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HomeMy WebLinkAbout0021 PARRISH WAY - Health 21PARSHrWAI A 144 l 4 TOWN OF BARNSTABLE <. I;OCATION p� �G.( �l S� t:J�.� SEWAGE VILLAGECDC,S� McenSi"Vt�';'ASSESSOR'S MAP&PARCEL 1 1 0/u S1 INSTALLER'S NAME&PHONE NO. S(_0 C��1�-� - C 6�r a y`{ O b poi SEPTIC TANK CAPACITY �?c c S� Sd a cz,���x LEACHING FACILITY:(type)AA2(b $''00 &c L (size) k .2S f ram' NO.OF BEDROOMS 'Z OWNER L PERMIT DATE:?/ �j /a d tS COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �J Feet Private Water Supply Well and Leaching Facility(If any wells exist on l 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) �U^� Feet FURNISHED BY �l�n 1 � a 1 _ . No. � � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Misposal *pstem (Construction Vprmlt Application for a Permit to Construct( ) Repair(c,jUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. '1A*� 04,9 LAC-1 Owne' ame Address,a d Tel.No. Assessor's Map/Parcel mQ_�h ';�M^r-.-3v NQ vc 'v �OTNO I to ler's Name,Address,and Tel.No. 6C>16 aq o OCM Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) V gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank �kcS� c, j� Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 6s4, ' Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this andealt i 7 I Date Application Approved by Date 7,0/5 Application Disapproved Date for the following reaso Permit No. Ob 1 h Z I' Date Issued )5d Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ` PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppfitation for Disposal *pstrm Construction 3pertmt Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ') ElComplete System ),❑Individual Components Location Address or Lot No. klobw 5 I,f iG Owne ' ame Address,a4d Tel.No. (\ Assessor's Map/Parcel N�/ Installeor's N e,Addre s,and Tel.No. SO1S ali q nc , Designer's Name,Address,and Tel.No. �7 c Type of Building:Dwelling No.of Bedrooms Lot Size V30 sq.ft. Garbage Grinder NP � Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �, gpd Design flow provided _ gpd Plan Date � I Number of sheets Revision Date Title L Size of Septic Tank p_kcs� � O Type of S.A.S. Description of Soil S Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in I accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of ' Compliance has been issued byrthie .card ealt Date gn Application Approved by Date Zags Application Disapproved by Date for the following reaso7 I Permit No. 2b1 " Z I Date Issued ---------------------------------------------------------------- --------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(� `Upgraded( ) Abandoned( )by .rP.VC.._ at ` I� vr-:� ( )C. S sbree o s cfe3`inaccordance - with the provisions of Title 5 and the,for Disposal System Construction Permit No.ZO I S` ZI 1 dated 31112015 Installer S C C>�\ �� �y�- Designer C e , 5 #bedrooms Approved design flow A gpd The issuance of t'is petit shall not be construed as a guarantee that the system will n /io,gas designed. Date R Inspector (� --------------------------------------------------------------- No. ZO I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *ptem Construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at �� �Gf �� (,� lc:L.I N,; 1= .UQ and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit Date������ Approved by Town,bf Barnstable P# Department of Health,Safety,and Environmental Services �1►,E r Public Health Division Date / J,20)6 Q„ 367 Main Street,Hyannis MA 02601 /y� BARNMEILE. �AlE1639. Date Scheduled h ;L/( Time Fee Pd. Soil Suitability Assessment for Sewrf� isposal fG„ti-J ; C Witnessed B 1� a Performed By: l�T� �� P y: I" LQCATION & GENERAL;INFORMATION; Location Address Owner's Name �Ah Address Assessor's Map/Parcel: �y Engineer's Name NEW CONSTRUCTION REPAIR 7( Telephone � ' �� P Land Use lZ�'D�7'?A-•• Slopes(%) le) Surface Stones Distances from: Open Water Body ft Possible Wet Area """ ft Drinking Water Well C).�_ ft Drainage Way ft Property Line 1.6 4-- ft Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) A Z.V Z/ ifs . �f/' Al - Parent material(geologic) f* �''+++R/ � '� �" Depth to Bedrock 2e,s`'' Depth to Groundwater: Standing Water in Hole: !�f A.. Weeping from Pit Face Esbmaied Seasonal Higii Groundwater J/ A, DETERMINATION F( R SEASONAT.HIC�I WATER TAT�E Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side,of obs.Bole: in. Groundwater Adjusimeit R: Index Well#_ ._-. Reading Date:.!_.___ Index Well level.-.—.— Adj.factor_ Adj.Groundwater Level PT+,RC'OLATION TIt�' `I' 1..ate Ttme c �` r Observation f Hole# Time at 9" 7. Depth of Pere V Time at 6" Start Pre-soak Time© 0 4.0 Time,(" End Pre-soak Rate Min./Inch 2— Site Suitability Assessment: Site Passed ✓ Site Failed: Additional Testing Needed(YN) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant ;i DEEP OBSERVATION HOLE LOG Hole# r Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. 'Consistency,%Gravel) l y Yx- DEEP QBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. nsi tent ° rave h 5 Cii�c- � , l. DEEP OBSERVATION HOLE LO(r Mole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent %Gravel DEEP OBSERVATION HOLE L:.OG Hole Depth from. Soil Horizon Soil Texture Soil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent °o Gravel 3. Flood Insurance Rate Map: Above 500 year flood boundary No Yes v Wi thin 500 Y boundary bound No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? y If not,what is the depth of naturally occurring pervious material? Certification c I certify that on /t �`/ `! (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training pertise and experience described in 310 CMR 15.017. Signature 7 --- --- Date I Town of Barnstable Regulatory Services Richard V.Scali,Interim Director • L�iNBfASIf. • Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: la f S Sewage Permit#J UIS— a 17 Assessor's Map�Parcel / C/ Designer: SMP REIQ A-JAA 1kS,PE Installer: 5do-tT" 1A- Address: t_,J�D'SC t6 Address: its Dcth. YA'WoeTT14 g ekOQ is , k A. 0243o 1 O ZfoloO On zc; a O I was issued a permit to install a (date) (installer) septic system at W Qed'on4a d tse gn drawn by (address) �"�t�E��� A� • 16�j dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. . I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed ' li ce with the terms of the IAA approval letters(if applicable) �a nstaller's Signature) Al (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Designer Certification Form Rev 8-14-13.doc COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS ' DEPARTMENT OF ENVIRONMENTAL PROTECI'IO �4 ONE WINTER STREET, BOSTON MA 02108 (617)292-5500 6/1 �t . WILMAM F. WELD ®� 110 '1 6, CO Governor � 11�101_ ARGEO PAUL CELLUCCI SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION F0 DpD`'B,STR -S Lt.Governor PART A Co r CERTIFICATION 8 - Property Address: 21 Parrish Way, West Bamstable, MA Address of Owner: Date of Inspection: February 13, 1998 (If different) Name of Inspector: James M. Ford I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: - James M. Ford Mailing Address: P.O. Box 49, Osterville, MA 02655-0049 Map: 110 Telephone Number: (508) 775-7927 Parcel: 044 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ✓ Passes Conditionally Passes Needs Further Evaluation the Local Approving Authority Fails Inspector's Signature: Date: Februga 13 1998 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: ✓ I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B) SYSTEM CONDITIONALLY PASSES: ,One or more system components as described iq tho "Coliditional Pass" sectiotl treed to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the.date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exf-titration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the Wond Wide Web: http://www.mapnetstate.ma.us/dep Printed on Recycied Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: '•'"a. 21 Parrish Way, West Bamstable, MA Owner: _ti William Woods Date of Iri'.spection:;``'' February 13, 1998 e , B] SYSTEM CONDITIONALLY PASSES (continued) t� T Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 r ty SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 21 Parrish Way, West Barnstable, MA Owner: William Woods Date of Inspection: Febnuiry 13, 1998 D] SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. 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 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 21 Parrish Way, West Barnstable, MA Owner: William Woods Date of Inspection: February 13, 1998 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No ✓ Pumping information was provided by the owner, occupant, and Board of Health. ✓ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ✓ _ As built plans have been obtained and examined. Note if they are not available with N/A. ✓ _ The facility or dwelling was inspected for signs of sewage back-up. ✓ The system does not receive non-sanitary or industrial waste flow. ✓ The site was inspected for signs of breakout. ✓ _ All system components, excluding the Soil Absorption System, have been located on the site. ✓ _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: ✓ _ The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. ✓ _ Existing information. Ex. Plan at B.O.H. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [15.302(3)(b)]. (revised 04/25/97) Page 4 of 10 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 21 Parrish. Way, West Barnstable, MA Owner: William Woods Date of Inspection: February 13, 1998 FLOW CONDITIONS RESIDENTIAL: Design flow: 330 g.p.d./bedroom for S.A.S. Number of bedrooms: 3 Number of current residents: 4 Garbage grinder (yes or no): No Laundry connected to system (yes or no): Yes Seasonal use (yes or no): lib Water meter readings, if available (last two (2) year usage (gpd): Well water Sump Pump (yes or no): No Last date of occupancy: Presently occgied COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present (yes or no): Industrial Waste Holding Tank present (yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: None on fle -per treatment plant . System pumped as part of inspection (yes or no): No If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM ✓ Septic tank/distribution box/soil absorption system Single cesspool Overflew cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: July 1994 -,per as built card Sewage odors detected when arriving at the site (yes or no): No (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 21 Parrish Way, West Barnstable, MA Owner: William Woods Date of Inspection: February 13, 1998 BUILDING SEWER: None (Locate on site plan) Depth below grade: Material of construction: _cast iron 40 PVC _other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: Yes (locate on site plan) Depth below grade: 32" Material of construction: ✓ concrete _metal _Fiberglass _Polyethylene _other (explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance (Yes/No) Dimensions: 10'6"L X 5'8"W X 57"D - 1500 Gal. Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle: 29" Scum thickness: 6" Distance from top of scum to top of outlet tee or baffle: 91, Distance from bottom of scum to bottom of outlet tee or baffle: 10" How dimensions were determined: Measuring stick Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Baffles were in,good condition Liquid level was even with outlet invert. Recommend riser be installed on outlet side. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: concrete _metal _F"iberglass _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: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 21 Parrish Way, West Barnstable, MA Owner: William Woods Date of Inspection: February 13, 1998 TIGHT OR HOLDING TANK: None (Tank must be pumped prior to, or 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/day Alarm level: Alarm in working order_ Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: Yes (locate on site plan) Depth of liquid.level above outlet invert: 0" Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) Box was level No signs (t carryover. PUMP CHAMBER: None (locate on site plan) Pumps in working order (Yes or No): Alarms in working order (Yes or No): Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Page 7 of 10 Y= SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION , (continued) Property Address: 21 Parrish Way, West Barnstable, MA Owner: Wlliam Woods Date of Inspection: February 13, 1998 SOIL ABSORPTION SYSTEM (SAS): Yes (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: I� Type: leaching pits, number: I - 6' leaching chambers, number: leaching galleries, number: leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) CESSPOOLS: None (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) ,PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 8 of 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 21 Parrish Way, West Barnstable, MA Owner: William Woods Date of Inspection: February 13, 1998 SKETCH OF SEWAGE DISPOSAL SYSTEM: t at east two permanent references landmarks or benchmarks. Include ties o 1 pe , Locate all wells within 100' (Locate where public water supply comes into house). A B IL' inla+ 7� a-'I," 0f-1- Z, wall y i� O 70 l 1 3 v A 1 A g o 150� 0 (revised 04/25/97) Page 9 of 10 I' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 21 Parrish Way, West Barnstable, MA " Owner: Wiliam Woods Date of Inspection: February 13. 1998 Depth to Groundwater: 75' feet Please indicate all the methods used to determine High Groundwater Elevation: ✓ Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions ✓ Check with local Board of Health Check FEMA Maps I Check pumping records Check local excavators, installers ✓ Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) Established using USGS Topographic Mcp and C,cp e Cod Commission Water Table Contour Map. Maps show dipth to water at location. (revised 04/25/97) Page 10 of 10 T APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION NO. a 6-7 VILLAGE DATE (O IDU APPLICANT BaW ZD FEE (Non-refundable) ADDRESS fi TELEPHONE NO. ENGINEER TELEPH NO DATE SCHEDULED (Ap icantIs signa ur ) • . • • • • • O O o O 0 e • e • 0 0 0 0 0 e . 0 0 • • • 0 0 0 • 0 0 0 • • • •• •0 • • • • •• 0 0 Ole •• • • • • 0 • 0 • • • • 0 • 0 • • • • • • ASSESSOR'S MAP & LOT NO: � SOIL LOG SUB-DIVISION NAME DATE \o`�-i -etc.. TIME lo°•30 EXPANSION AREA: YES --9'0 _7'_)_'j L_y k�F-a-c_wdzi ENGINEER: TOWN WATER PRIVATE WELL BOARD OF HEALTH t F. EXCAVATOR SKETCH: (Street name,etc. ,dimensions- of lot, exact location of test holes and percolation' tests, locate wetlands in proximity to test holes) • NOTES: \ o s as3 � PERCOLATION RATE:/ ( TEST HOLE NO: .� ELEVATION: TEST HOLE NO: ELEVATION: 1 l 2 �'�u-�so 3 3 4 4 _ 5 5 8 w� C933��5 8 g b 9 10 10 12 ° _ 12 13Z 13 14 14 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: ,• LEACHING FIELD LEACHING PITS t/ LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED -ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BYP. E. ANJ2 RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT TOWN OF BARNSTABLE LOCATION 14*n S, WA J SEWAGE # VILLAGE W. I AWn4A6tl ASSESSORS MAP& LOT INSTALLER'S NAME&PHONE NO. lt+ 1A C04C uu''DA SEPTIC TANK CAPACITY I50b GAL LEACHING FACILITY: (type) �, Pit (size) JC M RA). NO.OF BEDROOMS 3 BUILDER OR OWNER' Z A W 00 4-5 PERMITDATE: .' 10- 0t"I COMPLIANCE DATE: '`'►�-I Separation Distance Between the: Maximum Adjusted Groundwater Table and 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)_ /(00 "r Feet Edge of Wetland and Leaching Facility(If any wetlands exist _ within 300 feet of leaching facility) Feet Furnished by A 16 JAI, W 70 1 ' Y Q ' O O TON DF�B0,4�/ �SEWAGE # T tiRI�IST BLE � `��� LOCATION" 7 r r 4 VILLAGE ��rNSe ASSESSOR' MAP & LOT INSTALLER'S NAME & PHONE NO, t �rU �0 r o .cJ SEPTIC TANK CAPACITY 0 LEACHING FACILITY:(type�eCAS (sip) /OOO ( NO. OF BEDROOMS PRIVATE WELL PUBLIC WATER UJ BUILDER OR OWNER , D DATE PERMIT ISSUED: Z-7 IZ::$ DATE COMPLIANCE ISSUED: �� �✓ `��� VARIANCE GRANTED: Yes No �� /���o �l ���k � , �p oo c�,A f V"� � �,., �' r ,�, � - - �-r \ 3� q � � � � - � r � . 0 � A ,::-- / 10 -0 No..g.... ........ ... �� [ Fps IM0 f _.. .............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratioii for Di►y.pnial Vor1w C omitrurt"inn ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ....�o--�----�o,..�!......'�r��� �•vy-----------------•---. - Esr, ��� --.-----...---•----------------....---.......-- -•- 1 ---- LortAinn-Adc rc or Lot o. --- L �!?_Ai✓1�...L%LA... �®l�S----------------------- y<� �1! !---heUV.� A.45e...................... Owner Address W InstalIcr Address UType of Building Size Lot........92 3 Sq. feet .., Dwelling— No. of Bedrooms._... ..............................___Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.........._................. Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ __ W Design Flow..j/0---1plltlAr................gallons per person per day. Total daily flow.......53.12...........................gallons. WSeptic Tank—Liquid capacity lSOQ_.galIons Length Jb,!�..._.. Width_.5_.£3 __. Diameter................ Depth...z.1.._.. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leac ing area....................sq. ft. Seepage Pit No._.OjV -------- Diameter-----JD.`....... Depth below inlet---_..6`........ Total leaching area... ...sq. ft. Z Other Distribution box (X) Dosing tank ( ) f Percolation Test Results Performed by-----.X.Y&C_... �..�....................................... Date-_-JA.::Z7:B6...�. Zd7 a Test Pit No. 1... _..Z -minutes per inch Depth of Test Pit....ZZ/-_-_... Depth to ground water.N_07...0 1C.. GZ4 Test Pit No. 2................niiAutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 19 • ................................................... -•.......................-,...........•--------•----................--.•.- Descriptionof Soil...................... 5- �-; � L------------•-------------•----------- ---------•----------------------------............. x ......••••-•••-•••-•••-•--••-••..............•-••-.... 5-•---------------.------------.................... U W U Nature of Repairs or Alterations—Answer when applicable----- ----------------------------------------------------------------------------------------- ---•--••....--•••••••-•-••-----••....-••-••-•••••••--•---•--------•-•-•----••---•---••----••----•••-•--•-•-•-•------------------•••--•-•••---------- •••••••••-•........._...........----•---•-- Agreement: 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 Prther agrees not to place the system in operation until a Certificate of Compliance h en y the boar f health. Signed .X.... . . .. ........ .... ... .. ApplicationApproved By ........ .......................................:. ..o......11............... .... .....- - ............ ..............� ...... :...-�[e.......� Application Disapproved for the following re o s: . ........... ................................ ............................ ............... . ............................... ......... ....... ........ Dale Permit No. � ��.. .......... ........... ..................... Issued ..... ...... .. ... . .... _ ...... -0 - ! t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE App iratiun for Di!i.puual Wurlw Tontitrnrtiun ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: �o iVo, �rze�s / fitly Wes .��sT•�8�� .. 7._._...... .._1'...................•-•-------------•---------..._.... •---••-----T-�'---•--•--•---•----•...--• ••.........----------------...----......... Loc:yIion-Add or Lot •o Gtli�c�,��A v LiLf1 G��aavS 329-�.���i��- �y��N.__�. �-��......................._ ----------------------.........----.........------• ...................... Owner • Address W , Installer Address UType of Building Size �.......Sq. feet .—I Dwelling— No. of Bedrooms------—3----------------------------------Expansion Attic ( ) Garbage Grinder ( ) `1 Other—Type T e of Building _...... No. of ersons____________________________ Showers 0.t YP g --------------------• P ( ) — Cafeteria ( ) aI Other fixtures ................................. . Design Flow..,/Q.--t?1&AeMa...............gallons per person per day. Total daily flow-.-____3-�-2..._......................:gallons. WSeptic Tank—L'iquid capacitvl!SO ..gallons Length)[5__6! ____ Width._g_g_..... Diameter________________ Depth..S..7 x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--- .I C------- Diameter-----JD.1_ ..... Depth below inlet...... Total leaching area...ZjO6...sq. ft. Z Other Distribution box (X) Dosing tank ( ) t ~" Percolation Test Results Performed by...... i= :._-_6A1�.J.6............................L'.._. Date_..I4."Z7:44-_.p.6Z07 a . Test Pit No. I__ _._ ,..minutes per inch Depth of Test Pit---- Z.......... Depth to ground water.AJO—Z..ANC, 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ............................................................................................... . � . OIL Soil . ... U ........•-•-••-----....-•-•--•••-•--•-••---•••-••--.. >..'...-.144::'... /1 /�Tf _.�aPf! 5. U W ------------------------•------•--------.......-•-------••-•-----------•-------------.....-- U Nature of Repairs�or Alterations—Answer when applicable............................................................................................... ................... --------•-----------•-----------........---•--......---•--------•--........------------------------------........--•-------•-------------......-•--••-------------••---------.--•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—Th'e.undersigned further agrees not to place the system in operation until a Certificate of Compliance has-been issued i y the boar• dif health. Signed r.�• - / �/�` opt Application Approved By ... Ile ........ ........ --J rr /�� ../1.,. ............................elf ...... �a / Application Disapproved for the following rear: ............. .............. ......... ...................................................................... . �........................................................................... j ....................�..........!..... .........-- Date.................. / Permit No. ....�/.....1 Issued ......i�....�..1....�"� � .......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE I' (fertifi ate of Cfomplian e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ,( ) �— r -fir In:tallc� .. ... . ... .................. .. at ...... n.'I .�7�IC�..l �._>.. / � `C �f fin. a.,1�1. �......... ............ .. ................ has been installed in accordance with the 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. DATE........ ... ------ ..... _... Inspectorc_ ... .....---....._----------........._..........,........'...._ �J —�� THE COMMONWEALTH OF MASSACHUSETTS VVV BOARD OF HEALTH `! i l� TOWN OF BARNSTABLE No_!................... FEE------------------------ Biupuuttl �Nimbi Towitrutiun. Vanfit Permission is hereby granted T/V lY6._,�........ � 2 -------------- ...................................................... to Construct ( ). or, Repair ( ) an Individual Sewage Disposal System ,. 7 at No. �" � ' L -P/\�,4r� /S N //�/ {�` `/ if Z�>J r`C .. --- - Street � as shown on the application for Disposal Works Construction P�it No.f! �.:._____ ated-___---__.._.---__.__....._. ... •..---•- •...._ Board of�Healt�h� DATE............... .. ................................. i FORM 38908 HOBBS at WARREN.INC.,PUBLISHERS No. Fee—a-!�------------ BOARD OF HEALTH ; TOWN OF BARNSTABLE Applicat ion i orWell Cootruct ion Permit Application is hereb made for a permit to Construct ( ), Alt r ( ), or Repair ( )an in. 'vidual Well at: Location — Address Assessors Map and ParAM - ! _ r ----------------------- _-_______ -_ _____--__-_- Ow�nne�r Address �---: ------------- —-------------- — — ---------- -- -- -- — Installer — Dnller Address Type of Building Dwelling —- -— - ------ - -— Other - Type of Building ------- No. of Persons— ----- —------- '{ Pk C, Type of Well------------------------ Capacity----------------_— _—__ Purpose of Well--__, c? '!: ------_----------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance s been issued by the Board of Health. Signe 5- -- - —— -- y GN / '! S� date — 7 - - q Application Approved By------- _' �_-i.�.� _ _ - ----------____-- ---�-�--�-� date Application Disapproved for the following reasons:------------------------------- --- ------ - ----------- — --------_-------_— ---- —" date —_ Permit No.--- - -= _—_-------____-- -Issued-------- date BOARD OF HEALTH TOWN OF BARNSTABLE C,ertifirate Of Compliance THIS TO CERTIFY, That the Individual Well Cons ructed Altered ( ), or Repaired ( ) --------------- ------------------------------ Insta er at e — L------Y'9_M-1-55IV_— z 6�`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. 4/?h9(_t6—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 Ve[r Congtruct ion Permit 69_� No. - -- - Fee Permission is hereby to Construct ( L r, 'Alter ( ), or Repair ( ) an Individual Well atd0 17oq t ---------- Street as shown on the application for a Well Construction Permit No- - -- Dated-------- �-- _ _- =-~�—-—--- ---------- Board of Health DATE- ' ------- -- ----- ----------- No�-4 � :.r---- ,��_• �.,,�.,-a-.«� Fee-= ---�------------ 1 --� BOARD OF HEALTH : y TOWN OF BARNSTABLE (ppfication-forverr Con5tructionvermit Appli ation is hereb made for a permit to Construct ( ), Alt r ( ), or Repair ( )an in 'vldual Well at: y - moo ------------ �i__ r�01 � -- - ------------ _ (///'/� Location — Address Assessors Map and Pad/el I. -�-----•{ - - -, — ------------==tii�r - ------------- -------—-----—- --------------------------------------------------------------------------------- Owner Address ____ Installer — Driller Address Type of Building Dwelling- ----------------------------------------------------- Other - Type of Building ---------- No. of Persons----------------------------------------------------- Type of Well- - -� C'- - Capacity—- -- ---- - -- -- -------------------------- Purpose of Well------mod- -- - - Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. 60�c Signed g ►✓' t�^�" + ,J O — --- date--- pct36 7 Application Approved By-- 2.-n'2" date Application Disapproved for the following reasons:-------------- ---------------------------------------------—---------------------------------------- ------ ti 1 f+ I date Permit No. — = ---,' Issue_.d f . . --------------------- date { BOARD OF HEALTH / TOWN OF BARNSTABLE Certificate Of Compliance THIS 1S TO CE TIFY, That the Indiv*dual'Well Cons.ructed (Llf, Altered ( ), or Repaired ( ) at4 ------- _ 4 Sli-------- --- ---- - — -- - - —' ---------------- 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. k?11 44—------Dated---------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. - t DATE------f -``1 A,.; �=----� !�C J� �" Inspector_-' — - — -=�------------------------------------------ BOARD OF HEALTH TOWN OF BARNSTABYLE/ � o�P�Fr'��On�truct101��erTl� t"� '� No. Fee------------------- - � ------- - ---------- Permission is hereby grante fi,-----`------------------------- --------------\---------- ,,to Construct ( Alter ( ), or Repair ( ;an Individual Well,atd.� Oq P'q q'R1 S lyy \ . No. -------------------------------------------------------------- ------------------------ ----- - -- t� - ' Street as shown on the application for a Well Construction Permit No.-------� - ��------------- --- Dated --—J i "`' �b ----------- r !1 I Board of Health DATE ---- — -- -- -------------------------------- cc: Nabi; Boghos Doyle enginee ring ndi Prh Town Clerk x Mgr fit, 1985 .,. Y May 22, 19811 Prio9 to Bwrd of Health aWoval of each buff � fts=VsW M* *aW .. must catform to 310 C p 15-00. the State Co6tv Tuto 5,._ 'e n i KrenJudith trench, Chairman Res Preliminary subdivision of land in West Barnstable Planning Board Petitioners Nabil Boghos Tv!* tMarnstable Datei M41,7, 1985 Hqa i �f& 02601 Engineer: Doyle $ngineering Associates, Inc. _ Assessors No. 110, Parcel 1 ilds, as Dear nch: w' as rev owed this preliminary s ubdivisioh plan and make'd the following reco tions: shall be located w thif► the prescribed boundaries of each �r<idai�l lbct�L�I-i . TOWM OP BAR.NSTARL The developer must submit a copy of a master plan to the Board showing the locations of .n, deproposed wells and septic systems throughout the subdivision prior to the approval of cca defbiltWtVWn. +le anglo""Ag A ^ .t inc« Bulldingcpst-nits will not be approved by the Board of Health on individual lots until the well is installed and certification submitted as to the bacteriological and mineral content of the water by a State Approved Laboratory. The water must meet all of the standards established by the Safe Drinking Act of 1974. The developer shall have recorded on the deed that uo variances from.Title 9; Miniiriuin Requirements for the Subsurface Disposal of Sanitary Sewage, and the Town of Barnstable Health Regulations will be granted on any lot in this subdivision. A percolation test must be made on each lot, at tesiching site, before a Disposal Work# Construction Permit will be issued. Maximum ground water elevations must be determined by using data available from the United States Geological Survey - Probable High Ground Water Levels on Cape Cod, Mass. Each proposed septic system must conform strictly to 310 CMR 15.00, the State Environmental Code, Title 5, and Town of Barnstable Rules and Regulations. w i Mrs. Judith French Petitioner: Nabil &Mhos ' pale 2 f may 22, 1985 f'r Prior to Hoard of stealth approval of each budding and W must conform to 310 CMR 15.00, the State Ennvlronmentel Code Tltslet5,n and Tow et Supply Regulations. e � Y '+ R bert L. Cbllds, Chairman Ann Jane ebbaagh ` t . t3rover G.M. Farris , BOARD OF HEALTH TOWN OF BARNSTABLE Jill£/mei cc% Nabi1 Boghos Doyle Bnglneering Associates, Inc. ` Town Clerk . i a*4 K a i5 1 � ti YET t it ;64partment of Environmental Management/Division of Water Resources � b •' WATER WELL COMPLETION>tREPORT F WELL LOCATION } Addres /��iq/'r/CIA City/Town 4, is���^� Alm. G.S.Quadrangle Map Grid Location/ Owner��l// O D n Address �� 44,(-- WELL USE CONSOLIDATED WELL Domestic Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones � Method Drilled 1) From To 2) From To Date Drilled 3) From To 4) From To CASING Depth to Bedrocke/t & Lengt lQh 0 Diameter _ Type Rye- UNCONSOLIDATED WELL STATIC WATER.LEV ` -Water-bearing Materials Feet below land surfa•eYYb E Sand: fine❑ medium❑ coarse❑s Date measured Gravel: fine❑ medium-Er coarse Screen: GRAVEL PACK WELL #.�� Yes ❑ No V Slot length from d.. 4604 Split Screen (or 2nd screen) WATER QU LITY TESTS MADE!` Slot length from to Chemical Biological ® Depth To Bedrock A410 PUMP TEST Drawdown feet after pumping days hours at GPM. 1J' How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To KCb CIO �� DRI, ER �.'� Fir. s o Lj gg a Ad ress eJA L. _ City rs-RA Registration No. 1OF perator s Signature ease print it y . OARD.,OF_HEALTH COPY. , zsnl toss sonot ENVIROTECH LABORATORIES Mass. Cert.#:MA063 449 Route 130 Sandwich,MA 02563 • (508) 888-6460 CLIENT: Bill Wood LOCATION: Lot 21 Parrish Way ADDRESS: W- Rarnctahle- MA COLLECTED BY. L. Wile Drilling SAMPLE DATE: 1-7-94 TIME: DATE RECEIVED: 1-7-94 SAMPLE ID: Z 171 JOB#: New well WELLDEPTH: 100'/71' 4" pvc 10 G.P.M. RESULTS OF ANALYSIS: Parameter Units Recommended limit Result Coliform bacteria/100 ml (MF Method) 0 0 pH pH units 6.0-8.5 6.47 Conductance umhos/cm 500 107 Sodium mg/L 28.0 11.9 Nitrate-N mg/L 10.0 0.16 Iron mg/L 0.3 0.10 Manganese mg/L 0.05 <0.01 Hardness mg/L as CaCO3 500 20.6 Sulfate mg/L 250 4.03 Potassium mg/L 20.0 0.78 Alkalinity mg/L 200 22 Chloride mg/L 250 18.8 Turbidity NTU - 5.0 1.27 Color APC units 15.0 <1.0 Background bacteria/100 ml (MF method) 200 CO A 601 602 # ug/L N.D. # See report attached. YES NO UX ❑ WATER IS SUITABLE FOR DRINKING PURPOSE FOR P ETERS TESTED. /Yl DATE 1 �8 �w - ------------- -- --------- - --- ---------------------- 1 w 1-17 94 c: � PM ;C=RCUND��ATER ANALYTICAL 500 759 4475; 2/ GRQUN13WATER ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: Z171 Lab ID: 6797-01 Project: Wood Lot 21 Parrish Batch ID: 0799-W 01- - Client: Envirotech Sampled: 0794 ceived: 01-1 Cont/Prsv: 40mL VOA Vial/NaHSO4 Cool Re -94 01-11 Matrix: Aqueous Analyzed: -94 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) (ug/L) I BRL 5 Dichlorodifluoromethane BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL 1 trans-1 ,2-Dichloroethene BRL 1 1,1-Dichloroethane 1 cis-1,2-Dichloroethene * BRL BRL 1 Chloroform BRL I 1,1,1-Trichloroethane BRL 1 Carbon Tetrachloride BRL I Benzene SRL1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichl oropropane BRL 1 Bromodichloromethane BRL 5 2-Chloroethyyl Vinyl Ether BRL I cis-1,3-Dichloropropene BRL I Toluene BRL 1 trans-1,3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene 1 Ethylbenzene BRL 1 I' meta-and Para-Xylene * BRL BRL 1 (' ortho-Xylene * BRL I Bromoform _ 1 1,1,2,2-Tetrachloroethane SRL 1 1,3-Dichlorobenzene i 1,4-Dichlorobenzene BRL 1,2-.Dichlorobenzene QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 30 100 % 87 - 113 1,2-Dichloroethane-d4 30 29 96 % 83 - 117 % BRL Below Reporting Limit. * Non-target compound. Method References: Method 601 - Purgeable u.i .. ,.,. An,4 Mpthed 602 - Purcteable Aromatics, 40 C.F.R. 136, Appendix A (1996). _ SO LOG P c1o� SITE PLAN -�"° ' , vD7 TOP OF. FOUNDATION EL.: I • • TI,`V .<../�.-«4� MIN. 2% FINISHED GRADILI E `—I. o t� t• _ IM It IM 11 r..04 _MIN. COVER / B WASHED STONE� Y COVER I B 3/ {_.. +4 I I • L ,•1, L� - N!1!%AbtINOMA]'EK t i Ole w1G'SUMP IN EL. 3/4 11/2 WASHED STONE 4' 1 1 l QO D LEVEL 14 I, I: �ff ,� , IS. DEPTH •�O PE RC PEST RESULTS I PRECAST SEPTIC TANK WITH PRECAST LEACHIHH, PITS PfRC RAIF: z=�"` �� • ✓f Tj•Af:NCKGAN I •°• .r 'E�i p6lIN CAST N PLACE 1 ET -- ., •.+.� �•� WITNESSED DT IINLET AND —SIZE:EL N0. IZ •L CUTLET T'S PER TITLE V n i . � '• .vrfc BOARD OF HEALTH _ - ia-iv-e.r SIZE: �%^� GALLONS =OIA OF STONE- DATE: LONG r_�' WIDE a%/-DEF/) •� Pervious _''111A All- .AROUND Material FL. Rs.co NiI.L.•oa0`4NLE +.n�cilw6�t R.�.✓ON FK E!wT I " ty,y,:7ifn�r �'WRD OF .✓6 0<T�✓. PROFILE OF PROPOSED SEWAGE SYSTEM V ,y SYSTEM- DESIGNED BY THE TOWN OF CA-7,10cE REGULATIONS AND IV \� STATE TITLE V FOR SUBSURFACE DISPOSAL: OF SEWAGE. SCALE: I/4'-1'O" 1. ALE PIPES SHALL BE SCHEDULE 40 P.Y.C. SEWER- PIPE. t ALL PIPES SHALL 6'E SLOPED 1/4" PER f00T; EXCEPT FOR` ,r •, � � THE FIRST 2 FEET OUT OF THE 0/B WN16N" SNAIL, BE LEYEI'" 3. DESIGN FLOW = BEDROOMS AT 110 GALDAY PER BR 520 SALIDAT I ; SFPfIC TANK SIZE 320 X f• =ars GAL ,L a- ! J .\ i A USE GAL. W/ :n/i GARBAGE DISPOSAL `:-D• •' • \ LEACHING SYSTEM: USE' 4 0 ...........'•\ ancb�:i ✓•//•• .,,_Ar= 17/1A "t EFFECTIVE AREA: SIDE ' BOTTOM' =x,.y. ' �$P TOTAL FLOW -<e?.i-r= s�9:✓0 tk .. ti II TOTAL REQ'D FLOW 150 X'h­4 = s.706�w W/1w_7 0 A R I A G I DISPOSAL `� .,,T,. �PG� 1 RESERVE FLOW: 6A1/DAT IN BE �y REFERENCE PLANS: /r-•N t��M 4/B Oi•GE SS \ pr, k�' ��E 1� �T i - APPROVED BY: i BOARD' OE HEALTH OATS: SITE AN.D, SEWAGE. PLAN : $ROPERTY OWNER: w.::/i+n/.wo u�A wdevr FOR: IJ/LL/AM- J~n� Ni/NN/�� •/.+»• _ •'�w � ��,."aty � n�eaa BEDROOM SINGLE FAMILY: DWELLING IOT; NO. /ffvcr/SN r✓Ay pan OA T E.lrcarzeeic rr,l"-v BOYLE ENGINEERINO ASSOCIATES. INCORPORATED l� Boa 595-530 Thomas B.Landers:Road. W. Falmouth, MA 02574 ��= r2o , Sn E , N C 1 T E PLAN , sU85�i� • � 4 TOP OF FOUNDATION EL.: AMSz=' 6 7 lels6e/ee"ew To 1 / F I N I S H E D wi Tf1 9 3 wi rNi v 1Z ,CAM. 6R40 a A D E GOBS+ F. I N EL IN k t 9s'°9 I H E L 94.84 I►fl I N. C 0 V E R wi Wi./ /z F > > ! — --_. ------- _ . •5. . 2 COVER 1/8 3/8 WASHED STONE i IN Et95_So t } � '; iHft 95, - o a `. i IN EL.94.Sa •, ;r �--- 3/4 1 1/2 WASHED STONE N� G�'��N��r.� �e 1 3 U/ 9 W/ 6'' SUMP 4 ' LIQU10 LEVEL J (.p • ° .a Ira o ° •• • • V • i o � . . 6• E F F A • � I � : DEPTH g . ° ° PERC TEST RESULTS PRECAST SEPTIC TANK WITH PRECAST LEACHING PITS ` ZMii✓- pER �nicH o PERC Ra1E : ° - • ° `p a a '�i•9.. x ,a�-rH WITNESSED BY Mit, TOM /�icK�i►n� CAST IN PLACE INLET AN D p NO.. SIZE. E . yl0 Jr0 r s s ' r o O �N� �� OUTLET T 'S PER TITLE V I _ BARN-�TWf� B 0 A R D OF HEALTH ! ► DIA DATE . SIZE : lSoo G A L L O N S i s��E OF STONE ( ELK L O N G x _L'2L W 10 E x 0 E E P I " Pervious :L 0 1 A ALL AROUND f Material E L. 8�,so :9eco2 .qiv e� ✓i�i v, ,+�,9s T�,e ��.�.,� o�v .�i�c 47 E gQ Troll of i�5 T i PROFILE OF PR� OPOSED SEWAGE SYSTEM , ! SYSTEM 0ES16NED BY THE TOWN 0E - .154R sT40e-5 REGULATIONS AND ! STATE T1TLE V FCR SUBSURFACE 0 1 S P 0 S A L OF SEWAGE . SCALE 1�4"• 1 ` 0 ,. ° V AY u \ I a �, All 1 . ALL PIPES SHALL BE SCHEDULE 40 P.V.C . SEWER PIPE �� P� _ 96 ED6� 2GG,/!g � 2 ALL PIPES SHALL BE SLOPED 1/4 „ PER FOOT EXCEPT FOR I THE FIRST 2 FEET OUT OF THE 0 / 8 WHICH SHALL BE LEVEL L� rB. R;S oo' \`, D �y�WA�' 3, DESIGN FLOW BEDROOMS AT 110 GALDAY PER BR 36 GAL/ DAY SEPTtC TANK SIZE ` X so% ` 42 6- GAL I USE GAL . W GARBAGE 01SP0SA � - I LEACHING SYSTEM : USE -' `— 4 EFFECTIVE AREA . SIDE ZMetix2.S= 2xT/x X6X 4 5Z,S= 7/ GPD '�- ! ti� ,'.�Q, 423J�`, gyp, 1 !!I B 0 T T.0 M 77"2-x i 0 2sx/,0 = -9 Goo IV TOTAL FLOW 471f �8= TOTAL R E Q a 0 FLOW 33o x 219% 33o Gf'c W/ '"L r GARBAGE 0ISPOSAI RESERVE FLOW s49- 3369 :.: zip GA ! / DAY IN RESERVE a, /6' �i9G� `"� �� 1 REFERENCE FLANS . ���,v ,� 4 � � a 01 ! I w APPROVED BOARD 0 f HEALTH �o�✓ry o� �AiPNST•48G� I c� �r DATE : _� SITE AND SEWAGE PLAN n I t' I` p 0 T Y OWNER : W/LL/AM A�/D G/L.0 OF _ f O R ; W/G L/A,41 W04DS I 3Z9 W, /ti7A/n/ ST NYAA/N/S MRSS. O�� q�� ;i 'Of �4s I } � JOHN J, jti��-. soy, T</,[�E BEDROOM SINGLE FAMILY DWELLING P.DOYLE,III !r ? f+_ L Q T N0. .2/ .fi9.e�/S/`/ y,/A y No.33589 a' !`{ 0 A 1 E . DEGEMBE/� 22, /993 9FciSTER�� a DOYLE ENGINEERING ASSOCIATES, � I ° •� INCORPORATEU Box 595- 530 Thomas B. Landers Road W. Falmouth, MA 02574 ACCESS COVERS MUST BE WITHIN 9" MIN/MUM, INVERT ELEVATIONS : DES I GN CR I TER I A : GENERAL NO TES : 6" OF FINISH GRADE 3' MAXIMUM COVER FIRST 2' TO INVERT OUT SEPTIC TANK: 98.0 DESIGN FLOW: BE LEVEL MIN 2" OF PEASTONE INVERT IN DI ST. BOX: 97.67 3 BEDROOMS AT l l0 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION 4 101.0 MAX OR F I L TER FABR l C INVERT OUT D I ST. BOX: 97.5 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE D 1 SPOSAL SYSTEM ONLY. 4- DIAM PIPE INVERT IN LEACH CHAMBER: 97.0 DOU - l lHE" STONE � 98.0 97.5 � 2' R-9 DOUBLE WASHED STONE BOTTOM OF LEACH CHAMBER: 95.0 NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS SET. SEE S/TE PLAN. GAS 97.67 % 97.0 95.0 ADJUSTED GROUND WATER: N/A SEPTIC TANK REQUIRED: BAFFLE OBSERVED GROUND WATER J. ALL CONSTRUCTION METHODS AND MATERIALS AND 3 OUTLET 2-500 GAL LEACHING CHAMBERS N/A 330 G.P.D. X 200x - 660 GAL. EXISTING 0-BOX W/4 STONE AROUND. 12,8'r x 25'1 x 2'd BOTTOM OF TEST HOLE #I: 89.0 SEPTIC TANK PROVIDED: 1500 GAL. EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL 1500 GAL H-20 CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL SEPTIC TANK 6' CRUSHED S TONE OR SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS. COMPACTED BASE DES t GN PERC RATE < 5 M J N/INCH i N PROFILE :NOT TO SCALE SOIL TEXTURAL CLASS - 1 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER 330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH- STANDING H-20 WHEEL LOADS. PROVIDED: 2-500 GAL LEACHING CHAMBERS W/4' STONE AROUND. A-471 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR { PARRISH WAY 471 S.F. x 0.74 - 348 G.P.D. APPROVED EQUAL. 1 SOIL TEST P l T QA TAs 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED I WELL PRECAST CONCRETE OR APPROVED POLYETHYLENE. O INDICATES INDICATES PERCOLATION - OBSERVED BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER TEST - GROUNDWATER TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE TP #1 Ps/4712 TP f2 OUTLET. I CB/DH FND I HO LOAMY IOYR RIZON TEXTURE COLOR HORIZON TEXTURE COLOR 0" 101.0 0� LOAMY IOYR 102.0 7. BEFORE CONSTRUCTION CALL 'DIG-SAFE'. I I I i I I A SAND 4/4 Q SAND 414 1-888-DIG-SAFE AND THE LOCAL WATER DEPT. 9' - - - - - - - - - - - - - - - 100.3 9' - - - - - - - - - - - - - - - 101.3 FOR LOCATION OF UNDERGROUND UTILITIES. 1 I LOAMY IOYR LOAMY IOYR I I I I B SAND 518 B SAND 518 I WELL I 34' - - - - - - - - - - - - - - 98.2 3o" - -- - - - - - - - - - - - 99.5 8, SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE w \\\ /I j i j I C/ FINE-MED IOYR C/ FINE-MED IOYR I I SAND AND 614 SAND AND 6/4 DES l GN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION \\ I I STONES STONES OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE WELL \\ \\ ! I a \ CONSTRUCTION INSPECTIONS. 60' 9. EXISTING LEACH PIT TO BE PUMPED DRY AND BACKFILLED. \ \ \ \ \ NO WATER WATER NO 89.0 Ito- 92.0 /0. ALL UNSUITABLE MATERIAL IA 6 B HORIZONS) \ \ \ \ \ \ DATE: JUNE 12. 2015 ENCOUNTERED BELOW THE INVERT OF THE LEACHING \ \ �\ \ \ TEST BY: STEPHEN HAAS FACILITY TO BE REMOVED FOR A DISTANCE OF 5' WITNESSED BY:. DAVE STANTON AROUND AND REPLACED WITH SAND IN ACCORDANCE PERC RATE: C`\ 2 M /NCH -- _-/N/ Wl TH-TI-TLE 11. EXISTING SEPTIC TANK TO BE PUMPED AND CLEANED. INSPECT AND REPLACE INLET TEE I F REOUI RED. +94.8 \ \ r 101)9 I I \ - LOT 21 Qpt �� I I II I 30, 923fi S.F. \ P g�z 8 OAK EXISTING �I \\ III 9*� \�97.7 ��--___mac SEPTIC TANK \ \ �- \ I•. \ 8.O� �\ `59-----------_- \ 'N ♦ \ \ \ 8.5 %$'OAK \ \ , � I \ 24'QAKl . -------- i7 D-80M ' \ \ \ \ V02.7 \ r100 \ \ \ ro 2-560 GALLON N LEAaiING CHAMBERS T �/ �` ^ , \ ,•� 'off I\ ; ... W14 STONE AROUND S E P / l C S / S / E M D E S l O / V \ \ 1 8-OAK \ .. .. ...:....:.., l 00.8 21 PARR i SH WAY . MAP l / O , PARCEL 44 0 101.5 WE S T BARNS TA B L E . MA . H/Gy ST \ \ � 8M. ORANGE PAINT \ \ -20-OAK -ON-ROCK.-EL-102.58 \ \ _ LEGEND _ LOCUS PREPARED - FOR ■ CB CONCRETE BOUND PA A U L COTTON qo -W WATER L I NE o HYDRANT - �o�`GypO� -G GAS L lNE SCALE : l 2 O J U N E- 12 . 2015 ypOpQa ��'a Qo° OHW- OVER HEAD WIRES 4F LIGHT POST STEPHEN A . HAAS UNDERGROUND ELECTRIC LINE } ENGINEERING , INC �oGr o94' _T_ UNDERGROUND TELEPHONE L l NE I P . O . Box 1 6 -CTV- UNDERGROUND CABLEVISION LINE // `., �\� Sou t h Dena 1 s MA 02660 +40.4 SPOT ELEVATION � I/���h� 508 362-8 1 32 _­._40------- EXISTING CONTOUR LOCUS MAP PROPOSED CONTOUR 0 10 20 40 JOB N0: 15-023 ,a 1711