Loading...
HomeMy WebLinkAbout0149 COACHMAN LANE - Health 149 Coachman Lane __.. E Marstons Mills A-151-037 Commonwealth of Massachusetts ��- r� Title 5 Official Inspection Fora �1 r:, ill Subsurface Sewage Disposal System Form -Not for Voluntary Assessments {, 149 Coachman Ln Property Address Ann King Owner Owner's Name r., information is H required for every W. Barnstable V MA 02668 8-21-19 page. City/Town State Zip Code 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. A. Inspector Information 64 Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);1 have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 8-21-19 Inspector's signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system 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 e DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of,Massachusetts r, Title 5 Official Inspection Form i i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � > 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System.,Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. 2) System Conditionally Passes: ❑ One or more system components as described in the "ConditionalPass" 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 olid*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): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form ill Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r/Ci1 149 Coachman Ln Property Address - Ann King Owner Owner's Name information is required for every W Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y El ❑ 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 El ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3 Furth er Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc°rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System°Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form nl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .�._� 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool I ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 1 l .\ Commonwealth of Massachusetts �I Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/Z day flow ❑ ® 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 water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is W. Barnstable MA 02668 , required for every 8-21-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for aH inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 I { i r Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage Well 9 ( Y 9 (gPd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 8-2019 Date t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts r� 3� Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day d P Y�9p ) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner----pumped 6-2019 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form w: Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2004 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 24"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.): Good condition. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 s Commonwealth of Massachusetts r� Title 5 Official Inspection Form �l Subsurface Sewage Disposal System Form =Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 16" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle 29" Scum thickness 0 Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. z i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Fora i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form V. 5 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition with water at working level and no sign of back-up from field. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 s Commonwealth of Massachusetts 3 Title 5 Official Inspection Form wa II Subsurface Sewage Disposal System Form -Not for Voluntary Assessments :. ? 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3-500's ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 3 Commonwealth of Massachusetts a Title 5 Official Inspection Form ► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach chambers in good condition and empty at inspection with stain line at 3" off bottom of chamber. 12. Cesspools (cesspool must'be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction - Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts ,w Title 5 Official Inspection Form <1"i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins .doc rev.7/26/2018 p Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form I.'i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately l Cr 3 -311 ell r t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora ht Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - >'I 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans shwo no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts ' Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Coachman Ln Property Address Ann King Owner Owner's Name information is required for every W. Barnstable MA 02668 8-21-19 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 t5insp.doc-rev.7/28/2018 P 9 P Y 9 s TOWN OF BARNSTABLE LOCATION lye (cacc6-tvy. SEWAGE # VILLAGE e ASSESSOR'S MAP & LOT IS - 37 � m J INSTALLER'S NAME&PHONE NO. wh tR,)6:- ,- S( [ ace W 775- r770 SEPTIC TANK CAPACITY 6-1 LEACHING FACILITY: (type) 33 x�wells �/1Jo) (size) 33,S NO.OF BEDROOMS L BUILDER OR� �t �PERMITDATE: 11.21) COMPLIANCE DATE: 1 l 19 0 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ys' "� Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) r(03 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by UurnS�ib/t 615 004 Qecefeli { rOA+ OF Hose P� • O O A 1= i b3 ® p L- 1 No. ' Fee 1 t.O.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in comp — >__<✓ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,s MASSACHUSETTS ZIppYicatiou for lkgaar *potem Com5truction Vermit Application for a Permit to Construct( . )Repair( X)Upgrade( )Abandon( ) El Complete System 0 Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 4 2 0—31 0 6 Asses1�o ' a s9MY)m2hman Ln, W. Barnstable ;Iim King 151 /37 149 Coachman Ln, W :Barnstable Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco—Tech PO Box 108.9, Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 leach system (heavy duty) to plans of Eco—Tech, ETE— 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 B,pard o ealth. Signed gi ,, "� . d' Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued No. 2(3v " . . 7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: " Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIpplifation for Migonl *p5tein Congtrurtion Permit Application for a Permit to Construct pp ( . )Repair( X)Upgrade( )Abandon( •) El Complete System O Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 0—3 0 14 C a hman Ln W. Barnstable dim King AssessorMap/�arcecl r 149 Coachman Ln, W Barnstable 1 51 /37 Installer's Name,Address,and Tel.No. ?7 5—B 7 7 6 Designer's Name,Address and Tel.No. 3 4—0 8 9 Wm E Robinson Sr Septic Eco-Tech PO Box 1089, Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder(nc Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. z Plan Date Number of sheets Revision Date f Title Size of Septic Tank Type of S.A.S. & . ►' Description of Soil, r Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 leach system (heavy duty) to plans of ?,co-` ecn, l TE— t) . 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 o , ealth. �1 J ,� L `�r 1 Signed �Cr-'` �` d Date` �.•G 1 Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued " --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS King BARNSTABLE, MASSACHUSETTS Certificate of Compiianre THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed.( )Repaired( X)Upgraded( ) Abandoned( )by Wm E Robinson Sr Septic Service at 149 Coachman Lane, W. Barribtable has been constructed in accordance �. with the provisions of Title 5 and the for Disposal System Construction Permit No.a.c c-L/ SS `/ dated r _-2 Installer - Designer The issuance of�j's pe shall not be construed as a guarantee that the system wtl`function as designed. Date Ill 1 l ��D L/ Inspector J 0 7- w �tl --- ' No ------------------------------ '7 Fed 1 o n.On King THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po5af 6p5tem Congtrurtion Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon System located at 149 Coachman Lane, W. Barnstable and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of thiss.perm _J Date: / 2�D� Approved by TOWN OF BARNSTABLE LOCATION (OacheA­ L.• SEWAGE # VILLAGE Lo. ASSESSOR'S MAP & LOT IS-1 3 INSTALLER'S NAME&PHONE '5W 77S' r7'7b SEPTIC TANK CAPACITY loco 6�a� % LEACHING FACILITY:{type) 3')K Pa Qrrwoll3 (Ado) (size) 33-S x/a•S xd NO.OF BEDROOMS BUILDER OR WNE kt j 'PERMTFDATE: I .2 v COMPLIANCE DATE: ,Ill 0 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ys' °� Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility.) �03 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by &rr S 61c 615 W4 Perc4-l.r �j L s - 0 0 i `, asc+o 3 0 +%,,aj 4 Town of Barnstable Regulatory Services • Thomas F.Geiler,Director ' P Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Designer: D. C006H INOWK Installer: Wm E Robinson Sr Septic Address: �+D IN W(oLC C I M4LE- Address: PO Box 10 8 9 S��JIJWICH. MA 6)2,563 Centerville On Wm E Robinson Sr SePtmia issued a permit to install a (date) (installer) septic system at 149 Coachman Ln, W. Barns tablbased on a design drawn by (address) � �`I(J n C UGl fiN 'WtZ dated 08-17-04 (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. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. OF DAVID s t3. cGn staller's Si ) #1093 �a COUGH' �" a P� (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:Healtb/Septic/Debiper Certification Form /TOWN OF BARNSTABLE LQCA►'ATON._ . 9 �04Clit:�/yICC 11 _ SEWRsGI; t .. VIT:,L A SSESSOWS Mi4x'�i LOT S INSTAUER'S NAM PROM NO $EMC TAH CAPACUY �DGrO �LE.ACi�iCi T+A►CILITXs ( �) C�rc.+�.b�rS��{six ),.:,,� ��TO -S ICU: (DF.-MbROMS ._.... v MOM PBRfi/dYTDATE COWt, MCE 1RA' E Sip quart 19Istfl nzss B'two th,: Matclmam°Adjusts Gkauutlwutet Tahts to tljc Bctttani uTLeach k�tu;ility. ....;.:;,,,,.•,,; .;:.+„,;F Prlvaie i�Vutr Sup+ty W�: sazd t,ca�6uz�g pmcilzt�► (If"y c^�al4s cxtst an altos oc wlthlri?Ap geet of lPiistuzIS Ftciiity) Feai P.st t�af'UUetian autd Leacihing i acslity:(jf* y.wetlandFur ex,sE � .ultfalzi 3�0 f�ctQf leaaiaic�:.Paalixry) ��+ae gaa: y c rf-rvr t � Gvel( y7 3 -(- 311 A -3i ' h-3-53' 6 r3-55-3/, i TOWN OF B.ARNSTABLE LOCATION,_©7" /G 1,fde- SEWAGE 'I NVILLAGE�� ASSESSOR'S MAP & LOT ISM G J t3a INSTALLER'S NAME & PHONE NO. •l SEPTIC TANK CAPACITY ( LEACHING FACILITY:(type)Z,�-��.x�/, —(size) /XG /�d0 Q NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER_ 4 BUILDER OR OWNER_ ,lyo,¢�-/,der DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ✓` r u},?/1 �� a Fizic THE COMMONWEALTH OF MASSACHUSETTS �J BOAR® OF HEALTH ..----- /Otero................OF.... D�.L` .................................... Appliration for Dispaii ai Works nniirnr#iun 1hrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Sy at: � - ----------------------------------�--` ---------------•--•--..........--•......-- Location-A Owner Address ---------•--------....•..........................................•---•-- -•-...------------•-----fR- T.... =.........&J---...�,/3.V.�.,c� Installer Address Type of Building Size Lot.-� Sq. feet Dwelling—No. of Bedrooms................._...........___....Expansion Attic ( ) Garbage Grinder (^-� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria04 ( ) Other fixtures ................................ A—J__ --- W Design Flow......... 14.........................gallons per-ger-seu er day. Total daily flow_....... ........______.__...gallons WSeptic Tank—Liquid'capacity/�i._._.gallons Length.. _.-.61-.. Width.�.1:7//2.. Diameter..._=........ Depth_67: x Disposal Trench—No. ........ .......... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........./......... D' meter.._..&p_..... Depth below inlet............... Total leaching areR= ..,7.--.sq. ft. Z Other Distribution box ( Dosing to ( ) '-' Percolation Test Results Performed by.........j!�... .__.��e..��7-----ao-L. Date..... ,aa Test Pit No. 1.._...<` __n inutes per inch Depti of Test Depth to ground water...... ..A__ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ o ..............Q_-_C9-. .....`...:7' -L.....COO D- r� rr ......................................... Description of Soil................... "�:_... �? ........ -----. / � x 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 of 1 TLi; 5 of the State Sanitar e—The undersigV�Iala ther agrees not to place the system in o ation until a ertificate of Compliance h bee ed by e andth.Signed.......... ........ .................. .... __�Z _ Date Application Approved By_........�s.-- -----------------•--- Date Application Disapproved for the following reasons-------------•--------------------•--•--...----•--------•--------•------------------------------•-•••.....------ ••--------------------------••-----•--------•---------------.............--------•------••.....-•-...---------•------------------------•----•------------------------------•--------...............--•-- Date PermitNo....�f.7 - .. Issued.........................................�:---•------•---------...... Date ...-----------•--..._...... No......................... Fss............._........... THE COMMONWEALTH OF MASSACHUSETTS BOAR F HEALTH AVVIkatiun for Diupuottl Works un,strurtion Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal . " b(� Location-Address or Lot No. ......................_.......................................................................... ................................................................................................. Owner Address W Installer Address dl U Type of Building Size Lot..A_ �.-.____--�,�_..Sq. feet �--� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ................................. W Design Flow________ 1..................... .... gallons per p�PSan�perf�ay. Total ail}' flow____....-� ...................allon WSeptic Tank—Liquid'capac� � gallons Length.tl .`�.. Width.�:(.��.. Diameter._...._..... Depth.�..` x Disposal Trench—N7 ----------- Width 7- Total Length Total leachingarea _ .s ft. Se page Pit No..................... ameter.....14.......... Depth below g let................... Total leaching ar q. Z Other Distribution box ( Dosing tanlq �_ 2 �� � a Percolation Test Results Performed by.......... .......---/�J...._.______,�............... Date......................�./... Test Pit No. I.....� minutes per inch Depth of Test Pit..,/ Depth to ground water........................ (i Test Pit No. 2................min pe� h eto Test i�t...._._-.-----.-.-.--.r ---�---p-.tc-h�----to a- grou nd wate r______...._.____.__._... e •.-. `0 - _` c - o Description of Soil ----- ------------------------- - U ...........................................--- w -----------------------------------•---------------------------------------------------------------------------------------------------------------...-----------.....----.........-----------•-------- U Nature 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 TITLE, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in /op�ration until a ertificate f Compliance has been issued by the board of health. 61 Sied ------------------------------------------------------------------- ------------------------------- Date ApplicationApproved BY.................................................................................................. Date Application Disapproved for the following reasons:----•-----.......•.............•----•--•------•--------•---....-•-------------------.........................._ --------------------------------- y — --------------------------- •------------- ---- ---------------------------------------------------------------- •------ ._ •Date-----•------•- PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD'(qF H H ..........................................OF..................................................................................... 1 1/ Trrtifiratr of T-am rliunrr k (' TH ��O'CLv '1IFT *at the Individual Sewage Disposal System constructed ( ) or Repaired ( ) o'1 7� by . r:�� . �! ..........................................•............... ......... - Installer at--••--•--•.......................•----•......_..••--•---------.........-•..._................•,�C 7 �-r.`s-'.tyc--------------------------------------------------------------------------- has been installed in accordance with the provisions of 11TIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated_............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................7.....a-..:..f5.7................................. Inspector------ .1 .--- . ----•----•----•-•---•- THE COMMONWEALTH OF MASSAHUSETTS BOAR ...........................................OF.............................................................................. No......................... FEE....................... �/ �iu�ou�� or���= n�#rion .erutit Permilsi g,is?h re�yaran .. �...... ....... to Construct ( ) or Repair ( ) an Individua S . ,a Disposal System r Street as shown on the application for Disposal Works Construction . 'ermit No....................L Dated.......................................... ........................... ...•---.-``-•-•--......�-�...................................... - DATE .---•--^..........................^-• Board of Health FORM 1255 MOBBS & WARREN. INC.. PUBLISHERS �j- Department of Environmental Management/Division of Water Resources -yi WATER WELL COMPLETION REPORT I / WELL LOCATION Address_ d7' 14 City/Town /,, . G.S.Quadrangle Map Grid Location Owner ':::7A(J,-e 1d7e ,(Vt�lw• Address '/317 �!?IIYtn/r- r WELL USE CONSOLIDATED WELL Domestic 9d, Public ❑ Industrial❑w Other Type of Water-bearing Rock Water-bearing Zones Method Drilled 100 c r ld t 1) From I To + �1 2) From To Date Drilled /n^ A 3) From To 4) From To CASING Depth to Bedrock I Length 20 t Diameter P '� �r I� Type �Q �'F,C UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface lap Sand: fine❑ medium Q'coarseC%3 Date measured U' a/- 91(0 Gravel: fine ❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL Slot# /r® i �--,/ length � from to c Yes El No l�+f Split Screen(or 2nd screen) l WATER OUALITY.TES.TS MADE Slot length from to Chemical ! Biological ❑ Depth To Bedrock PUMP TEST Drawdown feet after pumping days W hours at Q G,PM. How measured Oe--4 I r"r rY-),!N Recovery ""' feet after hours. LOCrof FORMATIONS COMMENTS: (On well or water) Materials From To 0 ' �• �� m DRILLER Firm p?fwi, i/ byi it/i �C7 y t, Address 1po x cR0 e5 \ City roy0 CA'a ie Registration No.-ffl Operator's Signature ease prmr rrm y BOARD OF HEALTH COPY 2SM 10-85-8 07101 t ` ENVIROTECH LABORATORIES 66 Lewis Bay Road • Hyannis• Massachusetts 02601 • (617) 771-7265 CLIENT:Shoreline Building LOCATION:Lot 16 ADDRESs439 Station Ave Coachmans S. Yarmouth,MA 02664 W. Barnsta le, A COLLECTED BY: Ed Meehan SAMPLE DATE:10/27/86 TIME: 9:15 AM DATE RECEIVED: SAMPLE ID:ET 47A JOB #: New Well WELL DEPTH. 184 ft. RESULTS OF ANALYSIS: Parameter units Recommended limit Result Coliform bacteria/100 ml (MF) 0 0 p pH units 6.0-8.5 6.42 Conductance umhos/cm 500 97 Sodium" mg/L 20.0 9.7 Nitrate—N mg/L 10.0 .05 Iron, mg/L 0.3 .11 �w Manganese mg/L 0.05 Hardness mg/L as CaCO3 500 Sulfate mg/L 250 Potassium mg/L 20.0 Alkalinity mg/L 200 Water is suitable for drinking purposes for all parmeters tested. i D :_E �,T / x Z �-� L RENCE CONTOURS WEST BARNSTABLE. MA o ,R P A s . u.� �,� s �" PLAN BOOK 3$4 PAGE 56 - - - - - - - o �c� EXISTING 150 mE o� ASSESSOR'S MAP: 151 MINIMAL GRADING PROPOSED o Aoo wa �<� 1WOO N r LOT: 37 /� LN E v m zk' C! / `/ V 4 � �. S/►DDLER S w N C O A EDGE OF PA VEhEN� L1� LOCUS O LANE F ROAD ,62 L50 t °�° ,. Fw<3 64 I . �� 41.5 ftx13 ftx2ft -w ,� <pz - - w 0 LEACHNG GALLERY LOCUS MAP LL Z USE H-20 UNTS v Nw� tt° NOT TO SCALE w wyro 4 _) J� N W _ w w _ ' - J 4 L EGEND _�� < -J n ��, i IEOODT GALLON a p W Q Z - r�i 1� P SEPTIC TANG .I w \ I4-20 D-BOX O Z_ LLI `', TEST PIT Q 1_ i \� �1 EXASTm Q o V LEACH PIT LL �. 91 O \ I TREE _j W� X o , EXISTING x w r� Ba<Pis rc�urErse ri HnEs tartar uarEs rwE O-OAK "A-LE P IE z -' N u"f v_ in v_ ` 4 BEDROOM W LL o< _ o" DWELLING s� w(� a ' �, TOP OF FlC7N O LL a? 'a ' anti \ I llb cr_ // ,n 154 152 150 LL 148 O t^v 0_ - LOT 16L BENCH MARK AREA 43964 sf •- W TOP OF FOUNDATION Z ELEVATION - 150.34 - .� J ; w O z USGS DATUM ASSUMED o L- 3 z _ - SYSTEM PLAN O z o o 0m < _ _ SEWAGE DISPOSALS S c' o �, O 24s.00 ft -TO SERVE EXISTING DWELLING o 4 `-L' o_ w HOF JAMES AND ANN. KING. . M �� .oAvi�. 149 COACHMAN LANE W. BARMSTABLE. MA L PLAN � � 0-T H ENVIRONMENTAL w LL ,— g SCALE: I In 30 ft �? : ,0�3 R ti E C TECH O o q Quo 43�TRIANGLE CIRCLE SANDWICH MA 0256 o- I-ii F ��'�trna�P�' 508 364-0894F 4 ETE-17.55 . AUG D. 2004 ;'/ ► = I/2,r': n THS PLAN IS TO BE CONSIDERED`A_DRAFT PLAN UNLESS,IT �vBEARS_TI-E'STAMP AND SIGNATURE OF,THE.DESIGN ENGINEER f • 0 ORIGINAL PLANS INTENDED FOR SUBMITTAL%T0 TI-E,BOARD;, OF HEALTH WILL BE SIGNEVIN BLUE AND STAMPED N RED. I DATE OF TEST: AUGUST • 13. .2004 S O I TEST ` O G SOIL EVALUATOR: DAVID COUGHANOWR. RS WITNESS .REOUIREMENT WAIVED - NO. VARIANCES SOUGHT- DESIGN C AL C U LA T 10 N'S = A NO GROUNDWATER ENCOUNTERED TEST PIT I PARENT' MATERIAL: PROGLACIAL OUTWASH s - ELEVATION - 149.00 +- PERC AT 82 in 2 MIN/INCH IN C SOILS DESIGN FLOW: 4 BEDROOMS X 110 GPD - 440 GPD DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SEPTIC TANK: 440 GPD X 2 DAYS 880 GALLONS- (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING USE EXISTING 1000 GALLON SEPTIC TANK I`F IS SOUND STRUCTURAL 0-16 FILL CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) 16-17 O WOOD LOAM 10 YR 3/2 NONE FRIABLE DISTRIBUTION BOX: USE 3 .OUTLET D-BOX. 17-18 E LOAMY SAND 10 YR 4/1 NONE FRIABLE SOIL ABSORBTION SYST.EM:- A 33.5 ft x 12.5 ft x 2 ft LEACHING GALLERY CAN LEACH 18-21 A LOAMY SAND 10 YR 3/4 NONE FRIABLE A 6 o t - (33.5 x 12.5 ) - 418.75 of 21-64 B LOAMY SAND 10 YR 5/6 NONE FRIABLE A s d w - ( 33.5 ; 33.5 12.5 • 12.5 ) x 2 - 184.0 of Atot - 602.75 sf 64-144 C MEDIUM SAND 10 YR 6/3 NONE LOOSE-15i STONES V t 0.74 x 6 0 2.7 5_--. .446.03 GPD . USE A 33.5 ft x 12.5 ft x 2 ft GALLERY. Vt - 446.03 GPD > 440 GPD REQUIRED / 31,001 GROUNDWATER LEACHING GALLER Y CONSTRUCTIONADJUSTMENT DETAIL EXISTING GROUNDWATER LEVEL GALLON PRECAST DRYWELL BASED ON BARNSTABLE GIS GS CONCRETE 500 DEPARTMENT RECORDS GALLOYW x. �� LEACHING UNIT OR INDICATED GW: 40.0 `. EOurv^LENT STONE INDEX WELL: SDW-253 = s'-s-X 4'-10-x 2'-9- ZONE: B 2 ft EFF. DEPTH 33.5 ft READING: JULY. 2004 LEVEL: 51.0 ADJUSTMENT: 5.2 fit ADJUSTED GW: 45.2 N in N NOTES - - 1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 4.G 8.5' 8.5 8.5" p' 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 33.5 ft 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310- -CMR 15) 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED 6) ALL STONE TO BE .DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 7) LINES" EXITING. D-BOX TO RUN LEVEL FOR 2 O�cc BEFORE PITCHING DOWN J SEWAGE DISPOSAL SYSTEM PLAN 8) ECO-TECH ENVIRONMENTAL RECOMMENDSr�THE-INSTALLATION OF LOW FLOW FIXTURES ; AND APPLIANCES. AND BIANNUAL PUMPING OF;;THE SEPTIC TANK -TO. SERVE EXISTING DWELLING 9) SYSTEM -IS NOT DESIGNED TO WITHSTAND VEHICULAR�' LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC- SYSTEM. t= JAMES. AND '. ANN KING - J:e 10) INSTALLER TO OBTAIN DISPOSAL WORKS, PERMIT ,BEFORE STARTING WORK. 149 COACHMAN LANE W - BARNSTABLE�,�,.,MA • ... - .. .. � t 11) SEPTIC TANKS SHALL -BE� INSTALLED LEVEL ,AND;-T.RUE TO GRADE ON^ A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND,'0N •-TO WHICH : r ECO TECH 'EN Y I+RONMENTAL=} SIX!`INCHES 'OF CRUSHED STONE HAS'�'BEE4•-PLACED TO 'MINIMIZE UNEVEN`SETTLING n 12) _SEPTIC°,TANK 'TO .BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND 'CHECKED 43..TRIANGLE CIRCLE .SANDWICH�MA02563 FOR STRUCTURAL INTEGRITY. INSTALL .PVC OUTLET.,TEE -FITTED WITH GAS BAFFLE. _: ' ' ETE-1755 AVG 17: 2004 2/24 s •r r ..a a. _. R .. y ,> r ,. ,.,. .. t n r., :..{., t �1 .. ,:h. .. ., ' ♦ .. , nr' "taF ,. $ .. .. .. - ,n F. a^" .+ �. ... Y. a .. - <, �C T , .,.,.. .5 ,. ,: 1N ,. ', ":. • :: .. ...x.:,r v -'{.. .. . -N' 1? l ,!�,^'. ., ,. .:. M1u•n ♦- r. . � .. .A .:,. :,..,.. . , -`.Y'A ':. s.ea-. rr ...,* P ,f.. .. _ , .... .- '_:' •. .... , ... Y w� : ,.a -- .. f _4 ,:.. ,. .. .ate -. , t.l n .'.$c. � ,.4 `oST. 3 :r am._stA�,.:, J 20 FT. MIN. SOIL TEST TOP OF FOUND, EL A .�.. -- 10 FT. MIN. OBSERVATION HOLE I OBSERVATION HOLE 2 OBSERVATION HOLE 3 CONCRETE 4 SCH 40 PVC DATE OF TEST `� � � DATE OF TEST _ DATE OF TEST COVERS - � CLEAN SAND u ht PIPE- MIN. PITCH I WITNESSED BY WITNESSED BY WITNESSED BY ;. f CONCRETE 1/ 8 PER FT v. c PERC RATE MIN./ INCH PERC. RATE MIN./INCH PERC. RATE MIN,/INCH COVERS , 4 CAST IRON (OR -7 ELEV. ELEV. _ _ ELEV.= EQUAL) PIPE - MIN. -� 12"MAX PITCH I/4" PER FT --- .P�_- El: _ 15314 � } 2% MIN Y, 2-0 0 rL EVE L _ FLOW LINE cj con�rn�Bond EL= EL m. �7 / MIN. EL- St1 o. = EL = /4?, o I D I ST EL _ BOX b I WATER AT _ EL= WATER AT EL = WATER AT EL = -^' LOCATION MAP {'Mc cucrr`e� �rtcr�r.�rrt�r��r'1 � ._._. .. GAL SEPTIC PRECAST LEACHING ° EL = LEGEND ' BASIN OR EQUIV. .` pr� GU1Cf7 Mc7 l TANK EXISTING SPOT ELEVATION 00.0 / /0' 010- EXISTING CONTOUR . FINAL SPAT ELEVATION 1 FINAL CONTOUR ^Q�---------- - PROFILE OF SOIL TEST LOCATION BOTTOM OF TEST HOLE Of EL = SEWAGE DISPOSAL SYSTEM ADJUSTED GROUND WATER TABLE ( / / ) EL = TELEPHONE POLE -0- NOT TO SCALE HYDRANT ' TOWN WATER ... W . . ,«...».M..VV• . ,. �• CATCH BASIN Cm'' fir. FRAME a COVER SHALL BE �O Cvf 8 DG,r�o%cf Ana �rCK ----- - - SET WITH MASONRY UNITS i WHICH ARE TO BE MORTARED 1,5 rch M©,--k. CLEAN SAND �!�' �`'7 f1rJ'✓/ A,v.. _ � IN PLACE P' � r; l . 143, 3 _ _. ---- GENERAL NOTES t I - - `- '• i i 2" LAYER OF 1. ALL WORKMANSHIP AND MATERIALS SHALL. _ ui1r, � I/$ - I/2 WASHED STONE - CONFORM TO D,E O E TITLE 5 AND THE' P,�or7�:�fe?�`i/� --- TOWN OF _�.-,,,RULES A REGULATIONS FOR THE SUBSURFACE DISP05iAL OF' SEWAGE 0 2 ALL covERs To SANITARY UNITS SwalarL BE BROUGHT TO WITHIN 12 OF FINISHED GRADE 3/4 3.EXISTING AND FINAL GRADES SHALL REMAIN "- 1 1/2" -' - r:, WASHED STONE ESSENTIALLY THE SAME ` ' h jar g` '` _ _, ►' 1 a uCL 6 4. NO DETERMINATION HAS BEEN MADE BY THIS 53. 2 ' �' 1 U_ PRECAST LEACHING OFFICE AS T N L I 0 COMPLIANCE WITH T W D w BASIN OR EQUIV ZONING REGULATIONS OWNER / APPLICANT IS --- 24 rt DIA . COVERS _ TO OBTAIN SUCH DETERMINATION FROM " APPROPRIATE AUTHORITY . __ `"`_ + i-• f--.-__ -",- /52 ..-,__ y. /G+O°n r2E'Scorv� �;,, '' ` sue.--... � ._ ` 'r�ti•—.4=�' y /( !GO" r0' SIG•`I `" /�®/ 1 5. THIS PLAN IS VALID ONLY IF IT IS STAMPED, f PLAN VIEW I f AND SIGNED IN RED. THIS OFFICE ASSUMES � �---- � � -� NO RESPONSIBILITY FOR INFORMATION CONTAINED \ r FRAMES & COVERS SHALL ON COPIES WHICH DO NOT HAVE ORIGINAL Milt , t�i► ( �� ,. �, BE SET WITH MASONRY UNITS i�" Dip. STAMPS AND SIGNATURES ,- WHICH ARE TO BE MORTARED 1N PLACE 4),50x ��' C` 6. ALL COMPONENTS OF THE SANI ARY SYSTEM _ SHALL BE CAPABLE OF WITHSTANDING H-10 INLET n �. c - �_ LEACHING PIT DETAIL LOADING UNLESS THEY ARE UNDER OR WITHIN - - - M IN - 10 FT OF DRIVES OR PARKING AREAS. H-20 'Ge r \ +�\ . - '� �� / - - - - 63MIN �` OUTLET NOT T(0 SCALE LOADING SHALL 8E USED UNDER OR WITHIN vi y� \/ FLOW LINE T /---REMOVEABLE COVER AO FT OF DRIVES OR PARKING AREAS al Tt s OUTLET PIPES 10"MIN. OUTLET TEE AS REQUIRED ^`"" I S, _ L LIQUID DEPTH TEE r DEPTH_ BELOW FLOW LINE /. 4 FT 14 INCHES ' MIN. FRONT SETBACK 3p INLET 5 5 FT 19 INCHES i °.. OUTLET MIN. REAR SETBACK �� 4 FT MIN `FLOW �� 6 F T. 24 INCHES '� t LINE / —� MIN. SIDE SETBACK 15 LIQUID 7 FT. 29 INCHES i 1 DEPTH � ' 2" 6' c APPROVED . BOARD OF HEALTH 8 F T 3 4 INCHES L t * Br r //� DATE AGENT INLET TEE PROVIDED - ,�} � r / .,. -- - _. - ) u - . r 52 ', ,-•------ .- PER SECTION 15.10.2 TITLE 5 PROJECT LOCATION: r5o L 1tL7 Coachrrmon Cane N0. OF OUTLETS. . 3 - - _. 8 �✓e/! CROSS SECTION VIEW G✓. /3arnsole, MOssoChUSe \ C.7 APPLICANT well f SEPTIC TANK DETAIL SEPTIC BOX DETAIL 1 horer�e lC�e 5 NOT TO S AL ;o • NOT TO SCALE E � r s. RJ 0 HEARw IAIC. 41 Reg. Land Surveyors - Re9 S oni tori ons (DESIGN CALCULATIONS 35 ROUTE /34 - UNIT 2 - P, O. BOX 237 /3c2 -f s/c7Z> /%� NUMBER OF BEDROOMS , SOUTH DENNIS, MA. GARBAGE DISPOSAL UNIT ^� TOTAL ESTIMATED FLOW GAL/BR/DAY x — BR. } 3�� = GAL./DAY REQUIRED SEPTIC TANK CAPACITY ` GAL, ACTUAL SIZE OF SEPTIC TANK ' GAL. LEACHING AREA REQUIREMENTS + ` /Vof�e/ SIDEWALL AREA % GAL./S.F. well /UCo i��7 c✓ f ' , rbr? rC r1� r �- ' ' x d'✓� 7� (BOTTOM AREA . GAL-/S.F , p d over-all well d � p/' p�rC l) LEACHING CAPACITY ( BOTTOM SIDEWALL) `'`�� GAL. b A el �Q �E' _�tJl y�?'._' P'':,5✓f ' 71i f �="s�A' ,aFwAs REVISIONS r 04Z / •!i t w ,. . ,y-) w fjGf7�i�csta �; e .0 f rr x G X fc') J fi G.. % r% ,? x 5 SCALE, DATE' gip ; c�h ` c br .- -cccr'a RESERVE LEACHING CAPACITY GAL.GAL, %�rt)c1��4u� U, r �'' r �, r ' / 3G?' /ut ' 2, 1087 R� 3R '1`g DR. BcI / /7 APPD. BY O'HcARN Hk �+ 1{a x 15CY=a { F 4 A fa ' g, Na 27671 c "q 9 `���J�EcrsTtR�•� `ti � .� r�" Joe NO.: _ SHEET / OF e FORM 11/6/ 85 a' dam , A :,.. •.-- ._.. , < rsrrtLW:a'. _. , s .rfi t Y 1. ... ,. ....... ... r'41s k.�, ,' N.M �• - . .. r. ... 4 y.... , •n`� , .,..n :;. S t ,. q ': ,,. d. sr... .�a .. :. ,?e..-: wamm 4 ._ ._ fig* ,u'. :,.,. .• ,,. ,. x ,4N .. ,_ ,....,ay, -.: .h '*?.�$`��^ t �". r :-2,•w..,.::ws:W4'^.at>ma,; .n�„ ,,. x�,<!. �. -t ,.�'�at.n�.c:.,..x.,>_„_......u., Y.�'k�a.... ..t't.,...,,, —.