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HomeMy WebLinkAbout0020 TROTTINGBRED LANE - Health 20 Trottingbred L<wN _ l TOWN OF BARNSTABLE L TION '�G SEWAGE# VILLAGE�A� galmV Y ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY 1 h Sri-roC C-) 1=I1,"s 60-L-1J?,ed Chy LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet' FURNISHED BY v � Clog' �.R%ateAI& ` P ,o ab 3 s — IO Title 5lnmectim Form 6/15/2 — L.®` TOWN OF BARNSTABLE LOCATI 7- 577— ,1/• SEWAGE# 9LCU7'S6 . 1 VILLAG ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. (..Lz S' a. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) EGG �L t baiya�r�(size) �.S NO.OF BEDROOMS OWNER Sm 17,// PERMIT DATE: is I10 tU:3 COMPLIANCE DATE- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ® o 3 p 3 !3 3 30., No. . 97' Fee V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUJBLIC HEALTH DIV ION -TOWN OF BARNSTABLE, MASSACHUSETTS (s pplication far_ igpo5al *pgtem Con0truction Permit Application for a Permit to Construct(' )Repair pgrade( )Abandon( ) O Complete System Ltidividual Components Location Address or Lot No. � 1 �. �� r.__ s Name,Address and Tel.No. Trn,"/ l ,_ Assessor'sMap/Parcel 5 -- �- ��'� 0Lfi �?4d-e� �+�t:1 l Installer's Name,Address,and eh.N.. Designer's Name,Address and Tel.No. - V 1' � M L %VL cA 6 Pi qSoN f'vo i"�13-- a Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 )�- 110 -3 3 V� gallons per day. Calculated daily flow gallons. Plan Date 4 4)0 Number of sheets l Revision Date Title Size of Septic Tank IQQ Q Iz A,SLR_ Type of S.A.S. S Description of Soil` ,St„r � Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued y this Board of H , Signed '`� ' Date � Application Approved by Date a v Application Disapproved for a following reasons Permit No. �2lYJ?�'. -7 Date Issued o. �} �t : j 1 ✓� i No. L .,�z, ! `= ;t - Fee •/VU THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. t PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS; Yes _k0 N F-P a2c5 ZIppYication for -Misspogaf *potem"Conttructiof Permit 7 Application for a Permit'to Construct(`. )Repair�,41upgrade( )Abandon( ) ❑Complete System d?<Ividual Components Location Address or Lot No,)o �� L "Owner's Name,Address and Tel.No. Snl+ Assessor's Map/Parcel_ (� S> 1 r,s�j ' .1 l`�Ci r `� Installer's Name,Address,an Te.No. — F S � ��•C Pf�� Designer's Name,Address and Tel.No. S'-t•. t,..,r k. rA Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other 'Type of"Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures - - " Design Flow 3 )- I 10 3 3 v; gallons•per day. Calculated daily flow gallons.- Plan"Date 04 a� 1 D-] Number of fh 6etsa 1 Revision Date •.A Title Size of Septic Tank iOfj Q J7 A, Type of S.A.S. 'a� S L X k 4,-yL'S(,I- �1��.,"• �y/J r Description of Soil S-" Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with,the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of a th Signed �.F O - ' ' ' Date L� Application Approved by _ )_)(AA ("`� Date ApApplication Disapproved for the following reasons y L Permit (0 7 'to 7 Date Issued i ----,tom-- --_ _ -___.,_ -- - - •--- - - -�_ _ - - - -- - . - - - �- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS 3 Certificate of Compliance THIS IS TO CERTIFY, that the On-site -ewag,qDisposal System Constructed ( ) Repaired (Upgraded( )✓ Abandoned( )by at{ fR 0 tr'o t j `r;l BrAf Lci^! , L-�st 6-1- cnP1 6'ell has been constructed in}accordance, with the provisions of Title 5 and the for-Disposal System Construction Permit No. �)oa 7- SG 7 dated l -1 V-,j 7 "Installer 1:11 1 S 1tF/k A Designer Q5 t,'64 8 /1-7 /V, The issuance of this, enm hall,not b•,e construed as a guarantee that the s fed will functio ?as •esi ��i�d. Date p g Inspector No. fi)7 — 6'6 Fee160 q i f THE COMMONWEALTH OF MASSACHUSETTS .. PUBLIC"HEALTH DIVISION'- BARNSTABLE;. MASSACHUSETTS Mfi6pogar pgterrY Con!Aruction Permit ti Permission is herebyranted to Construct, Re a '1 g ( ) p (� )Upgrade.( )Abandon( ) System located at Lc 1 �' '. t,�/ L` •'�-r S %39 1, c, v • - and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this.permit. Date: � ��,, Approved by �(" � 4,J I 10� iV VO iLi JJ�+ - .'7Utf-tf���Gl II P. 1 Town of Barnstable ,$ Regulatory Services _ Thomas F.der,Director ' AB Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,.MA 02601 Office:.508-962-4644 Fax: 509-710-6304 Installer&Desiner CertiScation Form Date: �J ZW,�j Sewage Permit# &CEO 7—5 4%7 Assessor's MaplParcel /S s 7 ;.Designer: �A�Q �' Installer: Address: 1 �YJW(G Address: 93 on - was issued a G 7 �iL L c �?/la�/-�G�C' pern�it to install a (date) (installer) septic system at a C; 7Z . based Qn a design drawn by (address) dated � (designer) i 'certify that the septic ep system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank Stripout (if required) was inspected and the soils were found satisfactory. �bt.�t_� •��,,�������� /��7���'1„_ / 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: Sttigout(if requurP,d)was mspecrted and the soils were found satisfactory. (Installer's Signature) NI 4 ► '}I\ `JI ter..Gti:' ~_.♦ (Design s Signature) (Affix Des St Here �P ) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVW&%vJAJJL II` CERTIFICATE trr 4.VlYlt'LiANCE WILL NOT BE ISSUED UNTIL BOTHt THIS FORM AND AS- BUIL1'CARD ARE RECEIVED BY THE JBARIVSTABLE PUBLIC$ ,Tg DIVISION TIL4NK YOU. Q-'\SVdctDes 9w Ccr iticWcm Fonn Rev 03-OM6.doc _ t r Town of Barnstable Regulatory Services Thomas F. Geiler,Director MAE& Public Health Division 1659.n►." Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Sewage Permit# : 007 (07 Assessor's Map\Parcel ;Designer: Installer: tf S' !?/1 o j/G-j2s Address: Address: 92v /2C� On was issued a permit to install a, (date) (installer) septic system at 0 ;-2 n TT-r,r/a 12 c.=�I-) LJ1 . based on a design drawn by (address) dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. (Installer's Signature) (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 03-09-06.doc .e. COMMONWEALTH OF MASSACHUSETTS d ExECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 20 Trottingbred Lane,West Barnstable,MA �--P Owner's Name: Rims and Ronald N.Smith Owner's Address:20 Trottingbred Lane,West Barnstable,MA Date of Inspection: 09/18/2007 1 05 Name of Inspector:Reid C.Ellis Company Name: Ellis Brothers Const.Co. r c Mailing Address:23 Enterprise Road ` CD s Yarmouth Port,MA 02675 /V c " Telephone Number:508-362-6237 CERTIFICATION STATEMENT _ I certify that I have personally inspected the sewage disposal system at this address and that the inforc ration repoited'"�: below is true,accurate and complete as of the time of the inspection.The inspection was performed b ed on m'- '' training and experience in the proper function and maintenance of on site sewage disposal systems.I a a' m' r approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes ditionally Passes eeds Further Evaluation by the Local Approving Authority t=ai; L 1 Inspector's Signature: _ Date•�(�"'"" o r 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 ****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. 1 Title 5 Inspection Form 6/15/2000 page I V Page 2 of 1 l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:20 Trottingbred Lane,West Barnstable,MA Owner:Rima and Ronald N.Smith Date of Inspection:09/18/2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: /0 1ave not found any information which indicates that any of the failure criteria described in 310 CMR 1 ,303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: V 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 c r repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the fbi the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or th septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or ta ik failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as apl iroved by the Board of Health. *A metal septic tank will pass inspection if it is structurally iound,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 break out or high is water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven dis 'button box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are repl Lced obstruction is removed distribution box is leve ed or replaced ND explain: The system required pumping more than 4 times a y ar due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are repla ed obstruction is removed ND explain: 2 Title 5 Insnection Form 6/15/2000 2 Page 3 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:20 Trottingbred Lane,West Barnstable,MA Owner: Rima Smith and Ronald N.Smith Date of Inspection:09/18/2007 C. Further Evaluation is Required by the Board of eal : Conditions exist which require further evaluation by t e 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 p otect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface ter _ 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 Pu blic Water Supplier,if any)determines that the system is functioning in a manner that protects the put lic health,safety and environment: _ The system has a septic tank and soil absorption ystem(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water su ply. The system has a septic tank and SAS and the SA S is within a Zone I of a public water supply. _ The system has a septic tank and SAS and the S S is within 50 feet of a private water supply well. The system has a septic tank and SAS and the Sfi S is less than 100 feet but 50 feet or more from a private water supply well".Method used to determin distance "This system passes if the well water analysis,perfoi med at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates thal 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 mi st be attached to this form. 3. Other: 3 Title 5 Inspection Form 6/15/2000 3 1 Page 4 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 20 Trottingbred Lane,West Barnstable,MA Owner: Rima and Ronald N.Smith Date of Inspection:09/18/2007 D. System Failure Criteria applicable to all systems: You,4nust indicate"yes"or"no"to each of the following for all inspections: Y No ckup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ischarge 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 A� pool tr iquid depth in cesspool is less than 6"below invert or available volume is less than%a day flow Required Pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number o times pumped y portion of the SAS,cesspool or privy is below high ground water elevation. portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface ffy r supply. portion of a cesspool or privy is within a Zone 1 of a public well. portionofa cesspool or privy is within 50 feet of a private water supply well. 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 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.] (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 rve 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 ad ' 'on to the criteria above) yes no — — the system is within 400 feet of a surface ng water supply the system is within 200 feet of a tributary o a surface drinking water supply — — the system is located in a nitrogen sensitiv area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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 a the system in upgrade ys accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Title 5 Inmecton Form 6/15/2000 4 Page 5 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:20 Trottingbred Lane,West Barnstable,MA Owner:Rima and Ronald N.Smith Date of Inspection:09/18/2007 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Y No _ — umping information was provided by the owner,occupant,or Board of Health ere 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 th affles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum a Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has.been determined based on: Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] 5 Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 20 Trottingbred Lane,West Barnstable,MA Owner: Rima and Ronald N.Smith Date of Inspection:09/18/2007 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of b oms):— Number of current residents: Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(y r no . f yes separate inspection required] Laundry system inspected(yes r no); Seasonal use:(yes or no)W 1 _ Water meter readings,if available(last 2 years usage(gp Sump pump(yes or no):— Last date of occupancy: G COMMERCIAL/INDUSTRIAL f v/ Type of establishment: Design flow(based on 310 CMR 15.203):7systwem�(ye Basis of design flow(seats/persons/sgftetcGrease trap present(yes or no):Industrial waste holding tank present(yes Non-sanitary waste discharged to the Title ):Water meter readings,if available: Last date of occupancy/use: / OTHER(describe): ! GENERAL INFO' RASATION Pumping Records Source of information: Was system pumped as part oe inspection(yes or no If yes,volume pumped:...,.,_ gallo --How was quantit�r ped determined? Reason for pumping: !Y' VOF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool —ivy —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) —Tight tank _Attach a copy of the DEP approval —Other(describe): Approximate pge of all components,date 'His led(' own)pnd`LD%e o f� rya%�� Were sewage odors detected when arriving at the site(yes or no). D 6 Title 5 Inspection Form 6/15/2000 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VO LUNTARY O UNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 Trottingbred Lane,West Barnstable,MA Owner. Rima and Ronald N.Smith Date of Inspection:09/18/2007 BUILDING SEWER(locate on site plan) � Depth below grad Materials of construction:_cast iron Z40VC_other(explain): Distance from private water supply well or suction line: ° Comments-(on condition of joints,venting,evid ce ea cage, c.): SEPTIC TANK ocate on site plan) l Depth below grade: /�� Material of construction _concrete metal— fiberglass_polyethylene other(explain) —ttank is metal list age:T Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) ' Dimensions: Sludge depth 9 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: 2� How were dimensions determined: Comments(on pumping recommendat3r6ns�inl to and outlet tee or baffle condition,structural integrity,liquid levels related tp outl§0aveM evide Of e,etc.): GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal—fibe rglass_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 o baffle: Date of last pumping: Comments(on pumping recommendations,inlet and ou let tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): I I'7 Title 5 Inspection Form 6/15/2000 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: 20 Trottingbred Lane,West Barnstable,MA Owner:Rima and Ronald N.Smith Date of Inspection: 09/18/2007 TIGHT or HOLDING TANK: (tank must b�� m 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 no): Date of last pumping: Comments(condition of alarm and float switches,et(.): DISTRIBUTION BOX: (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 equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: (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 s and appurtenances,etc.): 8 I Title 5 Inspection Form 6/15/2000 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: 20 Trottingbred Lane,West Barnstable,MA Owner: Rims and Ronald N.Smith Date of Inspection:09/18a007 j f SOIL ABSORPTION SYSTEM(SAS) ovate on site plan,excavation not required) If SAS not looted explain why: I T j leaching pits,number_ / z / , leaching chambers,number: leaching galleries,number leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number. innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc. �6 M FICA CESSPOOLS: (cesspool must be pumped as part f on site plan) �• i Number and configuration: i 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 or no): Comments(note condition of soil,signs of hydraulic ,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic ,level of ponding,condition of vegetation,etc.): r 9 9 Title 5 Inspection Form 6/15/2000 Page 10 of I I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) i Property Address: 20 Trottingbred Lane,West Barnstable,MA �. Owner: Rime and Ronald N.Smith � Date of Inspection:09/18/2007 SKETCH OF SEWAGE DISPOSAL SYSTEM 4/1 t;J Provide a sketch 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 thebuilding. Or an, lot .��� 40 2 '' 1 e 10 I 3 I I Title 5 Inspection Form 6/15/2 0 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 Trottingbred Lane,West Barnstable,MA 02668 Owner: Rima and Ronald N.Smith Date of Inspection: 09/18/2007 } SITE EXAM Slope Surface water Check cellar Shallow wells /, ` <� Estimated depth to ground water feet Please indicate(check)all methods used to determine the 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) 4 hecked with local Board of Health lam ]/A hecked with local excavators,installers-(attdumL % '� G _ ' '—�� ccessed USGS database-explain: �` You must describe how you established the high ground water elevation: 1 y 60� rh& AV . � E •Awll 11 � Title 5 Tncnectinn Form 6/15/2000 11 4 b I Town of Barnstable. r# °f Department of Retutatory Services sass . Public Health Division Date �D Zaa 200 Main Street,Hyannis MA 02601 Date Scheduled j�... �i Time Fee Pd. ,Foil Suitability Assessment Sewage for Disposal o 0 OI Performed By Witnessed By:z�� �W) '5 LOCATION & GENERAL INFORMATION Location Address Z�* f f � l� Owner's Name LA4' LC.� ✓ /" Address a� } "lD Assessor's Map/P4tael: 15 7_ Engineer's Name t. NEW CONSTRUdtON REPAIR _ Teiepho,ie# D . �( Land Use Slopes(9b) O '-'Surface Stones ! ft iDrinking Water Well . ' ft Distances from: Open Water Body, ft` Possible Wet Area ft Other s ft 0 Drainage Way ft Property Line SKETCH:Meet name,dimensiods'of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) I I s Parent material(gedlogic) 1 be th to Bedfock ' 00 r �✓ � r`' Depth to Groundwater. Standing Water in Hole: / i Weeping from Pit Face CD �3ittof��d.�'SF: 131 ��+ttrd�Y+4ers�,.�-3T A1 `' DN FCkt ATEIT Tbl T Mood Usedt � '� _ a ���•� �i��l mtltl�'��WA , Depth a ���N�,s.bolt: r � �t � • ., _fe. � `_�, Index WellOjG Date ST # ftdirig!1� � fintl�c 11Vell:Itr�bl 7 : t , nLttbt :.t» t ryl q bliserti2ttiiwt ''i!tiit�air, - '1, �'►3d� y*�•-.` � YE. 6 Start Pre-sat kt irite. •I' I . L,id Prb•soalt � yt�°t 1 hate Min.i'111t it 4P , a.± $ — AM9galdWj j dcd(YIN) ' Site Stlttabi�tA314b�smenC 5,tt Posed z � � b ' ited'on Back------- -- L Dilc 'bbaeiry ttoti Hdle Data v • Ongii,a !� ehith t)tvts,d0 ,;�. ! *�x r ' t� • b �-. � �. 7..�ty � i. z� ... • � •' 1. � !}'� �.'� ' . must first notify the' �'�ielrcfiil� fig, s'9���e;cbnd�ters v0'tl�ti3h�00' ti>��v�t ►�b: B6rvisiafle'�1tioii' 1��+iIbu Sait°eitin (l�wct" r beginning. DEEP OBSERVATION HOLE LOG' Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,StfYt} kYoulders. onsi§tern" ` vel �`7D N, DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color_ Soil. Other Surface(in.) (USDA) - (Munsell)" '.'. Mottling (Stru its, boulders. V Y 4D a 15 7771 4-DEEP OBSERVATION 4 1 � Depth from,.,a Soil Horizon Soil Texture ��iq . Solt Atha r Surface(rp.) (USDA) (]4'vnsell) Mottling' "(Structure,Stc8es,Roulders ., Consistency, O ve :i 1 hr DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) 1 '• (USDA) ' . F• (Mansell)i a _Mottli'tig (Structure,Stones,Boulders. �'_..-. . . n ist n a, i Flood Insurance Rate May: Above 500 year flood boundary No— _Yes_ _E_ .._w_.. ..,. . Within 500.year boundary Nov Yes F Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material .Does at least four feet of naturally occurring pervious material exist.in all areas observed throughvtrt ih area proposed for the soil absorptiotr system?,- - ...... If not,what is the depth of naturally occurring pervious materiki? yip i:: •. . .. ..,, •'� , ' .. ::C-.. . Certlf eatlon A a I certify that on y (date)I have passed the soil evaluator exammafion approved by the Department of Enviro ental Protection and that the above analysis was performed by me consistent with ' the required:training,,expertise experience described-in M CNiR 1514,, _ _• ,,,__ .- ,Signature Date " Q:\SEPTICVERCFORM.DOC __ -' down cape engineering, inc. SIEVE SOILS ANALYSIS DAVE MASON 2 DATE OF REPORT: 11/12/2007 JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 20 TROTTINGBRED LANE WEST BARNSTABLE LOCATION: "C" HORIZON SIEVE ANALYSIS Weight Sample(Grams): 356.5 SIZE RETAINED WT. RET. % RETAINED: % PASSED 1-" _L(wton indsieve) (sum) ----------- _ --------------------------j---------------------------- 0.0: 0.0: 0.0%: 100.0610 : --------- ff--------------- % 3/4" ------T--------------- ..----....066 0.0%; 100_0/ -------------- - _ 3/8" ------------- 0- M: ---------0.0%;---------------100_0% ------------; -------------Z ----------- ------------o- 10 14.9; 14.9: 4.2/o; 95.8% ------------o-------------------4---------- t--------------- ------------------ 20 ---------__-40_6 ----- ------_15.6%; ----------- 84.4% ------------A- ---- -5.5: 0 94.0 149.5: ___--_-41_9%: 58.1% ------------�-------------------� ------------- -------------------- 50 43.8 193.3:193.3: 54.2%:-- ---- ---- 45:8% ------------ ------- - -- 80 78.4; 271.7; 76.2% 23.81 100 ------__---_24_3: 296.0: ----_--76.2%i----------------23_861, 200 37.1 333.1 ---_--93.4%a________ 6_6% PAN: 23.4: 356.5: 100.0%;----------------- 0_0% SAMPLE: 356 5;. NOTE: TEST'ON PASSING#4 ONLY, 21% RETAINED ON#4 <45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-3 (GRANULAR, SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE MEETS : #4 100% (TEST ONLY MATERIAL PASSING#4) #50 100/6-100% #100 00/6-20% #200 0%-5% REQUIREMENT FOR"FILL" IN TITLE 5. <5%PASSING#200 SIEVE, O.K. FOR USE IN LEACHING FACILITIES RESULTS: PERMEABLE MATERIAL- CLASS 1 <5 MIN./IN. MATERIAL A down cape engineering, inc. SIEVE SOILS ANALYSIS_DAVE_MASON_2 NONCOMPACTED SOIL DESCRIPTION: FINE TO MEDIUM SAND Y v� 0 . 4' 'TOWN OF BARNSTABLE LOC,XXC, ON �� b'�iO3�totlq�i�� SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY ' Q LEACHING FACILITY:(type) ; (size) 000 NO. OF BEDROOMS PRIVATE WELL OR UBLIA� BUILDER OR OWNER ` e&%` S®\� ® irej x DATE PERMIT ISSUED: C/> DATE COMPLIANCE ISSUED: 1 VARIANCE GRANTED: Yes No f e o Lk o' r . ,. .. . .., -N .. /. - ♦ .+n ..i. 1• •r . .w .vim ., Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: C.© 5a xl ilce,5l / BUSINESS LOCATION: c�. 12c�` t`'� 5?k7z C MAILINGADDRESS: �f��f �"_ Mail To: TELEPHONE NUMBER: ,5`95 -Y-Z?-7a 70 Board of Health Town of Barnstable CONTACTPERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: ,� 'T� Hyannis, MA 02601 TYPEOFBUSINESS: S e Does your firm store any of the toxic or hazardous materials listed below,either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or.coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil / NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Paint brush cleaners Any other products with "poison" labels (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) --,,;may-may be toxic o'r4iazard please list): Spot removers & cleaning fluids (dry cleaners) Other clesaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS v � 2 .: ASSESSORS MAP NO: I No.. _ PAROEL N0: Fss. .�- THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Allp irtation for Dispati al Works Tnnitrurtinn thrutit Application is hereby made for a Permit to Construct ( <or Repair ( ) an Individual Sewage Disposal System at, .....�- �" / %r fit. La e . / .�L ._....:".-:V< <3 z 1 sf•g 3 4'a . - . .... .................. ..e- -- ---- Location•Address / or Lot No. SL "Z ems./� "—'r—u jt ©1d , _te /32 Ow er -yam A dress �... �"t, c-, C ...._...................... a l -�-----�..�.v>S�..--••••...•--•......-•--- -••----•-- f•------••-••......•....--� •........................ v-� Installer Address Type of Building Size Lot___j.�'. g Sq. feet �- :.... Dwelling—No. of Bedrooms............3...........................Expansion Attic— Garbage Grinder pa, Other—Type of Building ___ ... No. of persons___________________________ Showers ( ) — Cafeteria ( ) a Other fixtures ...................................................... W Design Flow........................ per person pep day. Total daily flow.._..._......_--�.�'..o...._._....gallons. t V �i WSeptic Tank—Liquid*capacity`d A�..gallons Length.A_..6.._�� Width... Diameter________________ Depth_---`_....._.9 x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-___._.-•---..-_----sq. ft. Seepage Pit No---------/.......... Diameter.._.__ ..._ Depth below inlet............... Total leaching area..33.4...sq. ft. Z Other Distribution box ( �f Dosing t � L 2 �-s e e '�' Percolation Test Results Performed by.-_.. _o.wh-•.C....o!#---........... ................. Date.... _ .....__. a-1 Test Pit No. 1...-1�_<`�r__minutes per inch Depth of Test Pit____j. .�...... Depth to ground water._-1._ ._...:�� ri, Test Pit No. 2---:.. minutes per inch Depth of Test Pit_____.q..._... Depth to ground water..... � . O Description of Soil-•-•--/' 2�r..c�`^'�._....��.'_?... � . . f V •••.....••••-••---••------•-••••••••-••----•--••--•••••••••--•--•-•••-•--•-----•-••---••••••••••----••••••••-•-••-•--•-•---••--•.............. ......................................................... ••-••-•---------------•----•...--••--•---------•-•-•--------••-•-------•-•-••-...-•-•••--••-•-----•----•••••-••-•--------------•----•---------•-----•--------•---••---•-•••......-••••-••-------.•••••. UNature of Repairs or Alterations—Answer when applicable................................................................................................ -•-•-----•-•-•••-----•---•-•---•-----•--•-•-••--•-----••••-•••••----•-••••-••-•••••-••..............•-•••-•--•-•-•-••-----------•---•-•----•--------•----------•••-•-•-••--•-••••-•--••••-••••......•-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation unt a rti cite of Compliance has been issue by the boa.W of health. or • ... ---- .. --.• - -- ---- A Iication A roved B - --------- Application Y ---•••••- D ate Application Disapproved for the following reasons----------------------------••-----------------------------•-----------------•---------••---••-----•--------•---- -••••••...--•---........-•---••-••-•-----....••••---••••••-•--•--••----.....-•.............................•--._...•-•-•-•-----•-------••••......-••---•------••-•-•-••••---••-•...-••---•---••-•-•---- [ Date PermitNo......................................................... Issued----........ ' b � Date L------ • - i No�S- .& 2 Fss..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .. ........... . OF. ...................................... ........................................ ApplirFatiun for Uiupuual Works Toutilratrtiun ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: 77 =::..... ......... ...... ............................................. •- Location-Address '� ' s * c f�' .or Lotto .� / r� f ! _..... ....._`:_......_........................4'ei..i .,�._.°.._..:.✓..x:_.:r......_.__.._ _......---------._....'---.....................=--._.............. Ow ^. �1 Address Installer Address OI ,7 � ClC Type of Building Size Lot.......,..:.................Sq. feet U Dwelling—No. of Bedrooms..........._*��............................Expansion Attic.•("'}"°"' Garbage Grinder�'� P-4 Other—Type of Building __(____ u__^ ..._ No. of persons........`I----------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ......................................... Design Flow________________....... ______� - .__gallons per person per day. Total daily flow............._..�__ ............gallons.a WSeptic Tank—Liquid capacity -J_ "._gallons Length. ___ '_` Width__ ___f` Diameter________________ Depth_ --------- Disposal Trench—No..................... Width.................... Total Length....._.............. Total leaching area----------_---------sq. ft. Seepage Pit No......... Diameter..... Depth below inlet__............... Total leaching area.• '_!!_! l...sq. ft. Z Other Distribution box (f, T Dosing tank-'(`" ' Percolation Test Results Performed by.___��.---_ � -__� �____________ Date...p _ =:!'�!�.�...__-. aTest Pit No. 1._' n_` minutes per inch Depth of Test Pit._....:- .......... Depth to ground water____'__*______ Test Pit No. 2... ___:'...minutes per inch Depth of Test Pit__Z_..Z._`.._.... Depth to ground water.... .=p..g.......... �+ . ••---•,-••••-•-- _... •----••-----------•------ O Description of Soil C`�s ....-z 7 ... •....r. �................�--�=------------•---------------- x = �; U •------------------ ----•-----------------•---------- "•------------------------•------•-•--•--------------------------------------------•-------•----------------------•--------•----------- W ••--•--••-••-----•----------•-•--•-•---••••-•-••......-•-•-•-•--•--••-----------------•--•-••-----------•-------------------------•-•••--...--•••------------•----••--•-••-•••-••----•••-••--•------•••- UNature of Repairs or Alterations—Answer when applicable......................................................................._....................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions r1 .� 5 of the State Sanitary Code- The undersigned further agrees not to place the system in operation untr Ce titicate of Compliance has been issuefi by the board of hheaa h --.-!Signed r� - :� `� X.__.... ...--- `� ._. - - - A lication A roved B _ � a� PP PP y.=-= ---- ----- -- -------- Date Application Disapproved for the following reasons:___•_•______•___________________________________•__•__•_•_••_____________•••_•_______....__...................._ -----------------------------------•----••---------•---•-----......_.........---•--...----•-•---•--••••---•-•-•••--•••--•--..... --------------- ---•--. ------------------------- �e--7r-' Date PermitNo--------------------------------------------------------- Issued_--------- ......................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................ra............ .................................................................................... (9rdifiratr of ToutpliFanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ="j or Repaired ( ) S - ..... 'mil 1 Ins at_ ,. .............. ! s.................................... r y... r taller(V.' .. -I4? t.. z. . ri .. has been installed in accordance with the provisions of TIT IE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._..S..�..... _ ��... dated_... °{ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... --.3D' ............................ Inspector.....................Q1,-a .............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � ..,)..., OF.. .. . No.�i.. FEE......,.:, ......... �tu�ouatl murk$ �on,�#rn�#ion �eruti� Permission is ereby granted ....................= ' '= .�--=----------------•--- to Construct or Repair ( ) an Individual Sewage Disposal Systemat `------......•• --•a----- ...... •--- Street as shown on the application for Disposal Works Construction Permit No._'_.. _ Z.Dated........... .0 .... ------ - Board of Hearth DATE-------- 11.._ ��.. •••---- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ASSESSORS MAP : TEST HOLE L.O G - NOTES: PARCEL: S /oCr/� ' SOIL EVALUATOR : I:)AVli� �j, � L FLOOD ZONE: ,- /....... , '` .:. — v _ ..._... . u _.,., 1d� O 1L7 1 The installation shall comply with Title V and Town� WITNESS : �� d I �J' �,� ) p y ow of Barnstable Board of b REFERENCE: 4: 12T7rl �.. 1'9' DATE: N 7J, . 2100 Health Regulations. PERCOLAT 1 ON RATE : 2 The installer shall verify the location of utilities sewer inverts and septic components prior to installation and 0 0 Z setting base elevations. 3 , r 1' � ,/�� ) All gravity septic be 4 inch Sch 40 PVC at 1/8 per foot. The first TH 1 two feet out of the d-box to the leaching shall be level. 4) This plan is not to be utilized for property line determination nor any other purpose other than the proposed system installation. 5) All septic components must meet Title V specifications. ---- ' . � o 6) Parking shall not be constructed over H10 septic components. `� 7 The property is bounded b property corners afid property lines. - �b � b ) P P Y Y P P Y P P Y LOCATION MAP �S. _------ ' 116.65 i t _-- �' t U9" ¢, 8) The property owner shall review design considerations to approve of total ►R LO�`to to &7 0�1V design flow and number of bedrooms to be considered for design. Receipt (PLO Iv (-I- 0 of payment for the plan and installation based on the plan shall be deemed *40 10 approval of the design flow by the owner. 1 ` 9) The existing leaching or cesspools shall be pumped and filled with material per Title V abandonment procedures. Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean washed 1 � IF`b Q 0419 NO.�.� �_�.:�� '�- sand per Title V specs: Cc�. 10)System components to be 10 feet from waterline. Sewer lines crossing the _.. . ...... ... .._,.. ..,.._ -___.__ _.:.._. _.__ water line shall be sleeved with 4;inch SCH 40 PVC with ends grouted if SEPTIC SYSTEM DESIGN applicable. j 11) If a garbage grinder exists it is to be removed and is the responsibility of the lv� owner to ensure such. FLOW ESTIMATE, 12)The installer is to take caution in excavation around the gas line. 13)The installer shall verify the location, quantity and elevation of the sewer ,L BEDROOMS AT GAL/DAY/BEDROOM GAUDAY lines exiting the dwelling prior to the installation: - 14)Excavate 5 feet around the SAS and below to a depth of approx. "ce.,a f SEPTIC 7ANK elev.80:78/Fine to Mediurp Sand and fill with clean sand per Title V ,/� � GAL specifications. � �' G:j�#,./DAY x 2 DAYS 15 Relocate existing water line to be 10 feet from proposed SAS as shown. 1 ff ) g p P 1 NE {Lk� GALLON SEPTIC TANK (EX 1 ►ua(.�. kiM t e v}ctr c �+E 1 21►�i rZ2 _. _ 411J�11 j4 is ti o-a Aae �; SO I L Ail° ORPTiON SYSTEM ! � _ , 1 tom.adz � ��t ft(A it 1�2- U� 1�J " r 1 00040 VIOL.-At — j 1 0� S Dc AREA: z P ti�j �C 1 ,.l�Y, I St l',► T. i3e-T'i OM AREA: b — jt�,p} ,tom ?"';` EXISTING1 y—� E) LLIN TOP OF FNDN SEPT I C SYSTEM SECT I ON 1 - 1 EL Vp WkX . 9 1 ID l5 Ff `J1D, 0 f p—Box,, ,6Z. CI GAL 0, '� �''�.. . �..�. .. , _. 0 � I 1 g � 78 58 SEPTIC TANKY tit :,, to �, 3 �_ . .�.._-�l31� ►�'��ili ':7 _�_ '�` vA `, I�,� � �: ,y -, Vic.►ST��I _ _ ill. Dr I �0 SITE AND SEWAGE PLAN LOCAT I ON : 'l o�Ttr~�1 � /-,qA/� FOR ; i Qo�l Q' Q�� PREPARED �� GE (7F< PAVEMENT W � +>rl ., �\ E3RED Q 0 2 SCALE:�� TIND � �RO B . MASON DATE: IZ Z Zao DAVID � . 7 DBC ENVIRONMENTAL RONMENTAL DESIGNS Z Qw NE EAST SANDWICH . MA z DATE HEALTH AGENT 3 t508 ) 833- 2177 - W �L I� �[..e.lJ� I I BENCH MARK TEST HOLE RESULTS P# ?- ?- a DATE : W I T N E SSE D BY _ 7-o tvi K E-A �/' J3.0.J••l• 1y) . M UG, tq Zyw.-/ C'AP o TEST HOLEx1, E_a o TEST HOLE 2L 80a0 S 7-(:D p „ S vI3 . o t�.- W S v X3. o ,c / © T' T a C co N 7 e,;4) C.. T 7 z ,t... 0 7- 7 ! ' a 7- 2 9 �, • tjG >''' D /1 7- 7— o� • �- C 7- 2 2_ ^® GROUND WATER �LO GROUND WATER ENCOUNTERED ENCOUNTERED 13Fn��H M c lb�_ MANHOLES AND COVER TO BE BUILT TO 80 . q�, , ELEV. TOP OF " JOpo �G . w aw t`� ;�A at 8© to FOUNDATION WITHIN - 12 OF FINISHED GRADE o 5Ef'Tic FINISHED GRADE MIN. 2 /o SLOPE °, i/ �•' _ 4" DIA. ---- _ ---- 4° DIA. PIPE FIRS 2"Ml l - MIN. 2� LAYER OF _.1_7-. -P 1 E -.. .. . i . : � .^'1' w. M I N. TCH � FT, LEVE , f H J O 4 An-1 �° ' /� MIN. PITCH fir Sol- -A; 1�8'••�2' PEAST0NE 4 a�-- 2 /,cO o 14 F T. L ln�uv 8 0,c 1T 7 F 8 3 '. / INVERT // h/ZOGALLON INVERT 6"J"*4p INVERT _*0 �Q ��; . ry • $C7,S'Q F3p00 DIST ., ® ' a m �4''' I �2 "DIA. SEPTIC TANK 7 5,0 ® -G Oct •,. INVERT `% wU_ ©.' WASHED STONE- = i4.7 r-,° --- �. '� loom Gi, >.c. . FOOTING TO BE, PLACED :. INVERT eox �0 ON A MINIMUM OF 18 OF PLACE �N N2o INVERT �q� � � �,�; ALL AROUND a. p ,, a ... , . VIRGIN OR COMPACTED � > FIRM BASE b rS . M �`"""'. �.""�'� 2a'z� . c v BOTTOM AT ELEV. 72.Q - _ I0 I p ti .a G 3 SAND GARBAG E ( 2 03M1 N.) 3� + C? , •S 7`"q ,,�/,. r:,��' _ GRINDER r_ 4" DIA. PERFORATED - ;_ � ELEV. 66, 0 _ DRAIN PIPE WITH 3/4N PROF [ LE OF GROUND WATER TABLE TO I VZ ' DIA. STONE DIRECT FLOW TO goo SANITARY DISPOSAL SYSTEM �i9GG ® N .�, ,2yw4G-1- 4. ( NOT TO SCALE c��/E ) DESIGN ..DATA • . CONSTRUCTION OF SANITARY DISPOSAL 3 BEDROOMS SYSTEM ' SHALL CONFORM TO THE MASS, DESIGN FLOW 33o GAL./DAY ENVIRONMENTAL CODE TITLE -3= LEACH RATE 4 - 5"' MIN.INCH (REVISED 771-77) AND THE TOWN REQUIRED LEACHIN G CAPACITY ' 330 HEALTH DEPARTMENT REGULATIONS • SEPTIC TANK, DISTRIBUTION BOX AND LEACH- PROPOSED y" ` 30GAL,/DAY ING UNIT TO BE OF REINrORCED CONCRETE . 7->-l2} MIN. CONCRETE STRENGTH = 3000RS.I. REQUIRED SEPTIC TANK : /000 GAL. MIN. STEEL STRENGTH 20,000 -FS. 1. MIN. D E S I GN LOAD I N G PROPOSED SEPTIC TANK : /000GAL. • DRIVEWAYS NOT TO BE LOCATED OVER SYSTEM UNLESS H2O DESIGN LOADING IS USED • ALL PIPES AND FITTINGS TO BE WATERTIGHT AND TO BE OF CAST IRON OR APPROVED P.V.C. HEALTH AGENT APPROVAL- DATE PLANSITE SHOWING PROPOSED CONSTRUCTION ZONING DATA LEGEND LOCATION WEST BARNSTABL.E , MASS, FOR : LEBEL- SOLLOWS DEV. CORP. • A p co ini DATE ZONE : DP N_S A TtPr Z0/VE 2S� TEST HOLE LOCATION � ' � � � s'0 $ SHOWN ON : 3 2 REQUIRED 3s�o o8vo�' REFEREN CE LOT ,�'` A S REVISIONS &� Q AREA _- 14_� I EXISTING SPOT ELEVATION 17.6 REQUIRED FRONTAGE �50 37.5' _ _ ��Lxwof PLAN BOOK � � � PAGE TA E EXISTING CONTOUR I6 �,•� c .�`, 1Z o . REQUIRED FRONT SETBACK : -(3o) 3C�' ,�_ 4 PROPOSED CONTOUR 16 � . REQUIRED (�s) io ' A' SCALE • - o EQ IRED SIDE SETBACK PROPOSED WATER SERVICE -W- REQUIRED , REAR SETBACK : PROPOSED GAS SERVICE G----- AL 23 Do �4 , , '►; a ilc-7 4 ©� � '�3/8 7 PROPOSED ELEC. a T E L E E & T C RAI G R . SHORT , P. E . r _ f PROFESSIONAL C IV I L EN G I N ESE R BUILDING INSPECTOR APPROVAL DATE 131 OLD ROUTE 132 HYANN IS , MA, 02601 FILE NO. -s TELE. (617 ) 362 - SHEET I - OF BENCH MARK : . " TEST HOLE RESULTS ' . DATE : WITNESSED BY Te nn K ErA l\/ TEST H L x � �_0 E 2, E_l,v o TEST HOLE 1 AFC. 60,0 \ S V J3 s 15 L79,0 2 a .5v13.so>L 77 4107- 74 3.8 7 ±s f q� J o S/3*'.S �' 1 ,rill ,1- k� ;O �.J r. ��e� �''' w//5/L T T CJ 14 4 L. G o 9, 1 .{ •q F_ L. �o J 0 N OVr G,oq��4 No G 0 U /✓o 7� R ND WATER . _ GROUND WATER ft ENCOUNTERED ENCOUNTERED loon ' `V� �° ° � l '• / r ` `''� - MANHOLES AND COVER TO BE BUILT TO LEEV. TOP OF WITHIN 12° OF FINISHED GRADE Z3 qy / E'�Ti c �`_--�- w�<< �A FINISHED GRADE MIN._ 2% SLOPE 3 • +� �� 4 DIA. _ 4„ DIA. PIPE FIRS NI / ea�y'� R�•s.�•r�V�: ° / � `; _. � _. _ MIN. 2" LAYER OF 4. i� e PI E _ . „V. MIN.PITCH FT. 2� LEVE "-_. ` h91N. PITCH mw•. w. 1#1 PEAST0NE �9 0 T- �.©� I n�ay. 8 0.2.5 . Z./ M . �4%F T. LQQQ_ 7 9 8 3 .. INVERT :.. N20GALL0N INV O 6. s"g~ INVERT � N� tD t" • , - i �i Es'CJ�i'Q EPTIC TANK a DIST, ,; ® ~ - -• I r ® �Q m� �4 �2 D IA. - �'9. � p /ovl.c. . FOOTING TO BE PLACED .•� INVERT _ INVERT eox 78,0 GAWZ v.•.• WASHED STONE - - -- r ON A MINIMUM OF- 18 OF =• , N2o INVERT. _ . , , u d .t 3� 1 �-/ VIRGIN OR COMPACTED �'> /v . PLR (CE9A E r •. vo aQ m� ALL AROUND `� �•` T �/✓ 10' MI FIRM �e -• --►� Zo' v 6t•' BOTTOM. AT ELEV,72.0 T SAND �� ,0=- � 7—Q °�.; • ; A(O GARBAGE ( 2 O' M I N.) 3' G• 3' �`- , _ GRINDER ' lNST_ 4" DIA. PERFORATED - � - ' ✓ DRAIN ,PIPE WITH 3/4" ELEy. GB. o © TO I V2 DIA. STONE PR O F I• L E OF GROUND WATER TABLE o � - DIRECT FLOW TO o SANITA-RY DISPOSAL SYSTEM BALL � �✓ .-0 /ZyWG-1- 4- ( NOT TO SCALE ) N E D E S I G N DATA • CONSTRUCTION OF SANITARY DISPOSAL 3 BEDROOMS ' SYSTEM ' SHALL CONFORM TO THE MASS. DESIGN FLOW 33O GAL. DAY ENVIRONMENTAL CO.-DE TITLE r/ LEACH RATE - MIN. INCH(REVISED 7- 1-77) AND THE TOWN . HEALTH . DEPARTMENT . REGULATIONS REQUIRED LEACHING CAPACITY : 330 • SEPTIC TANK, DISTRIBUTION BOX AND LEACH- PROPOSED Affto, 43�0GAL/DAY ING UNIT TO BE OF REINFORCED CONCRETE : 7_ •-l2) - 0. G ?J>-, c) MIN. CONCRETE STRENGTH 3000PS.I. REQUIRED SEPTIC TANK /000 GAL. MIN. STEEL STRENGTH 20,000 -FS. 1, MIN. DESIGN LOADING : PROPOSED SEPTIC TANK : /000GAL. • DRIVEWAYS NOT TO BE LOCATED OVER SYSTEM UNLESS H2O DESIGN LOADING IS USED • ALL PIPES AND FITTINGS TO BE WATERTIGHT AND TO BE OF CAST IRON OR APPROVED P.V.C. HEALTH AGENT APPROVAL DATE SITE PROPOSED PLAN HOWING � P POSED CONSTRUCTION MONZONING DATA LEG END LOCATION : WEST BARNSTABLE MASS. F 2s,$ FOR : LEBEL-- SOLLOWS D EV. CORP. DATE : �,�'Z O N E : 0PwN SPACE IN 12Pr' •ZON TEST HOLE LOCATION 4�_ REFERENCE LOT 171 AS SHOWN ON REVISIONS : F .REQUIRED . AREA � _ _,�43SGo� Io,89o" EXISTING SPOT ELEVATION 17.6 REQUIRED FRONTAGE :_ / TO) 37.5' EXISTING CONTOUR 16--„ Q PLAN BOOK PAGE REQUIRED FRONT SETBACK : -�3 0) 3 0 l ��' � �,�"�.. �✓°', rz ,�''� . o �• 1'7,zw.:�- t� .� PROPOSED CONTOUR � ,,- REQUIRED SIDE SETBACK / O' er . SCALE - PROPOSED WATER SERVICE --W 2i483 REQUIRED . REAR SETBACK ,Ve) PROPOSED GAS SERVICE GPFA;e o V-OQ 4 cla"/ �3/a --- /!87 PROPOSED ELEC. 8 TELE E & T CRAIG R . SHORT , P. E . PROFESSIONAL CIVIL EN OI N ESE R B U I LD I NG INSPECTOR APPROVAL DATE 131 OLD ROUTE 132 -. HYANN 18 - � MA. 02601 FILENO. TELE. (617 ) 362 - 9 JI-) SHEET OF ! 7