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HomeMy WebLinkAbout0010 DESIRE'S LANE - Health /J 10 DESIRES LANE, W. BARNSTABLE Al= 088 007 0 i `rJ'40WN-0h8ARNSTABLE LOCATION J ,,t t �cce r•,o S Lv, SEWAGE # VILLAGE �,J , 'C3 p,� ,'�S�e b ASSESSOR'S MAP &L 7 LOT 4 b INSTALLER'S NAME & PHONE NO. Fv c}-„L A4 ; ISEPTIC TANK CAPACITY 15 D� c U , LEACHING FACILITY:{type) �Lo S"7 E F ssa f s (size) & - Jq V$ O. OF BEDROOMS r3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER -5 r DATE PERMIT ISSUED: ATE COMPLIANCE ISSUED_f . VARIANCE GRANTED: Yes No i - — s� �I 55 ► a d 1 S-7 113 a. CD OWN Of'BARNSTABLE LOCATION J,v1 ,Jcsf r`e S L.v� SEWAGE # 099 -,&# 7 4 b 7 VILLAGE NJ , ASSESSOR'S MAP & LOT r INSTALLER'S NAME & PHONE NO. �- SEPTIC TANK CAPACITY L, t LEACHING FACILITY:(type) D,(F v ssa r!; (size)S X� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER r- S i DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No � 0 1 13 5-7 '3 CD a rp V A/ap i( Ce %BORTOLOTTI CONSTRUCTION, INC. 765 WAKEBY ROAD,MARSTONS MILLS, MA 02648 508-771-9399 508428-8926 FAX: 508428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: o� Date of Inspection: / /9/9c7 Inspector's N me: Owner's Name and Address: CERTIFICATION STAT MENTs I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true,accurate and complete as of the time of inspection. The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal,systems. The System: / Passes Conditionally Pa Ess Needs Furthertion ocal Aproving Authority Fails Inspector's Signature: — Date: The System Inspector shall submit a copy of this inspection report to the Approving authority within thir- ty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY, A)SYSIXM PASSES: ✓ I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated Ore indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system, upon comple- tion of the replacement or repair, passes inspection. Indicate yes,,nor,or not determined(Y,N,OR ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal,cracked,structurally unsound, shows substantial infiltration or exfiltration,or tank failu 4 is!itnminent. The system will pass inspection if the existing sep- tic tank is replaced with wconforming septic tank as approved by The►Board of Health. Sewage backkup or breakotit'801 igh static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of The Board of Health): 1 _ a . 1 FORM x .SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION F O PART A CERTIFICATION(continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of The Board of Health): Broken pipe(s)are replaced Obstruction is removed_. C)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 the public health, safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: 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.. 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES-THAT THE,SYSTEMIS FUNCTION- ING IN A MANNER THAT-PROTECT THE PUBLIC HEALTH,AND SAFETY AND THE p ENVHONMENT: . The system has a septic tank and soil absorption system and is within 100 Feet to a surface t ;,.: water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to nit overloaded or clogged SAS or cesspool. Discharge or ponding of efluent 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 clog- ged.SAS ofcess000l. Liquid [depth in cesspodt,i$ ss than 6";below.invert or available'volume is less than 1/2 day flow. Required pumping more t A 4 times in the last.year NOT..due to clogged or obstructed pipe(s). Number of times pumped ; -2- , w SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (conlinucd) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large._System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: . The system is Within 400 Feet of a surface drinking water supply The system is within 200'Feet of a tributary to a surface drinking water supply The system is located in a nitrogen sensitive area Interim Wellheadl?rotection Area t (IWPA)or a mapped Zone II of a public water supply well. The owner or operator of any such system shall bring the system and facility•into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Check if the following have been done: ✓Pumping information was requested of the owner,occupant,and Board of Health. _None of the system components have been pumped for atleast two weeks and the system has ,been receiving normal flow rates during that period. Large.volumes of water have not been introduced into the system recently or as part of this inspection. As-built plans have been obtained and examined. Note if they are not available with N/A. JCThe facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. z- ✓ All system components,excluding the Soil Absorptton'System,.have been located on site. The septic tank manholes,'were uncovered,opened,and the interior:of.the septic tank was in- «} spected'for condition of,bid s or tees,material'of.constructionAimensions,depth of liquid, depth of sludge,depth f f" ✓'The size and location of the Soil Absorption System gn,the site has been determined based on existing information or approximated by non-intrusive methods. -3- N . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) 4'' The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - - - ..PART C .. -- SYSTEM INFORMATION FLOW CONDITIONS BESIDEIYTIALt Design Flow: _gallons Number of Bedrooms-_2_ Nun r or Current Residents: 12 Garbage Grinder:_ Laundry Connected To System: Seasonal Use: /JU Water Meter Readings,if yailable: &te1f Ala I-el- Last Date of Occupancy:. COMM .R A tINDUSTRIAL* ,A) Type of Establishment: Design Flow: t allonstday Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: Non-Sanitary.Waste Discharged To The Title V System: Water Meter Readings, If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System Pumped as part of inspection: IUO if yes,volume pum Gallons Reason for pumping: TY)r�OF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection records, if any) . Other(explain): ROXIMATE AVE of all compdtletnfs`Qdate installed(if known)and source of.information. Se Age odors detected when arriving;`04 site: �>d -4- r F. SUBSURFACE SEWAGE DISI'OSAL SYSTEM INSPECTION FORM �. PART IC:: GENERAL INFORMATION (continued) SEPTIC TANK: Depth below grade:�G Material of Construction: ---,concrete metal FRP Other (explain) — Dimisions`./O.S'X Co'x S ' Sludge Depth: Scum Thickness: " Distance from top of sludge to bottom of outlet tee or baffle: 3Q Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffleq,depth of liquid level in relation outlet invert, structural integrity, evidence of leakage, etc.)j:( D GL /d'' ti CQ"na�r�ee-lcv�'� - GREASE TRAP: Depth Below Grade: Material of Construction: - concrete metal FRP Other (explain) — — — — Dimensions:. Scum Thickness:' Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping, condition of inlet,and outlet tees or.bafl`16,depth of liquid i•, level in relation to outlet invert,stnictural integrity,evidence of,leakage,etc.)' TIGHT OR`IIOLDING TANK: /00 Depth Below Grade: Material of Construction:__concrete_metal—FRP_Other(explain) Dimensions: Capacity:_ gallons Design Flo�� �allons/day Alarm Level: Comments: (condition of inlet tee, condition of alarm and float switches. etc.) DISTRIBUTION BOX: Y Depth of liquid level above outlet invert: Comments: (note if 1 el and digribution is equal, evidence of solids carryover, evidence of leakage into or out of box,etc.) v ' PUMP CHAMBER: Pump is,in.working.order =:f�; �': ::, Comments: (note condition of pump chamber,condition,of pumps and appurtenances,etc.)' ) t 4 , r 1 SUBSURFACE SEWAGE'DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SOIL ABSORPTION SYSTEM(SAS): (Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: Leaching pits,number: Leaching chambers, number: Leaching galleries,number:.j Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool, number: Comments: (note condition of soil,signs of hydrau is failure level of ponding,condition of vegetation, eta) _ " �-3 - . . oa&z o, srh CESSPOOLS: Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of Cesspool: Materials of construction: Indication of groundwater: Inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soilk,signs of hydraulic failure, level of ponding,condition of vegetation, etc. PR IVY: n, Materials of construction: Dimensions:s ons: Depth of Solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) -G - 1 N ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) I SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to adeast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. . II h , I I DEPTH TO GROUNDWATER: I U WATER• Depth to groundwater: y Feet Method ofiDeternunation or Approximation: k 7- t °"7 O . •' � j A COMMONWEALTH OF MASSACHUSE l I EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i Ll TITLE 5 OFFICIAL;IIySI'ECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION I Property Address: !/D 0wner'sName: 1,G ,1y�il�lpNf 5'T .��T Owner's Address: i Date of Inspection: Name of Inspector: (please print) Antonino Caponigro Company Name: Tbnv Canonicrro' s TnsnP� rt i on Service Mailing Address: 21 6 Nnri-h Ma; n St Mpnsf field, Mass 02048 Telephone Number:;. ( 508 ) 339-821-.9 f CERTIFICATION STATEMENT 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 pefo�imed based on my training and experience in the proper function and maintenance of on site:se`w•age disposal systems: I am a DEP approved system inspector pursuant to Section.15.340 of.Title 5(3W tMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: The system inspector shall subiniv a copy of this inspection report to the Approving Authority(Board of Health or', DEP) within 30 days,of contplettrtg this inspection. If the system is a shared system or has a design flow'of I0,000; gpd or greater, die inspector and die system owner shall :mbinit the report to the.appro.priate regional office of the _ DEP. The original should be sent to the system owner,and copies sent to the buyer,.if applicable,and thetapprov�t authority. r w' i e�t cJa oa _ > Notes and Continents A15 .(�o r /1�'�'ic a,S'.c r< To T v,,:5 sys��E - Nl� 15l2 11it5 lfi i tin 4v.Y ****This report onNy describes conditions at the time of inspection and under the conditions of us at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Fr"Irn: 6/15/2000 page 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: /D Owner: oeLat/2'/1 ✓fi /fig S�T/Li�/T Date of Inspection: ?Z 7 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X1 have not found any information which indicates that any of the failure criteria described in 310 CMR I5.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: J 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. Answer yes, no or not determined(Y;N,ND).in the for the following statements. If"not determined" please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration-or-tank failure is,imminent:System°will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. •A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to.a broken,settled or uneven distribution box, System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 n 1► OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: S7iVdr' 'W��SS Owner: Date of Inspection: C.��JJFurther Evaluation is Required by the Board of Health: ND 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. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(i)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: 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 2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has aseptic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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. 3. Other- 3 A, OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECT-ION FORM PART A CERTIFICATION (continued) - Property Address: /Q VAS//yZ�FS� Owner Date of inspection: /21Z ,p7 D. System Failure Criteria applicable to all systems: You must indicate—yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool 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 . NA Liquid depth in cesspool is less than 6"below invert or available volume is less than X_day flow Y Required pumping more than.4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ NA Any portion of a cesspool or privy is within a Zone 1 of apublic well. VA Any portion of a cesspool or privy is within 50 feet of a private water supply well. !t/4 Any portion of a cesspool or privy is less than 1 OU feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [Thu system passes if the well water analysis,, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.] (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 114 E. Large Systems: `v To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply _ — the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped Zone 11 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 system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department- 4 n OFFICIAL; IN, FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: f� �,tj • Owner: -- �/ZV F,2z/","_S�,s�f Date of Inspection: _Z?/07 i Check if the following have been done. You must indicate`yes"or"no" as to each of the following: i Yes No _x Pumping information was provided by the owner,occupant, or Board of Health _ Were any of the systen components pumped out in the previous two weeks x _ 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? Iit dei���tlS Were as built plans of the system.obtained and examined?(If they were not.available note as N/A) _ Was the facility or dw.11ing inspected for signs of sewage'back up ? ✓� - Was the site inspected.for signs of break out ? I i Were all system components, excluding the SAS, located on site? A ._ Were the septic tank manholes uncovered;opened,and the interior of the tank inspected for the condition of the.,bafflesorlees,mA terial 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 ? i i i The size and li cation of the Soil Absorption System (SAS)on the site has been determined based on: Yes no A _ Existing information. For example, a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)J i i 5 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: A/l/L Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_ Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x 4 of bedrooms): ✓�✓?!� Number of current residents: a?_ Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system (yes or no): [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): Water meter readings, if available(last 2 years usageXgpd)): _-lU,OdL �-1 -F4, Sump pump(yes or no): Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15203): �Pd Basis of design flow(seaWpersons/sgf4 etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: 1 ST t�ysN.�EO ��s, A4%"e!5�Pu-)AV e11) Was system pumped as part of the inspection(yes or no): 7 If yes, volume pumped:_gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM xSeptic tank,distribution box,soil absorption system Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information:6_0rXr, CD,Wp , //z/ Were sewage odors detected when arriving at the site(yes or no): � 6 i OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SOBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: DF -laeS . I AIST I _ Owner: Date of Inspection: '. 7 BUILDING SEWER(locate on site plan) i Depth below grade: 4111,01 Materials of construction: _cast iron 40 PVC_other(explain): Distance from pri �jvate water supply well or suction line: Comments(on condition of joints, venting, evidence of leakage, etc.): HIVn/y`ioti O-C 0­01.y'7' ; !/fNrlly-z 10 i SEPTIC TANK: Y(locate on site plan) Depth below grade: 36 /�/.L f7- 2 '�OV"4e 6/V-047 Material of cons tru l ction: concrete_metal_fiberglass_polyethylene �othcr(explain) If tank is metal I{st age:_ is age confirmed by a Certificate of Compliance(yes or no): _(attach a copy of certificate) Dimensions: S X/L7 Sludge depth: •� Distance from tap of sludge to bottom of outlet tee or baffle: / Scum thickness:'-7=� Distance..from top of scum to top of outlet tee or baffle: _z, Distance from bottom of scum to bottom of outlet tee or baffle: _ How were dimen �f, siotu determined: ' -ZXA,5FI.-ev aN SITE Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): /ti.CE T 6 0&7-Z fT T S 6o a o S7-.e4/G7-411 <Z)1' -5-041AIP zi U p - �ll¢'�/!�/TJf-f GREAS ���cdi'Yi.VO 7.',4./✓fl .CAE G�!//�/.�EO f.1�9-�f+i/�/�� ����Y 2 y/�.S, T.�fe£.dFTF.e NoN£RAP: _(locate on site plan) Depth below grade:_ Material of construction:_concrete _metal_fiberglass_polyethylene_other 7-IS ,t e6-CCAWIVpF (explain): Dimensions: Scum thickness:', Uy ��2 ��l�11�/•5/6 Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): j I i li I 7 i - Y OFFICIAL INSPECTION.FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: 5W0A1 Date of Inspection: TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass___polyethviene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no). Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be openedxlocate on site plan) Depth of liquid level above outlet invert:-L/)Av.,7ldQ1/7-AET /�/dFiZT S 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..): Box is (t!/ZL 77/5 7-1211-4 Ti v)/ �yir>r��'F o-F .5o�/ram s «�rl y ovF.z �o �!///JFiY�F a1':�fs�lsKc PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): R v� OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 111'-0-57— .t/s G F Owner: . ,fW S PtlT Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why:. Type leaching pits, number:_ _J�leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool, number: innovative/altemative system Type/name of technology:. Comments (note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): CESSPOOLS:( ,(cesspool must be pumped as part of inspect ion)(locate on site plan) Number and configifation: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (Locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: T Zs1C57.af3.t f ��� Owner: L/2/l/1 f ,V1,4WY Sriaz&,r Date of Inspection: 1;12.7,1V SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. WV � qw CC- I jA /oxv,ze r x To -S7� 10 . OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART C SYSTEM INFORMATION (continued) Property Address: Owner: [' 2i?s�fil�i.�•yg QT2.�/T Date of Inspection: j 2/77/167 SITE EXAM slope S/ar Surface water dU0,r>P Check cellar ,l Y 0�5 Shallow wells DE�Ol��,LL Estimated depth to ground water r`fZ,,feet ItlDwf ,C�srNP Please indicate(check) all methods used to determine the high ground water elevation: Obtained from system design plans on record"-If checked,date of design plan reviewed: / a lr � Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Hwlth-explain: Checked'with local excavators,installers-(attach documentation) Accessed USGS database-explain: You nouns(describe how you established the high ground water elevation: State Enviromental Code Title V Chap. 5 Inspection Procedures Guidance on Completing Inspection Form Part A Certification. The Certification Section has two principal functions. First it .provides identification information on the property being inspected and the inspector. Second, it presents the results of the inspection relative to -the fa:i-line-criteria outl-ined in 310 -- CMR 15 :303 . In the certification statement, the .inspector is cer- tifing. that the conditions existing at the time of inspection are accurately 'presented in the inspection report: the inspector is not certifying that the system is adequate for the current use Lof the system. nor for the future use of the system._ __ it Y0111 Septic stem and How it Wofqks It is important to understand how your system works and how this treatment affects I� it in order to protect your investment. The typical system consists of three (3) main components. The Septic Tank The Distribution Box The Drainfield The Septic :lank Waste exits the house and enters the septic tank where solids settle to the bottom, . grease and scum from the household detergents float to the top, and liquids stay in between. The solids that settle create their own bacteria which decompose the solids naturally. There is no need to add additional enzymes and bacteria-to the tank. The tank eventually fills with solids and scum requiring it.to-be pumped. The Drainfield The liquid (gray water) flows to the distribution box where it is evenly dispersed into the drainfield. Finally, the drainfield begins treating the gray water. Microorganisms in the soil consume organic pollutants in the gray water and the pure water is absorbed by the ground below. How Problems Start From the first day of use, the drainfield of your septic system begins to deteriorate. Some solids, grease, and scum always pass through the septic tank into the laterals. This is because of natural solubility or the lack of settling time in the septic tank during periods of heavy use. - Problems especially arise when the septic system is not maintained" and the septic tanks fills with solids and scum that overflow into the drainfield: As the drainfield becomes clogged, the water flow becomes restricted. Since the water cannot drain into the soil, it filters upward causing ponding, foul odors, wet spots in the yard, and an unhealthy environment. TONY CAPONIGRO 216 No. Main Street Mansfield, MA 02048 Title V Inspections COMMONWEALTH OF MASSACHUSETTS IMPORTANT MASS.DEP *` If this approval is lost or destroyed,notify NEIWPCC,116 John St., Lowell,MA 01852.If the name and/or address has changed from t the above listing,contact NEIWPCC with changes to insure prop- APPROVED TITLE 5 SYSTEM INSPECTOR , w f—_ er mailing of the next renewal application.Approval is subject to the provisions of 310 CMR 15.000 and may not be loaned or c' assigned to another person. ::3 co Antonino Caponigro 114 Emory St. cA Attleboro,MA 02703 S13141 I 12/12/1995 6/30/2010 PURSUANT TO THE GENERAL LAWS i Town of Barnstable �pFIHE 1p�� Regulatory Services ,CABLE Thomas F. Geiler, Director y MMUAS& g i639. Public Health .Division ArE,D AAp'r p Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862. 644 Fax: 508-790-6304 This septic system p y inspection report was completed by a private inspector who is certified by the State of Massachusetts,Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report, please contact the certified Septic System Inspector who conducted the inspection. I gg r THE COMMONWEALTH OF MASSACHUSETTS DLL e480 BOARD OF HEALTH IT- TOWN OF BARNSTABLE �tV 1,5,-76 Appliration for Di-tipm3al Vorks Tomitrnrtion Fautit Application is hereby made for a Permit to Construct (v ) or Repair ( ) an Individual Sewage Disposal System at: 1121 S 1.� �. 4J. V - ... ............................................. - ,--•-•--- -•-•-•--..............-•- Location-Addres or Lot No. . - . tt = �.r MA...... W O ner � d-- a Installer Address U Type of Building Size Lot ... AA124.....Sq. feet -, Dwelling—No. of Bedrooms----------5-----------------------------Expansion Attic ( uD Garbage Grinder (00 aOther—Type of Building -------MI_.A----------- No. of persons.-______------------------ Showers (I�a — Cafeteria ( 00 Other fixtures ---------------- -----------•----------------•---------- W Design Flow..............IJI{O____.-•-.----`----•----gallons per person per day. Total daily tow--------------�..�...................gal)pnsli R: Septic Tank—Liquid capacity.-._ allons Length-_tZ:n0__ Width._ -J�O_. Diameter---Q).!4.... Depth_.. _ Disposal Trench— No. .!J. .............. Width----W--------- Total Length----3e......_. Total leaching area--.__4Ui?..sq. ft. Seepage Pit No--------- ----------- Diameter....--_----_---_.__ Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing to k ( ) _ '-' Percolation Test Results Performed b -�. _ t? __ � .......a Y Date...L? .'dr�'' --------- ,a Test Pit No. I..._.._?--__-minutes per inch Depth of Test Pit------(�►..___ _)... Depth to ground water_..(CA.CoAn-wed) noyle....._ ..Li, Test Pit No. 2................minutes per inch Depth of Test Pit__......_._______.._ Depth to ground water.- a ------------------------------------- •-••••-•-- ---------------------•--------------•----.........-------•----------....---------------.........•-•-..--- O Description of Soil........0-•-Q.......$•';;?....3 To Sut �o i�..�._.'.z_.o-__r2:.�.. . •---•---------------- xxljo� r }.. x ---------------- ------7�- �ou�az_iFFvoq� � oN ............. V Nature of Repairs or Alterations—Answ)r when applicable..................................................... ......................................... ••---•....----•-••••••-•----.--•---••--••-••-•--•-------------•••••-----•--••---•-------------•-•-----••--•-•---•-•------------------------------------------•-•.......-------•---•-•--------••--...--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions cf TITLE 5 of the State Environmen 1 Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia e as is d e board of health. Signed ..... Dace Application.Approved By ...... ------....._._--------------------_.---------------------------------- Dace Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------------------------------------- ------ ---------------------_.........._--------....-----------..............--------------------.....-------.......----------------.......-------------..........---------......--------------......- ---------------------------------------- c�jj Dace Permit No. ........../... - - .'. .. .............. Issued ................ -'...� ......... Dare Fs$..:. .�ta =.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEALTH �- TOWN OF BARNSTABLE .. g5-"b Appliration for Dio ooul lVorlto Ta tuitrurtion rumit A lication i is hereby made for a Permit to Construct or Repair PP Y ( ) p ( ) an Indlvldual Sewage Disposal System at: �- I--� -L.,- ----- _ ...................... Lo1c1a��tion-:\ddres or Lot No. f� -rll ..................... ....���._...�N_O vn ';' �� ............ � 5�1 }�......-�1 L dd ess� .:.�_ C1...........--..._. w rL� r --------------------•---•----•-•--- a --_..•------- Installer(� Address Type of,Building Size Lot-----.. - --_-.Sq. feet Dwelling— No. of Bedrooms----------5-----------------------------Expansion Attic Garbage Grinder (00 aOther—• Type of Building -------K) ----------- No. of persons---------------------------- Showers Cafeteria ( Q)o 04 Other fixtures . ------------------------------------------------------------------------ ........................................................... W Design Flow..,........ -----------------------gallons per person per day. Total daily Row.._._..____.-� d...................gal�onst� WSeptic Tank—Liquid capacity.3.S_allons Length--�Z:nd_- Width.._ '6_. Diameter...N1'.a-.-_ Depth__ ..-Z�. x `Disposal Trench—No. .............. Width....I-.�-.--------- Total Length----�.--------- Total leaching area------ ft. Seepage Pit No--------.------------ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( . ) aPercolation Test Results Performed by._J_�_�Ne t� .__. .,_• . J, Date---- •95...... Test Pit No. I--_---_?-.....minutes per inch Depth of Test Pit______ .._.. _J:4-Depth to ground water... 0OrC......... f4 Test Pit No. 2................minutes per inch Depth of Test Pit---------.------.--- Depth to ground water--.�-cy? cQ *red) OrxI •---------- -------------------------r--------------- --------------------------------------------•---------------------------•---------------------------- Soil Description of pI' --------0.,.9.'----$--o----i-To l'._^.._.�!?)3�o El„•1---�=�-�--r�--=-p-)--�aP YLtai�: ....................... 3=o IZ o. j -r}1.' 1?_-' 1 � S;a,.a -------------------- - - -- . ------------------. -- •--------..----- . -------- .. " - ..-..... ' p ` c P.�t,�C ._.:.. _ ... t.. l.r�t�l �FUSQ '��%w --.. _T o_N -...- ----•......... U Nature of Repairs or Alterations—Answdr when applicable.............................__----.-___.-.-_-------_ _-............................_:....... .•••-••-••------------•••-•-•-•-•••••-•-•--••••--•-••-••---•---•-••••••-••----•••-•••-•-•-•---•••-•----•---•-•-------•---• -----•-•----•---•••-•-----••-•-•------••--••••••-••••-••-•-...---•-•......... Agreement: r The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of'Compliani -as b . >Z is a board of health. ; -- - / � r Signed .--..l.... ---- ..... --- --------- --------- .^- ----... ------- - k DY Application.Approved By --- ^� < ,. , .... . ..... ............... - ....� ..... ...... Dve Application Disapproved for the following reasons: ---------------------------------_....-.....-.....------------------------------------------------------------------------- .... . .......... .......... .. �.................. .......... ........ - ................................. . .......... � -------._ ....------. ace Permit No. .: j Issued 1. ..�. - Dace - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C erttf ratjE of Tomplian e D CERTIFY That the Individual Sewage System constructed Repaired ( )g p y ( ) or Re a by ... ! k,:..... ---- -------------- --- 1 I ier at .........! -------- ------- -- ---W, ' has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _'I.F---------------- dated -------------_-_---------..............THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST UEA AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---- .."" °....�,"`` Inspect r✓. .:.............151, `.. THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF HEALTH • f No. ��, _ TOWN OF BARNSTABLE FEE....... Disposal Workii T notrudivit Verutit Permission'is hereby granted------------ b: f�. 1' ----------------------------------------------------------------------------------------------- to Construct ( `,1 or Repair ( ) an Individual Sewage Disposal System atNo...........f=- 7 R------40-.o�- `?4.......,V..------ >.. c ct ---------------------------------------------------------- Street as shown on the application for Disposal Works Construction Per it o.......'y-'. Dat .................... VAA fBoard of Health DATE..................... ................•----_.� -v--r-•- -- FORM 38508 HOBBS R WARREN,INC.,PUBLISHERS r r ENVIROTECH LABORATORIES, INC. MA Cert. No.: M-MA 063 449 Rte. 130 . Sandwich, MA 02563 (508)888-6460 . 1-800-339-6460 FAX(508)888-6446 CLIENT: John Weir, Jr. LOCATION: Desire Lane ADDRESS: W. Barnstable, MA SAMPLE DATE: 11-20-95 COLLECTED BY: DA Scannell DATE RECEIVED: 11-20-95 TIME: N/A LAB I.D. #: E11-231 JOB TYPE: New Well SAMPLE I.D. #: E11-231 WELL SPECS.: N/A RESULTS OF ANALYSIS: Parameters Units Recon¢nended Limit Result Coliform bacteria/100ml (MF Method) 0 0 pH pH units 6.0-8.5 6.52 Conductance umhos/can 500 92 Sodium mg/I. 28.0 7.9 Nitrate-N. mg/L 1 10.0 0.17 Iron mg/L 0.3 0.17 Manganese mg/L 0.05 0.018 Volatile Organics See attached report. EPA # 601/ 602 ug/L None detected. COMMENTS: Yes No TER IS SUITABLE FOR DRINK PURPOSES PARAMETERS TE XXX C. Date Ronald J. S ri Laboratory Director LT = Less Than ivrii Y't'iCAL ENVIROTECH 508 759 4475;# 2/ GROUNDWATER ANALYTICAL EPA NETHODS. 601 and. 602 Volatile Organics (GC/PID/ELCD) Field ID: E11231 Lab ID: 12258.=01. .. Project: Weir/Desire Lane Batch ID: - 0" W Client: Envi rotech sampled: 1 1 20-95. -- ' Cont/Prsv: 40ML VOA Vial/HC1 Cool Received: 11-20-95.. Matrix: Aqueous Analyzed: 11-22-95; . : PARAMETER CONCENTRATION REPORT ING:.1I,M:TT_: Di chl orodi fl uoromethane BRL Chloromethane BRL °5;... Vinyl Chloride BRL 5 BRL 5 Bromomethane 5 Chloroethane BRL I Trichlorofluoromethane BRL 1 1,1-Dichloroethene Methylene Chloride 1 BRL I trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethane BRL 1 cis-1,2-Dichloroethene * Chloroform 1 BRL 1 1,1 1-Trichloroethane Carbon Tetrachloride I BRL I Benzene BRL 1,2-Dichloroethane 1 1 Trichloroethene BRL BRL 1 1,2-Dichloropropane BRL 1 Bromodichloromethane 2-Chloroethyy1 Vinyl Ether BRL 5 cis-1,3-Dichloropropene BRL 1 Toluene BRL I trans-1,3-Dichloropropene BRL I 1,1,2-Trichloroethane BRL 1 Tetrachloroethene I BRL 1 nibromachlorcmethana BRL Chl'orobenzene BRL 1: EthyTben' 6ne` ,.> BRL meta-an �r =7(yTene * BRL ortho-ljrl ene * BRL Bromoform BRL 1: =' 1,1,2,2-Tetrachloroethane BRL 1,3-Dichlorobenzene 1` .1,4-Dichlorobenzene BRLI ... 1,2-Dichlorobenzene BRL QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS, a,a,a-Tri fl uorotol uene 30 31 102 % 87 - ,1:13,.% 1,2-Dichloroethane-d4 30 35 116 % 83 = :117 .:% BRL - Below Reporting Limit. * Non-target compound. Method References: Method 6,01 -. Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A -(1986). ENVIROTECH 508 759 4475;# 2/ D GROUNDWATER ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: E11231 Lab ID: 12258-01 Project: Weir/Desire Lane Batch ID: VG2-0734-W Client: Envirotech Sampled: 11-20-95 Cont/Prsv: 40mL VOA Vial/HC1 Cool Received: 11-20-95 Matrix: Aqueous Analyzed: 11-22-95 PARAMETER CONCENTRATION REPORTING(LIMIT (ug/L) . Dichlorodifluoromethane BRL 5 BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BR Trichlorofluoromethane L 1 1,1-Dichloroethene BRL I Methylene Chloride BRL I BRL I trans-l;2-Dichloroethene BRL I 1,1-Dichloroethane BRL I cis-1,2-Dichloroethene * BRL I Chloroform BRL I 1,1 1-Trichloroethane BRL I Car Tetrachloride on BRL I . Benzene BRL I 1,2-Dichloroethane BRL I Trichloroethene 1 1,2-Dichloropropane BRL Bromodichloromethane BRL I 2-Chloroet%yl Vinyl Ether BRL 5 CIS-1,3-Dichloropropene BRL I Toluene BRL I trans-l;3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL I Tetrachlor.oethene BRL I Dibromachloromethane BRL 1 Chlorobenzene BRL I Ethylbenzene BRL 1 meta-and.-para=Xylene * BRL 1 ortho-*I ene * BRL I Bromoform BRL I 1,1:22-Tetrachloroethane BRL I 1,3-Dichlorobenzene BRL I 1,4-Dichlorobenzene BRL I 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a;a-Trifluorotoluene 30 31 102 % 87 - 113' % 1,2-Dichloroethane-d4 30 35 116 % 83 - 117 % BRL = Below Reporting Limit. * Non-target compound. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1906). ENVIROTECH LABORATORIES, INC. MA Cert. No.: M-MA 063 449 Rte. 130 . Sandwich, MA 02563 (508)888-6460 . 1-800-339-6460 FAX (508) 888-6446 CLIENT: John Weir, Jr. LOCATION: Desire Lane ADDRESS: W. Barnstable, MA SAMPLE DATE: 11-20-95 COLLECTED BY: DA Scannell DATE RECEIVED: 11-20-95 TIME: N/A LAB I.D. #: E11-231 JOB TYPE: New Well SAMPLE I.D. #: E11-231 WELL SPECS. : N/A RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100ml (MF Method) 0 0 PH pH units 6.0-8.5 6.52 Conductance umhos/cm 500 92 Sodium mg/L 28.0 7.9 Nitrate-N mg/L 10.0 0.17 Iron mg/L 0.3 0.17 Manganese mg/L 0.05 0.018 Volatile Organics See attached report. EPA # 601/ 602 ug/L None detected. COMMENTS: Yes No WATER IS SUITABLE FOR DRINKI PURPOSES F PARAMETERS TESTE . XXX Date Ronald J. S ri Laboratory Director IT = Less Than MI X, c E. j 120 I � LOT 9 "41 Z5 47 L, VACANT LOT LOT 8 --� W 30 43, 724 S.F..t �52 i UTILITIES ASS. NO.: 88-07 114 — N 110 _ 1. v STONES' / 1 PLAN REF L. 7 D RESERVE ,ork �O,O I � I11. 111.2Pr 111.2P B AREA 20 w 02 ,c� RES. ZONE. / PROPOSED w 106TP / 1 / OOD ZONE. / p HdVSE 1B.O'_ ® I / C.B. 1 J� ,v Li th PA O B4 j o � . / 5 � � A. 2 .0 kiEFMEW 4 Zg 111.2P PORCX I� ��'� 11 9 No.32M �e ��ss�AECISTERE�JF,4 Q I I PROJEC T L OCA TION: 3—FLO WDIFFUSORS ' JWITH 4' OF STONE i rw LOT 8 DESIRE' R��SE / / \106 �_ � 6�` WEST EARNST TEMPORARY A0 00 I 104 L 30• 4q APPLICANT- ` - 102 ' l��l JOHN WEIR J / N52 37'07"W 245.68' EDGE OF PAVEMENT YAWEE SUR V/EY DESIRE'S LANE BENCHMARK P.0. BO TOP OF C. BASIN UNIT 5, 4OB IN EL=99.32 MARSTONS MILL r d: C.B. LOT 9 VACANT LOT O UTILITIES 114 � �112 110 RESERVE 111.2P 1 6 AREA 1 O oI PLAN REF. L C.40599E w / 2 1� RES. ZONE. 'RF" 106 / to b OOD ZONE. "C" 'p f M OF C.B. I )�" 1 M w / 'r/ ' ` QS 1 � ���, s9c o� JOHN yG / 5 � � LANDERS-CAUL wTp� G ENE $ M>efiRliEW v CIVIL y 2� o No.32098 c o.351 `y I S�NAL LhW3 S AL ENG 3-FLO WDIFFUSORS I PROJECT LOCATION: J WITH 4' OF STONE LOT 8 DESIRE'S LANE . WEST BARNSTABLE,, MA. tx 104 APPLICANT.• 102 _ - �✓' f��J , JOHN WEIR JR. / " 245.68' OF PAVEMENT YANKEE SURi/EY CONSULTANTS NE BENCHMARK P.O. BOX 265 OP OF C. BASIN UNIT 5, 40B INDUSTRY ROAD TOP O.32 MARSTONS MILLS, MA. 02648 PH.(508)428-0055 — FAX(508)420-5553 I ASSESSORS MAP N0; e •4 >� © PARCMK , `Z No. ------ ------ BOARD OF HEALTH TOWN OF BARNSTABLE i ZippCication-*rVell Cootructioni9ermit Application is!hereby made for a permit to Construct (All, Alter ( ), or Repair ( )an individual Well at: I "Location — Address Assessors Map and Parcel _ — O —R----------------——--�=---- - ���.�_--5-7=---- (0- T-------------------- - Owner Address -- 0/t �, - - -3( 6ow_Oo,.� A P0,� 960 /uas��cF c�w4 ----------- 7--.- - -------- ---------------- ----- ---------- Installer — Driller Address Type of Building Dwellingdour e- ------------------------------------------ Other'- Type of Building —-------------------- No. of Persons------------------------------�______ Type of Well � � —---------- Capacity-------------------- urpo e of We'll ----------------------- --�a_M�ZTi�---- Agreement: I 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 lin operation until a Certificate .o Compliance has been issued by the Board of Health. Signed ------------------------------ 1_-.r<_1-�' date r Application Approved —--—— ✓��' � idate Application Disapproved for the following reasons:------ -------------------------------------------__—_ date Permit No. -� �/i' ` "'7 _—___ Issued� �C ----- 1 date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed Altered ( ), or Repaired ( ) b %� =_-l�_s,•��_1� -✓�i-1�< f-------------------- Ins:aller at 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 �-4-' ` Dated-,—/ , i THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE - --------—- ---- -- - --— — -- Inspector---------------------------------------------------------------------- �'�, G� .� '°�tT"n"`'-�"�`-'tIX' r.r.{+p.+.�+yTtis�ly,� ��� ���,�. i .'''"�-,�r..�s�,r'SR.,�'"i.r}ri..iivraP�'c-,r��►�''. �rj A ` �� No.------------- Fee--------------------- BOARD OF HEALTH. s TOWN OF BARNSTABLE Application-ftlVel[ Con!9truct ion Permit Application is hereby made for a permit to Construct (,All, Alter ( ), or Repair ( )an individual Well at: ---9-i----e' esjfoos__�N Location — Address Assessors Map and Parcel -&--3 e if - —'1 =-- -- --- 4M(_i 1-^ ram' `0_T -- ------ - -- ---------------- Owner Address --------- ------------------------------------------------------ ---- � d►rt Installer — Driller Address Type of Building Dwelling ______ Other - Type of Building------------------------------- No. of Persons----------------------- . ---------------- i Type of Well— � Capacity------------------ Q -- - -- —— — --— — _ r, Purpose of Well--- �---6S-" - `-----���_ o!----------- 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 x place the well in operation until la Certificate .o Compliance has been issued by the Board of Health. �/ �� .f O Signed ----------------------------------------- -�---�--� ------ date - Application Approved B - — date -a Application Disapproved for the following reasons:----------------_ ______________________________—__—___—______—_ �� .� date Permit No. -- '� ----------- ----------------- sled—�-��--`--=-=-=�-�----- --------------------- '� r date r - - '�►�F�-�+10�4�! - ���:s.oe.nasan�:�'tamer:�.cr8+�ms'o.e.��a.s�-----�--'�.a a BOARD OF HEALTH TOWN OF BARNSTABLE ' Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Wefll/Constructed ( ►'J, Altered ( ), or Repaired ( )� by------------Q. "_•�GU N,,,<���''f�/ - _�! t_Installer — ——— —— — — — �v� g 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. �----- 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 Yell Con5truct ion Permit No. ----------��— Fee-------------- la S^Cu nj,. ,r Permission is hereby granted-�-==-- �------ ��'- `1-----------------_—__ to Construct ( �, Alter' ( ), or Repair ( ) an In ividual Well No. 4 - treet --------------------------------------------------------------- S as shown on the application for a Well Construction Permit No. - �" __ �-- ---------— -— - Dated-—O =` -�- '-- ------------------------- V ------- 45— DATE Board of Health ,. -----=----------- -���--_------- I_ c.E. LOTS � 5411 VACANT LOT LOT 8 0° W 43, 724 S.F. UTILITIES ASS. NO.: 88-07 114 — /O / 110 STK 7 D 111.2P 1 8 RESERVE "off` �O,O� IN STONES.' � / 111. I Ill.2Pi AREA �� PLAN REF- L C. 40599E 1 � � RES. ZONE: "RF" / w .PROPOSED ® O w los FLOOD ZONE: "C" o _-REUSE IB.0 / 1 cn w W / C.B. a ^ey iN OF 84.9 0 0 _ - 5 O / 24.0' ?�' 'P o� PAUL �G god JOHN � 36.OPORCH 3 o LANDERS•CAU EY CIVIL ' ~ MERWINEW No.32099 No.35101 STER� � orF FCX o I �e rLae�®S Al ECG 0 112 W� 192'f � o 3-FL0 9DIFFUSORS PROJEC T L OCA TION: WITH 4' OF STONE o LOT 8 DESIRE'S LANE ROPOSE 106 —� 1 1 '� WEST BARNSTABLE, MA. TEMPORARY / 104 APPLICANT.• — ioz JOHN WEIR JR. / N52 37'07"W � _245. 68 � EDGE OF PAVEMENT I DESIRE S LA JVE . YANKEE SURVEY CONSULTANTS BENCHMARK 'P. O. BOX 265 TOP OF C. BASIN UNIT 5, 40B INDUSTRY' ROAD EL. =99.32 MARSTONS MILLS, MA. 02648 On c.B PH.(508)428-0055 — FAX(508)420-5553 TURN—AROUND "=30' DA TE. 4118195 ., LOT 7 FRE v- RREV.• 5110195 VACANT LOT JOB NO. 50710 SHEET 1 OF 2. EL. =_II_2. 0_PROPOSED TOP OF FOUNDATION 20' MIN. 10' min 4" SCH. 40 PVC PIPE CONCRETE COVERS MIN. PITCH 1/8" PER FOOT 109. 0E 105. 0-± 1 LAYER OF 1/e"-1/z" 7-/ / / CONCRETE COVERS WASHED SY19NE 103. 0E 4" CAST IRON 2.2E �,,^� / / / i OR SCHEDULE 40 P�![+w 4" SCHEDULE 40 P. VC P. V.C. PIPE ra �S=Ar6b' D=27' DIST. 3 5'f FLOW LINE 0.j4, BOX CLEAN SAND S=0.08, D=27 S=0. 01, D=25 INVERT 1 10" 19" EL.=106.16 MIN ------ INVERT 2' ° ° INVERT EL.=103. 75 LEVEL o ° o 0 0 0 0 ° EL =10 IN 4' IO4 O INVERT EL = 98. 9 0 40 0 98. 0. Xz. INVER . 1500 GALLON _ 99.35 EL.= 99.18 SEPTIC TANK EL'------ 12'x32' 3/4"-1 1/z" I 7 WASHED STONE R FLOW DIFFUSERS 7.5' 4' STONE ON ALL SIDES PROFILE OF - Y SEWAGE DISPOSAL SYSTEM t NOT TO SCALE BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE EL=_90.5_ s ALL ELEVATIONS ARE ASSIGNED SOIL LOG J LANDERS—CA ULEY, PE �VA OF �qss WITNESSED BY: EDWARD BARRY JOHN yG 1` HEAL TH OFFICER �• LANDE AUL � 1 � VIL PERCOLATION RATE 2_ MIN./ INCH No.3 GENERAL NOTES Ago FOIST P# 8480 1. THIS PLAN IS FOR REPAIR OF SEWERAGE DISPOSAL SYSTEM. DATEZ5°/95 2. THIS PLAN IS FOR INSTALLATION/ REPAIR OF SEPTIC SYSTEM TEST HOLE EL = 102.5 .l AND NOT TO BE USED FOR SURVEYING OR ZONING PURPOSES. DESIGN DA TA: . 3. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO R E.P. -- TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. TOP & SUB NUMBER OF BEDROOMS 3 4. ALL COVER TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN SOIL 12" OF FINISHED GRADE. , GARBAGE DISPOSAL NO 5. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE EL. =99. 3 COARSE t SAME, UNLESS NOTED BY FINAL CONTOURS. SAND TOTAL ESTIMATED FLOW 330 GPD i 6. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE PERC. TAKEN 4l OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER AT 6'. ( 140__GAL./BR./DAY x —3__ BR.) OR WITHIN 10' OF DRIVES OR PARKING AREAS. H-20 LOADING MEDIUM TO SEPTIC TANK CAPACITY 1500 _ SHALL BE USED UNDER OR WITHIN 10' OF DRIVES OR PARKING. FINE SAND UNLESS NOTED. LEACHING AREA REQUIREMENTS 7. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL EL=90. 12' BE MORTARED IN PLACE. SIDEWALL AREA _74_ GAL.IS.F. 8. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH BOTTOM AREA - 74- GAL./S/F DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO LEACHING CAPACITY (BOTTOM & SIDEWALL) 344 GAL OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. NO WATER 9. THE EXCA VA TOR�CONTRACTOR SHALL VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES PRIOR TO ANY EXCAVATION. RESERVE LEACHING CAPACITY 344 _ GAL REVISED. 511015 _ JOB NO.: 50710 SHEET 2 OF 2