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HomeMy WebLinkAbout0117 FLEETWOOD PATH - Health 1�7 Fleetwood Path j Marstons Mills 1 rt TOWN OF BARNS A LE LOCATION rl,,�-nwoo SEWAGE# bb 6Z.10 VIL ,AGE_)&V--5 Ja,v 11(dS ASSESSOR'S MAP&PARCEL 65 O INSTALLERS NAME&PHONE NO. 6 vl l` S bA SEPTIC TANK CAPACITY. 1100 4 LEACHING FACILITY:(type) - 5 o q.� �oa���oNl �(size) 13 X �S NO.OF BEDROOMS OWNER A. PERMIT DATE: Q 3 COMPLIANCE DATE: G Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 9�: _C r PLICriI `- FUr: i'ERCOLATION TES 1 r1`' } 10 CANON C"Z / Z 3 f� � �GL�`�c:.n �7.�/" � b LLAG E / i4�t-4' �_:�.�'� l � �� DAT*';7 PLICANT �l��'/I .��� /j _ FEE ^DRESS,S/7 / /�1 ,, r Ct/ �•�iZ���p�.�/TELEPHONE NO. (Nora-refundable) GINEER TELEPHONE TE SCHEDULED /z/�� Ca 1/• ��3 / �31 s signature) . 0.0 O O . O . O . O O O O O . . . . . . . O . O . O . . . . . . . . O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOIL LOG B-DIVISION NAME //% /G Z �L.e-S DATE � � -Z1- S3 TIME fi,'OU .0-1, PANS ION AREA: YES v-_"�NO / _1 pGc� !-LJEL��2 /�'� • ENGINEER WN WATER PRIVATE WELL t/ /, /"��=;;� BOARD OF HEALTH EXCAVATOR ETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and, percolation tests, locate wetlands in proximity to test holes ) NOTES: 15 O II O/ Qh v 0 LLB�% ✓Jc�'O� ��,�' RCOLATION RATE: ,-2, ��%/J /vr•''i' ST HOLE NO ELE.VA`F'ION 'ST HO.;-,t_ _ C: ELEVATION - 2 ' ------ 3 4 rzr- �CD�U,"� �• ,J 4 5 5 6 6 7 7 8 8 9 9 10 16 11 11 12 �/ 12 13 13 14 Ajo of 7E 14 15 CM G ��Jl'�-�.J 15 16 16 ITABLE FOR SUB-SURFACE SEWAGE : LEACHING FIELD LEACHING PITS LEACH-SING TRENCHES SUITABLE FOR SUB-SURFACE SEWAGE . RFASQNS : TE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION IG INAL: CO`IPLETED III ENTIRETY BY P . E . AND RETURNED TO BOARD OF HEALTH No. z d p }a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes pplicatiou for TDi57Upgade ar �p!tem Con0tructiou permit Application for a Permit to Construct( ) Repair( ( ) Abandon( ) ❑.Complete System El Individual Components Location Address or Lot No. ee-k W e c5 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 04 S Installer's Name,Address,and Tel.No.ag 67v 'S + Designer's Name,Address and Tel.No. z" S� cse— 3 9 W61c Type of Building: Dwelling No.of Bedrooms Lot Size 5,Go® sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 Qs gpd Design flow provided 33 / , S-© gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank /06 -4 Type of S.A.S. C .epS " Description of Soil Nature of epairs or Alterations(Answer when applicable) S�/� °° -A ( r—16 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 Cod and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of _ ealth. Signed Date Jd Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 9 O O` .2-t 0 Date Issued . —a 3 `d oa LID No. _ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPgication for Di��o 'ar *pgtem �Congtruction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 1`, l k W V- O wner'ss Ni m�Addressi and Tel.No.` a� + Assessor's Map/Parcel A b+�� O 5(> � � Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. K J�r� 5+ ((r.. i1� l� << t�© C "(�P� �AX �-rcw S � '�`> i � ioSs' G& PlqshJc ► ass ac- 5 39 , 9y64, Type of Building: - Dwelling No.of Bedrooms Lot Size ��60° sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) -�' Q gpd Design flow provided -3 ' S- Q gpd Plan Date Number of sheets Revision Date Title Size of,Septic Tank 6 `� , Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �,r �� r - 5 ° 16 1 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 Certificate of Compliance has been issued by this Board of.Health. Signed r- 1 �'"'� "°� Date o Application Approved by Date d Application Disapproved by: Date i for the following reasons Permit No. O 0 ! l Date Issued 5` a 3 -O THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliances" THIS IS TO CERTIFY,that#he /On-site-Sfewag�e)Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by at 3 1 -7 T as been constructed in accordance D Y with the provisions of Titl and the for Disposal System Construction Permit No. C2 0 d '��.0 dated S�Z 3 Installer Designer /1 , e,.;;,,,. #bedrooms �7 Approved design flow / I&I-Vaof gpd �Cr The issuance of this per it Aall not be construed as a guarantee that the system will faun tion'as.designed. Date Inspector �f /T -_------No. 0 6 � '�(.-� . . . . . . . . . . . _� Fee — -- --- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Di5po5ar Aq§p5tem Con5tructiott Permit Permission is hereby granted to Construct ( ) Re !air I( Upgrade ( ) andon ( ) System located at 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 thi�4na( Date �3,d Approved by �a � � 09/07/2018 02:23 FAX IA001/001 Town of Barn,stable Regulatory Services _ t�wnrtsr�atE, Thomas F. Geiler, Director • t Public Health Division r6p ' Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790.6304 !installer& Designer Certification Form Date, 6/10/08 Designer: _Shay Environmental Services, Inc. Installer: Kevin Snnoller Excavation. Address: P.O. Box 627 East Falmouth Address: MA 02536 Falmouth. MA On 5/22/08 Kevin Smoller Excavation was issued a permit to install a (date) (installer) septic system at 117 Fleetwood Path, Marstons Mills. MA based on a design drawn by (address) _Shay Environmental Services. h1c. dated May 22,2008 (designer) XX 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. Flan revision or certified as-built by designer to follow. JJA OP CARMEN (Installer's Sign ture) SHAY No. 1181 0 s tDQ*igner's Signature) (Affix amp 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:Health/Septic/DesignerCertitication Form Fi. °`"E'°a►tio Town of Barnstable do � � ,. Public Health Division 0-4 J4.t'1'+1( 2008 STAB A,08' 200 Main Street EOr""R Hyannis, MA 02601 00 �9 02 1A • / MAILED FROM ZIPCODE 02601 WHO 0004606238 JUN 04 2008 1 � Maria Murphy MURP028* 021363512 1508 09 06/10/08 RETURN TO SENDER MURPHY'MARIA MOVED LEFT NO ADDRESS UNABLE TO FORWARD RETURN TO SENDER 1 y s 4 r r Town of Barnstable Barnstable AD-Am Regulatory Services Department mice j BARNSPAHLF- q M" Public Health Division 200 Main Street, Hyannis MA 02601 2607 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO April 15, 2008 Maria Muiphy _ 28 Hamiton Street Hyde Park, MA 02136. ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 117.-Fleetwood.Path,,Marstons_Mills MA was last inspected on March,31,,2008,by.Michael Kellett, a certified septic inspector for the State-oflVlassacfiusetts:"zl ' The )inspection of the septic,system showed that the system"Failed" under the guidelines of 1995 TITLE 5:(310 CMR'15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS.— • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE OARD OF HEALTH , �j t omas 1VIcKan R S t6� d -.rli i}. ar Agent of the Board of Health 01 CERTIFIED MAIL# 0.6 21.50 0002_1042.0200 Q:\SEPTIC\Letters Septic Inspection Failures\117 Fleetwood Path.doc t Town of Barnstable Barnstable Regulatory Services Department j Ica BARNErABLF- MAS& Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO April 15, 2008 Maria Murphy 28 Hamiton Street Hyde Park, MA 02136 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at"l,17 Fleetwood Path,Marstons Mills MA was last inspected on March 31, 2008,by Michael Kellett, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS.. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE OARD OF HEALTH omas McKean, R.S., Agent of the Board of Health CERTIFIED MAIL# 7006 2150 0002 1042 0200 Q:\SEPTIC\Letters Septic Inspection Failures\]17 Fleetwood Path.doc • 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy �� Owner Owners:Name DZ�3b information is required for Marston Mills MA 02648 03/31/08 every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Imporitant: When filling out A. General Information When forms on the computer, use 1. Inspector: onlythe tab key Y to move your Michael Kellett cursor-do not Name of Inspector use the return key. Aardvark Environmental Inspections Company Name P.O. Box 896 Company Address East Dennis MA 02641 CitylTown State Zip Code 508-385-7608 S13742 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 7 03/31/08 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. fail•08/06 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. Citylrown 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: 13) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined;" please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or 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 ❑ obstruction is removed fail•08106 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M s 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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. :ail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. Cltyfrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 coliform bacteria indicates absent and the presence of ammonia nitro gen o en and nitrate nitro less than 5 g nitrogen is equal to or m, provided that no other f Pp P allure criteria are triggered. A co of th attached to this form. 99 copy a analysis must be 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow ❑ ® 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. fail•08/o6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts u r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. CityJTown State Zip Code Date of Inspection B. Certification cont. D) System Failure Criteria Applicable to All Systems (coot.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate. regional office of the Department. fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the followinghave been done. You mu "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 NIA) ® ❑ 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: Z ❑ Existing information. For example, a plan at the Board of Health. ® EJ 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)] fail-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. Cityrrown 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). 330 Number of current residents: 3 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 Seasona I use? ElYes ® No Water meter readings, if available (last 2 years usage (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): fail•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 1985 Were sewage odors detected when arriving at the site? ❑ Yes ® No fail•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 3.8 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.): Septic Tank(locate on site plan).- Depth below grade: 2.9 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: 4" Distance from top of sludge to bottom of outlet tee or baffle 27" Scum thickness 5" I 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" Flow were dimensions determined? measured fail-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 I f Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 5 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was sound and tight with tees in place and liquid at outlet invert. 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.): 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): " fail-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °�M 5 117 Fleetwood Road Property Address Maria Murphy Owner Owners Name information is required for Marston Mills MA 02648 03/31/08 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cunt.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 1"above 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.): The box was level and tight with no sign of carryover Pump Chamber(locate on site plan): Pumps in working order: ❑ •Y��es ❑ No Alarms in working order: ❑ Yes ❑ No fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03%31/0$ every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): This system has a six foot by six foot precast pit surrounded by two feet of stone. The pit was fullto the cover. fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 115 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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.): 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.): fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owner's Name information is required for Marston Mills MA 02648 03/31/08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. wr fail-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 Fleetwood Road Property Address Maria Murphy Owner Owners Name information is required for Marston Mills MA 02648 03/31/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope P ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to ground water: 30 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: USGS maps show an elevation of over thirty feet fail•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 F THE T Town of Barnstable Barnstable mily Regulatory Services Department j >VaCt 1AkNSTABLE, pg, MASS. Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO April 15, 2008 Maria Murphy 28 Hamiton Street Hyde Park, MA 02136 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 117 Fleetwood Path, Marstons Mills MA was last inspected on March 31, 2008,by Michael Kellett, a certified septic inspector for the State of Massachrzsetts: The inspection of the septic;system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE OARD OF HEALTH omas McKean, R.S.; Agent of the Board of Health CERTIFIED MAIL# 7006 2150 0002.1042,0200... Q:\SEPTIC\Letters Septic Inspection Failures\117 Fleetwood Path.doc �/��� l,Q,-t C�?a,� ���� RE Cob £3A k ' µ { F7NE Tpb. li.�t�u _ Y Town of Barnstable Public Health DivisionLZ 1 200 Main Street Hyannis, MA 02601 0 y . 021A 0004606238 APR 1 6 2008 7006 2150 0002 1042 0200. MAILED FROM ZIP CODE 02601 s � , J TA k'4 NIXIE,-- -- —0'22 DC 1 00 OS/22/09 d+ RETURN TO SENDER C UNCLAIMED UNABLE TO FORWARD BC: 02601'400200 x2822-1"67-16 -37 028010400 Q r.+<q'l4 tf Y 9 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ;r ■ Complete items 1,2,and 3.Also complete A Signature I Rem 4 if Restricted Delivery is desired. X [3 Agent p I ■ Print your name and address on the reverse ❑Addressee I so that we can return the card to you. B. Received by(Printed Naive) C. Date of Delivery I I ■ Attach this card to the back of the mailpiece, I or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No I I _ `�,�, I _ �:�vp I �1 x 3. Service Type I WCertified Mail ❑Express Mail I \ I ❑Registered ®Return Receipt for Merchandise I ❑Insured Mail ❑C.O.D. 4. Restrfcted rW'- .n __--- — ❑Yes I 2. Article Number 7006 215❑ 0002 1042 0200 (Transfer from service label) I PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 Town of Barnstable 1 P# 0 oF� Department of.Regulatory Services B&WWABLK : Public Health Division Date V fD 39. 200 Main Street,Hyannis MA 02601 Date Scheduled t Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: (),._v. ,A, 'mot LOCATION& GENE' INFORMATION E Location Address Owners Name ee ' r�oc� MyQ,h� Address � �\1'� 6} , ,1/1'� dQ k t #,4 t� Assessor's Map/Parcel �- �S� Engineer's Name C � NEW CONSTRUCTION XREPAIR �— ele p �� —�C3 t,) 8 hone# Land Use _ Q$iC�t1"lt iG\ Slopes(%) Surface Stones Distances from: Open Water Body til ft Possible Wet Area _ft Drinking Water Well ft. Drainage Way I� 11 ft Property Line �{a' ft Other— j& { ft : t SKETCH:(Street name,dimensions of lot,exact locations of test holes&.perc tests,locate wetlands fn proximity to holes)" 11 t % r �z. G vl\ J Parent material(geologic) �LT t i C�s�l Depth to Bedrock Depth to Groundwater. Standing Water in Hole: i'30TV 6h 5 Weeping from Pit Face Estimated Seasonal High Groundwater A<,s uwy\ DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: __— in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level _ �p Adj.factor Adj.Groundwater Level PERCOLATION TEST Observation Hole# i Time at 9" f Depth of Perc 3 C�� B z� Time at 6' - Start Pre-soak Time @ Time(9"-6") ... ._ ' End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed _ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# / Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. consistency, v 1) ' . 3ja -PI—A Onke Cl DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) f7� 0 Y 12 ZLd �5 ioY(� /.c, Coo ' -C Sp�p SY /c, rev DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel)- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders 'U JJJ Consistency, Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes..m Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious Merl, exist in all areas observed throughout the area proposed for the soil absorption system? _ If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environm tal P a that the above analysis was performed by me consistent with . the required training,e e and xp�r' n e described in 310 CMR 15.017. Signature f Date Q:\S.EPTICVERCFORM.DOC I , COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i Y TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A L/ CERTIFICATION Property Address: 117 Fleetwood Path 131976 Marstons Mills Owner's Name: Zildete Oliveira Owner's Address: Date of Inspection: 10/5/2006 Name of Inspector: (please print) Patrick T. Sullivan Company Name: Ready Rooter Mailing Address: P.O.Box 371 Sandwich,MA 02563 Telephone Number: (508) 888-6055 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I.am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The System: asses Conditionally Passes Needs Further Evaluation by the Local Authority Fails i Inspector's Signature: /�i,� Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Boats f Health--or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design o of 10,00� gpd or greater,the inspector and the system owner shall submit the report to the appropriate regiona ce of t}� DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and t e approv&' g authority. tv CU Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 117 Fleetwood Path Marstons Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _Zl 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: B. System Conditionally Passes: One or more system components as described in the"Co itional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or r air,as approved by the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in the ,�for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*,!or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltrati¢n or tank failure is imminent..System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: r 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 obstruction is removed distribution box is leveled or replaced ND explain: 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): f fn broken pipe(s)are replaced obstruction is removed ND explain: f Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 117 Fleetwood Path Marston Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by a Board of Health in order to determine if the system is failing to protect public health,safety or the environm t. 1. System will pass unless Board of Health termines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner ich will protect public health,safety and the environment: _Cesspool or privy is within 50 f t of a surface water Cesspool or privy is within 50 eet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,:safety and environment: _The system has a septic tank and soil absorption systeT'(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water sup —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��d the SAS is less than 100 feet but 50 feet or more from a private water supply weel". Method used7�fo determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds}idicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and 9.ftrate 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. f �tl 3. Other: F f r f a Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 117 Fleetwood Path Marstons Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ _Z 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 and 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 well. _ Any portion of a cesspool or privy is 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] jlJC(Yes/No)The system fails. I have determined that one or more of the above 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/fac' ty with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the foll(The following criteria apply to large systems in additionteria above) yes no the system is within 400 feet of a surface f ing water supply _the system is within 200 feet of a tribut to a surface drinking water supply the system is located in a nitrogen s nsitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply vy 11 i 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. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 117 Fleetwood Path Marstons Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 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? jZ_ Was the site inspected for signs of break out? _ Were all system components,excluding the SAS,located on site? _ Were the septic tan_{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 than 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: Yes No -4Z _ Existing information.For example,a plan at the Board of Health. _,/_ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 117 Fleetwood Path Marstons Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): _ DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): : Number of current residents: q Does residence have a garbage grinder(yes or no): L?_ Is laundry on a separate sewage system(yes or no):�[if yes separate inspection required] Laundry system inspected(yes or no):— Seasonal use:(yes or no): � Y c �g Water meter readings,if available(last 2 years usage(gpd)): Q Sump Pump(yes or no): Last date of occupancy: g COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): d Basis of design flow(seats/persons/sq.ft tc.): Grease trap present(yes or no):_ Industrial waste holding tank prese (yes or no): Non-sanitary waste discharged tt e Title 5 system(yes or no): Water meter readings,if avai le: Last date of occupancy/us OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the ' spection(yes or no): I4es,volume pumped: i r—r-yz�. gallons--How was quantity pumped determined? � Reason for pumping: TYPE OF SYSTEM _�,Aeptic 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) —Tight tank _Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information: ��.•ram cs� �..1�aC'i� -+'��.,r-� ,5 , Were sewage odors detected when arriving at the site(yes or no):Lv O I Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 117 Fleetwood Path Marstons Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 BUILDING SEWER(locate on site plan) Depth below grade: 3 < 9 ` Materials of construction:_cast iron�0 PVC_other(explain): Distance from private water supply well or suction line:" Comments(on condition of joints,venting,evidence of leak ge,etc.): SEPTIC TANK: locate on site plan) _Z( P ) Depth below grade: `' � � Material of construction: /concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: q. Sludge depth: Distance from the top of sludge to bottom of outlet tee or baffle: 3a Scum thickness: 3" _ Distance from top of scum to top of outlet tee or baffle: " Distance from bottom of scum to bottom of outlet tee or baffle: 13 " How were dimensions determined`—Q, Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): �1GiC��Jl S• �.+��u�•�G. �'E'.J'�+� '.o\ O C;.)V\'�_V' \�U'-C� �,� \�S �G.i GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_metal iberglass__polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of/s,inlet baffle: Distance from bottom of scum to bot tee or baffle: Date of last pumping: Comments(on pumping recommendand outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence oc.): f Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 117 Fleetwood Path Marston Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 TIGHT or HOLDING TANK: (tank must be p d at time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete_metal ibcrglass_polyethylene_other(explain): Dimensions: Capacity: gallons Design Flow: gallo day Alarm present(yes or no): Alarm level: Alarm in wo ing order(yes or no): Date of last pumping: Comments(condition of alarm d no switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(not if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): 1to -S�c�� r� PUMP CHAMBER: (locate on site/ondition l Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chambe of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 117 Fleetwood Path Marstons Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 SOIL ABSORPTION SYSTEM(SAS): ,/(locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): n «� G•�,�-...,.r-`e�. ., ..��iL ��ax;a+.t:�z�Q� ��.`„� \ \l<r \ o�, `��.`C�c•»_+ �wy�J��f NJCJ �y is.��. -• \Ic�Se W w��a r c S S•c5 ivy? A r c�vwr� 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 or no): Comments(note condition of s ,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) / Materials of construction: `f Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 117 Fleetwood Path Marstons Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. / KS O 3 I Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 117 Fleetwood Path Marston Mills Owner: Zildete Oliveira Date of Inspection: 10/5/2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: �btained from system design plans on record—If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the local Board of Health-explain: Checked with local excavators,installers-(attach documentation) _LLAccessed USGS database-explain: r4,s, •. -ems_ ,_�C vo,�, You must describe how you established the high ground water elevation: ' TOWN OF BARNSTABLE , w� LOCATION 1 '1 `� © o`�� SEWAGE# <:k 0-LJ( O VILLAGE ASSESSOR'S MAP&PARCEL d Y? - C>S"C INSTALLERS NAME&PHONE NO.J�,,,^, S Cf�..,® s C SEPTIC TANK CAPACITY \DOp �� S LEACHING FACILITY:(type) (size) `ego Co k.3 ' NO.OF BEDROOMS OWNER PERMIT DATE: I 0 Ll COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ) ® Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �c�c�y �.�`���, S,t.G / Ph\ / c3 t Li is }. // 7 Sewer Permit No. Name Location lastallu's Name and Address AL ao/a Builder's Name and Address LI Date Perodt Issued: Date Compliam Issued: ! ' g I # , 'I r i+ 4 J �� l/.\�'� V , � , 1g . No... Fina.......`.0 ........ THE COMMONWEALTH OF MASSACHUSETTS P � q 31 BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration' for %gpaiial ork� I""trurffntt amit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ................__.------........... F.-ce�eoc..----.. . ...........................----....Z........................................................ •- Location-Address or Lot No. . etms xnun vk--- -----•----•..............•---------- .........................t�o...1�. ..i3z-► ulank. O ne D Address a --------------- 6a.e •-------•--- �► .............................. ......t0_--..6e.i x....&I......_U�.�4CSL�SO Installer Address Type of Building Size Lot...Z..��. __ .Sq. feet -� Dwelling—No. of Bedrooms............................................Expansion Attic (�� Garbage Grinder (kl;b `4 Other—Type T e of Building No. of persons............................ Showers Aa. YP g ---------------------------- P Cafeteria ( ) P4 Other fixtures ............................ . W Design Flow.................����..................gallons per person per day. Total daily flow____....._.33.v....................gallons. WSeptic Tan'.'.k—Liquid capacity19Pd__gallons Length.J�bL Width... Diameter-_-_N/A... Depth..4!:Q"... x Disposal Trench—No... �? ..... Width.................... Total Length..._.....)_....ii.. Total leaching area...............F sq. ft. Seepage'Pit No..........1________.. iameter.......�. ... Depth below inlet......-©..... Total leaching area.._2�'.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.................. : ........................................ Date----Ofr.8-c1......................... a Test Pit No. 1......2.._._minutes per inch Depth of Test Pit.....1. -���____ Depth to ground water..rlSne e-AAC_C.0 Test Pit No. 2....... :...._minutes per inch Depth of.Test Pit..._.__I 1:_S.. Depth to ground water....................... �+ --------------------------------- --•--....••-•-------•----------------......-...-------------------_.._....-..-.-....-------------------------------------- Description of Soil.......--....................................1------------------------ }------------------------ - rrrn-.e�,�u rv►..�.4�a1C'��.�'Y►4F. --•---....-•--••..............• 2' p o - ��o harm yt (-o -- . ,'�i�uli N.'�.. 3a..i s2�4I�-�._..Sc �L . V ---- ----- t W ••••-•---------------------•--------------•......•••.--••--•---------------•----•--•-••---••-•---••-----•-------......---.......------••••-••••--------------•--......_..•------•----••-••------------•. V Nature of Repairs or Alterations=Answer when applicable•-_-______W�A_ ........................................................................... -----•-----••-• - -------------------------------------------------------- .................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .... ----------------- --------------------=.... ...../K- ----- Application Approved By ------------- . . ---- --------------------------------------------------;----------------- --- Dare Application Disapproved for the ollowing reasons: .. ---------------------------------------------------------------------------.................................................. ------------------------------------------- ---- ------------------ ---------------------------------- --- --- --- -- -------------------- ------ --- ---------------------------------- ......................------------- ,¢ t Date Permit No. .-----el.--.,)--^-------/I e..........------------ Issued ..---- Date \I o No... ........ • J THE COMMONWEALTH OF MASSACHUSETTS 3� BOARD OF HEALTH TOWN OF BARNSTABLE Applira#iou for Uiipnoal orksnnolrnrtiun �rrmit Application is hereby made for a Permit to Construct ( h or Repair ( ) an Individual Sewage Disposal System at: ................-........_.......... Flce ooc...........-��..... ------------------------------...... �..................................................... -- .. ...... \ Location_Address 7 or Lot No. �1c�rvrn� Yl'lu�al�s1 ............... 1�0....X .44...13Z. �_Gt�rll` .; Owner +j Address W \I/�/1��� �►•r��{. A nX ���/1 1.1 I ct(Z(An;7 �ar� n W ................:.. . - --•-•----.._..- ......•.._ ....._...............-----•......-•-.----- Installer ...........:.. m Address d Type of Building Size Lot..2--r-�•-!e . -Sq. feet Dwelling,—No. of Bedrooms............-••a•-............................Expansion Attic (�� Garbage Grinder ( �, 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures .-------•--••-•..........-•••••• . W Design. Flow................����"..............•.__gallons per person per day. Total daily flow.._.........93 ...........:.......gallons. WSeptic Tank—Liquid capacity� n._gallons Length__:.b��__ Width._r--�'o.... Diameter..... �Q.__ Depth•_�1� ��.. x Disposal Trench—No........ .A..... Width.................... Total Length.................... Total leaching area_______________...sq. ft. Seepage Pit No..........I.......... diameter....... Depth below inlet..... Total leaching area...2_�'sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by................ ........................................ Date.... 7z..._..... � W Test Pit No. I......Z-----minutes per inch Depth of Test,Pit.....12t5..... Depth to ground water..Y?_ g_�_ c cu�t f=, Test Pit No. 2.......2-......minutes per inch Depth of Test Pit....... Depth to ground water........... W -------------------------------- ------------------ -----•---•---------.------•-------------------.-------------------------.- D Description of Soil..�................:�- --�� i c"rd� t-„ '�_ o• - �2.r x •- Z C� _�_... It. '''��1t4•`" ' (.f��sS -----AeL!24. W t VNature of Repairs or Alterations—Answer when applicable...........A--------------------------------------------------------_--.--________--••. ......................................................................................................................)........*...... ............................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has-been issued by the board of health. Signed --... !!r4�: - ... ...! _ ...................- ...................... ...... Date Application Approved BY .,. - r . -- +, --... ---'Date t/...9�.., Application Disapproved for the ollowing reasons: ----------------------- --- ---- ------ ----------------- ------------------------------------------------------------------ -------------------------------------------- ------...............................-------------------------------------.........-------"�...............................................------- -------------- -attee----------------- ------- � D' t..,� Permit No. �-.... ----C-4d----------------------- Issued ------------. ........- ..............-.-.................. Date ..-- THE COMMONWEALTH OF MASSACHUSETTS i V BOARD OF HEALTH TOWN OF BARNSTABLE GPrttfi ate of TomplianCP THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( L//) or Repaired ( ) by................................. ........................................... J,nstaller at ------------------ s�. ... � .......... -M,&/,--------........ .......k14.......A...............................-...........----........-------------------- has been installed in accordance with the provisl'bns of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ------tom ..f.-0............ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................. 1 ......... . .......................................... Inspector -----------.......1...... - V THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE / . FEE-•-�•-•-•--c No.. ..c?Z_-•V/CC) (� .e�.... Elisposal Vorkvdun r uan , anti Permissionis hereby granted.............................................................................................................................................. to Construct (>c-) or Repair ( an Individual Sewage Disposal System a Street `' as shown on the application for Disposal Works Construction Permit No.?2-.ylL-. Dated.......................................... •---------------•------•••-•--•-••••--� �� ------------------....------------•--•-•---.._ ` Board of Health DATE.................•••. -•-••--• 'Q---• ----- FORM 36308 HOBBS Q WARREN,INC.,PUBLISHERS TM I: 1, , I £L.= yR 6 20' " COAVCsDP nr lnmrmu�aty s COMM . . i . . . COAL' GZ?sm SlCttlQ' .•. 2z / T7 4-0 . . P.1<C • APPRO VED: BOARD OF REALTH swr.; r r�V. Z a* Sw aat . . raor,rars o.01 H s ELL Z . . �Icn�rwr - a� saas»s � o DATE - • Ec.= .:AGENT • - •:•: .... EL= pea c o Q o $arm nw EL Sim . . Z00o . . 11 Cr4LLGyVS 'i LOT 117 : '•• _ . . • • DJA�L 10 BO?7bY OF ?ffiT>1JOLd' 8l� d6.o NO WAY" aN &W7=0 s"y9 PROFIIjE OF l 04 __ SEWAGE DISPOSAL SYSTEM NOT TO SCALE IV. � -- � , ► , / ,, lIN IIATRR A vAtI.ABLL' l � -------- ► i � 11 ► 4 _, // ------__ l/ ► ► I l , L/ ALL JMNvA27ORS AS,SLED , ________ ► J �l / / c4 /l � 1 it 0 =--- I � i 30II. :LAG fill] ! // i if y , ► / i n lI . .J I t l l WUNESSED BY. Jmy Dvivi ^i , t Ara e D TAS1' 1YOLR' 1 ?SST XOLg 2 � I t t 7n11N 4F' RlR1�S!ABla' t r � � �_ _ l ti �I 1 - 9'7:6 ?tGt 0 tl 1 1 1 / �, .; i , , f1 LOT 524 / t 1 1,�t, ��o _ �e l ,,,, � t i ��11 I � 9'�� �/ , , . . � i- �� _ J M � Pb"RCOLAT7i7N RATS ltiltl n�t � 1 � l � t � 1 ► // a�eao 1 � � � o t/ 1 ►t i thy♦ t f i ` � ► l DESIGN ATA: N MER OF BEDROOMS ♦♦ � ♦ �/ � „ � • .a I u 1 � 1UurUlir m ♦♦ C I za lWARN ♦ �♦♦♦ ♦ ♦� SAND �♦♦���♦♦♦��� ♦� /l/,l 11 ► /►,l// , I COARN TOTAL FIAIf s GPAA ��♦♦ (� l/►ll,� / ,SAND H ♦ ♦����♦� J III 'P'' ._ Zo 1La 110 GAL AY s BR �r LOT 323 �� o ♦ � yea.o ♦ ♦ smI ,TIC TANIf CAPACITY LOW � LANDE a CAS ' N♦��0 CIVIL �� ��\��♦ ��H 9F '�qs LAG AREA RBQ N .35,oj 11� �♦ . � t. MZWALL AREA G P e5 a� . 1 .� wA>� a�rcocrivrr�m � �, 18�6 AL/S . F� �>: �S 1 ► t �/ RO??t?Y AR�t GALI \ t t p No.32098 ¢ 1eQ�• . ♦ � � Fss F�15TE��� qa`` � i 'O ti LAN os° LSACMYG CAPACITY ( BO"VJ( & SM"." GAL R1�5RRY8 L ACING CAPAaff "_ GAL ASS JL/P ,4T LOT 50 1VV= wAM AfADV 1s IN OPP06m Sata` - Of S?R�T. `ANO GJ2T US 11WI m � 56F i PRO.T1�,'CT LOCATION FLOOD-.PATE MR Tom' LOT. ]IARSTtiNS Y1ltS i LOT 322 d' AP.PLICAM` iAAW R NURPHY �, 1i7o BOVTZ 138 BYAIIrNJSy YA. 02601 GENIAL NOTES S JU2YMW AND:FINAL GRADAY S�YALL AnfALY Y Tf i YAM ' SURVEY CONSIILTAMS Z mw Pwr w i 1NR r LumoN OF mw A'Rvim i P.O. BOX 265, 143 ROUTE 149 SAYS i/NLSSS' 1V01aD BY FLVIL C10NTbL / MARSTIONS' .MILLS, AfA. 02648 Z PLAK b" 8oTS1 .$ SJi1" 4 Z ALL COYP01VR17S OF M SANITARY SYS2XV SZU BE CAP.�Ftl.Pi i OF 1RTJY 7AIVDIM 8-10 LOADING UXLJS`S Tf1RY ARE UNDMR Ed 6=2 4M--QM - S TRW PLAN N 1 VR XffALLA IR RBPA OF SaPM SYVY" OR wnmv 1o' OF Darm OR PARRTIVG AS H-RO LOADDVG AND NOT IV BE USRD JIVR VA72Nt; OR ZOMVW PURPDS'85C DOW -SH.lLL BE tJSaD UNLtRR DR 1177ffI1V 10' OF DRlW 'OR PARING. SCAALK1" = 90' � 14y 1992 - 4; ALL Ot7)MUNSEF AND,Afd2ZRRIALS 53ALL CDNFV" IV UX P. UNZws J02= 27= 5 AND ice' IVWN OF BAMWABZC RL2R5 AND JtWVLA=JW S ANY J WNRY UNITS UMCD 70 15t WO CO VA Tb GRADE SIMU , PVR TM SU6�SURM"ACV DS�°IClSAL 07 S"AGR BE .i�OR?AI?aD m PLACE COL S'T: ��' Ate 14 1�� 5 ALL C P= 2V SAMTARY UAM SFA BZ RROt1GW IV' W127MY 9. NO A27VN HAS BMW JUDE AS 2V COW'LU,NCA' IIITH 12" OF FL Z2= GRAB D OR SOAM AWVLl270AM :011'NBR/APPLXAM' ff n'1 -- OBTAW SL�H D17ZRAaVA27ON JPBOAf APPA0PRLlTR AUTMArYY. locAnON . YAP 19 501O9C S1237 1 OF 1 �• one`' VENT PIPE (O Least 24 inches tall) 10' min. from *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. Schedule 40 PVC w/Charcoal Odor Filter EXISTING Foundation house to septic tank D-Box cover must be s •- Septic tank covers must be within a• of GRADE SAS cover must be SECTION A -A . P• t within a In. of finished grade Grade over Septic Tank- 99.00 Grade over D-Box- 99.00 within 8• of GRADE over SAS- 10,.00 E F /- PROFILE VIEW OF LEACHING SYSTEM S . 0.02 3 HOLE TOP OF SAS- 97.00 p•f. r ►/s• re.kN�►,we slow •y r/S•- ,/s• fa,Aw ha�Mne (H-20) 015T. BOX 12• 5.0.01 INSPECTION cover must ;g-d. EXIST. 1 000 GA within a in. of ttnishedNFO PIPE 25 .01 er foot ca rFROM FDUNDATMIN SEPTIC TANK +,o►•++•.MH 10 CONCRETE FULL FOUNDA II O� of 4"d. hilorosoftr Oro moor nqi iltd;a afdrYrf.a3.6 3.6 o 0 0 0 0 SYSTEM PROFILE II z unit: a es' • v' 0 fZ' s P OVIDED 9' GENERAL NOTES Not to Scale Effective Width 4 4 > > 1. Contractor is responsible for Digsafe notification, Verification of Utilities -c -` 25 and protection of all underground utilities and pipes. Effective Length 2. The se tic tank an distribution box shall be set compacted stone level on 6 of 3/4 -1 1 2" stone. SOIL ABSORPTION SYSTEM (SAS) 3. Backfill should be clean sand or gravel with no Bottom of Test Hole 1 Elev.- 89.00 500 - C H-20 LEACHING UNITS / WIGGINS PRECAST stones over 3" in size. PERCOLATION TEST Not to Scale 4. This system is subject E inspection during installation by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance Date of Percolation Test: MAY 22, 2008 NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 8" BELOW GRADE with Title V of the Massachusetts state code, the approved plan Test Performed By. CARMEN E. SHAY, R.S., C.S.E. and Local Regulations. Results Witnessed By. DAVID STANTON (BARNSTABLE BOH) 6. If, during installation the contractor encounters any EXCAVATOR: SHAY ENVIRONMENTAL SERVICES, INC. soil conditions or site conditions that are different Percolation Rate: Less Than 2 MPI ® 12"" ® TP1 from those shown on the soil log or in our design installation must halt & immediate notification be Test Hole Test Hole _ made to Carmen E. Shay - Environmental Services, Inc. No. 1 No. 2 160.00 7. No vehicle or heavy machinery shall drive over the DEPTH SOILS ELEV. DEPTH SOILS ELEV. - septic system unless noted as H-20 septic components. 0 99.00 0 99.00 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. Sandy Sandy 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. Loam Loam 10. All solid piping, tees & fittings shall be 4" diameter 10 YR 3/2 10 YR 3/2 LOT 323 Schedule 40 NSF PVC pipes with water tight joints. A 98.50 0"-8` A 98.50 # 11. Municipal Water is Connected to ALL OF The Residence and Abutting Loamy Loamy 25,600 Square Feet t/- Sand Sand Properties Within 150 Feet. 10 YR 5/0 10 YR S/e Be Be THE PROPERTY LINES ARE APPROXIMATE AND j 8`-12' sa.00 e`-12" se.00 - COMPILED FROM THE PLAN BY YANKEE SURVEY CONSUTANTS, ENTITLED Mod- oarse Msd-Coarse PROJECT BENCH MARK 4 Sand Sand TOP OF FOUNDATION PLOT PLAN OF 323 FLEETWOOD PATH, M.MILLS, MA" 2.5 Y 8/0 2.5 Y e/e ELEV. = 100.00 (Assumed) DATED Feb 14, 1992 12`-120` C, 89.00 12"-120" r, 89.00 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN 25- Failed IT SHOULD BE USED FOR NO PURPOSE OTHER THAN LEACH PIT_ TEST H LE #1 THE SEPTIC SYSTEM INSTALLATION. 112 h'' cw 1 j ELEV.- 99.00 AREA r: j EXISTING Leach Pit TO BE PUMPED OUT AND FILLED IN PLACE t••.�.:,:,..a �:•• ., '•�;'.l 99 LOT #1 >7 110 �- -� yam- NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE D-Box EXiST. TEST HOLE_#2 1000 gal. ELEV.- gg 00 FROM THE EXISTING Leach Pit TO BE DISPOSED 108 z \ Septic Tank OF AS PER BOARD OF HEALTH SPECIFICATIONS. 3' Retaining II Perc #1 THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY Depth to Perc: 30" to 48" Perc Rate= Less Than 2 MPI 106 DECK 112 ASSESSORS MAP 47 PARCEL 050 Groundwater Not Observed LOT #322 104 SHED No Observed ESHWT LEGEND ADJUSTED H2O Elev. - None 102 r------ -- 110 i EXISTING o DENOTES PROPOSED o 3 BEDROOM o 108 0 SPOT GRADE ALL OUTLET PIPES FROM THE 1 O4X 1 DISTRIBUTION Box SHALL BE - SET LEM FOR AT LEAST 2 FT. 1Y CONCRETE COVER 1 CQ � ► HorrsE - 3- 5*�T " " �''• i 106 X 104.46 DENOTES EXISTING {� I #117 SPOT GRADE - as• a,nET '` 12• INLET 100 ; 104 i•, e' c' 'v --- PL PROPERTY LINE 10,2 r'aa' 4• - SCH. 40 To 1.7a• 96 c i ASPHALT I 100 996r PROPOSED CONTOUR PLAN SECTION CROSS-SECTION 94 i DRIVEWAY %� i 99 - - - - - -97 EXISTING CONTOUR 3 HOLE H-20 DISTRIBUTION BOX 3 s NOT TO SCALE 92 - 98 ® DEEP TEST HOLE & 6 PERCOLATION TEST LOCATION 2-1a• DIAM. ACCESS MANHOLES 9 a � 94 . . 6 FOOT STOCKADE FENCE ::. r -90 INLET / �• 4 I 160.00' 5' Retaining Wall rn 88 PLOT PLAN \ f OUTET .� 1 1 f` THE ACCESS COVERS FOR THE SEPTIC TANK, 82 ®Catch Basin 80 OF PROPOSED SEPTIC SYSTEM UPGRADE • t�' DISTRIBUTION BOX AND LEACHING COMPONENT / V _ ; •;, „�--.o,;+-. �j:+r r►-hM;; SET DEEPER THAN a INCHES BELOW FINISHED 1- -- ------------------ PREPARED FOR GRADE SHALL BE RAISED TO WITHIN a' of ----- -------- ------------------------- --------- ------ STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. A M A R I A M U R P H Y PLAN VIEW INSTALL TUF-TtTE GAS BAFFLES OR EQUALS B0 FLEE TWO O D .PA TH 3-24• REMovABIE covERs-\ (40 FOOT fiGHT OF WAY) = # 117 F L E ETW O 0 D PATH I - ; 4' MARSTO N S MILLS MA 3 min. clearance ?' . , Design Calculations L� INLET a min T- 2" min. Inlet to outlet s. •` IF L . OUTLET -}}- o Bedroom o s u�r -"' iJ Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. per Title V) Kitchen CD o CD Bedroom JR7;, BY:S• r S -7• ` ''Garbage Grinder. NoGf, 1 C A4'-0` min. Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) E;, v`: �N E. AJ Ht1 Y on@am !' !• Liquid depth � Bedroom Septic Tank - 2 x 330 Gal./Day - 660 USE EXIST. 1,000 GAL. Septic Tank. vI-r?` F Dining 0 ib ;'1 i ENVIRONMENTAL SERVICES INC. = S , - ' OIL ABSORPTION AREA: Using percolation rate of <2 min./inch I� . .,t, •• •.; "' ....• " ''1 Bottom Area: 0.74 gal/sq. ft. x 300sq. ft. 222.00 gallons Attic Storage Attic Storage �o a'-o- 4• -10• Sidewall Area: 0.74 gal./sq. ft. x 148 sq. ft. 109.50 gallons 185 ASHUMET ROAD CROSS SECTION END-SECTION Providing: - 331.50 gallons SA1dITAR\P�. MASHPEE, MA 02649 1st Floor 2nd Floor Use: (2) PRECAST 500-C UNITS, HAVING A 2' EFFECTIVE DEPTH, TEL/FAX : 508-539-7966 TYPICAL 1000 GALLON SEPTIC TANK TO BE USED WITH 3.5' OF WASHED STONE ON THE SIDES AND 3 BR HOUSE FLOOR SCHEMATIC SCALE: 1"=20' DRAWN BY: CES DATE: MAY 22, 2008 4' OF WASHED STONE ON THE ENDS. NOT TO SCALE (Description Provided By Owner) PROJECT#SD1090 FILENAME: SD1090PP.DWG SHEET 1 OF 1