The URL can be used to link to this page

Home My WebLink About0011 GEMINI DRIVE - Health 11 Ge- n ni-give West Barnstable , ` A= 131 =034 - AUG-29-2015 01:39 From: - To:15087906304 Pa9e:1�1 • FRo`1 :dowr, Gape engineering erin inc FAX NO. .15083629880 Aug. 28 2815 12:59Pt1 P1 Tht)ffiMs�.rigeiR��, irate fflialth DMSIOU csm,gD'iYectmr. 200��:oa�4rce#,�Bf�+�n WA,02 601 Fax: 508-J9M304 ofCre: 508-862415dA, Dat �1315— 13 :�A�R94DI'�g e: �! e�a��metffin� _. D �a :e rA DOenm8o If, ou Cv /S 17r1ai0euadaperuutto i�aell a .. r (M2Tark ode ) { �ecl��l�st�xtil�.eTLy accaYdjD.K to T ce�ti'l'p tint t}. s+ypt+� 5` m ir�fezeair�r.al1rnrea� islsl, �oca � oftht; the rw�'w bi&la y iac:�u�.c:'ixiinoT Ea�no'ved cba+r�f3 s 5�ictti a� le.te�, � disEributi nu box,andloi gejrtic t uk- J. ct;r y thF�i the s rhic syti rn-rf r BP. e& EI 0w Was Yl1 P•[� W12i1 Ir,�a az' o eo a tu► + — veamL thm 1,01 !Ater a4�i�afthe,RA.S�ar�azY y��c�l�:lo�tiG Of P�n rev�on.cn 0 t}!F%zmum b, S;f'd'.OT�TA(;F. Nif�] u' h3 a�•OCd�1L�ri�?y „N OF4tgPANIELA. i¢ Tl�e) OJALA CIVIL u' No,46502 (De�gilc�';a use) (, flux ai, 1v),P l�fj /3l- a3y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required forevery West Barnstable MA 02668 7/17/20 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. A. Inspector Information 510 M-4-bL4 Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 City/Town State Zip Code 508.272.6433 13010 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 7/17/20 Inspe r Signatu Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•red.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 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: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or 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. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rep.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Jo 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•re),.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will 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 a septic tank and soil absorption system(SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a 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 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 must be attached to this form. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v%J 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 system passes if the well water 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 attached to this form.] ❑ The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® 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. 5) Large Systems: To be considered a large system 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 CA. 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—IWPA)or a mapped Zone II of a public water supply well t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: 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? ® ❑ 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) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ 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)[310 CMR 15.302(5)] t5insp.doc•rev..7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments _i 11 Gemini Rd Property Address O'Neil Owner Owners Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Engineered plan on file at BOH Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d well water 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Occupied Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form !� Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 9 P Y rY 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. C4rrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: No recent pumping per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 AN Commonwealth of Massachusetts r� ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic 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)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 2015 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): Depth below grade: 24 14 feet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts ILI Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �w 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 18"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) H-10 tank appears to be structurally sound, covers raised to 3"of grade If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500g Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle >12" Scum thickness trace Distance from top of scum to top of outlet tee or baffle >2" Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3yrs to prolong the life of the system t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness 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: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev 7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments J' 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): H-10 box appears to be structurally sound, cover raised to 6" of grade t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �o .i 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev 7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Ja 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System(SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Chambers were video inspected and have approximately 1"of effluent at this time, no indication of past hydraulic failure 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer t Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev..7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official' Inspection Form r la Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owners Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts f Title 5 Official Inspection Form is Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 I � TOWN OF BARNSTABLE LOCATION j(-��I.V 1 jP-- SEWAGE# 147 5'-I.�i3. VILLAGE 3 .R , W ASSESSOR'S MAP&PARCEL 4 31� t INSTALLER'S NAME&PHONE NO.j C I 16*7"'7'1)-SMI- __ a SEPTIC TANK CAPACITY r�00 4,,4L ` �d LEACHING FACILITY:(type) —i U1J e.1.!— (size) 1�j�I•53�a r NO.OF BEDROOMS 3 d' 6",SgemS a�o OWNER xt(-7I ej i ry•-a.._... �= PERMIT DATE: & I.L•i f COMPLIANCE DATE: 2� Separation DistanceBetweenthe: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility d—`7 ;' Feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) _ I Li-, i 1S 1qDeet Edge of Wetland and Leaching Facility Of any wetlands exist within 300 feet of leaching facility) Feet MNSHEDBY �7`� f 00 A. 4 ` 1 j r s � R�cr Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: >162"feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 2015 NGW 162" Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: +7' seperation per 2015 compliance on file ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: TOPO mapping shows the site at 94'msl and nearby surface water at 10'msl You must describe how you established the high ground water elevation: See above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts �o Title 5 Official Inspection Form l Subsurface Sewage Disposal System Form-Not for Voluntary Assessments .% 11 Gemini Rd Property Address O'Neil Owner Owner's Name information is required for every West Barnstable MA 02668 7/17/20 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6(Checklist) completed ® D. System Information: For 8:Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 TOWN OF BARNSTABLE LOCATION I t 1m 1 �.__ SEWAGE# _�C 1�L_3 VILLAGE ASSESSOR'S MAP&PARCEL 4 31 -Z�k INSTALLER'S NAME&PHONE NO. ( . 5r67' `771- � SEPTIC TANK CAPACITY /Sdp -(otL LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER 6,V tit PERMIT DATE: & J,�- •i 5_ COMPLIANCE DATE: 2�1 i Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility d-7 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) {�—, t f 144 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BYir/i1 f/s✓+�'�7�'/S 00 ,6 sa Rio wor i - No.aIy 1 II 3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpYieation for Misposal *pstem Constru>rtiou Permit Application for a Permit to Construct( ) Repair(* Upgrade( ) Abandon( ) 9 omplete System 0 Individual Components Location Address or Lot No. // to; 18 t; Owner' Nam ,Address, d Tel.No.&/7-��/-707ot W. � e `�►''I Za a'AW 11 Gem f n i )Drn Assessor's Map/Parcel I3` (3(4 wi. S I U Instalilg's dame Address,an4 Tel.11o.. C$01r- i/as-4B�g0-Y10 signers ame, ddress,and Tel.No., - off" / .� ype of Building: Dwelling No.of Bedrooms J Lot Size 41 AcPe.S sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3q9 gpd Plan Date Mew ig. ' e)L S' Number of sheets Revision Date Title 1 Size of Septic Tank 410 , OpgoLe Type of S.A.S.e� 1 oZ• R/U 6C,4 bn,ni Description of Soil &p, :5%1, 64 Nature of Repairs or Alterations(Answer when applicable)APe, �(60 CSIX3 gczQ ee� Jh e;r C 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 a not to place the system in operation until a Certificate of Compliance has been issued by this B rd of Health. Date f Application Approved by - Date /T ?-viy Application Disapproved Date for the following reasons Permit No. 1 6?3 Date Issued G 117/ ?v/s' low" � /-�'� No.�ty_19 3 Fee �W ~ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes' Rpplicatlo4 for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair(* Upgrade( )` Abandon( ) [.Complete System ❑Individual Components Location Address or Lot No. // 6C-M('r)t 3 f• Owner's Name,Address, =aJ•t3avinStu t�t�2 `�iG�cIlAQ U'N+2i� /f (j,�,rh iY'1� ,t7l�. Assessor's Map/Parcel 13 (3(4 (.J- 0a'e-V Installer's Name,&ddress,and Tel.No. 50'; • 4/aZ-!r-169O—JK, Designer's ame,Address,and Tel.No. ,5M- V5yl for A-0 I c3bb Co nskf X- `on ►,C an C 42/'r i�,4. 9�S l�tccir`Sf 4D.13• no M; _ r4 to n 75 Type of Building: Dwelling No.of Bedrooms ,3 Lot Size 41 kj-eS sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) _3�(� gpd Design flow provided 3y9 gpd Plan Date MGtc,, 19,, Number``of__sheets Revision Date Title o T — .fit` P. C e. hly_ —� Size of Septic Tank 01 U 1SCX2"c¢_e Type of S.A.S.�v es�e� 141t) szoc_o (-'Arg?.,74 n Description ofSoil r Nature of Repairs or Alterations(Answer when applicable)YJ S- _,�ln.k:/14A � F� (/iw, ,� 1 E l C� ClL� �PC��i� �� /i► l� .St lollr. f L Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal s` ystem in accordance with the provisions of Title 5 of the Environmental Gode"'and not to place the system in operation until.a Certificate of r Compliance has been issued by this Board of Health. /S, Date Application Approved by /,�'�/ Date Application Disapprove Date " for the following reasons t Perm tNo.{�/� 1,F3 Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(„?d Upgraded( ) Abandoned( )by &C Va- r- 06 -S/..r fit�n-, at �� ,'n r` t3. , has been constructed in accordance j with the provisions of Title 5 and the for Disposal System Construction Permit N�� S3 dated tP 717o / Installer 1 I�r�tc�la[�i l !>Yr�, -i�i �f-/gym ._L.rt� Designer f �,7r� �:1',�� lsac #bedrooms 3 Approved design flow gpd The issuance of th e it shall not be construed as a guarantee that the system willf-) iaJdesigned. Date �* ( Inspector (R Av PIP No. � Fee' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Vermit Permission is hereby granted to Construct( ) Repair( , Upgrade( )�/ Abandon( ) System located at / , J' A1111 A-0 /t� / rho 41�0 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Proviced:Construction must be completed within three years of the date of this permit. Date Approved by IT-037 down cape engineering, inc. SIEVE SOILS ANALYSIS 11 GEMINI DR W. BARNSTABLE, MA.xlsx DATE OF REPORT: 5/22/15 .JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 11 GEMINI DRIVE, WEST BARNSTABLE LOCATION: DCE TEST HOLE SIEVE ANALYSIS Weight Sample(Grams): 116.3 SIZE :WEIGHT RETAINED % RETAINED € % PASSED (sum ) "1--------------:................................................0...0€....----------------0.0%-.0%:..................................... 3/4" 0.0€ 0.0%E 100.0% --------------:.......................................................---------------------=------------------ 1/2" 0.0 0.0% 100.0% 3/8" 0.0€ 0.0%i 100.0% --------------:......................................................:---------------------=------------------ #4 0.0; 0.0%€ 100.0% --------------1......................................................}--------------------y..................................... #10 10.7i 9.2%€ 90.8% --------------:......................................................:---------------------:..................................... #20 39.8€ 34.2% 65.8% --------------......................................................>---------------------,..................................... #40 83.9 i 72.1% 27.9% -------------- ............................... #50 97.0; 83.4%€ 16.6% --------------I......................................................>--------------------�..................................... #80 106.7€ 91.7%i 8.3% -------------- .....................................................:---------------------:..................................... #100 108.9€ 93.6%� 6.4% --------------i......................................................>---------------------}------------------ #200 112.8€ 97.0% 3.0% .............. ---------------------------------------- PAN: 114.4 100.0%:: 0.0% -------i---------------------------+---------------------L------------------- ------- SAMPLE: € 116.3€ NOTE:TEST ON PASSING#4 ONLY, 7.5% RETAINED ON#4 <45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-1-b (GRAVEL&SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION >97%SAND RESULTS: PERMEABLE MATERIAL-CLASS 1 <2 MINJIN. MATERIAL i)AOF446, NONCOMPACTED o`'�DANIEL& cyG� SOIL DESCRIPTION: MEDIUM SAND o� OJALA 0 CIVIL Cn q No.46502 G/S T E%lL�O��`v �SSIONAL ECG r 1` IY- OP17 To of Barnstable y� Departinelat of Regulatory.Ser-lees ZMM A Public Health Division Date 200 Main Street,Hyannis MA 07601 Date Scheduled Ti:mc,..�i A7n . Fee k'd, /o v Soil Suitability .Assessment fiar (Sewage isp®sal Performed-BY: Witnessed By: q ("u, LO CATZO &GENERAL]QVI'ORMATION Location Address // / ` 6 Owner's Name O W. U � � Address Assessor's Map/Parcel: 1,31 �C Engincer's Name 310 NEW CONSTRUCTION REPAIR REPAIR Telephone# 6 V�✓y6d Land Use: k&CIU Q l/ Slopes(%) U Surface Stones /"0n Distances from: Open Water Body--:! I ft Possible Wet Area >(� ft Drinking Water Well '2 ft Drainage Way I OU ft Property Line 7 30 ft Other ft SIMTCH.,(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands•11n proximity to halos) W I' Al • we I I �B' �i A,p ' Q ti�Ord C 010 well C,�, ��J 7.S,0 1 Ir Parent material(geologic) �I aC 1 a I T Depth t913edrack ��O . Depth to Groundwater. Standing Water in Hole:A//k ' Weeping from Plt Fate Estimated Seasonal High Groundwater eta; c[hod Used: �'EI NATION FOR SEASONAL RIGR WATER TABLE .zJ�Vl �tl a- Depth Observed standing in abs.hole: la, Depth to soil.monies: In, Dcpth to weeping from side of obs.hole: fn, Groundwater Adjustment fi. w.Index Well# Rcadiug Date: Index Well Adj,#actor- ALA,ptwundwnter bevel-,,,,, t nJ PE)R.COLATI.ON rfiEST Date . Tbna t�':Observation I Hole# Timo at 9" Depth ofPerc. rVe Time at6" Start Pre-soak Time @ _ Time(9"-6") End Pre-soak Rate Min./Inch / Site Suitability Assessment: Sitc Passed 5itr Fallod: Addldonal Testing Needcd(YIN) 14- ` Original: Public Health Division Observation Hole Data To Be Completed on Back------ /6 G ***If percolation test is to be conducted within 100' of wetland,you must first notify the. v Barnstable Conservation Division at least one(1)week prior to begillnwg. Qc13 EPTICTERCPORM.D O C I DEEP.OBSER'VA ION HOLE)LOG Hole# Depth from Soil horizon Soil Texture .Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, Consiste M'%'Craves) D-1 Z S L IDY�y/z Z c, Cz s zIfy I0�Yo brave DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA.) (Munsell) Mottling. (Structure,Stores,Boulders. o sis en %Grave o-10a Cj %L �,�y z 10'k Grave/ ,SY 71 DEEP OBSERVATION HOLE LOG Hole#.` Depth from Soil Horizon SollTexture Soil Color Soil Other' Surface;(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co i to c O e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sall Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders, Co si tan 6 • v Flood Insurance Rate_Ma•p: Above 500 year flood boundary No Yes .V "Within 500 year boundary No Yes Within 100 year flood boundary NO._'___ -Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �`e If not,what is the depth of naturally occurring pervious matoriall Certification / � I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in�10 CMR 15.017. Signature. —�G ay�� '� Datb � Q:15LPT1aPERCP0RM.D0C i "M Page: 1 CERTIFICATE OF ANALYSIS 39ss^ ; Barnstable County Health Laboratory Report Dated: 5/19/2005 Report Prepared For: Order No.: G0530169 Mary A. O'Neil 11 Gemini Drive W.Barnstable, MA 02668 Laboratory ID#: 0530169-01 Description: Water-Drinking Water Sample#: 30169 Sampling Location 11 Gemini Dr.W.Barnstable,MA Collected: 5/12/2005 Collected by: M.O'Neil Received: 5/12/2005 Routine ITEM RESULT UNITS RL MCL Method# Tested LAB: Inorganics Nitrate:as Nitrogen 0.56 mg/L 0.10 10 EPA 300.0 5/12/2005 LAB: Metals Copper BRL mg/L 0.10 1.3 SM 3111B 5/17/2005 Iron 0.16 mg/L 0.10 0.3 SM 3111B 5/17/2005 Sodium 20 mg/L 1.0 20 SM 3111E 5/17/2005 LAB: Microbiology Total Coliform Absent P/A 0 0 309 5/12/2005 LAB: Physical Chemistry Conductance 210 umohs/cm 1.0 EPA 120.1 5/12/2005 pH 6.7 pH-units 0 EPA 150.1 5/12/2005 Sodium level is above the maximum contaminant level. Those on a low sodium diet may wish to consult a physician. Approved By:_ ` (La irector) Qn E M- E; U1 ko M RL = Reporting Limit MCL=Maximum Contaminant Level Superior Ccurt House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 A§s`esso-r's map and lot number .......................................... I �,(7�i►'f 1 �1iir 7 �/�GS C u�j'. S�0�� / — 'C�•� _ /ions u.�. ' Sewage Permit number ................................ �o`T"E roe° TOWN OF B AR.N S T A B L E-___-.. BAH.BST/1DLE, i 69 ,•� BUILDING INSPECTOR �o uar a. u p �ed1tV o APPLICATIONFOR PERMIT TO '"..................................................... ...................................................................... TYPE- OF CON RUCTION ..... :Y.GlYYL ......... .►rl. c l,�G.`!..1..4 .. u �•-� ........ :�::.............� ...1...........1 ..... .. it TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: C>>> Locatil.....G•�.m- '—�n"....xx..........�E....C.qAyr... ...:. �'�` ProposedUse �i�c r�C>;!�1.. .... .... ........................................................................ . ........................ Zoning District ........ . .................................................Fire District �'. ...1..�;� x rn.� c� Y�.l�.. .1..:.1. :.s. ........ �y� �1 Name of Ownerx.G.> �'t........N� r) �........ N'Ill....Address .C�p&r.....S..f' Name of Builder ...A&.<.' .... :?:1.............Address .�.E. .....,t� �.... ....!, Name of Architect qQ.-...e...................... Addr ss ,... � a,�. ...............................................................:.... ............ .................... C'�^a iu S P . n ,(. Number of Rooms ..........�......................................................Foundation ..... ...C/4�) !?4.l.i.S....� �bi�►.�G� �� i� '�4'.t.!l�orc F � ,l (l ph Exterior ....W�! ....�� .........��:l.1�. .��.�............Roofing .�.��='!.!.........!........K............................................... Floors .....:....................................................................................Interior ............�....................................................................... Heating ............Q-i f...........................................................Plumbing .........:':..16—i.7...e....................................................... Fireplace ............../X&, ....................................................Approximate Cost .... .5 ...—. ............... ....... Definitive Plan Approved by Planning Board -----------_______-----------19________. p� Area .. j.......r�:.i ......... v Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i i _. ....._.. .................._.- .._...._..__... .__ O J U P rn i/7!.--..._-...................__....... ........ 1 f V .y I i I I 1 f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..�.. ! .............. 0»0ei lv Robert 668lx~ . � 16938 add toVi le - No ................. Permit for ....................................family dwe ling ' / ------------_-._---.------ � Location .�L.!��±.��. � .......................Waot. ______._ i �. � Owner -.--. .&...M"'`' .OoDe�Ll___.. _ Type of Construction --.'.��--__-_.. ` . ' ' --'--'---'~^^-----'-`---------'' Plot ............................ Lot ___________ � � Parm� Granted .................... 74 ` Date .......... ~' ''=p�^ '"'' -' ' Dote Completed � -PERMIT REFUSED - ----.'.---..--..-^..---.--- lA , . ......................................................... ^-.-._'--.--..---.~,..�^--..-.--.----. . . ---`'-^-'------'^--^--~`^`'----- ' ` ............................................ .................................. ` - . Approved ................ lQ ` ....................................... - .l-,___. ..........................................................' - � , - LEGEND NOTES 771 1. DATUM IS APPROX. NGVD o �e 99- EXISTING CONTOUR X 99 EXIST. SPOT ELEV. SYSTEM DESIGN: SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE 2. MUNICIPAL WATER IS NOT AVAILABLE eeQ MARKED WITH MAGNETIC TAPE OR 5r (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 3. MINIMUM PIPE PITCH TO BE 1 8" PER FOOT. Q\\ 99 PROPOSED CONTOUR ACCESS COVERS TO WITHIN 6'OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE / dot U)d 2" PEASABRI OR GEOTEXNE 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS \ Willo� [98.4] PROPOSED SPOT EL GARBAGE DISPOSER IS NOT ALLOWED \ TOP FOUND. EL. 96.4' FILTER FABRIC OVER STONE TO BE AASHO H-jD eet Street �Poa TH1 EXISTING 3 BEDROOM DWELLING MINIMUM .75' OF COVet OVER PRECAST 0 MaP e 96.0 2% SLOPE REQUIRED OVER SYSTEM 93.0' S. PIPE JOINTS TO BE MADE WATERTIGHT. Ie 5tr TEST HOLE PRECAST H-10 NOTE: MIN. WALL THICKNESS 2" BLOCKS OR Locus YY DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD ' RISERS (TYP•� PRECAST RISERS 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH 2'0 4"OSCH40 PVC MORTAR ALL �fm 2z; SLOPE of GROUND USE A 330 GPD DESIGN FLOW =\,93.5 * PIPES LEVEL 1ST 2' �4• COMPONENTs INVERT IN 89.17' 4' 310 CMR .15.000 (TITLE 5.) 61 UTILITY POLE ENDS (NP•) SIDES 90.0'10» 1500 GAL H-10 14" 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO SEPTIC TANK: 330 GPD 2 = 660 91 $1 ° ° p _ f °° ° °° BE USED FOR LOT LINE STAKING OR ANY OTHER ( ) TEE SEPTIC TANK TEE 156� ®®El® ®®®® ®®®® m En ° PURPOSE. °°000000 �--� FIRE HYDRANT °°°°°°°°°°°° 6" MIN. SUMP O ;0000000 ®®®®®®®®®®® ®®®®®®®®®®® tiW GAS BAFFLE; o ° ° ° ° ° InI�J®®InhJ®®®®® ®®®®®®®®®®® ° ° ° °° \ �o°o°o°o�o� 12" MIN. INT. DIM. nj 'o°o°0000 o°o°o°o° NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING USE A 1500 GAL. SEPTIC TANK F93. ^"^ " ° ° ®®®®®®®®®®® ®®®�®®®®®®® 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 89.44' 89.27' °0% 87.17'+: 4' LEVEL (ACME OR EQUAL) °° ° LEACHING: ` •• ^"' _ ' " �' WATERTEST D'BOX 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED °° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° °` FOR LEVELNESS 1°° ° °°�o�o„o,°�°°o°°°o°o^o^o^o^°„o�o„o°o°o. `H-10 500 GAL. LEACHING CHAMBERS 8Y ACME PRECAST OR EQUAL. WITHOUT INSPECTION BY BOARD OF HEALTH AND SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (2) UNITS REQUIRED PERMISSION OBTAINED FROM BOARD OF HEALTH. ALL AROUND PRECAST STRUCTURES 6" CRUSHEI STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83, *THE INSTALLER SHALL VERIFY THE BOTTOM 25 x 12.83 (.74) = 237 GPD I COMPACTION (1.5.221 (2)) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING LOCATIONS OF ALL UTILITIES AND ALL ;° DIGSAFE (1-888-344-7233) AND VERIFYING THE BUILDING SEWER OUTLETS AND TOTAL: 472 S.F. 349 GPD (2.5% SLOPE) ( 4 % SL)PE) ( 1 % SLOPE) LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES LOCUS MAP MIN. PRIOR TO COMMENCEMENT OF WORK. I ELEVATIONS PRIOR TO INSTALLINGANY PORTION OF SEPTIC SYSTEM USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) FOUNDATION-<,'30, - SEPTIC TANK 53'• - LEACHING D' BOX 12' FACILITY 79.5' BOTTOM TH-1 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE NOT TO SCALE I WITH 4 NO GROUNDWATER FOUND STONE ALL AROUND REMOVED 5 BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. ASSESSORS MAP 131 PARCEL 34 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. 5' REMOVAL OF UNSUITABLE SOIL REQUIRED 9-e-.21 AROUND PERIMETER OF LEACHING FACILITY, x 93.36 DOWN TO SUITABLE SOIL LAYER. REPLACE WITH CLEAN MED. SAND, TO MEET J Oj 112 6 EXIST. WELL ' SPECIFICATIONS OF 310 CMR 15.255(3) '> 92.00 w x 3.8 I °� EXIST. WELL 144•2 I I tiff X .20 g1 I x 90.7 TEST HOLE LOGS �� I TH I x 91.11 ENGINEER: DANIEL E. GONSALVES, SE #13587 WITNESS: DAVID STANTON, RS 0 148.1' _ TH1� 0 DATE: 5/19/15 P PERC. RATE _ < 2 MIN/INCH OAK 2.00 CLASS 1 SOILS P# 14686 X x 108.22 x 97.56 8 9 3 39.40 OO .02 x 91. 0 CID � 00 108.41 ELEV. ELEV. x 90.4 opt 4 93.0' p•' 4 93.0' - � 0 94.4 coA A x 95.1 X .61 n93.74 LS LS 108.30 \ r , n 12" 10YR 4/2 10" 10YR 4/2 _T _ x 97:17 97.06 _ e1 \ _ _ ,...dr . 00 � x 83.69 ° 3.43 95.19 G �\ 94 3 � � _ BENCHMARK pQ 9�4873 3.8 ) b° 3 82.48 LS _ LS - �- COR CONCRETE 0, "1 4.91 I " / 89.5' 36'» 10YR 4/4 90.0' BULKHEAD �'�i- �� / 42 10YR 4 4 EL. = 96.3' x 9 20 �\56 \ _ 88.07 / C X 9 96.2 ` \ C1\ �93. 3 \\S\L\\\\ \\S\\\\\ EXIST. DWELLING 94.4 91.10 / - 95.37 TOP OF FNDN \ \ / " u' ' 96 (� 60 2.5Y 6/2 88.0 60 2.5Y 6/2 88.0 EL. 96.4 \ \ UNSUITABLE SOIL x 97.96 x 9 .8 91.85 \ /x 98.28 C2 C2 \ 11� 84.63 MS MS 95.61 �O / 90" 2.5Y 7/4 85.5' 90., 2.5Y 7/4 85.5' 96 O x 94.67 .37 \ h,�. / \ 86.E x\99.42 x 97.87 .18 \ 9 .68 x 4.1 \ / \C�\ \Ct3\ \ 5.70 93.03 \ 2 \S I , \\S , \ 87. �5.7z 102" 84.5 102" 84.5 2.5Y 6/2 2.5Y 6/2 \ 95.50 95.29 85.96 86.8 C4 C4 \ \ x 97.21 i 94.0 86.7>� SIEVE \ L6 /�i - 93.04 MS MS/ i \ 8.06 PQQ�o x o.18 �86.45 162" 2.5Y 7/4 79.5' 162°' 2.5Y 7/4 79.5' \ I�5�, EXIST. WELL /� IMMEDIATELY GRANTEDVARIANCES FOR CBYYTHE BOARDSTEM OF HERS ALTH MAYCH BE OR x 96.29 // BY HEALTH INSPECTOR NO GROUNDWATER ENCOUNTERED \ / PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED \ /87,59 /97. BY,THE BOARD OF HEALTH REVISED DURING A PUBLIC �Q x 91.65 HEARING HELD ON AUG. 4, 2009 l \ T I T L"mm I T FE PLAN \2 7 96 x95.93 �� OF 1,111 \ A0, / �- 1) FAILED SYSTEMS ONLY : SAS TO PRIVATE ONSITE WELL \ / SEPARATION DISTANCE VARIANCES, IF LOCATED IN THE SAME S,. GENERAL LOCATION AS THE OLD SAS AND MORE THAN 100 11 GEMINI DRIVE \ x 92.65 FEET SEPARATION IS PROPOSED BOTH FROM ON-SITE WELL AND \ ANY AND ALL WELLS ON ADJACENT AND NEIGHBORING PARCELS. �89.22 c� WEST BARNSTABLE / \ / PREPARED FOR \ /90.15 \ L=75.02 / R 0 •0 BORTOLOTTI CONSTRUCTION/ \ -.- 91.07 . 2 O'NEIL I ®86-18 MAY 19, 2015 EXIST. WELL Scale: 1"= 20' i I 0 10 20 30 40 50 FEET EXIST. WELL off 508-362-4541 Wellbouse ,SNQFMASS I s sqc �� qo fax 508-362-9880 DANIELA. yes �o� DANIEL yes downcape.com OJALA A. 0 CIVIL N OJALA m 90W#7 cope engineering, /dC, f f No.46502 No,40980 civil engineers I Pods GIST � �`'� �OF SS\a�P .�- S/ONAL E� land surveyors 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 >5-087 15-087 BORTOLOTTI_ONEIL.DWG i i