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HomeMy WebLinkAbout0066 KETTLEHOLE ROAD - Health 66 Kettleh®le Road W. Barnstable P - --_. -- - — A = 109 031 - 1 i TOWN OF PARNSTABLE LOCATION . 6. KeR(46te- SEWAGE # VILLAGE Qtb+ 1-krW64"R P— ASSESSOR'S MAP & LOT JC6 _ INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY !act, + LEACHING FACILITY: (type) i— (size) too O5iCv1 NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: E6ivfPLMCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ��� . . �� �(b �a TOWN O.7F]BARNSTABLE LOCATION �'� ��l'r& Xo SEWAGE# f A0 l 0 PO VILLAGE � ;hr.9 le ASSESSOR'S MAP&PARCEL /0 .,INSTALLER'S NAME&PHONE NO. _0D%JC IG-S f aw4/-4 EN, C SEPTIC TANK CAPACITY LEACHING FACILITY:(type) fG 36 N -DL13 (size) 2 t W e'.^1C�X-s NO.OF BEDROOMS X d)C fZ' . 15 t ,twi5 a�i•F- L f : P Lce +✓° OWNER w c.A& PERMIT DATE: COMPLIANCE DATE: .Separation Distance Between the: Maximum Adjusted Groundwater.Table to the Bottom of Leaching Facility: Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands`exist within 300 feet of leachin ility) �D� Feet FURNISHED BY i 3 O > -s.t 2 Cr�S 5'eO 3 r ����� 0� %Aoo Se f - Town of Barnstable Regulatory Services Thomas F. Geiler,Director R Public Health Division N Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 1 Fax: 508-790-6304 Date: ti �Z, t Sewage Permit# — Assessor's Map/Parcel 10 Cf` rz_1 Installer&Designer Certification Form Designer: k C . Installer: 91A • 9'f6 '_A Y,C. Address: n W. Crer 4 s+r�-L 1 cal 0-� Address: C'Pg.a- ^A At MP-.0&23. On �' � was issued a permit to install a (date) (installer) �� septic system at �� �/ '.- " , 5?7' based on a design drawn by (address) f e�-erg) �1 C.�►�!-�,e Z' E . dated (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. Stripout (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-built by designer to follow. Stripout(if required) was inspected and the soils were found satisfactory. oF�i,�sscy 9 % L� PETER T. G . (Installers Signature) o WEN TEE � CIVIL -0 9 No.35109 a( (Ros—igner's Signature) (Affix De e) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISI N. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH FORM AND AS- BUILT C 12D ARE RECEIVED By THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAofrice formAdesipercertification form.doc TRANS::Nf ..::. APPLICANT: ADDRESS:: �' ��e +�r�-e - DESIGN FLOW: U. gpd REVIEWED;BY: eC.w c DATE: 1 �-LIIG N/A,. OK NO. . . .. o Ili 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 13.10 CMR 15..220 4 b System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is re ired 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)(p] ✓ daily flow septic tank ca aci (required andprovided) soil absorption s :stem(required andprovided) whether system designed for garbage grinder ✓ North arrow 310 CMR 15.220 4 Existingand ro osed contours 310 CMR 15.220 4 Location and lo$' of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)N] Names of soil evaluator and BOH representative [310 CMR 15.220 4 h and i Location and dale of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? 310 CMR 15,242 Certification statement by Soil Evaluator 310 CMR 15.220 4 Observed and Adjusted groundwater (method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.22 4 n Address Sheet 1.of 9 N/A OK Nn;- Location of every water supply, public and private, [310 CMR 15.220(4)(k)] within 400'feet of the proposed system location in the case of surface water su _,lies and gravel eked ublc.water su _1 within 250 feet of the proposed,s stem location in the case f within 150 feet of the:proposed system location in the case of private.water wells Location:of'all surface waters and wetlands located up to 100 ft. beyond setbacks lasted in 310 CM . :15 211=,and any catch.basins located within SQ_ft, 310 CMR 15120 4 ;1 Water hnes and other subsurface utilities located [310 CMR 15.220 4 m _at line cross see 310 CNfR 1°5 211 1 1 er Profile of-system>sh©wing invert elevations of al1_system,. cgin `onei ts'and Bottom.of the SAS 31.0CMZl522. . 04 Stam of de'si `er 310 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 perniitted in 31.0 CNM 15.102(2}or as approved for an u ,de under LUA at 3 l 0-CN - 15 4'05 1 °k Test hole-adequate to demonstrate four feet of suitable.material? 310 CMR 15.12. 3.4 Test Holes.adeq}�ate..to.confirm.adequate groundwater separation? 3;10 CMR 1,1,5 101 3 Benclmazk within50 75.' ofs:, tem. .3a O.CMR,15,22{� Materials.specifications-noted?Ivanous sections of 310 CMR 15.000 System compongAts not> 36" deep(unless.Locai Upgrade Aoproval or L Angnested) 310 CMR 15A05 .1 V . Address Sheet 2 of 0 r 'l N/A OK NO Size OK? 310 CMR 15.223 1 Inlet tee located ten inches below flow line 310 CMR 15.227 6 7 Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 - 7 CMR 15.227 6 Outlet tee with gas baffle or approved filter 310 CMR 15.227 4 Note regarding irAsta trdon vn 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 descried 3 1-0 CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k Minimum cover V(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 Three access c'oyers (inlet and outlet must be 20" or greater) - e �� middle access at least 8 7/07 310 CMR 15.228L2)] Access to within'6 of grade - one port for systems<1 O00gpd, two for stems;>1000 gpd 310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? `[310 CMR 15.228 2 > 10 ft from buffoing foundation 310 CMR 15.211 1 Buoyancy calculation Required/Done 310 CMR 15.221 .8. H-20 Where a ro riate? 310 CMR 15.226 3 Setbacks from resources 1310 CMR 15.211 Required when gther than single-family dwelling or flow>1000 d 310 CMR 15.223(1 First compartment 200O10 daily flow; Second compartment 1000M, daily flow 310 CNM 1.5..22 2 .and -3 "U".pipe through or over baffle, outlet of each compartment with as baffle or approved filter 310 CMR 15,224(4)] Address, Sheet 3 of 9 J_.. 1 N/A OK NO Located at least ten feet from any water line? [31.0 CMR 13.222(2)]. Disposal piping 4t least 18" below water line(when water and sewer cross .see 310 CMR 15.211 i 1 Cleanouts r 'wired/ rowided ? 310 CMR 15.222 8 Thrust blocks s ed in forge mains? 310 CMR 15.221 6 c Slope of sewer brie not less than 0.01 (1/8"/ft) 0.02 preferable 3:10CMR15.22(6 Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) 310 CMR 15.251 9 and 310 CMR 15.251(2)(c)] Siphonproblem/ eachfieid below punip chamber. End*' or vein manifold ed? Sie and orientation of discharge holes.speafied?.(not smaller than 3/8" not larger than.5/8") [310 CMR 15.251(8) and 310 CMR 15.252 2 Materials specified (310 CMR 15.251(5) specifies various pipe tYPO§'all Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffie tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer) [310 ,✓ CMR 15.323 3 a Riser if4 ;er than 9" 310 CMR 15:232 Inside mitumum dimension 12" 3.10 CMR 15.232(2)(b Minimum 310 CMR 15.232 3 e Watertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.23 2 3 d Capacity(en`tergency storage above workinr.design Clow)?'[3107 pro er setbacks. 310 CMR 15.211 same as tic tanks watertight 20'-in in�nium access njanhole 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 s pecified? Exceeds two unio must have two pumps operating in lead-lag mode. 31.0 CMS 15.231(6) and 8 Stable Cp *.Base 1310 CMR.15.221(2)] Address Sheet 4"of 9 Buo an c lc; ads needed ?Provided? 31.0 C11RR 15.221(8 t�� l is !. t f Address I N/A OK NO Calculations corroct? 4 feet of naturally occurring material demonstrated? [310 CMR 7777 15.24 1 Required s aration to_groundwater? 310 CMR 15.212 Aggregate specified as double washed 310 CNRR 15.247(7)] System Venting requim&pr-ovided?-(system under driveway or >36" d 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 Doc ent 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 4j/ tograde) 310 CMR 15.253 2 Aggregate 1' minimum- 4' maximum: 310 CMR 15.253 l 2' sidewall credit maximum 310 CMR 15.253 1 a In bed configuration, inlet evei. 40 . ft. r310 CMR 15.253 6 Width 2' minimum 3' maximum 310 CMR 15.251 1 v 100 feet -maximum len h 310 CMR 15.251 1 a Minimum separation 2x effective depth or width whichever greater f Ll--/ 3x if reserve between trenches 310 CMR 251 1 d Situated alon contours 310 CMR 15.251 2 Breakout OK? �10 CMR 15.211 1 jj4j and Guidance Document mminum 2.distribution lines 310 CNIR 15.252(2)(a)] Maximum se aratibn between lines 6' .310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252 2 Aggregate depth below discharge pipes 6" minimum, 12p maxirimtim; 310 CNa 15.252 2 S aration betwe s 10, mi um. 310 CM R 15.252 2 Bottom area UW4 in calculations onl 310 CNIlt 15,252(2)(i)] Sheet 6.of 9 ' Address. Pressure Dosed Syvtem ? Provided pump and piping calculations CIX as r aired 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 UA Remedial UseApprovals] 77 If used in gravellyss system-make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd)or quarterly >2000 dgood to note on lan 310 CMR 15,254(2)(d)] Construction iniff -Did the plan specify that the fill shall meet the specification a 310 CMR 15.255 3 ? Impervious barrier and/or retaining wall ? Guidance Document Impervious ' installation must be supervised by designer 310 CMR 15.25 5 2 Retaining wall must be designed by Registered Professional En ' eer 310 gM 15.255 2 a Side slope not exceed 3:1 ? 310 CMR 15.255 2 Breakout re4uirrements met?[310 CMR 15.252(2)and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended 10 CMR 15.255 2 e Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? 17/ Is the technology being properly applied and does it meet all C, DEP Approval Conditions? Is there a�ote on the plan regarding the requirement for etual maintenanceagreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has , submitted a COPY of a maintenance Bement? Are the variances listed on the [ plan ? 310 CMR 15.220 P 4 RLS Stamp;-necessary on plan if a component is within five feet of ro a 310 CMR 15.412 4 ':Addis§ ;St:7 of 9 S ' �,�����s�aron�or rncreas�d flow proposed - [��fer to 3.10 A , N .....v: a .. .. f ` P tdldINi N/A OK NO. 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 15.210 - also efer to Policy regarding upgrades of such wdsting systems] Is the system proposed on the same lot as served by private well ? 310 CMR 15.2.1-4 2 Aree the nitrogen loads proposed in compliance? [310 CMR 15.2.1 1 Pum in to s tic tank 310 CMR 15.229 Shared S stem �1-CMR 15.290 IN 1 i l Address Sheet 9.of 9 jj No. (��16 00� Fee t%V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitatlon for Oisposal Opstem Construitlori permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Co G Y-C I p a0)p Owner's Name,Address,and Tel.No. l. PNSiCb`Y Assessor's Map/Parcel �lS+ 6�ici _ Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ca! i Type o Building: Dwelling No.of Bedrooms Lot Size 3:K;26o sq.ft. Garbage Grinder( ) Other Type of Building (� 5 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) "3 '50 gpd Design flow provided 13 Y . 3 gpd Plan Date Number of sheets 'y Revision Date Title Size of Septic Tank i eXj5j-tQ1J r 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 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. Signed Date Application Approved by `- Date�L Application Disapproved by U Date for the following reasons Permit No. 02 C)1 0 60 Date Issued �'—e� 10 'r-'r.'r".'M�"^'N'''n„++aw'n,v..3''w�.s:}�*Ord,n.]W,ar9'Fu1re..a:F'.J�'R7x^h�x+..I'^-. .. __...:. �"'"�_sn:;,!'a,y,,,4;,�;,�. .: 1 -t�r..r..,' r:ii.�'.` i"...n n:-a.�-•�.,•i No. �G 004 Fee /VV THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS' - ftprication for bi p aY 6pstem Construction permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. G G )(r}+I e,n01 ro R Owner's Name,Address,and Tel.No. Assessor's MaMap/Parcell�rs+ I& b1 rcel 1 q . I Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. A Q 1 !2 --7 1S'C, Type of'Building: - v Dwelling No.of Bedrooms 3 Lot Size '3 C{p r,n sq.ft. Garbage Grinder( )_ Other Type of Building ► 6,,at No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided -3 t-//,. 2) gpd Plan Date //7//0 Number of sheeis qt=, Revision Date Title Size of Septic Tank 1 r c,9-,ti Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 4AX�e- )� Mlou)S� , r - 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. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. (9 0(O " 6L Date Issued J 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 ./,,��1,4 c �,.� ,�; at ,k7e-l' IA,41ir.✓Sfx��� has been constructed in accordance l with the provisions of Title 5 an..ddt�the for Disposal System Construction Permit No.a o!0 e� !dated —OG ^ j o Installer-- .4e Designer J w��i✓Yr�/w � /G' #bedrooms/ `', r Approved design�flo 3 !14, '3 gpd The issuance of this permit shall not be construed as a guarantee that the system witrfun3/t 0h as designed. Date 11 1.)-1 (,� Inspector �/ ) Al! Fee Doc No.-1t, d '� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Nsposal 6pste/construction 3permit Permission is hereby granted to Construct //( ) Repair((,r) Upgrade( ) Abandon( ) System located at � "S i- 44- 464 6< and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. 6N Date 1" 9 "(c) Approved by No. Fee------- ------------ BOARD OF HEALTH TOWN OF BARNSTABLE Z.pplication for Well Conaruction Permit Applicatio is he e y made for a ot to �ut , Alter ( ), or Repair ( )an individual Well at: M if anon — ddress Assessors Map and Parcel Owner Address Installer — Driller Address Type of Bui ding Dwelling -----_—_�-.--_-__--- Other - Type of Building--____-__-_______ No. of Persons--------------_----_--. Type of WellCapacity—____--------------------_-__-- Purpose of Well- 00. _ --_-_—_-. 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 - - -- ---a fv 1 Application Approved By )�5 ____-- at . Application Disapproved for the following reasons: —.---------_—_-_—___—__—_— -____ �2 date _-_______-�__ _ �__-_____-___ Permit No. - ---- Issued---- - date --- --- - __ . . _ BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO C RTIFY, That the Ind'vidual Well Constructed (`Altered ( ), or Repaired ( ) by--- - -- - -__ -— - -- -------- tal12AO: at--- -- i --- 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. �/1�-�ated—----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUN TION SATISFACTORY. DATE Inspector y No. -� !_ // Fee-----f//✓�J-( ---�_ "7 BOARD OF HEALTH TOWN OF BARNSTABLE 01pplicat ion,forMelt Cootruct ion Permit Application is here y made E r a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: L anon - dd yE�- Assessors Map and ttY-"arcel I, Owner Address —r -------- --- - ��-� -1 s — — 3� Installer - Driller Y A dress Type of Bui ding Dwelling------ - _-—_ -_- - Other - Type of Budding-=—_—__—_______ No. of Persons-_ __-________—_�—_____. Type of Well - Q rH ?/.LI/.fI>-- -- Capacity—_------------------ --- Purpose of Well-Q,,.��^,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. Signed VApplication Approved By �, v-- __ (I� �'� /��,.� - ',ate f Application Disapproved for the following reasons:— ----------- ._ • � date Permit No. AQ14 - -- Issued--- � _!-.i ------ -------- date ------------------------------------------------------------------------------------------- - _ -- i BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (1--KAltered ( ), or Repaired ( ) bY--� �' — � Installer at____ _ ) r� has been installed in accordance with the provisionslof the Town ofBarnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. - —_---____--------- g PP � ��--�-�'I)ated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL 4 SYSTEM WILL FUNCTION SATISFACTORY. DATE _��1 ram____�_ / � - Inspector - ------_—______----------___--- -------------------- ------------------------------- ------ BOARD OF HEALTH TOWN OF BARNSTABLE Melt Con�tructionPermit No. -r-LLA✓ Fee Permission is hereby granted -t��Z Z I to Construct ( 0,46ter ( ), or epair ( ) an Individual - ual Well at- No. �� No. — - .- j �-5-, - -L- ----------------------------------------- "�-Stre- et as shown o the application for a Well Construction Permit 42 - No•-—`-� Dated- - ----------- .-.__ . "Boaz(of Health DATE j/ _ __ l Town Department of Regulatory servfees D><vi<sion Hate i 51 ie3y.: 200 Main Street,Hyannis>MA 02601 Date scheduled I c OAT Time _ Fee Pd. Soil"Suitability Assessment for Sewage Disposal Performed By tkf �L°•t �� Witnessed By; LOCATION&.GENERAL INFORMATION. y� t r Sa Ar e4 S t3 c Location Address te '<�e,k%e kJl�_ ",MWs Name "�` n 0 0rie. 1 (3 c..r'n> t c- �t aAddress �g 8 . C:t S 1- PetS� n�...�'` 9 1E0 i Assessors Map./Parcel: - p 3 r Engineer's Name NEW CONSTRUC`I;ION / REPAIR �_ Telephone# gQ-'7 3? —`i (Q Land Use S i°rPvt pia Slopes(%) `�Q Surface Stones Distances from: Open Water Body";�I 5V ft Possible Wet Area2 fri_ft Drinking Water Web _1.25t L,tt Drainage Way ( ft Property Line Sc - ft .Other Sf E ::(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in:proximity to holes)" `0 ;2 gParent,material(geologic) Depth to Bedrock .Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face - Estimated'SeasonaLHigh Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE- " - .. .r Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottlds, Depth to weeping from side of obs.hole: in, Groundwater AdJustment ft. index.Well.# Reading Date: Index Well level AdJ,factor, ,o„�: At({,.Ot'tlutidwater.Level. PERCOLATION TEST Date— xis Observation Hole# ( Time at 4" Depth of PerC: ��. C�f� �, eP Time at 6:. �...ir.,. _.....:. Start Pre-soak Time Q C. t 8 'TMme(V-6") End Pre-soak Rate Min./Inch Z 4,3 iM'V% Site Suitability Assessment. Site Passed _ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observtition Hole Data To Be Completed on Back---------- percolation test is to be,conducted within 100' tpf wetland,you must first notify the. Barnstable Conservation Division at least one(1)welk prior to beginning. Q:ISEPTICIPERCFORM.DOC DEEP.OBSERVrT'ION HOLE LOG Hole# Depth from Soil Horizon :. .. ..Soil Texture. soil"Color. Soil Other Surface(in:): (USDA) (Mansell) Mottling (Structure�Stones;Boulders. ;146 36-ce tr " G DEEP OBSERVATION HOLE LOG Hole# Depth-{rom Soil Horizon Soil Texture Soil Color. Soil Other n Boulders.: n Structure Sto es, u 11 Mottling ( �. rface tn. -USDA Manse g Su d '1_S 0.•. '1a C5 �S -ti p C5 2 7 _ DEEP OBSERVATION'HOLE LOG Hole# r.pepth from.. _ Soil Horizon- Soil Texture Soil Color. Soil Other Surface.(in.) _ (USDA] (Munsell)-` ' Mottling (Structure,Stones,Boulders.. DEEP 4BSERVATION`HOLE`LOG Hole# De th=from, SottHorizon Soil Texture Soii.Color Soli Other-: Munsell Mottling (Structure,Stones,Boulders. Surface(tn}' (USDA) ( ) Flood Insurance=Rate IYIau. �. �. - -- Aove S00 yeaF flood>Souridary No Y77777 es , "Wtthia 50U'year'boundary >r No Yes VJtthin 0 year flood boundary No Yes De th of Naturally Occurring Pervious Material Does at least four feet.of naturally occurring pervious m terial exist in all areiis.abserved throughoutthe area proposed for the soil absorption system? If`not;what is thud"eptli'of naturally occurring pecvio ma vial? t Ce eat ion , date I have assed he soil.evil uator examination approved by}the I cerafy that on ( ) p De�artinent of Enviro mental Protection and that the above analysis.was performed by me consistent with ttie rec}u Ted train nYg, se and experience described in .10 CMR 15.017 Signatore: Date • EP'1'IG1Pl3RCFORM:DOC M1`pF ri4tir CERTIFICATE OF ANALYSIS Page: Barnstable County Health Laboratory Report Prepared For: Report Dated: 3/8/2010 Douglas Colwell Order No.: G1056189 66 Kettlehole Road West Barnstable, MA 02668 Laboratory ID#: 1056189-01 Description: Water-Drinking Water Sample#: Sampling Location: 66TKettlehole Rd:W Barnsfable;_MAC Collected: 2/26/2010 �- --- Collected by: Customer Received: 2/26/2010 Test Parameters ITEM RESULT UNITS RL MCL Method# Analyst Tested Note Total Coliform 66(TNTC) CFu/IOOmL 0 0 MF-SM922213 . RG 2/26/2010 r:"µre ced /' lY r Rn !er% Ae!cffino is C rCCi?ii'Ziae%INGN%2'fNnei%i:J:i C:%2 ufiil:2 ..v 1. L'C.j 1�Z- 7.»ler ed dll�fo �.2jf1 !22 C d . reconiniended. Attached please find the laboratory certified parameter list. Approved By: (Lab rector) //Cl/2- r s4' e� t f p C t� sc� " OD M ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory Report Prepared For: Report Dated: 3/3/2010 Douglas Colwell Order No.: G1056183 66 Kettlehole Road West Barnstable, MA 02668 Laboratory ID#: 1056183-01 Description: Water-Drinking Water Sample#: Sampling Location;[-66-K&t-1Chole Rd.W-Barnstable,M—A7 Collected: 2/25/2010 Collected by: Customer Received: 2/25/2010 Routine ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen 2.4 mg/L 0.10 10 EPA 300.0 2/25/2010 CFp � er 0.I 1 mg/L 0.10 1.3 SM 3111 B 3/1/2010 Iron ND mg/L 0.10 0.3 SM 3111B 3/1/2010 Sodium 18 mg/L 1.0 20 SM 311113 3/I/2010 Total Coliform Present P/A 0 0 SM9223 2/25/2010 Conductance 160 umohs/cm 2.0 EPA 120.1 2/25/2010 pH 6.4 pH-units 0 SM 4500 H-B 2/25/2010 The recommended maximunt contamination level for drinking water exceeded due to Colifornt Bacteria Retesting is recommended. Attached please find the laboratory certified parameter list. Approved By' (Lab rector) L ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory tc,f.t,t•, � , Report Dated: 4/21/2005 Report Prepared For: Cindy Lee Caldwell Order No.: G0529774 ,.CB Joly,McAbee&Weinert Realty 1025 Main Street ; West Barnstable, MA 02668 Laboratory ID#: 0529774-01 Description: Water-Drijildng Water Sample#: 29774 Sampling Location: 66 Kettlehole Rd.W.Banistable,MA Collected: 4/19/2005 Collected by: C.L.Caldwell Map 109 Parcel 31 Received: 4/19/2005 Routine ITEM RESULT UNITS RL MCL Method# Tested LAB: Inorganics Nitrate as Nitrogen BRL mg/L 0.10 10 EPA 300.0 4/19/2005 LAB: Metals Copper BRL mg/L 0.10 1.3 SM 311113 4/21/2005 Iron 1.6 mg/L 0.10 0.3 SM 311113 4/21/2005 Sodium 9.7 mg/L 1.0 20 SM 311113 4/21/2005 LAB: Microbiology Total Coliform Absent P/A 0 Absent 309 4/19/2005 LAB: Physical Chemistry Conductance 110 umohs/cm 1.0 EPA 120.1 4/19/2005 pH 6.9 pH-units 0 EPA 150.1 4/19/2005 Sample has higher than average levels of Iron that may have cosmetic effects(such as tooth or skin discoloration)or aesthetic effects(such as taste,odor, or color)of the drinking water. Approved By: 'dam (L Director) RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 - I COM ONTWEALTH OF',1NWSAC RjSETTS EXE Ct3TIY-E OFFICE OF EN VIRON'NIEN-T-A L AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION s - RCEt. DEC 14 2004 T TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLL"NiiTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A R R CERTIFICATION Property Address: 'E - LX o � Owner's Name: A =' e ' Owner's Address: O �F' Date of Inspection: -- - Name of Inspectonrt( lease tint) +Cyl t Company Name:, rlfRl�6t�KS Mailing Address: O Telephone Number. CERTIFICATION STATEMENT m at this address and that the information reported I certify that I have personally inspected the sewage disposal system below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my function and maintenance of on site sewage disposal systems.I am a DEP training and experience in the proper approved system inspector pursuant to Section 15-w of Title 5 010 CMR 15.0003• The system: �( Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Date: Inspector'g Signature: 8 The system inspector snail submit a copy of this inspection report to the Approving Authority(Board of Health or il.-1. i�g this won-If the system is a shared system or has a design flow of 10,000 DEP)within 3f1 days of co gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the owner and copies sent to the buyer,if applicable,and the approving DEP.The original should be sent to the system authority. Notes and Comments ****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. Title 5 Inspection Form 6/152000 page 1 Pace 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR`4�OLUNTATt FORM SUBSURFACE SEWAGE D SYSTEM INSPECTION . PART A CERTIFICATION (continued) Property Address: Owner;_ Alt) a.eP dtt�a Date of Immspection- Inspection Summary Check A,%C D or E P ALWAYS complete all of Section D A. System Passes: 1 have-not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Pssm'- one or more system components as desc7 tbed in the"Conditional Pass'sect' i}c-ed to be replaced or Y The � n completion the replacement or repair,as approved the Board of HeaW tivi11 P Answer yes,no or not determined(Y,N,ND)in the for the folio ' statements_if`snot determined"please explain- Ile septic tank is metal and over 20 years old'`"the c tank(Whether metal or not)is will won if the unsound,exhibits substantial infiltration or odd ation or failurre is i System tank as' Quad by the Board of Health. }lance existing tank is replaced with a complying�� Sound,not leaking and if a Certificate of Comp 'A metal septic tank will pass inspection if it is indicatingthat the tank is less than 20 years old is a le. ND explain: pbservation of sewage backup or oW orb s water level in the dismbution box due to broken or or uneven demon box System Will pass inspection if(with obstnx�d pipe(s)or due to a broken, approval of Board of;Health): ems)We isremoved distnlafim box is leveled or rep laced ND explain: The system r emir PiftPing more than 4 times a year due to broken or obstructed pipe(s)-The system will pass inspection if(with oval of the Board OfHeahh): bi } pipes)are replaced obstruction is removed ND explain: 2 Page 3 of l 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSMMI EN-"7S SUBSURFACE SENVACE DISPOSAL- SYSTEM INSPECTION FORM PART A l( CERTIFICATION(continued) Propertw'4Address: e.T t C `� owner_ t"Date of tion: C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to de ire if the system is failing to protect public health,safety or the environment_ 1. System will pass illness Board of Health determines in accordance with 31 MR 15.303(I)(b)that the system is not functioning in a manner which will protect public health, ety 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 w or a salt marsh 2. System will fail unless the Board of Health(and P is rater Supplier,if any)determines that the system is functioning in h manner that protects the I? _lic health,safety and environment: The system has a septic tank and soil abso 'on system(SAS)and the SAS is within i 00 feet of a surface water supply or tributary to a surface supply _ The system has a septic etc and SA acid the SAS is within a Zore 1 of a public water supply- _ The system has a septic tank and AS and the SAS is within 50 feet of a private water supply well. _ The system has aseptic tank d SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**.M od used to determine distance "This system passes if the e11 water analysis,performed at a DEP certified laboratory,for conform bacteria and volatile o c compounds indicates that the well is free from pollution tn dW provided that other ity and the presence of ammo ' nitrogen and nitrate nitrogen is equal to or less than 5 pp , failure criteria are tri Bred.A copy of the analysis must be attached to this form. 3. Othe . 3 Page 4 of l l ON FOB--.NOT-FOR VOLUWARY ASSESSMENTS oF�[C�nvSPECTY = SUBSURFACE SEWAGE D EAL SYSTEM INSPECTION FORM 'FART CMTMCATIb (continued) property Address: �b fawner. Date of Inspeetuon:D. System Failure Criteria applicable to all systems: You must indicate"yes"or"nor to each of the following for Wmoons: Yes No ged SAS or cesspool Backup of sewage into f9kility or system component dote overloaded or clog Discharge or ponding of effl►ient to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ed SAS or Static liquid level in the distribution — box above outlet invert due to an overloaded or clogged cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than'/,day flow Requked pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s)-Number of times pumped water elevation. An portion of the SAS,cesspool or privy is below high ground y portion i or tributary to a surface Any portion of cesspool or privy is within l00 feet of a surface water supply water supply. _ Any portion of a cesspool os privy is wig a Zone 1 of a public well. l well- Any portion of a cesspool or privy is whin So feet of a private water supply Any portion of acesspool or privy is less than 100 feet but greater than S0 feet from a private waxer -`~ supply well with no acceptable water gwbty analysis.hissystem paste of the well water analysis, performed at a DEP certified laboratory, indicates bacteria and volatile organic,co s indicates that the well is free from pollution from that facility and the Presence of anemones nitrogen and nitrate nitrogen is equat la or less&an 5. ,Provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails.I have determined that one or more of the above faihere criteria exist as described in 310 CNM 15.303,therefore the system fails.The system owner should cone=the Board of Health to determine what will be correct the failure. E. Lame Systems: now of 10,000 gpd to MOW To be considered a large system the system must serve a with a design lam- you must indicate either`yes to the criteria above) (The following criteria apply to large systems in yes no water supply — the system is within 400 f a surface drink>ug — the system is whin/,2 feet of a tnburtary to a surface drinking`eater supply — the system is 1 in a nitrogen sensitive area(Interim Wellhead Protection Area-1WPA)or a mapped Zone II of a p lic water supply well es"to any question in Section E sate system is considered a significant tl�,or answered If you have ti of anylarge stem considered a "yes"in Sectio above the large system has failed,The owner or operae b �' ce with 310 CUR �ificant under Section E or failed under Section D shall upgrade the system in accord 15.304. system owner should contact the appropriate regional office of the DepartmCut- 4 Page 5 of 11 INPECnON FORM—NOT FOR VOLUNTARY ASSESSMENTS O FiCIAL MN F®Fy SUBSURFACE SEWAGEILSpOSAL$ P FAR CHECKLIST property Address'_ 1 Owner. a to Date of Inspection• --- as to each of the following: Check if the_folio have been dose.You nnnst indit�te •�"ar`ono" Yes No lumping information was provided by the ownu,occupant,or Board of Health I Were any of the system components p out in the previous two weeks' .__.. Has the system received normal flows in the previous two week period? _ 6( Have large volumes of water been i wAxed to the system recently or as part of this ink? dT 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? manholes uncovered,opened,and the interior of the tank inspected for the condition Were the septic tank m depth of liquid,depth of sludge and depth of scum of the baffles or tees,material of construction,dimensions, q _ Was the facility owner and erent fit»owner)provided with information on the proper in erar_ce of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined bad on; Yes no jK gxisting 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 zs unacceptable)p 10 CMR 15.302(3)(b)] C f Page 6 of 11 OFFICIAI,INSPFCTIQN FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAR. SYSTEM I?�IFORMATION Property Address: V/9 Owner- Date of Inspection_ FLOW CONDITIONS RESIDENTIAL aj Number of bedrooms(design): 3 Number of bedrooms(actual): IaD DESIGN flow based on 310 CNrIR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: Q _ ,Does residence have a garbage grinder(yes or no): 00 Is laundry on a separate sewage system(yes or no): [if yes separate inspection required] Laundry system inspected(yes or no):U1 Seasonal use:(yes or no): AV Water meter readings,if available(Iasi 2 years usage(gpd)): Sump pump(yes or no): / 6 Last date of occupancy: COMMERCIAL/INIDUSTRIAL Type of esta/tbe): t: and Design flow n 310 CMR 15 3): Basis of desi (sea etc.): Grease trap (yes-or Industrial wing present(yes or no)- Non-sanitardi ged to the Title 5 system(yes or no):— Water meter ,if available: Last date ofcy/use:_�^,_OTHER(d : GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspectior.(yes or no): d or llons—How was quantity pumped determined? If yes,volume pumped: Reason for pumping: TYPE OF SYSTEM 9( Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool Privy_Shared system Lees of no)(if yes,attach previous inspection records,if any) a copy of the current operation and maintenance contract(to be Innovative/AIternative technology.Attach o_btained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe): _ Approximate age of all components,date installed(if known)and source of information: �5 Were sewage odors detected when arrivin;at the site(yes or no): 6 page 7 of I l OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESS INTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR NI PART C SYSTEM INFORMATION(continued) Property Address- �6 ealWe We Pe Owner:/ b� Date of Inspection: BUILDING SEWER(locate on site plan) Depth below grade: a Materials of construction:—cast iron -40 pVC other(explain): uc (Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc-): SEPTIC TANK: OC (locate on site plan) Depth below grade: t t lass olyeth lene Material of construction: IC concrete metal fiberg ,p y other(explain) If tank is metal list age: Is age confirmed by a Certificate of compliance(yes or iio)° (attach a copy of certificate) Dimensions: 100 O51�f Sludge depth: /a � a Distance from top of sludge to bottom of outlet tee or baffle: . Scum thickness: I it Distance from top of scum to top of outlet tee or baffle: 7 S N Distance from bottom of scum to bottom of outlet tee or baffle: I How were dimensions determined: L'[t / > Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural antegrity,liquid levels as related to outlet invert,evidence of 1 tre, tc.): L i V"�' uJ c. tit°c- aEJI GREASE TRAP: (locate on site plan) Depth below grade:— _other Material of construction:_concrete metal berglass__polyethylene (explain): Dimensions: Scum thickness: Distance from top of scum to top outlet tee or battle: Distance from bottom of sc o bottom of outlet tee or baffle: Date of last pumping: g Comments(on pumping endations,inlet and outlet tee or baffle condition,structural integrity,li q uid levels as related to outlet'in v ,evidence of leakage,etc.): 7 Page 8 of I I OFFICIAL.INSPECTION FORM—NO I'FOR vO3LID A3E�Y ASSESS�S SIBSURFA.ClE SEWAGE DISPOSAL SYST M INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner, J t.—O t Date of Inspeet'son: �, TIGHT or HOLDING TANK.• (tank must uanped at fine of inspection)(iocate on site plan) Depth below grade: other(expl�)= Material of construction: concrete metal fiberglass___polyethylene dons: Capacity any Design Flow: ordd`y Alarm present(yes or no): Alarm level: A in working order(yes or no): Bate of last pumping: Comments(condition o alarm and float switches,etc.): DISTRIBUTION BOX- K (if Present must be opened)(Iorate on site plan) Depth of liquid level above outlet invert: G RK � evidence of solids carryover,any evidence of Comments(note if box is level and distribution to outlets equal,any leakage Nita r out of box,etc.): / .�,� .� �,� nb S ox WC4 �'2dU �C PUMP CHAMBER: (locate on site Pumps in working order(yes or Alarms in working order Comments(note condid f pump chamber,condition of pumps and appurtenances,etc_): 8 f Page 9 of I OFFICIAL.INSPECTION FORA.—NOT FOR VOLUNTARY ASSESSMENTS Sv�SLTPFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Propert4Addre4ss:- ! i!2Owner: SDate of SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) if SA$not located explain why: Type / leaching pits,number: l leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovativelaltemative system Type/name of technology: �, soil.condition of vegetation, Comments(note condition of sot,signs of hydraulic failure,level of ponding,dame r etc.): 4i 0- OD "t i cK CESSPOOLS (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet ihv - Depth of solids layer. . Depth of scum layer: Dimensions of ces Materials of co ion: Indication of gr dwater inflow(yes or no): Comments(n a 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 dition of soil,signs of hydraulic failure,level of pondin„condition of vegetation,etc_); 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PANT C SYSTEM INFORMATION(continued) Property Address• G �•2 t•t We 1(k Owner. 0 Rafe of inspection: O _ S10ETCH OF SEWAGE DISPOSAL,SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply ebters the building. R,eLkf- 7al 3'f9 Page I I of I I OFFICIAL.INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORIM PART C SYSTEM INFORMATION(continued) Property Address- Ito,[) �Ole fi Owner: u13 VS Bate of InspectionLEW SITE EXAM Slope �tl�o 0 Surface water I I(IU Check cellar i Shallow wells 4J D Estimated depth to ground water 0 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-if checked,date of design plan reviewed: Observed site(abutting propertylobservation hole within I50 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: c� Csas-� ` CERTIFICATE OF ANALYSILHEAL7 9 2 Page: 1 003 ,gssActnS�, Barnstable County Health Laboratory HKN"+"""Resort Prepared For: Report Dated: 9/22/2003 H pEP71 I G 3 ' Order Number: G0322696 Nina Herman .l U '� 66 Kettlehole Rd. West Barnstable, MA 02668 Laboratory ID#: 0322696-01 Description: Water-Drinking Water Sample#: 22696 Sampling Location: 66 Kettlehole Rd.,West Barnstable Collected 9/4/2003 Collected by: N.Herman Received 9/4/2003 Routine ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates <0.1 mg/L 10 EPA 300.0 9/9/2003 LAB: Metals Copper <0.1 mg/L 1.3 SM 311113 9/18/2003 Iron 2.4 : mg/L 0.3 SM3111B 9/18/2003 Sodium 12 - mg/L _ 20 SM 3111B 9/18/2003 - LAB:Microbiology Total Coliform Absent P/A Absent 309 9/4/2003 LAB: Physical Chemistry Conductance 104 umohs/cm EPA 120.1 9/4/2003 pH 6.3 pH-units EPA 150.1 9/4/2003 Note: Based on the results of the parameters tested,the water is suitable for drinking,but may'present aesthetic problems(taste, -odor,staining)due to Iron Approved By: (Lab Director) 12- �3 �Kf,;•s.f - ri ♦ ., i �.'i1 • ' t Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 r� x 58,91 LEGEND N 60--_ __. ___ _._-.EXIS-TIN( LEA£-H-PI T00 60.49 �D 81' to rear pro_ perty-Iin`e- TO BE PUMPED, FILLED W/ - - 98 - EXISTING CONTOUR ` _BREq-- SAND.& ABANOONF J - _.____ �� LOCUS i KOU-T SETBACK TRENCH-2 _ --- - �62 x 100.98 EXISTING SPOT GRADE E1=63 -- - _ x _6�,,�59 - U UNDERGROUND WIRES 64x- ` �� @ - - ->64.02 EAKOU�.- .,_. , .1 �_�, G SERVICE SETBACK_- , ----------_-� 6 •' � T TRENCH--� __,� - `-` EXISTING GAS SE oa I EL=65 1 --�' 64" EXISTING WATER SERVICE 2..8 TR EXISTING WELL o z \tea - [_E�NCI�_ T or 68- [-]-- ----.---66.91 -- - r� TEST PIT 0/�'� a c 68.06. . g x 9Y_.::-. . x 68, - - BENCHMARK �F 2.8 -- ;,� ed e of clearin �,. - - - [TRNC - _ �+_ - -_ - 8 R 30 _I --__ _ �T s 70,39 10 _._ �� E.60 - 6 9 --- F - 6 =TP- _ - 2 7 yy 2 - 1 74 5'_.w -TP_ , kI __ .___.._ - �\ 74 (Lot 16) LOCUS MAP i PLAN.BK 2 PG 33 .NOT TO SCALE N _ _..- - -- _ 2 _ 72.99o _ n :t C 4 - <� r EXISTING SEPTIC- TANK. - - - - - - 78 C -00 N I , � --- --- -_- - - -----(ro REMAIN) \'R N GENERAL NOTES: _. �._� N - r, x7 75 A 7 TOP OF TANK, EL=73.1.O L---- _ '�6, 00 L -_..__.__. - - 1. ALL CHANGES TO THIS PLAN. MUST BE APPROVED BY THE LOCAL ` ... co '6r ' 'r' - - yNV(OUT)=71.77E("t/Ef�IFY) ) N BOARD OF HEALTH AND THE DESIGN ENGINEER. 8 - -- - --------- - -- _ - 6 - 2. ALL WORK•AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS ---- 79.57 /� - --- ------____-_.___ - BenChIrJCIr SP.f OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 81.27 -- SO-_---i -- _ `- _x REGULATIONS EXCEPT REQUESTED OW. �` LOCAL RULES AND REGU S E T AS STE BELOW: - - ---f --- - - --- - _ - �z `;- � - '�8 Orange PO/IJt�SOnOtUbe -310 CMR 15.405(1)(b): �4--- EL.=86.61 (Assumed, 1) max. cover.a S.A.S. shall be vented a�d rratedU�H 2O t, for 5' of l F,4- - �_______ ( - -- _ _s0-- --____ _ ^� ' . �� 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 86,61 C - _ X" �, TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE - - -- --- - 82.71� - 86 " S 0 _ - DESIGN ENGINEER. r X 8.8,1g OF o X_r- DECK j r- X 2 6G - x'92 8 7. (96 �` ��� M9SS9 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING + 93,92. ��, 4 1682 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 8 .5O ri'�'��'- i ' o PETER T. ENGINEER BEFORE CONSTRUCTION CONTINUES. cb / , ./ 92, 9287 a S:.ALL ELEVATIONS BASED ON ASSUMED DATUM: i ,F z? ` McENTEE I f/, i !/ i �' GARAGE/ x`.,92 68/�i 1 CIVIL. /% , / 8 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF i f /EXISTING-1//% / j / X 92.80 �; No: 35109 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF Coll: -'. / /r/' HOUSE 66 / �gyp/ 92 87 EO � HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. X'-9.2.04 i T.O.F.-98.46E �. I S LL �\ r SA X x i I ` `.8 F � 7. WATER SUPPLY, PROVIDED BY PRIVATE WELL: r - 94.57 / /%/ i/'is I 93.23 \ 6 Al 96,91 / '�' �� / ( DRIVE Y ` 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. �j'' 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE. RESTORED AS t _ 97,03 l, / i, f;i , --- \"'•8 �, �V AGREED UPON BY OWNER AND CONTRACTOR OR .AS OTHERWISE r 9�6b - J -94,10 4.29g4S 93. 0\\ �.� 8 I I DIRECTED BY THE APPROVING AUTHORITIES. r � 96, N/ 'y 97,46 `:ir�-� 4' (J 1 t 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY C THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING BRICK WAL � � -``� t - W96.6 t 36,62 9O CONSTRUCTION. . 8.08 G 1 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL. UNSUITABLE SOILS LOT 33 n \ X '97.6 �5 t��; `u `y A F. THE S.A.S. AND W - IN THE AREA BENEATH ND FOR 5' ON ALL SIDES 0 rn � , s T , r � _ _ REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 31 r r A PN 109 _ -\ , 97,91 kl- WELL `'� 12. AREAS REQUt� ���- UNSUITABLE MATERIALS S ALL BE f -- 35 200 S.F.t �\ 96.66 r a p�� 1� cD G INSPECTED BY HEALTH TO BACKKFF L-_ weer�;04 / �! 100.65X 100.60 �, LAMP �` G �8"_- 13. THIS PLAN IS D FOR SEPTIC SYSTEM PURPO'�ES ONLY AND 310 C' \�` ` , WELL Is NOT TO BE CONSIDERED A.PROPERTY LINE SURVEY. (5 ,� 1$b5008.95. �k `� 97,52 � `� PROPOSED SEPTIC SYSTEM UPGRADE PLAN X-100,44- N 05'56'48" E 98,2$J WEST BARN STABLE, MA x ---.-,x `1.00.14 97.8o z;�< 97,78 66 KETTLEHOLE ROAD, 99,63 100.00 edge of 99.79 _ - S97 51 ! Prepar cl for: D. A. Brown, Inc., P.O. Box 145, Centerville- MA 02632 pavement 98,41 97;42 TT uj Q d OWNER. OF RECORD Engineering. by: SCALE DRAWN JOB. No. I ^/ / ��/ / V�� ! ` n A D HINGHAM, THOMAS B TRS 1„_20' P.T.M. 239-09 BLAGDEN REALTY TRUST Engineering Works, Inc. 66 OAK NECK .ROAD 12 West Crossfield Road, .Forestdale, MA 02644 DATE CHECKED SHEET No. HYANNIS, MA 02601 (508) 477-5313. 1/7/10 P.T.M. 1 ` Of 2 t I Nk' iI gl i• A �ir�.'f1 Ge dr,,w v1 w,w cm ,,o _�_ 1 r l kav�. J X 58.91 LEGEND a N __ --TO P1�0 0,49 -81' to rear_ property-li'n'e TO BE PUMPED, FILLED W/ -- 98 -- EXISTING CONTOUR °` LOCUS SAND & ABANDONF -_-_-6 x 100.98 EXISTING SPOT GRADE -BRE9KQU.L�.ETBACK,_TRENCH_2 _ -------- r' --- rt 64X -_ EL-63 - ______ 2. _- X -6 U UNDERGROUND WIRES 64.02 Ai�Ob �EFBA �r ,� �., --------------- G EXISTING GAS SERVICE a 66__ V T EL=65 EH_1\ 35 - 6-EAg W EXISTING WATER SERVICE � 68--_ 2.8 __CTR N-- - __]__ `__'- ----`- •�-r-G'�---_ - - ---�� O EXISTING WELL o �� _- _ 68.06 .. e�. . . .x,66.91 :- ------ --------- TEST PIT °''R 0°` �` o� _ a 7 ___- 2j-8 --CrRNCI�i�j�` -- --- ge of clearing_-�,3 X 68 BENCHMARK R F 1 70.39 10'--i 69:6T1--30" _----------- _ ' O(/�'C ar Sf 72 TP\2 ? - - -- ------------- �\\,O 74 •_ TP - `--------�� G 33 (Lot 16) LOCUS MAP 3 N -_��_` _- --- -- --- `�\2 w PLAN BK 274/P NOT TO SCALE 76 r o 72,99 - --�� p I O O -__ t N - -� -`�� O EXISTING _SEPTIC-TANK X 4,77�� 0 0 78 `D -00 N ------ --- --('TO REMAIN) �� N GENERAL NOTES: r8 5.17 l TOP OF TANK, EL.=73.10f- ^'�E� 00 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL N �'76--- ------- ------ -7NV(OU�)=7-1.7�t(1/EkIFY) �) BOARD OF HEALTH AND THE DESIGN ENGINEER. 8 ��-- ---78- `------------ --------- �- -$. 6 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS - _ _____________ __ 79.57 �`� Benchmark Set OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 8127 \\� -_____-- --80-- ---- _ -_--- _ LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: $2r' ``\X-�30,21 _--- ---- - ---------- _ U` `80 - `_�8 Orange paint1sonotube -310 CMR 15.405(1)(b): .82--__-- _ __ - ---84- �� \ EL.=86.61 (Assumed) 1) A 2' variance to the 3' maximum cover requirement, for 5' of _ -------- - -_ �\ `�� max. cover. S.A.S. shall be vented and rated H-20. `. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR ' - --- �� X`�� TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE -_�6 86 61 ___- -------___ 82 71� S D X 88.18� �� `� `� \ `� �F DESIGN ENGINEER. �_� _ / ����` DECK '-� �'X 2-50"-X�92 8�a d'�?\ `� \ ���' M9ss9 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING / o X -f- 93,2�` `� ` `� � 4 1E82 y�`�Q CMG FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN cb "� �`89.5a 92, 9��`8,7 �`� �` o PETER T. ENGINEER BEFORE CONSTRUCTION CONTINUES. GARAGE � s0� �� �� McENTEE 5. ALL ELEVATIONS BASED- ON ASSUMED DATUM. f < x �92 68 CIVIL -92,35 EXISTING X �` \� \\ �� U No. 35109 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 92,87 92,80 / HOUSE (#66) THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF \� \�� \� �'fG/S1F� �Q HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 'I 92,04 '�,94 57X X T.O.F.-98.46± i �\\\ S LL 93,23 �\�� \`�\ \�`� \\86 F AL NG� 7. WATER SUPPLY PROVIDED BY PRIVATE WELL. d, O _J96.91 ( DRIVE Y 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. I 94,10 -94 X 93, 0 \ Zp8 � '� 9• ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 97,03 X y b 96 - 4 29 TS �\ t(� AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. cV( y 97,46 W �� �G,_ 94, \ �\ 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY a'I cam' Z �`�- C _-- -"`.\ `. `� `. THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING _ BRICK WAL 9 W' 96�6 >>� 7\6,62 �� `� O CONSTRUCTION. J LOT 33 \��\ G �'� �8 08 �� \`� ���� 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS X 97,6' w IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND r /( APN 109-31 C \�` \` �o�\` 92 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 97,91 WELZ 12. AREAS REQUI UNSUITABLE MATERIALS S ALL BE _ 35'200 S.F.f \` 96,66 a - _f p �� /- ----"��� � `� (j .� � INSPECTED BY�HEA�PARTMEN PRIOR TO BACK ILL_. IOleefi��7 � � PY` i 100.65X 100.60 LAMP G �3 _� 13. THIS PLAN IS 1� 5` DD FOR SEPTIC SYSTEM PURPOSES ONLY AND 310 C (D.82 �� WELL IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. 31 -1) ` 166<008,95 l� 9 7.5 2 PROPOSED SEPTIC SYSTEM UPGRADE PLAN iS.� 1 O,07 X ��� --X` 00 14 N 05'56'48" E 98.2aJ ��'� 97 80 S 7,78 \�� 66 KMLEHOLE ROAD, WEST BARNSTABLE, MA 99.63 100.00 edge of 7,51 p Inc., enterville, MA 02632 99,79 pavement � Prepared for: D. A. Brown, nc., P.O. Box 145, 98.41 97.42 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. KETTLEHOLE ROAD HINGHAM, THOMAS B TRS Engineering Works, Inc. 1"=20' P.T.M. 239-09 BLAGDEN REALTY TRUST 66 OAK NECK ROAD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. HYANNIS, MA 02601 (508) 477-5313 1/7/10 P.T.M. 1 Of 2 I - NOTE: TO PREVENT BREAKOUT, THE PROPOSED 2'8�__[TR NC FIEL.H69.0 (TRENCHGRADE L T BE LESS THAN: --7 EL.=67.0 (TRENCH-2) FENCE2. _ FOR A DISTANCE OF 15' AROUND THE CORNER 8 __[TRnJC SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. PERIMETER OF THE S.A.S. 16.4 bj 1[_]�_ INSTALL RISERS & COVERS OVER INLET & INSTALL INSPECTION PORT OVER END UNIT 30 OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT VENT 6. ' T.O.F. COVER SET TO 6" OF GRADE EXISTING F.G. EL.=75.0f F.G. EL: 68.0t F.G. EL: 69.0(MAX.) TRENCH-1 a R F.G. EL: 67.0(MAX.) TRENCH-2 MAINTAIN 2% GRADE (MIN.) OVER S.A.S. S* INSPECTION L = 25' L = 10'(MAX) ® S=1% (MIN.) ® S=1% (MIN.) PORT J - CENTER OF 4"SCH40 PVC 4"SCH40 PVC n J OUTLET 6" �• MANHOLE 10"I e" 10.38" TO o 0 14" EXISTING 48" LIQUID INVERT I I _ I LE�L ADD INV.=65.17 PROPOSED INV.=65.00 2 ROWS OF 6 UNITS AT 5.0'/UNIT)= 30' cns BAFFLE SOIL ABSORPTION SYSTEM. (PROFILE) INV.=71.77t D-BOX EXISTING 1/y/INLET TEE ESTABLISH VEGETATIVE COVER EXISTING SEPTIC TANK INV. EL.=64.54 TRENCH-1 BACKFILL WITH CLEAN NATIVE OR S.A.S.LAYOUT INV. EL.=62.54�TRENCH-2 PERC SAND TO TOP OF CHAMBERS F.G. EL.=67.0(MAX.) BENCHMARK F.G. EL.=69.0(MAX.) TRENCH-2A SONOTUBE NOTES: TRENCH-1 1) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE :;'�'• 1ON A -� (3) 5" DIA.OUTLETS I�s ONE BASE,NASALLY SPECIFIED ACNED101X INCH CMR 15.221(2)D TOP NV. EL.=64.54�TRENCH-13%62.54�TRENCH-2� 2) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTTOM EL.=63.67(TRENCH-1)/61.67(TRENCH-2) y Y 115.5- 6" `� a; 1 12" 3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 2.83' 2.83' t, AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 4' MIN. ABOVE BOTTOM OF 4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE T.P. EXCAVATION OR G.W. 5 7 Top View H-10 LOADING Section 2" INVERTS PRIOR TO CONSTRUCTION. NO G.W., EL=57.0 (TP-2) = EX MATERIAL ISTING ITABLE USE 2 ROWS OF 6-ADS Arc 36HC UNITS SEPTIC SYSTEM PROFILE IN TRENCH CONFIGURATION WITH NO STONE 63.25" TYPICAL SECTION N.T.S. 16" DESIGN CRITERIA SOIL LOG 34.5" DATE: JANUARY 6, 2010 (REF#12'810) NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER McENTEE PE 1 5 SOIL TEXTURAL CLASS: CLASS I WITNESS: DAVID STANTON R.S. HEALTH AGENT DESIGN PERCOLATION RATE: <5 MIN/IN ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH TOP VIEW DAILY FLOW: 330 G.P.D. 71.0 0", 69.0 0" so" A END CAP END CAP DESIGN FLOW: 330 G.P.D. SANDY LOAM i SANDY LOAM FRONT VIEW SIDE VIEW GARBAGE GRINDER: NO 70.0 10YR 4/2 12'1 68.0 10YR 4/2 12„ END CAP REAR/TOP VIEW LEACHING AREA REQUIRED: (330) = 445.9 S.F. BSANDY LOAM BSANDY LOAM NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW 74 10YR 5/8 10YR 5/8 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 68.0 36" 65.5 42" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. EXISTING SEPTIC TANK: 1000 GALLON CAPACITY C1 48„ c1 FINE LOAMYJ FINE LOAMY 11 4640 TRUEMAN BLVD - 1111111pp 10YR 6/4 6p" 10YR 6/4 LLuwPROPOSED D-BOX:: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED SAND PERC SAND ADVANCED DRANAGE SYSTEMS,INC. HILLIARD, OHIO 43026 UNITS 36HC STAMPED DETAIL 20 Zk 65.5 66'; 64.0 60" USE 2 ROWS OF 6-ADS Arc 36HC UNITS IN C C MED. SAND 7 MED. SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN_ TRENCH CONFIGURATION WITH NO STONE 2.5Y 6/4 2.5Y 6/4 61.0 C3 120" 59.0 C3 120" 66 KETTLEHOLE ROAD, WEST BARNSTABLE, MA (GENERAL USE APPROVAL FOR 7.80 SF/LF IN TRENCH CONFIGUATION) FINE SAND FINE SAND 2 x 30' TRENCHES = 60' 2.5Y 7/3 � 2.5Y 7/3 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 60' x 7.80 SF/LF = 468 SF 59.0 144' S7.0 144" Engineering by: SCALE DRAWN JOB. NO. En ineerin Works, Inc. NTS P.T.M. 239-09 DESIGN FLOW PROVIDED: 0.74(468.0 S.F.) = 346.3 G.P.D. PERC RATE 2.3 ±MIN/IN. ("Cl" HORIZON) g g NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. i (508) 477-5313 1/7/10 P.T.M. 2 Of 2 � -�--------- _ ___ x 58.91 LEGEND N -- 60--___ _ __EXIS-TING-L-EA-EH-PI fi6O 0.4 9 �a 1' to rear property-I-in`e- TO BE PUMPED, FILLED IN/ -- 98 -- EXISTING CONTOUR �o� SAND & ABANDON _-_ Goo o LOCUS E OU � _____ _,6 x 100.98 EXISTING SPOT GRADE,_ � - -- _--�- .SETBACK TRENCH_ - ------ 2 EL=63 - ___ _ x -6�,� - 62 PROPOSED CONTOUR 64 02 -'� - _ _____---____ Or U UNDERGROUND WIRES V E�T ENCH-14" \` Fro -- - �64 G EXISTING GAS SERVICE a a 66- -- �' 35---- ----- �� o _ 2.8 __-- _ - ��\ _ _____ _ NI EXISTING WATER SERVICE �oF ea 68-_-j_ - CTRE]NCI�=2C_]__ -- --- -- 66,91U6 ~\66 EXISTING WELL a�a i o \\ o . . . . ----- To/ _ TEST PIT �a 0 2.8 y 8.06.. . --edge of cleorin F3- - X 68, -----------. c 7 __ —�- --Cr_RNCI��1 _-�" BENCHMARK Ced _ G4 R �oQ\ r 70.930,TP-2 --- - -------------- ��/�'� 6 or 2 - - - - - ------- ----- 1�, �\.\) �. 0 74 �• w - TP ` __ --------- BK 274/PG 33 (Lot 16) LOCUS MAP �-- __ ____ - PLAN NOT TO SCALE -� = . Q o -o -x 4,77��j o o NOTES: Cb 00 N '� O EXISTING_SENTIC"TANK- 78 `° ao N �:.__ ------ ---- ------('TO REMAIN) 1 A N � GENERAL 0 Z _ J 7_5.17_ - TOP OF TANK, EL.=73.10_f- ''6\ aC � '� - - `-`--- -lN-V(OUY)=7-1�.77-f•-t/E'RIFY �� v� 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL _ ) ) BOARD OF HEALTH AND THE DESIGN ENGINEER. 8 \� _-_---- -7"0 - ---- ----------- -�� 6 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 11 _ _ __-----------__---- 79,57 `� Benchmark Set OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 81,27 _ __---- --80-- _---__ '-----X LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: r ---_ _ ---_ - --v�-__-_ --� ��� Orange paintlsonotube -310 CMR 15.405 1 b EL.=86.61 (Assumed)— 1) A 2' variance to the 3' maximum cover requirement, for 5' of -- ------------ �s---____- ___ �\ `� max. cover. S.A.S. shall be vented and rated H-20. _-O•---_-_____ �6� �� 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR -_06 86.61 _ _- - �� x`-�S TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 00 S ❑ ----- �� 8,2.7h� Q� DESIGN ENGINEER. x-88.18- / DECK ' -- �'X '2-60-----x-.�2 8� 48.E �� `� �\\' �F MASS9 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING -89.59 x -H 93,2�` ��� `.� �� ,� 4 1682 y�`�P �yG FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 92, 91`87 o PETER T. ENGINEER BEFORE CONSTRUCTION CONTINUES. COK D GARAGE �`� �0� �� \� McENTEE 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. x �92.68 CIVIL ___92.35 EXISTING x o N 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF ��• 92.87 92,80 �� `� \\ N 35109 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF `�'I �x"92.04 HOUSE (1#66) I �� �� oI, �'fG1S FREO HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. T.O.F.-98.46f \ e S LL \ 1 � � �- x x I � � � 6 S$ WATER SUPPLY PROVIDED BY PRIVATE WELL. - 94,57 I �� 93.23 \� J96.91 DRII/E Y �� 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. °rI - �` �� � 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS i - x 93 0 `. `88 U AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE ' /.bb 96 94,10 ` 4.2 994TS �� �` DIRECTED BY THE APPROVING AUTHORITIES. I /C ' ` r w/ 97.46� �V �• 94, \ o �-` C _ (/ . �� . I 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY Z - �u �`---- - ^ �`� �`� THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING BRICK WAL G� W 96.6 9,6.62 �� �� 90 CONSTRUCTION. \ XJ8.08 i r d / LOT 33 �� G `� x 97 6 a `� \ 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS APN 109-31 \� \ �"- - sr �`� \\ ' g IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND r r C J �� 2 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 35'200 S.F.t 97.91 WELZ`� \ 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE �/ -- —"� _ 96,66 INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL G i r 100.65x 100.60 �� LAMP G �9� �\ 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND \l 1 6.82 ��\ WELL IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. 166<008.95 97.52 , PROPOSED SEPTIC SYSTEM UPGRADE PLAN 07 0-4-- N 05'56'48" E 98.28J \` -------- x `100,14 �`7 97 80 ' 7,78 _,� 66 KETTLEHOLE ROAD, WEST BARNSTABLE, MA 99,63 100,00 edge of 99.79 pavement S 7,51 Prepared for: D. A: Brown, Inc., P.O. Box 145, Centerville, MA 02632 98,41 97.42 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. N0. KETTLEHOLE ROAD HINGHAM, THOMAS B TRS Engineering Works, Inc. 1"=20' P.T.M. 239-09 BLAGDEN REALTY TRUST 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. -PLAN REVISION-1/8f10 66 OAK NECK ROAD REVISE GRADING FOR BREAKOUT HYANNIS, MA 02601 (508) 477-5313 1/7/10 P.T.M. 1 Of 2 ' NOTE: TO PREVENT BREAKOUT, THE PROPOSED 2•8 }} �- FINISH GRADE SHALL NOT BE LESS THAN: ^ L-_EJR gn ff_2[_�_ EL.=69.0 (TRENCH-1) EL.=67.0 (TRENCH-2) _ OX FOR A DISTANCE OF 15' AROUND THE FENCE CORNER 2.11 __[TRRNC SEPTIC TANK PROPOSED D-B PROPOSED S.A.S. PERIMETER OF THE S.A.S. 16.4' INSTALL RISERS & COVERS OVER INLET & INSTALL INSPECTION PORT OVER END UNIT 30�, OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT VENT 6• ' TO COVER SET TO 6" OF GRADE EXISTINGF.G. EL.=75.Ot F.G. EL: 68.Of F.G. EL: 69.0 MAX. TRENCH-1 F A F.G. EL: 67.O�MAX,3 TRENCH-2 a 8S• tJ( MAINTAIN 2% GRADE (MIN.) OVER S.A.S. 6• r� j' u INSPECTION L = 25' L = 10'(MAX) PORT �p ® S=1% (MIN.) ® S=1% (MIN.) CENTER OF OUTLET 6., 4"SCH40 PVC 4"SCH40 PVC MANHOLE s" 7ER o 0 74 EXISTING 48" LIQUID ; LEVEL ADD INV.=65.17 PROPOSED INV.=65.00OWS OF 6 UNITS AT 5.0'/UNIT)= 30' GAS BAFFLEINV.=71J7t D-BOX ABSORPTION SYSTEM (PROFILEEXISTING yy/INLET TEEFLt EXISTING SEPTIC TANK TIVE COVERINV. EL.=64.54 TRENCH-1AN NATIVE OR S.A.S.LAYOUT INV. EL.=62.54�TRENCH-2) PERC SAND TO TOP OF CHAMBERS F.G. EL.=67.0(MAX.) BENCHMARK F.G. EL.=69.0(MAX.) TRENCH-2 SONOTUBE NOTES: TRENCH-1 1) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE : :;'< ;:: 1 ---� (3) 5" DIA.OUTLEfS 16^ STONE BASE,N SALLY SPECIIF EDA INE3101 CMR F15.221(2)D NV. EL.=64.54(TRENCH-1)/62.54(TRENCH-2� 2) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTTOM EL.=63.67(TRENCH-1)/61.67(TRENCH-2) 15.5" s" 12" 3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 2.83' 2.83 AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 4' MIN. ABOVE BOTTOM OF t 4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE T.P. EXCAVATION OR G.W. 5 7 Top View H-10 LOADING Section 2" INVERTS PRIOR TO CONSTRUCTION. NO G.W., EL=57.0 (TP-2) EXI MATERIAL STING ITABLE D-BOX USE 2 ROWS OF 6-ADS Arc 36HC UNITS SEPTIC SYSTEM PROFILE IN TRENCH CONFIGURATION WITH NO STONE 63.25" TYPICAL SECTION N.T.S. DESIGN CRITERIA SOIL` LOG ,6 34.5" DATE: JANUARY 6, 2010 (REF#12'810) NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER McENTEE PE SOIL TEXTURAL CLASS: CLASS I WITNESS: DAVID STANTON R.S. HEALTH AGENT DESIGN PERCOLATION RATE: <5 MIN/IN TOP VIEW ELEy. TP- 1 DEPTH ELEV. TP-2 DEPTH so" DAILY FLOW: 330 G.P.D. 71.0 A 0',' 69.0 O END CAP ENO CAP DESIGN FLOW: 330 G.P.D. SANDY LOAM SANDY LOAM FRONT VIEW SIDE VIEW GARBAGE GRINDER: NO 70:o B 10YR 4/2 12 68.0 B 10YR 4/2 12„ END CAP REAR/TOP MEW ' LEACHING AREA REQUIRED: (330) = 445.9 S.F. SANDY LOAM ; SANDY LOAM NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW 74 10YR 5/8 i 10YR 5/8 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 68.0 C1 361' 65.5 C1 42" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 48" FINE LOAMY FINE LOAMY 4640 TRUEMAN BLVD PROPOSED D-BOX:: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED SAND PERC SAND ADVANCED DRAINAGE SYSTEMS,INC,® HILLIARD, OHIO 43026 UNITS Are 36HC STAMPED DETAIL ak 10YR 6/4 60`' 10YR 6/4 65:5 C2 66' 64.0 C2 60" USE 2 ROWS OF 6-ADS Arc 36HC UNITS IN MED. SAND MED. SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN TRENCH CONFIGURATION WITH NO STONE 61•0 2.5Y 6/4 12o'" 59.0 2.5Y 6/4 120" 66 KETTLEHOLE ROAD, WEST BARNSTABLE, MA (GENERAL USE APPROVAL FOR 7.80 SF/LF IN TRENCH CONFIGUATION) C3 FINE SAND C3 FINE SAND= 7/3 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 2 x 30' TRENCHES 60' 2.5Y 7/3 NE 60' x 7.80 SF/LF = 468 SF 59.0 144 57.0 144" Engineering by: SCALE DRAWN JOB. NO. Engineering Works Inc. NTS P.T.M. 239-09 DESIGN FLOW PROVIDED: 0.74 468.0 S.F. - 346.3 G.P.D. PERC RATE 2.31MIN/IN, ("Cl" HORIZON) g 9 ( ) NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. } 477-5313 1/7/10 P.T.M. � (508) 2 of 2 i