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HomeMy WebLinkAbout0900 OAK STREET (CENT./W.BARN) - Health r 900 Oak Street W. Barnstable A = 216 008 a I I c� Commonwealth of Massachusetts a 008 i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel _ Owner Owner's Name information is required for every West Barnstable VIMA 02668 03/23/2021 page. City/Town State Zip Code Date of Inspection- Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Imng out forms A. Inspector Information 514v- 1531'-{ filling out forms on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road Company Address Teaticket Ma. 02536 Cityrrown State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 03/23/2021 I spector's Signature Date The system inspector shall 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 r c Commonwealth of Massachusetts Title 5 Official Inspection Form 1' ; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 0 900 Oak St v Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: This 2 bedroom home has an H-10 1500 gallon septic tank with an H-10 D-Box feeding (2) leaching chambers with stone. At the time of the inspection no visible failure criteria was found. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth f ea th o Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St V� Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broke-i pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts +M1 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments >r 900 Oak St v Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: r Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �m Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section C.4. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments v 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ (Existing information. For example, a plan at the Board of Health. ® ❑ 'Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityfrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based) on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 22 plus GP Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d well water 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St v Property Address Tracey Sossel Owner Owner's Name information is West Barnstable MA 02668 03/23/2021 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping; t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 i c Commonwealth of Massachusetts +� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 4. TypeY of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 11/27/2002 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 15"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10 plus feet feet Comments (on condition of joints, venting, evidence of leakage, etc.): Water was flushed and it came freely. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 6"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: H-10 1500 gallon Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. based on the future use of the home. At the time of inspection the liquid level was at working level and the tee's were in place. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construcJon: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments I 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid leve above outlet invert 0" 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.): At the time of the inspection the liquid level was at working level and there were no visible signs of leakage or solids carryover. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 I c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: Two ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 f cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M-,6 900 Oak St u Property Address Tracey Sossel Owner Owner's Name information is West Barnstable MA 02668 03/23/2021 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection no visible failure criteria was found. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 f c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St V Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): Lt5,n.p.,d:oc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately U I rt9�� / N f0 t � 76 0 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 ( c� Commonwealth of Massachusetts +M1 ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St V Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 12 plus feet feet Please indicate all methods.used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: I augered a hole at a lower elevation and shot it with a transit to show 4 plus feet of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form � i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 900 Oak St v� Property Address Tracey Sossel Owner Owner's Name information is required for every West Barnstable MA 02668 03/23/2021 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 f � i TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date l ' Time: In Out Owner Tenant Address J '" 1/U4"'V`" 6L Address r 17 Complian a Remarks or Regulation# Yes KNO Recommendations 2. Kitchen Facilities �( 3. Bathroom Facilities IMP�nri- 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities Q 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width �-�✓� 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) �� I Person Insectors) Interviewed p If Public Building such as Store or Hotel/Motel specify here ld;IJ } TOWN OF BARNSTABLE Approved: sk4-1� ---- - BOARD OF HEALTH MLD Cent ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date .�21jq IV Time: In (000 Out Owner Tenant a w &A Address ffir 1 Y-�� 5 Al Ic A) �� Address Compliance Remarks or Regulation# Yes ZNO Recommendations 2. Kitchen Facilities Ah V l D wq)1-0-A) 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing 18. Driveway Width 90 ,Z' 447- 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicle w d ax) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here Massachusetts Department of Environmental Management 0 w Office of Water Resources TYPE OR PRINT ONLY Well Completion Report 1. WELL LOCATION GPS (OPTIONAL) LATITUDE . LONGITUDE Address at Well Location:�� ��K r Property Owner: 5d S5 OC�"►�4¢C- 44'JS- 0 Subdivision Name: Mailing Address: �L/ GKYKot?/(i�G �2 i City/Town: J/�!�S7i4 gLt City/Town: A4"sz7o vf Assessors Map 2"R O Assessors Lot#: Obg NOTE: Assessors Map and Lot# mandatory if no street address available Board of Health permit obtained: Yes C Not Required ❑ Permit NumberW -*, D eJssued 2.WORK PERFORMED 3. PROPOSED USE 4. DRILLING METHOD ] ❑ New Well ❑ Abandon K Domestic ❑ Irrigation ❑ Cable D,.Auger } ElDeepen ElRecondition ❑ Monitoring ElMunicipal ElAir Hammer" ❑ Direct Push ",Replace ❑ Other ❑ Industrial El Other K Mud.ho'ta ,❑ Other 5.WELL LOG oC Unconsolidated Consolidated 6. SITE SKETCH(use permanent landmarks with distances) Q PemieabiGly — -0 ID Al From (ft) To(ft) > High Low rn C7 g m Other Rock Type " 0 5 011 l 2- M-r T 2- 1.7 9�0 o TAq 7.WELL CONSTRUCTION 8. CASING Total Depth Drilled l O� From (ft) To. Casing Type and Material Size O.D. (in) Well Seal Type - Date.D^Ili'g C9mplete d S 5 �- (C t�S S l �t(0(02- 9.SCREEN From (ft) To (ft) Slot Size w Screer-Type and Material Screen Diameter g p 10.FILTER PACK I GROUT`/ABANDONMENT MATERIAL 11.ADDITIONAL WELL INFORMATION .6 Developed? N Yes ❑ No From (ft) To (ft) Material Description.',, Purpose Fracture Enhancement? ❑ Yes E No Method Disinfected? Yes ❑ No 12.WELL TEST DATA(PRODUCTION WELLS) 13.STATIC WATER LEVEL(ALL WELLS) Yield,.,'Time Pumped Drawdown to Time Recovery to Depth Below Date Method (GPM) (hrs & min) (Ft. BGS) . (hrs & min) (Ft. BGS) Date Measured Ground Surface (FT) 1862 -Bock ( 00 gc^I 0,0 Z- I-XL- 'd 2• 14.PERMANENT PUMP(IF AVAILABLE) 15.NAME/ADDRESS OF PUMP INSTALLATION COMPANY 'PumpDescription '. Z ' Z,, CCG kC- � a-uq p � V� Horsepower Pump Intake Depth v (ft) Nominal Pump Capacity �0 (gpm) 16.COMMENTS \IAJt �ZM LL 6_� P,�� 14tL 6f4PZ- �6t l ,VLQ MC, 17.WELL DRILLER'S STATEMENT IThis well was drilled andto b ndo ed under my supervision, according to applicable rules and regulations, and this re o ,s m lete and correct to the best of my knowledge. Driller. 0 - �.t NC.To Supervising Driller Si nature: Re istration #:1 1 7161 1'] �j 9 9 C, 9 Firm" °r a1.C. (C-LC I&I Date: -/ 2 2 r7 2— - Rig Permit#: T"1 NOTE Well Completion Reports must be filed by the registered well driller within 30 days of well completion , �w .F . .a,, ►, f `=:BOARD OF HEALTH t E .E;' { «. ♦ p * •a-# ) afr a52ra • . _ a4 < s il °5, kSx .K c ,-�4 F -ii�4�i.. ra t9�T4 t4. wr {.�'Y 10/03/2002 THU 09:43 FAX 508 888 6446 ENVIROTECH LABS 0 001/007 .�� x'NVIROTECHLABORATORIES,.r1Vr ALA CERT NO.:lid AIA 063 449 Rrc.130 S:wd-7ch,, MA 0250 908(RRR-fi'460) 1-800-3394460 FAX(508)888-644G CLIENT: Atlantic Wells LOCA170N. 900 Oak St. ADDRESS; PO Box 339 W. Barnstable, MA N. Eastham, MA Tracey Sossel COLLECTED BY; Atlantic Wells SAMPLE DATE., 9/18/2002 SAMPLE TIME: NA WATER SAMPLE TYPE., New Well DATE RECEIVED., 9/18/2002 LAB I.D. #. 0209428 WELL SPECS.; 811/101, RESULTS OF ANALYSIS: Parameters units Recommended Results Method Date Analyzed Limits Collform bacteria /100ml 0 0 9222 B 9/18/2002 PH PH units 6.5-8.5 6.53 4500 H+ 9/18/2062 Conductance umhos/cm 500 113 120.1 9/18/2002 Nitrate-N mg/L 10.0 1.74 300.0 9/18/2002 Nitrite-N mg/L 1.00 <0.004 300.0 9/18/2002 Sodium mg/L 20.0 24.2 200.7 9/18/2002 Iron mg/L. 0.3 .40.1 200.7 9/18/2002 Manganese mg/L 0.05 c 0.008 200.7 9/18/2002 Volatile Organics ug/L See Report None Detected. EPA 524.2 9/25/2002 COMMENTS: Sodium level is not a health hazard. WATER MEETS EPA STANDARDS AND/S SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. ND=None Detected. <=less than >=greater than TNTC=too numerous to count R ald J. Sa Laboratory Director 10/03/2002 THU 09:43 FAX 508 888 6446 ENVIROTECH LABS 1@ 002/007 Page 2 of 3 R.Y. Analytical Laboratories, Inc. CERTIFICATE OF ANALYSIS r Envirotcch Laboratories, Inc. Date Received: 9/20/02 Approved by: Work Order# 0209-12334 R.I. Sample#: 001 SAMPLE DESCRIPTION: 0209428 900 OAK STREET,W. BARNSTABLE GRAB 09/18/02 SAMPLE DET. ANALYZED PARAMETER .RESULTS LIMIT UNITS METHOD DATE/TEWE ANALYST Volatilc Organic Compounds Bromodichloromethane <0.5 0.5 ugA EPA 524.2 9125102 17:32 NPV Bromoform <0.5 (1.5 ug/l EPA 5Z4.2 9/25102 17:32 NPV Dibromochlommcrhane <0.5 0.5 ug/1 EPA 524.2 9/25M 17:32 NPV Chloroform <0.5 0.5 ugA EPA 524.2 9125102 17:32 NPV I,z-Ilibrgmoethane(ED$) <0.5 0.5 ug/I EPA 524.2 9/25102 17:32 NPV Benzene <0.5 0.5 ugA EPA 574.2 9/25/02 17:32 NPV Carbon Tetrachloride <0.5 0.5 ugA EPA 524.2 9/25102 17,32 NPV 1,20chlorocthane <0.5 0.5 ug/l EPA 524.2 9/25/02 17:32 NPV Trichloroedwne <0.5 0.5 ugA EPA 524.2 9125/02 17:32 NPV 1,4-Diehlorobenzene <0.5 0.5 ug/l EPA 524.2 9125102 17:32 NPV 1,1-Dichloroethane <0.5 0.5 ugA EPA 524.2 9/25/02 17:32 NPV 13,1-Thrhloroethane <0.5 0.5 ugA EPA 524.2 9/25102 17:32 NPV Vinyl Chloride <0.5 ().5 ug/l EPA 524.2 9/25/02 17:32 NPV Bromobenzene <0.5 0.5 ugA EPA 524.2 9/25/02 17:32 NPV Bromomethanc <0.5 0.5 ugn EPA 524.2 9/25A)2 17:32 NPV Chlorobenzene <0.5 0.3 ugA EPA 524.2 9/25102 17:32 NPV Chloroedta,te <0.5 0.5 ug/l EPA 524.2 9/25/02 17:32 NPV Chlnromethane <0.5 0.5 ugll EPA 524.2 9/25/M 17:32 NPV 2-Chlorotolucnc <0.5 0.5 ugll EPA 524.2 9/75102 17:32 NPV 4-Chlorotoluene 0.5 0.5 ugA EPA 524.2 9125102 17:32 NPV Dibromomethane <0.5 0.5 usA EPA 524.2 9/25/02 0:32 NPV 1,3-Dichlorobenzenc <0.5 0.5 ugA EPA 524.2 9/25/02 17:32 NPV 1,2-Dichlorobenzene <0.5 0.5 ug/1 EPA 5Z4.2 9/25/02 17:32 NPV trans-1,2-Dichloroeftne <0.5 0.5 ug/l EPA 524.2 9/25102 17:32 NPV cis-1,2-Dichloroedlene <0-5 OS ugA EPA 524.2 9/25102 17:32 NPV Methylene Chloride <0.5 0.5 og/I EPA$24.2 9/75/02 17:32 NPV 1,1-Dichloroerhene <0.5 OS ugll EPA 524.2 9/25102 17:32 NPV 1.I-Dichloropropme <0.5 0.5 ug/l EPA 524.2 9/25102 17:32 NPV 1,2-Dichloropropanc <0.5 0.5 ug/I BPA 524.7 9125/02 17:32 NPV 1.3-Dichloropropane <0.5 0.5 ug/I EPA 524.2 9125/02 17:32 NPV cis-1,3-13ichlorupropene <0.5 0.5 ug/l EPA 524.2 9/25/02 17:32 NPV 2,2-13ichloropropane <0.5 0.5 us/1 EPA 524.2 9125102 17:32 NPV Edtylbemene <0.5 0.5 ug/l ' EPA 524.2 9/25/02 17:32 NPV Styrene <0.5 0.5 ug/l EPA 524.2 9/25/02 17:32 NPV 1,1,2-TrieWoroethane <0.5 0.5 ug/l EPA 524.2 9/25/02 17:32 NPV 1,1,1,2-7Luachlorocthanc <0.5 0.5 ugA EPA 524.2 9/25102 17:32 NPV 1,1,2,2-Tctrach1oroedlane <0.5 0.5 ug/1 EPA 524.2 9/25/02 17:32 NPV 'retrachloroe(hene <0.5 0.5 ug/l EPA$24.2 0/25/02 17:32 NPV 10/03/2002 THLT 09:44 FAX 508 888 6446 ENVIROTECH LABS 0 003/007 Y-. Page 3 of 3 R.I. Analytical LAoratorim Inc. CERTIFICATE OF ANALYSIS Envirotech Laboratories, Inc. Date Received: 9/20/02 Approved by: Work Order 0209-12334 R.I. Ana ytical Sample#: 001 0209428 900 OAK STREET, W. BARNSTABLE GRAB 09/18/02 SAMPLE DET. ANALYZED PARAMETER RESULTS iXkHT UNITS METHOD DATErrIM E ANALYST 1,2,3-Trichloropropane <0.5 0.5 ugA EPA 524.2 9/25102 17:32 NPV Toluene <0-5 0.5 Usti EPA 524.2 9/25/02 17:32 NPV Xylcncs <0.5 0.5 ugA EPA 524.2 9/25/02 17:32 NPV 1,2-1)ibromo-3-Chloropmpane <0.5 0.5 ug/l EPA 524.2 9125102 17:32 NPV Bromochloromerhane <0.5 0.5 us/l EPA 524.2 9/25102 17:32 NPV n-Butylbenzene <0.5 0.5 ugA EPA 524.2 9/25102 17:32 NPV Dichlomdifluoromothane <0.5 0.5 119/1 EPA 524.2 9/25/02 17:32 NPV Tru:hlorefluoromethanc <0.5 0.5 Usti EPA 524.2 9/25/02 17:32 NPV Hexachlorobuuuliene <0.5 0.5 ugtl EPA 524.2 9MI02 17:32 NPV Isopropylbenzene <0.5 0.5 ugA 2PA 524.2 9125/02 17:32 NPV p-Isopropylrolumc <0.5 0.5 ugll EPA 524.2 9/25M 17:32 NPV Naphthalene <0.5 0.5 Ug11 EPA 524.2 9125/02 17:32 NPV n-Propylbenzeae <0.5 0.5 ustl EPA 524.2 9125/02 17:32 NPV sec-Butylbenzene <0.5 0.5 ug/l EPA 524.2 9/25/02 17:32 NPV tent-Burylbowmne <0.5 0.5 ugh EPA 524.2 9/23102 17:32 NPV 1,2,3-Trichlombenzenc <0.5 0.5 ugA EPA 524.2 9125t02 17:32 NPV l,2,4-Trichluubenzene <0.5 0.5 ugA 03A 524.2 9/25102 17:32 NPV 1,2,4-Trimetbylbenzcne C0.5 0.5 Usti EPA 524.2 9/25/02 17:32 NPV 1,3,5-Trimcthylbenzene <0.5 0.5 ugA BPA 524.2 9/25/02 17:32 NPV Methyl Tertiary Butyl Ether <1 I Usti EPA 524.2 9/25/02 17:32 NPV n-Hexane <10 10 ugA EPA$24.2 9/25/02 17:32 NPV SURROGATES RANGE EPA 524.2 9125102 17:32 NPV 4-Bromotluorobenzene 0 90-120% EPA 524.2 9/25/02 17:32 NPV 1,2-Dichlorobenzene-d4 83 80,120% EPA 524.2 9/25/02 17:32 NPV No.__—_____ Fee---- --------------- BOARD OF HEALTH �O TOWN OF BARNSTABLE �1� licat ion,forVrll ConQructionAhrmit Application is hereby made for a permit to Construct 0<), Alter ( ), or Repair ( )an individual Well at: OAS S7t< - -- --- Location — Address Assessors Map and Parcel A Ow er Address A'-a4uzu- Installer — Driller f— Address Type of Building / Dwelling �° ---------- Other - Type of Building--- ---- No. of Persons------ ---------------- Type of Well ��'---- Capacity--ZL't --- Purpose of Well- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of vate Well Protection Regulation — The undersigned further agrees not to place the well in operatio until a t i to f Compliance has been issued by the Board of Health. Signed Z��- Application Approved By ----- f - date Application Disapproved for the following rea ---------- ------------- date — Permit No. mo Issued __ — - ----- ----------- ate BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by— — --- --- — —-- - — -- Installer at-- -------- ------ has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --- ------Dated---- -------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-- Inspector-------- - ------- —---—- No.=-��! OD� Fee-------------------- /) BOARD OF HEALTH o TOWN OF BARNSTABLE licationi orlVell Construction ermit Application is hereby made for a permit to Construct X), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel _T a 6S4L— — __— quU C7 1< rC q AIZ" _ S_T, _( , �4 O T Address cc� ���r� cc 7 0 (oG �9-:-026. Installer — Driller Address Type of Building / Dwelling --- ---- - ---- Other - Type of Building-= ------ No. of Persons----- -- ---- --------- a Type of Well_-_ �r�'--_-------- Capacity----- - -- P Purpose of Well---DaMA&& - -- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board o�-kl\t�ate Well Protection Regulation - The undersigned further agrees not to place the well in operation until a rt i to .of Compliance has been issued by the Board of Health. Signed — �20 2 Application Approved lication A d B _ — — G" �!_ Y Edate , 11 Application Disapproved for the following rea n . --------- - ------ ----- date— r Permit No. -- Issued-- -- - ----------- d�ate BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by-- Installer — — — — athas been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -------Dated----THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--- - Inspector-- ----- -- ----- —----—- BOARD OF HEALTH © TOWN OF BARNSTABLE eCC Con5truct ion Permit all No. - g o Fee----- --_ Permission is herebyranted ry ' + v [g AfLA �D4 to Const Alter ( ), or Repair ( ) an }�dividual ell t: "T t Street as shown on the application for 1 Construction Permit No.- ___ Dated- _5 --- -- - s B and of Health DATE OCT-3-2002 01:57P FROM:RTLANTIC WELL DRILLI 508 240 1591 TO:15084201340 P:1/3 FJVVM07ZCH.LABORA,r0"4.VVl: JWA CERT.Ar0_:A4�fA/Jr,3 44PRw.LV Sandwich, MA"J ms(BB8JF P) 1.�P11-.939�460 FAX(S08)88 66M6 CUEAM A#lantic Wells LOCATION: 900 Oak St. ADDRESS: PO Snx 339 W_Barnstable,MA N.Eastharn,MA Tracey Sossei COLLECTED BY., Atlantic Web SAMPLE DATE., 9/18/2002 SAMPLE TIME: NA WATER SAMPLE TYPE., New Well DATE RECEIVED: 9/18/2002 LAB I.D.#: OM28 WELL SPECS.; 81,1101, RESULTS OF ANALYSIS: Perameters !tufts Recommeaged Resuhts Method Dane Ans/ywd Lhnits Cofflarm badtleda /100ml 0 0 92225 9/18/2002 PH PH units 6,54-5 6_53 4500 H+ 9/18/2002 Conductance umhoskm 500 113 120.1 9/18/2002 NihateW MOB- 10.0 1.74 300.0 QM&2002 Nitdte-N mglL. 1.00 <0.004 300.0 9/1W002 Sodnrm MOL 20.0 24.2 200.7 9/18/2002 Iron mg/L. 0.3 <0.1 200.7 QII W2002 Manganese MOIL 0.05 <0.008 200.7 9/18I2002 voleffre o► epics u90L See Report None Detected. EPA 524.2 W512002 COMMENTS! Sodium level is not a health hazard. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKfNG PURPOSES FOR PARAMETERS 7ES7ED. ND=None Detected. Mess theft >=greater than TNTCPtoo numerous to Gourd R Id J. La oratory DftbdW f OCT-3-2002 01:57P FROM:ATLANTIC WELL DRILLI 508 240 1591 TO:15084201340 P:2/3 Page 2 of 3 R.I.Analytical Labaraborle%I'uc. CERTIFICATE OF ANALYSIS Emirotech Labormofies,Inc. Date Received: WOW Approved by: Work Order y 0209-12334 R.I. 5ampte b: 001 SAMPLE BESCRIMON.,0209428 900 OAK S7?JM7.W-BARNSTABLE GRAB 09/19M SAMPLE DET. ANALYZED MAFri = RESULTS IJMIT UNM BWMOD DATE M ANALYST Volga 013mk Camp w ds BrOmod'rchtommedtane <0.5 0.5 ugA EPA 524.2 W25/02 17:32 NPV Bmm ibrm <0.5 0.5 ugA SPA 524.2 9/25M2 17.32 NPV Ilmlomathlwauteam m <0.3 0.5 ngh 13PA 524-22 9/25/02 1732 NPV Chloroform <0.5 0.5 ug/1 EPA 514.2 9W/02 17:32 NPV l.74)ibromm&weX=) <0.5 0.5 ugh EPA 124-2 9I25/02 17:31 NPV Benzene <0.5 0.5 ugh BPA 524.2 9/25/02 1732 NPV Call on Tetmchlotlde <0,5 0.5 "A EPA 524.2 9M/02 1732 NPV 1,24)rchlomedma <0.5 0.5 ugh EPA 524.2 9n5102 17.32 NPV TArhlnrostlume <0s 0.5 ma EPA 524.2 9I15102 17:52 NPV i.4-Diddurobftu wn <0.5 0.3 ugh EPA 324.2 91IM 17:32 NPV 1,1 ftWo <0.5 0.5 "a EPA 524.2 9tnW 1732 NPV 1.1.1•Trkhlomdum <0.5 0.5 u9n EPA 524.2 WSW 17:32 NPV Vinyl Cplornle e03 tls ugh &A 524.2 9/23/02 1732 NPV Eromober+une <05 0.5 ugh EPA 524.2 9raW 17:32 NPV Bromamadme <03 Os trgh EPA 524-2 W25MZ 17:2 NPV Cblorobenzm <03 0.3 ugA EPA 324.2 9/25M 17:32 NPV Chlotoeftn <0-5 Os 40 EPA 5241 9/25102 17:32 NPV Chlmmnzd= <0.5 0.5 ugh EPA 5242 9/25/02 17:32 NPV 2-Cblotolab= <0.5 0.5 ugA BPA$24.2 9MI02 17:32 NPV 44Cbteromh" <0.5 0.5 ugA EPA 57A.2 9/2SA2 17:32 NPV Dibmm m mamma <0.5 0.5 uwI EPA 324.2 9/25102 17:32 NPV 1,3-]JWotcobenz= <03 0.5 ug/l EPA 524.2 9fB)M 17:32 N?V 1,2-Vkmmvbmum <0.5 03 tall EPA SU.2 912m 17:32 NPV Isoo-1,2-Dkhlocoedtene <0.5 0.5 uSA 13PA S24.2 9MM2 17:32 NPV cto-1,2 Diehlooeed+eoe C9.5 Ds w EPA 52AI 9r2m 17:32 NPV Medtyiene Chloride <0.3 0.5 ugh EPA 524.2 9A5/02 17:32 NPV 1,1:Dkhloru dme <0 5 0.5 WA EPA 524.2 9125M2 17:32 NPV 1.1-bichinropmpa- <0.5 0.5 09/1 EPA S241 9M)M 1T:32 NPV 1,2-DkhWrupwpw : <0.5 0.5 "A SPA 5U.2 9At5142 17:32 NPV 1.34ketloroXopme <0.5 0.5 u8/1 EPA$24.2 9/25/02 17:32 NPV c1s-1.3-01 opeae <0.5 0.5 Vol EPA 324.2 WSW 17:32 NPV 2,2-Dilehlaravmpnn <0.5 0.5 ugn EPA 524.2 9/25= 17:32 NPV Eftitma mte <0.5 0.3 w EPA 524.2 9/a5/0x 17:32 NPV Styrene <0:5 0.5 ugh EPA"A.2 9125/02 17:32 NPV 1.1 yTacAlal+Oethane <0.5 0.5 00 EPA 524-2 9/25/02 17:32 NPV 1,1,1,2-'hr ddo.oatmw <O.5 03 USA EPA 514.2 9/25102 17:32 NPV 1 12.2-Tt:ltachlaroetbane c0.5 0.5 U9A EPA 324.2 9/2i102 1732 NPV Tetrachtwoomene <0.5 0.5 yg/1 EPA 524.2 9/23/02 17;32 NPV OCT-3-2002 01:58P FROM:ATLANTIC WELL DRILLI 509 240 1591 TO:15084201340 P:3/3 Page 3 of 3 R.I.Analytical Laboratories,Inc. CERTIFICATE OF ANALYSIS 6 EnviTOt001 L*ofatDdcs.I= " Date Rccrived: 9120/02 Approved by: work order# OM-12334 R.i. y. Sample : 001 0209429 9W OAK sTREU,W.BARNSTABLE GRAB 091181M SA1k1 U Der. ANALYZED PARAM9M R11SiJ TS lMdff [)NM 141EMD DATFdPA',tE ANALYST 1.2.9-TridilumpmPa- <0.5 0.5 W EPA 524.2 912M 17!22 NFV 1b1= <O.5 0.5 me EPA 5241 925Al2 17:32 NPV 7iylue6 c0,g 0.5 nn EPA 5241 912M 17:32 NPV 1.2.D(b <0.3 0.5 ugA EPA 524.2 V25102 17:32 KP1/ 8MffMchlonlmed= <03 0.5 ugn EPA 524.2 9RSA12 17:32 NPV n-Hutyftmc a c0.3 0.3 UO 9FA 524.2 MSM 17:32 NPR►. DkWorodi8wwrock a <0.5 Os MA SPA n4-2 9MM2 17:32 NPV T4iddam wrol>tec3tM <0.5 0.5 ogA EPA 524.2 9r23/02 17:32 NPV Hwaichiu <OS 0.5 ugn EPA 524.3 925/02 17:32 NPV isaploprlb =w <0.5 0.3 ogA EPA 524.2 9MI02 17.32 NPV P-1sepropy1whims <0.5 0.5 UO EPA 57A.2 912S102 17:32 NYV Nwids u" <0.5 0.5 usA EPA nd 2 9250 17:32 NPV n-Propyib-zm <0.5 O.s USA EPA 524.2 9ralm 17:32 Nw 1hc:meae <03 0.5 w EPA 524.2 9/2902 17.32 NPV uff-MMMM ne <0.5 0.5 MR EPA 524.2 OM/02 17:32 NPV 1.2.3 Trk OOMberaM <0.5 0.5 ugn EPA S24.2 925Al2 17,32 NPV 1.2,4-T*M <0.5 Os u911 FiPA 524.2 9/7SV2 17:32 NPV 1.L4-Tdu thy1W=ne <OS 0.3 agA EPA 524.2 912SM 17:32 NPV 0.5-TYimahy1beuoe e0.5 0.5 USA EPA$U.2 9/25M 17:32 NPV Mefti Tettim DW Elmer <1 1 4911 EPA 524.2 9R5141 17:32 NPV tw onrw <10 10 ugA SPA S24.2 9125102 17:32 NPV SURROGATES RANGE EPA 57A.2 9MM 17:32 NPV 4-8mmnfhwrobMM 4d g(W120% EPA 524.2 91251M 17:32 NPV 1.2-Dicblomb d4 63 W120% MA 524.2 9/ZS/02 17:32 NPV TOWN OF BARNSTABLE I� - LOCATION GIGO SEWAGE # � �2 VILLAGE e+/ � ��a�l� ASSESSOR'S MAP & LOT 1 00 INSTALLER'S NAME&PHONE NO. .J� r✓ SEPTIC TANK CAPACITY /,f GcL LEACHING FACILITY: (type) 50o G� G.jG�y�,�� � (size) /d NO.OF BEDROOMS BUILDER OR WNER G PERMTrDATE: I�' (a 42- COMPLIANCE DATE:_)1 00T Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ff 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 ".., e G�-�n� . , _.—.--- } a / _ ,,� - 7'°`W' � f, , _ . . . ,9� i � e 9� p%,� _ .9C� ,� � / pit J � / ,�� � � I � � ���� � � P�6� . �. } No. J�2 2_ J Fee 1 Yi. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for Migogal *pgtem Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade(lam)Abandon( ) LFComplete System ❑Individual Components Location Address or Lot No. ®® Owner's Name,Address and Tel.No. Assessor's MapTarcel Installer's Name,Address,and Tel.No. / Designer's Name,Address and Tel.No. 7/ Type of Building: 1�- Dwelling No.of Bedrooms Lot Size ZW_ sq.ft. Garbage Grinder(10 Other Type of Building e.5 e4tV No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow Jj� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Oir I/ g✓� Nature of Repairs or Alterations(Answer when applicable). Date last inspected:, - . Agreement: The undersigned agrees io 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 t ' B and Signed Date j- Application Approved by Date Application Disapproved for the following reasons Permit No. 'i Date Issued O �— " q5f 2 # Fee -ay. No. ! t� \, THE COMMONWEALTH OF MAS�SACHUSETTS Entered in computer•.' Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS-, 3pprication for Miopooar *p.5tem Con!6truction Permit Application for a Permit to Construct( )Repair( )Upgrade Abandon( ) 16Complete System ❑Individual Components Location Address or Lot No. ©D 0�/i c ems-, Owner's Name,Address and Tel.No. Assessor's Map/Parcel 21Io-tJ 62 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4 OO CD DOWN e9le 7 7/ ` Type of Building: Dwelling No.of Bedrooms f"°� Lot Size sq.ft. Garbage Grinder(1 Other 'Type of Building � L�Sf L'�' No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 5`00 Type of S.A.S. 2 - d Qe/ C Description of Soil Zet 3" 1' 9-� 1 Nature of Repairs or Alterations(Answer when applicable) J2� 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 t�/hhis B ard,o Health. A. Signed 62_V Date p f EApplication Approved by Date Application Disapproved for the following reasons Permit No. Date Issued O 1 0�- _: .. nI THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Grx 1 Certificate of Compliance THIS,IS TO CER FY,that the On-site Sewage Disposal System Constructed( )Repaired,,(l• )Upgraded e ) Abandoned )by 7VQ �'Oi/S nd at hats been constructed in cordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2 002-y 3-L dated ro ([O 0 Z Installer Designer The issuance of this permit shall not be construed as a guarantee that the s ste will function a desi\ ed. Date 1 I- �' o�. g Inspector �• s, ._,........ -- No. ZZ}(�2 ��1 0 �--------------------.v/i�.-`�O� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1wigpo5ar *pgtem Construction Permit Permission is hereby ranted to Construct( )Repair( )Uppgrade(,/)Abandon( ) System located at 040 OQ•�` S Lam. and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construct' n m st be completed within three years of the date of this p Date: f) 16 Z Approved by f l . TOWN OF BARNSTABLE LOCATION GIGO D4l ,9 7-1 SEWAGE # . VILLAGE tr/• 4aif4J l� ASSESSOR'S MAP& LOT A-00 INSTALLER11'S NAME&PHONE NO. �a � �.� !✓ S/ '- 1��� SEPTIC TA1 K CAPACITY /fog Col . LEACHING FACILITY: (type) Soo (size.) 3s ;r�z' A NO. OF BEDROOMS BUILDER OR WNER S G PERMTT DATE: I. l a 6'� COMPLIANCE DATE: I 7 O X Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S� 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 faro,✓ C�,�i •�"�9i :•y� 9£ � P4 407 OCT-3-2002 01:57P FROM:ATLANTIC NEF-L DRILLI 508 2;O 1591 TO:15084201340 P:1/3 .&WIROTLCHLABORATOJUR4 PVC )WA CLRl.Nat:At-MA 010 449Rrc.130 Sandwich, MA02S63 508(M.I.. de) I-80&M94460 r+AX(508)888-"46 CLIENT. Atlantic Wells LOCATION: 900 Oak 5t. ADDRESS: PO a;)x 339 W.Barnstable,MA N.EaMham,MA Tracey Sossel COLLECTED BY., Atlarttic Wells SAMPLE DATE., 911812002 SAMPLE TIME: NA WATER SAMPLE TYPE., New Well DATE RECEIVED., 9/18/2002 LAB I.D.#: 0209429 WELL SPECS.: 81 Y 101, RESULTS OF ANALYSIS. Perametsrs Units Recommended Results Method Date Analyzed Limits Collfarm bacteria 1100m1 0 0 92225 9/15=02 PH PH units 6.5-8.5 8.53 4500 H+ 9/18/2002 Conductance umhc<s/cm 500 113 120.1 9/18/2002 Ndrate-N mg/L 10.0 1.74 300.0 9/18/2002 Nhrfte-N mg/L 1.00 <0.004 300.0 9/18/2002 Sodium mgA.. 20,0 24.2 200.7 9/1812002 Iron mg/L 0.3 40.1 200.7 9/l a/2002 Manganese mg/L 0.05 <0.008 200.7 9/18/2002 Volatile organics ug/L See Report None Detected. EPA 524.2 9/2512002 COMMENTS! Sodium level is not a health hazard. WA TER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. ND=None Detected. <=less then >=greater than TNTCatoo numerous to court R4nald J.Saaq Laboratory Dftkftr OCT-3-2002 01:57P FROM:ATLANTIC WELL DRILLI 508 240 1591 TO:15084201340 P:2/3 Pagc 2 of 3 R.I.Analytical LaWratortes,Inc. CERTIFLCATE OF ANALYSIS Ellvirotech Laboratories,Inc. Date Received: 9120/02 Approved by- Work Order/1 0209-12334 R.I. 5aviod#: 001 SAMPLE DESCRIlP'I'ION.' 0209428 900 OAK STREET,W.BARNSTABLE GRAB 09/18102 SAMPLE DET. ANALYZED PARANT1z M RESULTS LIMrT UNITS METHOD DATEITIME ANALYST volw*OM-ic Compounds BtomodWorontethalm <0.5 0.5 vgn EPA 524.2 9/25/02 17.32 NPV 8mmolorm <0.5 0.5 ug/l EPA 524.2 9125102 17:32 NPV Dlbromochlotomp9tane <0.3 0.5 usn EPA 524.2 9125/02 17;32 NPV Cw0rarorm <0.5 0.5 411 EPA 524.2 9/25/02 17:32 NPV 1.2-mm-b-Mm) <0.5 U•5 ugn EPA 524.2 9/25/02 17:31 NPV Benzene <0.5 0.5 ugn EPA 524.2 9/25/02 17:32 NPV Cabot Terraehlotide 0.5 0.5 ugn EPA 524.2 9/25/02 17:32 NPV 1,20chloroedwe eo.s 0.5 Ug/i EPA 524.2 9125102 17:32 NPV Tddilomemene <" 0.5 WA EPA 524.2 9/25/02 17:32 NPV 1,4-Dichlarolyer t- <0.5 0.5 ug11 EPA 524.2 9125102 17.32 NPV 1,1-Dichloroeth- <0.5 0.5 ugn EPA 524.2 9/25M2 17:32 NPV 1.1.1•Trich1oroedt ro <03 0.5 ugn EPA 524.2 9/25MZ 17:32 NPV Vinyl Chloride <0.5 11.5 Ug/I IPA 524.2 9125/02 17M NPV Bromebam m <0.5 0.5 ugfl EPA 524 2 9/25/02 17:32 NPV Bromometbans <015 0.5 ago EPA 524.2 9/25/112 17:32 NPV Cw0mbenzehe <0.5 0.5 ugn EPA S24.2 9125/02 17:32 NPv Chlamedwe <0.5 0.5 ugtl EPA 524.2 9125/02 17:32 NPV Chlommethano <0.5 0.5 Usti EPA 524.2 9/25/02 17:32 NPV 2Chlorotolacnc <03 0.5 ag/1 EPA 524.2 9/25M 17:32 NPv 4-Cld61MIUene <0.5 0.5 ugn EPA 524.2 9125/02 17:32 NPV Dibmmmnrdwe <0.5 0.5 U1/1 EPA 524.2 9125/02 17:12 NPV 1.3-Diehlorobettme <03 0.5 ugn EPA 524.2 9R5102 17:32 NPv 1,2-Dlchlombenzeee <0.9 OS Usti EPA 524.2 9/25/02 17:32 NPV cram-1,2-D1chlotppd c= <0.5 0.5 Ugn VA 524.2 9/25/02 17,.32 NPV cir'l,2-Dieltloroedxue tU.5 03 Ug/i EPA 524.2 9/251M 17:32 NPV Medlylwte Chloride <0.5 0.5 Usti EPA 524.2 9125/02 17:32 NPV 13 ElkNotuettiene <0.5 0.5 ugil EPA 524.2 9/25M 17:32 NPV %I-Dichinmpmpcno <0.5 0.5 Usti EPA 324.2 W25M 17:32 NPV 1,2-Dichloropropanc <0.5 0.5 ugn EPA 524.2 9/25/02 17:32 NPV 1.3-Dichbropmpane <0.5 0.5 U911 EPA$24.2 9/250 0:32 NPV cis-1,3•Dichlotupmpeue <0.5 0.5 ug/1 EPA 524.2 9/25/02 17:32 NPV 2,2-Dichlaroptvpane <0.5 9.5 Usti EPA 526.2 W26102 17:32 NPV EdLvlbc .c= <0.5 0.5 ugil EPA 524.2 9125102 17:32 NPV gry,m 40.5 0.5 ugn EPA 524.2 9/25/02 17:32 NFV i,1,2-Tti"meiltalle <0.5 0.5 ugn EPA 124.2 9175/02 17:32 NPV 1,1.1,2-iAm ahloroetbsae <03 0-5 USA EPA 524.2 9/25/02 17:32 NPV 1.1.2,2-Tettachlometttane e0.5 0.5 Ugn EPA 324.2 9125/02 17:32 NPV reuaclllatoetllene <0.5 0.5 4g/1 EPA 524.2 0/2$t02 17.32 NPV OCT-3-2002 01:58P FROM:ATLANTIC WELL ORILLI 508 240 1591 TO:15084201340 P:3/3 Pape 3 of 3 R.I.Analytical Laboratories,Inc. CMTIRCATE OF ANALYSTS E1lvirotoeh Laboratories,Inc. Date Reedved: 9/20/02 APDred bY= work Qrdu# 0209-12334 R.t.An ycical Sample/i: OOI 0209428 900 OAK STREET,w.BARNSTABLE GRAB 09/18/02 SAMPLE DID'. ANALYZED PARAMETER RESULTS LDGT UNITS METHOD DATFA ME ANALYST L2,3-T&Morprcpa- <0,5 0.5 ugA EPA 524.2 9n5/M 11:22 NFV gyym,m <0.5 0.5 u9/1 EPA 524.2 9/25102 17:32 NPV xylcnas <0.3 0.5 ugA EPA 524.2 9125/02 17:32 NPV 1.2-Dibrom0•Q101vpm1- <0.5 0-5 ug/I EPA S24,2 M5102 17:32 NPV ammacwOrmihm <03 0.5 ug/1 EPA 524.2 91M/02 17:32 NPV n.Buriftn-a <0.5 0.5 ugA EPA 524.2 9/25102 17:32 NPV Dicidomditluoroun6sm <0.5 03 ugh EPA 574.2 9M/02 17:32 NPV TrUiorafhwtomelbane <0.5 0.5 USA EPA 524.2 9MI02 17:37 NPV Hexubinfobuladieu <0.1 0.5 ug8 EPA 324.2 9125102 17,32 NPV inprMitemene <0.5 0.9 ugA EPA 524.2 9nJM 17:32 NPV p•lsoprOPyltoluone <0.5 0.5 qn SPA 5U.2 9123/02 17:32 NPV Naplitbsltne <0.5 0-3 ugA EPA S24.2 9M/02 17,22 NPV wPmpyibwzm <0.5 0.5 ugh EPA 324.2 9P25N2 17:32 NPV gce-BOrylbenuue <0.5 0.5 USA EPA 5241 9/29h12 17:32 NPV ten-Hurylbenum <0.5 0.5 ugA EPA 524.2 0123/02 17:32 NPV 1,2,3--Tridlombumm <0.5 0.5 u5/1 EPA 524.2 9/25N2 17:32 NPV 1.2,4-7}b;h1urobenz= <0.5 0.5 ugA VA 524.2 9n5/02 17:32 NPV 1,2,4-Trlmethylbeanrc <03 0.5 u811 EPA 524.2 9/25102 17:32 NPV 1,3.5-Wrnahytbenmat <0.5 0.5 ugA EPA 524.2 9/25/02 17:32 NPV Methyl Tertiary Butyl Bd= <1 1 ugA EPA 57A.2 9/25102 17:32 NPV tr-Hexane <10 10 ugA EPA S24.2 9/25/02 17:32 NPV SURROGATES RANGE EPA 524.2 9/25107 17:32 NPV 4-ftmoNumbemett8 9M *420% EPA 524.2 9/25/02 17:32 NPV 1,2-Dtcblor0bnnaane44 93 W120% EPA 524-2 9n5/02 17:32 NPV Barnstable Assessing Search Results Page 1 of 2 r r MIND ssessors Division: Property Assessment Search Results «back to search 900 OAK STREET Owner: Property Sketch Legend SOSSEL,TRACEY A Map/Parcel/Parcel Extension 216 /008/ Mailing Address SOSSEL,TRACEY A4 900 OAK ST WEST BARNSTABLE, MA. 02668 �y Assessed Values: fi Appraised Value Assessed Value y Building Value: $59,000 $59,000 Extra Features: $0 $0 Outbuildings: $600 $600 Land Value: $45,000 $45,000 Interactive Property Map: Map requires Plug in: Totals:$ 104,600 $ 104,600 1 have visited the maps before Show Me The Mapes Sales History: Owner: Sale Date Book/Page: Sale Price: SOSSEL,TRACEY A 9/15/1991 7695/065 $ 113,700 HICKEY, MALCOLM K& 5/15/1991 7516/093 $ 109,000 ALLEN, J FAYE 10/15/1984 4334/318 $0 Tax Information: Tax Rates: (per$1,000 of valuation) W. BARNSTABLE FD TAX $ 161.08 Town Fire District Rates Other Rates 9.26 Barnstable 2.61 Land Bank 3%of Town Tax LANDBANK TAX $29.06 C.O.M.M. 1.38 Cotuit 1.69 TOWN TAX $ 1,158.74 Hyannis 2.54 West Barnstable 1.54 Total: $ 1,158.74 Due to rounding differences these values may vary http://www-.town.barnstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/Asse 12/2/02 Barnstable Assessing Search Results Page 2 of 2 Land and Building Information Land Building Lot Size(Acres) 0.5 Year Built 1963 Appraised Value $45,000 Living Area 755 Assessed Value $45,000 Replacement Cost $71,904 Depreciation 18 Building Value 59,000 Construction Details Style Ranch Interior Floors Hardwood Model Residential Interior Walls Drywall Grade Average Grade Heat Fuel Oil Stories 1 Story Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 2 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 4 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value SHED Shed 80 $600 $600 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.barnstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/Asse 12/2/02 SYSTEM PROFILE TEST HOLE LOGS TOP FNDN, AT EL. 97.12 ACCESS COVER TO WITHIN 6' OF FIN. GRADE <NOt TO SCALE? ACCESS COVER (WATERTIGHT) TO ENGINEER: RICK JUDD, PS I 95.5' MINIMUM .75' OF COVER OVER PRECAST WITHIN 6' OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 94.0' WITNESS: RS 2' DOUBLE WASHED PEASTONE I_ DATE: 14-�24�01 * RUN PIPE LEVEL - FOR FIRST 2' 3' MAX. PERC. RATE _ < 2 MINfINCH _ PROPOSED1500 r 91.0 CLASS I SDILS P# (� `� 7 93.25'* GALLON SEPTIC 93.0' I TEE 41 wr TANK (H- 1O ) GAS - c�� o°+ BAFFLE 90.36' 19 Q Cl C] O 0 [� 01 C7 �Io \ 90.17' C a p CI C] C7 Q Cl 0 17-1 4' AROUND LEV MIN F1C7COC7 EJ L7CI = E❑ ; 0 E950' Focus * ( 2 % SLOPE) t____6' CRUSHED STONE OR MECHANICAL 0$8 2' 0 El 0 0 0 0 L� © Q 88.17'EXIST. INVERT OUT DEPTH DF FLOW = 4 COMPACTION, (15,221 123) © L- 9- _ A UNKNOWN, PROVIDE MIN. 2 TEE SIZES < 1 % SLOPE) ( 1 % SLOPE) 3/4' TO 1 1/2' DOUBLE WASHER S ❑NE PITCH TO PROPOSED INLET DEPTH = SL 10„ SEPTIC TANK „ OUTLET DEPTH = 14 g,> 10YR 5�3 FOUNDATION- 16' SEPTIC TANK 15' D' BOX 4' LEACHL415 B LOCATION MAP NTS FA'CILI ;'Y DENSE SANDY ASSESSORS MAP 216 PARCEL 8 5.67' LOAM 10YR 5/6 BENCH MARK 36" 92.0' TOP OF CONC. ��`� C1 BND. EL = 87.2 EXTREMELY(ASSMD G,I.S.) PARCEL 8 �� DENSE STONY 25,663±SF Q � J Ohl 82,5' SILTY SANDY 87.2 cc-, 0 6'r y LOAM e9 � fv� - 96^ 2.5Y 5�6 87.0' 5' REMOVAL OF UNSUITABLE - ✓ SOIL REQUIRED AROUND II� �LJ� ` C2 PERIMETER OF LEACHING C,/y� U 0 v� a ' " 1� � � STONY 9� FACILITY, DOWN TO LOAMYD A SUITABLE WITH CLEAN LAYER,CLEAN MED. {' r�J�j0 52Z h� ��� iZ.4;tj 93.1 SY 6 A6 O SAND. ENGINEER TO - UV / INSPECT AND CERTIFY �1'�I on 9 2 REMOVAL �WU "`�U MS. 150" 82.5' - C0 Sa dl/19 i3U 010 10/l�U,� NO WATER ENCOUNTERED l + 5.7 �� ! l�-[--'- 9�94 a a N EXIST. APPROXIMATED FIR( QUAD 1. DATUM IS + 95.3 z�, T)ESIGN: (C;ARRAGE DISPOSER IS NOT_Al, OWI�. _ + 95.7 iC.�`"DG":� 97o SEPT.�_ L - - - -- - !,_ _rtiE � ,a DESICN r Loy✓: 3_ BEDROOMS ( uPu) 33L? �r SHEG oaf' 6.2" 6.Si - V. 3, MINIMUM PIPE PITCH TO RE ,'S" I'L� F hIJT. + 9 .3 99.9 USE F� 330 GPD DESIGN FLOW 4. DESIGN LOADING FOR A',-.,I- PRECAST UNITS TO BE AAl;I-IO -H-").. 0��4T SEPTIC TANK: 330 GPD < 2 > = 660 5, PIPE JOINTS TO BE MADE WATEPTIGF-IT. / + 97.3q, 1500 EXIST. LZ- A USE E, ____ GALLON SEPTIC TANK 6, CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. .. + .4 ENVIRONMENTAL CODE TITLE V, gi o.o LEACIIING. 2(30 + 9.83) 2 (74) = 118 7, THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT + 96.6 / SIDES: TO BE USED FOR ANY OTHER PURPOSE, + 94.8 4/1 0.4 B❑TTt;M: 30 x 9.83 (.74) 218 8. PIPE FOR SEPTIC SYSTEM TO SCH, 40-4* PVC. .7 TRI 10" / TQTAI..� . COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT + 96.6CHERRY TWIN _ 454 S.F.S,F, 336 GpD INSPECTION BY BOARD OF HEALTH AND PERMISSION L7BTAINED + 9 OA ` USE ;2) 500 GAL. LEACHING CHAMBERS (ACME OR FROM BOARD OF HEALTH. 0� 95.7 5.55 6 / ._ ® 4. 16" PIN / EOUAL) WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5' 10, PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING SEPTIC SYSTEM o + .2 / BETWEEN UNITS 97 01.9 r.. � SYSjEN` Ock 0.2� + 9 98 97.9 / SO SEpZiC LEGEND / ,-7 � - - Ti /L E 5 SITE 101 !V 150' 100.0 PROPOSED SPOT ELEVATION OF WELL 900 OAK STREET r 1007 _ „01 ( 100x0 EXISTING SPOT ELEVATION LL I' IN THE TOWN OF: 1 go] � go] 0 PROPOSED CONTOUR ( WEST) B A R N S TA B LE 103 <k 03.6 to . . 04 ------ / �� 100 EXISTING CONTOUR PREPARED FOR: BORTOLOTTI 105 � CONSTRUCTION/SOSSEL 0 WELL ,3 20 0 20 _ 40 60 BOARD OF HEALTH AP(' ROVED DATE MA SCALE: 1„ = 20' DATE: OCTOBER 29, 2001 off 509-362-4541 +. / fox 508 362-99M L ._ 8f . �:,' �P iH or 9 o`'� ARNE iq -.N Sam 4, o OJA A J down cape engineering, Inc. A� No.26348 0- CIVIL ENGINEERS A Ev rsf� s1[.k ao LAND SURVEYORS 1, of _ 939 Thin st, yarr30uth, mo, 02675 ARNE H. JA , P.E., P.L.S. DATT 10 1-233 SYSTEM PROFILE TEST HOLE LOGS TOP FNDN. AT EL. 97.12' ' (NOT TO SCALE) ACCESS COVER TO WITHIN 6 OF FIN. GRADE ACCESS COVER (WATERTIGHT) TO ENGINEER:_ RICK JUDD, RS / 95„�,' MINIMUM .75' OF COVER OVER PRECAST /` WITHIN 6' OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM WITNESS:_ AMY VON HONE, R_ 94.0' 2' DOUBLE WASHED PEASTON L � h * RUN PIPE LEVEL �� DATE 4 1 FOR FIRST 2' 3' MAX. PERC. DATE _ < 2 MIN/INCH PROPOSED 1500 GALLON SEPTIC 91.0' ,* 93.0' TEE CLASS_ SOILS P# TANK (H- 10 ) GAS 9• 0 O C 0 0 C) C) C CD a o< BAFFLE 90.36 g0,17' O ED C7 0 O C] Cl C' CO 4' AROUND P I MIN 1 C7 O C] EO CJ C M C ED Q ELEV. ( 2' 88 17� 0; 95.0' ;, * DEPTH OF FLOW = 4 1_� Soor5 EXIST. INVERT OUT COMPACTION. (15.221 C2]) A SL LOCUS UNKNOWN. PROVIDE MIN. 2 TEE SIZES ( 17 % SLOPE) ( 1 % SLOPE) 3/4' TO 1 1/2' DOUBLE WASHED STONE % PITCH TO PROPOSED INLET DEPTH = 10" SEPTIC TANK 14„ 10YR 5/3 OUTLET DEPTH = 9' FDUNDATIOh 16 SEPTIC TANK ' 4' LEr,CHING L❑CAr10N MAP NTS �- 15 - D' BOX FACILITY B DENSE SANDY ASSESS❑RS MAP 216 rARCEI_ 8 5.67' LOAM tOYR 5/6 i BENCH MARK 36" 92.0' TOP OF CONC. �F`� Cl BND. EL = 87.2 EXTREMELY (ASSMD G.I.S.) PARCEL 8 T DENSE STONY 25,663±SF O 82.5' SILTY SANDY •�`� LOAM 872 5' REMOVAL OF UNSUITABLE 96" 2.5Y 5/6 87•0' Ap SOIL REQUIRED AROUND C2 PERIMETER OF LEACHING STONY 41 FACILITY, DOWN TO LOAMY SAND SUITABLE SOIL LAYER. �j 93.1 REPLACE WITH CLEAN MED. 2.5Y 6/6 �C -// SAND. ENGINEER TO - +e9 ti� INSPECT AND CERTIFY REMOVAL 150' i r 82.5' NO WATER ENCOUNTERED 94 71NOTES, EXIST. APPROXIMATED FROM QUAD / \r - �95.3 `s- + 95.7 � a997.Q SEP1 IC DESIGN (GARBAGE DISPOSER IS �� - _ 1. DATUM IS TINT WELL NOT LLOW ABANDON - ---- - - . - , DE \��t/ n l�r .�j I r l.l�w t5l' t�'IJ1.)Mti C ��^ l�l'LI) J.�V I i ''I c:. �li•,iC i, ..L vvATF R ice_ + ; USE A 330 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/9' PER FOOT. + 99.9 4. DESIGN L❑ADING FOR ALL PRECAST UNITS TO BE AASH❑ H-10 SEPTIC TANK 330 GPD < 2 > = 660 S. PIPE JOINTS TO BE MADE WATERTIGHT. EXIST. � /(i + 97.3� -- 1500 DWELL. F USE A -__- GALLON SEPTIC TANK 6• CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. + +.a ' ENVIRONMENTAL CODE TITLE V. ; � g1 0.o LEACHING / 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT a 7J =- ti 2(30 + 9.83) 2 (.74) 118 ,a� j + 96.6 SIDES TO BE USED FOR ANY OTHER PURPOSE. �° 30 x 9.83 (.74) = 218 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4' PVC. 3.7 TRI 10" 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT CHERRY TVON / TOTAL: 454 S.F. 336 GPD INSPECTIDN BY BARD OF HEALTH AND PERMISSION OBTAINED 96.6 559 OAS USE (2) 500 GAL. LEACHING CHAMBERS (A(CME OR FROM BOARD OF HEALTH. 095.7 1 6 / a. 16" PIN / EQUAL) WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5' 10, PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING SEPTIC SY�TEM + 2 / BETWEEN UNITS 0 L ` 97 01.9 0.2 + 9 . / / SO SEPTIC s �M LEGEND gg 97.9 / �o TITLE 5 %SITE PL.AN - -_-- � 99 ISo' L 100.0 PROPOSED SPOT ELEVATION OF _ ____ 900 0 A K S T R E E 1 100.7 -' o �. I ALL 100x0 EXISTING SPOT ELEVATION IN THE TOWN OF: ' WELL 102 - ) " // ��` 100 ip PROPOSED CONTOUR ( WEST) B A R N S T A B L E 103 03.6 10 - 04 / � EXISTING CONTOUR PREPARED FOR: BORTOLOT Tl 105 CONSTRUCTION/SOSSEL 0 WELL 3 / O� 20 0 20 40 60 BOARD OF HEALTH 1 APPROVED DATE MA SCALE: 1 = 20 DATE: OCTOBER 29, 2001 off -362-4541 fox 508 362-9880 +G� .' Nar ` 4f'' N\N OF 9 / dip r- �A\ JJ9( � o ARNE , G . j 105.8 H H. down cape engineering, zinc. .g �07p� NO e,4 �rf �i/$j�R�Q��4Q sow q l E�1�\ �s CIVIL ENGINEERS NAL s0 FCISIERE� Nqf 1n110 � LAND SURVEYORSol 939 Thin st, yarmouth, mo, 02675 ARNE H. JA , P. P.I,.S. DATF, 01 -233 -