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HomeMy WebLinkAbout0015 POPPLE BOTTOM ROAD - Health 15IA Pap.ple,Bottom Road W. Barnstable Commonwealth of Massachusetts �0 "�D 1 �^ Title 5 Official Inspection Form � 'CCi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Uz15 Popple Bottom Rd } x Property Address Tara Marini Owner Owner's Name information is = required for every W. Barnstable MA 02668 10=48-18 page. City/Town State Zip Code Date°of Inspection r_, ry.�.) 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. A. Inspector Information 151Nr l3463 Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);l have personally inspected the sewage disposal system at theproperty address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 10-18-18 ,1nspector's Signature Date t The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving.authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts ,w Title 5 Official Inspection Form :.ri Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Popple Bottom Rd J' Property Address Tara Marini Owner Owner's Name requir atifor a W. Barnstable MA 02668 10-18-18 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. 2) System Conditionally Passes: ❑ One or components mores stem as described in the ConditionalPass" section need to be Y 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 well pass Inspection If It Is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 s Commonwealth of Massachusetts w Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - 15 Popple Bottom Rd . Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ 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): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form �i;I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 9 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 1 Commonwealth of Massachusetts Ir Title 5 Official Inspection Form P111 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments :- to >" 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow ❑ ® Required pumping more than 4 times in the last year NOTdue to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section C.4. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 i r -.. Commonwealth of Massachusetts y Title 5 Official Inspection Form �► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1.,_ •„.a� 15 Popple Bottom Rd T•y�/ �f Property Address Tara Marini Owner Owner's Name information is required for every W Barnstable MA 02668 10-18-18 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant Y 9 threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for an inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ •Were all system components; excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 1 Commonwealth of Massachusetts Title 5 Official Inspection Form �i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ® Yes ❑ No If yes, discharges to: Window 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 Well water 9 ( y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 10-2018Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form wr, M Subsurface Sewage Disposal System Form -Not for Voluntary Assessments :2 F ;> 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped:' gallons How was quantity pumped determined? Reason for pumping: - tSinsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 I Commonwealth of Massachusetts m� 3 Title 5 Official Inspection Form } ;p Subsurface Sewage Disposal System Form,-Not for Voluntary Assessments 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: 2002 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 12"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from orivate water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 ., Commonwealth of Massachusetts r� y Title 5 Official Inspection Form wa . Sri Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable • MA, 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 6"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) t If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" 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 15" How were dimensions determined? Tape 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 is in good condition with baffles installed and no sign of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts ,w. Title 5 Official Inspection Form il Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes , ❑ No 9. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid 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.): Good condition with water at working level and no sign of back-up from field. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 C Commonwealth of Massachusetts Title 5 Official Inspection Fora PI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c 9 p Y rY 15 Po le Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" j Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits ` number: ® leaching chambers number: 2-500's ❑ Teaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 f Commonwealth of Massachusetts p� Title 5 official Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ; 15 Po le Bottom Rd Pp Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach chambers in good condition and empty at inspection with stain line at 6"of bottom of chamber. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts ,YI Title 5 Official Inspection Form �p 0i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •;_ ��% 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 f .., Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668' 10-18-18 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately WO. f. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 ck4� Commonwealth of Massachusetts ,'4 Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form Not for Voluntary Assessments r a r, >` 15 Po le Bottom Rd Property Address Tara Marini Owner Owner's Name information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form .�� I1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 15 Popple Bottom Rd Property Address Tara Marini Owner Owner's Name, information is required for every W. Barnstable MA 02668 10-18-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 18 of 18 Page: 1 CERTIFICATE OF ANALYSIS y Barnstable County Health Laboratory Report Dated: 10/31/2002 ;. Report Prepared For: Kaplan,Walter&Barbara MAP 5 Order Number: t;-G02174V O Walter R. Kaplan �1533 Popple Bottom Rd. . �' PARCEL `West Barnstable",. MA 02668--� LOT Laboratory ID#: 0217937-01 Description: Water-Drinking Water Sample#: 17937 Sampling Location: 1533 Popple Bottom Rd.,West Barnstable Collected: 10/25/2002 Collected by: Walter Kapla 105-001 Received: 10/25/2002 Routine ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates <0.1 mg/L 10 EPA 300.0 10/25/2002 LAB: Metals Copper <0.1 mg/L 1:3 SM 3111B 10/25/2002 Iron 6.4 mg/L 0.3 SM 3111B 10/25/2002 Sodium 16 mg/L 20 SM 3111B 10/25/2002 LAB: Microhiology Total Coliform Absent P/A Absent 309 10/25/2002 LAB: Physical Chemistry Conductance 179 umohs/cm EPA 120.1 10/25/2002 pH 6,4 pH-units EPA 150.1 10/25/2002 Note: Based on the results of the parameters tested,the water is suitable for drinking,but may present aesthetic problems(taste, odor, staining)due to Iron. Approved By: ' ... (Lab Director) Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 D'V Old BARNSTABL c. �e .tom cis p��$ESa�dlt'S MAP d o I A NSTALY.. RIS NAMB P1 bNE NO. / $M.-IC'd'A - CAPACITY L ACiiING 1�AClLrrY'.EtyPa) Lq--— --- ---�--_ IS9Jll.JC�BIZ QR OIR; FRi %TR3�.'T C.IA�I�TCE S Amuon�9isi�i3 Bstvieep t�0: ivlaicimum..MIT ed Gmureifw�tc Table�a i_ho B�ttntn bk ar�►tnB FFsuu;�lit �e1 ' Y PrIvato mr,i Sully VIal d i,.caei�ia� pacdity:l7f may+dells g ist �Clt4B opt aW ce wItEun 2A0€eet aP.104 iiiag P,sl r c� l�tetR�d aitd Los 09�acUicy�umy gv�tland�east ult{aui`�00 fern f 1cac�ing�'aclltry} / .� fee Y�urnlshed tsy �r �� a --- dal A TOWN OF BARNSTABLE LOCATION J 3 rd ►� G"/ a ,r ,�, r SEWAGE # O, ' 9 06_ _ VILLAGE. L_ �� �+-S�av� AS MAP & LOT S INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY / LEACHING FACILITY: (type)�5,� oZ O'lJ (size) y3'3s--,:z L..S NO. OF BEDROOMS 3 BUILDER OR OWNER S Tt= T=YL t�fy PERMIT DATE: COMPLIANCE DATE:r�- 2. �— Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 3 o , 41 ' � d a y No., �CIJd� � 1� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS -p4to6struct ion f r 0topogal *potent Congtructton 3permit �rApplication for a Permi ( . )Repair( y)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. o e- Owner's Name,Address and Tel.No. 15,3� �onnplebo -tom Rd. , W Barnstable Margery Petersen Assessor s ap arckl d Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service Dan Johnson P 0 Box 1089, Centerville 804 Main st. Osterville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder 042)) Other TypeofBuildingResidential No.ofPersons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow gallons. Plan Date 2-2 8-0 2 Number of sheets 1 Revision Date Title Size of Septic Tank Isl(-06 cxAST ,mac- Type of S.A.S. Description of Soil gr��o l,y fine 8 a n,a Na Re 'rs or Alte 'ons(Answer when applicable) Replace failed s a s with a 1 e 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 Environmen 1 Codo place the system in operation until a Certifi- cate of Compliance has been issued b this Ward oTl�_ ,7c7 SignedDate cJ' Application Approved by Date Application Disapproved for the following reasons Permit No. ��a'�� Date Issued .3 1) ..,.'"�u.�""...wv. ,.-.,... -wr�..�.��.. ... ..-... ..�.-.. -r i 1 No r THE COMMONWEALTH OF MASSACHUSETTS THE in computer: a Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE. MASSACHUSETTS Is) oapplica; ion for IDigpool 6pmem Con$truction Permit r`Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. u✓�QCIA' Owner's Name,Address and Tel.No. 15,M Nopplebo tom Rd. 0 , Assessor's ap a arc I W Barnstable Margery Petersen 01 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service Dan Johnson P O BOX 1089, Centerville 804 Main st. , Osterville Type of Building.- Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder o'W) Other Type of BuildingResidentia1 No.of persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow gallons. Plan Date 2—2 8—0 2 - Number of sheets 1 Revision Date Title Size of Septic Tank 1(1( ,U�� ��. �C—r Type of S.A.S. �`f� €. y ca r,..Sec S Description of Soil grsyAly fines sa^a 5 Ci Ye,I-0- Calk-: Nature o,Rep rs o Alteradofis,(Answer when applicable) l�epl aca failed sas with a Date last inspected: j° h Agreement: ,r v The undersigned agrees to eir4e.the construction and maintenance of tli!e.afore described on-site sewage disposal system t in accordance with the provisions of Title 5 of the Environmental Code and a o to place the system in operation until a Certifi- cate of Compliance has been issu b this yard of e t Signed Date '� � Application Approved by Date O e: Application Disapproved for the foll wng reasons F Permit No. �?Oo2 1� Date Issued U ————————— — — '�t THE COMMONWEALTH OF MASSACHUSETTS Petersen BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( X)Upgraded( ) Abandoned( )by Wm. ' E. Robinson Septic Service at 1533 Popplebottom Rd. , W Barnstable has been construe ed 'n accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.J O 19-2 dated 3 U Installer WM. E. Robinson Sr. Designer Dan Johnson The issuance of this ermit shall not be construed as a guarantee that the system�will function as designed. Date � ��f1 -- Inspector ,F✓��- C �J v --------------------------------------- No. IC12 Fee$5 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Petersen 0igoof *p.5tem Con5tructton Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at 1 `533 POpplebottom ad. , q Barnstable and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construe 'on ust be completed within three years of the date of thi p t Date: 3U� Approved by G a TOWN OF BARNSTABLE i LOCATION J� 3 yo r° +� Y,-)61 SEWAGE # Qcg VILLAGE �� �� -sl �� y ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �7t, SEPTIC TANK CAPACITY A LEACHING FACILITY: (type), (size) NO. OF BEDROOMS BUILDER OR OWNER'O�A -5 Tt� 72K2 f ff.4— PERMIT DATE: 3 6 _COMPLIANCE DATE- :Z -o Z Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and.Leaching Facility (If any wetlands exist Feet within 300 feet of leaching facility) Furnished by jZ r -� P10 5/25/Ol NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, -)'4/v let- J of ysa-,J hereby certify that the engineered plan signed by me f dated , concerning the property located at t meets all of the - following criteria:' • This failed system:is'connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. y The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface)Elevation (using GIS information) go B) G.W. Elevation 43 +adjustment for high G.W. 6 DIFFERENCE BETWEEN-A and B SIGNED : / DATE: u Z NOTICE Based upon the above information, a repair permit will be issued for 'bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. a q:health Folder.percump AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION/,f `.?'3 o SEWAGE# T' VILLAGE_:2, ASSESSOR'S MAP&LOTJ05 INSTALLER'S NAME&PHONE NO.�a�.t.!a ��St?'J Z SEPTIC TANK CAPACITY LEACHING FACILITY: (type).:�-S;,` O C__s NO.OF BEDROOMS 3 BUILDER OR OWNER::L-/.,' s s � — PERMfrDATE: �r—.3—IS-IL_ COMPLIANCE DATE- 2:5 z Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by -s rJ 1, - http://issgl2/intranet/propdata/prebuilt.aspx?mappar=105001&seq=1 2/11/2019 AsBuilt Page 1 of 1 v "f4WN OF?BA3t1�STA�L . AS m�sx �t's rtavz�&��or�:rio S TXC TANK CAPAt "L P APturry RNt1<T3Jl� COM3� 1G AAM Soparat,an 17 tin a Tiakvleer�tlao, Mn�cls u�AdjustedGrn c wit 'Csbtetotlto ot�tnatLeuthtri Peel r►lva is 1�1atc a Sil raid I.twag p6m'jy (If any tells�xlst n�:adte or wtthia 20t1 feet be leactiin f�cll�y� W�(10 dS 2x15f P.c1Lt;n'UVet9aiidandLoacdtjn��aclity.(EFatiy` ril,liin'jt1tl�Bcet f lcaultiug�'aclliry) ' - � W Al 673 '3 0 9.3 http://'issgl2/intranet/propdata/prebuilt.aspx?mappar=105001&seq=2 2/11/2019 No..r �j� Fps.. f, ......... THE COMMONWEALTH OF MASSACHUSETTS '. BOAR® ® HEALTH oo ..........OF_....... i Applira#ivn for Bisposal orks (foustrurtft iti Vautit Application is hereby made for a Permit to Construct ( ) or Repair ( ) I dividua ewage Disposal .�ystem at:. . . ... . ........ w• ✓��H ,� ILA. ............. ocation-Ad or Lot No. ,. .. .ems. . ..... ........................................... .............................................. w ne ,Address r Installer Address U Type of Buildi Size Lot_ � - q. feet Dwelling No. of Bedrooms......................................Expansion Attic ( ) Garage Grinder ( ) Other—T e of Building ...... No. of persons............................ Showers — Cafeteria Other fixture .... W Design Flow.................... ..Q............ aIlons per person per day. Total daily flow............ 04 Septic Tank—Liquid capacity] ....gallons Length................ Width-_-____-__-_. - Diameter......_..._____. D pth._...__....___.. xDisposal Trench L No. .................... Width.................... Total Length.................... Total leaching area... ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( )� _ Percolation Test Resul Performed by.._ �./.f...:� �G........V..t�........................... Date..._ Test Pit No. 1r ..__.minutes per inch Depth of Test Pit. 3 .._.... Depth to ground water__._-_._:y� (Zq Test Pit I1to. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... �' ------ -------- - O Descri do of So ... :_ _�.. _ �f_ x P r , - - -- -- _ - ----• , ---- -- •-- ------- :. W ---•----------------------------------------------------------- . . UNature of Repairs or Alterations—Answer when applicable........:.................__...............__..._....._:_._._._____..__..__...._._.........____. -------------------------------------------------------------------------------------------------------------------------------------•---------•--------------------------------- ...................... Agreement The undersigned agrees to install the a redes ribed Individual Sew e Disposal System in accordance with the provisions of Article YI of the State Sani ry de—The undersign rther agrees not to place the system in operation until a Certificate of Compliance ha e n issued by t and altb. Sign ... •.... .. ••• ........... .7 17 . ate Application Approved BY ---------••------------ ate Application Disapproved for the following reasons-----------------------•••--••-•-•-----------•--••---•----------•---••-•••••-•••-....-•-••......-•-•••-••---.---- ---•------.............:............................................................................................................................ ................................................... Date PermitNo......................................................... Issued...........-...:........................................ Date No .-... ------- „ ..... w: �' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH x Appliration' for 11isposa! Works Tono rurtion Vrranit Application is hereby made for a.Permit to Construct ( ) or Repair ( ) an Individual Sewage.; Disposal System at Y , ..........s�. ...(24, ... Locatton•Addre. or Lot No ....... ............................................ .......................................... r ..e Address a .... ..... :ye"'rr ,o#................... ............................................ .........................................-- ns alter Address Type of Buildi g Size Lot.. , X... W.sq. feet Dwelling No. of Bedrooms.....................................Expansion Attic ( ) Garbage Grinder ( ) `-1 Other—T e of Building No. of persons............................ Showers — Cafeteria Other fixtures ...................... ... W Design Flow..........:......... ......... gallons per person per day. Total daily flow............, ..........gallons. C4 Septic Tank—Liquid capacity .. _... allons Length................ Width................ Diameter................ Depth............... Disposal Trench 4-No...............:..... Width.................... Total Length.................... Total leaching area... .."—.sq. ft. > Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area....::............sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-_.__-_____.___-______-- f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C4' .......... /---------------------------------------------- O Description of Soil..... / -z r........ f ... - x ....................................................Z--------------------------------------------------------------------------- ................................................... V Nature of Repairs or Alterations—Answer when applicable................................... .:.......................................................... -•..............................................................................................................•....._.....-----------•--•••••••-••-••----•--•----•......---------•-•-•-•----•-•-•-•--- Agreement The undersigned agrees to install the a redeseribed Individual Sew�ge Disposal System in accordance with the provisions of Article XI of the State Sanifary.,C�ode—The undersigned-furtlier agrees not to place the system in operation until a Certificate of Compliance has begin issued by the bard oUiealth. J f ` Si ed1]? a,. Aj x > `:..._ .s� ................ s✓ \ Date Application Approved By...........i .•••- .L .. ; ' atc Application Disapproved for the following reasons:................................................................................................................ .................•---•-••--•------•--•---•-------•-------••--•------------------.............-----------•---•-•-•---•-••-••-----•-••---•••-•-----------•--•-•-•--•----•-•-••--•-------•••-•--•••........ Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O� HEALTH I .. ......4............ Tatifirate of Toanphaurr ITH -CERTIFY, T -t he Individual Sewage Disposal System constructed ( ) or Repaired ( ) V by yi .............................................. has been installed in accordance with the pr6visions of Article XI of The State Sanitary 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. ff� DATE............... Inspector..... l.. ...... ... ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA H 2�`�- +� .......OF....... :. ............... '"" � «� .r > No......................... 4-'a� 4,en-. FEE., .,;.............. Dh1VVq 1 orbs (go straartiqu ramit Permissio hereby granted..._. ... . . ........ . ... ---------........................... ... ......-............................--- to Con ruct or R air ( ) an dividua age ',is ?reei S stj� at I�To ���.Q., l . . . ... �! p'z�.. ... ..—. .`. s ................................................✓ 'fit cC p " � �� � /� � as shown on the application for Disposal Works Construction Bevint No. ....... . . Dated._ -- .................. .................... 13`uard o Health DATE........................................... --------------------------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS PC.19I�1 of �6'1°Tl L 5 Y S-TE/"t � ; . Di' tTItUT1ON BOX SC,4 . ! - Ao �_- 3ENcNK TEST PIT DATA REMOVABLE CAA „ I d SCH 40 OUTLET LATERALS DISTRIBUTION BOX T,O MEET SHALL BE SET LEVEL FOR A /}S�vweF Gt.= tau•va Performed By: Daniel B. Johnson REQUIREMENTS OF310CMR MINIMUM OF THEF1RST TWO CoRNCA. or dorroo4 15.232('W',ATERTIGI{TNESS, FELT AND CONNECTED TO ST£P CONSTRUCTION,ETC). 2" EACH DISTRIBUTION LINE Date: January 24, 2002 4"SCH40 6" WITH SOLID SCH 40 PVC PIPE 335�.�1 , �' / 444 NO,OF OUTLETS:3 TP-1 (EL. = 99.8) oo c 6"(MIN) o o� MECHANICALLY CRUSHED STONE(t*3/4"DIA.) 0" - 16" A/FS l l Sandy loam t Bou lde rs) STABLE LEVEL BASE 98 16" - 45" Bw, 5R5/8 Sandy loam (Boulders) ' 1 96�'I♦ ALa.s� 96 � h 1 >,t0Eptr�c Tar✓K i ' 45" - 84" Cl, 2 . 5Y6/2 Loamy extremely fine sand y$+ �. _.. r... 84" -132" C2, 2.5Y7/4 Gravely fine sand 1 No Observed ESHWT No Obse rvod Groundwater t.!'DIt1TI�Of LFACIiINC311NF 30' LEACHING FIELo _ ' r v ---------- '1~ND"MOSS SFCTIOM u G� 99'` �„ oa " F P1 ACOLATIOt3 TESIT DATA D g9t3 ` E SAS o,�rntd Fr8 DS # ff�lAL t1f1An( TO tIP"'S?AI�It, Tt) 4 Iq ` _' ,� .... .+�- .-9 ',, F ,�!`� o, �� Date: January 24, 2002 FIhrISIiGC�AF'nr(S` ,OpcRV) 6. N Steil Class: ClAnn I (0. `14 G/SIF) 4"5CH4QPfff,PVC91 III 12''(MINI III Faro late; 2 MCI (T(`i1 ) ,.. ,.. „ Ir x'tAYER t •1 , ,. DOIJOLE WASSHED STONI` No f„i#�Af�f tlAt,f�?I.3Tf110t1Y#l'tN R. � j EE. got LINES 3 b "" '2 " D- - I�" fill deNt Depth 9f' E'e�" �' !��., b 3!4".11l2"DOUBLE WASHE �,(., 1 �, 6/I)" C�RIFACF.piA LEACHING FIELD DIMEN IONS . • t 6,A�AsbE . 3° 4 SCTtEDUTZ Off' ZL VATION,11?1 30`L X 15'W X 0.V H � �°"'.a.», ,.» � ....., .�._.»..�'�' STONE 6�.►sr/ 5;.9( A'r.—Va'� Inv. Out Foundat;.l on (ey 1 rat,i..n ) 8 .0 ��c.L �.rr� tLA CC �, END OF DISTRIBUTION LINES TO ACTUAL NO.OF DiSfiIBUTiON PIP S MAY LEACHING FIELD TO MEET ,,,M -> C 0 Inv. 2n Septic Tnn1; (r.�!1 �C� rrr� ) �718 FROM ABOVE DETAIL. REFERENCE NO, Apt �9 �►. Atct ' ` ' BE CAF�D,UNLESS VENTED. REQUIREMENTS OF 310 Inv. Out Septic Tnnk (ox1)Rt.1rm;) 9116 (REF.PLAN AND PROFILE) Fl15TFIIQUTIONLINeSANOF'LAA!V1Ew• CMR15.252. Q `° .'"' -� .:,.`• � Inv. In Distribution Noy 96. 9 3 Ilk Inv, Out Distribution AQx C . `!C a Inv. Sogi,n of I�eac)ji•Tlp f"ic�t,s`i 6 . 6!5 3 3 I , ,. � Inv. End of Loarhinq r'i:old raa�1 j Bottom of Lonchinq r'i{"Id 4t, . 00 E S HWT (T P-1 ) t)iI , t3 NOTES 1 . All construction methods shall conform to the Title V (310 /O;L -- — -- -- — ��� LEGILND CMR 15) and the Barnstable Board of Health Regulations . roe*� Existinq Contour R � p 98 � 2 . There are no known rivets or public w� w n 1 r p p c wells ithi S� JV feet/400 feet, respectively, from the proposed leachir~.g Proposed Contour area. U G� I Test Pit 3. Existing SAS to be pumped and removed prior to U installing the leaching field. �aPr � Finished Floor Elevation E">"E: 4 . No changes are to be made in the field without the approval M Basement Floor Elevation f3FE of the Board of Health and the design engineer. Water Line W to Q04e S. Proposed leaching field is not designed for use with GAs ,Line G garbage disposal . 6. Contractor to notify Dig Safe 72 hours prior. to gyp. cohltructlon. (800) 344-7233. Property -line i.nformAtion taken from a Subdivision of LAnd 1n S rnsl;ablo, MA, POPPIO SOttom, dated June "gip, 1970, John White" ET.S. SoPtic Plon not to be uned nt, a proporty 1in(s 633s, "s11rvd y Il. Pomov 5 t+~,ot, hr.>x1:�c?nt..�l1y Aro\and thss p opc)so�� :1r�ach,inci �l'�a sand vnrtloally, approx;imatoly 7 Foot 4topsoil., subsoil, fill and 10, my fine, nArkd lay or (C11 ) And ropl�ace with Title V fill (Rof ror�c;„e 310 CMR 15.255 for spnc,:lficivions of fill (nand) J • Th total amount of f,il.l rnguirod i approximately 180 cubic;' yard»o . CALCULATIONS 3 Bodrooms (E� i st i r1q) roQ _ F OFILe Of 56PTt C S YP-6M 110 GPD/Bedroom X 3 Bedrooms � 330 GPD 1 � E= roT,�t Sc�rl.E : RS StFoW/V Percolation Rate - � 2 MPI (TP-•1 ) Soil. C1a,sn : Class l .(0. 74 G/SF) PROPOSED LZAC'SI2vTG AREA rot Leaching Field: 30' L x 15' W x 0. 51H I Bottom Area: 450 SF X 0. 74 G/SF 333 CLR q°Scr44o Total Leaching Capacity: 333 GPD vE'rtf o E>�rSriKG (rf-40E I to pX8 / 6"IT1+14 � O'�, 111 '.'�e��� r0 °co ro Nv� } ♦� `S `� 2 at c �@` 9 , �tiFo4 Rp°�� ,, / r : 4A ? �ry _`""^►.�..� ����) 7 S± ± q�fCN 9 O '4 _ w.,.�a �, ' r Ply t* ,j .ire o ? b f40{ 1 l Ep,{Sri.+v(r ��rSrinr 6,93 ( 4 V � IS 4'scf!q o ;PERK pVC !! 96 y67b S% Oos' 96,50 1 :o *to.c,.e��^Pr 4(c ff= Hw �P�*rrf CMURtH 96,bS r�r�E= 95,a+ LEAG/�tiY 6 FIEG1� ° 3O'LY. IT W X 0iS�lr{ ,fib.a0 'CAOOn[p CARTWAY ♦`�`�� .•� V EX 17 r +► r� 0 $FENore �` A PRz-EtrS1'!NG K °� ''� �f ° r4 a fti..tlL`J S ♦ y l D o o 6-4 G.L 0A/ .-...._ 'FG (1 'gyp �'OWN y 5 6P77 L 7'AA/K -2 a' 0 Z .n Y' �Q � r1 f� din 3 4 o ser,n,4 tb 7l 441, � �rh sµ'sk 01? MARST'ONS .�' y r .�• M N a ..�{ L O nl rie�4 cro A- TO !iv 5 e e4 L�, ace o MILLS r j� � R��a '� �� tp l CN}��� wiiwdRo Ap Z } Z�! EEL F(Lrt it (A-(too) I � (OS- ©QCC I Na DsS. b SUBSURFACE SEWAGE DISPOSAL SYSTEM Bg �/o 1533 Popple Bottom Road, W. Barnstable lz �.., ' SCALE: DRAWN BY \,r. APPROVED BY a ate,. tr n a;, 1 'd. €,1tet I� .c DATE: 2/2s/02 Daniel D Johnson D.S. Joknson ; Prrpar+d William Petersen (509) 429-7026 W � ��� ���?� � 4'4 � If 3'os; 1533 Poppla Hottoia Road, N. llarnsttDla. M71, f�r00 OHO 8t.tcy OfJo ptQQ Otsb 0+6ts pt70CC J6 b /y p "'.. '* � � rw C PTIC DXSXGN, INC. (50®) s20-1DOt DRAWING NUMBER d4-SD ©+90 1tO0 f �. /,�to ? a7; 004 Main street, snit. B, ostwrrilla, W 02635 �� R,