y ct d a���.� �(� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI'LLE 5 of the State Sanitary Code—The undersigned further agrees not to place the ystem in operation until a Certificate of Compl nce has een sued t oard of health. v Application Approved B - PP PP Y.._.. ...............• ........ Date Application Disapproved for the following reasons----- --------------------------•----•---------•-----•---------------------------•---------------...•••-••..._.._ . . .........................•----••-•--•------••---------....._.....-------......--------••------------••--•-••--••••-••--••------ •------••-----------------•----------....-•------••----._...._ _ Date PermitNo... - Issued....................................................... Date y • � v f I .���/� •, 1 y No THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................................................ Appliration for Disposal Works Tonstrnrtion Errant Application is hereby made for a Permit to Construct ' ) or Repair ( ) an Individual Sewage Disposal System at: ^/ � M ..... ...................... - cation- Address� S ' o1r* ot No. . :'-�'`-�-- 1 S!.. � �,: Owner �j Address .................................. .... �...._.._...`...._........ ------------------ --------•------•--------••-•-•---- ----------•---------•--------......... ---------- Y Installer Address d Type of Building Size Lot..,�rG? __._Sq. feet V Dwelling—No. of Bedrooms.............`1...........................Expansion Attic ( ) Garbage Grinder kVo) `4 Other—Type of Building No. of persons............................ Showers — Cafeteria 0.1 Other fixtures .......................................... -•. W Design Flow...................... Z_O.............gallons peron per day. Total daily flow.......:�.........................gallons. WSeptic Tank—Liquid capacit)/�P ..gallons Length fr__..',_4.':... Width....C_`...... Diameter................ Depths. x Disposal Trench—No. ..... ............. Width....1Z......... Total Length___-5;9'[ ......... Total leaching ......sq. ft.` � Seepage Pit No.-_---__-__.___-- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (�) Dosing to c ( ) `" Percolation Test Results Performed by_.... �_ � �'1n t�e-S....................... Date.:_' '' .,.��'_ __.....__.. �.a Test Pit No. 1....<__?_.minutes per inch Depth of Test Pit____` ........... Depth to ground 'water...9_'.............. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •---......•-----------------•-------•--•--------.............----- .. ...., .............---•--•----•-------•------------•--••••-•--••-••--r O Description of Soil 0 3_.,4-'_2�,-2 ..................... ...` .. _.. nr _.� .`1. ��--- rrt .... _ � ' CI,cq,.✓_r� __l_c�e�nC...... � ,. �!>�:� v x ..• --------------------------------------•--_._ ..... ......-------•--•--••----•.•--•- ------------.. -- ••• •• ......_......... U Nature of epairs or Alterations saver when applicable ` Y1fl1 Ir" . ......... Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—T e undersigned further agrees not to place the.,system in operation until a Certificate of C*'ancehas ee •ssued oard of health.ed- ...............9Vate Application Approved By.......:" -- �r Date Application Disapproved for the following reasons:------•-------------•----------,==' - •...................................:..•----•--------------•---------------------•--...-----------------•-•••-•••--•--•----•••-•--•••--••---••-•-•-•---------•••--••-•••-•---•••----••-••-••••--•-••---- •--.•������ Date PermitNo........................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a,r ...............OF......:..-.. ''... n� ............................... At wrtifiratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage D s osal System constructed ( ) or Repaired ( ) ....... —--J. -nst ller �1--at.................1..,Q l- 1(. ~5 �C. ? ...------"'" 51._..-(tom" ^ ---------•------................ has been installed in accordance with the provisions of TIT 5 of The State Sanitary Coe as described in the application for Disposal Works Construction Permit ..... dated_.:._ � ..'�....................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........... -Z 1J Inspector......................................................... IV j eVt5lh`1--le ^ THE COMMONWEALTH OF MASSACHUSETTS5y$f tv5t S�p�w�►S _V, S��4<��`{rUtV BOARD OF HEALTH '4t--Sfil e6 A,-tv,r41,r p /4 nC� Ge r'�ti"q .� q ...........................................OF...................---....--•-------- > F>ss�... Dispo fat Works Tons1rnrtion rr a Perm> s><on Is hereby granted.-w....................:... ,._-° .�^.. .._ ......... Constr ct ( ) or Repair ( an Individual Sewa e Disposal System at No.----. e.(....... `=,' ` ' =f ...... t ':t Street �q as shown on the application for Disposal Works Construction Permit b .o.----?......._ Dated..__ _/��.�-. ............. a ------------------ r• 'Board of.Health DATE......`_ -=1i, J ......................... 4 1255 A. M. SULKIN, INC., BOSTON TELEPHONE: 362-4860 362.6106 LEEMAN WELL DRILLING SERVICE OWNED & OPERATED BY CLOUGH & CAHOON WELL DRILLERS INC. WEST BARNSTABLE, MASS. 02668 L/ 1'WA . . -kL �. 4", �5 -52,, a,,4 0. VLVt &WV14 i j-t-;t J-4 a-w ztu AI) wam Pn V Al -b �� . a r C' -h1c ; rd HIGH GROUND-WATER, LEVEL COMPUTAl ION Site Location: Lot No. 146 Owner: D�C�.I �FnL Address: h//��„�v�—�T A pr Contractor: Address: Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . s/2 kcf UiV date STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: ' ,ajv�sZ A) Appropriate index well . . . . . . . . . . . . B) Water-level range zone . . . . . . . . . . . . STEP 3 Using monthly report"Current Water Resources Conditions" determine current depth 'to . .:� water level for index well . _ _ . _ -- mo yr STEP h Using Table of Water-level Adjustments for index well STEP ,2A , current depth to water level for index well (STEP 3) , and water-level zone (STEP 2B) determine - water-level adjustment . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . STEP 5 Estinate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water �� f level at site (STEP 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 3 7- - i ' 1 i r w TO: Barnstable Board of Health FROM: Stetson Hall DATE: February 3, 1987 SUBJECT: Certification of System at Lot #16 Deer Jump Hill for Douglas and Barbara Bean An inspection of the installed subsurface sewage disposal system at Lot #16, Deer Jump Hill , West Barnstable, revealed that although the flow diffusors have been installed at the proper elevation, some of the diffusors were slightly tipped to the side. Also, it was pointed out that the septic tank should .be lowered slightly to allow a slope of 1/4 inch per foot in the pipe from the cellar wall to the septic tank inlet. Mr. Bean has stated that the above corrections have been made, however, the changes cannot be certified without great disruption to the presently existing lawn area. Other than this exception the system has been installed as shown on the March 31 , 1986 Titl.e 5 plan. The well has been installed at a distance of 155'± :from the leach area. STETS i LL I U No.521 sanaan�a�` / J 4 'rOP OF ARD "WOTES AID GROUND SURFACE 'GRO UND SURFA CE EL--, F 47'OR 77.�F MSTAIZA 711 -V OF 4 r I) 7,WS P&O I 4y S1?77C SYSTMA 4 OUTLET PITELEM ALL LVST_41_L4Tdr0A' PROCEDURDS AND AfATERL41S �SIIALL CONFORM To x6 cim j5.ooa THE s TA_7w EN�7ROA7m,&A`T_41. CODR, VENT, REQUIRED FIRST TWO FEET GU A eAj�7-;l 15—/ 6 77Y7E 5, AND r1E rOXX Or 4� SURSURTACE E ZA T10AIS VkL LIQUID LE TOP EL 0 MIN 2' LAYER DOUBLE WASHED JV0 ,bTT r7, 0NZ]zS B4.'jUA1,AfADE AS TO COMPLIANCE OF, A 11A]ZABLE PROP-ERTY 1jVL-,0RA[ATr0_,`1 W77ri? RECORDED DEP-3DS D-BOX 1/9'- 1�2' ,STONE OR Z0)MVG-..?.E-GUL47101.,fS. 10" FArWRTEL Z4 4) AW, WA TAR 9_-wrR EFFECTIVE GAS BAFFLE,AT 0 UTLET HE,RE APE, R11�4 TE WFELLS OJ?V THZS'PF0Pr"RTytqR 5 ?X>> INVERT EL 6. MAW T SIDEITA LL P JNVERT EL JNVERT EL ­SY 1,9" OF 12-1111SHED GR RS OF, STEV COMPO)NENTS SEALL :BE BROUGHT TO #7THM ADE, W1411 O-VE CO YWR OF THE : ,, 6) ,,, ALL ,CO�F 9 D -Z 9,, 'M A,A A 1�e4,', ROUCHT GR H7TIHN 6 OF -4 DE Box a- SEPTIC TANK B 3/4'- 1 1/2' DOUBLE Mwkll) -CT LO A E Y ALL, SYSTEM COM06NEMS. H REMAIN A CCESSIBLE.FOR INSPE ION. NO;STRUCTURES SHA BE C T D DIRECTL 6 BASE' IArVERT EL �j N ;5;i 0 11, WASHED STONE ALL LL b '5 R %j :UPONL�01? ABOVE THE COMPONENT ACCESS LOCATIONS, , WHICH WOULD IN7E TTRE W77H THE PERFORMANCE, A CCESS, INSPECTION bK I rrP A/--Vj 01, " ,STONE EL 11 5,0 0, Gal Septic, Tank' 14 BO TTVM EL PUMPING OR REPAIR (Typica Z t -,r 1 ) : NO`DRI VE WA PA RNNG )4 t 51 OR TURNING AREA, OR OTHER IMPER117OUS ARE4 SHALL BE LOCATED ABOVE, A SOIL ABSORPTION S.Wm M BOTTOM OF TEST HOLE EXCEPT WHEN, VENTING HAS BEEN PRO WDED, SEPTIC 'TANKS, G EASE TRAPS, DOSLVG CHAMBERS AND DISTRrEUTION BU S�S 9 R 40 HALL BE PLACED ON A '6" STONE BASE "SVR,6� STABIUTY AND PREVENT SE=NC. OUTLET DISTRIBVTION�LZNES--SHALL REMALN LEVEL' FOR -NZNIAfVM---OF 171k FMST-TWO FEET OF THEIR LENGTH -10 1 LOADING. UNLESS THEY ARE UNDER OR IVITHIN 10' 1) ALL SYSTEM COMPONEW= SHALL BE CAPABLE OF KTHSTANDING H OF DRIVER 1S,OR;TARKWG`OR TURIUNG AREAS, IN WHICH CASE H-,-20 COMPONENTS SHALL BE USED. 12) ALL.BUILDING SEWER :LINES SHALL 1MVE AN IMNEW DIAMETtR OF ,4- A.ND'SHALL BE CAST-IRON OR SCHEDULE 40 PVC .13 THE DEPTH OF T11W-TOP OF ALL SYSTEM:COMPONENTS SHALL NO T EXCEED 36 UNLESS VENTINC ;HAS BEEN PROE?DED 14) IN THE AREAS DF, EXCA VA TIOX, EMTING GRADES SHALL BE REESTABLIS�VED UAEESS NOTED AS PROPOSED CONTOURS LOt � .W�SOILS ARE ENCO UNTERED DURING THE.EXCA VA rMN OF, THE SOIL ABSORPTION SYSTEM, THAT DIFFER NOTABLY FROM TRE DEEP,OBSERVATION HOLE LOG,I CONTACT THE ENCfl&ER BEFORE PjWCEEDING. 16) CONTRACTOR 9 , VERIFYOCATION OF ALL 'UNDERGROUND UTILUIES. 0-1 DESIG, N DATA DEEP OBSERVATION -Num er, 6 b f BedrooMS: 4 HOLE LOG & st Hole Garbage Grinder: -NO Te (EL esi n,�Flow. D 0. Df? soil, soil Soil Horizon Texture color (USDA) (Mumell) (no. Gal/BR/Day it Number of BRY LA 6,�. 01 c Septi' Tank C, (Minimum iDesign7low x 200%), 7 4; ,A Leac Are a:hing Sidewall: X' Z Sidewalls Ft Deep Obe Hole Date. Soll Evaluator-, t")6- ' (�tEndwaUs x x _�=__Ft Witnessed W. Bott6 Soll Survey Desoriptiow CARVER M, Geologic Material: OUTVASH t4 Depth to Standing Water. ffA� 38 Depth to Weeping Water. -NA �, erm �'Rate (LTA Acceptance R) 0. 7,4 Depth to Mottling(Color): NA Est Seasonal High GW. NA NA Leadhing ',Ar a, D Capacity: L4 Date of USGS Observation Well: e esig'n �5 4 last Measurement. NA Cornrnentw. (SidewaU Area'+ Bottom Area) x LTAR Bldg 4 Bed Ho use DEEP OBSER VA TION /17 OLE,.. LOG, ,, , Te St -1101e,1 , Enc. Soil Son bou Porch ur, ft), Hoi 2 D7 FA CILITY ce, �IA PROPOSED LEACHING —8 , X 04 deep, (Pool Filte�) Four �4 8" 67 114, 211 w one on , s­zdii�s' Exis t 1,500 Con ere t e Chambers (or , Sim it � 4 s -7 14 A' Gall- S-77ank 34 '12. 6:) (Total. re r Deep 0 ole Da e: be 0 Soil Evaluatorl, A� 30 Witnessed Br. 41 Pe= Rate. Soil Sur": 3VER 100e DescApuon: CA, G Npth to Standing Witen KA PROJECT L 0 CA TION I 04,_ �eolojlo Materiab OUIVASH NA De*�'to,Weopirg Y*ter < M0tnQC* rat'Seepoi3ol -�NA NA _T 99GS,C)bservati,-r_�Wall: ASSESSORS, MAP I-OT Date UlwaL MonsurernamL N4 Ex. ia ndscc Stoe 'S ve), ,e4PPaC,4NT 0A CA PREPA RED Y A & M: Lan d -:.Services 5 AO t� t 17 V V, e 15 Sunset 10�i M South Na rm o u U, � A102664 (508) 394, V23 V AK40 DA TZ, SCALE 'RE V .'LOCLTS.MAP ' eE7 SHEET IA/ D WG. NO, OF 0 3/� - i y i I { - _ �Q' ca�•✓arRR y i OF / i s \ �c '3 .�6 EDWARO � r 4 2 100 t f ` 1 _ .7 1 C� g .. v. ,,..,'.:^"c ,+b.....R, ....;,.» •,c,^^^ .,...e""+^F»_-"."\.,"n""^t'•`""««T" .,""``"'.fR'�°' 'M;SRti..„ g. x a+ .='Y'$"`'dw, `.`t u.. t u- 'Y•3 ::.y '.'.a°"` #.-":F`..a':rwL¢w .'yR10- ` I � • � , 5�..+> :f..i`i< ., a i:t:n. '}aY�.�,.. .. ..:,e;..' ,.,;;, -"se qy,,O^E� A i ..rt, .,. :.:.'i ..'` Y. •,.,+.,,. yf y L'e Sf .r' '-µ• .s ,:t^+.'. ai sit � ,W. _ •, -��,.` '7 A 7, I ` \ "\ E I J a .. .� .. s ..,.c. ..xe°. t,>k...rw.«a..,:»w»+w-.,....:a•.+: EL 1 TOPOF FOUNDATION CONCRETE COVERS --mac zz.oS ✓ 6\ w zs. 7y��/ _ \ : 9 - e o 4,. CAST 1 RON z�.Yo kµ # a PIPE(oR i AX• 4" SCH• 40 P.V.C. (oR eou'v,) Pv. „ . / 2 'c eaviv) - MIN, PIPE MIN, 2`Li)E y" ° `�9 -/li" '� $ PITCH PER Egsr c PITCH %s• PER FT w�tss,(ra i T , P I � ELF_NVERT /' NVERT IST, INVERT °s \ \ - -` SEPTIC TANK / i G8 i \ \ a EL ELd?. /.V 14i 8' �' 6• B f `qIN o {NVERT /.SD GAL NV RT X �3 f+7 - - U- I 8 ' O I v . EL _ O � +r osnt ; I I e EL2Z fi a./\ w �4> CO r ✓6 ` \ ` ti } '� - LC �b r ✓A n 7• _ y7• 7' o•v o, EL .S PROFILE OF SEWAGE DISPOSAL SYSTEM A NO SCALE ° WITNESSED BY ° SOIL LOG r I D A T E TI ME - - - - - - - 41 :'VEST HOLE I TEST HOLE 2 ✓� _ I - _ , ENGINEER rELEV._Z,?.8-9 ELEV. /✓O c: /ALL rMPE'�'✓iG✓; i.✓ f N� r a .rJ�CA Win/t /� " .3E)/41n✓LD / z �7 DESIGN DATA } A(rG.F.9�i`.9 /A �.5�'92s-^. /�RTyJ ,�� cL 2D•F'J� ' v., ' n NUMBER OF BEDROOMS - - - - y - - - - - -- - - -- R yc'cLOwgn�G _ Tkrtrs c: = -r.cr GARBAGE DISPOSAL UNIT- �✓O • q,,. sra.✓� s TOTAL EST, FLOW 4' ( I-Io_GAL/BR/DAY x -'OR.)- 85 ------- „t REQ. SEPTIC TANK CAR . ('X150%) - - - - - - - � f T C /� Q f� / _ /� / ACTUAL SIZE OF SEPTIC TANK__ _/_S©Q - _ - _ _ SITE PLAN UI EI / /-' /`1 I \ 4' S /`1 B L E� A , LEACHING AREA REQUIREMENTSs.°% c .jOr.Y4r.2♦ .2 SIDE WALL AREA �_� GAL/S,F, x i xz,s= 26o - - — BOTTOM AREA GAI,/S.F, -0'0-1 ' FOP LEACHING CAR (BOTTOM SIDE WALL)_7lio C�-�C. - `; DOUGLAS. p B �1 R gA � /`1 � E� �nw' '�, '.APPROVED- BOARD OF HEALTH RESERVE LEACHING CAP, __7_S'�_f_��7- _ (� DATE- - - - - - - - - /'/,�.2L/� .�/ / C56 "= q0 ' AGENT OR INSPECTOR 3 OF ni t G G,C. 6 0� .�•c. /����3 78a8,r3 .,,, � Svirm ` PETITIONER 01