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HomeMy WebLinkAbout0066 JENKINS LANE - Health 66 Jenkins Lane West Barnstable A= 128 —004 - 009 TOWN OF BARNSTABLE e, LOCATION Uo ) lLIAA, L SEWAGE# ( � I b VILLAGE 1 SSESSOR'S MAP&PARCEL f "OOV-06 INSTALLER'S NAME&PHONE NO. C6 JA Tf ,\A- Stir 77S ON 91 SEPTIC TANK CAPACITY U D LEACHING FACILITY: e 1 * (tyP )'�� (size) In,-Li ,��/� X NO.OF BEDROOMS `��� � � O OWNER PERMIT DATE: _ �(, /6 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A feet Private Water Supply Well and Leaching Facility(if any wells exist s��® on site or within 200 feet of leaching facility)- �( feet Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching:facility). /®� feet FURNISHED BYE. �` Li A,:: _ - A3 - �FS t TO aa� © ''� c Z (� No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: C"..'ex PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Rpplication for Digotal *y5tem Construction permit Application for a Permit to Construct( ) Repair O Upgrade( ) Abandon O ❑ Complete System ❑Individual Components Location Address or Lot No. (d ' Owne,'.4 Name,Address,ag Tel.No. Assessor's Map/Parcel /4® oc)� Installer's Name,Address,and Tel.No. ICAN 60 bq Designer's Name,Address and Tel.No. Type of Building: flA,./e'j\,Nl,S J 0 Dwelling No.of Bedrooms Lot Size 4 W sq. ft. Garbage Grinder (v)o Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) J V gpd Design flow provided gpd e- Plan Date ��� d Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. `�(� c Ys �J Description of Soil . 0U^ �`1 c� J� 's, r sk ,, C-ru,4 - ' tol 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 t is Board of Health. Signed r Date N& /v Application Approved by Date _ —O Application Disapproved by: (Vf— Date for the following reasons Permit No. g ool — ) '6 Date Issued �� *, - ,ems _ 200`1- li,b r No. * . , Fee L-oez THE COMMONWEALTH OF MASSACHUSETTS 'Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes k Rpplication for Migogal *pgtem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. V �FCJR '�R�p LwAa W ' own ' Name,Address,a Tel.No. Assessor's Map/Parcel `a / ® � 00 Installer's Name,Address,and Tel.No. s'D� sX�y 6� 6 1 Designer's Name,Address and Tel.No. kwwd Type of Building: t-'► '��5 �5 03� t ' krz,• Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder NO c Other f�..` Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date a l:30 10 Number of sheets Revision Date Title Size of Septic Tank e)(Vb* I d 6 O Type of S.A.S. (o A II Cca Description of Soil 0L--\y r1t- JE"1 c4u\1 ' Nature of Repairs or.Alterations(Answer when applicable) G��Q ��� I !�� I,•, -145 A rAkiS Date last inspected: Agreement: i 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 t is Board of Health. f/� Signed Date �/s— / 0 / Application Approved by Date $ IO ' o Application Disapproved by: Date for the following reasons Vd Permit No. g o0 1 — I '6 Date Issued r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (V ) Upgraded ( ) Abandoned( )by at U \tA\kA.n> l �,:,..L W .� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. aw�— 11/0 dated S 6 d Installer � rc�r•�C_.. Designer Zx #bedrooms '� Approved desi flow gpd gn The issuance of this e it shall n N be construed as a guarantee that the system wir nction/ajs de, gne Inspector Date Jr Ins � r3 p I . No. QU � � 1� - ------- _ _ ._ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS X110i5po5ar *patent c w5tructiou `vertu Permission is hereby granted to Construct ( ) Repair ) Upgrade ( ) Abandon ( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognize his/her duty to comply with Title S and the following local provisions or special conditions. Provided: fi Construction must be completed within three years of the date of this ^6 � x. Date Approved b pp Y . � d Town of Barnstable ,*THE T Regulatory Services • Thomas F. Geiler,Director snaxSTnaLE. 9 MASS. Public Health Division 039 plfDMA�A Thomas McKean,Director 200.Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: iS °`� Sewage Permit# ® �� Assessor's Map\Parcel �Z�''061�-ac(3 Designer: S7�--SPH-'ti_ ffiPe,�S (?E. Installer: 56o-77— K- 4544CE Svc v��.v�. IA cC, Address: �23 Avw77-- e-4 Address: A:re,"P-, f9f; o16 7S— On�l e Co 56777 was issued a permit to install a (date) (installer) septic system at 66 .T �,yS L >E based on a design drawn by (address) 5 � / 5 dated 3 38 1.6`7 (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. 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 A. HAAS .,, OVIL (Installer's ignature) No.3s461 AFC Eilk RA F� AL E�6 (Designer's Signature) (Affix esig er'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 REC EIVE BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Designer Certification Form Revised.doc TRANS. NO.: CITY/TOWN: APPLICANT: ADDRESS: 66 DESIGN FLOW: :3-36 gpd REVIEWED BY: DATE: N/A OK NO Legal boundaries denoted [310 CMR 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] ✓ Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] Easements shown [310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] °✓ Location of impervious surfaces (driveways,parking areas etc.) ✓ [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] System Calculations [310 CMR 15.220(4)(0] daily flow septic tank capacity(required and provided) ✓ soil absorption system(required and provided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)] Existing and proposed contours [310 CMR 15.220(4)(g)] Location and log of deep observation holes (existing grade el. on ✓ each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? [310 CMR 15.242] ✓ Certification staterrent by Soil Evaluator [310 CMR 15.220(4)0)] Observed and Adjusted groundwater(method for adjustment / given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Address &_> l 607 Sheet 1 of 7 r i N/A OK NO Location of every water supply, public and private, [310 CMR 15.220(4)(k)] t/ within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 P. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] (if waterline cross see 310 CMR 15.211(1)[1]) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR 1 5.220(4)(o)] Stamp of designer 1310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as J approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benclunark within 50-75''of system [310 CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR 15.000] System components not>36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405(1(b)] 7/ Address �Z� '�v`� '��' Sheet 2 of 7 f r� N/A OK NO :.hr- ....,.. _ .cam........... ... Size OK? [310 CMR 15.223(1)] Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15.228(1)] Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<1000gpd, two for systems>1000 gpd [310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] `Multi-Compartmeu't��anks� - r 4 s �� �i�.5' .r°'�,a��saat'�a �' �,� �, ls..�� �'�� ��,;,x� Required when other than single-family dwelling or flow>1000 t/ gpd [310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and(3)] "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] Address I q - Sheet 3 of 7 f N/A OK NO F,�,,. �,.,�.. ,-,,;�.a<���F ` * �i°: `r:�..,✓_. �'�,�Y;�..,.,xM�"ter+``�a�t.^+,��`�'�rD., .%�,._ds,,: ��,'u k-?N a Located at least ten feet from any water line? [310 CMR 15.222(2)] Disposal piping at least 18" below water line(when water and sewer cross, see 310 CMR 15.211(1)[1]) Cleanouts required/provided ? [310 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 C1v1R 15.251(9) and 310 CMR 15.252(2)(c)] Siphon problem/ (leachfield below pump chamber) Endcaps or vent manifold specified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) Stable compacted base [310 CMR 15.221(2) and 310 CMR / 15.232(2)(a)] o/ Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 / CMR 15.323(3)(a)] f Riser if deeper than 9" [310 CMR 15.232(3)(f] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sump 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] Capacity(emergency storage above working--design flow)? [310 CMR 231(2)] h� �` Proper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE [310 CMR 15.231(5)] Service components accessible (not too deep with piping, disconnects accessible) Alarm floats - alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and(8)] Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)] Address vOq- oo I Sheet 4 of 7 N/A OK NO Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] ✓ Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] GALLERIES 1PI `S C�HANIBERS 310'ClY1R 1°512553_ _ r Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole (if>2000 gpd must be to grade) [310 CMR 15.253(2)] Aggregate 1' minimum- 4'maximum. [310 CMR 15,253(1)(b)] 2' sidewall credit maximum [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 sq. ft. [310 CMR 15.25,3(6)] TRENCHES 3104CMR 1S 251N �� � r cw Width 2'minimum T maximum [310 CMR 15.251(1)(b)] 100 feet -maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater(3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OIL? [310 CMR 15.211(1)[4] and Guidance Document] zt�xr �` s BED,SAS (lti'Iaxamumsize of bedo fie7�s5000� j d � th � 3Es, � �� f , �111 , 1,..�W minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' [310 CM RI5.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] Separation between beds 10'minimum. [310 CMR 15.252(2)(0] Bottom area used in calculations only [310 CMR 15.252(2)(i)] Address 1 &0- 0&14 Sheet 5 of 7 N/A OK NO DID VMS +,THEPLAN INUO _ ��� ���� Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems >2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] If used in gravelless system -make sure jet is directed as not to scour soil interface [Guidance Document] Inspections once per year(systems<2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fall - Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] .w�..a.M.s.., <�F�.s_,.w� ...��,�.�.�,:�✓lx, .k �,"S�T..�. m <szsn.nm�$ a.�c4,�i!� ?l. „�.s::`e.��'':',�°.+wf'ss:�,.cr ''�.a..u.'tee c`"S- 4���s.rm ..""fh.,.r�e" Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface I t^ "3:�3"' a' e.: a ae s r�" `a,, re-,t �*i •e as �afi?B'cY> Alternate e,Se fcS stem I/ A roval Zette s � > �k _� E Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance g2v * "��' x" A Are the variances listed on the plan ? [310 CMR 15.220 (4)(q)] RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed - [Refer to 310 CMR 15.414] Address /20 - cry 4 - o6 9 Sheet 6 of 7 j N/A OK NO IM Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(l)] Pumping to septic tank ? [ 310 CMR 15.229] Shared System [310 CMR 15.2901 Address /20 - Sheet 7 of 7 v �,t+E Town of Barnstable P# Department of Regulatory Services • wtaer.+e[s, Public Health Division Date puss. t639 200 Main Street,Hyannis MA 02601 Date Scheduled i/ Time Fee Pd D Soil Suitability Assessment for Sewage Disposal Performed By: S72=-PHA� f�--r4.�'> Witnessed By: P f } LOCATION & GENERAL INFORMATION Location Address / Owner's Name 0 r� G-ri V) M--f1 W ��nS�-rib Address ( o Assessor's Map/Parcel: Engineer's Name NEW CONSTRUCTION REPAIR `-e- ( Telephone# Land Use Xc 's A-C_ Slopes(%) % Surface Stones Distances from: Open Water Body ,:,"i"4- ft Possible Wet Area od ft Drinking Water Well eft Drainage Way P/14 ft Property Line f b-f-- ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) JJ �w U U� Parent material(geologic) Ae0W_,-i V ZL`v S Depth to Bedrock 2 , Depth to Groundwater. Standing Water in Hole: /t- Weeping from Pit Face �1A Estimated Seasonal High Groundwater �l 1 DETER_NIINATION FOR SEASONAL HIGH WATER TABLE Method Used: ��dv.v-t -�--`� Depth Observed standing in obs.hole: in, Depth to sQil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj,factor Adj.Groundwater level PERCOLATION TEST Dutp ^4g Time Observation Hole# Time at 9" d`'�' Depth of Perc Time at 6" 7:� Start Pre-soak Time @ Time(9"47 End Pre-soak Rate Min./Inch G 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. Q:\SEPTICtPERCFORM.DOC s DEEP.OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistencv.%Gravel) & x 3 L—"S �!P DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulders. Cns' tec %Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi to c Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) tMunsell) Mottling (Structure,Stones,Boulders. Co_nsisten I Flood Insurance Bate Man: / Above 500 year flood boundary No— Yes ._✓._ Within 500 year boundary No '� Yes. Within 100 year flood boundary No Yes ,.�. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what,is the depth of naturally occurring pervious material? Certification I certify that on // / g (date)I have passed the soil evaluator examination approved by the Department of Environm ntal Protection and that the above analysis was performed by me consistent with . the required tra' i p rtis and experience described in 310 CMR 15.017. Signature - Date ' . d ASEPTICtPERCFORM.DOC `-�—� ��� i`� ._. TOWN OF BARNSTABLE L(i ATION �� La- , pa �' SEWAGE # , VA-LACE 0 k) :SCL, . - ASSESSOR'S MAP & LOT 12 S-66 INSTALLER'S NAME&PHONE NO. `'C' {� , . SEPTIC TANK CAPACITY �D CD LEACHING FACILITY: (type) CAW [04>6 NO. OF'BEDROOMS :3> BUILDER OR OWNER PERMITDATE: _COMPLIANCE DATE: Separation Distance Between the: j M gum Adjusted Groundwater Table.and Bottom of Leaching Facility - - Feet Water Supply Well and Leaching Facility '(If any wells exist --� _ site or within 200 feet of leaching facility) Feet of Wetland and Leaching Facility(If any wetlands exist within 300 feet o e c ' facility) 1 Feet Furnished by "` C S r No. 's 1 Fee—, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Mfi5poml *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No Owner's Name,Address and Tel.No. Assessor's Map/Parcel C3 ' Installer's Name,Address`and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 2- a gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) s 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 T' e f the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued this o d of Hwltfwl Signed tea- Date 4e—ly` tip Application Approved by ' Date !�_/ Application Disapproved for the lowing Yeasons 15 Permit No. Date Issued No. Fee THE COMMONWEALTH OF MASSACHUSFJ/TSS Entered in computer: h Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABI E., MASSACHUSETTS ZIPPlication for Miqoal *paem,co . 5truction Permit Application for a Permit to Construct Repair Upgrade"(' Abandon El Complete System ❑Individual Components Location Address of0ot No Owner's Name,Address and Tel.No. Assessor's Map/Parcel I I— '?_ K. Installer's Name,Addiess,and Tel.No. Designer's Name,Address and Tel.No. ? Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder Other Type of Building No. of Persons Showers Cafeteria( Other Fixtures Design Flow gallons per day. 0Alcdl&e­1d daily flowd gallons. Plan Date Number of sheets" Revision Date Title Size of Septic Tank 16,r>6 —Type of S.A.S. Description of Soil, 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 systek N I in accordance with the provisionse f the Environmental Code and not to place the system in operation until a Certifi- 0f T$qN cate of Compliance has been issued b this hogxd of H lth4 Signed • Date ele- Application Approved by Date— t L/ - Application Disapproved for the&lowing asons Permit No. Date Issued- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed Repaired Upgraded Abandoned by at as been constructed in actor ce with the provisions oVitle 5 and the for Disposal System Construction Permit No. ?k-A3 I dated �-14, Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date L Jq- �g Inspector- 0 ---———�---------------------------------- No. 3 I/ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Muigpo5a[ *pgtem Construction Permit Permission is hereby granted to Construct P jepair Upgrade(Abandon System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: Approved by� i 10/9197 3 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) hereby certify that the application for disposal works construction 4P permit signed by me dated _ ,concerning the property located at meets all of the following criteria: There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will W be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: ® ' ' A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) ._ B)Observed Groundwater Table Elevation(according to Health Division well map) / SIGNED: n DATE: ',=?f i-3 LICENSED SEPT SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also If the licensed installer posesses a certified plot plan, this plan should be submitted). q:health folder:cert d `tIL) 2s D TOWN OF BARNSTABLE LOCATION �� l _ t'—'�►'k SEWAGE # ... . '.'VILLAGE !�Ec9­ ASSESSOR'S MAP &'LOT/a S•�y• ? ... `INSTALLER'S NAME&PHONE NO. p , M �,ru►1 SEPTIC TANK CAPACITY (D m I ACHING FACILITY: (type) J )s 4!Z-401S No.OF BEDROOMS ro f�3� i :8UILDER OR OWNER — ';.sPERMITDATE: —L Z COMPLIANCE DATE: :: .. :Separation Distance Between the: i �F' 30sf� Adjusted Groundwater Table and Bottom of Leaching FacilityFeet ater Supply Well and Leaching Facility (If any wells exist 1. .�-� Feet or within 200 feet of leaching facility)etland and Leaching Facility(If any wetlands exist within 300 feet o e facili�y) (J Feet ::Furnished by F r„ ��•S �91 A� � 12S " TOWN OF BARNSTABLE LOCATION L 1-ioS L eo SEWA.Gi? SILL AG E_�/ 5��h�i. ASSESSOR'S MAP & LOT INSTALLER'S NAME Cz PHONE NO. 5 CK\ � � SEPTIC TANK CAPACITY /a)0 LEACHING FACILITY:(type) p; r-CwSj- P, f (si7e) 60b _ NO. OF BEDROOMS__3 P�F, OR PUBLIC WATER BUILDER OR DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED VARIANCE GRANTED: Yes 'No • ,� `��. a �� �� � 3� ��� � I �� r Lam! i o(3 —0 04 0 0 FRk ` THE COMMONWEALTH OF MASSACHUSETTS (/✓ BOAR® OF HEALTH — :.(:U=Lt1A) ....._.....OF......... !.l.P !�!�.ST �, loll, Applirtttiun for Disposal Works Cnunsirurtiun Prrmit Application is hereby made for a Permit to Construct V) or Repair ( ) an Individual Sewage Disposal System at: ...661. ... ...... J. A 5 r: .Lj-r��..... -•--- --------------------•-•-- --••-•-•-- Lo tion- ddre s or Lot No. a 'L caner Address....... (7 g I staller Address p,!1 / Q Type of Building Size Lot...4-_!__�4�.....Sq. feet U Dwelling_—No. of Bedrooms......................................................................Expansion Attic (/��� Garbage Grinder Other—T ) e� yp of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ..--•-- W Design Flow________________________________��._.gallons per person per day. Total daily flow..._.....__� ._ . .gallons. WSeptic Tank—Liquid capacity.j1d---gallons Length................ Width................ Diameter-_______-____-- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) / .7 ~' Percolation Test Results Performed by'.... F.. ��{_ ................. Date------ a Test Pit No. 1__.. ,_minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ .....................----i---------------------•-•-----•-•---•------------•-•....---•----••_-••--•........................................................ O Description of Soil............. r--•----•-�f..... --_-nt— .d/6----------------------------------------•----------------------•-----------....-•-------- L� 1 s -- x ----------•----•-•--•----•-----••--•---- U Nature 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 Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed......... • •.....f"""'. .. •. Date Application Approved By........... � Date Application Disapproved for the following reasons------------------------------------•---------------•----------------------------------------•--••----........... -•••--•.............•------------•-•-----•--•---...------•--•----•-••-----...----•-..._..--•-•-------...---------••-•-•--•-••---••---...----••----•••-- ---------- •••................................ Date Permit No,.... _. ----- .�� Issued._... jCsl Date 1 = --- Fee-- --.' ===- BOARD OF HEALTH TOWN' OF BARNSTABLE 0(ppritat ion,f or V ell Congtruct ion permit Application is hereby made for a permit to /Construct (-Vj, Allt�e(r)( Q C, or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel item r ecx ------------------- L- -�r 6)C—`r�� e., e�v��;1x__!�t O 6-'1'------ - ----------------- ------ n Owner Address ilA: N ! e ------�---��-Il.10.1 Ilr��wc. L tf _s��a_ -�o./3aX--���?---- WAs�l --�y__Q a6 s� ----------------- Installer — D ller Address Type of Building Dwellin /ous - - - -------------------- Other - Type of Building-------------------------------------- No. of Persons----------- - - ----------------------- Type of Well-10—QA!n, s Capacity--------- � r =__ — -- - — - —- ____--- — - Purpose of Well n�e�T.'c-_ fe ------------------ -- 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 until a Certificate of Compliance has been issued by the Board of Health. Signed- � u _ ��-—�S�- -�/ � ��— - - date Application Approved By — date Application Disapproved for the following reasons:------------------------------------------------------- -- - - - __- --------------------------------------------------------------------------------------------- __—_------------------- ----- CC�y date Permit No.-- - '111_-_ ---- -- -— — Issued----------------------------—__—-_ —-—— — -- date BOARD OF HEALTH TOWN OF BARNSTABLE (fertifitate Of Compriante THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) r by----------------- A-------- - -- -t1-&--------n- - -- —-------------------------- Installer a -------------- —-- - - 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.W-26-Y ----Dated--------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE'----------------------------------- = ---------- Inspector— ------ —-------------- y _ - Fee- a s BOARD OF HEALTH TOWN OF BARNSTABLE Applicat ion Ar Melt Con5truct ion Permit Application is hereby made for a permit to Construct Alter ( ), or Repair ( )an individual Well at: LoT 7= TCN iwS - ' ^L,_._ P�-A)7-'01-,N-`y`ll----/a--J1-=3 Location — Address Assessors Map and Parcel �irv� e✓��� ��ve% �,r r /o�� b r✓G7( S�O Pn �el-vlf//c /uu U Jb.3 //�� rr /Owner Address R1/4_= U — N fl I ��NcI� `"� �`- �fr �"'c--L�G-�-�a -�1-�� '` -���U - f�S_�ju ��. c�Z)6�? U. U _ ----------- — - ---------------- Installer — Diller Address Type of Building Dwelling ---------------------------------------------- Other - Type of Building------------------------- No. of Persons------------------------- Type of Well J00''A T',- -"C,-c — - PL) Purpose of Well----Oo-n�e,ST"c ------------ -------------- 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 until a Certificate of Compliance has been issued by the Board of Health. `e""r` --- -� - -?sJ - - l � �p Signed�=�=e�'?'��' ----------------- � ---- date Application Approved By-------- — --------------------------- date Application Disapproved for the following reasons:----------------- --------- ---------- ------------------------------------------------------------------------------------------------------------------ date Permit No.----- / �� ' -----------— - -- - Issued — -----------------'�"----_ date — --------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f (Compliance a THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) b D----- --�" �'!e x� -----------az — -- - ------- Installer 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.V%)'-- ----Dated------------------- THE-ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION-SATISFACTORY.. DATE------------------------------------------------ ------------------------------ Inspector---------------------------------- --------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Vell Con5truct ion Permit No. _-�o—3-- Fee ------- Permission is hereby granted '` ------------- to Construc)>< Alter ( ), or Repair ( ) an Individual Well at: No. ---------- r -------------------------------- Street as shown on the application for a Well Construction Permit No.------------------------------ Dated --- ---- --- - - - ----- — ------ Board of Health DATE------------------------------------------------------------------------------ DIT �.x. t. .......q THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH ........... .............OF........ / .7` C: ................................... Applirtttion for 14opoottl Workii Tontrnrtion ramit Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal System at: f. Lccation- dd Aress' or Lot No. W Owner Address Fa • ------------------ ----• ----•••.. ....._......, I staller Address UType of Building Size Lot.........:.....i�AV . Sq. feet Dwelling-No. of Bedrooms............................................Expansion Attic (fit) Garbage Grinder (4)6) aOther—Type of Building ___________________-___._- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures -------�---•••---••••-••••-•••-•-•-••-----•----•-•-----••••-•-•••-••••••.............•--•••-•---•••--•-----•......•-•-••-•--------•-------•------- W Design Flow................................!_.....gallons per person per day. Total daily flow----------- � .....................gallons. WSeptic Tank—Liquid capacity.&1+� __-gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---_---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by...__.R? ......1`... 1 ' '`- `-'��.�-----•--.......... Date_...�/?.5__.t Test Pit No. 1...L,2—_._minutes per inch Depth of Test Pit.................... Depth to ground water____--__-_-__-__--____-. Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Description of Soil .......................... ''---- r _ ..lr = ------------ U Nature 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 Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. r Signed------. Date Application Approved By....... �'� •-•---! _'k----------- ----- f mate 9{} Application Disapproved for t e f ollo ing rea"sons:....................................... ....-•---••---------•-----------------•--------------------•-•-------------------.....-•------------•--....---------------------------------------•••••---•-•-•--------••--•••-•••--------•-••---------- Date Permit No._. Issued..A ��._�� �i•+i ------ - at ... ..............•-------• THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. J4t?P ..........OF......... '................................ _ f �rrtifirtttr�of f�o�n�rlittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed 6l�/) or Repaired ( ) by.. - = Q. ......" .':_ ....-----•--•--...-•---•------------•...................................•-------•-•-----.._......--•-•---.....------••-•--•-----...........-- Installer has been installed in accordance with the provisions of TIT, ' 5 of The State Sanitary C9de as scribed in the �• application for Disposal Works Construction Permit No.... ___,._____ :_. -_..-- dated__! t ... . ... ............... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE C NSTRIIE® AS A UARA T THAT THE SYSTEM WILL F CT N SATISFACTORY. DATE....... �..�..---•----••-- --••-..._••--- Inspect i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Disposal Worb Tonotruction frrmit Permission is hereby granted....!?�:..I - 'h.9 f SC.a C' ..._..-•- ------- ------------------------- to Construct (Y) or Repair ( ) an Individual Sevt,age Disposal System at No....LAIC-A- .ti _ 4t �- `�.�X✓~.D'___'__fi_fi,�__ _C_�_ _____________ application for Disposal Works Construction Permit N PP P . _..__ . ------ Dated_ .. . Street as shown on the a •----•-•----.--••---••••---.•--•-•.-•----- q o r( of Health DATE...................)-- -- '-•l-L�--.........--•----•--------•-•... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS s> Department of Environmental Management/Division of Water Resources WATER WELL COMPLETION REPORT WELL LOCATION GEOGRAPHIC DESCRIPTION Address �oT 7• Ten'xc,-�S ,Ln� r' Or OS E W of � (leer) (circle) Ciry/Toyyn W'�Gr�/4 ,e /4,k J er• Ife,g Lnl Well owner�retn'�r 0-t✓ea�°i``e'"%Coi� !' (road) Address Pb •6ox- 5-/U 7 N S W Of CCN/y,elu rl, 1,40 O a�O (mi•in tenths) (circle) TI Board of Health permit: yes [ no ❑ intersect. w/ !,O"`"(road/dl WELL USE 'WELL DATA Domestic []'Public❑ Industrial ❑ Total well depth � ft. Monitoring❑ Other Depth to bedrock ft. /fJ�rU Water-bearing rock/unconsolidated material: Method drilled — f ,Description /Nfc� CouYSe' Sa.�c� Date drilled Water-bearing zones: CASING 1) From To 1 Type 41 jG� �I> PUL 2) From To Length IlLft. Dia(I.D.)5'in.. 3) From To Length into bedrock ft. Gravel pack well: dia. Protective well seal: Screen: ` �Ldia. r Grout-� Other Slot�js IengthL_fro toPD PUMP TEST Static water level below land surface ft. Date Drawdown�V ft_ after pumping hr. - min.,at gpm How measured /G Recovery"li�'J ft. after L hr. min. ' a - COMMENTS LOG of FORMATIONS COMM Materials -From To S.G Driller Z (o v e 61O b r` Mass. Registrations INPSOA� Firm /� �CLer�nG�l.G.ie/1 r�/r1/��r:�Nc G/o Gs' /0 Q p i /4P CoolJe Address 7 o Sp !p S City/Tovvn MuJ ll �e /`i 4 -nature of supervising registered well driller ,.Please Print rrmly b BOARD,.,OF HEALTH COPY „ a.'i+r.. B .;�. .,�,.::7+�.. ... .._ . -:,.-� .. ._ �_•`r.' ,i.� ,. .n.:;.,,,. r �. w .,"'w -r^..+�.*.T..,:F°-3e'1. «..,J;.rC,•`•,�,�, .,gK.ns�k�;r:..rw�,*'*.•i=1.'� te Log Number: `Bottle # D394 Date: a; of BA � BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT SUPERIOR COURT HOUSE p " BARNSTABLE, MASSACHUSETTS 02630 J �inss DRINKING WATER LABORATORY ANALYSIS PHONE:362-2511 '_Ext.337 Client: Greenbrier Development Collector: Sean O'Brien Mailing Address: Route 26 Affiliation: other 'k:AnteryiIIe, MA UZW4 Time & Date of Collection: 1/17/90 3:45 p.m. Telephone: Type of Supply: well Sample Location: Lot 7 Pioneer Path. Well Depth: UU, West Barnstade, MA Date of Analysis: 1/1119U 42b p.m. PARAMETER SAMPLE RESULT RECOMMENDED LIMITS y Total Coliform Bacteria/100 ml 0 0 pH 6.1 Conductivity (micromhos/cm) 94 500.0 Iron m) 0.1 0.3 Nitrate-Nitro en ( m) <•1 10.0 Sodium m) 10 20.0 I . X Water sample meets the recommended limits for drinking of all above tested parameters. II . Based only on results of the parameters tested for this sample, the water is suitable for drinking but may present the problems checked below: A. Water sample has higher than average levels of Nitrate. Future monitoring is recommended (2-3 times per. year) to establish any upward trends. B. The low pH of the water may shorten the useful life of the house's plumbing. C. Water may present aesthetic problems (taste, odor, staining) due to D. Water sample has high levels of sodium. Persons on low sodium diets should consult their doctor. III. Due to one or more of the reasons checked below, this water sample is unfit for human consumption: A. High Bacteria B. High Nitrates REMARKS: CC: Barnstable Board of Health r 117/85aboratory� i"rector Explanation of Test Results Total Coliform Bacteria Coliform bacteria are an indicator of the sanitary quality of a water supply. Water'supplies may become contaminated from malfunctioning septic systems, cesspools and surface runoff. A total coliform count of zero indicates that your water supply is safe and approved for human consumption. A total coliform count of greater than zero is most often the result of accidental contamination of the sample bottle through improper sampling methods. For this reason. it would be advisable to retest any well water that is not approved. pH pH is the measure,of acidity oralkalinityof the water. On the pH scale,the number 7 is neutral.less than 7 is acidic and more than 7 is alkaline. The pH of water on Cape Cod tends to be acidic in the range of 5.0 to 6.5. Conductivity Conductivity is a measure of the dissolved salts in solution. Amounts in excess of 500 micromhos/em are generally considered unacceptable and may have a laxative effect upon users. Iron The presence of iron in water in concentration of .3 ppm or greater may: give the water a bittersweet astringent taste,cause an unpleasant odor, often gives the water a brownish color and cause staining of laundry and porcelain. The average concentration of iron in Cape Cod's water is .2 - .6 ppm. Although the presence of iron in water may cause the problems listed above, it is not considered deleterious to health. Iron may be removed by use of an iron removal system. Nitrate-nitrogen The Massachusetts Drinking Water Regulations have set a maximum contaminant level for nitrates at 10 ppm. Excessive concentrations may cause methemoglobinemia (an infant disease) and have been suggested to form potentially carcinogenic nitrosamines. Contamination sources include fertilizers, cesspools and industrial wastes. Copper Due to the acidic nature of the water on Cape Cod, copper tends to leach from pipes..This normally does not present a health hazard: however. concentrations in excess of 1.0 ppm may cause a.metallic taste and/or a bluish-green stain on porcelain fixtures. Sodium A concentration of sodium over 20 ppm is only of concern to people who are on a low sodium diet. If the water supply has more than 20 ppm sodium. it is up to the people who are on such a diet to find another source of drinking water or contact their doctor to determine if consuming the water is advisable. Concentrations exceeding 50 ppm ind:.-ate that there may be ocean water or road salt runoff water getting into the well. c 1' BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT LABORATORY REPORT VOLATILE ORGANIC CHEMICAL ANALYTICAL RESULTS Client : GREENBRIAR DEVELOPMENT Collection Date: 01/17/90 Mailing Address : P . O. BOX 510 Date of Analysis : 01/24/90 ROUTE 28 Type of Supply: WELL CENTERVILLE , MA 02632 Well Depth (FT) : 120 Telephone : 771 -3616 Sample Location : LOT 7 PIONEER PATH, WEST LAT. (DDMMSS') : Not Given BARNSTABLE LONG. (DDMMSS) : Not Given Collector: SEAN O ' BRIEN Map/Parcel : Affiliation: BCHED Analytical Method : 502 . 1=1 , 502 . 2.=2 , 503 . 1=3 , 504= 4 , 601/602=5 -------------------------------- ------------------------------------ Contaminants Anal . Result MCL Detection Meth. ug/1 ug/1 Limits (ug/1) Chloroform 1 7 . 8 0 . 5 Only those compounds listed above were detected. Attached is a list of chemicals which the method is capable of detecting . NOTE: Contaminant levels equal to or exceeding the Detection Limits are reported . Contaminant Levels below the indicated Detection Limits are reported as -ND- MCL means Maximum Contaminant Level for EPA-regulated ,compounds . (ug/1 = micrograms per liter = Parts Per Brillion) The Environmental Protection Agency has set Maximum Contaminant Levels (MCL) for the following compounds . This sample compares as follows : COMPOUND MCL (in PPB) Benzene 5. 0 level not exceeded . * Carbon Tetrachloride 5 . 0 level not exceeded * 1 , 2-Dichloroethane 5. 0 * level not exceeded * 1 , 1-Dichloroethene 7 . 0 * level not exceeded * 1 , 4-Dichlorobenzene 75 * level not exceeded 1 , 1 , 1-Trichloroethane 200 level not exceeded Trichloroethene 5. 0 * level not exceeded Vinyl Chloride 2 . 0 * level not exceeded Comments or additional compounds found: + Ber.-riard E . Bartels , Ph . Labor ory Director BARNSTABLE COUNTY HEALTH' AND ENVIRONMENTAL DEPARTMENT LABORATORY REPORT VOLATILE ORGANIC CHEMICAL ANALYTICAL RESULTS Client : GREENBRIAR DEVELOPMENT Collection Date: 01/17/90 Mailing Address:P. 0. BOX 510 Date of Analysis : 01/24/90 ROUTE 28 Type of Supply: WELL CENTERVILLE, MA 02632 Well Depth (FT) : 120 Telephone: 771-3616 Sample Location:LOT 7 PIONEER PATH, WEST LAT. (DDMMSS) : Not Given BARNSTABLE LONG. (DDMMSS) : Not Given Collector: SEAN O' BRIEN Map/Parcel: Affiliation: BCHED Analytical Method: 502 . 1=1 , 502 . 2=2 , 503 . 1=3 , 504= 4 , 601/602=5 -------------------------------- ------------------------------------ -------------------------------- ------------------------------------ Contaminants Anal . Result MCL Detection Meth. ug/l ug/1 Limits (ug/1) ------------------------------- ------------------------------------ Chloroform 1 7 . 8 0 . 5 Only those compounds listed above were detected. Attached is a list of chemicals which the method is capable of detecting. NOTE: Contaminant levels equal to or exceeding the Detection Limits are reported. Contaminant levels below the indicated Detection Limits are reported as -ND- MCL means Maximum Contaminant Level for EPA-regulated compounds . (ug/1 = micrograms per liter = Parts Per Billion) The Environmental Protection Agency has set Maximum Contaminant Levels (MCL) for the following compounds . This sample compares as follows : COMPOUND MCL (in PPB) Benzene 5. 0 * level not exceeded , * Carbon Tetrachloride 5 . 0 * level not exceeded * 1 , 2-Dichloroethane 5.0 * level not exceeded * 1 , 1-Dichloroethene 7 . 0 * level not exceeded * 1 , 4-Dichlorobenzene 75 * level not exceeded * 1 , 1 , 1-Trichloroethane 200 * level not exceeded * Trichloroethene 5. 0 * level not exceeded * Vinyl Chloride 2 . 0 * level not exceeded * Comments or additional compounds found: Bernard E. Bartels ,X. Labor ory Director - - -- ___ _ _ __ ___ _ E , , �. . 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AND -MATERIALS SHALL 0 - S TITLE�:5 THE� TOW' RULES AND OF MOW GRADE a ckn H FOUNDATION TOP Or s, r6k HE�2SU B SURFACE. DISP r MIN. & AND THE 'REQUIREMENTS ,OF THIS PLAN. PIONEER PA7gV MASONRY ExTtiislom 2 _DELOW GRADE 2. ALL COVERS O -8ANITARY' UNITS SHALL -BE�,BROUGHT TO LOCUS WTH OF FINISHED GRADE� IN,�1.2" :0 SCH. 40 PVIC PIK, MAS MIN- P 'PER FT. ALL e ONRY- UNITS'U�SED TO BRING COVERS TO GRADE SHALL BE MORTARED 1N PLACE. FLOWNE .'2"14YEA OF SANITARY SYSTEM ,-SHALL 'BE 'CAPABLE 4. 'ALL COMPONENTS­,OF E7 10, Ta WAVED STDNE OF -WITHSTANDING H-1 0 LOADING UNLESS R �,OR -7, 3' MIN. < -10 2- MIN. LEACH WITHIN� FT. -OF ,DRIVES .,OR PARKING AREAS. _�H 20% LOADING, _o. 4! PIT < -SHALL BE USED U'NDEIR,.'OR 'Wi THIN 10 FT. ,OF DRIVES R 0 MIN. 710 1 1, --3/4' -A 1/2' WASHED STONE UCAXD 4 PARKING. LEVEL 6STRtBUTION NO DETER mpuANCE WITH DEED BOX ,,5. MINATION' �HA,s BEEN AS TO_�CO RESTRICIION-S ,OR,�ZONI�NGIREGULA11ONS. OWNER/APPLICANT -SHALL OBTAIN ,SUCH DETERMINATION FROM.'THE APPROPRIATE 'AUTHORITY. GALLON.�SIEPC TANK LOCATION MAP z HORIZONTAL AND VEWnCAL CONTROL, SEE LEVY, ELDREDGE ASSESSORS MAP 2�6 PARCEL 4�w 0 & WAGNER FIELD- NOTEBOOK LIQUID DEPTH IN SEP TAW DEP1H OF OUTLET TEE NIOW FLOW LINE �BOTTOM Or TEST HOLE_ 4 FEET, 14 IN04ES OR.USGS PROBABLE HIGH WATER LEVEL - 5 FEET 19 INCHES 6 FEET. 24 INC14ES CURRENT ZONINIG' INTERPRETATI'ON4 ESIGN CALCULATIONS SEWAGE DISPOSAL SYSTEM 'PROFILE MIN. FRONT SETBACK� 30 FEET NUMBER OF BEDROOMS NOT TO SCALE e GARBAGE DISPOSAL -UNIT MIN., SIDE, SETBACK 1 :5 FEET ESTIMATED FLOW 50 101 TOTAL 68.40 .......... MIN. -REAR 'SETBACK 15 FEET GAL./B R./D AY 2 X BR.) 33n GAL. /DAY REQUIRED *SEPTIC 'TANK APACITY q5 GAL. � 50 1060 GAL. ACTUAL S12E OF SEPTIC TANK 11 "ool LEACHING AREA REQUIREMENTS SOIL 71 EST 01 PERCOLATION 15' GPD./S.F. GPD,/S.F, SIDEWALL, AREA - BOTTOM AREA - EST -DATE OF SOtL SIDEWALL 27r(!&_/2)(4- )SF x SF G L/DAY 60 A - ------- --- 2 y EST BY E30TTOM �IT (-ZZ-12) ,SF x _L �112 ' ,GAL/DAY ------ —c> GPD/SF WITNESSED BY. IN./INCH PERCOLATION RATE 4- . SF �410 , GAL/DAY, �o 'Ile I PIT ,#1 TEST PIT #2 49 36 y s ' - 5 ' ' q.ft. TEST'. ULAT 64�. Zo ELEV. ELEV--17 f -00 —0,100 , 0, f 2Z4-6 to : ,-LEGEND. . (A E -n NG SPOT ELEVATION ONO XIS EXISTING 00————— T ELEVATION, 00.0 N A co :FIN rOUR ', 00, OLE SOIL:jEST FIT10CATIOW -0 �BOTTOM OFJEST H LE SEPTIC TANK W W t OR WATER ELEV, 'OR'WATER`ELEV.-'1_ TOWN WATER f STRIBUTION BOX'- PRIMARY LEACHING PIT 0 48' VA TE R'�. 'LEVEL ADjUSTM ENT: ��zW T;klsTo N/F. -RANTA .F. RESERVE LEACHING PIT TEST DATE ', WATER #tl A 4 66 INDEX WELL -EVEL RANGE 10 El!" , SAW WATER iTZ NITIAL 18SUE A DEPTH .TO ' NO.'�� _4�B WATER, LLVEL� FCR INDEX WELL D TE DESCRIPTION. TH 44 -:1 f __FbR .MON OF: 46 A 4A 17-1- PL�AN DE SIGN qF—PT]C ags:' ' et and 171' WATER -LEVEL ADJUST EN ik, M Ti '.DEPTH.TO 'MI GH :W 15A' 'S tR 18 L E ATER #1 A Ad 60�1 N S, LAW F_ #f8k IL 3A Well , G COR OF JENnNS STEPHEN e cind's ;BOARD ALLYN w tj AL RO"vo ED. - 14FALT APP fOF jAN 20A WILSON No.+30216 SCALE- I -NO: 14 ZO�7 7 JOB: AM ' -NT­AE 3 LA Y ��,A%, � 1� ' ',P N 1) AGL IAGNER ASSOCIATES INC. IIVY,''MAN AnaTILD- 100 ?�llm sumRs PERMIT ,,,,,# -0L4NMv=;-UA�02632 889 ;WEST, MAIN STR9b -NEW ENGL�ND RiEPROGAAAHICS SUPPL Y CO.