HomeMy WebLinkAbout0378 PLUM STREET - Health 378 Plum Street
196-015
W. Barnstable
I
e
u
Commonwealth of Massachusetts
Title 5 Official Ins `r ection Form
p
Subsurface Sewage Disposal System Form:-'Not for Voluntary Assessments
M 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name Q'}
information is West Barnstable Ma 02668 3/11/2016 =
required for every
page. City/Town State Zip Code Date of Inspection N
m
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out forms A. General Information
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not Sean M. Jones
use the return Name of Inspector
key.
S.M.Jones Title V Septic Inspection
�y Company Name
74 Beldan Ln.
Centerville Ma 02632
Cityrrown State Zip Code
774-248-4850 smjonestitle5@gmail.com S14522
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
��3/11/2016
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
y<a 378 Plum Street
M
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
The dwelling located at 378 Plum St West Barnstable is served by a Title V septic system consisting
of a 1500 gallon septic tank, distribution box and a leaching facility with 6 rows of Arc 36 units.
The system was found to be in proper working condition at the time of inspection.
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ 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
t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
"*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® 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 Y day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
a 378 Plum Street
�M
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.)
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
E] ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
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
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
f
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owners Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. CitylTown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 4 Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 443.3 gpd
provided
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 ®fficial Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
, 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
requinforrn
redd on is for every West Barnstable Ma 02668 3/11/2016
requir
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d well
9 ( Y 9 (gP ))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: current
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203):
Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
system installed 7/6/2010 per town records
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Joint were ok, no leaks, vented through the roof
Septic Tank(locate on site plan):
Depth below grade: 1.5
feet
Material of construction:
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
1500 gallons
Sludge depth:
6"
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
3"
Scum thickness 3
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom of outlet tee or baffle
10"
How were dimensions determined? opened covers, took
measurements
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank does not need to be cleaned now but should be done soon and again every 2 years for proper
maintenance. water level was even with outlet, tank was not leaking and was structurally sound.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M SV 0� 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code. Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
"Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
I
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Sox(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
0"
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Distribution box was in good condition, no rot, water level was even with outlet invert.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
*If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 21
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
s.a.s. consists of 21 Arc 36 units. Area of leaching facility showed no signs of saturation, no lush
vegetation.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
r
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information isequired or every
very West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks.
a ks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
0~MMARI CAYAGG FeoA)T
A
I
i G S
3
hl-Nq g2-S7 A3-7sc0
A1'C7,7 A 5-7y,y �1G-B�I,t C 7 438,6 C812,3 :U746.9 Uq-16; 3
A 4-80,G
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
f
Commonwealth of Massachusetts
. Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 9
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 2/26/2010
Date
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Design plan dated 2/26/2010 indicates that groundwater was observed at 116"and system is
designed to have 5'seperation between bottom of s.a.s. and adjusted high groundwater elevation.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
f
Commonwealth of Massachusetts
Title 5 official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 378 Plum Street
Property Address
Peter Johnson & Karen Wirtanen
Owner Owner's Name
information is required for every West Barnstable Ma 02668 3/11/2016
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or.E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
Page: 1 of 1
CERTIFICATE OF ANALYSIS
Barnstable County Health Laboratory (M-MA009)
`s...... Report Prepared For: Report Dated: 3/18/2016
Peter Johnson
Johnson Building Order No.: G1692136
7 Penelope Lane
Cotuit, MA 02635
Laboratory ID#: 1692136-01 Description: Water-Drinking Water
Sample M Sample Location: 378 Plum St.W. Barnstable Collected: 03/17/2016
Collected by: Customer Received: 03/17/2016
Routine
ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE
Nitrate as Nitrogen 3.6 mg/L 0.10 10 EPA 300.0 LAP 3/17/2016
Copper ND mg/L 0.10 1.3 SM 3111B LAP 3/18/2016
Iron ND mg/L 0.10 0.3 SM 3111B LAP 3/18/2016
pH 6.2 PH AT 25C NA 6.5-8.5 SM 4500-H-B DCB 3/17/2016
Sodium , 12 mg/L 2.5 20 SM 3111B LAP 3/18/2016
Total Coliform Absent P/A 0 0 SM 9223 RG 3/17/2016
Conductance 160 umohs/cm 2.0 EPA 120.1 DCB 3/17/2016
Water sample meets the recommended limits for drinking water of all the above tested parameters.
Attached please find the laboratory certified parameter list. Approved By:
(Lab Director)
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
3195 Main Street, P0. Box 427, Barnstable, MA 02630 Ph: 508-375-6605
Town of Balr»stable
Department of Regulatory Services
,» t Pal J,c H�al1�h Division Date t 1
2
. ' 200 Main Street,'Hyannis:MA 02601
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Date Scheduled d d Time �' Fee Pd. �
SW Suitabil ty Assessment for Se sposal
Aerformedby, �e Q�� c�1-a e Witnessed By
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LOCATION& GENERAL INFOI AAM—T. N
m
Location Address Owner ,
's Nae .r e. 7 �/�V4td'v)
37�s t'1��.
l,J . Lea art 3"b4_ Address 37 S` P►,i"i�t.S t-
. . txl t�o��v+s.}c�1-vim 4 z,
Assessor's Ma : ) (e ( d 5� , Engineer's Name_Fel-er-0' - & tie e- P t
NEW CONSTRUCTION REPAIR Telephone# -1 �a .
Land Use s i 14vi4-icy Slopes Surface Stones � �® LC CuS
Distances'from: Open Water Body ft Possible Wet Area 1_ft Drinking Water Well,Z .,,ft A b A ✓\o)
Drainage Way 7,! ft Property Llne �� ft Other ft
SKETCH;(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands'{n pmxim1tyto holes)"
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U O PA
`u`q( CJ U"f�f 31^
Parent material:(geologic) Depth to Bedrock Ii A-
Depth to Groundwater. Standing Water in Hole: '1 6 Weeping from Pit Face
Estimated'Seasonal High Groundwater J
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:.
Depth Observed standing in obs.hole: In. Depth to 5411 tntittles, In'
Depth to weeping from side of obs.hole: in, droundwater AdJusttnent. ft
Index.Well:# "a_ .Reading Date:---,7/ � Index Well leverdJ A ,thetrii!,,,�..... At({.6i�nundwafer
vDw-Zrz. �'A J 1&0 1 o 6_3 <
Observation
PERCOLATION TEST bate, Thne
'
Hole# _ Vf` Time at 9"
Depth-of Pere Time at b": .
Start Pre-soak Time® Time.(VwV)
End Pre-soak
Rate Mm./I .Site Suitability Assessment: Site Passed C Site Failed: Additional Testing Needed(Y/N) .
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
If percolation test is to be.conducted within 1009 f wetland,you must first notif the
Y
Barnstable Conservation Division at least one (1)we0k prior to beginning.
Q:ISEPTICIPERCFORM.DOC
D'EEP.OBSERVATION HOLE`LOG
Hole#
Depth from Soil Horizon Soil TT ..Sail,.Color. Soil 0 �
(USDA) (Mansell) , Mottling (Strucwre,Stones;Boulders..
1A It
lO ,"3 FS'AAd
c 4 3
a_
.,
.,,,.
DEED'OBSERVATION HOLE'LOG Hole#
l.
Depth from Soil Horizon . Soil Texture Soil Color : Soil" `; ', Other
„ u tructure,Stones Boulders.
Suface(in.) (USDA) (M nsell) Mottling (S
e
DEEP OBSERVATION HOLE LOG Hole#,
Depth from Soil Horizon Soil Texure Soil Color Soil Other
Surface(in.) (USDA) (Munseli) Molding (Structure,Stones,l3.oulders.
e
DEEP OBSERVATION`HOLE LOG Hole#
Depth from S, Horizon Soil Texure Soil Color Soil Other
Surface(in:) (USDA) (Munsell) Mottling (Structure,Stones,'Boulddrs.
i
Flood Iniiurance Rate Mau .
Above`500'year flood boundary
"Within S00'year`tioundary
No PIS, Yes
Within LOO year flood boundary No Yes
De oaf Naturally Oc¢urrins Pervious Material
Does at lea t four feet of naturally occumng pervio ma nil-exist"in all areas:obsorved throilghout zthe
area proposed for the soil absorption system?
If'riot;what is the'deptli'of naturallyoccurring pervious mammal?',..^.__.._..._
CertiScation
1-ci;rtify.that:on; �` �� .(dated I havepassed the soil evaluator examination approved-byfthe
Department of Environmental Protection and that the above analysis was performed 6y me cdflsistenf with
,., w ,
the required. g;expertise and experience described inIU'CMR 15.0`17:
Signature Date.
err ,
Q:SLPI7CEPBRCP0RM:DOC ,
J
TOWN OF BARNSTABLE
LOCATION 7E3 _Plorn Sf SEWAGE# 2010 - 07
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. Dcoc,6 5 h �j6cU L,�c, e -yao-yg�y
SEPTIC TANK CAPACITY l SO1C) Nrr_0
LEACHING FACILITY:(type) ARC (size)
NO.OF BEDROOMS 4
OWNER v N ,,S
PERMIT DATE: Py / COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 5,`/ Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet-of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching--facility) A Feet
FURNISHED BY �C1aS .�
�6MQ*IZTY 6AcY&ems
� S
hi'-4i q2.-5-7 A3r75- ` J -7iZ
No. Fee �U u `
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: z/
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftPuration for Misposal 6pstem Convtrurtion Verntit
Application for a Permit to Construct( ) Repair(,,<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.*37g i�lt)M S t- IAA �f A) Owner's Name,Address,and Tel.No. Fd- ,&d�.,3p6norD
Assessor's Map/Parcel
Installer's Name,Address,and Te.No. Designer's Name,Address,and Tel.No.
�ca�f/Gs /3r � LNG -Y�� ��► rnrrt�i �s,Es �� - -y��
Type of Building:
Dwelling No.of Bedrooms IV Lot Size a_7 sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 4/4/0 gpd Design flow provided E/Y3. 3 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank /Q00/V gf&J Type of S.A.S. L 36 116
Description of Soil 6ror ,/,1�4.•J
v
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
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 Board of Health.
e Date f!
Application Approved by Date(Q n l
Application Disapproved by Date
for the following reasons
Permit No. / Date Issued (�
f No. C/ �- Fee (0 r' �-
`' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yeess
Applitation for Disposal 6pstem Consirurtimt liermit
Application for a Permit to Construct( ) Repair(( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. '3'7g �' S t- rN Owner's Name,Address,and Tel.No. C � jo h Nson)
Assessor's Map/Parcel 1961
Installer's Name,Address,and Tel No. Designer's Name,Address,and Tel.No.
Av1�s A /3�ow.� •,.c so -YA9- /S ►Nrrr a ufo��S so - _y ,
Type of Building:
Dwelling No.of Bedrooms y Lot Size r-)-
.,-I S Q D sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) L/'V0 gpd Design flow provided //y3, 3 gpd
Plan Date Number of sheets Revision Date ,__
Title
1
Size of Septic Tank /15'00 IVt0 ✓ Type of S.A.S.
De�'criptiou of Soil
!J
i
Nature of Repairs or Alterations(Answer when applicable)
PTO r,
Date last inspected: + 1
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 Board oLHealth.
S' ne Date U
Application Approved by Date
Application Disapproved by ' : - Date
for the following reasons
1
Permit No. o U / Date Issued V
----.-------------------------------------------------------- ----------------
THE COMMONWEALTH OF MASSACHUSETTS
f
BARNSTABLE,MASSACHUSETTS
entifirate of Compriante
THIS IS TO CERTIFY,that the On.-site Sewage Disposal system Constructed( ) Repaired(e< Upgraded( )
Abandoned( )by , 'r If &aw
at 7 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No,�/C% ated h A
Installer b { H 6/owo2 LNG. Designer rnC(-�� 10
#bedrooms Approved design flow Iv�/ god
The issuance of thils permit shall not be construed as a guarantee that the systemP)ntioln as desi d.
Date 1 V Inspector �!` 1
No. (Rti I- Fee �®
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Disposal *pstem ConstCUttion 3permit
Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( )
System located at 376 ?Ivm Aep
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:Construc'on musl be completed within three years of the date of this permit.
Date (U � 7 yo Approve b�_�
s
TRANS. NO.:
CITY/TOWN: �ns►-�61�
APPLICANT:
ADDRESS: 37 2'
DESIGN FLOW: 440 gpd
REVIEWED BY: Kc DATE: 1 v
N/A OK NO
Legal boundaries denoted [310 CMR 15.220(4)(a)]
Street, Lot, tax parcel number and lot number noted on plan [310
CMR 15.220 4 `u
Locus Provided 310 CMR 15.2204(t)]
Plan proper scale? (T"=40'for plot plans, 1"=20' or fewer for
components) [310 CMR 15.220(4)]
Easements shown.131.0 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- if not, a variance is required 310 CMR 15,412(4)]
Location of impervious surfaces (driveways, parking areas etc.)
[310 CMR 15.220(4)(d)]
Location all buildings existing and proposed 310 CMR
15.220 4 c
Location and dimensions of system components and reserve areas.
310 CMR 15.220(4)(e)]
System Calculations 310 CMR 15.220(4)(0]
daily flow
septic tank capacity(required andprovided)
soil absorption system(required andprovided)
whether system designed for garbage grinder
North arrow 310 CMR 15.220(4)(g)]
Existing and ro osed contours [310 CMR 15.220(4)(g)]
Location and log of deep observation holes (existing grade el. on
each test) [310 CMR 15.220(4)(h)]
Names of soil evaluator and BOH representative [310 CMR
15.220 4 h and i ]
Location and date of percolation tests (performed at proper
elevation?),[3 10 CMR 15.220(4)(i)]
Percolation test results match loading rate? [310 CMR 15.242]
Certification statement by Soil Evaluator [310 CMR 15.220(4)0)]
Observed and Adjusted groundwater(method for adjustment /
given or indicated) [310 CMR 15.103(3) and 310.CNM
15.220 4 n ]
Address Sheet 1 of 9
N/A' OK NO
Location of every water supply, public and private, [310 CMR
15.220(4)(k)]
within 400 feet of the proposed system location in the case
of surface water supplies and gravel packed public water supply
within 250 feet of the proposed system location in the case
within 150 feet of the proposed system location in the case
of private water Mly wells
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins
located within 50 ft. 310 CMR 15.220(4)(1)]
Water lines and other subsurface utilities located [310 CMR
15.220(4)(m)] (if-water line cross see 310 CMR 15.211 1 [1] `�
Profile of system showing invert elevations of all system
components and the bottom of the SAS [310 CMR 1.5.220(4)(o)]
Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft. of lot line) [310 CMR 15.220(3)]
Test Holes adequate(two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2) or as
approved for an upgrade under LUA at 310 CMR 15.405 1 k
Test hole adequate to demonstrate four feet of suitable material?
[310 CMR 15.103 4 .
Test Holes adequate to confirm adequate groundwater separation?
[310 CMR 15.103(3)]
Benchmark within 50-75' of system 310 CMR 15.220(4)(g)] /
Materials specifications noted? [various sections of 310 CMR
15.000
System components not> 36" deep (unless Local Upgrade
,Approval or LUA requested) 310 CMR 15.405 1 b
Address Sheet 2 of 9
N/A OK NO
N
Size OK? 310 CMR 15.223 1
Inlet tee located ten inches below flow line [310 CMR 15.227(6)] /
Outlet tee 14" or 14" + 5" per foot for increase ft depth [310
CMR 15.227(6)]
Outlet tee with gas baffle or approved filter[310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228 1
Separation between inlet and outlet tees(no less than liquid depth)
[310 CMR 15.227 2
Inlet/Outlet elevations at least 12" above high groundwater
(except as descriped 310 CMR 15.227(5)) or permitted for
upgrades under LUA 310 CMR 15.405 1 k
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232 3
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" 7/07 [310 CMR 15.228(2)]
Access to within 6 of grade , -one port for systems<1000gpd,
two fors stems>1000 gpd [310 CMR 15.228(2)]
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)]
> 10 ft from building foundation [310 CMR 15.211 1 ]
Buoyancy calculation Required/Done 310 CMR 15.221(8)]
H-20 Where appropriate? 310 CMR 15.226(3)] t
Setbacks from resources-[310 CMR 15.211]
Required when other than single-family dwelling or flow>1000
d 310 CMR 15.223 1. b
First compartment 200% daily flow; Second compartment 100%
daily flow 310 CMR_15..224 2 .and .3 ]
"U" pipe through or over baffle, outlet of each compartment with
as baffle or approved filter [310 CMR 15.224 4
Address Sheet 3 of 9
j
N/A' OK NO
Located at least ten feet from any water line? [310 CMR
15.222(2)] r{
Disposal piping at least 18" below water line(when water and
sewer cross, see 310 CMR 15.211 1 [1
Cleanouts required/provided ? [310 CMR 15.222(8)]
Thrust blocks s o-fied in force mains? 310 CMR 15.221(6)(c)]
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
310 CMR 15.222(6)]
Proper pitch on all runs? (.005 within gravity-distributed trenches
and beds) [310 CMR 15.251(9) and 310 CMR 15.252 2 c
Siphonproblem/ ieachfield below pua chamber
Endca s or vent manifoldspecified?
Size and orientation of discharge holes.specified? (not smaller than .
3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR
15.252(2)(h)]
Materials specified (310 CMR 15.251(5) specifies various pipe f
types allowed
x
Stable compacted base [310 CMR 15.221(2) and 310 CMR
15.232(2)(a)]
Splash plate or baffle tee required on inlet/provided? (when
pressure sewer to d-box or steep pitch of gravity sewer) [310
CMR 15.323(3)(a)]
Riser if deeper than 9".f 310 CMR 15.232 3
Inside minimum dimension 12" [310 CMR 15.232(2)(b)] ✓
Minimum sum ¢" 310 CMR 15.232 3 e
Watertight cover if<2000gpd); waterproof manhole if>2000gpd /
[310 CMR 15.232(3)(d)]
Capacity(emergency storage above working=design flow)? [310
CMR 231 2
Pro er setbacks 310 CMR 15.211 same as se tic tanks)]
Watertight 20-in minium access manhole at least 20" MUST BE
TO GRADE [310 CMR 15.231(5)]
Service components accessible (not too deep with piping,
disconnects accessible
Alarm floats - alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. 310 CMR 15.23 1 6 and 8 ]
Stable Compacted Base [310 CMR 15.221(2)] .
Address Sheet 4 of 9
r
FB-uoyancy calculations needed ?Provided? P 10 CMR 15.221 8 ]
Address Sheet 5 of 9
l
N/A' OK NO
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.240 1
Required separation togroundwater? 310 CMR 15.212
Aggregate specified as double washed [310 CMR 15.247(2)]
System Venting required/provided? (system under driveway or
>36" deep) [310 CMR 15.241] t/
Inspection ports specified and within 3"final grade? [310 CMR
15.240 13
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document]
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. [310 CMR 15.253(6)]
Each structure With one inspection manhole(if>2000 gpd must be
tograde) 310 CMR 15.253 2
Aggregate P minimum-4' maximum: 310 CMR 15.253 1 b ]
2' sidewall credit maximum [310 CMR 15.253 1 a ]
In bed configuration, inlet eve 40 s . ft. [310 CMR 15.253 6 ]
Width 2' minimum 3'maximum 310 CMR 15.251 1 b)]
100 feet -maximum length [310 CMR 15.251 1 a ]
Minimum separation 2x effective depth or width whichever greater CA
3x if reserve between trenches _[310 CMR 251 1 d
Situated along cpntours [310 CMR 15.251 2
Breakout OK? [ 10CMR 15.211 1)[4,j and Guidance Document]
' � M
minimum 2 distribution lines [310 CMR 15.252(2)(a)]
Maximum separation between lines 6' 310 CM R15.252 2 d ] r/
Maximum separation between lines and outside of bed 4' [310 ✓
CMR 15.2522 e ]
Aggregate depth below discharge pipes 6" minimum, 12"
maximum. 310 CMR 15.252 2
Separation between beds IU minimum. [310 CMR 15.252 2 ]
Bottom area used in calculations only 310 CMR 15.252(2)(i)]
Address Sheet 6 of 9
N/A OK NO
Pressure Dosed Systems? Provided Mpump and piping calculations
as required 1310 CMR 15.220(4)(r)]
Pressure dosing required on all systems>2000gpd or alternative
systems under remedial approval [310 CMR 15.254(2) and I/A
Remedial Use Approvals]
If used in gravelless system -make sure jet is directed as not to
scour soil interface Guidance Document
Inspections once per year(systems<2000 gpd) or quarterly
>2000 dgood to note on plan [310 CMR 15.254(2)(d)]
Construction in fill -Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255 3 ?
Impervious barrieer and/or retainin wall ? [Guidance Document]
Impervious barrier installation must be supervised by designer
310 CMR 15.2552 b ]
Retaining wall must be designed by Registered Professional
Engineer 310 CMR 15.25 5 2 a
Side slope not exceed 3:1 ? 310 CMR 15.255(2)] ✓
Breakout requirements met? [310 CMR 15.252(2) and
Guidance Document
At least 5 ft. from impervious barrier to edge of SAS (10 ft. v
recommended) Q 10 CMR 15.255 2 e ]
d
Check DEPApproval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a rote on the plan regarding the requirement for
perpetual maintenanceagreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Hasa licint submitted a coRX of a maintenance agreement?
Are the variances listed on the plan?Y[310 CMR 15.220
4
RLS Stamp necessary on plan if a component is within five
feet of property[ine 310 CMR 15.412(4)]
Address Sheet 7 of 9
1
New construction or increased flow proposed - [Refer to 310 j
CNIR 15.414]
Address Sheet 8 of 9
` N/A OK NO
tPS
Is the system in a Designated Nitrogen Sensitive Area(Zone II for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216- also refer to Policy regarding upgrades of such
existing systems]
Is the system proposed on the same lot as served by private well ? f
310CMR15.2142 ]
Are the nitrogen loads proposed in compliance? [310 CMR
15.216 i ], ( 2;
Pumping to septic tank ? [ 310 CMR 15.229
Shared System [�10-CMR 15290]
Address Sheet 9 of 9
V�r <e G—. fd° a
No.- 0V"" Uun �,w t U--ro----------� A Fee
-
BOARD O H
TOWN OF BARNSTABLE 15C
2pplirat ion for Melt Con0trurtionVamit
Application is hereby made for a permit to Construct (4-j, Alter ( ), or Repair ( )an individual Well at:
Location — Address Assessors Map and Parcel
Owner Address
- CSh197.4
�- e—--- -- - _ _ -
Installer — Driller Address
Type of Building
Dwelling
Other - Type of Building— ---__--____ No. of Persons--- _•------.-_�__—_—_.____.
Type of Well
- -- �rn�.a.� paclty----------�----_-------_—_
Purpose of Well-
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until Certificate.of mpliance has been issued by the Board of Health.
Signed
— — date —�_—
Application Approved By
date
Application Disapproved for the following reasons:
date
Permit No. ��° �v 'D/ __ Issued— 2��(�
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
C ertif irate Of Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( )
Installer
-------------
at__ ,�� �L G�AP7 S 7—
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. -----.-.------Dated— _---_-__--
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE Inspector ---___---
,X.
Gr b a c G No. Gt/
I m. Fee- S------------
BOARD OF HEALTH
Y� TOWN OF BARNSTABLE EC
ZippiicationiorVelr uConotruct ion Permit
Application is hereby made for a permit to Construct ( ✓)', Alter ( ), or Repair-( )an individual Well at:
Location — Address Assessors Map and Parcel
c�c�a rc� s1�h_ so _ ��� P��•/Yi Sj' Gr/. Ida rz.7s7A?ea-
Owner — — — -- Address --
�E��h ecc G - 47 4iv s
Installer.— Driller —� Address
Type of Building
Dwelling
� + I
Other - Type of Building-----__-__--____ No. of Persons--- ---
Type of Well �i 4t�i ,avc_� h it i n Ga �t
YP —__ — —— C-apacity--
Purpose of Well-
Agreement:
I
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 Certificattee�of Compliance has been issued by the Board of Health.
Signed j ��L _-
f / date
Application Approved By _____
date
Application Disapproved for the following reasons:
date
Di 1, 4 �.
y, -
Permit No. Wa " �� ' ----
- -------- Issued date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( }, or Repaired ( } -
_____��
Installer
at—_3 r L 4 ter, .S TGc,
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. _-________________Dated---------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE - -- _. Inspector--------------------____—_____---____--
BOARD OF'HEALTH
TOWN OF BARNSTABLE
Ivell Cootruct ion Permit
No. IiJ 2o I Fee- � -
�[J/7�D/�//�
Permission is hereby granted
to Construct ( IA, Alter ( ), or Repair ( `).,fan Individual Well at:
r No. rG�ui>> S.T_ pt� .16 0/5y1 s 771f LC`^- ----— ---------------------------------
street
as shown on the application for a Well Construction Permit
No.-- -- -- Dated---^- _--- ------------------------- -
2f -
-
�/
DATE-- ,G��._.� -- Board of Health
Town ofBarnstable ,
Regulatory Services
Thomas F.Geller,Director
. : . :.T Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: -1 tq c v Sewage Permit# Assessor's Map/Parcel
Installer&Designer Cerdfication Form
Designer: rLo,��nT -ee5� ^'i'`^� , �`�C Installer:
Q-
Address: n- .
Address.
OZOZ
On ���- �^ was issued a permit to install a
(date) (installer)
septic system at 7J� f L o,(,, � W a , based on a design.drawn by
(address)
Fea-FV_ .M C—S,t'Ce 'i f 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. Stripout (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. Stripout(if required) was inspected and.the soils
were found satisfactory.
OF MR��cy
�s 9
PETER T. G�
11er's Signature) WENTEE y
CIVIL
No'
35109
•off 9F��
(Designer's Signature) (Affix De �b )
PL E-
TURN TO B STAB E P,UB C HEALTH D $ N. CEI IrM ATE
C L - E L NOT B S tI
BRECE.IVEDBY T E
q:lofftce form Wesipawrtification form.doc
o
CERTIFICATE OF ANALYSIS Page: 1
' Barnstable County Health Laboratory
Report Prepared For: Report Dated: 8/3/2010
Sally Desmond
Desmond Well Drilling Order No.: G1058936
P O Box 2783
Orleans, MA 02653`
Laboratory ID#: 1058936-01 Description: Water-Drinking Water
Sample#: Sampling Location: 378 Plum St.,West Barnstable,MA Collected: 7/30/2010
Collected by: Customer Received: 7/30/2010
Routine
ITEM RESULT UNITS RL MCL Method# Tested
Nitrate as Nitrogen 3.0 mg/L 0.10 10 EPA 300.0 7/30/2010
Copper ND mg/L 0.010 1.3 EPA 200.8 7/30/2010
Iron ND mg/L 0.25 0.3 EPA 200.8 7/30/2010
Sodium 14 mg/L 0.25 20 EPA 200.8 7/30/2010
Total Coliform 0 /100ml 0 0 SM 9222B 7/30/2010
Conductance 130 umohs/cm 2.0 EPA 120.1 7/30/2010
pH 6.0 pH-units 0 SM 4500 H-B 7/30/2010
i
Water sample meets the recommended limits for drinking water of all lire above tested parameters. i f
Attached please find the laboratory certified parameter list. Approved By: 1 Q
�( Director)
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605
'�°F HARv CERTIFICATE OF ANALYSIS Page: 1
r0 Tj:-
Report For: Barnstable County Health Laboratory
Sally Desmond Report Dated: 8/3/2010
Desmond Well Drilling Order No.: G1058936
P O Box 2783
Orleans, MA 02653
Laboratory ID#: 1058936-01 Description: Water-Drinking Water
Sample#: Sampling Location: 378 Plum St.,West Barnstable,MA Collected: 7/30/2010
Collected by: Customer Received: 7/30/2010
EPA 524.2 - Volatile Organics by GUMS
ITEM ]RESULT UNITS RL MCL Method# Analyst Tested Note
Dichlorodifluoromethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Chloromethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Vinyl chloride ND ug/L 0.50 2.0 EPA 524.2 yn 8/2/2010
Bromomethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,1,1,2-Tetrachloroethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,1,1-Trichloroethane ND ug/L 0.50 200 EPA 524.2 yn 8/2/2010
1,1,2,2-Tetrachloroethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,1,2-Trichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
1,1-Dichloroethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,1-Dichl'oroethene ND ug/L 0.50 7.0 EPA 524.2 yn 8/2/2010
1,1-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,2,3-Trichlorobenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,2,3-Trichloropropane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,2,4-Trichlorobenzene ND ug/L 0.50 70 EPA 524.2 yn 8/2/2010
1,2,4-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,2-Dibromo-3-chloropropane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,2-Dibromoethane(EDB) ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,2-Dichlorobenzene ND ug/L 0.50 600 EPA 524.2 yn 8/2/2010
1,2-Dichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
1,2-Dichloropropane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,3,5-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,3-Dichlorobenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,3-Dichloropropane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
1,4-Dichlorobenzene ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
2,2-Dichloropropane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
2-Chlorotoluene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
4-Chlorotoluene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Benzene ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
Bromobenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Bromochloromethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Bromodichloromethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Bromoform ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Carbon tetrachloride ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
pF Ifq CERTIFICATE OF ANALYSIS Page: 2
Report For: Barnstable County Health Laboratory
•..p,���tisl.• Sally Desmond Report Dated: 8/3/2010
Desmond Well Drilling Order No.: G1058936
P O Box 2783
Orleans, MA 02653
Laboratory ID#: 1058936-01 Description: Water-Drinking Water
Sample#: Sampling Location: 378 Plum St.,West Barnstable,MA Collected: 7/30/2010
Collected by: Customer Received: 7/30/2010
EPA 524.2- Volatile Organics by GUMS
ITEM RESULT UNITS RL MCL Method# Analyst Tested Note
Chlorobenzene ND ug/L 0.50 100 EPA 524.2 yn 8/2/2010
Chloroethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Chloroform ND ug/L 0.50 80 EPA 524.2 yn 8/2/2010
cis-1,2-Dichloroethene ND ug/L 0.50 70 EPA 524.2 yn 8/2/2010
cis-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Dibromochloromethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Dibromornethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Ethylbenzene ND ug/L 0.50 700 EPA 524.2 yn 8/2/2010
Hexachlorobutadiene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Isopropylbenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Methylene chloride ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
Methyl-tert-butyl ether ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Naphthalene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
n-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
n-Propylbenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
p-Isopropy[toluene - - ND - ug/L 0.50 _ EPA 524.2 yn 8/2/2010
sec-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Styrene ND ug/L 0.50 100 EPA 524.2 yn 8/2/2010
tert-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Tetrachloroethene ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
Toluene ND ug/L 0.50 1000 EPA 524.2 yn 8/2/2010
Total xylenes ND ug/L 0.50 10000 EPA 524.2 yn 8/2/2010
trans-1,2-Dichloroethene ND ug/L 0.50 100 EPA 524.2 yn 8/2/2010
trans-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Trichloroethene ND ug/L 0.50 5.0 EPA 524.2 yn 8/2/2010
Trichlorofluoromethane ND ug/L 0.50 EPA 524.2 yn 8/2/2010
Water sample meets the recommended limits for drinking water of all the above tested parameters.
Attached please find the laboratory certified parameter list. Approved By: 1
(L irector)i /
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
4++
-
»z I LEGEND
98-- EXISTING CONTOUR
x 100.98 EXISTING SPOT GRADE 611
APN 196-014
' EXISTING WELL
1 1
TEST PIT moo,
1
9s 9 BENCHMARK
CB/dh
96 1 �.' �� I �� I cPaO
ch a
Z" U t Church St
T in
� � I
9 \ irk ' + I / I R A� LOCUS
v
LOCUS MAP
NOT TO SCALE
APN 196-024 WELL 98
I 98,60
------ GS 97,.7 -----��
1 \ . _
0) /
i ------98--------------- i 99,43 /
00 GENERAL NOTES:
j 9823+ GS
/i''
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
/ i' __--------100---- /' BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
1) LOCAL REGULATION: 150' SETBACK REQUIREMENT-WELL TO S.A.S.
I / A 50' variance, private well (subject site) to proposed S.A.S.,
98167 ' ------------------ -_-- - for a 100' setback.
lenchmv�k Set j � �_ � O 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
tside cor. conc.4 apron l / � �p TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
.=f60.22 (Assumed) 1 `�\ (0 DESIGN ENGINEER.
/ PORCH ` I 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
GARAGE ^O� �\ N FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
ENGINEER BEFORE CONSTRUCTION CONTINUES.
SEXISTING �`� I 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
nl /i j l 1t HOUSE(#378) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
/ m / tt T.O.F.=f02.09f/ �� I� C THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
' ' ' ' ' •• 100.2 l Z t �� / HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
.�' 99,23
����� 7. WATER SUPPLY PROVIDED BY PRIVATE WELL.�� � 23• 0'..I � 100,1
O c) tt EXISTING, OUTLET 1.�1i
\` O i =106.1t
6 •-` � Q 8. THERE ARE NO ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S.
\� °'` _ 9 .84 ro INV..I�n 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
�'- -�-; i<���, AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
0 I I I- \ ___ DIRECTED BY THE APPROVING AUTHORITIES.
edge of cP\ A7,32 L` I I F �\ P-2 �� ---- � ```` ��� � I 100,62 L 100.73 101.37
I 997 �� 100,29 1j � CTOR TO VERIFY
J �Q�\\\ OF MASs9�y 10. IT SHALL BE HE LOCATIIONTHE OF ALLPONSIBILITY UUNDERG UNDF THE ERGROUND UTILITIES,
PRIOR TO BEGINNING
�\ Ic �\ Dc GRAVEL 1 Q z G CONSTRUCTION.
'j 1 lalal H \ DRIVEWAY 100.52 s� o PETER T.
97,01@4-gyp r� I + tt �u McENTEE 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
(o �I�.i I� I \ 1 Z CIVIL "' IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
t O O
REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255 3
co �:L•� kJ � '- 9'6 'L`100,19 � 1� o. 35109 • .
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
eo 1 + 9.5 99,42L+—CL00 °p Rf 1 t���. IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
`_� O AMP 27,500E S.F. \`� 101.28 SI 13. THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING A TRENCH
t 980'' ?�%n -- `'1'0fl_ Mop 196 PERMIT FROM THE LOCAL MUNICIPALITY IN WHICH THE WORK IS BEING
O "Y_ 58,95 —EXISTING CESSPOOLS-� PERFORMED.
t , o C) RECORD LOCATION-APPR\O(Y. Parcel 15
yp -- 9885 TO BE PUMPED, FILLED WITH 'q. PROPOSED SEPTIC SYSTEM UPGRADE PLAN
- __ SAND AND ABANDONED. 37$ PLUM STREET WEST BARNSTA
�� PROPOSED a� t �
100.0o BLE MA
�\ SEPTIC TANK �\ `� I
59.00' �� 22.46' - mot, ` ' Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632'
cn CB/dh` -F�' _'.� v CB dhtt RIGHT OF WAY �\ }} OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
o i \ TO PLUM STREET Q19 EDWARD F. JOHNSON Engineering Works, Inc.
1 1 =20 P.T.M. 108-10
APN 1961 018 + 96,74 C0 APN 196-
Jb \ \ 378 PLUM STREET 12 West Crossfield Road, Forestdole, MA 02644 DATE
CHECKED SHEET N0.
r
PLUM S EET 00 WEST BARNSTABLE, MA 02668 (508) 477-5313 2/26/10 P.T.M. 1 Of 2
4 21" 6-4• POLYSEAL OUTLETS t
.i NOTE: TO PREVENT BREAKOUT, THE PROPOSED 2" 2" 1-4" POLYSEAL INLETS
FINISH GRADE SHALL NOT BE < EL.96.33
FOR A DISTANCE OF 15' AROUND THE Y
SEPTIC TANK PROPOSED S.A.S. PERIMETER OF THE S.A.S. N O O e
PROPOSED D-BOX
INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT INSTALL INSPECTION PORT OVER END UNIT :. o
00
T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE
EXISTING F.G. EL.=99.1 t F.G. EL: 98.0f
F.G. EL: 97.3(MIN.)/99.3(MAX.) iv Top View D-BOX Section
MAINTAIN 2% GRADE (MIN.) OVER S.A.S. ;4
INSPECTION
L = 64' I L = 30' L = 14'(MAX.) PORT
® S=1% (MIN.) ® S=1% (MIN.) ® S=1% (MIN.)
4"SCH40 PVC _ 4"SCH40 PVC 4"SCH40 PVC
6"
10"I 6' 10.38 TO
t4" ? INVERT
INV.=97.00 48" UQUID INV.=95.87 ;-
LEVEL ADD
INV. 4
=96.27 PROPOSED INV.=96.10 6 ROWS OF ADS ARC.36 UNITS-SEE S.A.S. CONFIGURATION
GAS BAFFLE 17446"
INV.=96.75 D-BOX 1a•
SOIL ABSORPTION SYSTEM (PROFILE) �IN�GTH
PROPOSED SEPTIC TANK 9.45"
ESTABLISH VEGETATIVE COVER 16"
TIE E BACKFILL WITH CLEAN NATIVE OR
IN TO EXISTING SEWER PIP PERC SAND TO TOP OF CHAMBERS 12.37
OUTSIDE HOUSE, INV.=100.1 t
BREAKOUT=TOP i' VERT DOME END
TOP ELEV.=96.33 HEIGHT
NOTES: INV. ELEV.=95.87 POST END
1 CONTRACTOR SHALL VERIFY ALL EXISTING PIPE
INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=95.00 33.75"
NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT
2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 2.83' TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
TRUE TO GRADE ON A MECHANICALLY COMPACTED 5' MIN. ABOVE BOTTOM OF DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=17.0' 111111111114640 TRUEMAN BLVD
310 CMR 15.221(2). EXISTING SUITABLE HILLIARD, OHIO 43026
3) INSTALL INLET & OUTLET TEES AS REQUIRED. ADJUSTED G.W., EL=89.6 = MATERIAL ADVANCED DRAINAGE SYSTEMS.INC.® Are 36HC SIDE PORT COUPLER
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE SEPTIC SYSTEM PROFILE W ROWS OF ITH NO SEPARATION ARC
C 36 UNITS-SEE
NITS SEES ROW CONFIGURATION
STONE
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 63.25"
I
N.T.S. TYPICAL SECTION -�
16"
DESIGN CRITERIA
SOIL LOG 34.5"
NUMBER OF BEDROOMS: 4 BEDROOMS ROW 2: 4 UNITS + 3 COUPLERS = 23.5'
ROW 3: 4 UNITS + 4 COUPLERS = 24.7' DATE: JFEBRUARY 10, 2010 (REF.# 12,834)
SOIL TEXTURAL CLASS: CLASS I ROW 4: 4 UNITS + 4 COUPLERS = 24.7' SOIL EVALUATOR: PETER MCENTEE PE (SE#1542)
DESIGN PERCOLATION RATE: <2 MIN/IN ROW 5: 4 UNITS + 2 COUPLERS = 22.3 WITNESS: DAVID STANTON RS, CSE a TOP VIEW
ROW 6: 3 UNITS + 2 COUPLERS = 17.3'
DAILY FLOW: 440 G.P.D. ROW 7: 2 UNITS + 2 COUPLERS = 12.3' Elev. TP-il Depth EIeV. TP-2 Depth so"
DESIGN FLOW: 440 G.P.D. TOTAL EFFECTIVE LENGTH =124.8' END CAP END CAP
gg•7 A 0" 98.7 q 0" FRONT VIEW SIDE VIEW o
GARBAGE GRINDER: NO LOAMY SAND LOAMY SAND END CAP
10YR 4/2 10YR 4/2 REAR/TOP VIEW ff f
. LEACHING AREA REQUIRED: (440) = 594.6 S.F. r--7 1— 97.9 10" 97.9 10" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW
I I I I B B TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
.74 1 1 1 I I FINE SAND FINE SAND DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY 1OYR 5/8 10YR 5/8
95.8 34" 96.0 4640 TRUEMAN BLVD
32"
PROPOSED D-BOX:: 1 INLET, 6 OUTLETS (MINIMUM), H-10 RATED j I _ c I PERC C Ems.HILLIARD, OHIO 43026 Are 36HC DETAIL d
FINE SAND 42 FINE SAND ADVANCED DRAINAGE SYSTEMS,INC.
I _ I _
USE 6 ROWS OF ADS Arc 36HC UNITS W/COUPLERS_ AS SHOWN �_-___i_ _i__1I 2.5Y 6/2 2.5Y 6/2 TT I I PROPOSED SEPTIC SYSTEM UPGRADE PLAN
WITH NO SEPARATION BETWEEN EACH ROW & NO STONE i i i i rCO� s 89.6 ADJ. GW_ 89.6 ADJ. GW_
89.0 STG. GW_ 116" 89.0 STG. GW:L
116" 378 PLUM STREET, WEST BARNSTABLE, MA .
BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) i�rev r��r � W_ 1 - Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
TOTAL EFFECTIVE LENGTH = 124.8' 1 O I 1 1 1 0 L-J 86.7 144" 86.7 144"
I0 I O I O 1 O I Engineering by: SCALE DRAWN JOB. NO.
EFFECTIVE AREA = 124.8' x 4.80 SF/LF = 599.0 SF -i x 1 q5 1 -� PERC RATE <2 MIN/IN. ("C" HORIZON) y
L-+-+-+-� INDEX .WELL SDW-252 (ZONE A) Engineering Works, Inc. NTS P.T.M. �O$-1 O
WATER'LEVEL = 46.5' - JANUARY 2010 -
O.
DESIGN FLOW PROVIDED: 0.74 599.0 S.F. = 443.3 G.P.D. S.A.S. CONFIGURATION GW ADJUSTMENT = 0.6' 12 West Cr5313ld Road, Forestdale, MA 02644 DATE CHECKED SHEET 2
( ) (508) 477-5313 2/26/10 P.T.M. 2 Of 2
PP � ®
L
`� Town of Barnstable LEGEND
uI
QCiT old Kin Committeeg's Highway I EXISTING CONTOUR _� �'o N
� � �� - 98-- � U
I t X 100.98 EXISTING SPOT GRADE eq
APN 196-014 i
EXISTING WELL
G&DEVELOPM NT �� �' t
g
165.51 �'� r TEST PIT moo,
s�, r
9 BENCHMARK
CB/dh 1 / t
"--\ �' i' i� _O St Church St �00 S
9� \� /
�� ROUrE 6 �Q sf o�O LOCUS
LOCUS MAP
---------------- / ! i� NOT TO SCALE
APN 196-024 WELL 98
98.60
' - ---
1' ; ------pis------------- �s39� + 99.43 Gs GENERAL NOTES:
j 98j23+ /' '' � 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
1) LOCAL REGULATION: 15 SETBACK REQUIREMENT-WELL TO S.A.S.
A 50' variance, private If (subject site) to proposed S.A.S.,
_ ____________________-_ 1 - for a 100' setback.
Bent�hmark Set 98/67 �� /���� J O 3. THE SEWAGE DISPOSA SYSTEM SHALL NOT BE BACKFILLED PRIOR
Outside cor. conc.{{apron TO INSPECTION D PPROVAL BY THE BOARD OF HEALTH AND THE
EL.
=1 0.22 (Assudned) DESIGN ENGINEER.
PORCH I! �` I 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
I t' d GARAGE O� �f I �\ N FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
4 I t ENGINEER BEFORE CONSTRUCTION CONTINUES.
` �EXI$TING i �`� t 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
HOUSE(#J, 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
t f tt T.O.F.=102.09f/
10� II �� t THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
9' ,2 / I �� f HEALTH FOR PROPER. INSPECTIONS DURING CONSTRUCTION.
100,1 7. WATER SUPPLY PROVIDED BY PRIVATE WELL.
23. 0': '"F 39,23 t` EXISTING OUTLET I ��i
1NV=100.1t Q 8. THERE ARE NO ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S.
�� 9$.84 m m A� ' 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
1 I I {- � �_ I AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
edge.°f F(e i�i7' 2 L 1 I P-2 �-c /,. �' DIRECTED BY THE APPROVING AUTHORITIES.
\� ��I'
t 100.62 t 00, r, 101,37
�ICI -1 100,29 ' t `�` � �`� OF 'yASS 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
t r=I
` C+� h� 99.7 GRAVEL ( ' \ Q ��`�\ 9C�G THE LOCATION CONSTRUCTION.OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
I ¢I 70 �� DRIVEWAY , s� o PETER T. ,
97�Ojg 1 � I t
\ 100,52 I l W � McENTEE 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
ro ` ram•` I I ( t Z o CIVIL y IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
r� I" 1•,t�l I � 99.6 100.19 109 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
No. 35 eo, I + 9.5 99,42`�0-Q0 ` ° RfGISTE� �� 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
9e �_� L �P IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
o,� � AMP _ 27,500�;S.F. of �`'
_ .�n� �`� 101.28 AL 13. THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING A TRENCH
8.9S k 7p /J PERMIT FROM THE LOCAL MUNICIPALITY IN WHICH THE WORK IS BEING
EXIS77NG CESSPOOLS \�, ZI-Z- llU PERFORMED.
19 0 so. t o c� RECORD LOCAT70N-APPRb<Y. Parcel 15
�. 98, 5 TO BE PUMPED, FILLED KgTH 01PROPOSED SEPTIC ' SYSTEM UPGRADE PLAN
�o +98,15 m SAND AND ABANDONED.
PROPOSEDm
SEPTIC TANK 10m00' -A378 PLUM STREET, WEST BARNSTABLE, MA
Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
- CB/dh\ } 1`1 CB dh rt RIGHT.OF WAY \� OWNER OF RECORD Engineering by: SCALE DRAWN JOB. N0.
o 1 � TO PLUM STREET �� 1"=20' P.T.M. 108-10
Or� APN 196t 018 + 9�74 0° APN 196-Q19 EDWARD F. JOHNSON Engineering WoYks, Inc.
ct \T ' 378 PLUM STREET 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
�'r 44 �'LUM S EiEI �0, WEST BARNSTABLE, MA 02668 (508) 477-5313 2/26/10 P.T.M. 1 of 2
4'-0"x 4'-&" - -
3�i"
•----------------------- -4------- ------4------------------------- ------ -- - - - - -
- v M
AA A
3'-O" ,4
i
i
i
i
i
KITCHEN '
o� 2' 2'..&"x 4'-0"
3
9 BEDROOM *2
IT
ca
tV
I ---_ �I�11 2�$11
-------------
- ------------
--------
LIVING ROOM � 4
4 S
IV BEDROOM *1
Smoke Detector - ELECTRICAL
SCALE: 3/1(o" = V-O" B'-6"x 4'-0" 2'-6"x 4'-0"
1 21" y 8-4POLYSEAL
NOTE: TO PREVENT BREAKOUT, THE PROPOSED 2" 2" 1FINISH GRADE SHALL NOT BE < EL.96.33
FOR A DISTANCE OF 15' AROUND THEPERIMETER OF THE S.A.S.SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. C"I ,INSTALL RISERS & COVERS OVER INLET & INSTALL INSPECTION PORT OVER END UNIT :.OUTLET AND SET TO 6" OF FINISH GRADEINSTALL RISER & WATERTIGHT 00
T.O.F. COVER SET TO 6" OF GRADE
EXISTING F.G. EL.=99.1 f F.G. EL: 98.0f F.G. EL: 97.3(M1N.)/99.3(MAX.) i4 Top View
I O-BOX Section
MAINTAIN 2% GRADE (MIN.) OVER S.A.S.
L = 6 L 29' L = 14'(MAX.) I IN PORT ION
(
® S=1% (MIN.) p S=1% (MIN.) ® S=1% (MIN.)
4"SCH40 PVC _ 4"SCH40 PVC 4"SCH40 PVC i
6"
101 6 10.38 TO
14" INVERT Mffi
\INV.=97.00 48" LIQUID INV.=95.87 r I
LEVEL
GASAB FFLE INV.=96.27 PROPOSED INV.=96.10 6 ROWS OF ADS ARC:36 UNITS-SEE S.A.S. CONFIGURATION 17.04
INV.=96.75 D-BOX 14'
SOIL ABSORPTION SYSTEM (PROFILE) INSTAL
LENGTH
STALL
PROPOSED SEPTIC TANK 9.45"
-ESTABLISH VEGETATIVE COVER 16"
FTIUETSIN TO EXISTING SEWER PIPE BACKFILL WITH CLEAN NATIVE ORIDE HOUSE, INV.=100.1± PERC SAND TO TOP OF CHAMBERS
BREAKOUT=TOP 10.38 DOME END
i INVERT
TOP ELEV.=96.33 HEIGHT
NOTES: INV. ELEV.=95.87 POST END
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BOTTOM ELEV.=95.00
INVERTS, PRIOR TO INSTALLATION. ]333.75"
NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT
2 SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 2.83' DI CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
5' MIN. ABOVE BOTTOM OF DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
TRUE TO GRADE ON A MECHANICALLY COMPACTED T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=11.3'
SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN I 4640 TRUEMAN BLVD
310 CMR 15.221(2). EXISTING SUITABLE LLLLLy1mF1DS HILLIARD, OHIO 43026
3) INSTALL INLET & OUTLET TEES AS REQUIRED. ADJUSTED G.W., EL=89.6 = MATERIAL ADVANCED DRAINAGE SYSTEMS,INC.® Are 36HC SIDE PORT COUPLER
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE SEPTIC SYSTEM PROFILE WTHWNO SEPARATION OF ADS ARC 3BETWEENSEACH ROW & NOU STONE
RATION
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. -63.25"
N.T.S. TYPICAL SECTION
1s"
DESIGN CRITERIA
SOIL LOG 34.5
NUMBER OF BEDROOMS: 3 BEDROOMS ROW 2: 4 UNITS + 3 COUPLERS = 23.5'
ROW 3: 4 UNITS + 4 COUPLERS = 24.7' DATE: JFEBRUARY 10, 2010 (REF.# 12,834)
SOIL TEXTURAL CLASS: CLASS I ROW 4: 4 UNITS + 4 COUPLERS = 24.7' SOIL EVALUATOR: PETER MCENTEE PE (SE#1542)
ROW 5: 4 UNITS + 2 COUPLERS = 22.3' TOP VIEW
DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DAVID STANTON RS, CSE
ROW 6: 3 UNITS + 2 COUPLERS = 17.3'
DAILY FLOW: 330 G.P.D. ROW 7: 2 UNITS + 2 COUPLERS = 12.3' Elev. TP-'l Depth Elev. TP-2 Depth -so"
END CAP END CAP
DESIGN FLOW: 330 G.P.D. TOTAL EFFECTIVE LENGTH =124.8'
98•7 A 0" -98.7 q 0" FRONT VIEW SIDE VIEW
GARBAGE GRINDER: YES-TO BE REMOVED LOAMY SAND LOAMY SAND END CAP
1OYR 4/2 1OYR 4/2 REAR/TOP VIEW
LEACHING AREA REQUIRED: (330) = 445.9 S.F. �- 97.9 10" 97.9 ,o"
I I I I B B NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW
TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
74 I I I I FINE SAND FINE SAND DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY �- L-�-� _� 95 8 1OYR 5/8 34" 96.0 10YR 5/8 4640 TRUEMAN BLVD
32"
PROPOSED D-BOX:: 1 INLET, 4 OUTLET (MINIMUM), H-10 RATED -, li PERC C s HILLIARD, OHIO 43026 WArc 36HC DETAIL d
FINE SAND 42 FINE SAND ADVANCED DRAINAGE SYSTEMS,INQ
USE 4 ROWS OF 4-ADS Arc 36HC UNITS + 3 COUPLERS PER -T-'T-T-i i i 2.5Y 6/2 2.5Y 6/2
ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE I I I I PROPOSED SEPTIC SYSTEM UPGRADE PLAN
a--4�� 89.6 ADJ. GW_ 89.0 ADJ. GW_ 378 PLUM STREET, WEST BARNSTABLE, MA
BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) r=rt- , -rt--I 0-4 0 1 89.0 STG. GW- 116" 89.0 STG. GW_ 116"
(Arc36HC Units) 16 UNITS x 5.0 LF x 4.80 SF/LF = 384.0 SF 1 3 rd-r"�7 47 I I Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
3 L - 1 86.7 144" 86.7 144"
(COUPLERS) 12 COUPLERS x 1 .2' x 4.80 SF LF = 69.1 SF 10 100 i o 1 0 i -� I Engineering by: SCALE DRAWN JOB. N0.
/ F -� I I I--� PERC RATE <2 MIN/IN. ("C" HORIZON) Engineering Works, Inc.
TOTAL AREA = 453.1 SF +�+�+� I INDEX WELL SDW-252 NTS P.T.M. 108-10
L-1_1-J
WATER'ILEVEL = 46.5' - JANUARY 2010 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO.
DESIGN FLOW PROVIDED: 0.74(453.1 S.F.) = 335.3 G.P.D. S.A.S. CONFIGURATION GW ADJUSTMENT = 0.6' (508) 477-5313 1/21/09 P.T.M. 2 of 2
s
}
I , LEGEND
q8—— EXISTING CONTOUR
r' 1 x 100.98 EXISTING SPOT GRADE
APN 196-014
r
EXISTING WELL
165.51' '1'' I I TEST PIT Vol,g n1 � 1 ..
9S� r' rr j r I BENCHMARK
CB/dh
r a
9 h 6\� rrr rr' ' /ram, m Sr Church St
LOCUS
LOCUS MAP
�`--------------- / i/ i NOT TO SCALE
APN 196-024 WELL 98
- -------
I I ` ___________— ! _ + 99.43 j GENERAL NOTES:
Cq
�s
98,1123+ r' /� I
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
1) LOCAL REGULATION: 150' SETBACK REQUIREMENT—WELL TO S.A.S.
I / ' A 50' variance, private well (subject site) to proposed S.A.S.,
98167 � _ ----------------------- - for a 100' setback.
Benchmark Seth // r��� O 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
EL.=100.22 (Assull ed) I l r� �\ cOD DESIGN ENGINEER.
l / PORCH ` I 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
' p FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
5 /l GARAGE O� �� I cV ENGINEER BEFORE CONSTRUCTION CONTINUES.
,EXISTING ��� 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
l r i• l ,� HOUSE(#378) Y CO 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
1t T.O.F.=102.09f/ �� II THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
9> IOC`2 100,1 / HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
r39,23
I O� 1 EXISTING OUTLET 0.1 � 7. WATER SUPPLY PROVIDED BY PRIVATE WELL.
O INV.=l00.1f �
� t Q 8. THERE ARE NO ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S.
4 .84 \ �� \� �,� �� 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
c� I I \ n - r �_ AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
edge of c(e /hg' 2 L II �� P-2 ��C r DIRECTED BY THE APPROVING AUTHORITIES.
100.29 100,62 L - 100.73 `�_ 101.37 OF Mqs 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
�IW�� r r�� -1 99,7 �� tl 1\�\ J �P s�C, THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
C Dc GRAVEL Q �G CONSTRUCTION.
I '�0 DRIVE Y 1 1 s� o PETER T. ✓
100.52 1
97,\018� � i Lu McENTEE 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
Z o CIVIL "' IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
Ili u_J 99.6 `100.19 + 1 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
� r— l 1 � No. 35109
�i ed 1 + 9.5 99.42 +-0.'Q0 # \ Co �£GIs1ER�0 �� 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
r AMP — IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
p _ 27,500f, S F. oFFS
9 A J c!,,,,r � _ �y-90�` A, �� 101,28 E 13. THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING A TRENCH
,�8,95 Mop 196 PERMIT FROM THE LOCAL MUNICIPALITY IN WHICH THE WORK IS BEING
i; _ EXISTING CESSPOOLS-A Q Z.tZle� w PERFORMED.
X
ZD c� L51 , RECORD LOCH TION—APPRDX r ar�!f%I5+98.15 98B`85 S D PUMPED, FILLED wrtti 0PROPOSED SEPTIC SYSTEM UPGRADE PLAN
� G�o PROPOSED' \1 SAND AND ABANDONED. �\ \
SEPTIC TANK 100 00 378 PLUM STREET, WEST BARNSTABLE, MA
`, 22.46' — �� Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
59:00
cb CB/dh CB dh\� RIGHT OF WAY ��� OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
APN 1961 C TO PLUM STREET EDWARD F. JOHNSON Engineering Works Inc. 1 =20' P.T.M. 108-10
� I 018 + ,74 9. APN 196-�D19 g 9
378 PLUM STREET 12 West Crossfield Road, Forestdale, MA 02644 DATE
CHECKED SHEET N0.
PLUMS EET ,00 WEST BARNSTABLE, MA 02668 (508) 477-5313 2/26/10 P.T.M. 1 of 2
4
C�(JC7-C �-✓�° . �f� -fit�v -- "� 1 5 9 ,� i'i �sTA c-L AT
LEGEND
`1 --- 98--- EXISTING CONTOUR Rpm N
APN 196-014 x 100.98 EXISTING SPOT GRADE F sq
�' OO EXISTING WELL �
9 9 165.51' tea'' rl ,r TEST PITo,
t � y.
/9
CB/dh �'�/ r BENCHMARK-� --
t Q
ed° �
9� �6 i' / m church St �o°a 3
LOCUS~
-------- -- ----- LOCUS MAP
'APN 196-024 WELL 98 �� r"" r NOT TO SCALE
98,60
I 98a23 GS / GENERAL NOTES:
_ 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
t _ --------�fl`- - �.\ i' BOARD OF HEALTH AND THE DESIGN ENGINEER.
---- /� 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
/ f OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
1) LOCAL REGULATION: 150' SETBACK REQUIREMENT—WELL TO S.A.S.
Benmark 911/67 '� A 50' variance, private well (subject site) to proposed S.A.S.,
ah het � �-0 -- for a 100' setback.
Outside cor. cone;apron , /' 0 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
EL.=1 0.22 t;4ssugnedj j r co TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
co DESIGN ENGINEER.
GARAGE PORCH ��� I 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
1 ^O f ENO TH BEFORESHOWN HEREON
SHAC BE REPORTED TO THE DESIGN
EX/S77NG �/ �\ ; o
,< < I HOUSE(#378),/ \ 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
l 10�,2 100,1 t T.O.F.=1'02.09f/ `�\ r THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
99,23 ` ro 1t � HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
00.1f�A t EXISTING OUTLET
ro IN V.
7. WATER SUPPLY PROVIDED BY PRIVATE WELL.
� l f � � t =l �
` Q,-`�f��- 9 •84 1 �C 8. THERE ARE NO ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S.
•,
edge of c(e) 7•2 L j j k �� ��� � -` - �` 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
g� P-2 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
100,62 t.. DIRECTED BY THE APPROVING AUTHORITIES.
997 \\ 100.29 100.73 �`\\\ 101,37r �,�N OF 17gSs9 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
I �933,70 Dc GRAVEL J k� C' THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEG9NNING
97�019-4 � i �� - DRIVEWAY 100,52 ,t o� PETER T. ��, CONSTRUCTION.
r-t �l I I 1 W MCENTEE 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
ID_I J 9.6 t Z o
co ��.� 100.19 1 O CIVIL IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
L ed + 9.5 1 No. 35109 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
0 99,42�AMQ Q0� _ \\ R£C/SjE�E4 �� 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
{{ LL 27,5001- ,S F. r IS NOT.TO BE CONSIDERED A PROPERTY LINE SURVEY.
� 1t 98't30�'m -- -' -1p8` �+ AL 101,28
- Mop 19V 13. THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING A TRENCH
98`95_ EXISTING CESSPOOLS \�� PERMIT FROM THE LOCAL MUNICIPALITY IN WHICH THE WORK IS BEING
o• t\- i o RECORD LOCATION-APPRb Parcel 15 Z`1z_ I lU PERFORMED.
TO BE PUMPED, FILLED W1
PROPOSED_ +98,15 m 985 H
SAND AND ABANDONED. 01, PROPOSED SEPTIC SYSTEM UPGRADE PLAN
SEPTIC TANK \
100:00' 378 PLUM STREET, WEST BARNSTAB
4 59 0_0 ��,. 22.46' t LE, MA
t CB/dh �. CB dh RIGHT.OF WAY Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
��.., � t _ �� �
APN 196L 018 + 9•.74 0 TO PLUM STREET ' OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
Cp
APN 196='Q19 EDWARD F. JOHNSON Engineering Works, Inc. 1"=20' P.T.M. 108-10
AA � 378 PLUM STREET 12 West Crossfield Road, Forestdale, MA 02644 DATE
PLUMS EET 00 'WEST BARNSTABLE, MA 02668 (508) 477-5313 2/26/10 P.T.M.CKED 1 SHEET T 2
�a
.. •.
- - ._._.. _.. ,.... -_,_ .. . --.. _ .:- r .a :.- v Tel•. ', '.�,'.'.
... ,. a ..:. •
y
TOP OF FOUNDATION
T
Rou I
CONCRETE INSPECTION
RC• - �Q - ! 1•t
-t. ` COVERS _
•-�, �8,xo PART
C us s
N 9 I G'L..�t'.,T
� _ 32 . .-. 3,r 4 CAST IRON O a
•� SCHEDULE 40 4 SCHEDULE 40 P,V,C.(ONLY)
.� -
(� P.V.C.PIPE liiil: PIPE - MIN.PITCH ,ter"z4 To
PITCH 1/4'PER.Ft. 1/4'PER FT. ae 40vrG CLEAN BACKFILL SANS
` �
to i�,r INVERTS GAS BAFFLEloll 11
INVERT s� EC.Bfc�
EL :... SEPTIC TANK INVERT
6.STOIYE 33'zs
• � �,. ' ,a ,INVERT .._._..._ - ........ ii
EL �
El-
GAL. INVERT pIST. /
Q ,A ..•:...... E 4o INVERT
EL. ✓ �rG. s¢ Z
J_
, _. . :.SC EL. ss/3 G N c�,C.q�Aciry CHAMBERS
"4 �-rNG
s 2oaa ; ,3�e' TAnasC /o' _'_ DdS
GoCC+5 ",q f?. /-I GL. /
}
r 3
PRO FI LE O F
io L4�L ADJ. GROUND WATER EL:'Fl- - .
_ SEWAGE DISPOSAL SYSTEM
SOI L LOG
DATE.T,� 2t 2eo¢ TIME :/o_.00 i4/y NO SCALE
/74. Fe / 39 r!/ r 'LEST HOLE ........ TEST HOLE........a
ELEV. - $ IFLEV. VEGETATIVE COVER e---4.-Is.-To
0
zlR
........ ....:..... .
rs>•: DESIGN DATA
u
In/ LL 51� AIx S'v'i°yloF%v /L1 NUMBER OF BEDROOMS `T.... . . ..... ... �� E14
r �j fivFSR+vOdfra"S TOTAL' ESTIMATED FLOW ., 30.....GALLONS/DAY LL, 7-:-
BOTTOM LEACHING AREA ��?:�:4. SO.FT./TRENCHa �. � //
SLOE LEACHING AREA ... . ..... ..... SO.FT.JTRENCH '
GARBAGE bISPOSAL.X�'i✓ (50%e AREA INCREASE) ��-}� 4Tt2¢`" 1
t/ TOTAL LEACHING AREA �5�.30 SO.FT. 7w7,
Z 77 A-z,3Z.iag Cass o ¢�,.✓. LEACHING �1eew�rs
PERCOLATION RATE ,-, , ,, ,• PERANCH
FiNzs -TAr�p 3.3C/8
i � LEACHING AREA PER PERCOLATION RATE .........SO.'FT'�/G.A /Z
,/ ADJ.GROUN R EL. .. ..-,-
. h JJ i r-1 Ec . f'y'4L
✓. G/ .WATER ENCOUNTERED
WITNESSED BY: .�74 nGUti ST/2�G-r"
.:�.4t!/bT�1nrToi./ bt/ S T N2�/3 T l3GG- G� .5 7
P t °! .... . .. •. ... ... .BO RD OF HEALTH Q
�P
t , S1Z}TScnt 2AGC 2.5, 9EDSA
I? .I ,_ °: :..._..,......:............ . ENGINEER ... . . .._. ... ._._... .. OQ
.. .
fKAL�a
1'1 G'D /�'.P.�_S.
__.:.'___...:..,... .......�.•" /'� PETITIONER . _ .. . . . .. .
. A
PATS �,• w ' .. ..
ZZ� LoU1L /�S o7"�D
-- i -
C�L>�
' ,, _ i� - ' 1 ` / �,_. � % r;.� �� /,i �'.•)'r. .r'}• `! ' ,eC-C. Ala L, L,q-x,r� J`/i!Z✓-• o�
t-
__
" x „ -
�. - I
�j /^. /y t s p. t
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we
1
l9 V ,
m I � I :-. 1 3
as �, , : LA races
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' No. 26100
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ISTE
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