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HomeMy WebLinkAbout0043 LOCUST AVENUE - Health 43 LOCUST AVENUE, W. BARNSTABLE A= 197 027 o f'is W��,� s; Page: 1 CERTIFICATE OF ANALYSIS ' Barnstable County Health Laboratory Report Prepared For' Report Dated: 08/21/2002 Order Number: G0216866 Kathy Blackwell 43 Locust Avenue West Barnstable, MA 02668 Laboratory ID#: 0216866-01 Description: Water-Drinlung Water Sample#• 16866 Sampling Location: 43 Locust Avenue West Barnstable MA Collected: 08/19/2002 Collected by: K Blackwell Received: 08/19/2002, Test Parameters ITEM RESULT UNITS MDL MCL Method# Tested LAB: Microbiology Total Coliform Absent CFU/lOomL 0 0 P/A 08/19/2002 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. Approved By: (Lab Director) I - j Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 r roe CERTIFICATE OF ANALYSIS Page: 1 1w. Barnstable County Health Laboratory Report Prepared For: Report Dated: 08/19/2002 Order Number: G0216827 Kathy Blackwell 43 Locust Avenue West Barnstable, MA 02663 Laboratory ID#: 0216827-01 Description: Water-Drinking Water Sample#: 16827 Sampling Location: 43 Locust Avenue,West Barnstable. Collected: 08/15/2002 ollected by: Kathy Blackw 197-27 Received: 08/15/2002 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB:IC Lab Nitrates 0.3 mg/L 0.1 10 EPA 300.0 08/16/2002 LAB:Metals Copper 0.1 mg/L 0.1 1.3 SM 3111B 08/16/2002 Iron 0.2 mg/L 0.1 0.3 SM 3111B 08/16/2002 Sodium 20 mg/L 1.0 20 SM 3111B 08/16/2002 LAB:Microbiology Total Coliform Present P/A 0 Absent P/A 08/15/2002 LAB: Physical Chemistry Conductance 213 umohs/cm 1 EPA 120.1 08/16/2002 pH 6.3 pH-units 0 EPA 150.1 08/16/2002 Note: Recommended maximum contamination level exceeded due to presence of Coliform Bacteria.Retesting is recommended. Approved By: 1 (Lab Director) q�o� I i i Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Commonwealth of Massachusetts p �! AHe- 5111111111MMM Executive Office of Environmental Affairs C� 7 Dep women l °F 1�� Envirimmmen 61Pi?@)Q9 R@n William F.Weld Governor / Trudy CEoxe --- r OEA See , David B.Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A t rn b AtLtSA L � � i ry,ID e C CERTIFICATION u� S ci:9 � Lvast IbAtxw� ��r VIt!� m �2�O2 tj64 . Property Address: ` Address of Owner: � Date of Inspection: �1 17r (If different) Name of Inspector: t r� ( F ee SSC Company,Name,Address and Telephone Number; D � n � bo-CoA�tl-` M1 O 2-3 6 Ad AmS S 4,w4fi�A Rj Se v -�I_ f7 o-j` 21:� ©Z1-/ CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sew disposal systems. The system: _V Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signa r : Date: The System Inspector shall submit:a of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: .Check A, B, C, or D: A) SYSTE PASSES: . I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If not determined", explain why not). The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) One Winter Street a Boston,Massachusetts 02108 a FAX(617)556-1049 a Telephone(617)292-5500 `e}Printed on Recycled Paper . r . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: ��j? L D ri,S7 Av--t Owner: S/g Date of Inspection: B]SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a!broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 obstruction is removed 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: the %vstem nd+ a se pi tank. n hi„ 0 tc-s ! .:h..,,�l a u sui� auwiNuvu �y�icin n�i�. IS«'lt� 1 � fCC. t0 .i SUrf3CC 11'd� U,7�7�� C' surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this.determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. rID Backup of sewage into facility or system component due to an 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. (revised 8/15/95) 2 b SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 3 Property Address: Owner: 1-(SA 0240'l.+bAC t Date of Inspection: D] SYSTEM FAILS (continued): r' 12 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. 0/ A Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. n d Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped n (7 Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. n O Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. n0 Any portion of a cesspool or privy is within a Zone I of.a public well. h 17 Any portion of a cesspool or privy is within 50 feet of a private water supply well. nd 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E]LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: q3 Lo CV S* Av� W �N4 A v) Owner: L SA 1—k1 Y1bAC�c Date of Inspection: C5/17Nzw Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. vNone of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. �As built plans have beer. obtained and examined. Note if they are not available with N/A. 'The or dwelling was inspected for signs of sewage back-up. _V The system does not receive non-sanitary or industrial waste flow �`Atem 'te was inspected for signs of breakout. s components, excluding the Soil Absorption System, have been located on the site. _"The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees,7aterial of construction, dimensions, depth of liquid, depth of sludge, depth of scum. _The size and location of the Soil Absorption System on the site has been determined based on existing information or ap zimated by non-int-usive methods. _The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. As. Qvl 63i�n� C�prr'\ertS;K9 ` ` DArd� a�0� NO ) � 1'32 YL "k'-t L-t /i k of Ai �z-e , m qp (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 1 SYSTEM r /K INFORMATION" Property Address: '!3 Lv C�1 At—t r I&A r- s+4 Owner: )-t5>A (L%oj b>hC Lr Date of Inspection: 71 FLOW CONDITIONS RESIDENTIAL: Design flow: 5!11 D gallons `r Number of bedrooms: ,3 �Gct`s70� }`dv� f �G�1`pprv� eve Q Number of current residents: a Vle--wc,,q yl tcO CS Garbage grinder(yes or no): n O f Laundry connected to system (yes or no):4e5 Seasonal use (yes or no):_D,p Water meter readings, if available: Last date of occupancy: oUrM1[K k (v t'O DPr eC� COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING R CORDS and source of information: Pit System pumped as part of inspection: (yes or no)_ If yes, volume pumped: gallons Reason for pumping: TYPE OF STEM 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) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: rust4d r h Sewage odors detected when arriving at the site: (yes or no) 11 O (revised 8/15/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C --77 SYSTEM INFORMATION (continued) Property Address: qJ Loo,5T �kd ko, &Nrkr d/ab4 Owner: �(Sfj QZ�M�jt4C�7 Date of Inspection: SEPTIC TANK:_/ (locate on site plan) Depth below grade: � �cncrete �ti S Material of construction: — —metal FRP other(explain) Dimensions: Sludge depth: Z Distance from top of sludge to bottom of outlet tee or baffle: .3 Scum thickness:_ Distance from top of scum to top of outlet tee or baffle: (o Distance from bottom of scum to bottom of outlet tee or baffle:�L Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in rela•on to outlet invert, structural integrity, evidence of leakage,.eta.) inlet TS, ,4 V C_ I n -9 19c>d pr, f rt /rl v-CN t ry C' Y' r) fi L.-t.r - e fi " GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP_other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of crom to bottom of outlet tee or battle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 11 SYSTEM INFORMATION (continued) Property Address: tl L.O C(�S� Av--(— WO, Owner: afvK b'-e 4 Date of Inspection: C/'7 fl� TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of construction: _concrete_metal _FRP--other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: ' L2>(f�C 00to-C (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids c ryover, evidence of leaka�e into or-put of box, etc.) 67 ClIY)..C_ (LO�'t5 }�,A�.? e r,e7<.v►� I h "1"L� ��h PUMP CHAMBER:_ (locate on site plan). Pumps in working order:(yes or no) Comments: (note condition of pump ch�rpber, condition of pumps and appurten ces, etc.) ('h• . 15, 0L<<i4j N_,C r C'v o, lv 1 VC (6 , Ai,4(tth Owl- A Cf r t,.c1` t.V V'h A--- '`-pP--d (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ,( SYSTEM INFORMATION (continued) L� /�Property Address: 13 Lo Co N1 L,,e W e-bl- 4 >Avr"f 1-,,A b L Owner: L.tSl%- 91(y)-b,kc>Lt Date of'Inspection: ,)//'?/ / SOIL ABSORPTION SYSTEM (SAS): V (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number: r CV-�G�X leaching galleries, number. J� le leaching trenches, numher, ngth: j leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failtye, level of ponding, condition o vegetatio ,etc.) iLole rcse4 Ne_ l vl 11-i e CESSPOOLS: _ (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil. signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:_ (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 8/15/95) 8 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) c' Property Address: 7 Z L o e v-z,') 5�T W e S" ►� R n S 1�/�� Owner: LLS R JZ I r►j b4 e Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' 1000 14 h�1 Yti� IAh') ASV(l 6V` 16tE '"``VV'' ��}►nrel wob v rn� C' ►. ConcrCG UJAI 4 OAScow t-3 Axe DEPTH TO GROUNDWATER Depth to groundwater: k,ZSfeet meth f determination or appro imation: (revised 8/15/95) 9 TOWN OF BARNSTABLEs LOCATION 1'',3 Zo os SEWAGE # VILLAGE �o9rQ���a.�le.ASSESSOR'S MAP & LOT 117 ; 627 t INSTALLER'S NAME & PHONE NO. /`I, F, SEPTIC TANK CAPACITY /ppQ L LEACHING FACILITY:(type) �''%�CA,c.H- r NO. OF BEDROOMS PRIVATE WELL OR PUB1LiC WATER BUILDER OR OWNER Jam_ v� "� L 1 -31 k ;y1 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_' �a VARIANCE GRANTED: Yes No (/ I!_ 'E"Am K D- 7 No...j9z.:a,�.GZ / F.R$..... d... ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE . ppfiration for Disposal Works Tonstrnrtion ibrutit Application is hereby made for a Permit to Construct ( ) or Repair (./) an Individual Sewage Disposal System at: � ��Nue ---.....--- /[� Loc tion-Address or Lot No. ...............L/SA__..1.:!mAc ... W Owner Address W ........................................� E. , d� --•--....._•--••----....._•-----•-••----- � Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms_____________________________ ._.__Ex Expansion Attic F•-t g— y -.------- p ( ) Garbage Grinder ( ) Other—T e of Building No. of ersons____________________________ Showers a Other—Type g ---------------------------• P ( )..— Cafeteria ( ) Q Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length________________ Width................ Diameter................ Depth................ x Disposal Trench—No_____________________ Width..............-..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No................... Diameter....-............... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water........................ P4 ---------------------------------------------------•----•----------••-----------.......-•-•••--••-•.......................................................... 0 Description of Soil----•--••Sg^'o{f s�./sail-•••.._.....•-••----•-•--••-•-- U •••••••-•--••--••••--•--•••••-••••-••....--••••-••-•-•-----`---••••--------•-••-••------------•--•- W z •-•--•-----•-----•---•------••-------------••-•••-----•----•--------------------••••-••-•...................................................•------------ U Nature of Repairs or Alterations—Answer when applicable.....�5---- -S Fti iafFRtW ' ,�z- ----•------.V''------------------•---•------•------- ..•--•-•-•••--•-------•••-••--------••-••-••-•--------••••••-•-•-•••-•-••--•••••••-•..............•--••---•--••-•-•••---•-•-•---•••-••-•---••-•-••••-.................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State EnvironnWlao The nd f rther agrees not to place the system in operation until a Certificate of Complia����& ee o t . Signed ' Dare Application Approved By ...... 7 -- g Vv -.--.._--------------------_----------.---_.-.............._--------..-- Date Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------------- - ------------------------------------- ................................ ----- Date PermitNo. ...... -v .- 3Z'..0........................... Issued ------------- --------.....-------------- -- --------........ Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (9rdif rate of C ontylizatce THIS IS TO CERTIFY, Thatthe Individual Sewage Disposal System constructed ( ) or Repaired ( ►) by ........................ --`------- ----------------.......--......-----------------------...-----........... .. --- --..--------------- -----...........--------------.....----------- . Installer ---------- -----------------_--U--e �-- ------------------------------------------------------------------------- has been installed i accordance with the provisions of TITLE 5,pf The State Environmental Code as described in the application for Disposal Works Construction Permit No. .......... dated ............................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM.WILL FUNCTION SATISFACTORY. DATE ....................................... Inspector ......... -•------------...................................... 3 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstrurtiun 1rrutit Application is hereby made for a Permit to Construct ( ) or Repair (✓) an Individual Sewage Disposal System at:------------ -____---.._..----- , e y 3 ,�ocu s1- -----1 vtivu----- -.........._..._....... • - -- --- ----- --•-- ------____....._...___.._.._...... Location-Address or Lot No. ..------ �isst__'Rni���k ----------------------------------------------- --------------------------- -_._.__.._.._.. -------------------------- -------------- owner --------------------------------Address a %,�, �A �/R// ---- - - ------- Installer Address Type of Building Size Lot---------------------------Sq. feet U Dwelling—No. of Bedrooms__-_.____�_______________________________Expansion Attic ( ) Garbage Grinder ( ) aN Other—Type of Building No. of ersons____________________________ Showers YP g ---------------------------- P ( )--- Cafeteria ( ) dOther fixtures -----------------•-------------------------------------------------------------------------------------------------- ---------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width---------------- Diameter---------------- Depth______.________- x Disposal Trench—No--------------------- Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet-------------------- Total leaching area------------------sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- 1.4 Test Pit No. I________________minutes per inch Depth of Test Pit-------------------- Depth to ground water____________::______-_- (_, Test Pit No. 2----------------minutes per inch Depth of.Test Pit-------------------- Depth to ground water-_________•__-____..____ P4 --------------------- -------------------------------------------------------•-••------------------------------------------------------------------------ x . Description of Soil--------!S ===�L----`'"z---="-"L----------------------- -----------=---------------------------------------------------------------------------------------- V ---------------------------------------------------------------------------------------•---•------------------------------------------------------------------------------------------ ---------- ------- W UNature of Repairs or Alterations—Answer when applicable____A-5____ Fk_____FivtRFll 1-- v -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environm al Code�The and f��_ th��er agrees not to place the system in operation until a Certificate of Complia ,�/ as-eefi�is�" bo�o hea t . 14 Signed ------------------------ ---------------------------------------- Application Approved By _ c --I --------- --------------------------------------------------------------------------- - ---------------------- Date Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------- PermitNo. - ---------`a&'0--------------------- ---- Issued ------------------------------------------------------------re Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Oler#tftrate of (gompliance THIS IS TO CE IFY That Individual Sewage Disposal System constructed ( ) or Repaired by ------- -------- ---------- --------------------------------------------- ------------------------------------------------------------------------------------------------------------- Installer at �..-------- --------- ------------------------- has been installed in accordance with the provisions of TITLE �o f The State Environmental Code as described in the application for Disposal Works Construction Permit No. __-7-a - _G-0 _--.__ dated -__.---.-_----______________________________ THE .ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ---------- Inspector ----------------------- -------------------------------------------- = .--� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �J TOWN OF BARNSTABLE No..... Disposal 10orkii (guns udiutt jkrutit Permission is hereby granted-----------�!V-=----- -1-1 Q^.___ -------------------------- to Construct (.yl)'-O�Repair ( -.)fan Individual Seepage Disposal System at No-------------I �-------_ ------(D-c' PP P street l� � as shown on the application for Disposal Works orks Construction Permit No..__/_.__-_�.3___ Dated__________________________________________ '-q .� ....... UBoard of Health ----- DATE-----------------•---------�-7-�-,------�------tl-`--------------------------- FORM 36506 HOODS R WARREN.INC.,PUBLISHERS Y Date SEPTIC SYSTEMS INSTALLERS TOWN OF BARNSTABLE y�i 7N E Taw OFFICE OF B D D.SasTAEL O MM0. A R OF HEALTH 039. ��� 367 MAIN STREET am k. HYANNIS, MASS.02601 I fully understand that my Disposal works Installers Permit is issued contingent upon my observing all of the state regulations contained in 310 CMR 15.00, the State Environmental code, Title 5; all other laws and regulations of the state and the Town of Barnstable. I further understand that prior to my installing or repairing any sewage system, I must obtain a Disposal Works Construction Permit for each individual system. Permits will not be delivered at the time of inspection. I also understand that prior to backfilling any system installed, I must call for inspection and receive a certificate of compliance. A certificate will not be issued until all connections have been made and sealed. system will be inspected within 48 hours after notification, not counting Saturdays, Sundays or Holidays barring emergencies when no inspector is available. I agree to furnish the Builder or homeowner and the Board of Health a diagram on a 4" x 6" card - showing the location and size of all parts of the septic system. This includes exact distances from the nearest two corners of the building or other permanent feature to center of the clean out cover of the septic tank and leaching pit, or distribution box of the field. one copy shall be required by Inspector before compliance certificate is issued. Repairs or additions to system shall also be diagrammed. I am aware that additional inspections due to faulty installation or not being ready after calling for inspection will result in an additional $20.00 re-inspection fee. This applies to repairs in addition to new construction. I understand I am responsible for the installation of all systems where the permit is issued in my name and sub-letting to parties not licensed in the Town of Barnstable could result in the revocation of Disposal works Installers Permit. I understand that once I have obtained the permit and commenced construction or have excavated for the system that I am responsible for its completion. I realize that non-compliance with the above paragraphs could result in the suspension or revocation of my Disposal works Installers Permit and possible legal action by the Town of Barnstable. (Signature) (Address) Sfs WITNESSED: (Telephone No. ) DATE: ) sepinagr.doc l TEST T P I DATA TOP OF FOUNDATION = 105.00 FINISH GRADE = 103.9 NOTE: __ _ PERFORMED BY: JAMES HALL ALL SEPTIC SYSTEM PIPING WITNESSED BY: JERRY DUNNING • SHALL BE SCHEDULE 40 PVC PROVIDE ACCESS TO PUMP DATE PERFORMED: MAY 7.1992 AND FLOAT WITH MINIMUMFINISH GRADE FINISH GRADE = 103•9 30" RISER WITH STEPS OR 36" RISERS WITHOUT TEST PIT #1 TEST PIT2 A' : 10 -----{ FORCE 0 PVC Y " GROUND ELEV. _ 101 .0 GROUND ELEV. 99.5 GROUND WATER ELEV. = 94.75 GROUND WATER ELEV. _ 1 MIN. " 94.8 WITH CHECK VALVE 2 4 PVC /� BOTTOM OF TEST PIT - 92.2 .a 3" " ( PERFORATED = 93.7 BOTTOM OF .TEST PIT - Er 3 PIPE PERC TEST ELEV. = 96.0 PERC TEST ELEV. SEE PLAN 10" 14„ ENDS CAPPED PERC RATE = 2 MIN./INCH PERC RATE A MIN. INCH :.�e::: :4 4'-0" INV. ELEV. ��0. INV ELEV. _ 100,55 0" 0►' Z,oi 5 INV. ELEV. _ 100,qrj BOTTOM LOAM LOAM INV. ELEV. = 93.50 CAST CONCRETE EtEV 92.20ALARM ON INV. ELEV. [0©►--7� 35 ELEV. PRE ELEV s2.2o PUMP ON BOTTOM OF TRENCH MUST BE LEVEL /� 15" 18" SEPTIC TANK f1 ELEV 89.45 PUMP INV ELEV=93.25 PU�Ap OFF M,so PRECAST CONCRETE ��t✓� ALV C- _ FIELD OBSERVED GROUND WATER ELEV. INV ELEV=93.20 ORANGE ORANGE PUMP STATION SUBSOIL SANDY SIL SEPTIC SYSTEM PROFILE SPECIFICATIONS: 45" 45" NOT TO SCALE ! 1. PUMP: THE CONTRACTOR SHALL FURNISH AND INSTALL A GRAY GRAY SUBMERSIBLE SEWAGE PUMP IN THE PUMP CHAMBER. 7 1 2" FINE FINE SAID PUMP SHALL BE ENPO SPRINT 1, .5 HP, 1725 RPM, 2" SUBMERSIBLE SEWAGE PUMP RATED FOR 130 GPM AT 2» 1/8" TO 1/2" SAND SAND 10 FEET TDH. » 4 2. CONTROLS: THE CONTRACTOR SHALL FURNISH AND INSTALL A PUMP 1'8" �ITCO MODEL #210 COMPLETE WITH CONTROL BOX, TWO » 1 »3 4 TO 1 " _ " fvfER�tJRY FLOAT SWITHES, AND INSTALLATION INSTRUCTIONS. 1 -9 � gg gg AN ANCHOR ALARMPAK SERIES 200-1 WITH P70NO COMPLETE WASHED STONE WITH ROTO-FLOAT, CABLE, AND ALRM PANEL. BOTH ARE TO I I WATER ® 75" INCHES WATER ® 56" INCHES 00 BE MANFACTURED BY ANCHOR SCIENTIFIC, INC. THE CONTROL Fes--- 30 -�-I 8 • AND ALARM PANEL SHALL BE MOUNTED IN THE BASEMENT OR __,� $ �i• OTHER SUITABLE LOCATION. 3'-6" PLAN VIEW DESIGN CRITERIA: NO SU�iTI'ThT10N S- ALI,.,c�bJC C� SECTION A-A •. ,� ,^r 92 _ �\ •�.�_ PRDUc�T'S �tJl��t„)T~ A•PPRO�lAI.. (WITHOUT COVER) TYPE OF ESTABLISHMENT: 4 BEDROOM SINGLE FAMILY DWELLING 4. t/ (3 oeo RwM l4ouSE �I pyrprlaaM cGoym LlE) EDGE F ,-�� 3 NOTE: THE CONTRACTOR SHALL DETERMINE AVAILABLE POWER LEACHING TRENCH DISTRIBUTION BOX NO ADDITIONAL CAPACITY HAS BEEN PROVIDED FOR GARBAGE GRINDERS. STREAM F i1L..���� �� c� CHARACTERISTICS PRIOR TO ORDERING EQUIPMENT. NOT To SCALE _ DESIGN FLOW: 4 BEDROOMS X 110 GPD/BEDROOM - 440 GPD SEPTIC TANK CAPACITY REQUIRED: 1,000 GALLONS i' i + � TIE N 4" SCH40 ,� �� PVC PIP INTO EX. � �� / SEPTIC TANK CAPACITY PROVIDED: 1,0 NOTES 00 GALLONS �'�� %� �'' /� o AT APPR 94.5 �� » * 1 1 CONTRACT Ttia° '"` / 4 SCH. 40 PVC SCH. 40 PVC 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE BARNSTABLE ' / ---- SANITARY TEE DESIGN PERCOLATION RATE: 2 MIN./IN. _+ -`` FIELD VERi �- SANITARY TEE BOARD OF HEALTH AND ALPHA ENGINEERING + � ,�' � � �� � �� �---- -------------- ---��--� �--------------------------, _ _ I LEACHING CAPACITY REQUIRED: 440 .GPD ' 90 ._a E:?STING CESSPOOL \ `�� I 24* CLEANOUT COVER I -� I 3Cr MANHOLE 1 - 2. ALL WORK AND MATERIALS SHALL ,CONFORM 'TO THE REQUIREMENTS ~ - �.• -I'_ 1� ?T0 BE PUMPED AND I a !.- R q / �, I I-_ �_ SLEEVE. F ME I _ ,.,_._.--- .,.�_ .___ LEACHiPv� CAPACITY ; 4. ��2�� �/ FCF�T y FILLED IN (TYP) t I I AND CoV�2S'-To` I OF TITLE 5 OF THE STATE ENVIROtWMENTAL CODE AND ANY PROVIDED: 129.5 X 2.5 GPD SF + 122.5 X 1.0 GPD SF = 446 GPD J �9'20 \ + \ / \ / BE BROUGHT TO I ( / / / i I I I APPLICABLE LOCAL RULES AND REGULATIONS. 'IDEWALL AREA: '*' 8)�P �\ ✓ I 1 1 I I 4'-10" I 1 FINISHED GRADE I 4'-10" k . ` + TIE N& 4» SCH40 / / 96 I �_�� \\ �/ �_�� I i . \� �� \\ ��. I 3. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ' Pv PIPE INTO EX. + SEPTIC G\ � �� ti 1• d.�. � �_, �_, �. 1 'TRENCH X 2 SIDES�;>! 35�• LG. X 1.75 DEEP + 2 ENDS (3.5 LG X 1.75 DEEP X 2 ENDS),- 1.29.5 SF .�1 A APPROX 98.50 // �' \ D%, �� / / ,f•�' - i i FROM THOSE SHOWN HEREON SHALL BE REPORTED TO ALPHA ENG. ONTRACTOR TO / / BOTTOM AREA: 1 TRENCH X 3,5' WIDE X 35' LG = 122.5 SF IELD VERIFY \ qy V / L--------------------- ---- L--_-----__----------------J BEFORE CONSTRUCTION CONTINUES • + / �� \c�i�M9ER gg 4. ALL ELEVATIONS BASED ON ASSUMED VERTICAL DATUM. a + l ; ' PLAN VIEW COVERS PLAN VIEW / ® � / i PRECAST CONCRETE / too es � \ i / ��"��12K • � 5. ALPHA ENGINEERING IS N07 RESPONSIBLE FOR THE FAILURE / �V;Fo,, m �. -4"1 / , NAIL Ill 190I� SEPTIC TANK PRECAST CONCRETE PUMP STATION OF THE CONTRACTOR OR OWNER TO NOTIFY THE BOARD OF HEALTH 02.3 ,4 / p NOT TO SCALE NOT TO SCALE AND/OR ALPHA ENGINEERING FOR PROPER INSPECTIONS DURING ? °" �p Gc��/-- 160.00 �; + / �`` CONSTRUCTION. 4 J / Q , Q' f 6. AS NOTED IN THE SITE PLAN, ALL IMPERVIOUS SOILS WITHIN` THE AREA OF "LIMIT OF EXCAVATION" SHALL BE ,REMOVED AND 'REPLACED WITH CLEAN 102 COARSE SAND OR OTHER CLEAN GRANULAR MATERIAL HAVING A PERCOLATION RATE OF LESS THAN 2 MINUTES PER INCH. THE DEPTH TO WHICH ALL y I IMPERVIOUS MATERIAL TO BE REMOVED WILL VARY. REFERENCE ABOVE SOIL i C/rkq LOGS FOR FURTHER INFORMATION. LEGEND 7• INPECTIONS FOR CONSTRUCTION SHALL BE AS FOLLOWS: 96 :;' E TREE +$) o� boy ��( �� POST I FILTER FABRIC POSTS A. AT THE COMPLETION OF THE EXCAVATION FOR THE SEWAGE DISPOSAL o 0 / 01 PA:�POSSIBLE / " SEPTIC TANK L // / SECTION B" SYSTEM. ' �. g� FILTER FABRIC ❑ DISTRIBUTION BOX y xi�l�� + w DI.T 100' To BACKFILL B. AFTER STONE AND DISTRIBUTION, PIPES ARE IN BUT PRIOR TO FINAL B0 / I ESTIMATED �u SE COVER. 56--------- EXISTING CONTOURS I WELL LOCATION, " " 8. IN ADDITION TO THE BOARD OF HEALTH'S INPECTION THE ENGINEER SHALL SECTION A ' PROPOSED CONTOURS SILT FENCE / I I I ALSO BE NOTIFIED AT INSPECTION "B" TO PERFORM AN AS-BUILT OF ALL SEE DETAIL I I f1 TOP VIEW SEPTIC SYSTEM COMPONENTS. D DRAIN LINE �+ / �I NATIVE SOIL 9• ALL WELL LOCATIONS WERE DERIVED FROM CONTACTING THE INDIVIDUAL W WATER LINE A o ABUTTERS. NONE OF THE WELLS OIN THIS PLAN WERE EVIDENT FROM moso + �� / -�� THE GROUND SURFACE. THIS OFFICE ACCEPTS NO RESPONSIBILITY FOR 4100 G / �y- WELLS NOT ACCURATELY LOCATED IIN THE FIELD. ON ABUTTING LOTS., is TEST PIT j LIMIT OF EXCAVATION TOE-IN METHOD " A B A COUPLER PERCOLATION TEST �^ WITNESSED GROUNDWATER LOCATION o BALES TO / BUTT I TIGHT JOINT PIPE ow / J 100' To TOGETHER V ESTIMATED ---------- / p / WELL LOCATION 0 I PERFORATED PIPE v POST I�I FILTER FABRIC i ' 56x5 EXISTING SPOT GRADE � --I (2)2 x2 x3 .STAKES SECTION A 0 6 I EACH BALE pQ�' S6x5 PROPOSED SPOT GRADE BACKFILL SECTION "B" wl 6' / J . _ . _ . _ . . _ . . _ FLOW 0 0l �,�'� WETLANDS LINE f I � 3' (APPROX. N I 0 FLOW oI EXISTING GROUND -I-T'-� ��P + --------------- BUFFER ZONE I,"�I N C� I NATIVE SOIL j ,111c 0 ," 01 � 1 OIJS 2 x2"x3 STAKES I PAIR SUBSURFACE SEWAGE DISPOSAL SYSTEM FOR/ 1 TOE- IN METHOD " B" BALE EACH I NOTE:: TO BE USED WHERE EXISTING GROUND t� - -- __ Joe. NO. / I SLOPES AWAY FROM THE TOE OF THE �� LISA RIMBACK JOINING SECTIONS OF SILT FENCE EMBANKMENT. 0 � � � 43 LOCUST AVENUE TOE IN METHODS SECTION THROUGH C.Ma sr710� n. . , PREPARED FOR: LISA RIMBACK DWG. No- PLANVIEW I )`� .:ATE SCALE DRAWN DESIGN CHECKED f 7-1-92 AS NOTED J.H. J.H T.C. SILT FENCE DETAIL- HAY BALE DETAIL m/LIdAA/ :rla ch ENZ/F, P.L.S. Ash, ��Q�� ► NOT TO SCALE �! 1182 1,IArry 5n•ReET NOT TO SCALE WES7 WAREIIAM, NIASSACULIS£'r'TS 02576 �iaNasu�venNc ENGINEERING (508) 295-5505 I 'ASSOCIATES i