HomeMy WebLinkAbout0035 IRONSIDE DRIVE - Health Y7 Ift IRONSIDE DRIVE
WEST BARNSTABLE
:r
TOWN OF BArR�N_STABLE
LOCATION S��.5� � 1I�� SEWAGE# `��
VILLAGE b,ASSESSOR'S MAP&PARCEL i p 16M1 6
INSTALLER'S NAME&PHONE NO Ala l `C t' Get �hl
SEPTIC TANK CAPACITY k O®O
LEACHING FACILITY:(type) (size) x 6' A t
NO,OF BEDROOMS I
OWNERS
PERMIT DATE: 0 COMPLIANCE DATE:
Separation Distance Between the: c
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility > J Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) d Feet
FUli1I I3ED BY
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No. d&l& 1 tCf FEE'�l��•
Board of lkalth, J9 ►'l e , MA.
APPLICATION IFOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct Repair( U rade I` Abandon - 0 Com lete System ndividual Com onents.
PP ( ) P� ( ) Pg (�1' ( ) P Ys � P
Location 3 S Owner's Name 7—oi C v 4 fc� `C�
e-
Map/Parcel# I , D® I ® Address �w B� �' Q� Be a
Lot# Telephone# S��7 r g /S�-p __
0
Installer's Name �.J Designer's Name S J n
Address Address G /- f, M
Add 1 (. rtiV, S _ Iqi0 le-bof10 /'lt
Telephone# Telephone# (9 6
Type of Building (/i Lot Size Ow sq.ft,
Dwelling-No.of Bedrooms Garbage grinder.( )
Other-Type of Building No.of persons Showers(' ),Cafeteria( ).
Other Fixtures f
Design Flow(min.required) �q� lcul gpd Calculated design flowT Design.flow provided _gpd
Plan Date ri6, 20 L d Number of sheets Revision Date
Title f ..
Description o $oil(s). .. 1 Q
Soil Evaluator Form No. �( — Name of,Soil Evaluator `I,0 AWL.� Date of Evaluation Apr I 2-0 Lo
'DESCRIPTION OF REPAIRS OR ALTERATIONS Ia t'P_jEl^2 2 x%! A 0 " �19 A c{
A 1.
The undersigned agrees to install.the above described Individual Sewage Disposal System in accordance witit pro ' TITLE 5 and.
further agrees to not to place the syste. operation until a Certificate of Compliance has been issu d y tht tq
Signed f� Date
c CULVER
Inspections SPINK
No. r; t/' f�(/J + ! FEE
USETTS
Board of Flealih,; /l' 'fl J bQ MA.
APPLICATION OR DISPOSAL SYSTEM CONSTRUCTION PERMIT.
Application for a Permit to Construct( ) `Repair( Upgrade(G) A-bandoii - U Complete System @`Individual Components f
Location 3_,5- �L. r p U) Owner's Name �/�� r f i/
Map/Parcel# i ' Q - a0 _ P . o Address P (�� 96 �', �[,'� �w �Pd t�rail A
Lot# Telephone# Q _ 11/7�
Installer's Name � � � Designer's Name Sn 1,t ��J'(4 A
Address�}' �, ,�� �. "'"� Address
y: kiwi-\ Tr^�1�Y�fix��`� !A/��l -s t C /Cti ��- i/1 !!1 fo f
Telephone# -6 -< �.(�'� Telephone# 7 7,4(/- t� -7 5 9r(n
Type of Building (4 Q 1,0 j 4 AA; � ! enR Lot Size sq.ft.
Dwellin9 No. of Bedrooms H' Garbage grinder( )
Other-Type of Building / No.
of persons Showers( ),Cafeteria( )
Other Fixtures -Z V10 4,04 /�•Yt ^,tw)�I /!�1-/ � /rr7/� .,T-!/) = 6,1
s, Design Flow(min,required) ��� gpd Calculated design flow �y�� Design flow provided / 7 gpd
Plan: Date A Ar l E 9 4, 2.0)6 Number of sheets - Revision Date
K Title yy tF Nt J. 1 it( �e r1 t k Ya
r T
Description of Soil(s)
Soil Evaluator Form No. �E ;l 1 Narne,of Soil Evahiator U AC" ,r Date of Evaluation Apt, / ( 3. 2020
_ poi x r
DESCRIPTION OF`REPAIRS OR ALTERATIONS A f.,4 L.r c '�f 4e.N-
The undersigned agrees to install the above described Individual Sewage Disposal System in accordan wi the provisions of TITLE 5 and
further agrees to not to place the systemin operation until a Certificate of Compliance has been iss b he B th.:
n Signed ^�"i� � / .r~" '_ Date ����
r e CULVER
Inspections.
NO 30097
` �P�CI RHO
vJ:,aco:.rccccc cocZ�oo oaoc,,,ccC•aca:7U0oOG<iCOCJ:1C;;oOJOCOOi U�ia•rc,ccccuc .c�e:auoc:ao :a:oc:,cco<.u� ,.;.,, .:ONG. �c000
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No.la FEE _ ' 0( '''
COMMONWEALTH OF MrASS C14USETTS
-Board.of Health, ILL A.I �h ��-' MA.
CERTIFICATE OF COMPLIANCE 4
Description of Work: Individual Component(s) ❑Complete System.
The undersigned-hereby certify that the Sewage Disposal System; Constructed O,Repaired.( .),.Upgraded (')/Abandoned
by:
at
has be--n-installed in accordance with the,,Provisions of 31.0 CMR 15.00 (Title 5) and the approved design plans/as.-built plans relating.to
applications N,o. 20-��tO dated ? -201070 . Approved.D e;ign Flow ��y0 (gpd)
Installer k;; ., t,.�.. ��w i n ///y C //0 ��r/
Designer: . �� � Inspector161 �'� ..�15 ] Date: S i a���% 2
The issuance of this permit shall not be construed as a guarant�that the system will function as designed.
'Ct ROC JC;t(:^ry:_000f.- C00600.0c'00"C' c,.:�c C<: .0 t,:o� CC'GJ,i•q. ,C:iQ`D u.;u..,?(,J`.C''J.,U'0 C ct'Gc 0i Cunc -r vJ c•c
No. C �i���j 1� FEET
COMMONWFALT14 Of MASSACHUSETTS
Board of Health., ArA I 1���F , MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permtss"ton is.herreeby granted to Construct( ) Repair( ) Upgrade(..-)"'Abandon( ) an individual sewage disposal system
as described in.the application.for
Disposal System Construction Permit No. a -/Wedated. �0d go.
r C
Provided: Construction shall be completed within three years of the date of this permit.
All local conditions must be,met.
Form 1255 Rev.5/96 A,M;Sulkin Co.Charlestown,MA Date 5ja9 O Board of Health N� ��
I ` -
Town of Barnstable
lnspectgonal Services
Public Health Division
o BAWWABM
MOSS
.� Thomas McKean,Director
39. 200 Main Street,Hyannis,MA 02601
Off cc: 508-8624644 Fax: 508-790-6304
Installer & DesiZner Certification Form
Date: c Sewage Perm - � Assessor's Map�Parcel O ! Q
Designer: SPY e� 6A, Installer:
Address: S l u Address:
D
On was issued a permit to install a
"`(date) — installer)
septic system at T �c>�•s`.�- � ��' based on a design drawn by
(address)
dated
JL
(design
VZI certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-bwlt by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructe in compliance with the to rms of
the AA approval letters(if applicable)
qH OF�yy�9ry
JOHN
�A o CULVER a
(
Install ' tur �' SPINK
NO.30097
�FGISTE����`���
' is Signature) (Affix Designe ere)
TE
PLEASE RETURN TO BARNSTABLE SUED ,UBLIC IL BOTIi LTH THIS F4RM ANDAAS-
OF COMPLIANCE WILL NOT BE IS
BUILT CARD ARE RECEI'VED B� THE BARNSTABLE PUBLIC HEALTH DIVISION.
T
Atoaldcpts\HEALTH\SEWER connect\SMIODesigner certification Form Rev 8 1413.DOC
Commonwealth of Massachusetts 1/,9-- DO/—0AD
,, Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town_&Country Realty
Owner Owner's Name /
information is West Barnstable v Ma. 02668 June 10, 2020
required for every
page. City/Town 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.
Imng out forms A. Inspector Information 6/ o i'-t69�f
filling out forms
on the computer, Thomas Roux
use only the tab
key to move your Name of Inspector
cursor-do not
use the return Company Name
key.
89 Mayflower Lane
Q Company Address
East Wareham Ma. 02538
AA City/Town State Zip Code
B 774-678-9066 S14531
Telephone Number License Number
I
B. Certification
I certify,that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000);I have personally inspected the sewage disposal system at theproperty 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
22i 2® 2
Inspector s Signature ea�� — -
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.da-•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18
Commonwealth of Massachusetts
�s l Title 5 Official inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10 2020
page. CityrFown 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: ,
❑ I 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:
a
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-rev.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
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10 2020
page. Citylrown 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 pipes)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipes)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 b the Board of Health:
q Y
❑ 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•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
I
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10, 2020
page. Cityrrown 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
Tithe 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
,. 35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10, 2020
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.
❑ ® 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18
Commonwealth of Massachusetts
r9 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10 2020
page. CityrFown 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?
® ❑ Wasthe 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
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
�- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owners Name
information is required for every West Barnstable Ma. 02668 June 10, 2020
page. City/Town State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms(design): 3 Number of bedrooms(actual): 4
DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 340 gpd
Description:
The 4 bedroom house has a 3 bedroom system.There is an approved design plan on file to bring the
stem up to code at the BOH.
Number of current residents: 0
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
Seasonal use? ❑ Yes ® No
Water meter readings, if available(last 2 years usage(gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: unknown
Date
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is West Barnstable Ma. 02668 June 10, 2020
required for every
page. Cityrrown 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 information
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.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
.... �, 35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10, 2020
page. Citylrown 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:
12 years, Design plan dated Feb. 28, 2008.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
Depth below grade: 2.67
feet
Material of construction:
❑ cast iron ®4G PVC ❑ other(explain):
Distance from private water supply well or suction line: +100'to any well
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
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments vv-w;)
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10, 2020
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 1.67'
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
81x5.67'Wx5.67H
Sludge depth:
1"
Distance from top of sludge to bottom of outlet tee or baffle
31"
Scum thickness
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom of outlet tee or baffle
16"
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.):
t5insp.doc-rev.7/2612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
i; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10 2020
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.7/2 612 0 1 8 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
u 35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owners Name
info oration is required for every west Barnstable Ma. 02668 June 10, 2020
page. CitylTown State Zip Code Date of Inspection
D. System Information (coat.)
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.):
The D-Box is severely corroded and needs to be replaced.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10 2020
page. Cityfrown 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:
Since the septic tank and D-Box are both functioning correctly, The SAS is draining properly.
Type:
❑ leaching pits number:
® leaching chambers number: 4
❑ 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
f
Commonwealth of Massachusetts
F . Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &.Country Realty
Owner Owner's Name
requinfor redfo is West Barnstable Ma. 02668 June 10 2020
required for every
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
11. Soil Absorption System (SAS) (cont.) q
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
No evidence of 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
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
L
i
Commonwealth of Massachusetts
r9 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10, 2020
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
13. Privy(locate on site plan):
Materials of construction:
Dimensibris
Depth of solids
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 DisposalSystem-Page 15 of 18
l
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
w Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10 2020
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 b 6L 1&/
T4,t L
A40 qo,
SAS
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.•Page 16 of 18
Commonwealth of Massachusetts
- Tithe 5 Official Inspection Form
I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
ro�'P
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10, 2020
page. Citylrown 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: below 11'
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: Feb. 28, 2008
Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
From the design plan on file.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5insp.dac•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18
I
Commonwealth of Massachusetts
rn - Title 5 Official Inspection Form
r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Dr.
Property Address
Town &Country Realty
Owner Owner's Name
information is required for every West Barnstable Ma. 02668 June 10 2020
page. City/Town 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 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
t
t5insp.dx•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
ENVIROTECHLABORATORIES,INC.
MA CERT. NO.:M-MA 063
8 Jan Sebastian Drive Unit 12
Sandwich,MA 02563
(508)888-6460 1-800-339-6460
FAX(508)888-6446 zC?
Client Name Hathaway Property Services Location 35 Ironside Drive f..
Address PO Box 151 West Barnstable, MA
Forestdale, MA 02644 a
Sample Date 10/07/16
Collected By Client Sample Time
Sample Type Drinking Water Date Received 10/07/16
Lab Order Number DW-163809
Well Specs
Location Source Date Collected Time Collected Comments
A 10/07/16 09:26
Analysis Requested Units Recommended Limits Analysis Result Method Date Analyzed Analyzed By
Total Coliform CFU/100mL 0 0 SM9222B 10/7/2019 RS
pH pH units 6.5-8.5 6.46 SM 4500-H-B 10/7/2016 LL
Specific Conductancen umhos/cm 500 121 EPA 120.1 10/7/2016 LL
Nitrite-N mg/L 1.00 <0.006 EPA 300.0 10/7/2016 LL
Nitrate-N mg/L 10.0 1.36 EPA 300.0 10/7/2016 LL
Sodium mg/L 20.0 10.9 EPA 200.7 10/7/2016 MC
Total Irona mg/L 0.3 0.03 EPA 200.7 10/7/2016 MC
Manganesen mg/L 0.05 <0.005 EPA 200.7 10/7/2016 MC
Potassiumn mg/L 20.0 1.1 EPA 200.7 10/7/2016 MC
Calcium mg/L N/A 8.4 EPA 200.7 10/7/2016 MC
Magnesiumn mg/L N/A 4.2 EPA 200.7 10/7/2016 MC
Total Hardnessn mg/L 50-200 38.3 EPA 200.7 10/10/2016 MC
Alkalinity mg/L 200 22.4 SM 2320B 10/7/2016 LL
Sulfate mg/L 250 7.2 EPA 300.0 10/7/2016 LL
Chloriden mg/L 250 21.6 EPA 300.0 10/7/2016 LL
Turbidity NTU 5.0 <1.0 SM 2130B 10/7/2016 LL
Colorn APC units 15 <5.0 SM 2120B 10/7/2016 LL
Free CO2 mg/L 50 27.4 Calculation 10/12/2016 LL
Comments:
pH is below recommended limit and may have corrosive characteristics.
Water meets EPA standards and is suita le for drinking for parameters tested.
&A Date 10/14/2016
Ronal J.Saari
Laboratory Dir or
BRL=Below Reportable Limits *See Attached Page 1 of 1
cCertihcation is not available for this analyte for non potable water samples..
r
Commonwealth of Massachusetts
lta - obi-oao
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name /
inquired for
is west Barnstable V Ma 10/5/16
required for every
page. City/Town 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.
Imng out forms A. General Information S/ //97
filling out forms
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not Chad Hathaway
use the return Name of Inspector
key.
H.P.S.
Company Name
P.O.Box 151
Company Address
Forestdale Ma 02644
City/Town State Zip Code
774-274-2581 12866
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system:
Z Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
10/5/16
Inspectolem
ature Date
The sy inspector shall j�ubmit a y of this inspection report to the Approving Authority(Board
of Health or DEP)within of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
""This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
r
l5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
xe
Commonwealth of Massachusetts
,p Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. CityfTown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I 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:
tank in good condition tees in place. Tank was pumped during inspection as maintenance was
required. Dbox clear of carry overs is at working level. Dbox had no siggns of high staining to indicate
past failure
B) 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):
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
a
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M ��( 35 lronside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes(cont.):
❑ 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):
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 public health, safety or the environment.
1. 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:
❑ 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
t5ins-Z/13 Title 5 Official Inspection Foam:Subsurface Sewage Disposal System•Page 3 of 17
Y
4 Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Citylrown State Zip Code Date of Inspection
B. Certification (cont.)
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 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 aseptic 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 DFP 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.
3. Other:
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
❑ ED Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less
than %day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
f
Commonwealth of Massachusetts
JD
11.0 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owners Name
information is requi.-ed for every West Barnstable Ma 10/5/16
page Cityrrown State Zip Code Date of Inspection
B. Certification (coot.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or 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.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
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 2000gpd-
10,000gpd.
❑ ❑ 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.
E) 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 D.
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
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.
t5ins•SH3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® 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)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 4 Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440
t5ins'3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is West Barnstable Ma 1015/16
required for every W �
page Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: unknown
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available(last 2 years usage(gpd)): well
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: Date
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
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-V13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y � 35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: none
Was system pumped as part of the inspection? ® Yes ❑ No
If yes, volume pumped: 1000
gallons
How was quantity pumped determined? tank size
Reason for pumping: maintenance
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):
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
tank unknown leaching and dbox 2008
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: feet
Material of construction:
❑ cast iron .0 40 PVC ❑other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 16"feet
Material of construction:
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 gal
Sludge depth:
6"
t5ins•3113 Title 5 Official Insp
ection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
24"
Scum thickness
8"
Distance from top of scum to top of outlet tee or baffle
1"
Distance from bottom of scum to bottom of outlet tee or baffle
12"
How were dimensions determined? tape and sludge judge
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
pump every 2-3 years as maint. to protect leaching tank was pumped at time of inspection
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
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M y�� 35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
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
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
t5ins-313 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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.):
no carry overs no cracks or decay. no high staining to indicate past failure
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.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
probed area of stone around system no ponding to indicate failure. no backing up into dbox
t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
"p 35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every west Barnstable Ma 10/5116
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 4) hi cap
infultrators
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative 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 inspection) (locate on site plan):
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 ❑ Yes ❑ No
t5ins•T13 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systam•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M ' 35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is west Barnstable Ma 10/5/16
required for every
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level 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.):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
f
Commonwealth of Massachusetts
qi Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
Is�vt�'
9t o
- yl
3 - LI8
- �23
S3 ,
t5ins-3113 TRIe 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System form-Not for Voluntary Assessments
M 35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 4
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: Date
® Observed site(abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
back of property slopes down into woods and town GIS maps backyard to be el. 60 land slopes down
to a pond in wooded area at el.20
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
I •
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Ironside Drive
Property Address
Passalugo
Owner Owner's Name
information is required for every West Barnstable Ma 10/5/16
page. Citylrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
r
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
j0 �o
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
_PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
i1
RpPlicattou for �Digponl 6p5tem Cou6truction Permit
Application for a Permit to Construct( ) Repair(✓f Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No. 6 N Z �� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel i 'd 0
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Y (2 YQJ
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder (,,V O)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 3 c\ gpd Design flow provided 2 Lr 6 gpd
Plan Date 'a ()y Number of sheets Revision Date
Title
Size of Septic Tank 4e,-Y\4 \IS11 Type of S.A.S.
Description of Soil Mfg\ iSr--,
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
gned Date k
Application Approved b Date
Application Disapproved by: Date
for the following reasons
Permit No. Z5 '���� Date Issued .
No. .v`-"'V E—�/ "re .�:" K Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION =TOWN BARNSTABLE, MASSACHUSETTS Yes
01pprication for ai.5pogat 6pgtem Construction Permit
Application for a Permit to Construct( ) Repair . Upgrade( ) Abandon( .) ❑Complete System ❑Individual Components
Location Address or Lot No. isir"o Ow er's Name,Address,and Tel.No.
Assessor's Map/Parcel \Q . a o ice.
Installer's Name,Address,and Tel.No. ro l Designer's Name,Address and Tel.No.
I\� �ur.�ufi,,� �d c.S s 0� 36a x QJ
Type of Building:
Dwelling No.,of Bedrooms Lot Size �•' ,t a 2 y sq.ft. Garbage Grinder (06)
Other Type of Building No.of Persons Showers_( ) Cafeteria( )
Other Fixtures
Design_]Flow(min.required) (� gpd Design flow provided �„� gpd
Plan Date 1 S21{ 1 0 X Number of sheets Revision Date
Title
Size of Septic Tank 4!L*(\5 \ (S Type of S.A.S. `A Z tx�C.\��}� c-S
Description of Soil M e tl\V r.n Sc�r
Nature of Repairs or Alterations(Answer when applicable)
� � ��lS✓'t of01 rac! \ I
t .
Date last inspected:`
Agreement:
The undersigned agreesto ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operaiionuntil a Certificate of
Compliance has been issued by this Board of Health.
igned _ Date 3 .1 1 y C)
A
Application Approved b Date
Application Disapproved by: Date '4
for the following reasons
` Permit No. 3002, /0 tDate Issued` > .<A 0
THE COMMONWEALTH OF.MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of-Compliance '
r Y THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( V�) Upgraded (k )
Abandoned( )by Q(N r1
at 3s,2 r oc,S,d e_ �)rc\XCL C9`C \ has been conns�tructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ��p %l'� dated 3110 e-
Installer SC Designer SiK\te— k�r
#bedrooms Approved design flow 6:�UD gpd
The issuance of this permit sh7,x)0o7d
f nUstrued as a guarantee that the system will ft� cTl . s esigned.
Date L� Inspect�r
_ .
No. 00�— //o / '%- Fee /0 0
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
=1i.5po!ga1 *p.5tem C n 5tru{tion Permit
Permission is hereby granted to Construct ( ) Repair l ) Upgrade ( ) Abandon ( )
System located at ( �,r'V,n S
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions.
Provided: Construction 'ust b• completed within three years.of the dat off this p'ernrit.
y`
Date 3e-10 Approved b
Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director i
* BARNSTABLE,
9�A MASS. �� Public Health Division 1
a ,
jfa"1°�A Thomas McKean, Director
200.Main Street,Hyannis,MA 02601 v,
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: 3 a Sewage Permit# `ZCe- (� Assessor's Ma \Parcel
g I � p
Designer: 05Z:9 H-4,�-3 ' Installer: i �•(. � �� �.
Address: 2 3 izrry z. --,4. Address: J VS OLL�
43rY A-j-') k..)
On 3 t to>165 was issued a permit to install a
(d te) (installer)
septic system at b-x, y, based on a design drawn by
(address)
H�3 1-E. " ` 6— dated 2 Zg a
(designer)
�I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
I certify that the septic system referenced above was installed with major changes (i.e. `II
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. ,
of
MPH EN
A.
(Installer's Signature) v c��its
No.35461
r�• yw'J Y�i �.��tia
(Designer's Signature) (Affix es' ner's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Septic\Designer Certification Form Revised.doc
I
Town of Barnstable P#
Department of Regulatory Services
Public Health Divisi MAJ1 011 Date
200 Main Street,Hyannis MA 02601 '
Date Scheduled J LOY
Time (U/ Fee Pd:
Soil itability Assessment for Sewage Disposal
Performed B "5 P�
y' Witnessed By:
LOCATION& GENERAL INFORMAT ON
Location Address Owner's Namen
Address Assessor's Map/Parcel:, v Engineer's NameL�L
NEW CONSTRUCTION REPAIR Telephone#
Land Use /2-&_t�I ';" Slopes Sb Jv " z
P ( ) Surface Stones �u
Distances from: Open Water Body ft Possible Wet Area ' ft Drinking Water Well ft
Drainage Way ft Property Line /� -i— ft Other — ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes)
�M
Q �
%I 4:
fin-,
rrt
Parent material(geologic) 04—ff ' Depth to Bedrock `s
Depth to Groundwater. Standing Water in Hole:, LO' Weeping from Pit Face N f A_
Estimated Seasonal High Groundwater .V /A
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: In. Depth to soil mottles:
Depth to weeping from side of obs.hole: in, Groundwater Adjustment &
Index Well# Reading Date: Index Well level.. Adj.factor,,,,,,,.,..' Adj,Oroundwater Level,,,
PERCOLATION TEST Date 2 x'ttne
Observation -Z
Hole# Time at 9" 7
Depth of Pero Time at 6"
Start Pre-soak Time @ �'o� 'lime(9"-6")
zz
End Pre-soak
Rate MinJlnch L—
:x
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the. .�✓
Barnstable Conservation Division at least one(1)week prior to beginning. J
Q:\SEPTICIPERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
Consistency. v1
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.
LS
DEEP OBSERVATION HOLE LOG Hole# 3
Depth from Soil Horizon Soil Texture Soil Color Soil Other .
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.
ell
2 Co C. L—
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency. Gravel)
i
A
Flood Insurance Rate Mau:
Above 500 year flood boundary No_ Yes .x
Within 500 year boundary No Yes
Within 100 year flood boundary No k 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? S
If not,what is the depth of naturally occurring pervious material? _.._...._.._,._
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,a ertise and experience described in 310 CMR 15.017.
Signature Z-1 Date z�
Q:\SEPTlL%PERCFORM.DOC
_ TOWN OF BARNSTABLE
LOCATION � ^�c� x SEWAGE # �6
VILLAGE W< ASSESSOR'S MAP & LOT X ® a O
INSTALLER'S NAME& PHONE NO. T-'rt--^V- '-�M V 3�Ll 00 6�1
SEPTIC TANK CAPACITY "- VI Cibx.
LEACHING FACILITY: (type) \A-K C4,mQ (size) ks 3o W % L-Y to®i
sari ��
NO. OF BEDROOMS
BUILDER OR OWNER-� 5,S�\
PERMIT DATE: , 1 t D COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility N 1 Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist �I
within 300 feet of leaching facility) l �/\ Feet
Furnished by e' K3`0-^
i
4
C.Lv/L' e
' 9e� 0 ke'e'
A SJ pox S3
r
TOWN OF BARNSTABLE
LOCATION :F�,5�AoV Lfr,de V,7 /0'!VafSEWAGE
/d d-,
VILLAGE��(/� �,� ,�� ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. �%
SEPTIC TANK CAPACITY 14>a1 a�
LEACHING FACILITY:(type) 41P ` (size) '
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BffltUER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: "�
VARIANCE GRANTED: Yes No ��
LOT, NO. q6A ADDRESS:_ DP,.
-014NERS NA!E: � /T
SEWAGE PERMIT NO. : 44-47DNEW: REPAIR:
DATE ISSUEll:, DATE INSTALLED:
INSTALLERS NAME: F-P%' d'1 P CJ Z.R
r-
INSTALLATION OF: ►m GsT , n o 1.pLob
t
WATER TABLE: ' FINAL IN'SPECnON BY:
DRAWING OF-,INSTALLATION ON REVERSE SIDE:t. " _
ilA,
K �z
9f
Val
pit
'73` ,
............... .........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Divi-Vitial Workii Towitrurtijan rantit
Application isereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at: J 110 00/ .0Z0
.......lo-A . ................... .............. ...... .........
Xd
.Locatim,-, d,,,, 07 `or N
6L --------------------------------
. ..............................Qa
Installer Address
Type of Building Size Lot._ ......Sq. feet
U Dwelling— No. of Bedrni oos........3.......................__..__Expansion Attic Garbage Grinder 04 Other—Type of Building ............................ No. of persons__._____________________.___ Showers Cafeteria
PL4Other fixtures ------------------------------------------------------------------------- ------------- ..............................................................
<W Design Flow._..._.....5.15..................------gallons per person per day. Total daily flow-------33A..........................gallons.
1:4 Septic Tank—Liquid capacity.160.0_zallons Length A.�V_ Width____- Diameter................ Depth....
Disposal Trench—No. .................... Width___._____...-_..._.. Total Length_..______........... Total leaching area....................sq. f t.
Seepage Pit No----OM�------- Diameter......1Z'........ Depth below inlet..__..`............. Total leaching area.4.!06,/Z,.sq--q.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by------00.'J_U�....E14.6rjA_EV_QJJ_( ........... Date..... .............
Test Pit No. 1.....'.Z....minutesperinch Depth of Test Pit----1-31a Depth to ground water...IVANZ....
(T Test Pit No. 2................minutes per inch Depth of Test Pit-_.__-_-....___..... Depth to ground water......_.___........._...
----------------- ............................*--------------*.............. --------------------------
Ai -- . P U43
,u
0 Description of Soil......A. . IL 17-",
.1 �4 .....wrn-) C4__1QE5 ............................................................................................
j .......... ....r
........................................................................................................................................................................................................
U Nature of Repairs or Alterations—Answer when applicable._..............................................................................................
.................................................................................................I--------------------------------------------------------- ............................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Se e is
_�_j Disposal System in,accordance with
the provisions of TITLE 5 of the State EnviLorimental Code—The n rsigned further agrees not to place the
system in operation until a Certificate of Co p nce h2 s e issued Y e board of th.
Signe . ... .... ..I.. . ..... C'.
....... ........ ---------- ................6., .4
5-----------A..-----------------4......i...................�:-- ---------------------------------- ...............................
Application Approved By<;...... Date ...
Application Disapproved for the following reafonf: ........................................................................................................................................
---------------------------------------------------------------------------------------------- ------ ----- ---------- ------------------*"*'*'*----------------------------------------**........**---- ---------------------------- ------- -
Date
Permit No. ..................... issued ........ ...........
Date
No...... ~......
+�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratiun for Mnpm3al Wurk,i Cfunitrnrtiun Vrrntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: -?㤠11 110 oD/.O ZO
- L:c.....�AA.....►1Ns .2. DL1 P � mPIL. �t. °2 �Location-Address r or Lot Fo.
-, — O I
t........................ sl ,c.t it�lE_�i (`��'... •-,-/ h�hJ1.� I�
Owner Alddress
a �r _ Z•�•(•I( .--••-- U.-I................'............... ..................
I �c.,�� tc C C !JE yJW t S �Yt 'q
--------•-••-------- -------
� Installer Address
UType of Building Size Lot..41 j..Z ......Sq. feet
�., Dwelling— No. of Bedrooms---------3................................Expansion Attic ( ) Garbage Grinder ( )
a`1 Other—T e of Building No. of ersons---------------------------- Showers
YP g ---------------------------- P ( ) — Cafeteria ( )
04 Other fixtures ......................................................--------------------------------- -------------•---••---••--•••-••---•-•--•-----•------•-•-••--
W Design Flow...........5.J 15......... per person per day. Total daily flow-------
9 Septic Tank—Liquid capacity.l6oD_.gallons Length__�`'i-�3'___ Width----`�'�? Diameter---------------- Depth.... ...1�>'F
' Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No---- 4�------. Diameter......19t ..._.... Depth below inlet.....-`............ Total leaching area..5&-7/.'2.sq-ff.
Z Other Distribution box ( ) Dosing tank ( )
a Percolation Test Results Performed by......ID1�`�.tYt....E_t4 �F..6 ♦.t _ 1~�.l,1�a-
. ....__.... Date----- ..............
Test Pit No. I-----.__Z-....minutes per inch Depth of Test Pit----1.3.$______--- Depth to ground water----ly'J_Nz.......
GZq Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................
0 Description of Soil----- rQP. S_l�.!�_S �L. �Z-� _.__fif.>5-ff __.S�_4 `1...5�1`1 6Qtg.. .......
v .....► 1 ►.t�►✓l SANV.....w1-vi.... -- ----•----------------------•.
W
UNature of Repairs or Alterations—Answer when applicable...................................._______...........____..__._-_________......................
----------------------------------------------------
Agreement:
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 und, signed further agrees not to place the
system in operation until a Certificate of Compliance hds been issued by�the board of h" th.
ff' rj
SignedUt+:� .. �_t.l.€ .. 1.G::t . :.... f ...��.�. C. ..._:1� :�f..... .....................'
I
A ....Application Approved B � ...,.�... .. ... '-` t�....%
......................................
PP PP Y ��Y
Date
Application Disapproved for the following reasons: --------------------------------- ..---...................
--------------------------------------------------------------------------------------------------------------------------
'^ i..r Date
PermitNo. ... ------- - ------------------ Issued ._...__ ...... .............1--------------
Dace 'y
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
C ertifirate of Compliance
THIS IS-TO,CERTIFY, That the Indivilduall Sewage Disposal System constructed ( f' ) or Repaired ( )
/� �!!..-
.
by ... ... .r���?'`-�-� �"fir- ..... ... -� �.�� ----------------- _...... . ............................ -
at .....+ mod-. .._�f�+'<1 f ' - n ='�°` ... ?' ........... f `.,f..... .^:... °� ..........
t.
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. 7 �•_�r��"� -------- dated /�'""... `.. ..... _
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B'E CONSTRUED AS A GUARANTEE THAT THE
DATE-...-.� ��
<�
SYSTEM WI�FUNCTION SATISFACTORY...�-............................... Inspector �-.��''��,� h' '....`�''. �
j,
-------------------------------------------------------- -----------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
oaf—� TOWN OF BARNSTABLE
No.......�.............. FEE........................
�in�nntt� urkn �unnf :�rt�trrn �Prmit
Permission is,hereby granted......... `' �/ . tD a-U r ............................................
to Construct (k') or Repair ( ) an Individual Sewage Disposal System
atNo.... ---•--•-----------------•••-•-----•---••••......--••--•••. ••••-- s.. - -^----------------------•---------------------------------- .......
.POI as shown on the application for Disposal Works Construction Permit'W6._"`_���_ Dated..f__. .'..f�...........�`�`.
---...--••-.......-•-•--------•.... . ......................................----•---
DATE. -. .............................. Board of Health
FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS
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
i
CLIENT: Reef Realty LOCATION: Lot 40A
ADDRESS: 24 School St. Ironside Drive
W. Dennis, MA 02670 W. Barnstable, MA
SAMPLE DATE: 10-31-94
COLLECTED BY: Clifford Well DATE RECEIVED: 11-1-94
TIME: 4:OOPM SAMPLE I.D. : 40A
JOB TYPE: New well WELL DEPTH: N/A
RESULTS OF ANALYSIS:
Parameters Units Recommended Limit Result
Coliform bacteria/100ml (MF Method) 0 0
pH pH units 6.0-8.5 6.19
Conductance umhos/cm 500 104
Sodium mg/L 28.0 9.5,
Nitrate-N mg/L 10.0 0.07
Iron mg/L 0.3 0.11
Manganese mg/L 0.05 0.008
Volatile Organic Compounds
EPA 502.2 ug/L See enclosed report.
Chloroform 1
Yes No WATER IS SUITABLE FOR DRINKING POSES FO ARAMETERS TESTED,
XXX
Date l
Ro ld J. Sa i
Laboratory 'erector
IT = Less Than
GROUNDWATER
ANALYTICAL
EPA METHOD 502.2
Volatile Organics (GC/PID/ELCD)
Field ID: 40A Lab ID: 9142-01
Project: Reef Realty/40A Batch ID: VG3-0280-W
Client: Envirotech Sampled: 10-31-94
Cont/Prsv: 40ml VOA Vial/HCl Cool Received: 11-01-94
Matrix: Aqueous Analyzed: 11-01-94
PARAMETER CONCENTRATION REPORTING LIMIT
(ug/L) (ug/L)
Dichlorodifluoromethane BRL 0.5
Chloromethane BRL 0.5
Vinyl Chloride BRL 0.5
Bromomethane BRL 0.5
Chloroethane BRL 0.5
Trichlorofluoromethane BRL 0.5
1,1-Dichloroethene BRL 0.5
Methylene Chloride BRL 0.5
trans-1,2-Dichloroethene BRL 0.5
1,1-Dichloroethane BRL 0.5
2,2-Dichloropropane BRL 0.5
cis-1,2-Dichloroethene BRL 0.5
Chloroform 1 0.5
Bromochloromethane BRL 0.5
1,1,1-Trichloroethane BRL 0.5
1,1-Dichloropropene BRL 0.5
Carbon Tetrachloride BRL 0.5
Benzene BRL 0.5
1,2-Dichloroethane BRL 0.5
Trichloroethene BRL 0.5
1,2-Dichloropropane BRL 0.5
Bromodichloromethane BRL 0.5
Dibromomethane BRL 0.5
cis-1,3-Dichloropropene BRL 0.5
Toluene BRL 0.5
trans-1,3-Dichloropropene BRL 0.5
1,1,2-Trichloroethane BRL 0.5
Tetrachloroethene BRL 0.5
1,3-Dichloropropane BRL 0.5
Dibromochloromethane BRL 0.5
1,2-Dibromoethane (EDB) BRL 0,5
Chlorobenzene BRL 0.5
Ethylbenzene BRL 0.5
1, 1,1,2-Tetrachloroethane BRL 0.5
m+p-Xylene BRL 0.5
o-Xylene BRL 0.5
Styrene BRL 0.5
Isopropyl Benzene BRL 0.5
Bromoform BRL 0.5
1,1,2,2-Tetrachloroethane BRL 0.5
1,2,3-Trichloropropane BRL 0.5
n-Propylbenzene BRL 0.5
Bromobenzene. BRL 0.5
(Continued) Page 1 of 2
L-- No.---YY--9 ==t 00 1-0;2-b Fee--- - -------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appficat ion ArWeft Congtruct ion Permit
A� is hiveby made fora permit.to Construct , Alter ( ), or Repair ( )an individual Well at:
s
Locati Address As rs Map and Parc
-����.�---- ------ - -- ---------------------------- -�� -
O ner Address
e-_ f------------------- --- ------`��-�------
Installer — Driller J Addres,/
Type of Building 2
Dwelling -------------------------
Other - Type of Building----------------------------------- No. of Persons--------------------------------— ---
Type of Well- —_�3 ----------------------------------------- Capacity-------------- —
Purpose of Well---------e—�-------------------------------
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation un ' ertificate .of lia has been issued by the Board of Health.
/o �7
Signed � -- ---- --------------------------- ------�1—
date
Application Approved By-— s� -t -- -—------------ ---------
date
Application Disapproved for the following reasons:-------------------------------------------------------
-------------------------------------------------
---------------- - -----------------
date
PermitNo. —--------------- Issued---------------------------------- —---------------------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
(Certif sate ®f (Compliance
THIS ,1O CERTIFY, That the I div' ual Well.Constructed (i�Q, Altered ( ), or Repaired ( )
-- --------------------------------------------------------------
--------------
----------
Installgr
at--�� l�/G ' �cr�(a�i �_ �f�-----�-�! -------------��-"�-- ----------------------------------------------
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----------------------------------------------------------------------
L+ •r�-.�+rrv- +rl- ,-r„Y4 - :, '•��{,irr i ,�' t'�"41rn.,ys•-
00 O-z C _
-------
BOARD OF OF HEALTH
_ TOWN OF BARNSTABLE
ry :� Applicat ion ArVetl�'Cmtruct ion Permit
Agpjicati n is h by made for a permit to Construct ((K, Alter ( ), or Repair ( )an individual Well at:
ly� -_
---------------------�e�__D�l-- ----- rv�s- ��- /�/�` �- ------ ------------- -___—
Locatio', - Address Asses rs/Map
l a rc
and Pa —
JO ner Address
-------------------- x------ -------
Installer - Driller Addres§,/
Type of Building //
Dwelling ---------
Other - Type of Building --- No, of Persons-------------------------------------------------
Type of Well- � ---- -------------- - - - Capacity------------ —
Purpose of Well -- � — - ---—-
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in operation unt'.I--a ertificate .of ��has been issued by the Board of Health.
Signed -- ------ -
date
Application Approved By-- ------
y
date <
Application Disapproved for the following reasons:------------------------------------------------------------------------------
---------------------------
date
PermitNo. -- =_ - ------------------ Issued---------------------------------------------------------------------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f Compliance
THIS �O CERTIFY, That the I div' ual Well,Constructed (�), Altered ( ), or Repaired ( )
by- _6Cl� ---4�' Install --------------------------------------------- - - - - ---—--
r
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. 3�` ---Dated-------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------------------—- --------------------------- -- Inspector--------------------------------------------------------------------------
awrw am�w�.as ao m sr r:r:ar c�a�.am ears eao��eiur nr.0�.vrs rra�rry mr o�em�.rre�rr»..acim.�.r��rw..eci.ous.�s®�me.ass esxa..cE
BOARD OF HEALTH
TOWN OF BARNSTABLE
Vell Construct ion Verrnit
No. -1--f-= Fee--—�-
Permission is hereby granted-��'�- �i — � € <Gf�ic - -
to Construct (X,_Alter ( or Repair ( ) an Individual Well at:
---------------------------------------------------------------------------------------
Street
as shown on the application for a Well Construction Permit
L Lj- l
Dated----- - —-- ------------------------------
----------------------- —'=f I fr}
DATE
(Board of Health
-----------;,!lS_=t I -�L-1 _-------- _-
r
1
ENVIROTECH LABORATORIES, INC.
MA Cert. No.: M-MA 063
449 Rte. 130 • Sandwich, MA 02563
r
(508)888-6460 • 1-800-339-6460
FAX(508) 888-6446
CLIENT: Reef Realty LOCATION: Lot 40A
ADDRESS: 24 School St. Ironside Drive
W. Dennis, MA 02670 W. Barnstable, MA
SAMPLE DATE: 10-31-94
COLLECTED BY: Clifford Well DATE RECEIVED: 11-1-94
TIME: 4:OOPM SAMPLE I.D.: 40A
JOB TYPE: New well WELL DEPTH: N/A
RESULTS OF ANALYSIS:
Parameters Units Recommended Limit Result
Coliform bacteria/100m1 (MF Method) 0 0
pH pH units 6.0-8.5 6.19
Conductance umhos/cm 500 104
Sodium mg/L 28.0 9.5
Nitrate-N mg/L 10.0 0.07
Iron mg/L 0.3 0.11
Manganese mg/L 0.05 0.008
Volatile Organic Compounds
EPA 502.2 ug/L See enclosed report.
Chloroform 1
Yes No WATER IS SUITABLE FOR DRINKING SES FO ARAMETERS TESTED
xxx - C
Date
Ro ld J. Sa i
Laboratory rector
IT = Less Than
zy
ar
GROUNDWATER
ANALYTICAL
EPA METHOD 502.2
4 Volatile Organics (GC/PID/ELCD)
Field ID: 40A Lab ID: 9142-01
Project: Reef Realty/40A Batch ID: VG3-0280-W
Client: Envirotech Sampled: 10-31-94
Cont/Prsv: 40ml VOA Vial/HCl Cool Received: 11-01-94
Matrix: Aqueous Analyzed: 11-01-94
PARAMETER CONCENTRATION REPORTING LIMIT
(ug/L) (ug/L)
Dichlorodifluoromethane BRL 0.5
Chloromethane BRL 0.5
Vinyl Chloride BRL 0.5
Bromomethane BRL 0.5
Chloroethane BRL 0.5
Trichlorofluoromethane BRL 0.5
1,1-Dichloroethene BRL 0.5
Methylene Chloride BRL 0.5
trans-1,2-Dichloroethene BRL 0.5
1,1-Dichloroethane BRL 0.5
2,2-Dichloropropane BRL 0.5
cis-1,2-Dichloroethene BRL 0.5
Chloroform 1 0.5
Bromochloromethane BRL 0.5
1,1,1-Trichloroethane BRL 0.5
1,1-Dichloropropene BRL 0.5
Carbon Tetrachloride BRL 0.5
Benzene BRL 0.5
1,2-Dichloroethane BRL 0.5
Trichloroethene BRL 0.5
1,2-Dichloropropane BRL 0.5
Bromodichloromethane BRL 0.5
Dibromomethane BRL 0.5
cis-1,3-Dichloropropene BRL 0.5
Toluene BRL 0.5
trans-1,3-Dichloropropene BRL 0.5
1,1,2-Trichloroethane BRL 0.5
Tetrachloroethene BRL 0.5
1,3-Dichloropropane BRL 0.5
Dibromochloromethane BRL 0.5
1,2-Dibromoethane (EDB) BRL 0.5
Chlorobenzene BRL 0.5
Ethylbenzene BRL 0.5
1,1,1,2-Tetrachloroethane BRL 0.5
m+p-Xylene BRL 0.5
o-Xylene BRL 0.5
Styrene BRL 0.5
Isopropyl Benzene BRL 0.5
Bromoform BRL 0.5
1,1,2,2-Tetrachloroethane BRL 0.5
1,2,3-Trichloropropane BRL 0.5
n-Propylbenzene BRL 0.5
Bromobenzene BRL 0.5
(Continued) Page 1 of 2
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.ASSESSORS MAP.- 111
PARCEL: 65 TEST .MOLE :LOGS NOTES.
v� 1. VERTICAL DATUM:
ENGINEER. DOYLE ENGINEERING .�ASSUMED FROM QUAD (NGVD
w oG� CURRENT ZONING:RF WITNESS JERRY DUNNING 2. MUNICAPAL WATER '7S NOT AVAILABLE.
$� a' BUILDING SETBACKS: 3. SCHEDULE 40 4
.,� � DATE. 4-10-87 „ PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM.
I
F: 30' S: 15 R: 15' PERCQLATION RATE: < 2 MINIIN 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20
LOADING SPECIFICATIONS.
FLOOD ZONE. C TH-1 TH-2 5. PIPE PITCH = JZ4 PER FOOT(UNLESS NOTED OTHERWISE).
73J� 61.0 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID
� TOP'.& ELEV TOP dt ELEV LEVEL. .;
,o LOCUS SUBSOIL TOP & L 7• THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE
tz" 7zs USE OF A GARBAGE DISPOSAL
TIGHT ss` 58.0 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE
SILTY D STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL
LOCATION MAP MEDIUM
so" AN s8s SAND HEALTH REGULATIONS.
`a
LOT 40A 5 MEDIUM WITH 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR
41,220 SF SAND AND
WITH TO CONSTRUCTION.COBBLES GRAVEL 11. PROPOSED SEPTIC SYSTEM AND WELL LOCATIONS ARE IN ACCORDANCE
R vEL WITH MASTER PLAN, ON FILE WITH THE BARNSTABLE HEALTH DEPT.
Ise 62J 138" 1 49.5
NO GROUNDWATER ENCOUNTERED
-
S , t 1,JC SYSTEM DESIGN
DECK
0-_ sx
FLOW` ESTIMATE:
BEDROOMS AT 110 GALIDAYIBEDROOM = 330 GALIDAY 24' PROPOSED
3 BEDROOM
26' FUTURE L4's8 7072
DWELLING GARAGE
SEPTIC TANK:
GALIDAY * 1.5 DAYS = 495 GAL
O 64 66 I 74 w 14' 3,V 24'
USE 1000 GALLON SEPTIC TANK
so 6z '
58 ► i LEACHING AREA: PROPOSED DWELLING
ss '
O
54 i I ► i USE ONE LEACH PIT (6 x 49 WITH 3.0' OF STONE
52 I I yY 76
50 . 112' EFFECTIVE DIAMETER x 4' DEEP)
� � r I � i - � .•. 78 150' MINT14lUx �
48 I t i t r ! 0 ETWEEN WELL
r i i l �•-• tO a SEPTIC
AND SEPTIC AREA ;SIDE AREA: P2"x PI x 4 151 SF (2.5) = 377 GALIDAY
44 I I I I 1 I L �...:.. LEACHING
1 i I I I -i 1 70
.•.• •.•• : BOTTOM AREA 6 x 6 x PI = 113 SF (1.0) = 113 GALIDAY
_ . n v
t ul AL c.AJT'ACJrTY GLj .�
oe"
� � ► � � I I � � � � S� X
150' (MI P's
:.
1 '3
t I 'tNv- t�'• SEPTIC S 2" PE S 0
42 � � � � , � .� 6e � � GA . . SYSTEM SECTION A T NE
44 It 1 ► : I .. : : OF 3 4" 1 1 2"
1 \ 0500
4 ` ` �pY 9g1�0\ • 70.0 WASHED STONE
Y ��yi' p � �
_ r 9 ,gyp. . 6g : : TOP OF FOUNDATION
48
\ �. • .`
54 66.41 0 0
1 ,r $6.66 ELEV. D-BOX 49
56 ' ` ` :. 1000 GAL 65.80
ELEV. SEPTIC TANK '.65.97 E EV. 61.66
ELEV,:... ELEV. L
60 , , 9� 1 PROPOSED TEE S 65.66 3 3
WELL T SIZES:
� INLET: 6" UP, 10 DOWN ELEV. 12'
sz ` � � ► -
ONE LEACH PIT 6 x 4 WITH
EXISTING`WELLS OUTLET: 6' UP, 19 DOlWN ( )
TH-2 64 , 7a 3' OF STONE (12' EFF. DIAM. x -4' DEEP) (H-20)
80 UTILITY CLUSTER
66 r i 80. 5 BREACKOUT CALC: (66.5 50)I93 x 150 = 27'
68 I RONSI DE I
70 DRIVE 72 SITE AND SEWAGE PLAN
74 , i ,
KEY: 76 ► 80. 4 BENCHMARK AT LOCATION
98 O t CATCH BASIN
EXISTING CONTOUR. — ELEV = 80.4 k
LOT 40A IRONSIDE DRIVE
.............
PROPOSED CONTOUR: .. .....
EXISTING SPOT ELEVATION: 25.5 ggo D 80
civsTER W EST .BARNST ABLE MA
PROPOSED SPOT ELEVATION: 25
TEST HOLE: -�
PREPARED FOR:
UTILITY POLE: -4- 80. 7
FENCE LINE: r
. .- � ;�} � - = . .. .� REEF REALTY
r
HYDRANT: -� DEYAREST—lIcLELLAN ENGINEERING v �- SCALE: 1" 30' DATE: 10-6-94
A
24 SCHOOL STREET P.O. BOX 463 4
WEST DENNIS, MA.SSACHUSETTS 02670 REFERENCE: PLAN BOOK: 421 PAGE: 57 REV: 11-4-94
DM # 94_039=40 THOMAS MCLELLAN, P.E. JOHN Z.DEk'AREST JR., P.L.S.
I
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k5,-,-1'I ," �� : ", IN � I I _�,,� � , � ,,, \,;,",,I% I , I ,-� . -" ACCESS COVERS ,MUST BE WITHIN . I 11 � - � - .
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" ,� _. . "I I- �.._. I I I �, I - ;T S CL l7c, c , " � I . � I J. ALL CONSTRUCTION METHODS AND MATERIALS AND . I
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,1,"�,���_.. .1 11 � I I � - I I I . � _____[_fFFL I I � - . - SEPTIC TANK PROVIDED: /000 GAL. EXISTING . I 11
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ASSESSORS MAP: 111 i,-► ,
ST HOLE LOGS NOTES.
PARCEL: 65 -
v NGI1►•EER: DOYLE ENGINEERING 1. VERTICAL DATUM:_ASSUMED FROM QUAB�GVD -)
� E
v CURRENT ZONING: WITNTSS: J RRY DUNNING
0 2. MUNICAPAL WATER S NOT AVAILABLE.
BUILDING SETBACKS: _ _E 3. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM.
y � DATE. , 4 10 87
F. 30' S. 15 R: 15'
4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20
PERC6'LATION RATE: < 2 MINIIN
'ysT i LOADING SPECIFICATIONS.
T FLOOD ZONE. C '-1 - 5. PIPE PITCH = PER FOOT(UNLESS NOTED OTHERWISE).
� T.F, : TH-2 1./4
73.6 610 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL.
5 ELEV ELEV
LOCUS Top & TOP & 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE
A
1z. SU}SOIL 72B SUBSOIL
USE OF A GARBAGE DISPOSAL.
36" A CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE
T1G,gT 8. ALL CON TR
SIL''.Y STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL
/ SAS D
LOCATION MAP MEDIUM
- s8s SAND HEALTH REGULATIONS.
LOT 40A y� WITH 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL `UTILITIES PRIOR
�'. SAl D MEJIUY COBBLES
41,220 SF ��t AND TO CONSTRUCTION.
WI7'fl GRAVEL
COIBLEs 11. PROPOSED SEPTIC SYSTEM AND WELL LOCATIONS ARE IN ACCORDANCE
RJVEL WITH MASTER PLAN, ON FILE WITH THE BARNSTABLE HEALTH DEPT.
138" 62.1 138" 495
NO CR67NDWATER ENCOUNTERED
' SE I'1�T I C SYSTEM DESIGN
DECK
FLOC ESTIMATE:
.- 24'
-3 BEDROOMS AT 110 GAL/DAY/BEDROOM -�GAL/DAY PROPOSED
26' ]GAR
24'
i, 3 BEDROOM
DWELLING SEP"'IC TANK:
68
70 72� 14 41 GAL DAY * 1.5 DAYS = 495 GAL ' 14'
q � 74 w � � 34'
0 64 ss i 1 1 , U.E 1000 GALLON SEPTIC TANK
62 1
60 1 f 1 1 1 1 C, PROPOSED DWELLING
58 1 , i 1 1 , LEACHING AREA..
56
' f 1 1 ► O
-�IZ SE ONE LEACH PIT (6' x 49 WITH 3.0' OF STONE
52 54
f f I 1 76
50 f i i f 1 1 , _,12, )'FFECTIVE DIAMETER x 4 DEEP)
1 1 , f f f 1 i 1 f 1 150` MIN .. I
48 1 1 1 I f I EEN WELL
f f f 1 , i , , 1 BSD SEPTIC
4s 1 , f i i i AND G AREA SIDE AREA: 12 x PI x 4 151 SF (2.5) _, 377 GAL/DAY
44 1 1 f f 1 1 i 1 f 1 r• 78 LEACHIN BOTTOM,AREA,: 6 x 6 x PI 1�13 SF (1.0) = 113 GAL/DAY
42 490 DAY
1 f 1 f•. 96, ,
1 f , 1 f \' . 7yr 1 f �� ,• G
f + ► � f 1 � � •.• -,- - TOTAL CAPACITY =--. __ AL/ '.
, ► , � f i ,_ 1 , • , \ .1•• �•,•.� 150' (MIN)
, ► 1 1 1 , , , f , s Z� :
SE�k:TIC SYSTEM SECTION
2 PEASTONE
42
y y
► ' ► ► ► f , '\ �1 OF 314 - 1 112
WASHED STONE
46
TOP OF FOUNDATION
48
so
52
r�
68.39
70 ` : ; 68.64 ELEV. D-BOX }
5s GAL 68.16
69.d_ _ELEV. 62.0
� . ► F ': is ELE`r. SEPTIC :.TANK 68.33 ELEV.
58 ► ► 6 ELEV. <3;> < 3;-ELEV. i
so ' gd r ' PROPosED TEE SIZES: 66.0
` \ 1 ., : ► WELL ♦ ELEV. <-- 12' >
► 1 INLET:'6" UP 10 DOWN
► ► H WITH
sz ► ONE LEACH PIT (6 x 4 IT
► � ► W
.\ '1 W OUTLET. 6" UP 19 DOWN
► EXIST ELLS
3' OF STONE (12 EFF. D AM. x 4 DEEP) (H-20) 1
64 / a
TH 2 / 80 ( )/66.5 UTILITY
I CLUST R BREACKOUT CAM 50 93 x 150 27
66 / v i 80. 5
i
i
68 / % ' I RONSI DE
70' DRIVE
SITE AND SEWAGE PLAN
72 DR
74 /
► ' ► 80. 4 0CATION.
• BENCHMARK AT L
KEY. 76 78 p y CATCH BASIN
EXISTING CONTOUR: ELEV = 80.4 LOT 40A IRONSIDE DRIVE
PROPOSED CONTOUR.
R �
go v 80 TEST BARNST ABLE. MA
EXISTING SPOT ELEVATION. 25.5 pC1 F A� UTILITY
25 1SL CLUSTER
PROPOSED SPOT ELEVATION:Q I `
PREPARED FOR.-
TEST HOLE:
• 80. 7
UTILITY POLE. -O-
DM REEF REALTY ,
FENCE LINE.
SCALE: 1" = 30' DATE: 10-6-94
DEMAREST McLELLAN ENGINEERING
HYDRANT. -�
24 SCHOOL STREET P.O
. BOX 463 t
WEST DENNIS, MASSACHUSETTS 02670
REFERENCE: PLAN BOOK:-421 PAGE. 57
DM # 40
` THOMAS McLELLAN, P.E. JOHN Z. DEMAREST JR., P.L.S.
i
. -
1
a ;
l
_ r
-
-\(
NOTE: PLUMBING IN THE BASEMENT WILL REMAIN AT THE EXISTING ELEVATION.
PLAN CX, PROFILE
NOTE: THE CHAMBER WILL BE VENTED WITH A CHARCOAL FILTER,
T.O.F. = 66.69
° MIN. F.G. OVER THE EXISTING SEPTIC TANK IS: EL. 65.8t PROVIDED 9" MIN. COVER INSTALL RISER TO WITHIN
d 6" MAX 36" MAX. COVER 9" OF FINISHED GRADE
w ,-
e
Z F NOTE: ALL NEW MP -
/ /, FINISHED E COMPONENTS WILL BE H 20 LOADING.
Q GRADE
\ �.
v¢i °•�d //�/ \/\\��\\�
FINISHED GR
A DE
x\ d d �j // / / // //�//�//�/ \\ \ \ \ 2% MIN. SLOPE F.G. OVER THE SOIL ABSORPTION SYSTEM IS: EL. 65.5t
HIGH HIGH ST.
° \/ o d'j e e /
T�T
W Z i n i . i 3„ MIN a d e , eA �� /�� //i// \
3" MIN \
m • d \� n \ 63.8t p e 2'
O e d °` e e e d. � a d' LEVEL Z // /\\/�%\
� d SANITARY TEE 4" PVC PIPE e
d
15 221(7): GENERAL CONSTRUCTION REQUIREMENTS FOR ALL SYSTEM COMPONENTS p p A L = 18't ' 3" MIN w/GAS o (SOH. 40)
BAFFLE 6„ e SLOPE OF .06 d °' NOTE: THE ACCESS PORT
Fw- ° 'd L = 3' ° SHALL BE WITHIN 6" OF
VARIANCE REQUEST: THE TOP OF ALL SYSTEM COMPONENTS, INCLUDING THE SEPTIC TANK, Q O EXISTIN e 2" MIN c' 4" PVC PIP 1�
P r
DR. DISTRIBUTION BOX OR DOSING CAMBER AND SOIL ABSORPTION SYSTEM, SHALL BE INSTALLED Z L� ° XI L 6" MI (SCH. 40) USE AT LEAT A 2% PITCH FINISH GRADE.
NO MORE THAN 36" BELOW FINISHED GRADE. Z d EXISTING TO THE CHAMBER _
O 00 Z ed 4" PVC PIPE d �� 14" c 59.83a ° 60.0
VARIANCE TO HAVE THE NEW CHAMBER AND D-BOX AT A DEPTH OF 5.5'f, p . , (SCH. 40) ° a e 59.66t
-�
REQUESTING A R E
d
LOCUS pR NSID THE NEW CHAMBER WILL BE H-20, DUE TO THE DEPTH. U Z X p c SLOPE OF .02 a Z e ° - ° •° ° ° 60.Ot
Cn
0 0 0 0
I~w I w °id d . SANITARY TEE d OUTLETS 5
0
_ ` n D ,-_' °'d °'d .'d .°'d °'d .A .e PLUGGED 2
PERCIVAL FIRST FLOOR LAYOUT o ovfl �o �o L wo �o wp vo o 0 0 0 59.5t O O O OM.C:
DR. SECOND FLOOR LAYOUT Q z op o° oM Qp o 0 0 0 0 O o QoaQ o 0 0 0 0 0 O o
to o 10' MIN oDo0 00 00 00 00 00 g 0 oy 00 co0
a Z L� d 57.5 3/4" - 1-1/2"
a BEDROOM BEDROOM : O EXISTING SEPTIC TANK DOUBLE WASHED STONE (1 OF STONE ALL AROUND)
OCUS
MAP
DINING 3 OFFICE # 1 Of 0 # 2 y PROPOSED DOUBLE WASHED STOE2,(12" MIN.)
ROOM 1,000 GALLONS H-20 LOADING 50 57.5
Q a ¢ DB5 D- BOX
_ M711
ROOMY N 6" CRUSHED STONE WITH BAFFLE 10.5' I H-403LOADDING
Sco/e' 2 STALL I MASTER 310 CMR 15.232 1 - 500 GAL. CHAMBERS {�
GARAGE KITCHEN BEDROOM FULL FULL 0 H-20 LOADING (SEE LAYOUT) = I 10.83'
BAT „ BATH BATH 0 H-10 LOADING
NO GROUND WATER AT 52.5 1 - 500 GAL. CHAMBERS
THIS,-WILL BE VERIFIED AT
THE°}TIME OF INSTALLATION. (SEE LAYOUT)
H-20 LOADING H-20 LOADING
OPTIONAL KNOCKOUTS D135 D- BOX
DECK 1 - 500 GAL. LEACHING GALLEYS
WITH 1' OF STONE ALL AROUND SEE PLAN VIEW FOR CHAMBER AND
Book, Page: / 0_ � 3 STONE CONFIGURATION
s243, 265 ENTIRE BASEMENT IS UNFINISHED EACH CHAMBER Is s.sL x 4.8'w x 2.75'H
Property ID: 1.83
J
111069 NOTE:
NOT A BOUNDARY SURVEY Lr MANHOLE COVER
FOR SEPTIC SYSTEM UPGRADE 24" DIAMETER MIN. (TYP.) USE 1WIGGIN PRECAST COMPONENTS OR SIMILAR.
PURPOSES ONLY ALL COMPONENTS WILL BE INSTALLED ON A STABLE COMPACTED BASE
Book, Page:
[SEE 310 CMR 15.228(1)]
9000, 276 8'
Property ID: /
111066
EN
EXISTING DB-3 D-BOX TP N0. DTH-1 & 2 T G D
-'\(LE
3 TO BE REPLACED BY AN GRD. EL. 65.5t '(SOIL L TEST DATA
H-20 DB-5 D-BOX WITH BELOW 52.5 + v 1 BM BENCH MARK
o A RISER TO WITHIN 9 IN. GW. EL. ��? SW STONE WALL ® CB CATCH BASIN
N EXISTING FOUR HIGH CAPACITY INFILTRATORS OF FINISHED GRADE SURFACE SOIL SOIL SOIL SOIL DEEP HOLE
TL TREE LINE
o^ AND STONE ARE TO REMAIN IN PLACE DEPTH HORIZON TEXTURE COLOR MOTTLING ELEVATION SOIL EVALUATOR: THOMAS ROUX Us SMH SEWER MANHOLE $ UP UTILITY POLE
N AS IS. O DMH DRAIN MANHOLE HYD FIRE HYDRANT
0" - 44" FILL PERC TEST
44"-133" C COARSE 2.5Y7 4 � DONALD DESMARAIS W WELL 0 DHC DEEP HOLE -
s �I�y APPROVING AUTHORITY:
B.M. NAIL IN SAND / �� APRIL 3, 2020 EC EROSION CONTROL ® PROPOSED SPOT ELEV.
\ ✓ \ \ POST EL=67.10 DATE PERFORMED: ,-, s
(N.A.V.D. 88) v ' -- EXISTING
OCONTOUR
1 -ao--- xsss ' EXISTING SPOT ELEV.
PERC TEST
��'� SOIL EVALUATOR: THOMAS ROUX
\�N TP 3 �� \ \ �, DONALD DESMARAIS �ES
\; O \ APPROVING AUTHCJ,RITY: N T
\ \ TP 2 \ \\\ \' \\ APRIL 3, 2020
\ \ "� \ \ e # \ \ \\ \ DATE PERFORMED: 1. ALL ELEVATIONS REFER TO THE NAIL SET IN A POST, SEE PLAN FOR BENCHMARK LOCATION.
\ ESTIMATED SEASONAL GROUND WATER ELEV.
�,. NO G.W. ENCOUNTERED AT " (EL. = 52.5) 2. ALL CONSTRUCTION SHALL CONFORM TO 310 CMR 15�.00, TITLE V AND THE REGULATION OF THE TOWN'S BOARD OF
1 \ \ \ � TO BE VERIFIED AT THE TIME OF INSTALLATION SOIL EVALUATION PERFORMED BY: THOMAS ROUX
HEALTH.
SOIL EVALUATOR LICENSE NUMBER: SE2703
�\ \ BELOW 53.7 I CERTIFY THAT I HAVE TAKEN AND PASSED THE
3. THIS PLAN DOES NOT WARRANT OR IMPLY ANY SUBSURFACE SOIL CONDITIONS OTHER THAN THOSE OBSERVED AT
Book, Page: / �' / / J / 1l ���� �� TP N0. TP # 1 GRD, EL. 65.0± GW. EL. SOIL EVALUATOR CLASS ON OCTOBER OF 2000 THE IMMEDIATE TEST PIT LOCATIONS. IF UNSUITABLE MATERIAL IS ENCOUNTERED.
SURFACE SOIL SOIL SOIL SOIL ALL CONSTRUCTION SHALL CEASE, AND THE DESIGN ENGINEER SHALL BE CONTACTED IMMEDIATELY.
9574, 276 / PT / ��
Property ID: \ 11\\\\ DEPTH HORIZON TEXTURE COLOR MOTTLING ELEVATION 4. ALL TANKS, D-BOXES, AND CHAMBERS SHALL BE SET LEVEL AND TRUE TO GRADED ON A MECHANICALLY
0" - 54" FILL COMPACTED STABLE BASE.
110_001_020 \ / / O / \\ \\\\ 54 -126" C LOAMY 10YR5/6 5. AREAS DISTURBED DURING CONSTRUCTION SHALL BE STABILIZED TO MINIMIZE EROSION. THE AREA OVER THE
SAND PT N0. A SYSTEM SHALL BE GRADED TO A MINIMUM OF 2% SLOPE TO PROVIDE POSITION SURFACE DRAINAGE.
GRID. EL. 65.5f
6. THE ORIGINAL TOPOGRAPHIC SURVEY AND PLAN WERE DONE BY BORDERLAND ENGINEERING.
/ PERC DEPTH 58
START 1I5 MIN. PRESOAK: 10:09 A.M. 7. THIS PLAN SHALL NOT BE USED FOR THE REPRODUCTION OF PROPERTY LINES, NOR SHALL IT BE USED AS A
�& ico MORTGAGE PLOT PLAN OR TITLE SURVEY. CONFORMANCE TO LOCAL BYLAWS SHALL BE DETERMINED BY THE OWNER
Lot Size: 0.95 Acres ` Q�" '� z / I END 15 MIfJ. PRESOAK: 10: 24 A.M. PRIOR TO CONSTRUCTION.
41,220 S.F. , \ J O \\ / pR� I TIME AT' 12 IN.:
PLAN BK. 421 PG. 57 \ �� TP # 1 �� ., 8. THE OWNER IS RESPONSIBLE FOR THE DETERMINATION OF THE LOCATIONS OF ALL BURIED UTILITIES.
a° o qy TIME AT 9 IN.:
ESTIMATED SEASONAL GROUND WATER ELEV.
TIME AT 6 IN.: 9. FOR PROPER PERFORMANCE, THE SEPTIC TANK SHOULD BE INSPECTED AT LEAST ONCE A YEAR AND PUMPED WHEN
SHED \ I NO G.W. ENCOUNTERED AT (EL. = 53.7) WOULD NOT HOLD THE PRESOAK THE TOTAL DEPTH OF SOLIDS EXCEEDS 1/4 THE LIQUID DEPTH OF THE TANK.
1 - PROPOSED 500 GAL. PRECAST LEACHING I Q BELOW 55.5 PERC RATE OF <2 m. I 10. ANY ALTERATIONS MUST BE REPORTED TO THE DESIGN ENGINEER PRIOR TO PROCEEDING WITH CONSTRUCTION.
CHAMBER WITH 1' OF STONE ALL AROUND. TP N0. TP # 2 GRD. EL. 66.5t GW. EL. p
USE WIGGIN PRECAST OR SIMILAR \ \ \� W SURFACE SOIL SOIL SOIL SOIL 11. THE SYSTEM MUST BE INSPECTED DURING CONSTRUCTION BY THE BOARD OF HEALTH OR ITS AGENT AND THE
(USE H-20 LOADING) \ \ v - Q DEPTH HORIZON TEXTURE COLOR MOTTLING ELEVATION DESIGN ENGINEER AND BE CERTIFIED BY THE DESIGN ENGINEER.
w \ ��
�`�\ �� W \ \ `� ' / 0" - 12" FILL 12. THERE WILL BE A RESERVE AREA PROVIDED.
�`o+o' \ \\\\ BURIED fC \�' 100�0 , 12 -16 B SAND 10YR5/4 13. A SPLASH PAD WILL BE USED ON THE GROUND WHERE THE WATER ENTERS THE 1 CHAMBERS.
-� ► �� IRONSIDE
BURIE
/I \ \G I 16"-132" C MED. 10YR6/4 14. ALL STONE USED IS TO BE DOUBLE WASHED STONE.
SAND
1 I R .
15. SEE 310 CMR 15.255 FOR FILL SPECIFICATIONS. SEE 310 CMR 15.247
FOR AGGREGATE SPECIFICATION.
16. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING TAPE OR A COMPARABLE MEANS IN ORDER
TO LOCATE THEM ONCE BURIED.
DE DRAINAGE EASEMENT 250.7T ESTIMATED SEASONAL GROUND WATER ELEV. 17. THERE ARE NO WELLS WITHIN 100' OF THE SYSTEM.
20 WI N85'20'54"E _ - NO G.W. ENCOUNTERED AT " (EL. = 55.5 NOTE: tHE TEST PITS THAT ARE LABELED
_ ) TP#1, TP#2 AND TP#3 WERE DONE BY 18. THE EXISTING SEPTIC TANK WILL BE USED.
1
TP NO. TP # 3 GRD. EL. 66.0± GW. EL. BELOW 55.5 STEPHEN HAAS (ON JANUARY 23, 2008. 19. SLOPES MUST BE STABALIZED POST CONSTRUCTION.
_ SURFACE solL solL solL solL (SEE THE EXISTING SEPTIC SYSTEM DESIGN
_ DEPTH HORIZON TEXTURE COLOR MOTTLING ELEVATION PLAN AT THE BARNSTABLE BOARD OF HEALTH) 20. THE SYSTEM IS NOT DESIGNED FOR A GARBAGE GRINDER,
00.C), 0" - 4" FILL 21. PLUMBING IN THE BASEMENT WILL REMAIN AT THE EXISTING ELEVATION.
4"-8" A LOAMY 10YR5/4
SAND 22. INSTALL RISERS FOR THE INLET AND OUTLET OF THE SEPTIC TANK, D-BOX AND THE 1 CHAMBER.
8 -24 B SAND 10YR6/4 23. THE NEW CHAMBER WILL BE VENTED. (SEE DETAIL).
24"-126" C MED 10YR6 4
Book, Page: SAND /
16660, 92
Property ID: / SEPTIC SYSTEM DESIGN PLAN
110_001-019 ESTIMATED SEASONAL GROUND WATER ELEV. NO G.W. ENCOUNTERED AT (EL. _ '55.5)
CLIENT: LOCATION:
DESIGN DATA TOWN & COUNTRY REALTY 35 IRONSIDE DRIVE
WEST BARNSTABLE, MA.
TYPE OF BUILDING:
SINGLE FAMILY DWELLING NO (GARBAGE GRINDER ALLOWED. " 02668
W 00
0 n D > S P I N K PROJECT:; PREPARED FOR; , �I�oF TOTAL NUMBER OF EXISTING BEDROOMS: 4 SEPTIC TANK VOLUME: 1500 GAL �° '
m tis DESIGN FLOW: 110 GAL./BEDROOM/DAY DESIIGN PERC RATE: < 2 MIN/INCH DATE: APRIL 26, 2020 SCALE: 1 = 20 DESIGNED BY: TCR
m DESIGN TOWN & COUNTRY REALTY , o��wP s'��G DESIGN FLOW: 4 BEDROOMS X 110 GAL./BEDROOM = 440 GAL./DAY LTA = 74 GPD/SF DRAWING NO.: JOB NO: CHECKED BY: JCS
P.O. BOX 51351 CULVER a BOTTOM AREA: 10.5' �X 6.83' = 71.4 S.F.
59 CLAY STREET SEPTIC SYSTEM DESIGN PLAN NEW BEDFORD, MASSACHUSETTS S SPINK SIDE AREA: 2[2 (10.5 ) + 2 (6.83)] = 69.3 S.F. `� L� � �� # DATE REVISION DESCRIPTION DRAWN CHK
N MIDDLEBORO, MASSACHUSETTS TOTAL LEACHING AREA: 69.3 S.F. + 71.4 S.F. = 140.7 S.F. � � � ?�'
02745 �N0.3004�� �� � �� 1 5/7/20 ADD NOTE ABOUT SOIL LOGS TCR JCS
02346-1052 �o,�FGISTER `� 140.7 S.F. x .74GPD/SF = 104.0 GPD
sslorrnL�� SINCE 104.0 GPD > 100 GPD O.K. �� - 2 12 2 ADD NOTES AND WATER LINE TCR JCS
II N EXISTING FLOW: 340 GPD, THERE IS A DEFICITE OF 100 GPD (T'
o N o 774-766-0544 OR 774-678-9066 jspinkl®gmail.com SINCE 340 GPD + 104.0 GPD = 444 GPD, WHICH IS GREATER THAN 440 GPD. O.K. �1 A)