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HomeMy WebLinkAbout0200 PLUM STREET - Health ?00 Plum Street.,, West-Barnstable A= 196r-022;�001 r/ 4 V al "F''nR''a%.. CERTIFICATE OF ANALYSIS, Page: 1 °? Barnstable County Health Laboratory iVSt ' Report Prepared For: Report Dated: 2/26/2009 Lily Tu Order No.: G0950739 200 Plum Street West Barnstable, MA 02668 Laboratory ID#: 0950739-01 Description: Water-Drinking Water i Sample 4: SEmpling Location: 200 Plum St.W.Barnstable,MA Collected: 2/18/2009 Collected by: L.Tu Received: 2/18/2009 Routine i ITEM RESULT UNITS RL MCL Method# Analyst Tested Note I i Nitrate as Nitrogen 0.2_ mg/L 0.10 10 EPA 300.0 LAP 2/18/2009 Copper ND mg/L 0.10 1.3 SM 3111 B LAP 2/25/2009 Iron ND mg/L 0.10 0.3 SM 3111 B LAP 2/26/2009 i Sodium 20 mg/L 2.0 20 SM 3111B LAP 2/25/2009 Total Colifornl Absent P/A 0 0 SM9223 AF 2/18/2009 Conductance 290 umohs/cm 2.0 EPA 120.1 DCB 2/18/2009 pH 9.3 pH-units 0 SM 4500 H-B DCB 2/18/2009 pH is high(The acceptance range of pH is 6.5-8.5),and its retesting is recommended.Sodium level is at the ma-vinnum contaminant level. Those on a low sodium die,may wish to consult a physician. Attached please find the laboratory certified parameter list. Approved By: '� (Lab Manager) 4. ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PCB.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 -- 1 TOWN OF BARNSTABLE LOCATION Aoo SEWAGE # QO ,30/ VILLAGE A4 ASSESSOR'S MAP & LOT15;K-j6dp od/ { INSTALLER'S NAME PHONE NO. ZOW a0A-ld SEPTIC TANK CAPACITY v LEACHING FACILITY:(type) � NO. OF BEDROOMS I�EWELOR PUBLIC WATER BUILDER OR OWNER xu �- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 7 e"l�p ✓,f VARIANCE GRANTED: Yes No _ QC K 93, IO6 i N ..............Fz�$...v��............_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrurtiun Prrutit y Application is hereby made for a Permit to Construct ( ) or Repair f ) an Individual Sewage Disposal System at: , _.... .. ..... ........ .. --• •-•..._. . ................................ -- ------ -- Location-Address or� ---•--�,�f_.....�...`�"c.�.. ................. ..__�� ��..-•- 1- . ...... ......^�"- '_s..� .....__...-•---- Owner Address ewlj y'"T �� �. r..•�... -...IX--24 Installer Address d Type of Building Size Lot.................................Sq. feet U ►� Dwelling—No. of Bedrooms_________________Cz..................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixturgs -•--•••••-----•••-••---••-----•----•••••-•-•••-••--••-•••---••---•-•••••-•-••--•-----------•--•-•--••-•-•-••-••••---••-•....-•-••••................. W Design Flow________________�S..____.....____gallons per person per day. Total daily flow.........__��....................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth...... Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Test Pit No. 1................minutes per i ch Depth of Test Pit.................... Depth to Date........................................ Percolation Test Results Performed b .__ ground water________________________ fs, Test Pit No. 2................minutes per inch Depth of Test Pit...:................ Depth to ground water........................ --••• -•••-••-----•--•-•--- •--•-••••-•-•----•-•--•-•••••---•-•••---....._-•-•- --•••------•••-•......................... 0 Description of Soil................ - U ------ -•-•••..e!!��` x W U Nature of Repairs or Alteratio —Answer when appli ble4�' _ .r=GC e l� l y': 'NSeA.006 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 further agrees not to place the system in operation until a Certificate of Complia ha been is ued by the board of health. Signed ... -�� "�.-- Date Application Approved By -----------------� ;. -- r �e Application Disapproved for the following reasons: .................. ---------------------.....---------.........---------------------. ---------------------- . .. ................. .. .. .................................................. ....---------------...-...--...I.,.......-------------- ----.-... --------- -----------............................ Date PermitNo. �f . --.0 j-_----------------- Issued ..--......------............--- . ......... Dare Q _ r J No.....;,Z:... �?�.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH — TOWN OF BARNSTABLE { Appliratiou for Disposal Works Tonsh union Errant Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 7'.............._... .. !VST... -- ................_.............- Location-Address c or Lo N Flt%`_ 7 .......................�- !�l� ,r�G �M---- Owner Address 14 Installer Address Type of Building Size Lot---_ ---Sq. feet ------------ ---- �-, Dwelling—No. of Bedrooms.................c -_-------___-__-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons___---__-----------__-____ Showers ( ) — Cafeteria ( ) P4Other fixtures ------------------------------------------------------------------------------------------------------------------•-----------•-•-------------------- W Design Flow...................�� ..................gallons per person per day. Total daily flow...._.._ --------------------gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter_______---_.---- Depth---------------- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) HI Percolation Test Results Performed by.......................................................................... Date---------------------------------------- I.J Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water......................... R+ ----------------------------------------------------------- •------------------------------------------------------ ---------- D Description of Soil................n-- -------«-' ¢' �-- S / �a 'v x W U Nature of Repairs or Alteration .—Answer when applicable' s _ `_r"!l-C___ X_..................._ SP ..' 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 further agrees not to place the system in operation until a Certificate of Compliance ha been issued b_ the board of health. Signed...� .--. ... --�� '� ---------- ---- ................................................. Dare Application Approved By ----------------- `� �v:� _ :,_ -----?`- '.-9/ ---------------------------------------------------------- Application Disapproved for the following reasons- ----------------------------------------------------------------------- --------------------------------------------------- -------------------------------------------------------------------- ---------------------------------------------------------- ------------------------------------------------------------------ ---- ----------------------------= Permit No. 7 / Issued ------------------------------------------------------na-------- o --.....j..................... Dare r^ n THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE &x#tftcate of Comp inure THIS IS TO CERTIFY, That the Individual Sewage Disposal,.System constructed ( ) or Repaired ( �) Installer at -........................................................... -'�' �'� 1—�J/1� fFi- Zt)' -� '7+ C 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------...-7 -----lfW �--q'�--- Inspector�.--..-.-115 -4�--� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No... FEE TOWN OF BARNSTABLE FEE - .. Disposal Works Tuns#rudion f rrmit Permission is hereby granted................. ,cQrQG477 <'ds`.SC.�'770'� ---.....--•.............•••----- __.. to Construct ( ) or Repair an Individual Sewage Disposal System Street as shown on the application for Disposal Works Construction Permit No.__..Z_;-- Dated............................... ................................ _ _ DATE -----�-'---•�-"-�� 0 Board of Health FORM 36508 HOBBS R WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION r�Ll� c," SEWAGE 9/ VILLAGE dJ- ASSESSOR'S MAP G LOTS-lSd,?- o INSTALLER'S NAME & PHONE NO.SEPTIC TANK CAPACITY ,Q�� �j i LEACHING FACILITY:(type) - ,,� T 3 � NO. OF BEDROOMS VA EWE OR PUBLIC WATER_ ! BUILDER OR OWNER DATE PERMIT ISSUED: -7 Z e f DATE COMPLIANCE ISSUED• 7 `"� •� f , VARIANCE GRANTED: Yes =No j 1 9CK t I 93' Ir i f � t I t � t I I - /v 6 I 9'O N BARNSTABLE �1, L , / LOCA'[��U �f �fK Trt SEWAGE # 'w� { - - r VILLAGE Uh &f I� 5 ��{ ,.ASSESSOR'S MAP Q LOT LO%,,[ I INSTALLER' S NAME & PHONE NO. �ur! Lai � SEPTIC TANK CAPACITY 1000 y u of LEACHING FACILITY:(type) � (adze)' NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER w f BUILDER OR OWNER /t G^ O DATE PERMIT ISSUED:. DATE COMFI [ANCE ISSUED: VARIANCE GRANTED: Yes No 6"ap V • i Q TOWN OF BARNSTABLE l LOCARiq PIU44 S SEWA: # v ,,VILLAGE _(), G r ti „S�Gi K/ /CAS$ESSOR'S MAP 6i LOT LO / : n INSTALLER'S NAME & PHONE NO. 1 �i r 4 1 Loq SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 400 4 (size) U - � NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: '� 5 _ g 5 VARIANCE GRANTED: Yes No T\- F � Y Department of Environmental Management/Division of Water Resources i- -WATER WELL COMPLETION REPORT WELL LOCATION Address L t") 7— City/Town (3.4 7' 13,/ A" PI G—L G.S.Quadrangle Map Grid Location � r ?�C/ 141 Owner /4 Address 4 ✓ WELL USE CONSOLIDATED WELL Domestic Q. Public ❑ Industrial ❑ t Type of Water-bearing Rock Other Water-bearing Zones Method Drilled y TJ�Q Y 1) From To --2) From 1�A 1/ ,���T..o Date Drilled ! 42 3) From / /"'":To 4) From i To CASING �. Depth to Bedrock i Length GO Diameter Type �/� UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface // 9 J. Sand: fine❑ medium❑ coarse❑ /Date measured C/ ) Gravel: fine❑ medium Q' coarse❑ Screen: GRAVEL PACK WELL S ❑ r Slot# f) length from to �- Yes No 1 Split Screen (or 2nd screen) WATER QUALITY TESTS MADE Slot# length from to Chemical fU Bioloqical a/ Depth To Bedrock PUMP TEST Drawdown 3�feet after pumping--L days �/ hours at �Q GPM. How measured T14pz-�Z- Recovery T feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To try �� o DRILLER m Firm �{//�: �1C 6 Addressq City /'��//yl %z t4 l 1? Registration No. r *. Opera"tors 3,1gnature ease print irm Y BOARD OF HEALTH COPY 25M-10-85.807101 y /C ��1 OFFICE LABORATORY 149tHIGH STREET 176 PLYMOUTH STREET BRIDGEWATER, MA 02324 BRIDGEWATER, MA 02324 OLIVEIRA ENVIRONMENTAL. LABORATORIES, INC. FOOD- DAIRY PRODUCTS-WATER -WASTEWATER CHEMICAL B BACTERIOLOGICAL ANALYSES (508)697-2650 September 28, 1988 L. Wile & Son Drilling Co. 11 Annasnappitt Drive Plympton, Mass. 02367 Source.: Well Water — Drilled Well — 4 inch PVC Well — 60 feet deep — producing 10 gals/min. (static water level 22 feet) Located on the property of Mr. A. Taylor — Lot 1 — Plum St. — Barnstable, Mass. 1 Coliform Count /100 ml @ 35 C 0 Membrane Filter S.P.C./ml 370 - @ 35 C Color (APC units) 15.0 Sediment none Turbidity (NTU) 5.00 Odor none Taste satisfactory pH 6.30 Specific Conductance 80.0 micromhos/cm mg /liter Total Alkalinity (CaCO,) 12.0 Free CO, 11.6 Total Hardness (CACO,) 12.0 Calcium (Ca) 4.80 Magnesium (Mg) 0.00 Sodium (Na) 10.1 Potassium (K) 1.05 Total Iron (Fe) 0.09 Manganese (Mn) L 0.01 Silica (SiO,) 13.5 Sulfate (SO,) 10.0 Chloride (CI) 18.0 Nitrogen - Ammonia 0.05 Nitrogen - Nitrite 0.007 Nitrogen - Nitrate L 0.10 Copper (Cu) L = less than On site collection made by Mr. L.Wile — 9/25/88 at 11:00 A.M. Sample delivered to laboratory by Mr. L. Wile — 9/26/88 at 10:00 A.M. Bacteriologically, this well water is of a satisfactory sanitary standard and is suitable for drinking and domestic purposes. Chemically, this well water -.meets the- standards for all of the chemicals tested. 9 Director The Standard Plate Count indicated the general bacterial population of the well at the time of collection. Coliform Group Bacteria: Significance The coliform group bacteria includes organisms found in the intestinal tracts of warm blooded animals, birds,decaying organic matter(hay, leaves, wood, etc.), the top 2 to 3 feet of the soil, lakes, ponds, brooks, rivers, drainage and types of vegetation. Because the organisms can cause some illness; because the presence of coliform organisms in the water suggests that other more harmful organisms may be present, water containing one or more coliform group bacteria per 100 ml of sample should not be used for drinking or cooking purposes unless boiled 5 minutes or disinfected by other means. This bacteria is of animal origin(intestinal tract)and may be considered as closely associated with disease causing organisms.On this factor, none should be present. Color — APC Units- Ground water ought to be practically free from color. For attractive water - color should not exceed 15 units. Turbidity — NT Units- Recommended limit not to exceed 5 units. Odor Et Taste — For water to be of high quality, the water should be odor free and taste good. pH — The pH value defines the concentration of free hydrogen ions in solution. Expressed on a scale extending from 0 or very acid to 14 or very alkaline with 7.0 being neutral. Specific Conductance — Conductivity is a good criterion for measuring the degree of mineralization and assessing the affect of diverse ions on chemical equilibria. Total Alkalinity — The alkalinity of this water represents its content of carbonates and bicarbonates. Free Carbon Dioxide — Well water having a low pH and a Free CO, level in excess of 50. mg/I will be corrosive to iron, bronze, brass and copper tubing and fittings. Total Hardness — Standard not to exceed 50. mg/I. Waters having a hardness level of 50 to 100 are in the medium hardness range, over 100 very hard. Calcium -- Calcium contributes to the total hardness of water.Appreciable amounts of calcium salts break down on heating and form scale in boilers, pipes and cooking utensils. Magnesium — Magnesium is a common constituent of natural water. Magnesium and calcium ions are principal contributors to water hard- ness. Concentrations in excess of 125 mg/I can exert a cathartic and diuretic action. Sodium — Recommended limit not to exceed 20 mg/I. Potassium — Potassium concentrations in drinking water seldom exceed 20. mg/I. Total Iron — Standard not to exceed 0:3 mg/I. Manganese — Standard not to exceed 0.05 mg/I.The principal reason for limiting the concentration of manganese is to reduce esthetic and economic problems. Silica — Silica content of natural water is most commonly in the 1 to 30 mg/I. Silica in water is undesirable because it forms difficult to remove silica scales. Sulfates - Standard not to exceed 250 mg/I. Chloride — Standard not to exceed 250 mg/I. Nitrogen — Ammonia is present in variable concentrations in many surface and ground waters. Its occurrence in ground water is generally a result of natural reduction processes. Nitrogen - Nitrite — Nitrite in water poses a health hazard, but fortunately seldom occurs in high concentrations. Waters with a nitrogen - nitrite concentration over 1 mg/I should not be used for infant feeding. Nitrogen - Nitrate — Standard not to exceed 10. mg/l. Nitrate, in high concentrations can and do cause methemoglobinemia or so-called nitrate poisoning in infants. Water with 10 or more mg/I of nitrate is unsatisfactory and is not considered safe for drinking or cook- ing. It is especially dangerous to children and should never be used in infant formulas. Copper — Standard not to exceed 1.0 mg/l. 1 •0Z2- 0 9 TOWN OI^I FAFi2�1STABLEt ' LOCATION ; ----SEWAGE # VILLAGE �� WW I �$ ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. f' �(A t 3� --OIL SEPTIC TANK CAPACITY_ 1000 _ — Cg4t LEACHING FACILITY:(type)--( 0 0- / (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER U DATE PERMIT ISSUED: DATE CO2.[I=l iANCE ISSUED__,_ VARIANCE GRANTED: Yes__. '1 __._. 1Ta �00 'f tf "i TOWN G_- BARNSTABLE ` )� �/-� (� 60.1 Lc7CI'ICNplt/!�/� J r � ', SEWAGE # VILLAGE 6,tr H S 7LU{J /eASSESSOR'S MAP & LOT L o ly INSTALLER'S NAME & PHONE NO. (G r- CC411A 00 SEPTIC TANK CAPACITY l 4 LEACHING FACILITY:(type) 6 L9 G G (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER Ukf/ BUILDER OR OWNER L-e&1 T6N, V 6 DATE PERMIT ISSUED: DATE . COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 a2. �. : . . ,� . � . ., �x �® ® � �1 f -a� . ; �, F. 1I I - a° ;r: @, ,:< �s. ._ � � . _ ��� ..... .. i� � � � � I d ��_ ��� _� THE COMMONWEALTH OF MASS.ACHUSETTS BOARD OF HEALTH ..........f a it..................OF........ .................................................... Appliratilan for %ipmal Mirkii (9nnitrur#ilan Prrutit Application is hereby made for a Permit to Construct ()6) or Repair ( ) an Individual Sewage Disposal System at: I....: M --••-••- nn .......... -G --5�.... •--.�..-....._. Location-Address or Lot No. plur.� S>"S1,u-Tun :.._h:+1S,/_...._l.Jl4..._.._... ... .................................................... Owner Address Installer Address d Type of Building Size Lot.......... feet Dwelling—No. of Bedrooms...............�.h��.................Expansion Attic MCI) Garbage Grinder (li,f,) pa-, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ...................................................... W Design Flow__________________________________SS___gallons per person per day. Total daily flow............................3??©_____gallons. WSeptic Tank—Liquid capacity../-gallons Length__R -A..... Width_-4'-Ln"_ Diameter________________ Depth_a�__6.-.`:.. x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft., Seepage Pit No.........4........... Diameter.....1Z.......... Depth-below inlet__ae A:?.`_._. Total leaching area...9 /....sq. ft. Z Other Distribution box (X.) Dosing tank (A6) '-' Percolation Test Results Performed by._S*LPhom_L1_:.lA�i1n_�- xltr��_ • Date__'g_.1�?�rrt�i_l1`� _ . . --- Test Pit No. 1-__-3........minutes per inch Depth of Test Pit_._J�6_______ Depth to ground water..__ Test Pit No. 2..._.___—...minutes per inch Depth of Test Pit....C ....... Depth to ground water_ _ _�............ `S'q a j1 � r .... ---------- SIEPHEN O Description of Soil_. eL j_:Till... _ iz1411._ t n ;.�!?�srf3l��1��__ __-r_�f-� .._...1.k i ___________ �---•-•------ V .-JY�cGQ10M.._ If?�__5�ir5F.Q.�J�1cti lrr�1_a_...1._�# .�..Q. .�zn�.1-q��al�j--EL, 4_z_ .. 1/_. /�7........ .--_�ILSOidr tmcs. .maiii_s�9_ Nature of Repairs or Alterations—Answer when a licable..:�___&ccQi�a, ___.�x�nc� U P PP �?t as� --•-------------------•----------••--------•---------•----•--------------------------•-----...-•----------------------------------•-•- Agreement: f�r The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI}% 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been • ue y t e bo of health. C Signed-�. '•..... ............... ... . .. . ... .-- ------------------- •--•---------.........--•-----.. Date Application Approved By........ -------------------------------------------- ......... `'� Date Application Disapproved for the following reasons________________________________________________________________________________________________________________ -•-•-•---•---•---------------------•---•----•----------------•---._...--•---------------•------------•---•-•---•-.._._......•••-....-•••-•-----••---.....-------•---------=------------..._..._-•_••••- Date Permit No....... .' .................... Issued_ l_ .................. Date No.....��.'lpoo Fss- ...5... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - rt..................OF........e5 .s?.a.:eta.b.l4...._...............:.._........................... , pplirttfion for Disposal Works Tonstrurtion Prrritit Application is hereby made for a Permit to Construct ()4) or Repair ( ) an Individual Sewage Disposal System at: - ................--......-...w .... ................... .............................. -`•-�7--#/ ... ::.....:5.1.............. Location-Address or Lot-No. ......................................... ...........---- /u::?..:�. •_-....._..._...-• •---- Owner Address Installer Address UType of Building Size Lot.........Af4.,..Z.QsSq. feet Dwelling—No. of Bedrooms............. ................Expansion Attic WCI) Garbage Grinder (No) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ------------•............................................----.....-•---------------...........----•---•------•---------•-•......-----•........--•----- W Design Flow..................................5;F_..gallons per person per day. Total daily flow............................ ?.o....gallons. W Septic Tank—Liquid capacity.✓064-.gallons Length._2!:.14"... Width..A�:LQL Diameter............. ... Depth-��.Q... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..........L......... Diameter.....1.7.......... Depth below inlet..3,. ...... Total leaching area...jg-.(...sq. ft. Z Other Distribution box (X) Dosing tank (Ao) `-' Percolation Test Results Performed Ca..�. 'xkr_ •-l�js�c____ Date.. Test Pit No. 1__. ........minutes per inch Depth of Test Pit....l.•49. ........ Depth to ground water. 44 Test Pit No. 2........—...minutes per inch Depth of Test Pit.... Depth to ground wa .� .............. . ` a+ ' `'�� ta.-t_ ...,..Ta�satL_1..� ...-.3�..,..., ,.1 fi�... ull:,�.i.1.j.;. a.- ...-•---., ... TEPH[ ... c�. _ S___• N 0 Description of Soil_.Su. l .Titl.., a�.au�,�11._. :ts�ncs����o+ti��.! J__(94?_.-./. �.��.7. t�aG....-... ' .... ALLYN �e U •-►tuc�.wsxi.... �rsa.......rsr.�./r�itic=G-�-.t.....r..�.._�.�--4--1-�-•-r-i��p...e�-!.=---.Z__..:.._.Z_. ��...:lf�c...ru.z-..e .. . W Nature of Repairs or Alterations—Answer when applicable .rno, lrJ u� a '' ••`"���� U P PP -------------------------•----....------......................------....................--•---......................-----........--•------•---••-••........._.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of TILE5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be sue y t boar of health. / f Signed.. . ...................... �.�_ 1: 1 ......... Dat . . : �t ..... .A Application Approved By-:....... rts_._ .............•-•--..-•---- ......... ----.... o v Date Application Disapproved for the following reasons:............................................•..._........................_...__.................------....--- ---•-•••............................•-•----.........----••••--....------•------------------•-•-•-----.....-------•----•--------•--•----------•--•--•--•------------•-•-•--•----........................_ .�. Date Permit No....... � -= �= c�................... Issued........: -.... - - Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �c, .........oF.............. t'�r.���r:................................. fIrr#ifirair of Tomplitturr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...- -..... l..........P.-ae............................................... .-.........----•--•--................................•-•---...................... .......- Installer ^� �, /.P-4 1� p� .......... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No............ ....... dated..............r................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................A S 63......................... - Inspector................ ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � No....C.? .:..('?.<..r ..�••a�a�...............OF.......�� :1: .` ....................................... Fn......�..5:.. - �t��to�tt oxk� ori�#riYr�iolt �PrZltt# Permission is hereby granted........ .................................................................................--- to Construct (�j or Repair ( ) an Individual Sewage isposal System atNo........--- ... • ........ .:. .........:�.f ........JV 22-r.----- - ......................................... Street as shown on the applica *on for Disposal Works Constructio rmit No.._ - .�'?. ted.._..-. __ ._. .......... --•----- ----------------- ..r . ..............- Board o ealth DATE............ ............. j FORM 1255 . M. S LKI INC., BOSTON � T $UBJE 7 d� CT TO APPROVAL O�p��,�= No..........:...::....... V`A `�` RNSTABLE CONSE _ THE COMMONWEAI-*TH OF�MASSACHUSETT i MNJIy'y'ION BOARD Off' HEALTH .��.. ...... ��.......OF.... .Hts�..l...� � Q Appliration for Bisvaaal Marks Tonstrnrtion Vrrmit �00 Application is hereby made for a Permit to Construct V v or Repair ( ) an Individual Sewage Disposal #, System at: < Location-Address - ...............1-0 ' `�3 or Lot No. W Owner Address a ........................ ........ Installer Address Type of Building ^^ Size Lot---._----_----------------Sq. feet Dwelling—No. of Bedrooms......_."'•-----•_____________________Expansion Attic (�jo Garbage Grinder (�5� a Other—T e of Building a —Type g ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ------------------------•------•-----------•----------•--•-••- W Design Flow....... ......�5�..........gallons per person per day. Total daily, flow........... U...................g�llons�{ WSeptic Tank—Liquid capacity.. 0gallons Length._W......... Width...` ...___.. Diameter................ Depth.l�:_.-&.. x Disposal Trench—No...................... Width............ Total Length.................... Total leaching area..................._sq. ft. Seepage Pit No...._.�-._._._. Diameter--------2........ Depth below inlet........ ....... Total leaching area...4®Q....sq. ft. Z Other Distribution box (\e)j Dosing tank ( .)" aPercolation Test Results Performed by...jN ._c 21.11 a __ !.c --�<r.... Date_._ _Z.v--------------------------- Test 1 Pit No. 11.12...._minutes per inch Depth of Test Pit...._12__....._lepth to ground water___ f? Test Pit No. 2..`17—minutes per inch Depth of Test Pit----X z-_._____. Depth to ground water......... ..........L4 Ri a ' O Description of Soil..... _ Y.E- -----4CCA05E :_ - .....................••. ------------------------------------------------------------------------------•------•-•-•----------------------••-_.----- �f 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 Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. (� i Signed - U' tcl PS ..... ............ .. Date ApplicationApproved By............................................................................. .................. Date Application Disapproved for the following reasons-------------••------....-•-•-•--•-•----...........-----•---•--•-------•----•-•-•-----••.._....-•-•-•---......... -••..................•------------------...--•-------•---•-------•-------....----•-•----.......----•-•---.......---------.......-•---------...---------------------•-------------------------....._--•--- Date PermitNo..................•••---•------••-••-----•---•---------. Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... ....Q.wM. .............OF.......... .' ,426040 .................................................. Tatifiratr of Toutplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( Allor Repaired ( ) f D at_..'!Nlx...fah-� .. �....... .4/-----1' lral�i 1 ------ _---Z--- ........ ,_...... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated___.y'- ,/.-A-!!•7--- ..•---•_--•-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE T AT THE SYSTEM WILL FUNCTION.SATISFACTORY. 0 DATE....................................•--••---•-------••--•-••----------••..-•-•-- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS 7 BOARD HEALTH ®1 ........... ems �........OF............ !�!j... ....................................... No........�rt.... FEE................. Bisposal Iforko Tomitrurtivit Fermi# Permissionis hereby granted.............................................................................................................................................. to Construct ( kj'or Repair ( ) n Ind- 1 Sevva posal S em at No...- .................. ...�� Street A as shown on the application for Disposal Works Construction Pit N . A. %Dated--_.- . �. .�� 7_ .........- DATE Board of Health -----•--------------•---- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH App iratinn for Disposal Works Tonstrurtinn 11nmit Application is,hereby made for a"'Permit to Construct VI) or Repair ( ) an Individual Sewage Disposal System at ....- �9 �•c Location Address a ��i or Lot No. g ........ ... a..................................1.F J.....................`6.......g. 5*� �?S��Y�4� .......0 Owner Address W a ---•---------------------------------- ----•--•......_..._..._....•------••------•••.--------..........................--.......------... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms---------4.............................Expansion Attic ($ Garbage Grinder Other—Type of Building No. of persons............................ Showers a g ------•-•-•--•-•-----------• P ( ) — Cafeteria .( ) Otherfixtures -- ----------------------------------------------------------------------•---•--------- -----------------•----------•------•----••- •-------- W Design Flow.`_. ......�.5 ...gallons per person per day. Total daily flow.--........4I. .............gallonsf WSeptic Tank—Liquid capacity.14� llons Length.-l(a........ Width-- 1577....... Diameter...... ......... Depth:...: .:.. x Disposal Trench—No..................... Width.................... Total Length.......... Total leaching area....................sq. ft. Seepage Pit No.-.-.-.24n........ Diameter........ ........ Depth below inlet.......!: ....... Total leaching area..._'°-_- Q...sq. ft. Z Other Distribution box ( o)M Dosing tank ( ) 1-' Percolation Test Results Performed by...� ;.i._+f ►._. .� %� .: ' '_ L" _._--- Date.. _'_.....•---- ---------- Test Pit. No. LVJ.:.:....minutes per inch Depth of Test Pit.....1'%:.`....._ Depth to ground water....g :!! .. rZ4 Test Pit No. 2... l` ,_minutes per inch Depth of Test Pit................ Depth to ground water.......-'..............` a -•------•--• •--......... --••--......•----•-•--......••........ O Description of Soil--• 00, T��Sd- ;` ? €"t � �y --C`�------------------• i, � t . ----------•-•--•---------- t .--.•--•--.......... V ................................... .. ..........._.....-- ..... .... ....._........................r. i. ------------ .........-•..........................................................................................................•---........-W_ .............kk"'�......rp ....... U Nature of Repairs or Alterations-Answer when applicable-------------------------- --�.�•G��:`__ .t-..`......._=__ -------••--•----•-------------•••-•-•---•-•---•---•--••-•--•............-•---•--••-•-.......-••••---•--••-----•---••----•........•-•---••----•----•••••--•-•--•-•-•--•-•-•-•----•---------•-........---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. r Signed....4?t ......... t ` -7• _ Application Approved B _A"X��" �"'��"" i W_— � "µ�� Date PPPP Y-•-•--•-•-•-•-•-•••. ......--(!.................. ........................................ Date Application Disapproved for the following reasons:------••••-••-•---•----•.....•--•...----•...............•••----•--•••--••-•...•----•-------••-•-....•---•....._ ............................................................................. -----•---.•...-•----..........---.......-------••------••--•---•...................................................... Date PermitNo.............................Z........................ Issued-....................................................... z Date S f TH.E4LOMMONWEALTH OF MASSACHUSETTS .. BOARD OF HEALTH � f .y �itn-E..,......OF...............1 `. :":............................................... Tntifiratr of Tuntplinnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( r Repaired ( ) at....... w E ^d has been installed m acrdance with the provisions of TITLE 5 of The State Sanitary Codg asi czi the application for Disposal Works Construction Permit No........................................ dated....--- ----------------------- ...._._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEtioI WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE'COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH. a7 /' - - ................ srd r✓ .*..OF..................�� . c ..1�:....!......... . No........ :..... FEE`....................... Disposal Vorks TwOnstrurtion.Zpantit Permission is hereby granted............. -----------•------------------------- ��•--,----i-----....A.....------.........--•----••-•----- o Construct r Repair Ineaitwag Iiposal y at No.:. v - Street 1 \- as shown on the application for Disposal Works Construction Permrt N �"" ,Dated t ! ' Board of Health y DATE................................................................................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS X, LUC S N� h i--> Ul i Qr• �.. .^'� ram\ ko � t i ' Ir' 1AV. t � � VINT ej --� . ► G-vTTA C-E � B 3 f f I Z Z t '1 Pj� Irii 55. 5 LEA rGi/F .�115 u!1?I/Stt IG` '.,/,CLEA1J 79dt fi ;0 � ,y r HAiz.,-J.&! sTv� ;- / !wA — IZ -- d4 D Le-,\Aj = t U x 4 = 4 4-o 6 N VA NIL ,AM r r. ��►.5 E �, ► DEwA�+;, Ate:A I5 U 5 F �EZa► T .r..c > () SURD)& -/c-V �TT2)F t To?A,L DC'SIe.0 ZY,42-6- = 8S e) GPD 4-4v 6V P CC) I_,All uU P Ar11E ' RAJ id t►.� yc� S�t-5 EL.Ey4TI(AJ: 1;A5kzV OtJ VASL=a G S V�AGC L� 'S��ts.1..1 t3� A1_A�, W . 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