Loading...
HomeMy WebLinkAbout0034 RIDGE ROAD - Health 34 Ridge Road West Barnstable A=216-024 No. VV ©1 —60-3 Fee BOARD OF HEALTH TOWN OF BARNSTABLE 0[ppltcatiou Jor Yell Construction Permit Application is hereby made for }a�permit to Construct( ), Alter( ), or Repair( ) an individual well at: �C c, • i�� ��.�e @� Locat o -Address Assessors Map and Parcel Owner Address flistaller-Driller Address (3-2—C Type of Building Dwelling Other-Type of Building No. of Persons Type of Well +�(C- Capacity RC) (- 0-A Purpose of Welly cg `� Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Wel rotecti egulation-The undersigned further agrees not to place the well in operation until a Certificate o `lia c has sued b the Board of Health. Signed Date Application Approved By V � 3rZ Date Application Disapproved for the following reasons: Date Permit No. �J 90l 6— o 6_5 Issued Date -------------------------------------------=-------� BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of M Yiance THIS IS TO CERTIFY,that the individual well Constructed Altered( ), or Repaired( ) by 6 PN k 1 Instal�erlc at �SU has been installed in accordanaN ith the provisions of the Town of Barnstable Board of H alth Private Well Protection Regulation as described in the application for Well Construction Permit No. WM6— (9©-3 Dated 3— 9_1 (o THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE 0(ppYicatiou _for Yell Construction Permit Application is hereby made for a permit to Construct( ), Alter( ), or Repair( an individual well at: Locati n-Address Assessors Map and Pazce Owner Address �111 C-at-)"- vj-Qkk \ --V?Cz , \Z6 �����.�s� ev 'Foil Installer-Driller Address Type of Building / Dwelling ", Other-Type of Building No. of Persons Type of Well +�-V�- Capacity \O Cam`,\ Purpose of Welly Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Wel Protect /ri Regulation-The undersigned further agrees not to place the well in operation until a Certificate of !li ce has lledn issued by the Board of Health. Signed 3 ^ e� Date Application Approved By 3—.2 Date Application Disapproved for the following reasons: Date Permit No. V go 1 c)6_5 Issued J Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Cons Nance THIS IS TO CERTIFY,.that the':individual well_..Xonstructed Altered( ); or Repaired( ) by C Installer at �u i c�c t� . kA1�S� has been installed in accordance with the provisions of the Town of Barnstable Board of I;alth Private Well Protection Regulation as described in the application for Well Construction Permit No. W 0616- 00 Dated 3 (c) p, THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Yell Couotruction Permit No " I _ 603 Fee LI Permission is hereby granted to Installer to Construct( ), Alter( ), or Repair (( ) an individual well at: No. Street as shown on the application for a Well Construction Permit No. ate Date I Approved By i I CERTIFICATE OF ANALYSIS Page. 1 0 a= Barnstable County Health Laboratory (M-MA009) Report Prepared For: Report Dated: 3/1/2016 Shaun F. Harrington All Cape Well Drilling Order No.: G1691940 P O Box 126 Brewster, MA 02631 Laboratory ID#: 1691940-01 Description: Water-Drinking Water _ Sample#: Sample Location: 34 Ridge Rd.,Barnstable Collected: 02/29/2016 Collected by: Customer Received: 02/29/2016 Routine ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen 3.7 mg/L 0.10 10 EPA 300.0 LAP 2/29/2016 Copper ND mg/L 0.10 .1.3 SM 3111E LAP 3/1/2016 Iron •0.52' mg/L 0.10 0.3 SM 3111B LAP 3/1/2016 pH 6.5 PH AT 25C NA 6.5-8.5 SM 4500-H-13 DCB 2/29/2016 Sodium 26 ;' mg/L 2.5 20 SM 3111B LAP 3/1/2016 Total Coliform Absent P/A 0 0 SM 9223 RG 2/29/2016 Conductance 250 umohsicm 2.0 EPA 120.1 DCB 2/29/2016 Sodium level is above the maximum'contaminant level. Those on a low sodium diet may wish to consult a physician. The water may present aesthetic problems(taste, odor, staining)due to Iron. Attached please find the laboratory certified parameter list. Approved By: n (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e- 34 Ridge rd ' Property Address -, Scott Hempstead Owner Owner's Name -may z information is W Barnstable ✓ Ma 02630 6/1/16 required for every �'.• page. City/Town State Zip Code Date of Inspection Cd 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 s/4 /f on the computer, �70 use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain Company Name 8 Johns path Company Address Bra S Yarmouth Ma 02664 Cityrrown State Zip Code 508-364-9587 S103522 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 16.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ElNeeds Further Evaluatio -b1--.�q Lo.Approving Authority 6/1/16 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. �a VS l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 r Commonwealth of Massachusetts , W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is I required for every W Barnstable Ma 02630 6/1/16 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: System contains a 1500 GI tank as well as a concrete distribution box and a 472 Square ft leach field of high cap infultrators. 13) 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 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 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 l5ins•3113 Title 5 Official Inspection Form: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 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 D f Inspection State Zi Code ate o page. City/Town p 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 %day flow t5ins•3113 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 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is. required for every W Barnstable Ma 02630 6/1/16 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. . ❑ ® 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 page. City/Town 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 maintenance of subsurface sewage disposal systems? proper 9 p 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): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is W Barnstable Ma 02630 6/1/16 required for every _ page. City/Town 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 Well 9 ( Y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Occupied Last date of occupancy: 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M ,•�'" 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information W Barnstable Ma 02630 6/1/16 required for every 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: Recommended at this time 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): (Sins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 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: 4 yrs Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(iocate on site plan): Depth below grade: 2 feet Material of constriction: ® 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.): System is vented both at roof and field Septic Tank (locate on site plan): Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: 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 34 Ridge rd Property Address Scott Hempstead Owner . Owner's Name information is Ma 02630 6/1/16 required for every W Barnstable State Zip Code Date of Inspection Page., .CltylTown P p D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No evidence of Ieaking,Tees and or baffles in place at time of inspection. 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 l5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form a o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 page. City/Town 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.): Tees are in place and levels are normal. 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 f , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level and at normal level 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.): PumpChamber 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 16 High caps ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: 472 sqf ❑ 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.): Field is like new 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 page. CitylTown 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.): No ponding no break out 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 ILE VILLAGE ASSESSOR'S NIAP Sz PARCEL INSTALLER'S NAME& PHONENO. �.-.5-,, SEPTIC TANK.CAPACITY LEACHING FACILITY.(type) (size) NO. OF BEDROOMS —L OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -4- 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 -rl V// __ Irk �� I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •''�t 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 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. 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 ge Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 City/Town/Town page. Y 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: 10+ ft 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: 4/21/11 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: Test hole data on plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 34 Ridge rd Property Address Scott Hempstead Owner Owner's Name information is required for every W Barnstable Ma 02630 6/1/16 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 0 n II � � ipepactmcnt of Regulatory Services / �l [/ y �>t���>3� } Public Health Division Date 10AS& 200 Main Street,Hyanuis MA 02601 9 Date Scheduled Time /` lcee Pd. ( G Foil Suitability Assess�p�entfor �'eu age Disposalf Pcrfonned By; WiUtessed By.: (14Voo Location Address D l d /�Jp Owner's Name /fie yv n� Address r / � ��� Assessor's Map/Parcel: '6 a I Cngiueer's Oa Namc J W('-, e NEW CONSTRUCTION REPAIR Telephone It oe�J!7 Land Use• �iL1: ALA Slopes(%) /0 C*/- Surface Stones_/7!!✓ LP Distances from: Open Water Eodym(4— ft Possible Wet Areaft Drinking Water Well �/® ft Drainage Way— , Ft Properly Line Ft Other ft SKETCH, (Street came,dimensions of lot,exact locations of IesL holes&pert tests,locate wetlunds'I b n proxinuty to holes) 7/ /° �y iA fiH q V) Parent material(geologic)_/'+d r4 ox Depth tU Bodrock � 3,do Depth to Groundwater: Standing Water in Hole:hJ d IVZ� Weeping I'ronl Pit PROD n,0 Estimated Seasonal High Oioundwater A I DE,`J[ERTY11NATION FOR S14CASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _ - In, Depth to SQ11 lticj[dn; Depth to weeping from side of obs.hole: _,._,I!1, Orttuiidwnter AdJuslhtent„_ Ft. Index Well f# Reading Date: Index Well level _ AdI,f,.tetor � A41,dtountlwater Level PE RCOLATI.ON 7C]C+'S"d' -- lDute l<'lulm Observation Hole#t I Time at 9" Depth of Perc _ / Tlmp al 6" G✓1 _ Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch L S Site Suitability Assessment; Sile passed—y--ol Sile'Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation;`Tole Data To Be Completed on Back----��/ ***It percolatlou test is to be conducted }vlti In 100' of wetland, you must first Uotify flic. Barnstable Conservatioli JAVisiola it least one (1) weeh prior to beginnhog. Q:\SEPTIC\PL'•RCFORM.DOC ]D11C]C P.01 SEd2VA'�,0N HOLE' LOG 1�' #m e� fir-----__ Depth from Soil Horizon Surface(in.) Soil Text Sdil Color Soil (USDA)_. (Mansell) Mottlin Other g (Structure,Stones;boulders, Con istency. %a ravel .d�s �sr� DREP Depth from Solt Horizon # Surface(in.) Soil Texture Soil Color (USDA) Soil(Mansell) Mol Other ding (Structure,Stones,Boulders. Consi ency %Gravel) S'T a ca _ d� S' J DE Depth from OBSERVATION ITOLE LOGSoil HorizonTax ii Surface(in:} Soil hire Soil Color, .rr, (USDA) Soil Other (Muns411) Moftlln g (Structure,Stones,boulders. Co sistency DE]EP OBSERVATION HOLE w Depth Erorn I.®�a ](-][D]� �' Soil Horizon Soil Texture Soil Color (USDA) „ (Munseil) MOttlln Other ---__ g (Structure,Stone6;Boulders, Consi is e"cy,°,y Oray� eI�T ][�Wd lfnsul'ance Rate I ap.- Above 500 year flood boundnry No Ycs ` Within 500 year boundary No_ Yes. Within 100 year flood boundary No� lr s De>ptl>I ®t P�Ttuttutral9y` ccflfl>rrun�Peirvaolts 1lRaterla9 Does at least four feet of nal'urally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? 11 not, what is the depth of naturally occurring pervious matoriall Ce�ti�catio�a I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental.Protection and that the above Hnalysis was performed by me consistent with the required training, expertise and experience described in�10 CMR 15.017. Signature ' G Date /.-f 0/kl Q:\SF,PTlC\PERCrORM.DOC TOWN OF BARNSTABLE �S LOCATION 3 IZt N6t_E `ZQ._ SEWAGE# 40 11— 111 VILLAGE U3, �tsE� L2ASSESSOR'S MAP&PARCEL c34(-� INSTALLER'S NAME&PHONE-NO. .C. f. 46V 711 1-93!" SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ''�a e�Z (size) ! 'yam 13 NO.OF BEDROOMS OWNER l PERMIT DATE: •J-H COMPLIANCE DATE: ,j Jo/ly Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4- Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) 400 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 14 1.4--. Feet FURNISHED BY 4. w GZbrir a.iesS �t rar 3'i6' / ` f- 9G R � �V a No. 8 Fee THE COMMONWEALTH OF MASSACHU TTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye Rpplitation for Mispo8al *pstrm CDnstCuttion Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.34 Kche Pj Owner's Name,Address,and Tel.No. S! W.&fnS =zr�M�Ma ux: NemPs�e�. 3�l RicS� � Assessor's Map/Parcel oZ Ko a r 6 /I�nsta�ller's Name,Address,and Tel.No. 5-OS -18- t Designer's Name,Address,and Tel.No. 5 66' a l"AC'to�v-�r��c�c..�i©Y��'��- �+ JJ�')�/p.2�r�i✓�21'-e' ��Y�C Q,�F!a(Q.!Yt Jr-. 1ur�� t1�a �5 ;Ils but oa�Sl� 4rmot. r �s Type of Building: Dwelling No.of Bedrooms Lot Size DSO sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) t;tO gpd Design flow provided �� gpd Plan Date f��l Is I I Number of sheets !� Revision Date /o?�J/ �/l�Ut�(/e Pjj�Title—1'!ae r5:><e &0 ���/�l'QE �n Size of Septic Tank 1�4 ;� Type of S.A.S.%(B A'Cox e v ] " !Ue Description of Soil 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 Enviro Cod and not place the system in operation until a Certificate of Compliance has been issued by t is Board of He e m Date (! Application Approved by e Date Application Disapproved by VKS Date for the following reasons Permit No. r Date Issued L t t lIN No. / I Fee THE COMMONWEALTH OF MASSACHUS• TTS Entered in computer: Ye PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Z[pplitation for MisposaY *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) []Complete System ❑Individual Components Location Address or Lot No.-34 Pl � i Owner's Name,Address,and Tel.No. tlx .•.Aw•Qan,S-f�.�. Xo/Fa�Muu2� t-�.vr,(,s�cd 3y l�icQS e. ssessor's Map/Parcel a/�a p� �[ L2�t33Sf r s 6I irl " CnCv� Installer's Name,Address,and Tel.No. aUb yak Designer's Name,Address,and Tel.No. SY/ �bt-��LGr-�std"uckf on�2rC • ��� E'r�i•�c2r'�r 7=.I+a[ Q,�t dKa r r��. S3us�r [l�trs�vrstitYl���s �vI v �/� �/arru�uu� Type of Building: Dwelling No.of Bedrooms Lot Size p� a 50 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons _ Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) acvl U gpd Design flow provided 3V9 gpd Plan Date n�r,:_h IS 3o I Number of sheets Revision Date/ I/-;I �7 r� �nf Title I t k SSr It 1��OPO/ 7 f�/p� /� G(J�`.��'/ ('f1S t Size of Septic Tank !<S( �- Type of S.A.S.,/6• r{"(<<in�Jj,_J ����,�j..�jA Description of Soil y t -w r� Nature of Repairs or Alterations(Answer when applicable) rn i Date last inspected: IQ Agreement:_ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provi'sinns°ef'Title 5 of the Enviromr�rrta Cod and not to place the system in operation until a Certificate of Compliance has been issued by thi0Board of Health. Aed / o f _ Date J/ v —„ - Application Approved by Date y / � Application Disapproved by / V Date I for the following reasons 3 e� . f Permit No. Date Issued i y'---'-----'-f'--- - ------------- ----- ---- - --" -----_-=-�--------------1 - -----------�•�-'---------- -. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance r THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired W) Upgraded( ) Abandoned( )by ZAo to-c �(�r15 u c�`i cn.,, A-0 C /� j at t;i-3� �ii�a� j2,�. [k�S� 1 rr�lSTct Wi5� has been cons to ina ordance 11- with the provisions of Title 5 and the for`Disposal System Construction Permit dated Installer&f 'n Vi t �.C�a�c� IK..�k, �,fs'� Designer oWr1 �2110 FnIl n too i(1Q S nC #bedrooms O` Approved design flow gpd The issuance of this permit shall .of be construed as a guarantee that the system w funcf o as esigne . � Date ��I ;l Inspector c .�^"""•^�^^^�^=^-'^ -o. - .�- ----- = -- N Fee � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Mis' posal *Pste 'Construction Permit Permission is hereby granted to c Construct( )`, Repair( Upgrade( ) Abandon( ) System located at '34 t and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Y y. Title 5 and the following local provisions or special conditions. Provided:Construction nius be c pie ed within three years of the date of this permit. Date Approved by I_ _ u MAY-12-2011 13:39 From:BORTOLOTTI CONST 5084289399 To:15087906304 P.1/2 FROM :down cape engineering inc FAX No. :15OS3629880 May. 12 2BL1 02:35PM F1. V � r r .'huxrne�+k9. Qri ter,Dirmfo.r �a AA�NL'iADUC, a' maw& � V�1lljni R4��Og�)f4 A�BV➢Ci�l(J�7 �� +�i9�.'dJr� i'bit6�a5 ��]K4'i�� �IGC�'.�'•�lRlC 1f)0111Wu Street,Up3ania,MA 024-0). %or, 96 46411 Fax: ;BAR-774 6304 1Ca;od F: la Iti �¢�'r�n,uitr;lC�!J f/� A,s �rrw� '�114Tw�r�t'mra ill c /� Tb�;sii�Unr. buJY1�t: J+ng Tauti�slllflFsr. �✓ / �� �,.a��ls= .LQ,r !'.lw,,,_,_. - Addraata: �� r�r �Ll.�.„� ��!-�.. C y! ate) septic syotam utC� —!l 'b:tard ou a dasiM,dytiwil ny (u 11 `.as) f r;s!i gi(n) i c rtify that thi, septic sygtrM rofmnml Rbr,Me W M9Wled O$StR+'ttia ll.y f t,00'rding to w._. th,a cii.5il? away >zib.luIL-. rn,iflnr t► �c7vrcf chans{t:� at�cfi i batovil, rvlucillm of&c. dJ4tnbl4io.j3 box&Yi/or, g"..1,mly.. T uardy that thr septic sysfrrn fe�eranf-ra above wa-4 iWmijrel with mAjo.r. chungm (i c. " �xeatcx lou 1 Q° lam al relnutiduu oft,. HA c►ur ecy veltij.411 trinceti.{jn uj',,4.1y Cnmpo)uent lit'the sepdv "em)bot ua Rzerm]aww, with�`-bitc&Luml TteguloTions. i'latl x0va?5i.®r at uazjits�.d a,4- by t+wdgun to Nlow qN Oi y i DANIEL A. OJAUk (l�iit�i}1ir's 5►.};ri wrre) CAVIL 1 No,4860 4 N � —7A f aix l]c aT ft+a'3 ate-nti H;"C�) , -U—rytTfl�, �TK ,0 g stAILLf aff wi As-m•�J,9 T. CARLU Q•Nr,�ilt7:lSnp.i�;pig>u��=crtilira,u�n�.+osm,a.2fHQd.du� e pp nn_ r e s s Thomas F. G eLler, D•n➢'�E�LQDr &.4YUNSTASLE, x i MASS. �� s T� lIl� s7i(��I1��11 l�Il'1Il5L�ZIl Office: 508-862-4644 Fax: 508-790-6304 instancy & Designe-r tCertti&2 ion Forma Datte: �Y l� Serval-e permit-4 ao Assessor, �i a��p1l�areeb C / O? Designnera DvJVI ` " Metr, lmstaflere lUOV �i1O c rs, Address* � MCu r1, \ILLAddress: 0 ' �• �� /� On was issued a permit to install a (date) (installer) septic system at / ((%C /* based on a design drawn by ^ / 0 (address) 4 n' �1 dated esigner) 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. 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. OF Mgss�c DANICLA, y�N (Installer's Signature) OJALA NIL N NO.46502 q��c Spa/S T BR�G��<u S/ANAL EN �� --signer's Signature) (Affix Designer's Stamp Here) \ PLEASE FEET T-N TO BARNSTA3L E PUB-LIC 11HALT14 DIVISION. CERTIFICATE OF COIF:W-4CE, tiy—ML NOT 'B SSUED uN'llR BOT11E THIS FORM AND AS-BUILT CARD ARE R ECE �Ti ID BY THE BA NSTABLE PUBLIC HER ALTHA DIVISION. THA1`a YOU. (1 iTr.alth/Sentir./I7e.,iG7nP.r Certification Forni 3-26-04.doc FROM :dow-- cape engineering inc FAX NO. :150836213880 Apr. 21 2011 03:48PM P2 i DEED RESTRICTION WHEREAS,..SC +9''�ttaf'c _ ZV�+ .._.� e�� of J`f .. (owncPs name) 3�- Z ' L")• PA— S� s MA . (addross) is the owner of 3q 12- located (addresgr at MA (hereinafter referred to as and being shown on a plan entitled 'Subdivision of Land in MA, Property of , et al, duly recorded in Barnstable County Registry Of Deeds in Plan Book Page ; Or on Land Court Plan Number WHEREAS, Se,s .t y �k�,i as the owner of said lot has (owner's name) agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CNIR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, dwdr FROM :douse cape engineering inc FAX NO. :15083629880 Apr. 21 2011 03:48PM P3 NOW, THEREFORE, t. a�adu I-Ld�loes hereby place the (owne(s name) following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: �Zt`A4!= (3a.-Y,,-, o iUmay have constructed (address) upon the lot a house containing no more than luo (Z) bedrooms. Saur� ,s1�e z �,,agrees that this shall be permanent deed (ffWl'12P6 rldnle) restriction affecting located on IUTA, and being shown on the plan recorded in Plan Book l s-1 , Raged� . Or on Land Court Plan For title of see the.following deed: Book /&'D2 , Page S Or Land Court Certificate of Title Number Executed as a sealed instrument day of _.0 ner's signature Owner's signature V Owner's signature COMMONWEALTH OF MASSACHUSETTS pss . 20_// Then personally am eared th above-na ed known to me to be the person ho executed the foregoing instrument and acknowledged �UZABETy R=ARDINI the same to be free act and deed, before me, Notervpubt all . cm Public My commis 1 on xpires: (date) dmir FROM :down cape engineering inc FAX NO. :15083629880 Apr. 21 2011 03:4BPM P4 Jc Note : This restriction is automatically removed if all properties in the area are connected to municipal water, as site is then no longer in a nitrogen sensitive area. of THE Tp� Town of Barnstable Barnstable Board of Health BARNSrABLE, y Mass. 200 Main Street,Hyannis MA 02601 1639. ,orED MAC°' 2007 OFFICE: 508-8624644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. BOARD OF HEALTH MEETING MINUTES Tuesday, April 12, 2011 at 3:00 PM Town Hall, Hearing Room, 2ND Floor 367 Main Street, Hyannis, MA A regularly scheduled and duly posted meeting of the Barnstable Board of Health was held on Tuesday, April 12,2011. The meeting was called to order at 3:00 pm by Chairman Wayne Miller,M.D. Also attending were Board Members Junichi Sawayanagi and Paul J. Canniff,D.M.D. Thomas McKean, Director of Public Health,and Sharon Crocker,Administrative Assistant,were also present. I. Hearing — Food Variance: Aaron Webb, The Daily Paper, 644 West Main St, Hyannis — lease notification regarding insufficient number of toilet facilities. Aaron Webb was present. He informed the Board that the owner at the time of the Board hearing in January 2008, he was looking at buying the property once his lease came up for renewal and that is why he had considered covering the cost of the additional bathroom. Someone else ended up purchasing the property and he feels it is an unfair burden to request of a renter. The Board will have Mr. Webb bring additional suggestions to the June meeting, stating the possibility of a toilet facility upstairs. The Board would like information gathered for the next meeting on other locations that the Board approved unisex toilet facilities and to compare the number of seating at the establishments. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to Continue until June 14, 2011 meeting. (Unanimously, voted in favor.) II. Hearing — Pool (Cont.): George Simpson, owner—Anchor In, One South Street, Hyannis, lifeguard requirements (continued from March 2011). Dr. Miller read the proposed policy and broke it down having the Board discuss and vote on each item. Signage: 'Children under 16 shall not use swimming pool without a responsible adult in attendance.' Yes, all in favor. Signage: 'No alcohol allowed in the pool area.' Yes, all in favor. Page 1 of 5 BOH 4/12/2011 c Maximum pool occupancy of 20. Yes, all in favor. Access to pool area by key or key card Yes, all in favor. Maximum pool depth for 5 feet for all new pools, and Newly renovated pools. Pre-existing pools do not need to Apply for a variance. Yes, 2 in favor, No= Dr. Canniff. No diving board, slides, or other such appliances. Yes, all in favor. Pool Hours from 8am — 9pm, if no lifeguard or qual.swim. Yes, all in favor. No organized/scheduled children's activities without a Lifeguard or qualified swimmer Yes, all in favor. Staff member with adult and child CPR on site Yes, all in favor. Trial Time Period: One Year Yes, all in favor. Limited to facilities with 50 units or less Yes, all in favor. Prior to the Board voting on the policy as a whole, Dr. Canniff stated that he believes a lifeguard and/or qualified swimmers are worth the expense to potentially protect human life. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to approve the above policy for atrial period of one year to be limited to pools at sites with 50 units or less. (Two voted in Favor, One voted to Deny-Dr. Canniff). III. Variances — Septic (New): A. Carmen Shay representing Allen Halliday, Trustee — 154 Eel River Road, Osterville, Map/Parcel 115-010-001, 74,985 square feet lot, setback variances for septic tank and pump chamber to wetlands (Postponed from March 8, 2011). Carmen Shay presented the plan. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to approve the plan for a five bedroom septic with a three bedroom Deed Restriction until a five bedroom plan is submitted to the Board, at which time the Deed Restriction will be lifted. (Unanimously, voted in favor.) B. Dan Ojala, Down Cape Engineering, representing Scott and Maura Hempstead — 34 Ridge Rd, West Barnstable, Map/Parcel 216-024, 24,250 square feet lot, three septic variances. Page 2 of 5 BOH 4/12/2011 Dan Ojala was present. The property currently has a private well and this leads to the Title V regulation stipulating that the property can only be used as a two Lbedroom with a two bedroom deed restriction. C. Dan Ojala, Down Cape ngineerin , Holly Point Road, Centerville, Map/Parcel 232-042, requesting an extension of septic replacement. Dan Ojala was present and acknowledged the extension has expired. He would like to have another extension. Dr. Miller said that without seeing a specific plan, he is reluctant to approve a plan. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to approve the extension of the septic replacement until September 15, 2011, and the Board prefers the installation to occur sooner, if possible. (Unanimously, voted in favor.) WITHDRAWN D. Mark Marinaccio and John Juros, Department of Public Works, request to upgrade existing toilet facility with Title V variance at Joshua's Pond, Osterville, seasonal use only. IV. Subdivision# 820: Dan Ojala, Down Cape Engineering, representing Stephen E. Wallace,—'0' High Street, a.k.a. Wayside Lane Extension, West Barnstable, Preliminary Plan Subdivision# 820 in Historical District, Map 110, Parcel 007, 2 lots on 6.96 acres, within the Resource Protection Overlay District. Dan Ojala was present and reviewed the plan. Mr. McKean said the staff commented on page 2, the proposed Well does not meet the 10 feet separation. Upon a motion duly made by Junichi Sawayanagi, seconded by Dr. Caniff, the Board voted to approve Conditions: Well needs to be relocated to be 10 feet from property line, and subject to no grinding of stumps, etc. (Unanimously, voted in favor). V. Variance — Food (New): A. John Greene representing Oceans 10 — 10 Ocean Street (formerly The Black Spot), Hyannis, grease trap variance. No one was present. Page 3 of 5 BOH 4/12/2011 e`er4-21---201 1 a 113 o ra.3ca DEED RESTRICTION WHEREAS, -�{ t Iu,(`c� �t�U�-Qs-�— of (owner's name) 3� 2�`d� w, 6A� � ¢ MA (address) is the owner of 34 t2 located (address at MA (hereinafter referred to as and being shown on a plan entitled "Subdivision of Land in MA, Property of et al, duly recorded in Barnstable County Registry of Deeds in Plan Book , Page Or on Land Court Plan Number WHEREAS, S�-�E � � } }��� as the owner of said lot has (owner's name) agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, deedr 1 NOW, THEREFORE, E,2b� Vavx�4t o�does hereby place the (owner's name) following restriction on his above-referenced land in accordance with his . agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: �2_t,,4 may have constructed (address) upon the lot a house containing no more than : wv (Z) bedrooms. agrees that this shall be permanent deed (owner's name) restriction affecting located on MA, and being shown on the plan recorded in Plan Book is 1 , Paged 3!3 . Or on Land Court Plan For title of seethe following deed: Book R,,x? , Page 9-e _ . Or Land Court Certificate of Title Number Executed as a sealed instrument day of �y ,,,OW-ner's signature Owner's signature Owner's signature COMMONWEALTH OF MASSACHUSETTS 20,// Then personally appeared theabove-narned �a t� known to me to be the per.,, uhn executed the foregoing instrument and E L I 'x acknowledged -.. Z4�1Ahe same to be free act and deed before me RI ELIZABEN Notary ROINI p' M� FtA , , r y �•, �Cx ;... COMMONWEALTH OF MASSACHUSETTS . �. r W o My CmiMissign E�res March 18,20tg `!w v�" �$,� ��` �" Public ay M• h -,, a ,g y commission xpires: :., (date) deedr I Note : This restriction is automatically removed if all properties in the area are connected to municipal water, as site is then no longer in a nitrogen sensitive area. BARNSTABLE REGISTRY OF DEEDS OF DATE: FEE: HARNerABLF. hum REC. BY Town of Barnstable SCHED. DATE: Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: rc,t zm.,to Assessor's Map and Parcel Number: ZUo '—� Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No )c Subdivision Name: APPLICANT'S NAME: Phone Did the owner of the property authorize you to represent him or her? Yes x No PROPERTY OWNER'S NAME CONTACT PERSON Name: Name: Address: ?Lto" Address: CA.V Phone: Phone: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) NATURE OF WORK: House Addition 13 House Renovation 0 Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) — Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian — Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) — Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutlers must be notified by certified mqil at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same ownerAcasce only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL ul J.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microeoft\Windows\Temporary Files\Content-Outlook\BALT9P9B7\VARIREQ.DOC Internet i tel.(508)362-4541 939 main street rt 6a fax(508)362-9880 yarmouth port mass 02675 down cape engineering, MC. structural design March 25, 2011 civil engineers&land surveyors Daniel A.01ala,P.E.,P.L.S. Arne H.Ojala P.E.,P.L.S. Barnstable Board of Health Timothy H.coven,P.L.S. land court 200 Main Street Andrew R.Garulay,R.L.A. Surveys Hyannis, MA 02601 Re: 34 Ridge Road, West Barnstable site planning Dear Board Members: sewage system designs The enclosed represents a variance filing for the upgrading of a failing septic system to a new Title 5 septic system. No increase in habitable space or bedrooms is proposed. The following variances are requested under Barnstable Board of Health inspections Regulations: permits Barnstable Regulations Section 397-8E(1): f. Reduction in setback,proposed leaching facility to existing wells (locus and abutter's, 150' to 100') landscape architecture and under 15.405 1(b): SAS to be greater than 3' but less than 6' below grade Due to site constraints to include the small size of the lot,the topography and the presence of wells (locus and the abutters to the north and west) setback variances are requested. The leaching facility is proposed at a minimum of 100' to the locus and abutters' wells,the minimum state requirement. The positioning of the neighbor's well to the west, along with unsuitable soils encountered in the only other possible area precludes the system from being proposed anywhere else on the lot. We feel that by granting these variances,the same degree of environmental protection can be attained without the need for strict adherence to the Town of Barnstable Regulations and Title 5 regulations. Very truly yours, Daniel A.. Ojala, PE, PLS Down Cape Engineering, Inc. cc: Bortolotti Construction, Inc. I i { I I i I I Maura&Scott Hempstead 34 Ridge Rd. West Barnstable, MA 02668 508-362-0044 i March 25, 2011 To Whom It May Concern: We grant permission for Down Cape Engineering to represent us at the April 12th Board of Health meeting regarding our application for a variance to our septic installation. Thank you, Maura&Scott Hempstead i i i i i i I i i i i TOWN Or 'ARNSTABL! ,m — O 3ttr. y f9 auto) ASSESSORS sac o .a3 33 _ 21 4cs °h I X1 N I s7ae 3/ '9"AV S� d 34 e .65 4 S 32 22 3 O 4 30 e�_s 1.25 4C bO .60 AC 4c SII u; .473e. a a 01. W O 65 .Sb At Ix --"A. 20 a 23 .93 CC .35 4C 24 .55 AC .! o SOS 39 J9 t9 R 10 GE D3 1-4 IV 'D 61 °j o :.TA AC N .et Et qn VS CID Ae 6a /Y/ V N J7 . bt 1M-tiL'1` ..ewe hP x ,q(4pp `` O co.i 10 `P,Q A 6T ON S52s N A y 4C la 16 .31wc 300 O 4r •Is ,q lb4. 3y 4Oe,y r A A( 15 OQ 'is G IV I ,A' .94 GC OL q0 4) '75 Ao bAP �� •6J Qg RN Go•L GIB) /25> ACO / ��pL Ip 1 40 L3? r)s` il6^ 4C ti U N N 6 �oD 4B0 49 76 ti f 4C a qq (p,PP 2- 27A� ,S N so °c `ory a•8S s i 'IV O S� pCom 10, o lD P 5` kqY q11 2 O 23 h 1'12 \ 40 V N > ti �3 v i 17, z 02 r a 1 m \ N -0 2-1 0t�3� i 1.04AC 9� i. �O�t,, ,� � �•Z n zap �,°,2 ''90 i lkbutterReport Page 1 of Board of Health Abutter List for flap & Parcel(s): '216024' direct abutters (no set distance)and the properties located across the street. r total Count: 7 Close Map &Parcel Ownerl Owner2 Addressl Address 2 Mailing CityStateZip Country Deed TABOR 216022 LYNN A,]AMES A& 63 HARBOR HILLS CENTERVILLE, ROAD MA 02632 24662/120 ARVANITOPOLOS, 216023 DIMITROIS.N& 46 RIDGE RD W BARNSTABLE, GRETCHEN MA 02668 16517/275 216024 HEMPSTEAD, SCOTT W BARNSTABLE E& MAURA E 34 RIDGE RD MA 02668 USA 18627/088 216032 SULKALA, KARL A& W BARNSTABLE, MAUREEN C BOX 93 USA 2567/123 MA 02668 216064 GUEST,THOMAS W %GUEST, DOROTHY 9244 ASHLAND LORTON,VA &DOROTHY S S ESTATE OF C/O GUEST, MARK WOODS LN, APT 2027/201 C1 22079 216070 TROE, DAVID N 28 RIDGE RD W BARNSTABLE, MA 02668 USA 9604/272 216071 TROE, DAVID N 28 RIDGE RD W BARNSTABLE, MA 02668 USA 10641/128 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 3/22/2011 . i i ittp://66,203.95.236/arcims/a eoa /AbutterRe ort.as x? ppg pP p p type=BOH 3/22/2011 Town of Barnstable Geographic Information System March 22,2011 -'6060 41,19 217011 z L #23 21 is 216033 �ti #1866 #18 #1837 216061 rFs e #1894 216031 i q #1894 216034 .: #1 #1912 l 216052 N 196006 # T #1781 0 C 46 f216030 � 216D22 #1871 #1849 N j 216032' 216053 2116025 #57 # 5 216029 #1919 21ti055 216054 216020 216023 216024 #84 #74 #71 #46 #34' �16070: RIDGE RD g � 216067 0 9 j #968 216056 216061 216064' ':_',.'`..:.`: 216047 #37t :r:.:'.':i.. 216071i ;':.:.:.':._ g #991 #81 3 #30 216062 9 216063 ® ® 216028 216057 #10 #952 216065 #4D 216026 46PJ #951 216046 216060 $OX #24 f #2423 5 Fe t #41 216016 IVOOo t 216027 �R #t0 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:216 Parcel:024 Board of Health boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1'=100'may not meet established map accuracy standards.The parcel lines on this map Abutter List Type-Direct abutters(no set distance)and the properties located are only graphic representations of Assessor's tax parcels. They are not true property across the street Abutters boundaries and do not represent accurate relationships to physical features on the map such as building locations. Buffer tel.(508)362-4541 939 main street rt 6a fax(508)362-9980 yarmouth port mass 02675 down Cape engineering, kc structural design civil engineers&land surveyors Daniel A.Ojala,RE.,P.L.S. Arne H.Ojala RE.,P.L.S. Timothy H.Covell,P.L.S. land court Andrew R.Garulay,R.L.A. surveys March 28,2011 site planning Dear Abutter: A public hearing has been scheduled for the Barnstable Board of Health to take action sewage system designs on a request for variances from Town of Barnstable Regulations and Title 5 Regulations for the subsurface disposal of sewage for the proposed Title 5 septic system at 34 Ridge Road, West Barnstable. The variances requested are as follows: inspections Under Maximum Feasible Compliance, 15.405: I(b): Leaching facility to be greater than 3' but less than 6' below grade permits Town of Barnstable Section 397-8E l(fl: Proposed leaching facility to be 100' to landscape existing wells (locus and abutter)—50' variance requested. architecture Said hearing will be held in the Hearing Room, South Street, Hyannis, April 12"' at 3:00 pm. Plans and the application describing the proposed activity are on file at the Board of Health office, 200 Main Street, Hyannis. It is recommended to check with the Health Department to confirm date and time if you are interested in attending. Sincerely, Sarah B. Ojala Down Cape Engineering, Inc. cc: Abutters file Barnstable Board of Health barnboh :. "k4 ROOM a 140 0� s`F P f. 4 TFL� 45 Z+ 3A.v d: i` SEES jKOOR - .Cw i TRANS. NO.: DESIGN FLOW: 5pd REVIEWED BY: SATE: : N/A OK NO .•4. ,.1.: :�Y.+ :.�:. .11'0 .�•` '.t.' ,.! � .� a:Y`:;:nti,.....2-7,4.u r:S `; . k 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)] y I f ff_ Plan proper scale? (1 =40 for plot plans, 1 —20f or fewer for components) [310 CMR 15.220(4)] Easements shown [310 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 CDR 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)(c)] System Calculations [310 CMR 15.220(4)(f)] daily flow .� septic tank capacity(required and provided) soil absorption system(required and provided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)] Existing and proposed contours [310 CMR 15.220(4)(g)] Location and log of deep observation.holes (existing grade el. on each test)1310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] 4✓ Location and date of percolation tests (performed at proper elevation?) [310 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 CDR 15.220(4)(11)] I Address Sheet 1 of 7 I i i NIA 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 supply 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 CMR15.220(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 u-1 310 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)(q)] Materials specifications noted? [various sections of 310 CMR 15.000] System components not> 36" deep (unless Local Upgrade46 Approval or LUA requested) [310 CMR 15.405(1(b)] i Address Sheet 2 of 7 i N/A Oki NO `�•4:�1L•;1;.t4�-.y.L A19JC):} ,. r .i� fa''.ta.ltE rj Ybfl-- si r���fitZ y'r��.�V+��trt31� t �� � M1 1� r t i z.•.Size OK? [310 CMR 15.223(1)] i Inlet tee located ten inches below flow line [310 CMR 15227(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 CNM 15.228(1)] Separation between inlet and outlet tees (no less than liquid j depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater , i (except as described 310 CNIR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minunum 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)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<1000gpd, two for systems>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 Re uired/Done 310 CMR 15.221 8 Y Y q [ O] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] �x^c fir,• •�:raa�vrrum�trx�artM �e iue � t • '�.n4':yl:e•sG3•.Zea ,?'±F, t. 1 � �� � ��: '�:.u���.k�;!,•j� t .n �onapai;t enf�'ll�atsks �.";� �;��� 5� y!;�., ;. ,u;•x.,;;;tf':;: `17.. T::Jr�:. �..'...�,'I�,:.r1f.;7:a�.I_��I,:r.: •:FS 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 gas baffle or approved filter[310 CMR 15.224(4)] i i i Address Sheet 3 of 7 N/A OK NO :.,._:.....,..�._:.,....�;-y-�.......---.-....,....-.„._.._�_.> .Y ,.. MAN,,. Located at least ten feet from any water line? [310 CUR 15.222(2)] Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) f Cleanouts required/provided? [310 CMR 15.222(8)] Thrust blocks specified in force mauls? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/fi) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distrbuted trenches and beds) [310 CUR 15.251(9) and 310 CMR 15.252(2)(c)] Siphon problem/(leachfield below pump chamber) Endcaps or vent manifold specified? "not smaller e holes specified? 1 Size and orientation of discha_g h , 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 types allowed) +t Sir�mtJknc:r��. 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" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15-232.(2)(b)] i Minimum sump 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] ro' +�Fr(' � Mf TYI t?C Capacity(emergency storage above working—design flow)? [310 CMR 231(2)] Proper setbacks [310 CMR.15.211 (same as septic tanks)] Watertight 20-in numum 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 i5.231(6) and(8)] Stable Compacted Base [310 CMR 15.221(2)] j Buoyancy calculations needed?Provided? [310 CMR 15.221(8)] Address Sheet 4 of 7 t N/A OK NO LABSI�P�jT��T`7S'S�' `FEl`/s ;( ��)G7111\TAT�G� 4� i? i. sat'�' Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] Required separation to groundwater? [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] . 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 15.2.11(1)[4] and Guidance Document] ;�.A1�k,F]E2�1'+S`P _� �•�� �1,4'S 3`�6;`CiVJ[ �• 5ti5`3 z,4,�,� � ��^ =.t, •'�''. 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 to grade) [310 CMR 15.253(2)] Aggregate 1'minimum-4'maximum. [310 CMR 15.253(1)(b)] 2' sidewall credit maximum [310 CMR 15.253(1)(a)] In bed configuration,inlet every 40 s . ft. [310 CMR 15.253(6)] Na 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 (3x if reserve between trenches) [310 CMR-251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] minimum 2 distribution lines [310 CMR�15.252(2)(a)] Maximum separation between lines 6' [310 CM R15.252(2)(d)] Ma7dmum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)]' Aggregate depth below discharge pipes 6"mirrimtun, 12" maximum. [310 CMR 15.252(2)(g)] I Separation between beds 10'minimum. [310 CMR 15.252(2)(f)] Bottom area used in calculations only [310 CMR 15.252(2)(i)] I� Address Sheet 5 of 7 N/A OK NO �.T .� T ij:I1v11 Y� S.JA�.���1 �'.. ZJ,YI Pressure Dosed System ? Provided pump and piping calculations as required [310 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 (>2000gpd) good to note on plan[310 CMR 15.254(2)(d)] a Construction in fill -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? Impervious banter and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15255(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. recommended) [310 CMR 15.255 (2)(e)] Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface :. 316 1 elr tirccfiyweS'ystez AMS. ers 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 note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance [manual? Has applicant submitted a copy of a maintenance Are the variances listed on the plan? [310 CMR 15.220 RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CMR 15.414] Address _ Sheet G of 7 j i N/A. OIL NO ,:zft�'o e" Fetasifive'�'i�eas": .;;<,r;*•-�,}:� + ' �� i ,5`, "'�.. j)� ". ; Y: ..s .. vim:....:-,".:....: .........• .e,. ."'..:�,u. ..,',r. 1 ., „ ....,... .. .,.•. . ::: -. .:. ... Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 ChM 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 ? [310 CMR 15214(2)] Are the nitrogen loads proposed m compliance? [310 CMR 15.216(1)] i� { t t t ZSCCrQ'j1202dS fiRurtkrrp s �� �}�it �f{!a :.a,:ti1.t yr .k„ +{ a: f� 5f2���d�1� '1}�" Pumping to septic tank? [ 310 CN 15.229] Shared System [310 CMlt 15.290] Address Sheet 7 of 7 ECO TECH 0 Environmental T; `.r BARiNSTABLE www.eco-tech.us rictvLTH DEPT. THIS FORM IS A FACSIMILE OF THE STANDARD SEPTIC INSPECTION FORM ISSUED BY THE MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION(revised 6/15/2000) TITLE 5 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION 4NP 4. Property Address: 34 Ridge Road West Barnstable Owner's Name: Lillian Heisler Owner's Address: 34 Ridge Road VD West Barnstable,MA 02668 Date of Inspection: May 20,2004 Name of Inspector: (Please Print) David D. Coughanowr,R.S. Company Name: Eco-Tech Environmental STPg�E Mailing Address: 43 Triangle Circle HEA�gH oEP� Sandwich,MA 02563 Telephone Number: (508)364-0894 CERTIFICATION STATEMENT: I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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: X Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature'� (-<Z7- r�S Date: &694- 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 NOTES AND COMMENTS Inspector's Note—> A septic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. ****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. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 INSPECTION SUMMARY: Check A,B,C,D or E/ALWAYS complete all of section D: A] System Passes: yes I have not found any information which indicates that any of the failure criteria described in 310 CMR 5.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. COMMENTS: Locus well is 85 feet from leaching trench. A satisfactory well water analysis has been performed and the results are attached. 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. Answer yes,no,or not determined(Y,N,or ND). in the_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. ND explain: Observation of sewage backup or breakout or high static water level in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced. ND explain The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain 2 Page 3 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 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 and 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 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. i 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 "Thus system passes if the well water analysis, performed by a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form 3) OTHER 3 Page 4 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 D)System Failure Criteria applicable to all systems: You must indicate either"yes" or"no"to each of the following for all inspections: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. yes no X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of the SAS,cesspool or privy is below high groundwater elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well X Any portion of a cesspool or privy is within 50 feet of a private water supply well X 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 by a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form) No (Yes/No)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 You must indicate either"yes" or"no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 Check if the following have been done: You must indicate either"Yes"or"No"as to each of the following: Yes No Y _ Pumping information was provided by the owner,occupant or Board of Health. N Were any of the system components pumped out in the last two weeks? N Has the system received normal flows in the previous two week period? N Have large volumes of water been introduced to the system recently or as part of this inspection? n/a _ Were as built plans of the system obtained and examined?(If they were not available as N/A) Y _ Was the facility or dwelling inspected for signs of sewage back-up? Y _ Was the site inspected for signs of breakout? including Y _ Were all system components,exeleding the SAS. located on site? _ N Were the septic tank manholes uncovered,opened,and the interior of the septic tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum.? Y _ Was the facility owner(and occupants, if different from owner)provided with information on the proper maintenance of subsurface disposal systems? For information on the proper maintenance of subsurface disposal systems please go to: WWW.ECO-TECH.US The size and location of the Soil Absorption System(SAS)on the site has been determined based on: N Existing information. For example,Plan at the Board of Health. Y _ 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(3)(b)] 5 Page 6 of 1 I OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): 2(per assessing division records) DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a—No plan on file at Health Dept. Number of current residents 0 Does the residence have a garbage grinder(yes or no): no. Is laundry on a separate sewage system(yes or no): no :(If yes, separate inspection requiredl Laundry system inspected (yes or no): n/a Seasonal use(yes or no): no Water meter readings,if available(last two year's usage(gpd): n/a—well in use Sump Pump(yes or no): no Last date of occupancy: December, 2003 COMMERCIAL/INDUS TRL4 L: Type of establishment: Design flow(based on 310 CMR 15.203):: gpd Basis of design flow(seats/persons/sgft/etc.): Grease trap present: (yes or no)_ Industrial waste holding tank present: (yes or no): Non-sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings,if available: Last date of occupancy/use:_ OTHER: (Describe): GENERAL INFORMATION PUMPING RECORDS Source of information: System not pumped in recent past(Owner) Was system pumped as part of the inspection: (yes or no) No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM: Septic tank,distribution box, soil absorption system X Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternate technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe) leaching trench APPROXIMATE AGE of all components,date installed(if known)and source of information: Age unknown—no records on file at Board of Health Were sewage odors detected when arriving at the site: (yes or no) no 6 Page 7 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 BUILDING SEWER_(Locate on site plan) Depth below grade: 1 ft Material of construction: X cast iron _40 PVC_other(explain) Distance from private water supply well or suction line 20+ Comments: (on condition of joints,venting,evidence of leakage,etc.) Sewer is vented through roof and appears structurally sound with no evidence of leakage or backup into dwelling SEPTIC TANK:none (locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene other(explain) If tank is metal,list age_ Is age confirmed by Certificate of Compliance_(yes or no):_(attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: How dimensions were determined: Probe to top of tank Comments: (on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP: none (locate on site plan) Depth below grade: 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: Comments: (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 TIGHT OR HOLDING TANK: none (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/day Alarm present(yes or no):_ Alarm level: _ Alarm in working order(yes or no):_ pumping:Date of last Comments:(condition of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOX: none (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments:(note if box is level and distribution to outlets is equal,any evidence of solids carryover,any evidence of leakage into or out of box, etc.) PUMP CHAMBER: none (locate on site plan) Pumps in working order: (yes or no) Alarms in working order: (yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 SOIL ABSORPTION SYSTEM(SAS): Yes (locate on site plan;excavation not required) If SAS not located,explain why: Type: _leaching pits,number _leaching chambers,number _leaching galleries,number X leaching trenches,number, length 1—approximately 40 feet _leaching fields,number,dimensions _overflow cesspool,number 1 —innovative/alternate system Type/name of Technology Comments: (note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.) Soils above overflow leaching trench appeared unsaturated.No evidence of surface ponding,breakout,lush vegetation,or other evidence of hydraulic failure was observed. Observation hole dug into leaching trench stone showed no standing effluent or effluent contact staining. CESSPOOLS: 1 Primary (cesspool must be pumped at time of inspection)(locate on site plan) Number and configuration: 1 block cesspool Depth-top of liquid to inlet invert: 6 in Depth of solids layer: 6 in Depth of scum layer: 0 in Dimensions of cesspool: approximately 6 ft x 6 ft Materials of construction: concrete block Indication of groundwater inflow(yes or no): no Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.): Soils above primary cesspool appeared unsaturated. No evidence of surface ponding,breakout,lush vegetation or other evidence of hydraulic failure was observed. NOTE ON BLOCK CESSPOOLS: DO NOT DRIVE VEHICLES OR OPERATE MACHINERY OVER OR IN THE VICINITY OF CESSPOOLS PRIVY: none (locate on site plan) Materials of construction: Dimensions:_ Depth of solids: Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 SKETCH OF SEWAGE DISPOSAL SYSTEM: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100'(Locate where public water supply enters the building) LOCATIONS LEACHING TRENCH A B 2 1 49.5 f t 25 f t 2 58 f t 39 f t PRIMARY CESSPOOL A EXISTING B DWELLING # 34 WELL - APPROXIMATELY 85 FEET TO TRENCH NO OTHER WELLS WITHIN 100 FEET OF SYSTEM RIDGE ROAD NOT TO SCALE 1.0 f Page 11 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 34 Ridge Road West Barnstable Owner: Lillian Heisler Date of Inspection: May 20,2004 SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to ground water: 50 feet Please indicate(check)all methods used to determine high ground water elevation: Obtained from system design plans on record-If checked. date of design plan reviewed Observed Site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of health-explain: _ Checked local excavators,installers-attach documentation) X Accessed USGS database You must describe how you established the high ground water elevation. Town of Barnstable GIS Department records indicate property is 50 feet above groundwater table 11 ENVIROTECHLABORATORIF.S,INC MA CERT.NO.:M MA 06.3 8 jan Sebastian Di- Unit#12 Sandwich, AM 02f63 .508(888-6460) 1-800,3.394460 FAX(508)888-6446 CLIENT. Eco Tech LOCATION: 34 Ridge Road ADDRESS: 43 Triangle Circle Barnstable, MA Sandwich, MA 02563 COLLECTED BY. DDC SAMPLE DATE: 5/12/2004 SAMPLE TIME: NA WATER SAMPLE TYPE: Existing Well DATE RECEIVED: 5/12/2004 Title 5 LAB I.D. #. 0405265 WELL SPECS.: NA RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria /100ml 0 0 9222 B 5/12/2004 PH pH Units 6.5-8.5 6.07 4500 H+ 5/12/2004 Conductance umhos/cm 500 170 120.1 5/12/2004 Nitrate-N mg/L 10.0 2.06 300.0 5/12/2004 Nitrite-N mg/L 1.0 <0.004 200.7 5/12/2004 Sodium mg/L 20.0 17.2 200.7 5/13/2004 Iron mg/L 0.3 0.5 200.7 5/13/2004 Manganese mg/L 0.05 0.029 200.7 5/13/2004 Ammonia mg/L 1.0 <0.5 350.2 5/13/2004 Volatile Organics ug/L See Report None Detected. EPA 524.2 5/14/2004 COMMENTS: pH is below recommended limit and may have corrosive characteristics. Iron level is not a health hazard. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. <=less than 0.4,J dIa-4.-- Date_,�f 6 Y >=greater than 'R Ald J. Saa TNTC=too numerous to count La oratory Director Groundwater Analytical,Inc. P.O.Box 1200 ANALYTICAL 228 Buz Main Street Buzzards Bay,MA 02532 Telephone(508)759-4441 May 20,2004 FAX(508)759-4475 www.groundwateranalytical.cwm Mr. Ron Saari Envirotech laboratories, Inc. 8)an Sebastian Drive Unit*12 Sandwich, MA 02563 LABORATORY REPORT Project: Eco Tech/34 Ridge Rd Lab ID: 72615 Received: 05-13-04 Dear Ron: Enclosed are the analytical results for the above referenced project. The project was processed for Priority turnaround. This letter authorizes the release of the analytical results, and should be considered a part of this report. This report contains a sample receipt report detailing the samples received, a project narrative indicating project changes and non-conformances, a quality control report, and a statement of our state certitications. The analytical results contained in this report meet all applicable NELAC standards,except as may be specifically noted, or described in the project narrative. This report may only be used or reproduced in its entirety. I attest under the pains and penalties of perjury that, based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is,to the best of my knowledge and belief, accurate and complete. Should you have any questions concerning this report,please do not hesitate to contact me. Sincerely, Jonathan R.Sanford President )RS/kal Enclosures GRCNJNDMVATER EPA Method 524.2 Volatile Org irtics by GGMS Field fD: OM265 Matrix: Aqueous Project- Ec o Tedd34 Rklge Rd Container. 40 ml VOA Vial Client: Erwi pled I.Aoraboria,loc. Preservation: MCl/Coal Laboratory ID: 72613-01 QC Bakh ID: VM50197-W Sampled: 05-12-04 00:80 Insttumertt ID: MS-8 AgRent i890 Received: 0543-04 16-A0 Sample Volume: 25 mt Analyzed: 05-144)4 06:24 Dilution Factor. 1 Analyst: 04 Pop= 1002 75-71-8 Dichlorodifluororrredrane BRL ug/L 0.5 - 7487-3 ClOoromed%ane BRL ug/L 0.5 75-01-4 Vinyl Chloride BRL ---- 0.5 7483-9 Bromomethane - BRL -- UWL 0.5 754XQ-3 Chlomedtane TT BRL Ugh 0.5 75-694 _ -_ TrkNorofluommethane BRL ug/L 0.5 75-35-4 1,1-Dichloroethene BRL up/L 0.5 75-09,-2 Medryierwe Chloride BRL --- - 15660-5 trans-1,2-Dkhloroethene BRL U91L 0.5 1634.04-4 Methyl tert-butyl Ether(MTBE) BRL UWL 0.5 75-34-3 15i6chloroethane _ BRL ug/L 0.5 R 594-20-7 2,2-Dichlo e - BRL ug/L 0.5 156.59-2 cis-1,2-Dichkwoethene BRL u9/1. 0.5 74-97-5 Brornochloromcthanc - BRL uWL 67-W3 Chloroform BRL UWL --0.9 71-55-6 1,1,1-Trichloroethane BRL WA _ _0.5 S6-23-5 Carbon Tetrachloride BRL ug/L 0.5 y S63-5" 1,1-DichloropTpcne BRL ug/L 0.5 71-43-2 Benzene BRL U91L 0.5 107-06-2 1,2-Dlchloroelhane BRL ug/L 0.5 79-01.6 Trichloroethene _ BRL L 0.5 7"7-5 1,2-Dichloro ne - BRL ug/L 0.5 74-95-3 Dibromomethane BRL -91L 0.5 75-27-4 Bromodichloromethane I BRL 0 5 10061-01-5 cis-1,3-Dichloropropene BRL uf/-L 1OB4W3 Toluene BRL USIL 0.5 10061-02-6 trans 1,3-Dichlompropecte BRL r L 0.5 794D0-S 1,1,2-Trichimoethane _ BRL ug/L 0.5 127-18-4 Tetra6lome0werm BRL L 0.5 142-28-9 _ 1,3-Dichloro a BRL L 0.5 124-48-1 Dibrtirmtlnrumethane BRL U91L 0.3 106-93.4 1,2-Dibromoedwe BRl 0.5 108-90-7 Chlorobenzene BRL ug/L 0.5 63020.E 1,1,1 Tetrachloroedune BRL ug/L 0.5 IOD41-t Ethylbenzene BRL ug/L 0.5 106-38-313064" meta-XyiPneand ra-Xylene BRL u 0.5 95.47.6 ortfoo-Xylene, BRL USA 0.5 10042-5 Styrrre J BRL ug/L 0.5 75-25-2 Bromoforrn BRL u�/L 0.5 98-82.8 Isopropylbenzene BRL ug/L _0.5_ _ 1088&1 BromobenienP BRL ug/L 0.5 79-34-S 1,1,2,2 Tetrachloroethane BRL ug/L 0.5 96 18 4 1,2,3-TricMoropropane BRL ug/L 0.5 103-65-1 n (benzene BRL _ ug/L 0.5 9549-8 2-0lorutoluene _ _ BRL _ UgA 0.5 108-67-8 1,3,5-Trimethylbenzene BRL ug/L 0.5 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street,Buzzards Bay, MA 02532 EPA Method 524.2(Continued) Volatile Organics by GUMS Field 0: 0405265 Matrix Apu—n Pr*lct: 6coTeachf34 Ridge Rd coMairwr 40 net VOA VW Client: EmArotmis Laboratories,Inc Preservation: HCLACooI Laboratory ID: 726IS-01 QC Batch ID: VMt1-0197 W Sampled: 05-12-04 00:00 Instrument ID: MSd AdAud 6690 Received: OS-13404 16 40 Sample Volume- 25 mL Analyzed: 05-14414 06.24 Dilution Factor: 1 Analyst: CM P"W 2912 10643-4 4-Chlorotoluene BRL US& 0.5 98-06b W-ButylbevWeiew BRL ugly. 0.5 95-63-6 - 1,2,4-Trimethylbenzene BRL 0.5 135.98.8 sec-Butylbenzene_ _BRL UWL 0.5 541-73-1 1,3-Dichltmahenzene -- BRL ug& 0.5 99.87-6 44sopropyltoltsene BRL ug/L 0.5 106 46 7 1,4-Didrlorobenzerte BRI. uffLfL 0.5 95-50-1 1,2-Dichlorobenzene -�.- BRL ug/L 0.5 104-51-8 n-Butylbenzene BRL _tWL 0.5 96-12-8 1,2-Dibromo-3-chloropropane BRL US& 0.5 120.82-1 1,2,4-Trichlorobenzene BRL u 0.5 87-i8-3 Hexadtlorebutadiene BRL U81L 0.5 91-20-3 NaphdWene BIM ug/L 0.5 8761-6 1,2 3-Trich_k. obenzene BRL ug/L 0.5 �A& m — _ r 1,2-Dichlorobenzened. 10 1 9.7 97 X 70-130% 4-Beomoflrmrobenzene 10 1 10 101 % 70-130'- Method Rofaernoe: t adwds for the Dewmination of Omit Cornpouds in Drinking Water,Supplement IN,k S EPA, EPA-60M R-95/131 0995). Medwd Revision 4A. Report Notatiow BRL lrrdkun coneweatim N any,b belay mmrUnrg IIMt for analyte. Repooft Mundt Is dae loomt cant.-entration that can be reliably quarwbed under Fortune laborarlmy operuin8 conditloos. Repw ins bmr'ls are adjusted for ssrnple size and dilution. Groundwater Analytical,Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 RROLM.3WATER Project Narrative Proles Eco TedwU Ridge Rd Lab ID 7Z615 Client Envlretech taboratoriies„kic. Received: os-1304 16.40 The following documentation discrepancies,and client cfwnges or amendments were noted for this project 7 . No docarnen(ation discrepancies,changes,or amendments were noted. The sample(s)in this Project were analyzed by the references analytical rnethod(s),and no method modifications, norfconfornmrices or analytical issues were noted,except as indicated below: 1 . No method modifications,non•canformances or analytical issues were noted. Groundwater Analytical, Inc.,P.O.Box 1200.228 Main Street, B,I rds Bay.MA 02532 i3OE B.tk,1,.1 } Page: 1 CERTIFICATE OF ANALYSIS M g �C" Barnstable County Health Laboratory 9ss^CHliSF.'i Report Prepared For: Report Dated: 4/14/2004 Byron,CRS Realtor Order Number: G0424740 Kate Byron P. O. Box 826 u� Dennis, MA 02638 -'ARCEL _OT Laboratory ID#: 0424740-01 Description: Water-Drinking Water Sample#: 24740 Sampling Location: 34 Ridge Rd W Barnstable MA Collected 4/12/2004 Collected by: K Byron Received 4/12/2004 GL- Routine �L �{-�1,512-00'T ITEM RESULT UNITS MCL Method# Tested LAB: !C Lab Nitrates 2.7 mg/L 0.1 10 EPA 300.0 4/12/2004 LAB: Metals Copper 0.4 mg/L 0.1 1.3 SM 311113 4/14/2004 Iron <O.1 mg/L 0.1 0.3 SM 3111B 4/14/2004 Sodium 16 mg/L 1.0 20 SM 311113 4/14/2004 LAB: Microbiology Total Coliform Absent P/A 0 Absent 309 4/12/2004 I LAB: Physical Chemistry Conductance ISO umohs/cm 1 EPA 120.1 4/12/2004 pH 6.1 pH-units 0 EPA 150.1 4/12/2004 Note: Water sample meets the recommended limits for drinking water of all the above tested parameters. Approved By: a--- - :'7.----- . ( hector) 44 RECEIVE® .` APR 1 6.2004 TOWN OF BARNSTABLE HEALTH DEPT. Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 ALL S SHALL SYSTEM PROFILE SYSTEM M RK D WITH CMAGNETIC TTAPE ORBE NOTES PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS APPROX. NGVD ACCESS COVERS TO WITHIN 6" OF FIN. GRADE PROVIDE INSPECTION PORTS TO 2. MUNICIPAL WATER IS NOT AVAILABLE \ WITHIN 3" OF FINISH GRADE 80.0 77.0' - 79.0' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. Raii�oad MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM PRECAST H-gyp MIN. 8"IDIAM. 4. DESIGN LOADING FOR ST TO BE AASHO H-ll��( ) DESIGN LOADING FOR D'BOX TO BE AASHO H-20 to RISERS 4"0SCH40 PVC 5. PIPE JOINS TO BE MADE WATERTIGHT. Wa Ede " PROP. TEE PIPES LEVEL 1ST 2' ' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE 10" 1500 GAL H-10 1,}" 73.0' WITH Locus y. 77•2rj' TEE SEPTIC TANK TEE 310 CMR 15.000 (TITLE V.) CommunCape ity 77.0 6" MIN. SUMP o GAS BAFFLE.'.' °°°°°°°°°°°° 12" MIN. INT. DIM. 72.5' 7. THIS ?LAN IS FOR PROPOSED WORK ONLY AND Ga17'e Ca/lege SLAB EL. 85.5' NOT TO BE USED FOR LOT LINE STAKING OR ANY Pond 4' LIQ. LEVEL (ACME OR EQUAL) 72.77' 72.6' 0.92 OTHER PURPOSE. .':;:. 71.58' � 000°o°o°o°o°o°°°°°O°oog°g000gogo0°g°0000gog°000 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 3 �0000000ro°o,�o,�o�o°o°00000�o�o�o°o„o,�o�o°000. 16 H-20 HIGH CAPACITY INFILTRATORS (NO STONE PROPOSED) 9. COMPONENTS NOT TO BE BACKFILLED OR O 6" CRUSHED.STONE OR MECHANICAL CONCEALED WITHOUT INSPECTION BY BOARD OF COMPACTION. (15.221 (21) SEE DETAIL BELOW HEALTH AND PERMISSION OBTAINED FROM BOARD Exit OF HEALTH. #6 % SLOPE) ( % SLOPE) ( % SLOPE) 2 26 1 8 6' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR ( MIN H_20 BOTTOM TH 1 EL. 63.0' CALLING DIGSAFE (1-888-344-7233) AND LEACHING VERIFYING THE LOCATION OF ALL UNDERGROUND & LOCUS MAP FOUNDATION- 41' SEPTIC TANK 16' D' BOX 6' FACILITY OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. NOT TO SCALE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL EXIST. WELL UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 216 PARCEL 24 PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. VARIANCES REQUESTED UNDER TOWN OF BARNSTABLE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED REGULATIONS AND TITLE 5: AND REMOVED OR PUMPED AND FILLED WITH CLEAN 15.405 1(b): SAS TO BE GREATER THAN 3' BUT LESS THAN SAND. 6' BELOW FINISH GRADE (H-20 AND VENTING PROPOSED) TOWN OF BARNSTABLE SECTION 397-8E 1(f): PROPOSED SAS SYSTEM DESIGN" TO BE 100' TO EXISTING WELLS (LOCUS AND ABUTTER) - 50' VARIANCE REQUESTED GARBAGE DISPOSER IS NOT ALLOWED � DESIGN FLOW: 2 BEDROOMS ® 110 GPD = 220 GPD ° � b \ USE A 220 GPD DESIGN FLOW N O �� SEPTIC TANK: 220 GPD (2) = 440** I \ USE A 1500 GAL. H-10 SEPTIC TANK 63.90 PROP. VENT WITH CHARCOAL FILTER APPROX. WELL \ AND BUGSCREEN (FINAL PLACEMENT CONTRACTOR WITH HOMEOWNER LEACHING: �8 cowsuLTArION) 4.72 SF/LF x 6.25' LENGTH 29.5 SF PER HIGH 1 9 8 D CAPACITY INFILTRATOR UNIT 80 330 GPD/0.74 GPD/SF = 445.9 SF LEACHING TEST HOLE LOGS cp�� ' \`\ REQ'D 445.9 SF/29.5 SF/UNIT = 15.1 UNITS ENGINEER: ARNE H. OJALA, PE, SE �� k,ce�\cy 1 LIQUID LEVEL. S FiF�o. Q Ar Plr EL. _ 79.0' THEREFORE, USE GRAVELLESS SYSTEM OF (16) WITNESS: DAVID STANTON, RS H-20 HIGH CAPACITY UNITS IN FIELD � gy MARCH 15, 2011 I �6 CONFIGURATION (SEE DETAIL) DATE:PERC. RATE _ < 5 MIN/INCH S6 pC�YGYM l �' >> � -^ NOTE: "FIRM" 16 UNITS( x 2j.5 SF = 472 SF > (5.j SF (OK) 472 SF 0.74 = 349 GPD > 330 OK MATERIAL AT SOUTH CLASS SOILS P# 13215 8� C.O. SIDE OF TH 2 (SEE ** NOTE 2 BR DEED RESTRICTION REQ'D ELEV. ELEV. FBENCHMARK 8 SILLO WALKOUT DOOR EXISTING �� S. MA 0" 73.0 0" 78.0 ELEV. = 85.5 DWELLING APPROVED DATE BOARD OF HEALTH A A ELEV. SLAB -s5.5 SL SL 10YR 2/1 6" 10YR 2/1 DECK � TITLE 5 SITE PLAN 6 B B 8> '°�°°' OF SL SL STONES LOT 19 EXIST. WELL 92 4 �� � 34 RIDGE ROAD 28" 10YR 5/6 70.6' 30" 10YR 5/6 75.5' 24,250 SFf METER WEST BARNSTABLE 0 31' PREPARED FOR / BORTOLOTTI CONSTRUCTION/ C C / N �+ PERC HEMPSTEAD �3p 2 // \ 12. LS STONES LS STONES eoce pAV , \ 2 STONE _ MARCH 15 2011 fMENT _ DRIVE \ \ SAS DETAIL \ / 1 20 REV. 4/12/1 1 (MOVE VENT) 2.5Y 6/6 2.5Y 6/6 _ o \ _ , o / \\ 1A, off 508-362-4541 > ;' � ySN oF, s fax 508-362-9880, OANIELA cya I downcope.com DA�ill`L �'� o� 0JALA N� down cape engineering MC \ / No. �Q o �� civil engineers 120 63.0 120 68.0 JAB- No-46,502 NO GROUNDWATER ENCOUNTERED Scale: 1"= 20' /STE ���' land surveyors AL 939 Main Street ( Rte 6A) -046 0 10 20 30 40 50 FEET DATE OJALA, P.E., P.L.S. YARMOUTHPORT MA 02575 SYSTEM PROFILE L SSY EMWIT COMPON NTTAPSHALL E OR BE - NOTES (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS APPROX. NGVD PROVIDE MIN. 20" DIAM. WATERTIGHT ACCESS COVERS TO WITHIN 6" OF FIN. GRADE PROVIDE INSPECTION PORTS TO 2. MUNICIPAL WATER IS NOT AVAILABLE \ WITHIN 3" OF FINISH GRADE 80.0' 77.0' - 79.0' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. Ra//goad MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM PRECAST H-10 MIN. 8" 4. DESIGN LOADING.FOR ST TO BE AASHO H-1 DESIGN LOADING FOR D'BOX TO BE AASHO H0 0 °te DIAM. o o RISERS 2'0 ') 4"0SCH40 PVC 5. PIPE JOINTS TO BE MADE WATERTIGHT. ` W° �one PROP. TEE PIPES LEVEL 1ST 2' 00_ 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE 000000000 10" 1500 GAL H-10 14" 73.0' 310 CMR 15.000 (TITLE V.) LWITH ocus Cape Cod 77.25' TEE SEPTIC TANK TEE 77.0' Community t6MIN- SUMPGAS BAFFLE ::; . INT. DIM. 72.5' 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND Gu�e Col%ge SLAB EL. 85.5 NOT TO BE USED FOR LOT LINE STAKING OR ANY Pond 4' LIQ. LEVEL (ACME OR EQUAL) 72.77' 0.92 OTHER PURPOSE. :4'.: :,. .. . .. .... . f 71.58' °° ° °• °'° ° ° ° °' ° 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. °°°°°°°„o ° °,°, °,°°°° °,q g g g,g,o°°°°. 16 H-20 HIGH CAPiiCITY INFILTRATORS o (NO STONE PROPOSED) 9. COMPONENTS NOT TO BE BACKFILLED OR O 6' CRUSHED.STONE OR MECHANICAL CONCEALED WITHOUT. INSPECTION BY BOARD OF COMPACTION. (15.221 [2]) SEE DETAIL BE-OW HEALTH AND PERMISSION OBTAINED FROM BOARD Exit OF HEALTH. #6 8.6' ( 2 % SLOPE) ( 26 % SLOPE) ( 1 X SLOPE) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR MIN H-20 BOTTOM TH 1 EL. 63.0' CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP LEACHING VERIFYING THE LOCATION OF ALL UNDERGROUND & FOUNDATION 41' SEPTIC TANK 16' D' BOX 6' FACILITY OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. NOT TO SCALE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL EXIST. WELL UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 216 PARCEL 24 PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM SHALL BE REMOVED 5' BENEATH AND AROUND THE : PROPOSED LEACHING FACILITY. VARIANCES REQUESTED UNDER TOWN OF BARNSTABLE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED REGULATIONS AND TITLE 5: AND REMOVED OR PUMPED AND FILLED WITH CLEAN ` SAND. 15.405 1(b): SAS TO BE GREATER THAN 3' BUT LESS THAN 6' BELOW FINISH GRADE (H-20 AND VENTING PROPOSED) TOWN OF BARNSTABLE SECTION 397-8E 1(f): PROPOSED SAS SYSTEM DESIGN" TO BE 100' TO EXISTING WELLS (LOCUS AND ABUTTER) - 50' VARIANCE REQUESTED 41 8 j, J GARBAGE DISPOSER IS NOT ALLOWED DESIGN FLOW: 2 BEDROOMS ® 110 GPD = 220 GPD O b USE A 220 GPD DESIGN FLOW I N O SEPTIC TANK: 220 GPD (2) = 440** USE A 1500 GAL. H-10 SEPTIC TANK 63.90 PROP. VENT WITH CHARCOAL FILTER APPROX. WELL AND BUGSCREEN (FINAL PLACEMENT LEACHING: CONTRACTOR WITH HOMEOWNER �8 \ CONS)LTATION) 4.72 SE./LP' x 6.25.' L.ENvT'n = 29.5 SF PER HIGH B D CAPACITY INFILTRATOR UNIT 80\ 330 GPD/0.74 GPD/SF = 445.9 SF LEACHING TEST HOLE LOGS ' REQ'D 8� �`AppROk w 1 445.9 SF/29.5 SF/UNIT = 15.1 UNITS ENGINEER: ARNE H. OJALA, PE, SE ,cFq�ti LIQUID LEVEL \ FiF�O A AT PIT EL. = 79.0' THEREFORE, USE GRAVELLESS SYSTEM OF (16) WITNESS: DAVID STANTON, RS �5 , ..ems H-20 HIGH CAPACITY UNITS IN FIELD I �6 CONFIGURATION SEE DETAIL DATE: MARCH 15, 2011 �6 P�gYCY , Z7 16 UNITS x 29.5 SF = 472 SF > 445.9 SF (OK) PERC. RATE _ < 5 MIN/INCH \�$ M NOTE: "FIRM" 472 SF (0.74) = 349 GPD > 330 (OK) MATERIAL AT SOUTH CLASS I SOILS p# 13215 C.O. SIDE OF TH 2 (SEE **2 BR DEED RESTRICTION REQ'D NOTE 11) ELEV. ELEV. BENCHMARK 8 4 4 SILLO WALKOUT DOOR EX'c`STING �� 1S• , MA o„ 73.0 019 78.0 ELEV. = 85.5 DWELLING APPROVED DATE BOARD OF HEALTH A A BASEMENT SLAB ELEV. - 85.!V r SL SL _-A 10YR 2/1 10YR 2/1 DECK B � TITLE 5 SITE PLAN 6„ 6„ � � 8 ° �°' OF B 92 �4 SL SL STONES LOT 19 EXIST. WELL c� 34 RIDGE ROAD 10YR 5/6 10YR 5/6 24,250 SFt ELEC / 28" . 70.6 30 75.5 METER / a WEST BARNSTABLE 3t' PREPARED FOR / C C , BORTOLOTTI CONSTRUCTION/ / � w PERC HEMPSTEAD LS STONES LS STONES eo�E q� 730.22' / STONE T DRIVE MARCH 15 2011 P fMEN _ / / \ \\ ;AS 020TAIL REV. 4/12/11 (MOVE VENT) 2.5Y 6/6 2.5Y 6/6 � - / ^( /A, jNOFMqs off 508-362-4541 jNOFMgs y�IYA OF�lfgs�9 ``�� �y fax 508-362-9880 DANIELs9cycN jii'oFX� �� DANIELA. DOJALAoAk G`�� • downcape.com A. ° DAN1�� �� � � r CIVIL CIVIL�o � CQpe eng�nee�ing, �/!c. A. 120" 63.0' 120" 68.0' / OJALA Ate. Nov46 02 q �No.465 Na.40980 v o Fc a`� civil engineers NO GROUNDWATER ENCOUNTERED �P N° o., c, FS �sr� a Scale: 1"= 20' �` � �® �& � F sT,= ��� s�®wAL e /o'nC/ Surveyors ! F A L 939 Main Street ( Rte 6A) 0 10 20 30 40 50 FEET ) OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 > > 046