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HomeMy WebLinkAbout0131 KETTLEHOLE ROAD - Health 131 KETTLEHOLE RD., W. BARNSTABLE A=109-057 1 TOWN OF BARNSTABLE LOCATION k-efi to ka I P R/3 . SEWAGE #,Q OV 0—'33 VII"LAGE ASSESSOR'S MAP& LOT10�'Ds 7 INSTALLER'S NAME&PHONE NO.—';�A%02/ze SEPTIC TANK CAPACITY © LEACHING FACILITY: (type) Z4;4c�.,4.a C LA4,4hee c (size) Gf SO© NO.OF BEDROOMS_ e s BUILDER OR OWNER f'fa f� PERMITDATE:—? COMPLIANCE DATE: g11Lo T 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) 2 Feet Edge of Wetland and Leaching Facility (If any wetlands exist /�Z da c1 L✓ within 300 feet of leaching facility) Feet Furnished by o ' �o use CrmQA 5 wf 3 'a-C s-re�c p Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ' 131 Kettlehole Road r M r•c Property Addressy Alfred &Catherine Schofield " a� Owner Owner's Name information is West Barnstable V MA 02668 April 6, 20185 required for every P page. City/Town State Zip Code Date of Inspectionw'4 r� Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information Q on the computer, use only the tab 1. Inspector: key to move your cursor-do not Jason C. Ellis use the return Name of Inspector key. J.C. Ellis Design Co. Inc. Company Name P.O. Box 81 Company Address few North Eastham MA 02651 CitylTown State Zip Code (508)240-2220 SI 3600 IRS 1126 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Ne dstFANROEvaluation by the Local Approving Authority �ni, s<_ ` �'� i April 6, 2018 I `'ecto s§i• a2ur' Date \c,.a,rFt�O The s step Inspector s all submit a copy of this inspection report to the Approving Authority(Board of Healf yor D: - ) I hin 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 Aril 6 2018 required for every p • , page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in satisfactory condition at time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 Aril 6, 2018 required for every p page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 i Commonwealth of Massachusetts H W Title 5 Official Inspection Form _ o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 April 6 required for every p 'il , 2018 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 Aril 6, 2018 required for every p page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: 0. ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 1 0,000g pd. ❑ S The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ® the system is within 400 feet of a surface drinking water supply ❑ ® the system is within 200 feet of a tributary to a surface drinking water supply ❑ ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 131 Kettlehole Road Property Address Alfred &Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 required for every April 6, 2018 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any,of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): .440 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f Commonwealth of Massachusetts w w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 Aril 6, 2018 required for every P page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage N/A- private well 9 ( Y 9 (gPd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: currentDate Commercial/Industrial Flow Conditions: Type of Establdshment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road III Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 required for every April 6, 2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): I General Information Pumping Records: Source of information: BOH Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 April 6, 2018 required for every p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 7-31-01 - BOH Records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): � Depth below grade: 1.5'feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10'+ p pp y feet Comments (on condition of joints, venting, evidence of leakage, etc.): Satisfactory condition Septic Tank(locate on site plan): Depth below grade: 1.2'feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallons Sludge depth: 12" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred &Catherine Schofield Owner Owner's Name information is required for every West Barnstable MA 02668 April 6, 2018 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 22" � Scum thickness 12" ' Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 2" How were dimensions determined? Direct observation -measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank was in satisfactory condition at time of inspection. Inlet 16" below grade; Outlet 13" below grade. Recommend pumping septic tank at this time. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred &Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 April 6, 2018 required for every P page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts F W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 131 Kettlehole Road Property Address Alfred &Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 April 6, 2018 required for every _ p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box is in satisfactory condition -22" below grade. Some solids carryover present Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No` Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 Aril 6, 2018 required for every P page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach area was in satisfactory condition at time of inspection - Dry at time of inspection. Chamber 40" below grade, lid 14" below grade. No evidence of failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts H Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary 0 olunta Assessments - 9 p Y Y M 131 Kettlehole Road Property Address Alfred &Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 April 6, 2018 required for every P page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): If Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 I Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 131 Kettlehole Road Property Address Alfred &Catherine Schofield Owner Owner's Name information is West Barnstable MA 02668 Aril 6, 2018 required for every p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately 3 / o z 3 s Se�Pr Ta+�c. i� 13) z S'•� ' O O JtYT1k1_ 7A.4L d,.;r zo.s' 27.5 ' Sc,-?«< 101 Eau-Jtr 40 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is required for every West Barnstable MA 02668 April 6, 2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 5'+ below leach area feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: David C. Thulin, P.E. 5-4-2000 Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers -(attach documentation) ® Accessed USGS database -explain: USGS topo and groundwater contour maps You must describe how you established the high ground water elevation: Test hole data on design plan show no groundwater 11.9' below grade. Before filing thus Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Kettlehole Road Property Address Alfred & Catherine Schofield Owner Owner's Name information is required for every West Barnstable MA 02668 April 6, 2018 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ❑ System Information— Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 I M CERTIFICATE OF ANALYSIS Page: Barnstable County Health Laboratory Report Prepared For: Report Dated: 4/22/2004 Order Number: G0424819 Alfred P.Schofield 131 Kettlehole Road West Barnstable, MA 02668 Laboratory ID#: 0424819-01 Description: Water-Drinking Water Sample#: 24819 Sampline Location: 131 Kettlehole Road W Barnstable MA Collected 4/16/2004 Collected by: A Schofield Received 4/16/2004 Test Parameters ITEM RESULT UNITS MDL MCL Method# Tested LAB: Microbiology Total Coliform Absent CFU/100mL 0 Absent 309 4/16/2004 Note: Water sample meets the recommended limits for drinking water of all the above tested parameters. Approved By:_ _� _ Director) RECEIVED APR 2 8 2004 TOWN OF 13ARNSTABLE HEALTH DEPT. Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 =` CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory 9ss�r'FtuS�'� Report Prepared For: Report Dated: 4/20/2004 Order Number: G0424650 Alfred P.Schofield 131 Kettlehole Road West Barnstable, MA 02668 Laboratory ID#: 0424650-01 Description: Water-Drinking Water Sample#: 24650 Sampling Location: 131 Kettlehole Road W Barnstable MA Collected 4/2/2004 -ollected bv: A Schofield Received 4/2/2004 6L Routine 0-01� ITEM RESULT UNITS 1V MCL Method# Tested LAB: IC Lab / Nitrates 2.4 mg/L 0.1 10 EPA 300.0 4/2/2004 LAB: Metals Copper 0.1 mg/L 0.1 1.3 SM 311113 4/5/2004 Iron <0.1 mg/L 0.1 0.3 SM 311 lB 4/5/2004 Sodium 18 mg/L 1.0 20 SM 3111E 4/5/2004 LAB: Microbiology Total Coliform Presents P/A 0 Absent 309 4/2/2004 Y r1' LAB: Physical Chemist =--J Conductance 190 umohs/cm 1 EPA 120.1 4/2/2004 pH ! 6.5 pH-units 0 EPA 150.1 4/2/2004 Note: Recommended maximum contamination level exceeded due to Coliform,Bacteria.Retesting is recommended.', Approved By: _ _ b Director) Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 No. Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t� Yes / 1 NUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for W9pozar *pgtem Construction joermit Application for a Permit to Construct( "Rep ( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1 3.j Owner's Name,Address and Tel No. 'W X t qai 57'7;(3 L6 CL i Fj:rb R-0 w 'P�7z(L`� Assessor's Ma /Parcel �®Y, 3(9 ' a Sr-L49L J q 1 S-7 L 5-}-AJ D W I C-44 ®3 3-7 Installer's (ame,Address,and Tel.No. Designer's Name,Address and Tel.No. 3co--T- rDa*Ey 1k 3 YS I I)Avi a -,i4u1,� T-OR-�-t1 QS) Q 11 m 1 u, U, : 5 b i OA537 I S Aw o w ► C5a5 ,7 Type of Building: Dwelling No.of Bedrooms Lot Size ka 9' sq.ft. Garbage Grinder( ) Other Type of Building SW6-t.E horn hk o. of Persons Showers(9) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date j L 2.6 c9 v Number of sheets Revision Date Title 1 Size of Septic Tank 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 Certifi- cate of Compliance has been issue his B d-of Healt Signed /4 Date v'1. o� O� Application Approved by Date o Application Disapproved f r the following reasons Permit No. Date Issued No Fee Y. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ry✓ UBLIC HEALTH DIVISION -TOWN,OF BARNSTABLES MASSACHUSETTS ZIPP�ftcatton for 0iopool *pgtetn Con3struction Permit F � ,4 Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ,t" j"g' Owner's Name,Address and Tel No. �r 1� u/ Lt415T7�I✓ l_1 F-fb R--0 'W Assessor's Map/Parcel 0 K 3oq Installer's r4ame,Address,and Tel.No. Designer's Name,Address and Tel.No. 71OW6el Qb i' all Yy I►L,c, ►� Type of Building: ' Dwelling' No.of Bedrooms Lott Size qkc g sq.ft. Garbage Grinder( ) Other Type of Building 15 06Lt: t:;?n) o.of Persons Showers(a Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date �4 1 2_d v o Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. of Sod Description Nature of Repairs or Alterations(Answer when applicable) � k 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 P Pe provisions of Title 5 of the Environmental Code and not to P Y lace the system in operation until a Certifi- cate of Compliance has been issue is wd of Health. Signed �' Date i O Application Approved by q, Date - � t Application Disapproved or the following reasons r ' Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTI , that the On-site Sewage Disposal System Constructed( Repaired( )Upgraded( ) Abandoned( )by �O at C WAO 4A � OW, s n has ben construct e ip accordance with the provisio s o� f Tjile.5 and the for Disposal System Construction Permit No. © ated 6 O Installer ��r�"t ���„J� Designer The issuance of this permits +not be constr -,d as a guarantee that the syst 11 f�ncf a esigne /— p Date , Inspector •�j� --------------------------------------- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION . BARNSTABLES MASSACHUSETTS ;Siopooar 6potem Conotruction Permit Permission is hereby jated 10 Co truct( e r( � U gra e( ALB ndon 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:Constructi n must be complete within three years of the date of thi ermih �' / i t f'.. Date: a Approved by .rx f ASSESSORS MAP NO• c PARCL NO: - Fee-----° - ------- BOARD OF HEALTH TOWN OF BARNSTABLE Applicat ion Ar Vell Con0ructionPermit Application is her by made for a permit to Construct (-`), Alter ( ), or Repair ( )an individual Well at: Xg- ----------- -- --- Location — Address Assessors Ma and Par I ---- ----------- Owner - Address Installer — Driller Address Type of Dwelling ----------------------------------------------- Other - Type of Building---------------------------- No. of Persons------------------------- ____—__—_______ Type of Well--,C=�! Il�XX - -— ------------- YP — --T - --------- Capacity-------------------—---------- ------ Purpose of Well - -- -- - ----- --- -------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance � hass1�been issued by the Board of Health. Signed date Application Approved By date _ Application Disapproved for the following reasons:— -------------------___—------ ------------------------_—_ ------ �,�� date Permit No. Issued date BOARD OF HEALTH TOWN OF BARNSTABLE Oc ertif irate Of Compunce THIS IS TO CERTIFY, That the Individual Well Constructed (,,), Altered ( ), or Repaired ( ) by----- - ---------- ----- 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 PenktAXoc�-Q`l�_�____ Q_Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE Inspector---——-- - - --- —------- No. y � - '---'-'�-- " . Fee----- ------- BOARD OF HEALTH' TOWN OF BARNSTABLE ' 1pplicat on Ar V el[ Cootruction joermit Application is hereby made4for a permit to Construct(-I, Alter'( ), or Repair ( )an individual.Well at: 4 Location Address;, Assessors Ma and Par el z Owner Address 9 1__-----------//Q.pi/ �/� ----- ----- - �i_r/ ----------—------—-----— Installer - Driller Address — Type of Bu_rld'in Dwelling ----------------------------------------------- j Other Type of Building -=- -- '- Type of Well Caacit No. of Persons---- ------------------ -------- - ------ p y---- - - --- - --a -- - r- Purpose of Well ------- - - ------- , i .: t.x 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 date Application Approved By -- date Application Disapproved for the following reasons:—=-------------- -------------�_�__-_____-�_— --_ -- ----------------------------------- ------ -------- *• date a Permit No.�v. — __ - - --- Issued:,_, '" - - _ _ s �- d'tfs a date !o!$!d!�,�Ei!4!i4.+Ei@iEo.Ea¢$4o Ob!qEa!�!�$itofb¢d!+�¢e4�rlrli9ETro'iEi'JiB:E,iI�,QE1�iYR3Erfi4 Eli:lil@BliRi�6EiDi Rn!$E$E47 Ea!I�GYiT�Se6E$?:.1L!4:EpEiii4N:.E$1$9�!4liE.liR p'sagi!NeE + BOARD OF HEALTH TOWN OF BARNSTABLE ` 1 Certificate Of Compliance THIS IS.TO CERTIFY, That the Individual Well Constructed (el), Altered ( ), or Repaired ( ) 4i stailler - -- - - at-- /� l" j � --------------------- --- ----- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Per AoV' --#9-0!- --Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE wa!i!iM$q$Eif!i¢d?iRePirV$Efi93b$Oi9YEbQ3QL7i in4iE64ign0iE.>Qi4'6P'ifpYliOH@4EiEY!$EiYi"R.nRfoRYEYQGF6@49 it;¢�'i7SmfEi4iE$E8•li9slY?s sib!�i!a?.tl4ioisia;et!$s�.¢$,a;!;¢E�.'yq'g7j{gx7!dsy:�� BOARD OF HEALTH TOWN OF BARNSTABLE 'vela Congtruct ion Permit No. ufug n IVC Fee � � 1/ram Permission is hereby granted to Construct (''), Alte Q�) Repair ( ) an Individual Well atStreet as shown on the application for a Well. Construction Permit No.- Dated -- Board of Health DATE— i ENVIROTECHLABORATORIES,INC. MA CERT.NO.:M-MA 063 449 Rre. 130 Sandwich, MA 02563 908(888-6460) 1-800-339-6460 FAX(908)888-6446 CLIENT. Meehan Wells LOCATION: 131 Kettle Hole Rd ADDRESS: (Cliff Perry) W Barnstable MA COLLECTED BY. Meehan Wells SAMPLE DATE. 6/1/2000 SAMPLE TIME. N/A WATER SAMPLE TYPE: New Well DATE RECEIVED: 6/1/2000 LAB I.D. #: 0006004 WELL SPECS.: 4"Well 63'/80' RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Anal �` Limits ' Coliform bacteria /100ml 0 0 9222 B 6/1/2000 PH pH units 6.5-8.5 6.35 4500 H+ 6/1/2000 Conductance umhos/cm 500 176 120.1 6/1/2000 Nitrate-N mg/L 10.0 1.73 300.0 6/1/2000 Nitrite-N mg/L 1.00 < 0.003 300.0 6/1/2000 Sodium mg/L 28.0 19.7 200.7 6/1/2000 Iron mg/L 0.3 0.040 200.7 6/1/2000 Manganese mg/L 0.05 0.024 200.7 6/1/2000 Volatile Organics ug/L See Report. Pending COMMENTS: pH is below recommended limit and may have corrosive characteristics. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES _ FOR PARAMETERS TESTED. <=less than Date >=greater than Rodeld J. Saari TNTC=too numerous to count Laboratory Dire4ffor h88 088 6446 Pd9C 004 Jf GROUNDWATER ANALYTICAL EPA Method 524.2 (Continued) Volatile Organics by GC/MS Field ID: 131 Kettle Hole Rd. Laboratory ID: 33578-01 Project: 131 Kettle Hole Rd. QC Batch ID: VM5-1245-W Client: Envirolech Sampled: 06-01-00 Container: 40mL VOA Vial Received: 06-01.00 Preservation: HCI/Cool Analyzed: 06-02-00 Matrix: Aqueous Dilution Factor: 1 Page: 2 of 2 rti L 96-18-4 --,-.-.l.,.2,,3-Trichloropropane u BRL g/L 0.5 n-Propylbenzene BRL 0.5 95-49-8 2-Chlorotoluene ug/L BRL ug/L 0.3 108-67-8 1,3,5-Tri;ethyl benzene BRL 0.5 1 0��34 � 4-Chlo'rotc I uene BRL U 0.5 --98-0&6 tert-Butylbenzene r BRL ug/L 0.5 95-63-6 1,2,4-Trimethyl benzene BRL ug/L 0.5 135-98-8 -sec-B, utylbenzene BRL ug/L 541-73-1 1, -Dichlorobenzene BRL ug/L 0.5 9947-6 44sopropyltoluene 8 R L. 0.5 10 1,41-DichlorobWzene BRIL ug' jH000 19/ e 95-50-1 0.5 I 1,2-Dichlorol6�nzene EIRL I ug/L 0.5 104-51-8 n-Butylbenzene 96-12-8 0 0.5 1,2-Dibromo-3-chloropropane - r - --: ---- BRL ---1— ug/L 0.5 i 1 120-82-1 1,2,4-Trichlorobenzene VL 0.5 BRL H 6- — ---- BRL 87-68-3 7; exachlo utadiene ' BRL -20-3 Naphthaleneug/L 0.5 1 91 .T u 0.5 :1 87-61-6 1,2,3-Trichlorobe—nzen-e­ BRL u _qp 1,2-Dichloro6erizene-c!4 102 % 70-130% 4-Bromofluorobenzene —0% 70-130% Method Reference: Methods for the Determination of Organic Compounds in Drinking Water,Supplement III,US EPA, EPA-6001R-95/131 (1995). Method Revision 4.0. Analyte list as derived from 40 C.F.R. 141-40 and 40 C.F.R.141.61,and additional analyte MTBE. Report Notations- BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample dilution and sample size. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532 i L/db 1-t:3Z:L14 -> bdH HHH b44b Yage HU3 GROUNDWATER ANALYTICAL EPA Method 524.2 Volatile Organics by GOMS Field ID: 131 Kettle Hole Rd. Laboratory ID: 33578-01 Project: 131 Kettle Hole Rd. QC Batch ID: VM5-1245-W Client: Envirotech Sampled: 06.01-00 Container: 40mL VOA Vial Received: 06-01-00 Preservation: HCI/Cool Analyzed: 06-02-00 Matrix: Aqueous Dilution Factor: 1 Page: 1 of 2 �'1SAthbCC � x - � h� Fr�� t,x= ^. _ PF�41C3t'1[Fft" a � 4. 1�tQ� iepOrhlig,Llflil 75-71-8 I Dichlorodifluoromethane BRL ug/L_ 0.5 _ _ i r74-87-3 Chloromethane BRL ug/l- 0.5 75-01-4 Vinyl Chloride BRL ug/L 0.5 74-83-9 I Bromomethane BRL ug/L 0.5 75-00-3 Chloroethane BRL ug/L 0.5 75-69-4 Trichlorofluoromethane BRL ug/L _ 0.5 35-4 75 _.-...._.... . . _ 1,1-Dichloroethene BRL ug/L 0.5 75 09-2 1 Meth lene Chloride BRL i ug/L t 0.5 156-60-5 trans l,2-Dich(oroethene j BRL I_ uglL i 0.5 1634-04-4 Methyl tert-butyl Ether(MTBE) BRL ug/L 0.5 75-34-3 I M-Dichloroethane BRL I ug/L I 0.5 590-20-7 2,2_Dichloropropane BRL ug/L 0.5 156.59-2 1 cis-1,2-Dichloroethene BRL ug/L I_ 0.5__ 74-97-5 Bromochloromethane - - - BRL j ug/L T 0.5 -_ 67-66-3 Chloroform 1 ug/L_ 0.5 71-55-6 - 1,1,1-Trichloroethane BRL ug/L 0.5 56.23-5 Carbon Tetrachloride BRL I ug/L 0.5 563-58-6 1,1-Dichloropropene - BRL I ug/L 0.5 71-43-2 Benzene BRL ug/L 0.5 F107-06-2 12-Dichloroethane BRL ug/L i 0.5 7901-6 Trichloroethene BRL ug/L 0.5 _ 78-87-5 j_1,2-Dichloropropane BRL ugh 0.5 7;59 -'3 Dibromomethane I BRL ug/L 0.5 75-274 Bromodichloromethane I BRL ug/L 0.5 10061-01-5 cis-1,3-Dichloropropene i BRL ug/L 0.5 I 108-88-3 Toluene BRL u L 0.5 10061-02-6 trans-1,3-Dichloropropene BRL ug/L 0.5 79-00-5 I 1,1,2-Trichlorcethane BRL ug/L 0.5 127-18-4 Tetrachloroethene BRL ug/L 0.5 i 142-25-9 i,3-Dichloropropane BRL ug/L 0.5 124-48-1 Dibromochloromethane i BRL ug/L 0.5 106-93-4 1,2-Dibromoethane _ _ BRL ugh 0.5 108-90-7 Chlorobenzene BRL I ug/l 0.5 1 630-20-6 1,1,1,2-Tetrachloroethane - BRL ug/L 0.5 _ 100 41 4 Ethylbenzene BRL _ ug/L 0.5 108-38-3/10642-3 meta-Xylene and Para-Xylene BRL ug/L r 95-47-6- ortho-Xylene- - BRL ug/L 0.5 1100-42-5 Styrene BRL _ug/L 0.5 75-25-2 Bromoform BRL ug/L i 0.5 98-82-8 Isopropy lbenzene BRL ugf l 0.5 F-- ... - --- - - j 108-861 Bromobenzene BRL uWL 0.5 79-34-5 t 1 2 2-Tetrachloroethane BRL ug/L 0.5 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532 WR r .�•. a >' TOWN OF BARNSTABLEON :. I "_I OCATIO-N r( � 2�}r( l D LPG SEWAGI E VILLAGE_ sf RA1&� ?/ar? ASSESSOR'S MAP �?�.LOT ITasTALLEI S NAMIE&PHONE No.S��tt.9 S?EP"IC TAi'TC CAPACI'I'Y IO C� QA Y.i�AACIs?T�a Fr�CII.1TY i A; / .'.�01) 10/l NO. OF BEDROOMS �h a"I e1 S BUILDER OR OWNER C I Y ffa PERMITDATEs� �/r � CO --� l/C) 1. - 1�PL.IANCE .�t'�'I�: v Separation Distance Between'the Maximum Adjusted Groundwater,Table to the Bottomof Leaching.Facility Feet Pnvate Water Supply Well.and-Leaching Facility (If any wells xis" ton 'site or within 2¢O.feetof leactung faGiL[y) ' '� Z ' Feet Edge of Wetland and Leaching.Facility.(If any wetlands exist q L� within�g0 feet of leaching facility) Feet „ Fiimislaed by y ,E " I r �'St i F F•F : € pig"xSk4M. �Sm 04, �0 jSe k Cr( ' �f 4. 1 'Y . t. y s _ E LIMIT OF UNSUITABLE (n HpV`� ` ,' SOIL REMOVAL Q. N in to = FtE 4 - 500 GALLON CHAMBERS p N W/3' STONE ALL AROUND L j rl SEE PROFILE FOR TOTAL TRENCH LENGTH - - - - - - - - - - - - - -.� I (A � a EDGE WASHED STONE , cT w �p r o - - - ---� - - - - # 40.0 o N COMPACTED 0 A STONE SPLASH PAD pup A` �j.0 _ Z_ 2 O EARTH REMOVABLE ACCESS COVER w o U q _ - - - - - J Q Lo x BACKFILL X 4" PVC INLET / 3` PEAS70NE SEE PLAN FOR LOCATIONS I I / o 0 0 0 0 o c o 0 0 0 0 0 0 O o 000000000 000000 0000 _ �L = =_� Lo N Oa0aOa00a aOGaOO OaaG � "•I I 1500 GALLON `� Oo . o o 3/4'- 1 1/2" z 3. -1 ` L. I Q LEVEL BASE SPLASH PAD STONEWASHED - - - - - - - _ - - _ g" SEPTIC TANK I 0 o 4_ INLET INVERT 500 GAL. LEACHING CHAMBER t DIST. BOX I f J N (30 NOTE: UNSUITABLE SOIL REMOVAL SECTION A - A LEACHING CHAMBER PLAN WHERE REOUIRED TO EXTEND AT / I _ _ _ / Q � F- � LEAST 5';BEYOND LIMITS OF LEACHING CHAMBER DETAIL STONE TRENCH. Q 0 i Q N w O t _ _ _ _ `� SAS RESERVE � v N TS 0 40.0' r CCL SEPTIC SYSTEM DIMENSION DETAIL SEPTIC SYSTEM DESIGN DATA GENERAL NOTES 1. ALL MATERIALS AND CONSTRUCTION METHODS SHALL 4. THE LOCATIONS OF UNDERGROUND UTILITIES SHOWN 6. REMOVE ALL UNSUITABLE SOIL, Do. A. AND B SEWAGE FLOW ESTIMATE CONFORM TO THE PROVISIONS OF THE COMMONWEALTH ON THIS PLAN ARE APPROXIMATE. AT LEAST 72 HORIZONS FROM BELOW THE SAS INVERT ELEVATIONS HOURS PRIOR TO ANY EXCAVATION FOR THIS AND WITHIN 5 FEET OF THE PROPOSED LEACHING SOURCE UNITS GPD/UNIT OTY GPO COMMENT, OF MASSACHUSETTS ENVIRONMENTAL CODE TITLE V. to PROJECT WORK, THE CONTRACTOR SHALL MAKE THE SYSTEM. REPLACE WITH CLEAN SANG FILL MEETING SINGLE FAMILY RESIDENCE I BEDROOM 1 110 1 4 1 440 310 CMR 15.02 (13) 2. EXCEPT AS OTHERWISE NOTED, ALL PROPOSED REQUIRED NOTIFICATION TO DIG SAFE (1-800-322- THE REQUIREMENTS OF 310CMR 15.255. O 4844),FOR VERIFICATION OF LOCATIONS N SEPTIC TANK TOTAL ESTIMATED PEAK DAY FLOW 44-0 GPD NO GARBAG E GRINDER SEPTIC SYSTEM PIPING SHALL BE 4" ' SCH40 PVC SET TO THE LINE AND INVERT ELEVATIONS 5 SHOWN. THE MINIMUM PITCH OF PIPES CARRYING $ CONSTRUCTION OF THE SEPTIC SYSTEM SHOWN ON SEWAGE OR SEPTIC TANK EFFLUENT SHALL BE 1/8TH THIS PLAN IS SUBJECT TO THE INSPECTION OF THE 7. WATER SUPPLY FOR THIS LOT IS A PRIVATE WELL TO BE TOTAL FLOW X DET. TIME 440 GPD X 2.0 DAYS = 880 USE 1500 GALLON TANK INCH PER FOOT IF NOT OTHERWISE NOTED. TOWN OF BARNSTABLE HEALTH AGENT, NO PART OF LOCATED AS SHOWN 150' MIN. FROM SEPTIC SOIL ABSORPTION 3. PRIOR TO CONSTRUCTION OF THE SEPTIC SYSTEM THE SEPTIC SYSTEM SHALL BE BACKFILLED OR MADE SYSTEM ON THIS AND ADJACENT LOTS. LEACHING FACILITY DEPICTED ON THIS PLAN, THE CONTRACTOR SHALL INACCESSIBLE UNTIL INSPECTED AND APPROVED BY THE HEALTH AGENT. THE CONTRACTOR SHALL OBTAIN A DISPOSAL WORKS CONSTRUCTION PERMIT La CHAMBER TRENCH LEACHING AREA CAPACITY FORM THE TOWN OF BARNSTABLE BOARD OF•Y,EALTH. SCHEDULE INSPECTIONS AS REQUIRED. cF- r NO. LEN WIDTH DEPTH _ SIDE BOTTOM SIDE BOTTOM TOTAL a o z o w it ft ft sf st d d d 1 <40.0 10.8 2.0 203 433 150 320 Q 470 w } = w m cn uj PERCOLATION RATE: 2.0 MIN./IN. LEACHING RATE: (GPD/SF) SIDE - 0.74 BOTTOM - 0.74 SOIL TEST DATA a $ N a r o 115 DATE: 3/14/00 P-9701 o = w U a O ol ol N2 3 EXISTING GRkDE EXCAVATOR: BOUSFIELD Q RES. RISER TO WITHIN 6 OF FIN. GRACE B.O.H. AGENT: ED BARRY (BARNSTABLE) TOP FIND. 111.50 _ _ _ - - - ENGINEER: D. THULIN Q Ln LOCATION: TP-1 O 2' LEVEL-SEC ON PR . FINISH GRA E LIJEn In 110 ELEV. DEPTH OeA - DUFF, SANDY LOAN o 107.21 109.5 0.0 z = zr r vac 1o7.oa •. 109.0 0.5 LOCATION: TP2 c ��o B - SANDY LOAM J Q 4' 406.22 00 s- aao TOP EFF. DEPTH 106.22 ELEV. DEPTH O_ ,J [n _ 108.00 4'P%C D_ axo 107 52 106.5 0.0 OeA - DUFF, SANDY LOAM O m d 107. 105.8 3.7 106.3 0.3 B - SANDY LOAM V1 0 105 Cl - MED. SAND = -J IL zy i p LL 103.5 6.0 ERC 2 MIN./IN 103.5 3.0 � Q U N _ 4 - 00 GALLO�N`CH AMBERS BOT EFF. DEPTH 104.22 Cl - FINE SAND O J Of W 1500 G LON /3'STONE ALL ROUND7 INLET TEE SEPTIC TNAK _ ` 101.5 8.0 0 z LLO 4i 100 W OU T O TLET TEE- REMOVE UNSUITABLE SOI kAND REPLACEC2 - MED. SAND z 100.5 6.0 PERC 2 MIN./IN O_LIQUIDQO] J LEVEL GAS B FLE Y LIQUID LEVEL z 40.0 98.2 11.3 1 1 98.0 8.5 LLJ BOTTOM C2 - M-C SAND 3 24.0' 6.4' 9.9' LONGEST UN NO GROUNDWATER 95 94.6 11.9 4r- -10 0 10 20 30 40 50 60 70 80 90 BOTTOM NO GROUNDWATER SECTION TH RU SEPTIC SYSTEM 00-01 4 s w }' SHEET 2 OF 2 41 �. LEGEND \ a. \ EXISTING SEPTIC SYSTEM o N \ / - 99 - - EXG. CONTOUR LOCATION FROM I B/f�,CO/�2 5X21&Wo/k N x 99.4 EXG SPOT ELEVATION Lu N CIO T.O.B RECORDS PROP. CONTOUR cc Co too 99, [99.5] PROP. SPOT ELEVATION .. N 150't FROM EXG. WELL �` \ TP :zLOT 47 / / Q5 TEST PIT LOCATION m N �116 _ _ + 17g X_ _ / 4S' -�/ / / — / \\ I Q TEST PIT/PERC TEST < \ \ \ \ 335. / w / J ' i — W— WATER SERVICE o v O I I I Me LO MAILBOX V O 0 M 3 Z N \ 4 - 500 G-AL014 CHAMBERS J I / 72 7' / \ I ® WELL N 00 4 - W/3' STONE BALL AROUND / ;� I I goo / © CAN Q N °O 112 w ELECTRIC 0 c� o 0 \ Ln Lai LOT 31 0 �� \ �� 0? �? o / I TEL T5` / i 10g ny 'CiMLT OF UNSUITABLE�IL REMOVAL o a u / _�i - - - / � �' / I � I I Bif. Canc Cu-b \ o o ,�/ LOT 46 ZONING REQUIREMENTS: w ZONE RF zo FRONT SETBACK......30 FT 5 / \ _ - \ SIDE SETBACK.........15 FT uj a / 4 REAR SETBACK.......15 FT Cr o \\ \ o o 16ETLAND DEUNEATION BY DON SCHALL\ \ lal m Z -0 to OF ENSR, MAY 2, 2000 LOCATED BY d /� [106 , PR9POSED J ¢ Y N ¢ } o FIELD SURVEY MAY 3, 2000 O / I 1` r 1 WL < O t� J >- .� / L D_ 2 W U ¢ O U ol in Twee/ine 2 a 346.46' 0 i 98" Q Edge o/ woler o / I to Existing W&II 0 F Qi 150' FROM tXG. WELL � rn in D r LOT 45 DRIVEWAY APRON 0 z = FOR EROSIO - L ¢ U SITE AND SURVEY DATA F J ¢ } EROSION CONTROL /so From Erg. Septic System �P��`� "'A19. `�P��"��Mess a J En Ir s per 7 O.B records � �� DAVID DAVID goy �,ti Ld � a� 1. AN APRON OF 3/4" CRUSHED STONE 3- IN DEPTH OR LOT AREA: 48,298fsf 1.11±AC, o C. o C. G OT O THULIN m ST 1 LJ L` a 2" OF BITUMINOUS CONCRETE BINDER SHALL BE PLACED ASSESSORS MAP 109 PARCEL 57 x z- THULIN C3 LL. N AT THE PROPOSED DRIVEWAY WHERE IT JOINS EXISTING # o0 No.3940 NO 29976 �; ��` w PLAN REF: PLANBOOK 301 PAGE 99 LOT 46 9 CIVIL o 3 ¢ U to PAVEMENT. THE APRON SHALL BE IN PLACE AT THE TIME $ o o �r O J F- a OF THE FOUNDATION INSPECTION AND SHALL BE DATE OF SURVEY:MARCH 8, 200!) �N v 9o`FSSpNA�NG��``� ` `' �� 0 ~ zz w MAINTAINED UNTIL THE PERMANENT DRIVEWAY SURFACE IS , CONSTRUCTED. ALL SOILS, VEGETATION AND OCUS fY�� �1 d w m CONSTRUCION DEBRIS FROM THIS PROJECT SHALL BE I CONFINED TO THE PROJECT SITE DURING CONSTRUCTION. �o� `' Y (n z PERMANENT SURFACES INCLUDING PAVEMENT, LAWN AND 30 0 15 30 60 120 Arf-TIZEHOZE ROAD LANDSCAPED AREAS SHALL BE PROTECTED BY PROPER GRADING, MULCHING OR OTHER CONSTRUCTION AS MAY BE REQUIRED UNTIL STABILIZATION OF THE SITE IS I I� ACHIEVED. ( IN FEET ) �2 1 inch = 30 ft. . 00-014 1 SHEET 1 OF 2 ,I tj LIMIT OF UNSUITABLE (n sO� NaVS SOIL REMOVAL 4 - 500 GALLON CHAMBERS p 04 N " `� p " W/3' STONE ALL AROUND w SEE PROFILE FOR TOTAL TRENCH LENGTH ' ., - - - - - - - - - - 1 - -7 a t. w I Y L CIO a EDGE WASHED STOt _ I , a0 r 1 3 L.' p 40.0 W a COMPACTED A STONE SPLASH PAD M I A F`' S.0' - - - _ '= - - - \ J L) Lo EARTH REMOVABLE ACCESS COVER o - - - - - N X x BACKFILL o N - - ¢ w w 4" PVC INLET / ` I n / Q Q a SEE PLAN FOR LOCATIONS pp in 3" PEASTONE u Y` I. I LL 0 0 0000 0000 0000 = =,� o I Q = 000000000 Ely j I 1500 �ALLONU 0 0 0 0 0 0 0 0 o O O O O O O o a-4 O F- }}a'.d o 3/4"- 1 1/2LEVEL BASE SPLASH PAD STONE - - - - - - - - - 5 SEPTITANK i U 0 o 4" INLET INVERT J Q I 500 GAL. LEACHING CHAMBER DIST. BOX NOTE: UNSUITABLE SOIL REMOVAL LEACHING CHAMBER I J N 000 SECTION A - A PLAN _ WHERE REQUIRED TO EXTEND AT / - - / 1- m LEAST 5"BEYOND LIMITS OF Q N LEACHING CHAMBER DETAIL STONE TRENCH. o N W o �4 .SAS RESERVE Ln N TS - 0 40.0� o O SEPTIC SYSTEM DIMENSION DETAIL SEPTIC SYSTEM DESIGN DATA GENERAL NOTES 1. ALL MATERIALS AND CONSTRUCTION METHODS SHALL 4• THE LOCATIONS OF UNDERGROUND UTILITIES SHOWN S. REMOVE ALL UNSUITABLE SOIL. Oa. A. AND B SEWAGE FLOW ESTIMATE CONFORM TO THE PROVISIONS OF THE COMMONIVEALTH ON THIS PLAN ARE APPROXIMATE. AT LEAST 72 HORIZONS FROM.BELOW THE SAS INVERT ELEVATIONS HOURS PRIOR TO ANY EXCAVATION FOR THIS AND WITHIN 5 FEET OF THE PROPOSED LEACHING SOURCE UNITS GPD/UNIT QTY GPD COMMENT OF MASSACHUSETTS ENVIRONMENTAL CODE TITLE V. N PROJECT WORK, THE CONTRACTOR SHALL MAKE THE SYSTEM. REPLACE WITH CLEAN SAND FILL MEETING SINGLE FAMILY RESIDENCE BEDROOM /10 4 440 310 CMR 15.02 (13) REQUIRED NOTIFICATION TO DIG SAFE (1-800-322- THE REQUIREMENTS OF 310CMR 15.255. O 2. EXCEPT AS OTHERWISE NOTED, ALL PROPOSED 4844).FOR VERIFICATION OF LOCATIONS TOTAL ESTIMATED PEAK DAY FLOW 440 GPD NO GARBAG E GRINDER SEPTIC SYSTEM PIPING SHALL BE 4' • SCH40 Ln SEPTIC TANK PVC SET TO THE LINE AND INVERT ELEVATIONS > SHOWN. THE MINIMUM PITCH OF PIPES CARRYING Ld 5 CONSTRUCTION THE SEPTIC SYSTEM SHOWN ON SEWAGE OR SEPTIC TANK EFFLUENT SHALL OE.1/8TH THIS PLAN IS SUBJECT E THE INSPECTION OF THE 7. WATER SUPPLY FOR THIS LOT IS A PRIVATE WELL TO BE TOTAL FLOW X DET. TIME 440 GPD X 2.0 DAYS = 880 USE 1500 GALLON TANK INCH PER FOOT IF NOT OTHERWISE NOTED. TOWN OF BARNSTABLE HEALTH AGENT. NO PART OF LOCATED AS SHOWN 150' MIN. FROM SEPTIC SOIL ABSORPTION 3. PRIOR TO CONSTRUCTION OF THE SEPTIC SYSTEM THE SEPTIC SYSTEM SHALL BE BACKFILLEO OR MADE SYSTEM ON THIS AND ADJACENT LOTS. DEPICTED ON THIS PLAN, THE CONTRACTOR SHALL INACCESSIBLE UNTIL INSPECTED AND APPROVED BY LEACHING FACILITY THE HEALTH AGENT. THE CONTRACTOR SHALL o OBTAIN A DISPOSAL WORKS CONSTRUCTION PERMIT w t SCHEDULE INSPECTIONS AS REQUIRED. CHAMBER TRENCH LEACHING AREA CAPACITY FORM THE TOWN OF BARNSTABLE BOARD OF HEALTH. o F ` N0. LEN WIDTH DEPTH SIDE BOTTOM SIDE BOTTOM TOTAL a o Z O w ft ft ft s sf d d d N N w 1 40.0 1 10.8 1 2.0 1 1 203 1 433 1 150 1 320 1 470 } w m Q c=iI PERCOLATION RATE: 2.0 MIN./AN. LEACHING RATE: (GPD/SF) SIDE - 0.74 BOTTOM 0.74 SOIL TEST DATA `L- 0 -' Q Y N Q O ir = w U 115 DATE: 3/14/00 P-9701 C3 a O U O N :2 EXISTING GR E EXCAVATOR: BOUSFIELD' Q RES. RISER TO WITHIN 6 OF FIN. GRACE B.O.H. AGENT: ED BARRY (BARNSTABLE) TOP FND. 1 1.50 _ _ _ - ,- ENGINEER: D. THULIN Q 2' LEVEL SEC ON PROP. FINISH GRA E LOCATION: TP-1 O w M 110 ELEV. DEPTH o T07.21 109.5 0.0 OeA - DUFF, SANDY LOAN Z = 107.04 4" _ 109.0 0.5 B - SANDY LOAM LOCATION: T_22 J W a } mo nC 406.22 TOP EFF. DEPTH 106.22 D_.J In of_ 108.00 �' OD ELEV. DEPTH 107 52 106.5 0.0 OeA - DUFF, SANDY LOAM w Q �v 020 w 105 \107 105.8 3.7 106.3 0.3 B - SANDY LOAM O d Z CI - MED.-SAND = LL o W W N J 103.5 6.0 103.5 3.0 U! W m J r ERC 2 MIN./IN to Q Urn 4`- 00 GALLON �CH BERS PBOT EFF. DEPTH 104.22 C1 - FINE SAND d J 0'w 1500 G ON /3'STONE ALL ROUND. 101.5 8.0 O Z O _ INLET TEE SEPTIC TNAK REMOVE UNSUITABLE S01 'AND REPLACEC2 - MED. SAND 100.5 6.0 PERC 2 MIN. N Al Q LL W 100 W OU T O TLET TEE Z UQUID LEVEL GAS B FLE n W m LIQUID LEVEL , Y F- Z 40.°� 98.2 11.3 98.0 8.5cn 24.0' 6.4' 9.9' LONGEST tUN T BOTTOM C2 - M-C SAND NO GROUNDWATER. r- 95 94.6 11.9 -10 0 10 20 30 40 50 60 70 80 96 BOTTOM SECTION THRU SEPTIC SYSTEM "° GRDUN°WATER 00-014 r SHEET 2 OF 2 Y U ff- i F \ EXISTING SEPTIC SYSTEM 99 - - EXG. CONTOUR LEGEND a- o N r` \ LOCATION FROM COS Sidewalk N x 99.4 EXG SPOT ELEVATION LlJ N 101 T.O.B RECORDS 3 ::� �r [991, PROP. CONTOUR n- 0D v w m qj1 N ; / ^ m c00 9g [99.5] PROP. SPOT ELEVATION \ LOT 47 150't FROM EXG. WELL /� /� \ _ I �� Z � a IP / TEST PIT LOCATION J Q PT N Q \ _ 48� TEST PIT/PERC TEST Q 335• W— WATER SERVICE o v \ "s MAILBOX U Qp 3 CN 4 - 500 G7tL�ON CHAMBERS 72.7' / \ ® WELL N 00 4 -� ' W/3' STONE ALL AROUND / — I I Sao © CAN00 Q ¢ 000 112 — — � � � — �T � I I I 00 ELECTRIC N w C) LOT 31 � _ _ ` o="' o / I I I TEL \ \�Sf j o 'CIMU OF UNSUITABLE IL REMOVAL I / a= l I I � �. ° � / Bif. Con Curb 10 :IT \ \ ° oa OTT 46 \ 1 ZONING REQUIREMENTS: — I W ZONE RF o \ / FRONT SETBACK......30 FT 5 / 4 \ \ — — _ _ ,' I O SIDE SETBACK.........15 FT \ REAR SETBACK.......15 FT �. cnLLJ o O �� � I 9900 W Q U Z C) DO w UJ WETLAND DELINEATION BY DON SC.HALL\ I I DO cv = OF ENSR MAY 2, 2000 LOCATED BY Ch \ [106 PROPOSED F- z FIELD SURVEY MAY 3, 2000 \ O I [� W� / Q x N JQ } �a�LL 2 3 4 6.46' E Tree/ine 98�0 Q dge of tyoter o / o I Existing well OLn 0 150' FROM EXG. WELL Li LOT 45 DRIVEWAY 0 SITE AND SURVEY DATA POF"'Ass R EROSI Q < a W a >- � EROSION CONTROL >s0-E/Oln Ex . Se fic S tem _�� DAVID 9°s s9 a J En of o _ 9 P J'S o G DAVID o per T.O.B records C. `r' o) C. tiG titi a LOT AREA: 48,298fsf 1.11±A'„ THULIN cn o 1. AN APRON OF 3/4- CRUSHED STONE 3" IN DEPTH OR No.39403 : LIN = w Z 2" OF BITUMINOUS CONCRETE BINDER SHALL BE PLACED ASSESSORS MAP 109 PARCEL 57 " P" 29976 LT � � sr o J a H . AT THE PROPOSED DRIVEWAY WHERE IT JOINS EXISTING PLAN REF PLANBOOK 301 PAGE 99 LOT 46 �OFESS�� 'CIVIL �o c N W m -J . 3 t� Q N PAVEMENT. THE APRON SHALL BE IN PLACE AT THE TIME �4N O o O J < a OF THE FOUNDATION INSPECTION AND SHALL BE O� ��SS �v��� o y a N a w MAINTAINED UNTIL THE PERMANENT DRIVEWAY SURFACE IS DATE OF SURVEY:MARCH 8, 2000 /OtVALE Q O Z O Fes' O' �W CONSTRUCTED. ALL SOILS, VEGETATION AND' F F LOCVS Ep a Q a CONSTRUCION DEBRIS FROM THIS PROJECT SHALL BE R`�� Li m J CONFINED TO THE PROJECT SITE DURING CONSTRUCTION. ►- ui z PERMANENT SURFACES INCLUDING PAVEMENT, LAWN AND 30 a 15 30 60 120 KETIZEHOLE ROAD 3 ��I LANDSCAPED AREAS SHALL BE PROTECTED BY PROPER s 3 GRADING, MULCHING OR OTHER CONSTRUCTION AS MAY BE REQUIRED UNTIL STABILIZATION OF THE SITE IS ; I� ACHIEVED. ( IN FEET ) �? e� 1 inch = 30 ft. ' 00—014 4 SHEET 1 OF 2