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0075 LOMBARD AVENUE - Health
A Ir= d Ave/st F/R 4 i e { TOWN OF BARNSTABLE I LOCATION �S L 0 A 4/'A R D 4 ile SEWAGE # 'L G O ti 0 3 y VILLAME L' eS7 �i��h'�l/.5%A � ASSESSOR'S MAP & LOT PNSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type)L/'- !'AY "I (size) y.2 — /3 e� NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: I I� COMPLIANCE DATE: elo 3 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i V O � Z f No. woa-0_-H ' ! Fee$5 0. 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS AppItration for Xigpool *pgtem Congtrurtton Vermtt Application for a Permit to Construct( )RepaiX(XMpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 5 Lombard Ave Owner's Name,Address and Tel.No. ,z or'sNlp/Pacc�table,Mass. 02668 John Scandlen s� 00 Installer's Name,Address,and Tel.No S 0,9-7 7 5-3 3 3 8 Designer's Name,Address and Tel.No.5 0 8—2 7 3—0 3 7 7 J.P.Ma.comber & Son Inc. JC Engineering 5 Roundhill BLVD Pox 66 Centerville,Mass. 02632 Fast Wareham,Mass. 02538 Type of Building: Dwelling:X No.of Bedrooms 5 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 5 5 0 gallons per day. Calculated daily flow 5 x 1 1 0=5 5 0 C;P n gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 500 Existing Type of S.A.S. 42 'X1 2. 9 'x2 ' Description of Soil Loamy sand to medium sand Nature of Repairs or Alterations(Answer when applicable) Impervious soil removal with clean perkable sand. replacement per title five.Will install 5-500 gallon leaching chambers packed in 4 ' of 1 " stone. 42 'X12. 9 'X2 ' 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 issu d by this B and He Signed Date 1 21 3 Application Approved b Date 2 D 3 Application Disapproved for the following reasons Permit No. 20 C�"OS L Date Issued 1 2-2- 0,a -�.a ti... x Fee$5 0.00 No . .. '* THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -`TOWN OF BARNSTABLES MASSACHUSETTS Yes 0[ppticatioti for Mi0po0al *p!5tem Con$truction Permit Application for a Permit to Construct( )RepaiX(X)0)1Vpgrade( )Abandon( ) ❑Complete System ❑Individual Components i; Location Address or Lot No- 75 Lou6ard Ave Owner's Name,Address and Tel.No. west Raras,�able,Mas .02668 John Scandlen Assessor's Map, arce Installer's Name,Address,and Tel.No.5 08_7 7 5_3 3 5 Designer's Name,Address and Tel.No-5 0 8—2 7 3—0 3'?7 J P.Macomber & Son Inc. JC Engineering 5 Roundhill BLVD Box 6..6 Centerville,Mass.02612 past 4lareham,Mass.02538 Type of-Building: DwellingCX No.of Bedrooms. Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow S 5 0 gallons per day. Calculated daily flow 5 X 1 1 0=ra 5 0 GPD" gallons. Plan Date Number of sheets Revision Date Title _ F).0 rE 7 _. ' Size of"Septic Tank' 111r500 Existing _Type of S.M.... 42'X1 2.9'x2 ' Description of SoiP�Lolmy sand to medium sari U r _ W t CI! ;", 11;-� ell - Nature.of Repairs or.-A1telrations(Answer when applicAb 1 e,ryLouse.s-o i 1 removal with clean perk ,jg,, 4nd' eaAcement per ti ��fiivo.� . j/ i stall 5-500 gallon 1I>7CgLYiIbers packed in 4 ' of ` §'ton. . 42'X12.9 'X2' 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 issued by this B and o Heal =. 1, Signed d Date 1 /21 / 3 Application Approved b Date 7-7 O 3 ,Application Disapproved for the following reasons Permit No. Z90 3"03 Date Issued I 22 U 3 r t THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(XX>T Upgraded( ) Abandoned( )by J.P Macomber & Son inc.' ' at 75 Lombard Ave west Barrnstable s Mass. has been constructed iry accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2003-a3`t dated !'1 e 2 Z 0 3 Installer J.P.Macomber & Son Inc. Designer 3C Engineering The issuance of this permit shall not be construed:as a guarantee that the system, w ill function as designed. Date t r "�I,�D 3 Inspector No. q00 37 0.34 Fee 50.00 ' a THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Miopooat_*p5tem Conotruction Permit Permission is hereby granted to Construct( )Repair(XX)Upgrade( )Abandon( ) Systemlocatedat 75 Lombard Ave 'lest Barnstable,Mass.. 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 follcwing local provisions or special conditions. Provided:Cons f ction rust be completed within three years of the date of this pe Date: 22 3 Approved by D TOWN OF BARNSTABLE I 2 SEW AGE E # ,'1.C4, tiO3 L -4 A R l� v y LOCATION �`� d VILLAGE L�'C�-ST �A/ /� �R ASSESSOR'S MAP & LOT iM 20 3 INSTALLER'S NAME&PHONE NO. � � �� C �-� � S o� SEPTIC TANK CAPACITY �' -0 s LEACHING FACILITY: (type) pxy �tl�'LL '9' (size) �/� — /3 X. NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: rr _COMPLIANCE DATE: �Fo Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) tlands exist Edge of Wetland and Leaching Facility(If any wetlands Feet within 300.feet of lea� hin facility) Furnished by ' e , W Y� i D �S L 0.Mi8Af20 Aye S A DATE : 1 0/1 /02 PROPERTY ADDRESS:75 Lombard Ave ----------------------- - West-Barnstable,Mass.---- �' 02668 ------------------------ FAILED INSPECTION On the above date, I inspected the septic system at the above a- _ss. This system consists of the following: RECEIVED 1 . 1 -1 500 gallon septic tank. OCT 1 2��2 2. 1 -Distribution box. 3. 2-1000 gallon precast leaching pits. ( 6 'X10" ) TOWN OF BARNSTABLE Based on my inspection, I certify the following conditions: HEALTH DEPT. 4. This is a title five septic system. ( 78 Code ) @ 5. The septic system is in hydraulic failure. vZ 6 . A new leaching area needs to be installed. 7. Pumped the complete system at time of inspection. 8. Waste & waste water were above the all of the invert & outlet inverts of the system. SIG A N T U R - -- Name : J . P . Macomber Jr . ---------------------- Corrip any : Jos eeh PJ_ Macomber & Son, Inc . Address :__BQx _E_E--__-------__ Phone :_-508-775_ 3338 THIS CERT IFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachflelds Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775.3338 775.6412 ,per 1 �-\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:75 Lombard Ave West Barnstable,Mass. 02668 Owner's Name: John Scanlon Owner's Address: Yj�jrj. Rnad 0steryi l h- -MARR 0 6S5 Date of Inspection:1 o/1 f 0 2 Name of Inspector: (please print) Joseph P'Macomber Jr.' Company Name:J.P.Macomber & Son Inc. 'Flailing Address:Br)x 66 Cent-Prvi 1 le,Mass. O2632 Telephone Number: 56B_77S_3338 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector,pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: Passes Conditionally Passes � eds Further Evaluation by the Local Approving Authoriry Fa' t Inspector's Signatu . Date: The system inspector 4k submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspection. If the system 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 authoriry,. Notes and Comments This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (con(inued) Property Address: 75 Lombard Ave West Barns a e, ass. 668 Owner:John Scanlon Date of Inspection: 1 0/1 /02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes �d 1 have-not foundiamyinformation which indicates that any of the failure criteria described in 310 CMR '75. 003 Er7n 10 CI R`15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The leaching pits .are in hydraulic failure. A new leaching area need to hp i ncta 1 1 ad t 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. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If"not determined"please explain. ,VO 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. •Afietal 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. ND explain: We 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,approval of Board of Health): settled or uneven distribution box. System will pass inspection if(with ' broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: A_ 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 obstruction is removed ND explain: 2 Page 3 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 75 Lombard Ave West Barnat-ahl p. mAgg Owner:John S(-anl nn Date of Inspection: 10 111 /02 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. I. 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: �a 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 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. .(Jd The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. dfv 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 supple well". Method used to determine distance An 66 ,A&j "This system passes if the well water analysis, performed at a DEP certified laboratory, 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, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Paee 4 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Propem Address75 Lombard Ave West Barnstable,Mass. 02668 Owner: John Scanlon Date of Inspection: 1 fl/1 jo2 D. System Failure Criteria applicable to all systems: You must indicate "yes" or "no" to each of the following for all inspections: V No acku of sewage into facility or system component due to overloaded or clo eed SAS or cesspool Discharee or ponding of e�luent to the sur ace of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ Static liquid level in the isrributio, box above outlet invert due to an overloaded or clogged SAS or cesspool 1Lkb 5 6 xld squid depth in.ceupcel is less than 6" below invert or available volume is less than 'A day now equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _L. ny 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 FYy water supply. _ portion of a cesspool or privy is within a Zone I of a public well. portion of a cesspool or privy is within 50 feet of a private water supply well. v 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. jTbis system passes if the well water analysis, performed at a DEP certified laboratory, 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, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma �(Yes.rNo) The system fails. I have determined that one or more of the above failure criteria exist as described in 3 i0 CMR 15,303. therefore the system fails. The system owner r Y Y should contact the Board o. 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. You must indicate either"yes" or"no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) des no !/th>e system is within 400 feet of a surface drinking water supply e system is within 200 feet of a tributary to a surface drinking water supply i� the system is located in a nitrogen sensitive area (interim Wellhead Protection Area— IWPA) or a mapped Zone 11 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. 4 Page S of I I OFFICIAL INSPECTION SAL SOR VOLUNTY STEM NS ECTION FORM SUBSURFACE SEWAGE PART B CHECKLIST Properry Address: 75 Lomh,rrl nve ass. 02668 Owner: p T h Saa4en Date of lospectioo: Check if the following have been done You must indicate "yes"or"no" as to each of the following: Yes No _ �V Pumping information was provided by the owner, occupant, or Board of Health were any of she 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 pan of this inspection ? Were as built plans of the system obtained and examined? (If they were not available note as N/A) n Was the facility or dwelling inspected for signs of sewage back up . 'Alas the site inspected for signs of break out ? Were all system components,-a.,-�eluding the SAS, located on site ? Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condit;on 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 seµ age disposal systems ? The size and location of the Soil Absorption System (SAS) on the site has been determined based on Yes o Existing information. For example, a plan at the Board of Health. _/1�_ Determined in the field (if any of the failure criteria related to Pan C is at issue approximation of distance is unacceptable) (310 CM-R 1 5.302(3)(b)) 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 75 Lombard Ave West Barnstable,Mass. 02668 Owner:John Scanlon Date of Inspection: 1 0/1 /0 2 FLOW CONDITIONS RESIDENTIAL C Number of bedrooms(design): N Number of bedrooms(actual): t7 6, DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): tk�J� 04 l�I Number of current residents: e4 Does residence have a garbage grinder(yes or no): 40 Is laundry on a separate sewage system (yes or no):, [if yes separate inspection required] Laundry system inspected(yes or no): I Seasonal use: (yes or no): •,/ Water meter readings, if available(last 2 years usage(gpd)): If the well has not Sump pump(yes n been tested within Last date of occupaancyy:: I the past 12 months ` COMMERCIAL/INDUSTRIAL it should be doneat this time. Type of establishment: /I See pages 6A & 6B Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/s ft,etc.): lJ . Grease trap present(yes or no):�✓4 Industrial waste holding tank present(yes or no): ee—IX Non-sanitary waste discharged to the Title y tem (yes or no):_ Water meter readings, if available: �j Last date of occupancy/use: ,11� OTHER(describe): /1J19 GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection (yes or no): If yes, volume pumped: yED�gallons -- How was quantity pumped determined? //J611--wy/ Reason for pumping:Pumped the intire system Waste water was above all of the invert & outlet invert pipes.System is in hydraulic failure. A new TYPPOFSYSTEM leaching area needs to be installed. ,,'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) -100r_Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank �Attach a copy of the DEP approval Other(describe): Ap ximate aye of al com one s, date ' stalled (if known)and sourc f information: Were sewage odors detected when arriving at the site(yes or no): d 6 Page 7 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 75 Lombard Ave West Barnstable,Mass. 02668 Owner:john Scanlon Date of Inspection: 1 Q f 1 /o 2 BUILDING SEWER (locate on site plan) Depth below grade: 3r Materials of construction: cast iron 40 PVCVd other�(explain): WO Distance from private water supply well or suction line: � f Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of leakage.The system is vented through the house vents. SEPTIC TANK: i (locate on site plan)1t�G2'X�'�� Depth below grade: XG N Material of construction: vconcrete/Ornetalbfiberglass�_polyethylene /Ub-other(explain) Az If tank is metal list age: e Is age confirmed by a Certificate of Compliance (yes or no):'! Aattach a copy of certificate) ,( Dimensions: Sludge depth: Distance from top of sl ge to bottom of outlet tee or baffle: Scum thickness: _0 Distance from top of scum to top of outlet tee or baffle: C� Distance from bottom of scum to bottom of outlet tee or baffle: How'were dimensions determined: ptimnerj at ti me of i nspert-i nn Comments(on pumping recommendations, inlet and outlet.tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of-leakage, etc.): P»m= tha -,e t-i r rank PxiprV 2-1 VparS LnlPt &—QLltlpt tp,'S are in place The tank is cti ytu.�aiiy sound- souun,g and. grows no evidence of leakage. GREASE TRAP (locate on site plan) Depth below grade: 1W Material of construct,041f�concretwl,4�metal,Wfitberglass 44olyethylene/Ather (explain): Dimensions: Scum thickness: lyly 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): GrpaGa trap i -, nnt- prt?GE'nt� 7 Page 8 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 75 Lombard Ave W t Barnstable,Mass. 02668 Owner: John Scan on Date of lospectioo: TIGHT or HOLDING TANK (tank must be pumpcd at time of inspection)(locate on site plan) Depth below grade: 4)A Material of consrructio concrete IV4mcLal & fiberglass,60 polyethyleneti4other(explain): Dimensions Capacity. �gallonsDesten Floµay Alarm present (yes or no). Alarm level: _ Alarm in working order(yes or no): A 4 Date of last pumping: i! ,4 Comments (condition of alarm and float switches, etc.): Tight or holding tanks are nou presenL. DISTPJBUTION BOX: z(if present must be opened)(locate on site plan) ) Deptn of liquid level above outlet invert: l°iCj 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.): ox has two laterals .There is evidence of solids evidence of leaka e into or ou o e o Pt.'.11,1P CHA:�IBEVjt&4locate on site plan) Pumps in working order(yes or no): 0 Alarms to working order (yes or no):-9 Comments (note condition Df pump chamber, condition of pumps and appurtenances, etc.): t- nrt-sent 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:75 Lombard Ave West Barnstable,Mass. Owner: John Scanlon Date of Inspection: 1 o/1 f o 2 SOIL ABSORPTION SYSTEM (SAS): locate on site plan,excavation not required) 2-1000 gallon precast leachinq pit. ( 6 ' X10 ' If SAS not located explain why: Located: See page 10 Teaching pits, number: leaching chambers, number: a leaching galleries,number: r leaching trenches,number, length: leaching fields,number, dimensions: 6 overflow cesspool, number:t _ innovative/alternative system Type/name oftechnologyl/�.(� ✓`��� Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Clay-ri ay Sand mix to mP(3i tim sand gnth leaching pits are in Soils are dam .Waste water is above the invert pipes o the pits. A new leaching area needs to be installed.Vegetation is normal. CESSPOOLS(cesspool must be pumped as part of inspect ion)(locate on site plan) Number and configuration: _ Depth—top of liquid to inlet invert: �Q Depth of solids layer: /t Depth of scum laver Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspools are not present PRIVY/1�W&(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.): Privy i a nni- j)rr-sr-nt 9 Prdc 10 of I I OFF!C� INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMEN-5 SUBSURFACE SEwACE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM fNFOR ,,tATION (conilnvco) p.op,rr� moo/,,, 75 Lombard Ave o. o,r John SPst arns a e,Mass. 02668 c 01 In,p,c oo: 5X-ETCH Of SCwACC DISPOSAL SYSTCM po„I XI,cm Inclv4(A: I I c I IC 11 IcIll fwo permincni rcfcrcncc IInCln,rc, o,^cr,i„vzi to<,�, ,u ..,n, ..,,non i00 f„, l.oc„c wnfrf public w„<r Ivpply cnicrl Inc bvil0in, 1 i 40 ' Ii 13 O 0 to I � 0 p I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.... .................. FeE...$....3.0—na. i rusttl ork,a Tumitriutinn Permit Permission is hereby granted.......) .P.Macomber Jr . ........................................................................................... to Construct ( ) or Repair (X)o an Individual Sewage Disposal System at No..2.5...Lambard-Asze...hZas.t...Bax nstahle....................................... .............................................................. Street as shown,on the application for Disposal Works Construction Per ' y ���� Dated�������............. ....................... _ 44 -DATE............ .��,.. 1............................................. Board of Health FORM 36508 HOBBS Q WARREN,INC..PUBLISHERS THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE &rtifirate of CZomplizinrP THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) by J.P.Macomber Jr . .................................................................................................................................................................... at ......7..5....L.ambar..d...Ave....Was.t....Barnstable..................................................................................................................................... has been installed in accordance with the provisions of TITI.E 5 of The State Environmental Code as 4escrihed in the application for Disposal Works Construction Permit No. ..... ..y.......Y.s.g...... dated ......... ..lV. ..rj.y., THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............U......~.... ... '................ ....�.................. Inspector ......... `n 2:c ..... i ��%........................................ f Page 11 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 75 Lombard Ave West Barnstable-Mass.02668 Owner: John Scanlon Date of Inspection: 1 o 11 J n 2 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water ' ;eet Please indicate(check)all methods used to detennine the high ground water elevation: YES Obtained from system design plans on record- If checked, date of design plan reviewed: 10/1 /0 2 yF„S Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: //4 YES Checked with local excavators, installers-(attach documentation) YES Accessed USGS database-explain: http: I I town.barnstable,ma.us. You must describe how you established the high ground water elevation: Used: Ga 12 1 nd water above sea level, Ised: USGS• bservation well data June 1992 Ised: USGS; Technical bulletin 92-0001 Plate #2 Annrial rangpG of c1rn1inr3 Tup of Ground water elevations_ Leaching Pit /"eet Groundwater. Ta4417 Bottom of Pit High Groundwater Adjustment 1.8 ft er J p Fnmpter Method Therefore, the vertical separation distance between the borto 'rJ� of the leaching pit and the adjusted groundwater table is feet. ]1 y+•nrnnr.—rs•rs-�.-r�— rn—arr.•nmmn-.r...rr..r:-.•s.-r•.rsrr:.r.n•^rm en-•nv*va•a�i:rs-:z , TOWN OF Barnstable BOARD OF IIEALTII ST(1SlIftFACR SEWAGE I)I DISPOSAL SYSTEM I N� 9I'FCTION FORM - PART D .-- CERTIFICATION r - —TYPE OR PRINT UEARLY— PROPERTY INSPECTED ' STREET ADDRESS75 Lombard Ave West Barnstable,Mass. ' ASSESSORS MAP , BLOCK AND PARCEL #f OWNER' s NAME John Scanlan PART D - CERTIFICATION Y NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAMEJ.P.Macomber & Son Inc:"* COMPANY ADDRESS Box 66 Centerville Mass. 02632 Street Town or City State L(P COMPANY TELEPHONE (508-7175-3338 FAX ( 508 ) 790 -1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage dieposa7 system at dftthis address and that the information reported is true , accurate , and %®omplete as of the time of :inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent wi th m trainin g Y g and experience In the proper function and maintenance of on- site sewage disposal systems , Check one : System PASSED , The inspection «hich I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 16 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form , _ System FAILED* The inspection which I have condtcted has found that the system fails to Protect the public health and the environment in accordance with Title 6 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form , Inspector Signature1"OJ�,4644 Date .iMr T-� copy of thi t.ification must be provided to the OWNER, the BUYER Vnde where applicable ) and the BOARD OF HEAL'I'll. * If the inspection FAILED, the owner or"" Aerator shall upgrade ' the eyetem within one year of the date of the inspection , unless allowed or required otherwise as provided in 3.10 CHR 16 - 305 . patd .doc TOWN OF BARNSTABLE L&CATION 7 � L- d M Besse f SEWAGE # 9 VILLAGE S r 9 �/jL.ASESS0R'S MAP & LOT, INSTALLER'S NAME & PHONE NO. )r W ,4G OAJ eeX. t SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ,� a p/rs (size) O d O NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER OR OWNER 4f- ej -DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: (� ,_ - � VARIANCE GRANTED: Yes No �c. f a r I J lf2- � r IfAl FIms.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphration for Di-wip 3Ml Works Towitrnrtiun trrmit Application is hereby made for a Permit to Construct ( ) or Repair �CX15 an Individual Sewage Disposal System at: 75 Lombard Ave_ ...e s t .Barnstable -----------------------------------------•---•--------•-----------...---•----•-•••....-•----...... Location-address or Lot No. Co..n tt. _...................•------•----•-------------------------------•-•-----•-- •-•---•--•--••----••---------•--•--•........--•--•-•---...--•---..._......--•------•-•••.......--- Owner Address t1.._P....Macnmhes Jr-------------------------------------------------------- ---------------------------------------------•--------------------------------•---•----------- Installer Address UType of Building Size Lot............................Sq. feet Dwellings No. of Bedrooms............4____________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons----------5---------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ __ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid"capacity___._______gallons Length---------------- Width---------------- Diameter_-_.__--__..._ Depth................ Disposal Trench—No. -------------------- Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.__..-._-_---_-____- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by------------------ ....................................................... 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........................ 19 -----------------------------------------------------------------------------------------------••------------------....... ----------------------- 0 Description of Soil.....C 1 ag..t a.... and...•-•-•••------•---•......-•---•---•-•------------------------------•-••-------•-•------•----•---••--•-•-•-----•----------.--•-- x W UNature of Repairs or Alterations—Answer when applicable._ ....1-15 QQ,_--•.. allon•.tank___l_.... .str }..ut on_•.bQx--- --_-�..^'�/ �� P.--_�i ..... Agreement: t� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia ce has b en jgssuuee by the ar of health. Signe _.. . _.. -J% �1� dZ� -o-- 81 ./..9.�':.............. Application Approved . ......... �j/� j�9 Application Disapproved for the following reasons- ------------------------------_--------------------------..._...-----"------------------------------------------------------------ -----------------------------------------------------------------------------------_....._.-----------_-"----.".._-- . ----------------------------- ............................___-... ..... ..............--...-............. .... Date Permit No. �.�/�. .�r�-------------------- Issued --------- �d Date _ / ' ^� FEm_ $ N . THE COMMONWEALTH ormxssAoxussTrs BOARD OF HEALTH TOWN OF BARNSTABLE ��° �.°� ��- K �8� ��� ���0���������� ��� ]�������� ������ ���uti n FrrMtit Application is hereby made for u Permit to Construct ( ) or ]leyxic 2[X)� an Individual Sewage Disposal - System at: 75__ d _Ave_\�eot-'���g��t��bl�L'-'--_-' ------------'--'-_------'_----'----'------'------- Location-Address or Lot No. {�������____......................................................................... ________________________________________________ v°"= Add "ss JL.�2 -,I�� .................................................... -------_--------................................................................. 1.4 Installer Address PQ Type ofBuilding Size Lot............................Sq. feet Dwelling,—, No. of Bedrooms------------4-----------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons..........5............... 6bmpeco ( ) -- Cafeteria ( ) A4 Other fixtures ^� . -'--.-----.---_.-----............................................................................................... Design Flmv-'--------.-...-----.gallons per person per day. Total daily 8ow.-----'.-----------.gallons. Septic Tank—Liquid y �coyac� ---.gallons Length-----' \�i�b-----. Diameter_----' Depth--.---- DisposalTrcucb--��o- -'----_-' Width-------. Iood Length.................... Total leaching area.-----'---sq. 6. Seepage Pit Nu------.. Diameter--.---- Depth b6mv inlet.................... Total leaching area..................sq. ft. Z {}t6nc Distribution box ( ) Dosing tank ( ) '- Percolation Test Results Performed 6y------------------------------- .......................................... Date-.-_ ......... _ Test Pit No. l................miuotceperinc6 Depth of Test Pit-------. Depth to ground water 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth toground watcr--------. -- | »fS»�'-'��l��..���_.�.�n«____.__.________--_-_-----'----'_____'______________---'-'---'--'--'--______________-----'------'------------'--'-----''---'---------''----'' Z. --_._--''—'-'-'-_'---------''---------.----------_-_..------'-----'---'____'_ U Nature,of Repairs or Alterations—Answer -QT�i_t ce_s_spg ;L§ .j s_t_a_1_1 � _qall�� ...���� l.� tiou-]��?� - _ Agreement: The undersigned agrees zo install the ufocc6eocrUbe6Individual Sewage Disposal System io accordance with the provisions of TITLE 5 of the State Euvion000eotul Code--The undersigned 6uo6ec agrees not to place the system iuoperu6uoou f f } 6 b health. ..~~~..~~^~'�-'^--------' --^^ ^. ^ .----. Application Approved -------�.�'---------'�-----------� (}°������------ � Application Disapproved for t� 8ouing ,xasuxn: ---------------------------' ------------------------------------------------------------------' ------------- Permit No -'�x�~ '����---------------- Issued - ----__________---_-----__---_---_______----_________-______________-----____ ____ THE COMMONWEALTH oFwAssAcHussrrs ' BOARD OF HEALTH TOWN OF BARNSTABLE �T°~�i����+m °� ~��%tr� __--_'__-- -- ___'�-' THIS IS TO TY T a helnvdu SwgDspa S �m ���� ( ) m ��id XX ) J 9 }�acnmbez Jr ' ' . 6v---��--�--------------�-------------------------------------------------------------' ' *sae ut -'T ��J/�-J����t.-���nstabl/�-------------------------------------------' provisions of TITLE 5 of 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. ___________-________________-______'`______-_________________-____-----__- rxscowMomwcAcr* opmAssxoHussrrs BOARD OF HEALTH ��V��� ���� ��'������������~�� TOWN~ ~~ BARN STABLE ^ � l�o.-�.-�-.--.1'��m FEE-'~-''�.�'�!���' z/u e sommber Jr. Permissionin hereby granted----�-.�---_ ................................................................................... ............................. to Construct ( ) or Repair /Xl8 an Individual S Disposal Syom�o at ,o..75_I,��mba��d__�ve_lWc<git__B�����lstabI��-___.___.____._______.______._________________ Street «q uos6ovvono the annicu600for Disposal Works Construction Permit 0 � -------------------- --------------'---------'-------- o=rd o f H ealth DATE................ /��.l-.L_'-------_---------' � � FORM ywrooxpmesm WARREN,mC..PUBLISHERS 1/1� oll 7 5— . ?a , �-9, 6 ✓ LOCATION SEVAGE PERMIT I30• VILLAGE II'4 - (�,v v IOSTA LLER'S GAME b ADDRESS D U 11 D E R OR OCyp ER f� w w DATE PERMIT ISSUED DATE COMPLIANCE ISSUED _g (� r it �� 1. ., �, ,� Fps..... ...1...-.Q....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..................- TOE........OF.......�a=Stable---------------.......................................... Applira aan for Uhipaaaal Workii Toutitrnrtiaan ramit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: Lombard Ave._,___West_.Barnstable1_•MA._..02668 ..•---........___ -- - Location-Address or Lot No. Ruth King------•................................•-•--•.............-•------ - -- Chadwick Ave.._.Hyaxul ,._MA....Q2601...-------------•-----•-......•--•-- ....... Owner Address A._&__.. Cess.00l_ Service............................................... 128 Bishops_-Terrace,._.Hyannis .-_MA_....026Q],------ Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.................2_.................--....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons__--3-.----_------------ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- -- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter-----------..... Depth................ 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........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water..-._.-----.---__-_-.--. Test Pit No. 2................minutes per inch Depth of Test Pit----................ Depth to ground water........................ -•-•---•--...--•..............•---•-•-•---....-•----•------•-•--.....-•---------•---......-----------•-•---•--------------•-• ............................... ODescription of Soil----------------------Sand..•--•---••---•-•----•-.....--•--•--••---•-•-------------------------------•••-••-•-•--••-••---•••••••-••••-•----•-•-•-•..........------ x U W ----------------------------------------------------------------------------------------------------------------------------------------- --------------•---------------------------------------••••- U Nature of Repairs or Alterations—Answer when applicable_-__-i.Uat,.11ati_Qn._of--a... .,000_.ga 11an__prR=past, stone packed leach..pit (overflow_._____ -----------------------------------------------------•-----•-----------------------...--•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T T p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has, issued by the boar of li. th. Si e ems. .... .....; 9�23.18Q•- Dat Application Approved B �.G g PP PP y---•-- •/ . . 11f --------------------- ---•---------9/--23�80 Date Application Disapproved for the following reasons:................................................................................................................ ---------- ----------------------------- _------------------------------------------------- --------------------------------------- •-------------------------------- •------••--•----------- Date Permit No.---80................................................ Issued---9/23/80 Date N6.Q=----'", °2�-�--= FRim $... .00........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tom. --.....O F......$a.=J$t 61? e-----"---------.......................................... Appliration for Uiipoaal Workii Toostrortiuo Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: Lombard Ave.•,_.West Ba.rnstable,..MA_..02668 .................- --------- ---- •..... ........ Location-Address or Lot No. Ruth Kind .. - Chadwick_Ave. -H�!annis,..MA....0260...............•---•--- Owner Address aA de_ B Cesspool Service________________________________________________ 128 Bishops Terracex.HYra:nnis-,---MA--•02601....... Installer Address Q Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms................2._......._...............Expansion Attic ( ) Garbage Grinder ( ) a1, ther—Type of Building ............................ No. of persons.... Showers ( ) — Cafeteria ( ) � Other fixtures ---------------------------------------------------------------------------------------"----------------------------------------••------•-------•---- W Design Flow............................................gallons per person per day. Total daily flow...........................................gallons. WSeptic Tank—Liquid capacity............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 ( ) 11 Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water-._-_-_______-__.-_-_--- rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------------------------•------------•------...----•------•---.................-----•--------------•-----------•----------•-•-•--....-- O, Descrjption of Soil --------------------Sat].....................................................---................................................................................... t . U W •-------•-----------------------------------•----------------------•-------------_.--------- -----•-------••-•-----..._.:----•---••-•------........-----•-------•--------••---.........--------... V f Nature of Repairs or Alteratio s—Answe when applicable._.__instillation-.of--a-.1.000 -.gall oIt•-��e-Cast, ,. c stone packed leach pitoverflow . -- f Agreement: - The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with " the provisions of TI:L y g g p y 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in Y- �'operation until a Certificate of Compliance has been issued by the boarg of li lth. t Is?e . .............fir _-- __ _...-�.� =�` E g(�3180- / Application Approved By.... `"r' ... -- .. j ------......g1 �80 // Date Application Disapproved for the following reasons:_......' V t r p Date Permit No. .......... Issued__.9/2 3/80 a!` Date THE COMMONWEALTH OF MASSACHUSETTS BOARDr OF HEALTH ........Tow..........OF...................Barnstable .................. ..................................... 01rrtifiratr:of Tompliaorr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Re aired (x ) b A & B Cess ,00l Service, 128 Bishops Terrace, Hyannis, p1A 02601 - -- 264 y 7.?.5............ ------------ Lombard*Ave-''• West Barnstable, MA OW6r - Ruth Kind at ----•----- has been installed in accordance with the provisions of TIT Z j of Ape State Sanitary Code As qescribed in the application for Disposal Works Construction Permit No 80t -X',Z,*............ dated_...._-__9 8Q ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TR_ E® AS A GUARANTEE THAT THE � SYSTEM WILL FUNCTION SATISFACTORY p ----� . ------------------------------------- DATE 9/23/8o Ins ector y//+may .. 'i7.'t°�'K''r"�x iV ate+ <. ,,. • ? 4! ZZ s `r y F ++ ,;it7"t.'fl+F r„ �'. .Yr�k ,�k' �f'f. a:4 �, t,:.. 'e '�i`, �-tc ' n. .� x � a s �r- "`�ItiF�.i7 wM.;K�.�h `�' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 80-5'4 To .....OF. B*nstable--------------•-- FEEA...5..00........ �i��ro��l ork� �oa��tr�rtiort rrbtit A & B Cess ool Service Permission is hereby granted ................ P•..... • .... .... to Construct ( j ) or Repair ( x)) an Individual Sewage Disposal System at No.Lombard Ave. Vest Barnstable YA 02668 - Ruth King � ••-•------......•--------------------------•---- 1 Street as shown on the application for Disposal Works Construction mit 0^ _. __-_. Dated.___________9/z�180............ -------•--- �G! - 9/23/SO Board of Healtt ' 1 DATE --------•-•---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 9 it TOP OF FOUNDATION = 101 .8' 5" DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS= 91 .00'-91 .83' GENERAL NOTES REMOVABLE COVER SLOPE @ 2% MIN. OVER SYSTEM FINISH GRADE OVER D-BOX= 91 .50' 4" SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE @ FND. EL.= 99•9' FINISH GRADE OVER TANK EL.= 95.5'-96.5' 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. EXISTING 4" 20"MIN. ACCESS COVER � PLACE RISERS ON ALL CHAMBERS 9" MIN. TOP OF SAS= 8 8.8 3 C I. PIPE (TYPICAL FOR 3) 36" MAX. 36"MAX. 9"MIN TO 6" OF FINISHED GRADE 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD PROPOSED 4" �_ 88.0' 36"MAX• BREAKOUT EL = 88.5' OF HEALTH AND THE DESIGN ENGINEER. PVC PIPE 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL -- „ 2" DROP MIN. PROVIDE WATERTIGHT BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. JO' 6 3 3" DROP MAX. 3'� 9�� JOINTS (TYP.)14" M 93.50' SEPTIC TANKVC IN OM 4" PVC OUT TO o = = oo �oELEVATION = 88.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS $ 93 75' I LEACHING FACILITY op o o A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF po THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 12" 2' o ©� p� opt 5• SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. ' OUTLET TEE $$.rj0' MIN. 8$.33' 48 � � '� � � � � � � o0 0 0 � � � � � o0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 47.3' 22"ZABEL FILTER a 6" CRUSHED STONE ! po 0 0 MODEL#A1801 HIP OVER MECHANICALLY 4 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED (APPROX.) COMPACTED BASE - 8•5' - 4' PRIOR TO BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND (GAS BAFFLE ON _4'_ 4.9' BOTTOM) 5 OUTLET DISTRIBUTION BOX 42.0' (TYP) READY FOR INSPECTION. SYSTEM IS NOT TO BE BACK FILLED TO BE INSTALLED ON A LEVEL STABLE < 78.35' 12 9' WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. BASE. FIRST TWO FEET OF OUTLET 86.00' GROUND WATER ELEV.= PROPOSED 1500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. - 500 GAL. CI- AMBERS 5'MIN. 8. ELEVATIONS BASED ON ASSUMED DATUM OF 100.0' MSL OBTAINED ' LENGTH 10'6" WIDTH �'� DEPTH 5'7" CROSS SECTION VIEW FROM PK NAIL IN PAVEMENT AS SHOWN ON PLAN. SEPTYPICAL CHAMBER PROFILE E DETAILS CHAMBER END VIEW TIC TA PROFILE DISTRIBUTION T 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION NOT TO SCALE NOT TO SCALE THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE NOT TO SCALE AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY �y �� � f DISCREPANCIES TO THE DESIGN ENGINEER. �q- SI G 4 J � '�'� "� ��'`, �` ' '� ' " ` '_ �' 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE "a 4 �`�r: STRUCTURES SHALL BE MADE WATERTIGHT. R r ' 4, INSPECTOR: SOIL EVALUATOR: Samuel Philos Jensen 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR IN, \ j� ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN IN, DATE: October 15.2002 SUCH DETERMINATION FROM APPROPRIATE AUTHORITY N. v \ \ t TEST PIT#: 1 ! '� ' 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS r___..----___ ���* k N w ELEV TOP= 91.10, B M LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH co PK Nail 4 �� , ELEV WATER >153" BGS CASE THEY SHALL WITHSTAND H-20 LOADING. CL ~ PERC RATE _ < 2 Min/I n Assumed 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND Assumed rrr , ,\ �� FINES. r o o c ^ \ �� DEPTH OF PERC= N.A. 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND � \b\ � . ` 3 TEXTURAL CLASS: 1 UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES `.� � ' OF LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN ff11 �` �' '� O,\A \ a F �" COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN 'a i,a 7 Yi -9y. . i ACCORDANCE WITH 310 CM 15.255(3). G� < ti 0�� fit � �� 0 Fill 91.10" ©�.O �') }+ L E , 3 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES E z - Z , Szz, u bwry i r,h. k s "� 3(, 90.85' FOUND IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. A Loam EXISTING WELL 2.5Y 3/3 16. PROPOSED PROJECT IS LOCATED WITHIN: � �� f , „` a nn r' " y �x y� � i ��. 1 JT•" 89.85' Us N + ,� Silt Loam ASSESSORS MAP 155 PARCEL 003 r } s j 24" 89.10' 17. OWNER OF RECORD: JOHN SCANDLEN 0 C1 Silt Loam 5Y 5/2 ADDRESS: 66 BLANID ROAD •r . � T � � "•.,,,.. O� "Yr't } '� � ``rt ., ! t �ta�.E�' s n � Y �i,y � x�. fi�^ww++' 86.60' � - r 54 " OSTERVILLE, MA 02655 , EXISTING 1000 GALLON SEPTIC ' ' Loam Sand x ;� � 5i Y TANK TO BE PUMPED, BOTTOM to a - N 2 5 Y 5/4 r , H 1 a C2 ° :. w. .. <5/o mottling ACKFIL D + _ _ n _ e.:_ P r t _ .; 5 PUNCTURED AND B LE _ , o } \ \ WITHCLEAN SAND f ' t �, t.: z Faint' 18. PLAN REFERENCE: BOOK _ 553 PAGE 12 T fTl }} 1 . ,� �`,.\ '� fi �.,. ��4 ",.� fj- t $r82.45u, Med. Sand 0 d " 4' Loose, Single ' HSE#75 "' � �' � �. { 1 g. , ALL DISTURBED AREAS SHALL BE-RESTORED TO ORIGINAL CONDITION. , \ `` C3 Grained ` � h �h' + � •, EXISTING 5-BDR , ,� + \ �.,` DWELLING + `t ; '� \ No Groundwater or + ,. ,5z.` 20• PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY + + ` LOCUS PLAN Weeping Observed FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY PROPOSED 1500 ; ;+ 35 O.F. = 101.8' ; ; \ FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. GALLON SEPTIC TANK ' Deck i i ~`` `\ xT r ✓' \ `., SCALE: 1" = 1000' ., DATALEGEND ;} ° i 513 r f' '`� 50 EXISTING SPOT GRADES iu �`"3� ..,. �30 EXISTING CONTOUR DISTRIBUTION BOX }O .4F / NUMBER OF BEDROOMS (ASSESSORS) 5 `}} Bush i; NUMBER OF BEDROOMS (DESIGN) 5 50 PROPOSED SPOT GRADES lrtI NUMBER OF PERSONS 5 I-5� }. 3 , DESIGN FLOW 110 GAUDAY/BEDROOM PROPOSED CONTOUR INSTALL 4-500-GAL 19p �} 12'"Locus `� - ASSESSORS MAP � 55 f/ TOTAL DESIGN FLOW 550 GAUDAY Ef'1'�. --- -- EXISTING ELECTRICAL UTILITIES CHAMBERS 16" Locus �}, a �" � s PARCEL 3 " -GAS-GAS- EXISTING GAS LINE „ ar Bust 67 857 SQ. FT. ± ,� 10 le �Oherry ,� r p Us�1 ,f DESIGN FLOW X 200% = 1100GAUDAY -`�'-`- `�w° - `� �"--'--'-- EXISTING WATER LINE c REMOVE UNSUITABLE SOIL WITHIN ; 24"'Locus ,,'f USE 1500 GALLON SEPTIC TANK 5-FT OF SYSTEM TO ELEV. 82.60' 2s �f pie - TEST PIT LOCATION AND REPLACE WITH CLEAN SAND `,TP 1 7 �T w, w ,.... (MINIMUM PER TITLE V) (SEE NOTE 14) ush �•, 15'F1r 1�1.10 INSTALL 4- 500 GAL. CHAMBERS O 00 PROPOSED 1500 GALLON SEPTIC TANK n 4 SOLID SCHEDULE 40 PVC PIPE SIDEWALL CAPACITY ``-�- __� 4 5�__ '" (L+W) (2 SIDES) (2' HIGH) (.74 GPD/S.F.) = GAUDAY Q DISTRIBUTION BOX (42' + 12.9�') (2) (2') ( .74 GPD/S.F.} = 162.5 GAUDAY 500 GAL. LEACHING CHAMBER qu�os!" 0" Lac ta'°Maple BOTTOM CAPACITY 20 Locust (LENGTH x WIDTH) (.74 GPD/S.F.) = GAUDAY (42'x 12.9') (.74 GPD/S.F.) = 400.9 GAUDAY REV. DATE BY APP'D. DESCRIPTION TOTALS: PROPOSED SEPTIC SYSTEM UPGRADE TOTAL NUMBER OF CHAMBERS 4 PREPARED FOR: TOTAL LEACHING AREA 761.4 SQ. FT. JOHN SCANDLEN TOTAL LEACHING CAPACITY 563.4 GAUDAY �7 , F LOCATED AT 75 LOMBARD AVENUE WEST BARNSTABLE, MA 02668 SCALE: 1 INCH = 30 FT. DATE: OCTOBER 23, 2002 0 15 30 60 120 FEET � AAA PREPARED BY: JCHN L "URC"'LL m� JC ENGINEERING, INC. JR. NaCNIL 5 ROUNDHILL BLVD. EAST WAREHAM MA 02538 SITE PLAN �r� : 508.273.0377 Drawn By: SPJ Designed By: SPJ Checked By: JLC JOB No.313 SCALE: 1"= 30'