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HomeMy WebLinkAbout0153 WHITE BIRCH WAY - Health 1_53 WHITE BIRCH WAS, 1z , �, M �; � , i -. ' � `� �;.._.. � � �� ��� .a..._.._�_ � �.....� . . ,,�; _ ; ,��'�t � r t�- �. � �� i .,_ `s t ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. Ma 02668 5-18-11 W Barnstable C state Zip Code City/Town Date of Inspection 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 A. General Information filling out forms I 1, on the computer, use only the tab 1. Inspector: key to move your p cursor-do not David J. Burnie use the return Name of Inspector key. David J. Burnie Management, Inc �y Company Name 3 Perry's Way Company Address Harwich Ma. 02645 Cityrrown State Zip Code 508432-0223 SI 386 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�m1aintenance-of orti to sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15,340,of Title 5(310 CMR 15.000).The system: = ( ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 'Axe* 5-18-11 Inspector's Signatu ^�� Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•!!/!! Title 5 Official Inspection Fom:Subsurface l S 1 of 17Sew a a f Commonwealth of Massachusetts Title 5 Official Inspection Form WSubsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system per plan calls for a 1500 gallon septic tank a distribution box and 3 flow diffusors and'-to be stone lined. We were able to verify the Septic tank, the distribution box and enter the leaching , using a sewer camera. Please note that we were able to locate the diffusors and they are within 5' of the in ground swimming'pool and in fact may be closer than 5'. They may also be partly under the pool. The state regulations do not classify this as a failure. I contacted Tom Mckeon the Barnstable Health director and discussed this situation and he informed me that the town of Barnstable follows the state regulation and does not have any further requirement and that this would not cause the system.to.fail. B) System Conditionally Passes: ❑ one or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-09/08 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 M 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 City!Town State Zip Code Date of Inspection B. Certification (cont.) 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, t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 N Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 City/Town State Zip Code Date of Inspection 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 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: ** lif rm This system passes if the well water analysis, performed at a DEP certified laboratory, for co o � 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: U D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No t5ins•09/08 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every Ma 02668 5-18-11 page. V1/Barnstable State Zip Code City/Town Date of Inspection ❑ ® 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 '/2 day flow B. Certification (cont.) Yes No El ® 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 t5ins-09108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts a u . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 Cityrrown State Zip Code Date of Inspection ❑ ❑ 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 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 upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined?(if they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] I t in •09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 5 s f� 9 Y Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is required for every Owner's Name page. W Barnstable Ma 02668 5-18-11 City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 349.2 per plan D. System Information Description: The system is a 1500 St distribution box and 3 flow diffusors per plan dated 10-2-95 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last ears usage d well 9 ( Y 9 fgP ))� Detail Well Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 x u S Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments .'� 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every Ma 02668 5-18-11 page. W Barnstable Cityrrown State Zip Code Date of Inspection 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: D. System Information (cont.) Last date of occupancy/use: Date I Other(describe below): General Information Pumping Records: Source of information: None per BHD 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 t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every Ma 02668 5-18-11 page. W Barnstable City/Town State Zip Code Date of Inspection ❑ 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): D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Plan on file BHD dated 10-2-95 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 26"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): OK Septic Tank(locate on site plan): 20" Depth below grade: feet t5ins-09/OB 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 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 City/Town State Zip Code Date of Inspection Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 2-4" Distance from top of scum to top of outlet tee or baffle 20" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? estimated Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank should be serviced every 2-3 years depending on usage. t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 110 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M °r 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 Cityrrown State Zip Code Date 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 D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every Ma 02668 5-18-11 page. W Barnstable Cityrrown State Zip Code Date of Inspection Design Flow: gallons per day Alarm present: ❑ Yes ❑ No I 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 D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): Normal level. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 153 White Birch Way Property Address Edgar Sullivan Owner information is Owners Name required for every page. W Barnstable Ma 02668 5-18-11 Citylrown State Zip Code Date of Inspection Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Located, pipes in flow diffusors were dry, no standing water. D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 3 per plan ❑ 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.): t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 Citylrown State Zip Code Date of Inspection No signs of failure. 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 D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: ` Dimensions Depth of solids t5ins•09/0B Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M yvayr 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every page. W Barnstable Ma 02668 5-18-11 City/Town State Zip Code Date of Inspection Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is required for every Owner's Name page. W Barnstable Ma 02668 5-18-11 Cityrrown 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: 1419"feet Please indicate all methods used to determine the high ground water elevation: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 J. 6!"r41A .�hw q-c • J qc% Lit C T 40 1 it - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 153 White Birch Way Property Address Edgar Sullivan Owner information is Owner's Name required for every Ma 02668 5-18-11 page_ W Barnstable Cityfrown State Zip Code Date of Inspection ® Obtained from system design plans on record If checked, date of design plan reviewed: 10-2-95 ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Plan on file ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: See below You must describe how you established the high ground water elevation: We did a hand auger at the lowest location on the property and found water at 57' below grade, using a laser level we set grades to the location of the leaching. The water is 14' 9" below the grade at the location of the leaching Before filing this Inspection Report, please see Report Completeness Checklist on next page. 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 jr� pt liAipyj�. RE sE!V . p 4 CERTIFICATE OF ANALYSIS age '¢ Barnstable County Health Laboratory J U L 2 3 2003 Report Prepared For: Report Dated: 7/17/2003 TOWN OF BARNSTABLE HEALTH DEPT. Sullivan,Patricia Order Number: 153 White Birch Way West Barnstable, MA 02668 Laboratory ID#: 0320650-01 Description: Water-Drinking Water Sample#: 20650 Sampling Location: 153 White Birch Way,West Barnstable Collected 6/24/2003 Collected by: Patricia Sulli Received 6/24/2003 Routine ITEM RESULT UNITS MCL Method# Tested LAB:IC Lab Nitrates 0.2 mg/L 10 EPA 300.0 6/25/2003 LAB: Metals Copper 0.1 mg/L 1.3 SM 3111B 7/3/2003 Iron 1.2 mg/L 0.3 SM 3111B 7/3/2003 Sodium 12 mg/L 20 SM 3111B 7/3/2003 LAB: Microbiology Total Coliform Absent P/A Absent 307 6/24/2003 LAB: Physical Chemistry Conductance 103 umohs/cm EPA 120.1 6/24/2003 pH 6.1 pH-units EPA 150.1 6/24/2003 Note: Based on the results of the parameters tested,the water is suitable for drinking,but may present aesthetic problems(taste, odor,staining)due to Iron. Approved By: (Lab Director) i . I Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 F - ^ -i e. - � � u p -����� .x, � a •g � �. � .'y,?� � 4 is �I fo Vp r 4. L x r • _ a - » ¢ ,'� •< � 6 �3„ ei 1, , a R � n 4, asi a:{ it y A e' sp v , � - S� U ay a :., t yr e a •! x a °§ 4, '0 a ✓:,v r, x ss. i".i"i 6` R S ii'+. „ 4h10 Date: ) 1-(?-Cf) TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS:MncX�c 1 nfVC\nM C)e- Xr,ODr_Q1--- BUSINESS LOCATION: 63 19�: . . 5 MAILINGADDRESS: al`ab Mail To: Board of Health TELEPHONE NUMBER:43-8- S 1 l°l Town of Barnstable CONTACT PERSON:,' XCI- :: cY P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: LOuYdSz ccaeioQ 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: iSL-t) i_hile 1131f- ij\ t�� ��: I'.�rn�l�W-, TELEPHONE: 1 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) �qae 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 Any other products with "poison" labels Paint brush cleaners (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 be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 1 1- la-C4 ) Vj TOXIC AND HAZARDOUS MATERIALS REGISTRATION ,FORM NAME OF BUSINESS:Fnnc�r,Y Id Lh t�,C'� Oe 'Ue lr �YY1Q �-- BUSINESS LOCATION: 1S3 Lcjrl' (c [ S lo) MAILINGADDRESS: Q0 eDCA a)iab a nk Ni L . Mail To: Board of Health TELEPHONE NUMBER:�a8- `S� VCI Town of Barnstable CONTACT PERSON:,'`�CY >-�-� c�Y Lie(u l�l Q _ P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: Laoc1SCc e nG 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: ►S--:t) tL-)V ►i -e, (�,rc h t� � , �. l r�n�ra►b e_- 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 US.ED___. ... insecticides', herbicides, rodenticides Gasoline, Jet Fuel Photochemicals (Fixers) .5Qo-k 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 Any other products with "poison" labels Paint brush cleane,(s (including chloroform, formaldehyde, Floor & furniture s rippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS z 05-01-1997 11:17AM FROM SWEETSER ENGINEERING TO 7753344 P.01 S WEETSER ENGINEERING P.O. BOX 713 - SOUTH DENNIS - MASSACHUSEI I OZ660 TEL (508) 398-3922 FAX (508) 398-3063 LAND SURVEYING ENGINEERING FAX 'l?JVS ITM anzE: Sh�9T TO: z4wD12E�AW477-Y FAX t: 77S 3�s!Sl FROMI: RF,P>rW7-E/PRWWr: JOB #: — NUMMM OF Sql= (INCLUDING COVER): r a i 05-01-1997 11: 18AM FROM SWEETSER ENGINEERING TO 7753344 P.02 S WEETSEA ENGINEERING P.O. BOX 713 - SOUTH DENNIS - MASSACHUSETTS 02-660 TEL (508) 398-3922 FAX (508) 398-3063 LAND SURVEYING - ENGINEERING November 12, 1996 Mr. Edward Barry, Health Inspector Barnstable Health Department 367 Main Street Hyannis, MA 02601 Re: Lot 4, White Birch Way, West Barnstable File #3643 Dear Ed, On 10/22/96, I made an on-site inspection of the installation of the septic system for the above referenced property and found the system to be installed as indicated on the "As-guilt'- plan prepared by me on 10/22/96. Your attention is directed to the notes on said plan. If you have any questions, don't hesitate to call. Very truly yours, Theodore A. Dumas, R.S. LEA 7LC) 7wTY(AREA X RATE) %. �q'�Z�'CK../DA' �. f'-••.• .� - GOD// RESERVE LEACHING CAPACITY s'9'i CAL/DA` l9 i NOTES: m 1.ALL WORKMANSHIP AND YATERLAV SHAM CONFgR11 To QEP. d �9 frNOcr J TITLES AHD THE THE Of R �"� RULES AND • Aec.� i J REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWA.^f. v / S,�tC( C �: 7hNlPtf>tp IA/Ra/9G / • 2 NALL COVERS To SANITARY"'l►ta 6',OP FlN19®CAAGETS SHALL 8E BROlJRIT i0 cl M f Si9ccer.! pDE_�/Vo VEN;- - ../ - 3.ALL COMPONENTS OF THE SANITARY SYSTEM SH^U BE CAPA9 1YlTHSTANOWG H-10 LOADING UNLESS THEY ARE UNDER CA M 11ll / 10 FL OF DRIVES OR PARKING AREAS H-20 LO^DNLC SHALL USED UNDER OR`WITHIN 10 FT. OF DRIVES OR PARIDHC ARE.AS 4.ANY MASONARY UNITS USED TO BRING.COVERS TO OWE R%A • / BE MORTARED IN PLACE. • S.►4O OETERMWATIOH HAS BEEN MADE AS TO COMFJANCE VAT►. D:r^JM N.ZONING,REGULATIONS.ouwr-R/APPLJCJNr IS To OBTAIN SUCH DETERMINATION FROM APPROPRIATE:U'AUTHORITY. APPROXIMATE UTILITIES SHOWN ARE APPROXIMATE ONLY.CXCAVATGN CONTII. IS TO CALL-DIG-SAFE' AT I-8OD-322-4a44 A4•LEAST 12 V. K ON ly- I. CONTRTACTOR IS TO VERIPRIOR COMMENCING FY GRADESI AND ELEVATIONS AS W-tL � O i � SITE CWiDlTONS PRIOR TO COMYR7CINC WORK D7•4 SITE.SITE.�-aa y _ I B.PARCEL IS IN FLOOD ZONE C� 9. LOT IS SNDPM ON.ASSESSORS MAP IZ AS PA4CEL I ! . i• 3�O -- -� -_ � � !p, pppgg« J•+!✓,rARc:M9rtaiA� JN.ytl tG-P. ` I - n � �•9� '. � / / r/LO�•✓OV JO C2•10f Ra.re.,J J rrlriw~'i�.-•Y C-r • / b �'� ftiy / /,Q rlY•-il Al•tom/ef P�f�i•+ I� j � 1,yr• L W !-. / J!O GH/Z !S.LS�'(TJ. W t ° ! II W `Z1 APPROVED: BOARD OF HEAL i in 3 1 - ' '� DATE AGENT U) ,00 a'All PROPOSED PLOT PLAN - r►, \ FOR k LL OD / ` PRO•ECT LOCATION L r S! 5 in ' G SWEETSER ENGINEERING ! 4 ( 235 GREAT VFSTERN ROAD OQ SOUTH DENNIS, MASS.P• 0. 90X71317 51398-3922 02E �¢01) p {'6'� —SCALE �. _2V DATELr S of 2G,/95 0%% C REVISED � -i � __ -.__�� A(/ mot- ... 'N�� %�'. •r../ •.t ._.. .._ -...�•-•' • .-.� ' 1 h,` S WEETSER ENGINEERING P.O. BOX 713 - SOUTH TENNIS - MASSACHUSETTS 02660 TEL (508) 398-3922 FAX (508) 398-3063 LAND SURVEYING ENGINEERING November 12, 1996 Mr. Edward Barry, Health Inspector Barnstable Health Department 367 Main Street Hyannis, MA 02601 Re: Lot 4, White Birch Way, West Barnstable File #3643 Dear Ed, On 10/22/96, I made an on-site inspection, of the installation of the septic system for the above referenced property and found the system to be installed as indicated on the "As-Built" plan prepared by me on 10/22/96. Your attention is directed to the notes on said plan. If you have any questions, don't hesitate.to call. Very truly yours, Theodore A. Dumas, R.S. 40-1] LE TO F B� ARNST,,AB LOCATION C6 —! , e lG,/vl SEWAGE # 9^6 6` '7�� VILLAGE 1�4�5 i4 Vv ASSESSOR'S MAP &LOTS "<2P INSTALLER'S NAME&PHONE NO. A�O�'Jl S $ �g SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 3 �!�`��/,"C�vS (size) NO.OF BEDROOMS 3 FOR OWNER PERMIT DATE: � COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 uo Pf6 l0 No. FEE / THE COMMONWEALTH OF MASSACHUSETTS C , MASSACHUSETTS ._ �yyfirativn for Pispusttt �$VstPz (fvnstrurtivn Ilerntit Application is hereby made for a Permit to Construct( or Repair( )an On-site Sewage Disposal System at: Location Address gr Lot No. LB,T_ Owne�r'sjmy/ d s and lel,wo. c®r�- 1 ���z� Installer's Name,Address,and Tel.No. Des i er's Name,Address an 1.No. ^.l`l'.�16=r4L=./Z %.✓ 4:�— V 3 -pe-��eis;l�J� ���3�zz Type of Building: r� Dwelling No. of Bedrooms / Garbage Grinder Other Type of Building No, per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow l�� allons per day. Calculated daily flow gallons. Plan Date ���T, Number of s eets Revision Date Title Description of Soil IC'e__*-AJ Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Titl 5 of the E ental Code and not to place the system in operation until a Certificate of Compliance has been i ued is Boa ealth. Signed Date Application Approved by �✓ Date Application Disapproved for the following reasons Permit No. ��" ��� Date Issued O Jt J-✓� Vim,.. '' } F o+ c/ •�' __ ` ,•Q O— r i'EEE THE COMMONWEALTH OF MASSACHUSETTS MASSACHUSETTS tom-Ts _�yylirativn for Visposal *Vstera (fons#rurtion ITerntit Application is hereby made for a Permit to Construct( or Repair( ) an On-site Sewage Disposal System at: Location Address gr Lot No. G•T Owner's N me�d¢.c�s and :gl—No. 00W ,VV 7�U Installer's Name,Address,and Tel.No. ti Des' Aer's Name,Address and et.No. Ad 31j?39Zz Type of Building: " -Dwellirig' -No. of Bedrooms Garbage Grinder + Other Type of Building No. per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow q gallons per Calculated daily flow" �3U gallons. Plan Date / /9/� Number of sheets Revision Date Title OSE� rG/¢rJ f'o/Z AI Al SG4+7-T /fie e-Ria u ALAP Description of Soil r� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system 1w accordance with the provisions of Titl 5,of the E M ental Codeand not to place the system in operation until a clmrpia , a e y hts'BoA . . ," �r =e" Signed Tate Application Approved by '-TDate Application Disapproved for the following reasons Permit No � Date Issued 0 THE COMMONWEALTH OF MASSACHUSETTS t /I MASSACHUSETTS . ��\ C�er#tftr�x�e of C�um�Itttrcce _ THIS IS TO CERTIFY , that the On-site Sewage Disposal System installed( or re aired/re laced( ) on by • D� for C. 0 at J " t-� as ,gen c structed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.This Certificate expires on DATE % !� Inspector . THE COMMONWEALTH OF MASSACHUSETTS No. g-S -3 � .! �, MASSACHUSETTS FEE �0 v n �is�u�ttl ��s#em CZII>tts#ruc#tu>n �ermt# -�Permission is hereby granted to ,� o��" , to construct ( or repair( )an On-sit Sewage System located at /5-3 W Ct 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. i All construction must be completed within three years of the date below. DATE � -�' Approved by FORM 1255 Rev�3/95 A.M.SUIKIN CO.-BOSTON,MA - d , No.-i►�--{� �, wi Fee----r),, �- BOARD OF HEALTH TOWN OF BARNSTABLE ZippCication1brVell Congtruction Permit Applic tion is h eb made for a permit to Construct (1-1, Alter ( ), or Repair ( )an ' dividual Well at: Location dress Assessors�vlap a Parcel q� ------------------------------------------------------------ --- -------------------------------------------------------------------- Owner Address ----------------------------------------—-----------------—----------------------------- ------------------------------------------------------------------------------------------------- Installer — Driller Address Type of Building ���� Dwelling------ — Other - Type of Building------------------------------ No. of Persons------------------------------- Type of Well—----— —- Capacity -----Purpose of Well---------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. Signe a date Application Approved By -� —'q= _�S_:____ —------- —— date Application Disapproved for the following reasons: —------ ---------------- - --- ------------------------------—------------------------------------ ----------------- _ Permit No. -- � -- ---- Issued---X-' �— -- -date------------ date BOARD OF HEALTH TOWN OF BARNSTABLE C ertif irate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (✓), Altered ( ), or Repaired ( ) by-- ----------------—-------- --- - --- - -- - Installer �,- l-!m ffiWifta Cc da ------------------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --9/-fJr- L3-Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- ---- -- — -- Inspector-------------------------------------——--- --— { ..,i,�'1"1...,T+'-�ra�..r'."'"`r.`-.-. rµ'�" `'-€"►'„•✓.a.aw��e's`Yi-�.r«'�,.-.-� _._... �.;r..�r,.'r`.^+'+."�'.�7.r'�•'�'-aa'ti.�..,p*y.(`�r�r�....nta,-r ' � -.:>: __. _ ,. _.j.. Fee---- BOARD OF HEALTH � � TOWN OF BARNSTABLE Application forlVell Cootructionpern t Application is hereby made for a permit to Construct ( vT, Alter ( ), or Repair ( )an 'Individual Well at: - - �— Location — AAdress Assessors Map an Parcel Owner _ Address i ---------------------------------------—---------------------------- ---------------------------- Installer — Driller Address Type of Building Dwelling i Other - Type of Building-------------------------- No. of Persons-------------------------- i 4 Type of Well--------- -- - --=-- - Capacity--------------------- -- -- - - - ---- -=--— Purposeof Well---------------------------------------- ---------- Agreement: 1 The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of. Health. f. Signe ——— — date Application Approved By--- date Application Disapproved'for the following reasons-.---------------—-----------—------ ---------------------------— ------- - =---- - - --- -- - - - - -------- - date ---=--- 0 'Permit No. �t� `� -- Issued--- r c- '- — ; -------- 1 date BOARD OF HEALTH TOWN OF BARNSTABLE - Certificate®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (vl, Altered ( ), or Repaired ( ) by-- tangy- ----------- ---=--- - --= "------------- - -- - -----=-- - - ------ Installer at- 1.5 4--in I ffik1c -k T= _ I(_,5NCLUL----------------------------------------- ------ --------- has been installed in accordance with the provisions of the Town of Barnstable.Board oof�Health Private Well Protection Regulation as described in the application for Well Construction Permit No. - dJr� -( -Dated- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY: --- Inspector------------------------ t; DATE------------------------------------------ -------------------------------------- f BOARD OF HEALTH TOWN OF BARNSTABLE Well Congtructionpermit I'It No. ,,l Q� -�d�'--G-^-=-�5 Fee---- IIPermission is hereby granted-- - ' ---------- -------__--__-____ to Construct (v.4!Alter�,( ), or Repair ( ) an Individual Well at: N o. - -�! 1 -i�lLC_� i e a I_i -S---_� - __ --— --- ----------------------------------- ' J Street as shown on the application for a Well Construction Permit No. - _IN ---- ----- --- - - Dated--- t =' "^�-�� --------------------------------- -------------------= - ----------------------------------. ... .-� Board of Health DATE -- ENVIROTEGH LABORATORIES, INC. MA Cert. No.: M-MA 063 . 449 Rte. 130 . Sandwich, MA 02563 (508)888-6460 . 1-860-339-6460 FAX(508) 888-6446 CLIENT: Aqua-Jet LOCATION: Lot 4 ADDRESS: 135 Rte 130 White Birch Circle Mashpee, MA Barnstable, MA SAMPLE DATE: 10-16-95 COLLECTED BY: Ken/ Aqua-Jet DATE RECEIVED: 10-16-95 TIME: 3:OOPM LAB I.D. #: E10-210 JOB TYPE: New Well SAMPLE I.D. #: E10-210 WELL SPECS. : 200' 36' static RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100ml (MF Method) 0 0 pH pH units 6.0-8.5 6.62 Conductance umhos/cm 500 89 Sodium mg/L 28.0 7.8 Nitrate-N mg/L 10.0 0.08 Iron mg/L 0.3 0.28 Manganese mg/L 0.05 0.020 Volatile Organics See attached report. EPA #601/602 None detected. COMMENTS: Yes No WATER IS SUITABLE FOR DRINKING RPOSES R PARAMETERS TESTED. XXX Date te) ly :S Ron ld J. LaboratoryXari irector IT = Less Than GROUNDWATER ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: E10210 Lab ID: ' 12023-01 Project: Aqua Jet/Lot 4 Batch ID: VG2-0710-W Client: Envirotech Sampled: 10-16-95 Cont/Prsv: 4OmL VOA Vial/HC1 Cool Received: 10-16-95 Matrix: Aqueous Analyzed: 10-18-95 CONCENTRATION REPORTING LIMIT PARAMETER (ug/L) (ug/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BRL 5 Trichlorofluoromethane BRL I 1,1-Dichloro.ethene BRL 1 Methylene Chloride BRL 1 trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethane BRL 1 cis-1,2-Dichloroethane * BRL i Chloroform 1 l,l,l-Trichloroethane BRL Carbon Tetrachloride BRL 1 Benzene BRL 1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichloropropene BRL 1 Bromodichloromethane BRL I 2-Chloroethyl Vinyl Ether BRL 5 cis-1,3-Dichloropropene BRL 1 Toluene BRL 1 trans-1,3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethylbenzene --- BRL 1 meta-and Para-Xylene * BRL 1 ortho-Xylene * BRL I Bromoform BRL I 1,1,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL I 1,4-Dichlorobenzene BRL I 1,2-Dichlorobenzene BRL I QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 30 101 % 87 - 113 1,2-Dichloroethane-d4 30 33 110 % 83 - 117 % BRL - Below Reporting limit. * Non-target compound. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986). -------------------------------- 4 _ - GAS L1Nt t; �C/Z�Xf�Y�{ 7L S0; FT. f LEACHING CAPACITY (AREA X RATE) y'Z'GAL/DAY V7Z X0.7SA o Z RESERVE LEACHING CAPACITY GAL/DAY _ NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN OF ��R.vs-r•9,74 t=RULES REGULATIONS FOR THE SUMRFACE DISPOSAL OF SEWAGE D ic1R.719G 2- ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO / r S�(3eGow GaF7DE� WITHIN 6- OF FINISHED GRADE 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE C pT WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WlTrl:N 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE �• [ls��/S f USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL i - BE MORTARED IN PLACE /"/ 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH o� 90 _ l D=rnED ^? ZON!*IG REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRAC'_ IS TO CALL 'DIG-SAFE" AT 1-800-322-4844 AT LEAST 72 HO =,_ PRIOrR TO COMMENCING WORK ON SITE. 7. CONTRACTOR IS TO �E RIFY GRADES AND ELEVATONS AS `NE'! A.- �o SITE CONDITIONS PRIOR TO COMM LING WORK ON SITE. c 8. PARCEL IS IN FLOOD ZONE Z L 9. LOT IS SHOWN ON ASSESSORS MAP _2 AS PARCEL � gyp, Rc�� v..ss✓ -H�3crr M9 r�zir,� S.V « B� k'e- C� jLo N] L.,rd Z A n/D F v 2 'A A- I%e7 /Z�✓.J p SpL 40.clo2PTiw.J 7*e-�z11¢4� 09-s._5o e�fj�v i� GM/Z /s z 5'5-'(7). 9 APPROVED: BOARD OF HEAL DATE AGENT 00 PROPOSED PLOT PLAN FOR o..).9 c PROJECT LOCATION co- IV ! ti G SWEETSER ENGINEERING • � ROAD .- �0 ;` ,•� 235 GREAT WESTERN �l� 9 c�° ' 508— P. 0. BOX 713 `} _ SOUTH DENNIS, MASS. 6 5 � \ 398 3922 0260C 0 T• Y y�' �`* ! .='--•. ► LOc v5 SCALE 1 = ZU DATE ��Pr 2� /9 J`� t; 1 LC,,x _:• • + REVISED F� c�s REVISED ,� `tiy i � _� ---• U .r�N�••3i��i to ,. �l 'F,w.J I�4 <4 , sr ;'t' ;,; `;I_--; rJ� LOCATION MAP Joe NO. S�;-o o SHEET OF / GAS UjNL G LE INC, -- _q. . .:,. E Sq.''�-- FT. / f f LEACHING-CAPACITY (AREA X RATE) Z GAL/DAY RESERVE LEACHING CAPACITY _ -AL/DAY NOTES. 6 _ / 1. ALL WORKMANSHIP AND MATERIALS SNAIL CONFORM TO D.E.P. TITLE 5 AND THE TOWN OF I3 a.v,-r,q at 6f RULES AND 9Tiogs ' REGULATIONS FOR THE SUBSURFACE' DISPOSAL OF SEWAGE. �A{'� ` •} '`.vspE / ` 2 ALL COVERS°TO SANITARY UNITS SHALL BE'BROUGHT TO "/9.0E-.�' WITHIN. OF FINISHED GRADE ollo -.oF $ No VEiyr 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE C e,7-i.v!/y , ,,•�� WITHSTANDING'H-10 LOADING UNLESS THEY ARE UNDER OR Wi TrI;►; O �-- 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL SE (} f • � � /' ' . Cj,sO/y S f - USED 'UNDER OR OW1THtN 10.FT'. OF DRIVES OR,PARKING AREAS. 4. ANY MASONARY UNITS USED. TO BRING COVERS TO GRADE SHALLBE MORTARED IN PLACE '5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH �: %✓ r 90 D�M1_9-�pc> ZONINGRE.GiJLA.TIONc. QWPIER APPLICANT IS:TO + - •� _ OBTAIN, SUCH DETERMINATION FROM)) APPROPRIATE AUTHORITY. TIES 6.+ A, i UTILITIES A APPROXIMATE ONLY, EXCAVATION CONTRAC IS LI SHOWN RE TO GALL DIG-SAFE AT 1-800-322-484-4 AT LEAST 72 HOL!?= -- PRIOR TO COMMENCING WORK ON SITE_ o� 7. CONTRACTOR IS TO VERIFY .GRADES AND ELEVATIONS AS WELL E �o SITE CONDITIONS PRIOR TO COMM�ICING WORK ON SITE. 8. PARCEL IS IN.FLOOD ZONE G 9. LOT IS SHOWN ON ASSESSORS MAP I Z- AS PARCEL Z M,9 7-r'rs1.9Q S,�/�f�t BG' 2E •• ve-lPcrz AiJ10 0=v2 /! /•'7iN., i✓7dry c7A-- f 1 ' , / � '� Ck T � R.�O✓.:�D Soil �Aafo2!'�riu-J .sY t�-�a+ �+�D �s'!' e.: APPROVED: BOARD OF HEALT S DATE AGENT - 100 PROPOSED PLOT PLAN FOR Jr -�64��2 ,\ I '� C� i 7 \k j PROJECT LOCATION L T 51 �., ,�r Y1.00 t AOG S WEETSER ENGINEERING 235 GREAT WESTERN ROAD , SPIV \ 398-3922 SOUTH DENN S,7MASS. 0266E 01 tt,1.1�y �►„y"_ f f ,,_,..�\ OO OCvS SCALE �» _ �U DATE�crP� 10� L REVISED t /57S� / z wj-Cox 95� tV� 313.1 c 5 . ; 1, : . . -.• ,ioe rlo. ?-D U SHEET O F :, �. ._ ,: ` �; ..y,?,-}=ram LOCATION MAP 36 f'.� / �� • t SOIL TEST FIELEV. FOUNDATION _-- -- _._- ._—_ __ 20 FT_ MIP�IMUM _-- -- -- - - r / `Y ,1q 5' l (�(� DATE OF SOIL TEST �'i 10 FT. MINIMUM CLEAN SAND SOIL TEST DONE BY wc�T Er' F•�GrNfl� •JG CONCRETE WITNESSED BY COVERS 4' SCHEDULE 40 PVC PIPE OBSERVATION HOLE 1 ELEV.= o� ' OBSERVATION HOLE 2 ELEV.- MIN. PITCH 1/8' PER FT. 2' LA(ER OF PERCOLATION RATE Z ' MIN./INCH AT + INCHES �\1/8" TO 1/2' DEPTH HORIZ I TEXTURE COLOR MOTT. JOTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER ---- -----_-_---�-.�� — 'WASHED STONE 4' CAST IRON PIPE 6" -- '� �g0.2 VENT 0_`f U (OR EQUAL) MINIMUM NOT REQUIRED PITCH 1/4" PER F,. -�,: Z 1 CU. FT. OF 9- (, e` r" r ;014 l�)y>z ��t -7 F►^'� S�f•,p (UyQ-'� T CONCRETE FLOW LINE p� a I ANCHOR 6-0 A SA,JPY Z.~ 10yr ��b 7-1 I SA.rpr(.ow/✓' (DYE �4 ELEV. = j 10' .— ..-rz- -TMIN. 19" + 2'0. ° ° I c� o a o n a o ° _ - +J L.oAMY 5A1-'n ,✓YP 76 ' V. _ � o o c� o 0 0 0 12 _ rI�Z' - L�Artyiw..rr3 (Or�Q 7jZ LEVEL ° ° ELEV. - 8B 0 x}-5`f Cr 1'1'* SiF•jb^ 10YI? al - -- ?60 �N� X2�/ � ELEV. - 6' SUMP _ - i ELEV. = 2— ELEV. - Gs` r f SA.�Dt DISTRIBUTION ELEV. _ _ 4-0 Sr`'y 7 s/c-yY / BOX ' FLo►.✓��t-fvs- � I s z fcAr- L�+t 2,SY �j 65'lyl �z cosy Gc,gi✓, ZY 7Z STUNS /� �� [ / Mr7r.ir� 1 i1`���1Y z �Y y/4 l92- �3 .�tE>�;�,• (TO BE PLACED ON FIRM BASE) TO BE WATER TESTED 500 GALLON IF MORE THAN ONE OUTLET lZx;?. TRENCH FORMrItON f� SOIL ABSORPTIO�� SEPTIC TANK t>� Sbti✓ ?''j WATER ENCOUNTERED AT 132 ELEV. = 76 1 WATER ENCOUNTERED AT ELEV. = 74 I ZONE_ 8 3/4" TO 1 1/2'-� SYSTEM (SAS) U1 INDEX SZ WASHED STONE � ADJUST LEGEND: DESIGN CALCULATIONS BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TAH-E ELEV. = a� % EXISTING SPOT ELEVATION 00,�0 NUMBER OF BEDROOMS SEWAGE DISPOSAL SYSTEM PROFILE - OBSERVED WATER TABLE ( � /� � /;�' ) ELEV. _ � •' EXISTING CONTOUR ----Oo---- GARBAGE DISPOSAL UNIT NOT TO SCALE / FINAL SPOT ELEVATION 00.b1 TOTAL ESTIMATED FLOW 33� / FINAL CONTOUR-- {00 r----- ( 11:: GAL./BR./DAY X _L BR.) GAL/DAY SOIL TEST LOCATION 6 REQUIRED SEPTIC TANK CAPACITY 6d GAL J711J'Y POLE __Cl_ ACTUAL SIZE OF SEPTIC TANK oo GAL. TOWN WATER =W W SOIL CLASSIFICATION / CATCH BASIN ®� _- DESIGN PERCOLATION RATE < S MIN./IN. A �9��. / GAS LINE - - G ' EFFLUENT LOADING RATE LEACHING AREA, µ 7 L SO. FT. /S.F. LEACHING CAPACITY (AREA X RATE) J 1 GAL/DAY 74 p RESERVE LEACHING CAPACITY i 7 GAL./DAY NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TFPLE 5 AND THE TOWN OF 1'uu" ''{''�' RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE.2. ALL COVERS TO SANITARY UN'TS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. 'T 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF i L ©T WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN J 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE USED UNDER OR '61MIN 10 FT. OF DRIVES OR PARKING AREAS. / b 4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH ^A JBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. r �^, 6. JTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR / 3 ��'<� <'� jl �`. ,A ✓ �� IS TO CALL "DIG--SAFE" AT 1-800-322-4-844 AT LEAST 72 HOURS PRIOR 7. CONK ON SITE. TRAOToRMMEN0 VERIFY vA. IORGRADES AND ELET10NS AS WELL AS SITE CONDITIONS PRIOR TO COMME)4CING WORK ON SITE. 8. PARCEL IS IN FLOOD ZONE _ - + 9. LOT IS SHOWN ON ASSESSORS MAP 1 Z 1 �- 1, •_ _� AS PARCEL ; •.: Q J ` O?+o M V^�i7a ,�.: A N 1a /�w/C A M ray i .✓t rJ i*r t , rF-I rrJ.o r�2 .q� gS „f'��c''�"ero r.✓ 1 3io cM/z z s'5"•(V, �' APPROVED: BOARD OF HEALTH DATE AGENT I / PROPOSED PLOT PLAN FOR ; l/ / - PROJECT LOCATION L b•,-u -- - S WEP, SER ENGINEERING 2135 GREAT WESTERN ROAD ` 9 4g 508- P. 0. 90X 713 / / f IsO OQ \ of v y/ / i o5 (� 398-3922 -- -- SOUTH DENNIS, MASS. 02660 all / //� ! ✓ ; tt0f. Loc v�j SCALE -� - f' �4 I REVISED -------- I REVISED -- 1134 `OCATION MAP ,� _ I I SHEET OF J r',vj<r d ti e-,Oj 01995 SWEETSER ENGINEERINGf TOP OF FOUNDATION i 20 '-T. MINIMUM SOIL TEST < ' - -- - - - - - --- - -- " { - � DATE OF SOIL TEST F P ELEV = 93 6 10 FT. MINIMUM CLEAN SAND SOIL TEST DONE BY WITNESSED BY T D CONETE COVERS 4" SCHEDULE 40 PVC PIPE OBSERVATIO!� HOLE 1 ELEV.= ° ' ' OBSERVATION HOLE 2 ELEv.= 9/ � MIN. PITCH 1 /8' PER FT_ PERCOLATION RATE MIN./INCH AT INCHES \WAUD " LAYER OF _ O 1/2" DEPTH HORIZ TEXTURE T COLOR MOTT. OTHER DEPTH HORNTEXTURE COLOR MOTT. OTHER STONE 4" CAST IRON PIPE - �- DENT Q-'F 0 CU�GA•jrC 0 0 (�'A'Jfc_ (OR EQUAL) MINIMUM - --- r NOT REQUIRED y PITCH 1 j 4" PER FT_ I Z I 1 CU. FT. OF 4- (, t jt^'r SAS) �d rfZ y --- ----- ►R'� t -- CONCRETE /, -- — -7 F if•,D �V Y2 - --- FLOW LINE - as i ANCHOR h-lµ SA1�1pY Z.*kl lon 4`6 ?-� SA.JprtorNt 10YR- 4/4 ELEV. = 9 6 t0' t 9' a -- - _ _ --- --— f3 C p�gMY RED ore �1 MIN. 4 0 2'0' ° a o 0 0 0 0 ° ° S �UyQ 7/3 ll-Zj �oAMYfb Z A - --- LEV. _ / LEVEL a o c� o o n o 1 e" ELEV. _ � ELEV. a Z7 ELEV. gi 6" SUMP -ELEV. _ n� V-9f C� F ICE S��D �o rr_ 8i/t Z;40 Co sR�yN +wv l0 X211/ DISTRIBUTION ELEV. a S14-((Y Cz C t[ T Y 2.5'Y 7/1 5 a-ryZ C2 Aic? �.� 5'y -7/t: i B0X �MrOr�N TO BE WATER TESTED 114,17 y C L SANS 2 SY 5'/4 TO BE PLACED ON FIRM BASE) ' 500 GALLON iF MORE THAN ONE OUTLET IZx;� r I TRENCH FORMATION SOIL ABSORPTION Z WELLSD`�✓ 2S3 WATER ENCOUINTERED AT 1 Z ELEV_ _ /� WATER ENCOUNTERED AT /go ELEV. = 76•1 SEPTIC TANK ZONE_ _ 3/4' TO 1 1/2" SYSTEM (SAS) ZONE INDEX WASHED STONE ADJUST LEGEND: DESIGN CALCULATIONS BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELEV. _ �^� EXISTING SPOT ELEVATION 00„0 NUMBER OF BEDROOMS SEWAGE DISPOSAL S 1 S TE M P R O F L.E OBSERVED WATER TABLE ( %, ',!) ELEV. = EXISTING CONTOUR ----00---- GARBAGE DISPOSAL UNIT NOT TO SCALE FINAL SPOT ELEVATION TOTAL ESTIMATED FLOW FINAL CONT(XUR — 1/v GAL./BR./DAY X �_ BR.) 3�'� GAL/DAY SOIL TEST LOCATION REQUIRED SEPTIC TANK CAPACITY GAL JTIUTY POI -O- ACTUAL SIZE OF SEPTIC TANK Z 5"J C• GAL. q TOWN WATER —W W — SOIL CLASSIFICATION T CATCH BASIN �m� DESIGN PERCOLATION RATE < 57 MIN./IN. ^) --"!� / / GAS LINE — G - — - EFFLUENT LOADING RATE 0.r4 GAL/DAY/S.F. _EACHING AREA 4'7z- SO. FT. / LEACHING CAPACITY (AREA X RATE) Jay' Z GAL/DAY V7Z ,r0 7 RESERVE LEACHING CAPACITY ` GAL./DAY NO 1 ES: I 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 1 ,1TLE 5 AND THE TOWN OF I "" RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. I f,L 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. / / \ 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN !�� o� ` /f 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE�a�`" n �S��r JSED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 10, 4 ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. N, NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6. JTIUTIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR J IS TO CALL 'DIG-SAFE AT 1-800-322-4844 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. 2 \ / Jr 7.�;k / 7. CONTRACTOR IS TC VERIFY GRADES AND ELEVATIONS AS WELL AS �' SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. o - - �. 8. PARCEL IS IN FLOOD ZONE . 9. LOT IS SHOWN ON ASSESSORS MAP AS PARCEL i Z" A(K' 7N i:.rf /�f7 T C "z �A, S'AOjo 4r t'! A"A � � � � 1 ( • ';\'`. `�,� . o � �... � �Pc,4cvr.� w1rf! k7�Tc�"4L A'S;s/�ciR�fo �� PR ARD OF HEALTH DATE AGENT i 1 l J f �je PROPOSED PLOT PLAN Qi FOR -7 a PROJECT LOCATION .� 6 S WEETSER ENGINEERING 235 GREAT WESTERN ROAD 508— P. 0. BOX 713 / '• 09 OD >< / 9 U5 �� ! 398-3922 _ SOUTH DENNIS, MASS. — _- 02660_j of I ol ,r _ SCALE __j ?G —� DATE REVISED REVISED - ---- f ---- --- '� 1- UMAS ter► 0 ---- v z�` �` _ G, ,a ! �° ;�, �� ` .,,,. . LOCATION MAP ; i Jos No. 3� - J SHEET — O F J I �ASr✓�'�t''OJ 0 1995 SWEETSER ENGINEERING