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HomeMy WebLinkAbout0106 GREAT HILL DRIVE - Health 106 Great Hill-Drive Marstons Mills F/R A = 174 038 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 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. Important: A. General Information When filling out forms the computer, r,use 1. Inspector: only the tab key to move your Raymond F. Dumas, Jr. cursor-do not Name of Inspector use the return key. Dumas Landscape Const. Inc. GF Company Name 564 Old Stage Rd. Company Address Centerville, Ma. 02632 Cityrrown State Zip Code 508-778-0249 S1437 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. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fail -. ❑ Needs Further Evaluation by the Local Approving Authority N.) 1/14/2009 Inspecto Sign ure Date r-- The system inspector shall submit a copy of this inspection report to the Appr wing ANoritFBoard 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. Scott Gonsalves Septic Inspection.doc•03108 Title 5 Official Inspection Forth:Subsurface a Di g sposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °M '< 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown 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: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, 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 Scott Gonsalves Septic Inspection.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown 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: N/A 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. Soott Gonsalves Septic Inspection.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. City/Town 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 nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 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. Scott Gonsalves Septic Inspection.doc•03/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): 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. Scott Gonsalves Septic Inspection.doc-03= Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. CityrFown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the 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)] Scott Gonsalves Septic Inspection.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Citylrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 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 Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2007-48000 g ( y g (gp ))' 2008-39000 Sump pump? ❑ Yes ® No Last date of occupancy: now 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): Scott Gonsalves Septic Inspection.doc•03108 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 GM , 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: 12/08 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): also has 1000 gallon pump chamber Approximate age of all components, date installed (if known)and source of information: 4 1/2 years old compliance date6/3/2004 Were sewage odors detected when arriving at the site? ❑ Yes ® No Scoff Gonsalves Septic Inspection.doc•03/08 Title 5 Official Inspection Fonn: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 e. SVeye: 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 3 ft. feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: approx 20'from town water line feet Comments(on condition of joints, venting, evidence of leakage, etc.): good Septic Tank(locate on site plan): Depth below grade: 24 inches 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 gallon tank Sludge depth: none Distance from top of sludge to bottom of outlet tee or baffle n/a Scum thickness none Distance from top of scum to top of outlet tee or baffle n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a How were dimensions determined? n/a Scott Gonsalves Septic Inspection.doc•03108 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M Svey�< 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown 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.): recommend septic tank to be pumped every 2 yrs. 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): Scott Gonsalves Sapfic Inspection.doc•03/08 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 , 106 Great Hill Drive Property Address Scott Gonsalves Owner Owners Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: approx. 6'x6'x8' Capacity: 1000 p �' gallons Design Flow: 440 gallons per day Alarm present: ® Yes ❑ No Alarm level: 24" inches Alarm in working order: ® Yes ❑ No Date of last pumping: 12/08 Date Comments(condition of alarm and float switches, etc.): good *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 at level Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): level/no carryover Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No Scott Gonsalves Septic Inspection.doc-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): all good 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: 2-50'x12' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: two 4" pvc perferated pipe in stone as per plan on record Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): good Scott Gonsalves Septic Inspection.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 every page. City/Town 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.): Scott Gonsalves Septic Inspection.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's Name information is required for W. Barnstable Ma. 02668 1/14/2009 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. #Ter. 4 _ _ o 0 i "a Y 7:fl a chic doc•03R9 Title 5 Orfiaat hspeckm Fam:S�rafwe Sewage Disposal System•Page 44 of 15 r.1; P Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M s 106 Great Hill Drive Property Address Scott Gonsalves Owner Owner's iName information is required for W. Barnstable Ma. 02668 1/14/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 8.5 ft feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 5/20/2004 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Obtained Engineered plan ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: J You must describe how you established the high ground water elevation: Engineered plan on record Scott Gonsalves Septic Inspection.cloc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 TOWN OF BARNSTABLE �C Y LOCATION SEWAGE # G'lDOy VILLAGE ASSESSOR'S MAP &LOT I'*7 "03 R' INSTZLER'S NAME&PHONE NO. 0 O SEPTIC TANK CAPACITY 71— LEACHING FACILITY: (type) (size) -/2�--�"� / NO.OF BEDROOMS - r , BUILDER OR OWNER / PERMITDATE: S::� COMPLIANCE DATE:_ log 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 49:: (C l 130?' y= � � No. 00 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS e 01pprttatton for Dtzponl 6potem Con!5tructton Permit Application for a Permit to Construct( )Repair( )Upgrade(�bandon( ) ❑Complete System El Individual Components Location Address or Lot No. ner's Name,Address and Tel.No.9A�Q, Assessor's Map/Parcel (�c) 0 re (00 Installer's Name,Address,and Tel.No.`?k &1E i)(CA O�T k1�j Designer's Name,Address and Tel.No. �ncEY � ��16covCC�Qc�c3- �►a�tS `� rW Cro - w e�`� � Vic/ Type of Building: � f t Dwelling No.of Bedrooms "i Lot Size Lis I�D sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Liq gallons per day. Calculated daily flow L gallons. Plan Date .S'-o U� Number of sheets � Revision Date jor Title Size of Septic Tank Type of S.A.S. ' X Sc z �� ce Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1 0 \to o (W �'►'°�`�lR��- � �. b(✓ 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 iss ed b hi and of Hea t Signe A CO 1,0 Date Application Approved by Date Application Disapproved for the following reaso Permit No. Date Issued No..A N Fee THE COMMONWEALTH OF MASSACHUSETTS i Entered in compute , W. i:` Yes ' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS Zippfication for �Bigoof *p.5tem Con!5truction Permit Application for a Permit to Construct( )Repair( )Upgrade(L')Abandon( ) ❑C,omplete System El Individual Components Location Address or Lot No. 31 wner's Name,Address and Tel No. 1�Ck-AR(7� Assessor's Map/Parcel (A S-1 ArSte U{/, Installer's Name,Address,and Tel.No. `-1 M_,Q E�xC A dA TJJPJ Designer's Name,Address and'Tel.No. ` uRRO�EY R�; E_6 t&NC-G-t2� Nb WOQ�S s,��n����► wt� oa5�� yaw c(o � t8z Grp �e N,t va6� Type of Building: r Dwelling No.of Bedrooms Q Lot Size 1431 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow L+y v gallons per day. Calculated daily flow y L( y gallons. Plan Date Jn" Number of sheets 3 Revision Date f Title Size of Septic Tank Q�iS t' S Type of S.A.S. 4 X So Le�­(ktl Ce I d Description of Soil Nature of-Repairs or Alterations(Answer whe-n7ape licable) OVA.) \L_*0 or" O���'��"— ��►^'►v "" (✓ ' a A e ( '�✓ Date lest inspect' dP "4!r )1 Agreement � 10 The u derstgne, agrees to ensure-the construction and maintenance of the afore described on-site sewage disposal system ", ,f. /'/ka' 1t. I !�' in accordance with the provtsons of iTitle S/of the Environmental Code and not to place the system in operation until a Certifi- 'cate of Compliance has been is ,ued b nth' o dar o ealth Signe!0 AA 0 � 14Date Application Approved by / „ ,�/� t�AZ .� v Date Application Disapproved for the following reaso� ~ c 1 s Permit No. r U ,— Date Issued LW52f:7,/ ---------- ------------- -- -- --- -THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE th the O .-site S wage Disposal yste I Constructed ( )Repaired( ) Upgraded AbanMe ( , y �� L �/ 1_h� at f A6 D has been constructed in accordance with the provisions of itle.5 nd the for Disposal Syste Construction Permit N r. I dated �l2 y/y y Installer13S Designer The issuance o this permit shall not be construed as a guarantee that the system function as designed. Date 3 2 00 Inspector No. �/ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migoal *p,5tem Con.5truction Permit Permission is hereby gra ed to Cons c��j�'") e it( )Up a,�J( )Abyaqddn System located at 'tU�—o_� V lJ /�46M 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 followlg local provisions or special conditions. _ Provided:Construction must be comnlefed within three years of the date of this unit. Date:_. �� ` / 1 Approved by �S V . r , TOWN OF,BARNSTABLE LOCATION SEWAGE # VILLAGE' ESt ASSESSOR'S MAP & LOT �� "�3 INSTALLER'S NA PHdNE N0. 0 0 SEPTIC TANK CAPACITY P LEACHING FACII.I - pe) A7 (size) NO.OF BEDROOMS' — BUILDER OR OWNER I PERMIT DATE: COMPLIANCE DATE: y Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility Of 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 a9/ e 06 �- i Town of Barnstable Regulatory Services Thomas F. Geiler,Director + BAEtNfi Fi46r e. MAW' Public Health Division rEo eiu►'�°i Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: S- - q - y Designer: eel✓tub Installer: Q Address: l_3 G(�5& Address: Zo64✓86f= on t S 7-2 E )"0( was issued a permit to install a (date) (installer) septic system at 106 6 ✓e4d- 6111 l)rIy-C based on a design drawn by (address) r q e e✓r (_Q Uk4 dated (d igner) 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 Re Ian revision or certified as-built by designer to follow. ' e" ft. Kdstaller's Signature) 0 (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC BAALTH DIVISION. CERTIFICATE F—;:C_N�::i�_ OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOT161 THIS FORM AND AS CARD ARE RECEIVED BY THE BARNSTABI X P ,LIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiper Certification Form FAlEj INSPECTION COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENV75, ROTECTION W ' d TO OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 106 GREAT HILLS DR W E 02668 I�7 4* Owner's Name: SUSAN PICARD pMp ,,, Owner's Address: 106 GREAT HILLS DR W. BARNSTABLE 02668 PARCEL • .� Date of Inspection: 4/22/04 LOT ; Name of Inspector: (please print) JOHN GRACI,INC. Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 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: _ Passes _ Conditionally ses _ Needs Furthe aluation by the Local Approving Authority X Fails Inspector's Signature: Date: 4/22/04 The system inspector shall submit a py of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspectio If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments SYSTEM FAILED TITLE V INSPECTION. THE LEACH FIELD IS SATURATED AND HAS NO EFFECTIVE LEACHING LEFT. ****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. Titles 5 Tmnertinn Fnrm A/1 V1000 1 f Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: SYSTEM FAILED TITLE V INSPECTION.THE LEACH FIELD IS SATURATED AND HAS NO EFFECTIVE LEACHING LEFT. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a 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: n/a n/a 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: n/a n/a 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: n/a Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 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. _ 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 n/a "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. 3. Other: n/a Z Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No X _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than''/z day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped NOT IN TWO YEARS PER OWNER. X Any portion of the SAS, cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] YES (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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. a f Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22104 Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection ? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site'? X _ 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 ? X _ 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: Yes no X _ Existing information. For example,a plan at the Board of Health. X _ 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)] S Page'6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 FLOW CONDITIONS RESIDENTIAL 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: 4 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)):iika 03y two Sump pump(yes or no):NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: NOT IN TWO YEARS PER OWNER Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X 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): n/a Approximate age of all components,date installed(if known)and source of information: TANK-1984-NEW FIELD IN 99 PER OWNER Were sewage odors detected when arriving at the site(yes or no): NO Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4i22/04 BUILDING SEWER(locate on site plan) Depth below grade: 22" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 16" Material of construction:Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: L 8' 6" H 5' 7" W 4' 1011' Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle: 28" Scum thickness:4" Distance from top of scum to top of outlet tee or baffle: 0" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined:.MEASURED 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 PIPE FROM SEPTIC TANK TO D-BOX IS BROKEN LIQUID LEVEL IS OVER TEE IN TANK.TANK IS STRUCTURALLY SOUND. GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a 7 . I Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 106 GREAT HILLS.DR W. BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): STRUCTURALLY SOUND PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a � R Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 106 GREAT HILLS DR W. BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type n/a leaching pits, number: n/a INFILTRATORS leaching chambers, number: 4 n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): THE LEACH FIELD IS SATURATED-SOIL PROBED DRY-FIELD WAS INSPECTED BY VIDEO FROM D-BOX AND THE LIQUID LEVEL WAS UP IN PIPE IN THE FIELD-FIELD IS IN HYDRAULIC FAILURE. BOTTOM IS AT 6' CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): n/a 4 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 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. W �. � Q C AA 3L � 3 AC io Page 11 of 11 i F OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 106 GREAT HILLS DR W.BARNSTABLE 02668 Owner: SUSAN PICARD Date of Inspection: 4/22/04 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 10+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: GROUNDWATER WAS DETERMINED FROM HAND AUGER-NO WATER AT 10' tt U ` TOWN OF BARNSTABLE 1 LGCATION �' 1 � 114,11 NZ. �SE,�y,W�AG�E # , 7 VILLAGE �'��ASSESSOR'S MAP & LOT1 % &—:W INSTALLER'S NAME&PHONE NO. �g�� �s_ 10 ep : cS e.,� SEPTIC TANK CAPACITY /CYO LEACHING FACILITY: (type) /n %,�r i21 (size) NO.OF BEDROOMS OR OWNER PERMITDATE: 0'` _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 ��1�2 5�� ' I /, �� c L ® CATION SEWAGE PERMIT NO. CN VILLAGE I N S T A LLER'S NAME A ADDRESS (8 U I L D E It OR OWNER V ve-e v 1. DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �j/ � � Lo� s 1 4 e THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .................... ...................._0F...............,�;,4.c f f/ 6_1. . App iration for DhipmFa1 Workii Tomtrurtion Vamit Application is hereby made for a Permit to Construct (®() or Repair ( ) an Individual Sewage Disposal System at: -A ss v or Lot No. ............ _._.- e.�s.......•... �>�+——-- -- -----------•-----C��. .. 1��� �{ � A- Location e � , - Installer Address ��"" Type of Building Size Lot....�i _ __ ..Sq. feet �., Dwelling—No. of Bedrooms....................____...____.._._Expansion Attic ( ) GarbaVe Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures ---•-- • -------------- W Design Flow................: . gallons per person per day. Total daily flow.............. .. ......... .'�._.Ogallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) - -/ `" Percolation Test Results Performed by............................... .........-._.. --- Date__....... _ _( _-r.. Test Pit No. 1...�. f';ininutes per inch Depth of Test Pit---- _.. Depth to ground water.... - -- -- f=, Test Pit No. 2......44 f nutes per inch Depth of Test Pit.................... Depth to ground water....... (---0---I.. O Description of Soil.......................................0 .. .---.......0. - - - - V ...................................................................... -- -0............... �-K. ......... !3� ---------------i C 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 TIT1 5 of the State Sanitary Code— The undersigned further agrees t to place the system in operation until a Certificate of Compliance has been issued b the board of th. p Sig e ............. - - ------ ---------------- A � Cf� ................... t; I pplication Approved BY = ��, gj Date Application Disapproved or the following reasons-----------------------------------------------------------------------------------------•-•--•••-•......---•••-• ---------------------------•-----•--------........----------•------------....--------•--•--•---------------•-••=••---•••--•---•---•----•-•--•--•-•••...-----•-•-••--•--••.........••--•-•-••-----••----- Date PermitNo......................................................... Issued-....................................................... Date No-------------•/`•~- Fxs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................OF.................. .� li S ,/t 4P ' f Appliration for Uiipusal Works Towitrurtiun Frrutit Application is hereby made for a Permit to Construct f'r or Repair an Individual Sewage Disposal System at: f .M ....................•................................--_. _..............---.................. ----•---• .......... .... _ --..........__. Location.Address _ F t,. or Lot No. _ •.................................................... s ].,5::i c Ih ... r.............................................................. --•----• 'v . Qwner;t ` _ / y Address W _-.J .-fir n *C 0 c. , E, Y .x�i-•f �-." •...-•-- :... :......... •.......:....... ................... Installer Address dType of Building Size Lot... '_`_.f'%_ ..Sq. feet Dwelling—No. of Bedrooms............... �.--...._._.....__..._Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .... No. of persons............................ Showers — Cafeteria Q' Other fixtures -----•-----••-•-•-•-----•--•-••. _ d _ •-------••--------------------••-------------------- WDestgn Flow................. :._;___.gallons per person per day. Total daily flow..__..._..__..=.______. ______,.gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench--No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----_-------------- Diameter.................... Depth below Dosing tankinlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosi g, r z ' '6`"YDate-••_.....�:./_S�_:?�=:..�j. a Percolation Test Results Performed by....................... - " Test Pit No. 1...t__.A_?KSminutes per inch Depth of Test Pit----- ... Depth to ground water......H.....:...:.... Test Pit No. 2...... :minutes per inch Depth of Test Pit_________ ______ Depth to ground water____ ..._......._... WI?— -....... A O Description of Soil....................••----------------.....--•-•------......-•----==••...:-.. ........------------••----------j-----------•------ -----•-•-------.•---_----.----- F - x ........................... ...................................r'— �.t . - v* ys ................_D.r s rI ----------- 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 TITIL' 5 of the State Sanitary 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..............................;.,*.... -.. / xl✓ .�� ' J ;.....................Date f Application Approved BY........................................................ ---.._..:��, ,/ 1----•--•--- Date Application Disapproved for the following reasons:__...-•-----------------------------•----------------------------------------------------------------......••... .............................................._.......................................................................................................................................................... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... Tntifiratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal Syst constructed or Repaired ( ) by-------------------------------------------------------•- '• ,ter.,,.�:�:.----•--•---.1)-=!�.� --•------....-- ...)' ' s Installer at..................................................................................................................................................................................................... has been installed in accordance with the provisions of L �� dated TITLE, /5 of The State Sanitary Code as described in the u5' /lJ application for Disposal Works Construction Permit No-------.._....___'±.___ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATI• FACTORY. DATE............................................ ------•---- Inspector. -------------------------------•----•-------•-----------•-----.-••-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �,t �? G . ..........................................OF.............. ..:.,_..............;...-----,,L .._...:-........................ c No.•-•••••••-•-•-•--•---�� '' " FEE......•• ._.'.....-- Ehap o sal Nab Tnnstrttrtinn rrrutft Permission ishereby granted................... �'!_�%� !'.*_.. =r u�� � ....._.. ---------------------••--• ._.....__.. ..---•... .._._....-•-•-•-• •. .�... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System ,. I - • � � at No.------. •-----•.....-•-•-•-----••----- = ' /. :: i _ `-II _/ - Street t' as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 1 Jr � ( V, wr A o jvq 14 17 Ile -- � v7- 3 D) c .� • j , /, �� = --) 4/ ` 3/ C \ . S,a�t�S ¢3 �3� s,F y r r u�E� °F�°� CERTIFIED PLOT PLAN �11 ©f 4RSn 61?Ie 4T f/ , D/e/vE I.P�� R08�RT CE/V T /2 I/1 L L_E BRU N 16951,L0 y + ;EtDRED ' N A ���/Y/ car ��r •, E �O� Glut a,6`� , � ` ` \ F`rs/DNA1.`� ^L +'I� G f rA.�� e �5 f.r�A+ \ '- 4 su SCALE, /"-40' DATE t, F 7- ya CLIENT. -------- I CERTIFY THAT THE PROPOSED k a� r 4tar ,� i "�'1 t' 3.2 9 , t EGIST,,e F. REGISTE i� J BUILDING SHOWN ON THIS .PLAN L't4ND� G'nc '' �� " CO2; ONFORMS TO THE ZONIN.O LAWS s °`"# N G I N ER R Y � ; ®Rr•�v, -----..-.--. QXA All 'STABLE MASS. t4, ,�47I2 -��`'�.4,111VYIIEET.....: OF E REO. LAND SURVEYOR 1 t yt it 20 J-'T M/N. /1lOTF'°: P E/TNE.4 TN.E S�PT/C TAN/C DR G.�AcainrG P/7 ARE /YORE .7'HAN /2"BELOW,/ /O f•T /+9/A! GRAOFF Z4'!!!AMET.EP CoNCiC'ETLC. R �— q"PYC P/PF SW•9LL. Q.E BROI/GHT TO G/�A®�.�.4N CONGR&TE h'EAVy CAST IRON C0l/4=R Si/.4LL !3E U3E.0 _ Q M/N. aX CO VER CL EA/V -TA IV 17 D,�• XEDtJLf•� SC �-. 2�LAYFR 0 0.0 - - 4 o or //e`-3/e" • -•as M/N.N/TCN f GAL. D/ST. ' a t • • • • • s • • p •q W,4 SHFD S7YJNE ®CAR PT / SEPTIC TANfC o s t t a • • • • • • o s . 4 • BOX o • t • • e ea • .•p • o- o , t r eEFF�CT/✓E ' e : 3/4" '.: �Y e e o r • • DEPTt! • •t • • o ' 1yA5HED STOiY�:'� Jtr:a r'F 7S 9 x z_S' _ .�3 9:7 e e oQ • t • ® • • • • • o p o �,✓' o / s 3;61 • • PRECA5T SE,54AaE OJY.S T CA,-,4-c.:7 y .S/¢�•4 L/DAy e 0.0 • • • • o o • • • o o P/7.OR EVVI V. s m o a �L 8�.8 • INXEXT AT M114D/NG 8 FT. 3 6 t'�: DlAM. ' //5/LE7 SEPTK' Ti4/VK 87• FT, /`f FT O/fflyl. C SEE 77�ULA�'J[7A/, 0U71-E7-SERTIC TANH 87•Y FT y //V,CET GalST1�/i�B/T!®N BOX 8 7,Z FT. GROuN AI o ItTEx TA6GE A,A)(.0. 76,8 P, DIJTdFTD/STIt/®t1T/ON BOX 97•o Fp .S'EC7'�/ON OF' f lr 6�a G�uw✓� c ✓07? INLET LEACHINCB ®JT FT. •�E�VAGE ®lSPCeSA t e .ST�. LC!'Y//NG A/T TA��1Le4?'l®IV SCALE : " _ / -O D/MEN.s/ON A DES/SN CR/TENIA �4 a/jrE�rs/Aa *'T. NUiMBER OF EE®DOOMS 3 DOMENS/®N G 50/1.. LOG SD/L `PEST TOTAL EAS711447Ed. FLO*V 33 0 0.41-1DAY SO/L TEST A/ SOIL TES7-*2 _ NUMAER QF LE,4CHIN4 PITS / f^FLEY. BS,S rEL�V. -OATE OF SO/L TEST s z. /89 S/OE LG�.4CH/NG PER P/T /7`r SYd FT. \ U' - -3 RESULTS N//7-NE5SED BY /�l3 G. ✓"uv 3 i 60T710M AADACN/NG PER P/T /�so. A s L.D<rr' cam' -CRC®lAT/O!V Il.4ETE At/ L�s 5 RP1J/V�/NCN TOTAL LEACf///9�G AREfO 3 2`l.8 soy p7; s S g S a t c_ PEIeCOLA7-/ON RA7-,E�2 �"" •/ M/N.f AfCH RESERYEGEAC///JVG eaREA 3 Z.'f 54). F7. ,� 3 '_. /O _ D Ste.Al All 4r 4a; ' � �. 77,Z `, _ 3 T /-f OF h4,4S l•^ $4. _. pt8�T)� .j o RSE N EA.DREAMW AMWMAWRIAW CV. � : /�I VC. t2 AUf 9, MASS10951 - Y / PNo. CL 7S"S qf V/� DATE, sT LLENT 3 0 r. ® NOGROUNV W, Tt - *' fS�lOTiA0- JM CRO UAO'o W.4TER AT 4E4 EV. 7 7./ JOB /1/2. 8 Z -:;r r� 79.5' LEGEND EO gg PROPOSED CONTOUR o C 0.4' a ' 99 PROPOSED SPOT GRADE joe Thompson Holder Lo O' EXISTING CONTOUR s LOCUS 4' E78. O EXISTING SPOT GRADE .� TEST PIT • e� OO ro +7 /� S7/c423 a W EXISTING WATER SERVICE Race Lane G 7 7.1 + ' EO P coa 8'3 _ PROP. PUMP CHAMBER LOCUS MAP N.T.S. + 6' / EX15T. 5EPTIC TANK EOP' TORE: AIN o� 2oH "1 ' + 3.8' GENERAL NOTES: Po / \ 661 + e 5EE N I I /.. 58 9' ML 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL /.. . . BOARD OF HEALTH AND THE DESIGN ENGINEER. /, / 3y, 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS } 69.8 a / ` ' OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS.)"i-e 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR �(O I Q� j, TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ' „�` ► DESIGN ENGINEER. OP 68/ Q��/ `� d. 58.5 S�"rIP O / HSE 0� 1 0�� 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING � L 1'r FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Q ' /• (D �� a`1 J 8 ENGINEER BEFORE CONSTRUCTION CONTINUES. / �(1! / \ //" �/�n�w ��� v' („vac.►. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. �' / 6� Q7 tV% 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF + v J �� �;n hL THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF ' HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 0 ./ HS I `J� ,rS� 7. WATER SUPPLY TO BE PROVIDED BY TOWN WATER. MI POLY UNE 61 8' 61 . 1 ' �QA a 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. EL:63 5 TO 62.0 EOD EO DECK 58.E6 u� 9• ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE LANDSCAPED AS 69. ' + s �P ' �3.1 ' G EL DRIVEWAY - AGREED UPON BY OWNER AND CONTRACTOR. EO .6' OD 60.7' i 10. LOCATIONS SHOWN OF EXISTING UTILITIES ARE APPROXIMATE. IT E D EOD� SHAg aW THELL BE THE LOCATION OFSPSBILITY OF ALOLNUINDERGROUNDEUTIILTIESCTOR PROROTOERFY STI RTING ' EXI5TIN S.A.S. tf� CONSTRUCTION, 68.Q + OD TO BE NDONED APN 1 74-3V 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS EO P p O SE C AS OF RECORD) (LOT 3 1 )LOCATION ILT IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). 43,734± S.F. �� 5F Mqf 12. TOPOGRAPHICAL SURVEY SHOWING LOCATION OF HOUSE, GAS AND + 379 2�- sy WATER SERVICES HAS BEEN PROVIDED BY OWNER. 66.8 63.1 -BENCHMARK: / S$�o� 55e + ' o� PETER EOP RT. 70M 5R / 800E 58.3 McENTEE PROPOSED SEPTIC SYSTEM UPGRADE BOTTOM STEP (( + o No I35109 ti EL:63.28 (ASSUMED) 59.8 106 GREAT HILL DRIVE, WEST BARNSTABLE, MA 9FG/SI FSS/ONAL N� Prepared for: Wayne Picard, 106 Great Hill Drive, West Barnstable, MA Engineering by: SCALE DRAWN JOB. NO. �2d1� Engineering Works 1"=20' P.T.M. 44-04 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 5/20/04 P.T.M. i Of 3 NOTE: TO PREVENT BREAKOUT, A 40 MIL POLY LINER FIRST FLOOR SHALL BE PLACED 5' OUTSIDE THE PERIMETER EL.=64.4 OF THE S.A.S., WHERE SHOWN, AND EXTEND F.G. EL: 66.0t FINISH GRADE = 64.3(MIN.) FROM EL: 63.5 TO 62.0 EL.62.Ot EL.-62.7 F.G. EL.64.0t "� MAINTAIN 2% MIN SLOPE OVER LEACHING AREA 36"MAX. COVER a PROVIDE 20" RISER W/COVER OVER INSTALL RISERS OVER INLET & OUTLET 12' x 50' LEACHING FIELD W/2-4" Q TO WITHIN 6" OF FINISH GRADE PUMP TO WITHIN 6" OF FINISH GRADE OVER PIPES SET FEET SCH 40 PERF PVC DISTRIBUTION LINES a. ENDS TO BE CAPPED a Max) L s' a0 PVC s a' 4" SCH 40 PVC 2 SCN 4' SCH 40 PVC 6" EFF, N1P�N @ S= 1% 0 PV DEPTH e 14' @ S= 1% (MIN.) FpRC� 'a TEE'S ARE TO BE D-BOX I SLOPE OF PERF, PIPE = 0.5% _I INV. EL.=62.50(END) 4" SCH 40 PVC INV.=59.75t PUMP 0 24' INV.=63.00 r 50' EFFECTIVE LENGTH EXISTING 1000 GALLON (EXISTING) 14' (MIN) SEPTIC TANK PUMP OFF INV.ELEV.=62.75 INV.=59.69 g" INV.=62.83 GAS BAFFLE TO BE INSTSALLED ON S TEE SHALL NOT EXTEND SOIL ABSORPTION SYSTEM (PROFILE) OUTLET TEE AS MANUFACTURED BY INV.=59.94t BELOW FLOW LINE N.T.S. TUF-TITE, ZABEL, OR EQUAL 1000 GALLON PUMP CHAMBER OF (See Pump Detail, Sheet 3 of 3) 1/8L1 2R DOUBLE - (EXISTING) BREAKOUT ELEV.=63.25 WASHED STONE PUMP CHAMBER & D-BOX SHALL BE SET LEVEL AND TRUE 3/4"-1 L/2° DOUBLE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED BOTTOM ELEV.=62.00 WASHED STONE STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 3' 6' SEPTIC SYSTEM PROFILE 5' MIN, BOTTOM ❑F T.P. EXCAVATVATI❑N OR G.W. 12' EFFECTIVE WIDTH MAJfq HIGH G,W, EL: 56.9 N.T.S. SOIL ABSORPTION SYSTEM (SECTIONI Hrs o PETER T. _E: McENTEE BUOYANCY CALCULATIONS CIVIL DESIGN CRITERIA No. 35109 Pump Chamber SOIL LOG NUMBER OF BEDROOMS: 3 BEDROOMS BOTTOM OF PUMP CHAMBER EL.= 55.1 ".r.: SSA SOIL TEXTURAL CLASS: CLASS I I HIGH GROUNDWATER EL.=56.9 DATE: MAY 13, 2004 DESIGN PERCOLATION RATE: <2 MIN/IN (2. BUOYANCY FORCE PER FOOT OF DEPTH: SOIL EVALUATOR: PETER MCENTEE PE, CSE V" 5.5 x 8.4' x 1.0' x 62.4 IbS/Cu.ft. = 2882.9 Ibs/ft INSPECTOR: DONNA MIRANDI-HEALTH AGENT (FOR)POSSIBLE FUTURE EXPANSION) MAXIMUM DISPLACEMENT = 56.9'-55A'= 1.8' BARNSTABLE B.O.H. `DESIGN=FL�W-. :440 MAX. UPLIFT PRESSURE = 1.8' X 2882.9 Ibs/ft = 5189.2 Ibs. Elev. TP- 1 Depth EXISTING SEPTIC TANK: 1000 GAL. CAPACITY WEIGHT OF EMPTY PUMP CHAMBER = 8806 Ibs. 65.7 A p,SANDY LOAM PROPOSED PUMP CHAMBER: 1000 GAL. CAPACITY 8806 Ibs > 5189 Ibs O.K. 10YR 3/3 LEACHING AREA REQUIRED: (440) = 594.5 S.F. 65.2 B 6" .74 LOAMY SAND 10YR 5/8 62.4 C1 40" 12' X 50' LEACHING FIELD W/2 DISTRIBUTION LINES LOAMY SAND Perc test SIDEWALL AREA: (NOT APPLICABLE) DOSING & STORAGE REQUIREMENTS 2.5Y' I 69" BOTTOM AREA = TOTAL AREA: 12' x 50' = 600 S.F. 56.9 = MOTTLING 106" DAILY FLOW: 440 GPD C2 DESIGN FLOW PROVIDED: 0.74(600) = 444 G.P.D. DOSING REQUIRED: 4 CYCLES/DAY (LOAMY SAND) 440 - 4 = 1 10 GALLLONS/CYCLE SANDY LOAM 2.5Y 5/1 DISTANCE REQUIRED BETWEEN PUMP (MOIST) PROPOSED SEPTIC SYSTEM UPGRADE ON AND PUMP OFF FLOATS: 49•7 192" 110 GAL/CYCLE - 250 GAL/FT = 0.44 FT/CYCLE (SAY 6" MIN/IN.PERC RATE < 2) ("Cl" HORIZON) 106 GREAT HILL DRIVE, WEST BARN STABLE, MA STORAGE REQUIRED ABOVE WORKING LEVEL: 440 GALLONS Prepared for: Wayne Picard, 106 Great Hill Drive, West Barnstable, MA Engineering by: SCALE DRAWN JOB. NO. STORAGE PROVIDED: MAX. SEASONAL HIGH G.W. EL: 56.9 (MOTTLING) N.T.S. P.T.M. 44-04 INV.(IN) EL: 59.69 - PUMP ON EL: 56.52 = 3.17' Engineering Works STORAGE PROVIDED = 3.17' X 250 GAL/FT = 793 GALLONS 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 5/20/04 P.T.M. 2 of 3 r � .r 4 <. e INSTALL 1' PVC C❑NDUIT TO HOUSE FOR WIRING PROVIDE WATERTIGHT CONCRETE RISER y WITH WATERTIGHT J❑INTS. WIRE HIGH WATER ALARM WITH SECURED COVER TO GRADE FLOAT TO GP 2000 HIGH WATER ALARM PANAL ON A CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP. NEMA 4 JUNCTI❑N BOX C❑RR❑SI❑N RESISTANT & LIQUID-TIGHT CABLE CONNECTORS SUPPORTED HOISTING CABLE 7x19 STAINLESS STEEL BY 1-1/4' PVC CONDUIT, J❑INTS TO BE MADE 8'-3.5" 1/8' DIAMETER, / 1,760 LB, STRENGT WATERTIGHT 2'BALL VALVE w/ UNIONS SCH, 80 PVC 4'SCH, 40 GEORGE FISHER CO, MODEL NO. 560 FROM TANK 2'SCH, 40 DISCHARGE TO D-BOX B B ALARM ON EL: 57.35 2'SCH, 40 TEE w/ CLEAN-OUT CAP _ i_ - ` - _ _ INV.(IN) ' I EL: 59.69 PUMP ON EL: 56.52 PROVIDE 1/4' WEEP HOLE IN DISCHARGE PUMP OFF EL: 56.02 24' PIPE FOR SELF-DRAINING FORCE MAIN BOTTOM OF 1a• CHAMBER B' 2' BALL CHECK VALVE SCH, 80 PVC PUMP PUMP AM 100 P,S,L FL❑WMATIC MODEL No, 208S ELEV. 5.1 PROVIDE 2- WIDE ANGLE FLOATS, 2' SCH, 40 PVC DISCHARGE PIPE FLOAT NO,11 PUMP ON/OFF (BARNES 073618) A FLOAT N❑,2; ALARM ACTIVATI❑N (BARNES 073612) BARNES SE411 PUMP ,4 H.P. li5 V 2' DISCHARGE PASSING 2' SOLIDS PLAN 4" Dia. Inlets 5'-6.5" 4" 4" Dia, Outlets PUMP CHAMBER, PUMP & ACCESSORIES AVAILABLE AS A UNIT f THROUGH WIGGEN PRECAST CORP,, BOURNE MA, (800) 564-6774 / ^T PUMP & ACCESSORIES AVAILABLE THROUGH WILLIAMSON ELECTRIC (781) 444-6800 0 fff O PUMP DETAIL 67.5" 63.5" 63.5" N.T.S. 54.5" 48" Liquid Level 3" 51.5" (TYP.) I ' I a 3" 8'-0.5" 5'-2.5" SECTION B-B SECTION A-A 1' NOTES: 1. ALL PIPING JOINTS SHALL BE MADE WATERTIGHT. I44' GRAVITY 2. 1000 GALLON CAPACITY (H-10) IOUTLET(TYP.) (3) 4" DIA.OUTLETS �16_,,I 2' , MONOLITHIC PUMP CHAMBER 4" GRAVITY I' N.T.S. OUTLET(TYP.) q_ 15,5' i 12' 6' 8' 2" FORCE MAIN H-10 LOADING 2' o� PETER T. G✓ INLET WITH 2" VERTICAL TEE FILL UNUSED KNOCK—OUTS o£ Mc h WITH MORTAR 11 CIVIL VIL f ' No. 35109 PLAN SECTION PROPOSED SEPTIC SYSTEM UPGRADE �FSS " ` NG DISTRIBUTION BOX 106 GREAT HILL DRIVE, WEST BARNSTABLE, MA 1: r1SJ Prepared for: Wayne Picard, 106 Great Hill Drive, West Barnstable, MA N.T.S. Engineering by: SCALE DRAWN JOB. N0. Engineering Works N.T.S. P.T.M. 44-04 I 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. 5. (508) 477-5313 5/20/04 P.T.M. 3 of 3