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HomeMy WebLinkAbout0048 HARTFORD AVENUE - Health 48 Ha;ills ford Aven L Marston -- -- — - — - �,= 103 47 i I Commonwealth of Massachusetts 1,93 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MAR'STONS MILLS ✓ MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection jr o. Inspection results must be submitted on this form. Inspection forms may not be alterecRin any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not ,JOHN P GRACI SR use the return Name of Inspector key. GRACI SEPTIC INSPECTIONS LLC reb Company Name PO BOX 2119 Company Address rewn TEATICKET MA 02536 Cityrrown State Zip Code 508-641-6694 S1468 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 Evaluatio y the Local Approving Authority 08/15/2016 Inspector's Signature Date The system inspector shall s it a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 d of completing this inspection. If the system has a design flow of - 10,000 gpd or greater, the in ctor and the system owner shall submit the report to the appropriate regional office of the DEP. Th riginal should be sent to the system owner and copies sent to the buyer, if applicable, and the ap oving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 LO .4 A Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: UNABLE TO INSPECT UNDER NORMAL USAGE. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): NA t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 � Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is MARSTONS MILLS MA 02648 08/15/2016 required for every page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. / B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): NA ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): NA 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 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 ' s 1 � Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City(Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: NA **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: NA D) stem S Failure Criteria Applicable to All Systems: Y pP Y 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 t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ Z 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 0 ❑ 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. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 � Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City(Town 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? ® El information 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection D. System Information Description: 1500 GALLON H10 SEPTIC TANK DISTRIBUTION BOX (3) THREE 500 GALLON H2O LEACH CHAMBERS FIELD MEASURING 13W X 33.5L Number of current residents: VACANT Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): TOWN Detail: 2016 ZERO 2015 ZERO SHUT OFF SEPT 23 2014 Sump pump? ❑ Yes ® No Last date of occupancy: UNKNOWN Date Commercial/Industrial Flow Conditions: Type of Establishment: NA NA Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): NA 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: NA t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 '08/15/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ' Last date of occupancy/use: NA Date Other(describe below): NA General Information Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: NA gallons How was quantity pumped determined? NA Reason for pumping: NA 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): t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 06/28/2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1'6" Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC 40 PVC ❑ other(explain): Distance from private water supply well or suction line. 10+ FEET feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: (1) ONE FOOT feet Material of construction: ® concrete - ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: NA years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 GALLON Sludge depth: (2)TWO INCHES t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle (32)THIRTY TWO INCHES Scum thickness ZERO Distance from top of scum to top of outlet tee or baffle (6) SIX INCHES Distance from bottom of scum to bottom of outlet tee or baffle NA 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.): SEPTIC TANK APPEARED TO BE STRUCTURALLY SOUND AT TIME OF INSPECTION. UNABLE TO INSPECT UNDER NORMAL USAGE. RECOMMEND PUMPING NOW AND EVERY TWO YEARS. Grease Trap (locate on site plan): Depth below grade: NA p g feet Material of construction: El concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): NA Dimensions: NA 1 Scum thickness- NA Distance from top of scum to top of outlet tee or baffle NA Distance from bottom of scum to bottom of outlet tee or baffle NA Date of last pumping: NA Date l5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 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.): NA Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): NA i Dimensions: NA Capacity: NA gallons Design Flow: NA gallons per day Alarm present: ❑ Yes ❑ No Alarm level: NA Alarm in working order: ❑ Yes ❑ No Date of last pumping: NA Date Comments (condition of alarm and float switches, etc.): NA / "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 • f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name - information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): DISTRIBUTION BOX APPEARS TO BE STRUCTURALLY SOUND AT TIME OF INSPECTION. UNABLE TO INSPECT UNDER NORMAL USAGE. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): NA * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: NA t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is MARSTONS MILLS MA 02648 08/15/2016 required for every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: (3) THREE ❑ 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.): 3-500 GALLON H2O LEACH CHAMBERS WERE EMPTY AT TIME OF INSPECTION NO VISABLE STAIN LINES AT TIME OF INSPECTION . UNABLE TO INSPECT UNDER NORMAL USAGE. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): NA Number and configuration NA Depth —top of liquid to inlet invert NA Depth of solids layer NA Depth of scum layer NA Dimensions of cesspool NA Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): NA 4 i Privy (locate on site plan): Materials of construction: NA Dimensions NA Depth of solids NA Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): NA t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately i C 5 oA A B DWUL 0 0 0 DQeVEN � AA- 09" --'4q6 CA - oVp Ao- 515 cc- Title 5 Official Ins ection Form:Subsurface Sewage Disposal System•Page 15 of 17 t5ins.doc-rev.6/16 P 9 � i r r Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10+ 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: RECEIVED ENGINEERS DESIGN ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: HAND AUGER Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 48 HARTFORD AVENUE Property Address BANK OWNED Owner Owner's Name information is required for every MARSTONS MILLS MA 02648 08/15/2016 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A,B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ti TOWN OF BARNSTABLE LOCATION �6 geA c4 rnvp SEWAGE #ZO05-Soo VILLAGE Ma r S 06 � M t A s ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. l26nS SEPTIC TANK CAPACITY ZZ—bo F(to LEACHING FACILITY: (type) (size) /3 3 NO. OF BEDROOMS pp B $ R OWNER PERMIT DATE: g/®�" 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) �G�ivh G✓a Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by t G c P No. Fee COMMONWEALTH OF MASSACHUSETTS Entered in computer; Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIppffcation for 33f5pool *r5tem Construct on. Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1/8' 1410 P '- cs f` A U e Owner's Name,Address and Tel.No. Assessor's Map/Parcel Jo 3 — 4 7 1M YY\ Installer's Name,Address,and Tel.No. -7 7 Designer's Name,Address and Tel.No. ao cJk-e_-P_fe,�.. w* MtvcV--e-_ Gd 6 YJ Pa 1Z o ,� OF Type of Building: Dwelling No.of Bedrooms '7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow --gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil" Nature of Repairs or Alterations(Answer when applicable) 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 d by is and off f�ealth. Signed C� Date 6 Aff,10X— Application Approved by Date (D Application Disapproved for th owing reasons Permit No. oZC9O 5 oo Date Issued `fir . o - -.. • - 1\fir � - . � .✓' . -�, . ... No. " �o© w . —gay Fee -` '�'PWE COMMONWEALTH OF MASSACHUSETTS Entered in computer; Yes . PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE. MASSACHUSETTS • ��y .ate I a 4 .. 01ppi cation for 'Zigposml *paten Con!6truction Permit Application for a Permit to Construct('4=_)Re ajr(I )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Addressor Lot No. " p V, e Owner's Name,Address and Tel.No. rr1 Assessor's Map/Pazcel O 3 4 7 � J, Installer's Name,Address,and Tel.No. / -7 7o' 7 7 Designer's Name,Address and Tel.No. RoNI,S irC to,r,��i, b/� 12� r i'h e yin 20 C-A-eelet, 110 MAC-W--e— G,� 6 Vj PO 1� o Y - Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow --gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil P . Nature of Repairs or Alterations(Answer when applicable) -- _►' Date last inspected: I ' __Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board gf"Flealth. Signed ` Date_ Application Approved by Date Application Disapproved for the o owing reasons Permit No. Date Issued — -- ------ — --------- ------ .._.-_ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( ) Repaired ( ( Upgraded( ) Abandoned ( )by eo ej- at v has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. :Z r-,o I©Cdated��� Installer QO rS 5 Designer The issuance of this permit shall n t be onstrued as a guarantee that the s stem i tton as designed. Date -�i Inspector No. I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi5pont *pgtem Cot%truction permit Permission is hereby granted to Construct( )Re air( ) grade( )Abandon( ) System located at t r' � �-�cx ,r^ Po-r � 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. vi on t b completed within thr a of the date o this a t.Provided:C stru(c,,t must e t three years ��. Date: �/� Approved by ` Town of Barnstable y�P IVE'°w Regulatory Services Thomas F.Geiler,Director • MRNSTABLE, i ' . a Public Health Division ATF pA Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 1V1,7 7 ZOv-r .. Designer: � �.�( /V l N el' Installer: Address: T. SOK I�_/ Address: SP,[,)0,VV1L# MA- ozs-'O On Zg �� D/��S J5k1 - A__RA/ was issued a permit to install a (date) (installer) septic system at HPaTFo►2D AVF_tIUF. based on a design drawn by -, (address) "(• (' e 6*" ,`+ dated e-. 2,3 2d&S - (designer) IT I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revis" or certified as-built by designer to follow. - CDR Gs 0 Itallee, ature) ` " ;o E40 N J a SgNITAR�P� (Designer's Signature) (Affix Designer's Stamp Here)'" PLEASE RETURN TO BARN TABLE 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/Designer Certification Form y f `J a jA O � 100 �r �� 0 R, t IMPORTANT — UPGRADE REQUIRED ALL DOOR& o STATE BUILDING CODE REQUIRES THE UPGRADING OF WINDOW LOCATIONS TBD BY SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN HOMEOWNER ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. _ NUM: A SEPARATE PERMIT IS REQUIRED FOR THE 15'-71/2" - a'-21/2' a'-a" e'-r" e'-11" o . INSTALLATION OF SMOKE DETECTORS—THE ELECTRICAL � .r PERMIT DOES NOT SATISFY THIS REQUIREMENT. , z STEPS TO BE DETERMINED BY " SMOKE DETECTORS REVIE D EXISTING GRADE s , 1w XH o 24.OH:' 2'4"X24`AWNING 2'4'OHx B E BUILDIN T � P • DATE � •. ... �.B. e Zq 2J 000a ^ t •'v -° •. REF7=7 I DEPARTMENT —DATE ad._ • PULL DOWN I WALL STAIRWAY N� 1 ;,. IAOUNTED ♦ e I - N e B S! NATURES ARE REQUIRED FOR-_ IMNG s-VV "` z�e•xs•e•• 2-26 DWN— EXISTING STRUCTURE ' S Y PASS nw $ / 1 LINC T .� S 3 t . 4'C.O. • O O u .. . m � Zp 0 3'-9 3/4" a t a C� IS 5 �m LITG- � ICI 16�1P,N , 9.0.�y.E. _ } B 1 i TRIPLE 2'eX2.4"A WNING5 U TRIPLE 2'4"X2'4'AWNING$ 24"0H 5��2G 24 Ali STEPS TO BE c <. X r DETERMINED BY EXISTING GRADE a ° STEPS TO BE DETERMINED BY EXISTING GRADE _ B 5'-4 3/4" ' 6 Ov w z A�NgT 18'-4" 22'-0" � Of lov a FLOOR PLAN �PS� 2n' z1'�% °�Oo �. Scale: 1/4" 1, a ~ 1 F 1/4"=1' 4 P oroWo-g w. of ' • - 4 I �Yid N 1 d s4 FOOTING EXISTING FOUNDATION v r��----------- -------= ---- ---- ---------- -- �., � FOUNDATION S r. Z I I i .q..................... 1 1 =' I 1 p I r LU ce .. ...................... r \ t I � f........:..........: FULL BASEMENT CRAWL SPACE t g NE E NG CUT a 3 I O RATION w�-------------•----•i I I I I i I CRAWL SPACE ACCESS s 's o ----- -------------- � n } FOUNDATION o,n 2"X 6"TREATED Scale:1/4"=1' -011 oNi SILL AND SILL v SEAL 00 c 0 I � tin • V • y _ t t I � STEEL SILL BOLTS L 6'OC PER CODE i STEEL SILL BOLTS 6'OC P r ' ;i ER CODE ® 0� o e _ 2"X 6"TREATED SILL .t AND SILL SEAL - - Lu POURED CONCRETE @ } W> Z SLAB � ®� • b ' '�` �—POURED CONCRETE W Q r. <v.- • e. - ',y `°_ t DUST COVER �a 811•' Z V-CL ' 1-4 COMPACTED EARTH ° 4.v ; ': -- ------r &GRAVEL a� �.}i - r Lu u- f -600 o a. .1. _ _ .--`!_< • Y' \.� . .i Y., [' COMPACTED EARTH 6 �! _ Y , ' GRAVEL t P' A09�S�`, - - !° 16" �—KEYWAY IN FOOTING stole . KEYWAY IN+t o, 1/4 1 i` Droving N.. FOOTING 1611 � , r 1' FOUNDATION SECTION FOUNDATION SECTION Scale:1/2"=I'-0^ _- Scale: 1/2"=1' - 0" of 4 r 58405 G'00"E ;- 130.00' APN 104-47 20,800±5F i 20.0' EXISTING 5,21_ FOUNDATION 00 0 O o d' to ° o 0 0 o - o — O� 0 No.48 5' ,I STY. V✓D. MM. T.O.F. = 101.02' �•� 130.09 N64°5G'00'W HARTFORD AVENUE (40' WIDE) I HEREBY CERTIFY THAT, TO THE BE5T OF MY KNOWLEDGE, AND IN MY PROFESSIONAL OPINION, THE FOUNDATION 15 LOCATED ON THE GROUND A5 SHOWN HEREON, AND IT5 LOCATION 15 IN CONFORMANCE WITH THE HORIZONTAL 5ETBACK REQUIREMENTS OF THE TOWN OF 5ARN5RABLE ZONING BY-LAW. `[ D RICHAR J. OOD, PL5 DATE FOUNDATION CERTIFICATION JOB No.: 05175 DATE: I I OCT05 h O U S E N o. 4-8_,�N_A RT FO fD SCALE: I" = 20' NvVv IVI 6R5T0 N SM'IiLLS'; M A55AC h U S ETTS of jH MNAss9c� hood curve rou Ilc RICHARI] y 9 p' /� HOOD N land surveyors - en9lneer5 - consultants ', No. 35031 18 old kings highway - p.o. box 23 I `.�° -p4:)�``�o sandwich, ma 025G3 �d ph: 508-888- 1090 - fax: 508-888-7890 hood5urveygroup.com �� - r 1 1• 1 i I: I I Ids W(t5 ;`; E o'� Z 2 BD BY 18'-0" 6'-10" 15'-2" 15'-7 1/2" 4'-2 1/2" 3'-3" 6'-1" 6'-11" d } c 0 0 Z STEPS TO BE DETERMINED BY EXISTING GRADE o� 0 � o M w > 2'4"DH 2'4"DH 2'4"X2'4'"AWNING 2'4"OH d3 ON d E� 3'0"X6'8° o 0 2 V iz DUTCH DOOR o cv -----, Ail REF o a o PULL-DOWN WALLY � STAIRWAY i � MOUNTED u _ 2'8'X6'8" SINK N i a i � O� _DW o Lu Om PA55 THR p U X a m m m a v LIN CLST n rn d E o�i 0 `-------- 3'0"X6'8" a o v a' to n` 4'C.O. - O o O E' O ci w ai m m } U a � L x O 3'-9 3/4" m J 00 U i N d' .D � Q i 4-- "X6 8 i 4- TRIPLE 2'4°X2'4"AWNINGS TRIPLE 2'4"X2'4"AWNINGS 2'4"DH V STEPS TO BE E Q DETERMINED BY EXISTING GRADE a LU 5'-4 3/4" W Lo ixQ Z Lu > J 18'-4" 22'-0" W O a' i 1 • 'C - 4l - -J IMPORTANT - UPGRADE REQUIRED ALL DOOR& o STATE BUILDING CODE REQUIRES THE UPGRADING OF WINDOW n { SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN LOCATIONS TBD BY if ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. HOMEOWNER 6'-10" NOTE: A SERE PERMIT IS--REQUIRE[) FOR THE 15'-71/2" 4'-2 1/2" 3'-3" 6'-1" 6'-11" ! INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT, STEPS TO BE Z DETERMINED BY S'MO E DETECTORS REVIEWED $ ` EXISTING GRADE a 2 u� Lixu H 2'4'%2'4'AWNING 2'4'DH LE BUILDING DEPT DATE o > Zg310 o D oR - s� � t . FIRE DEPARTMENT DATE — 1 PULL-DOWN WALL STAIRWAY (SINK T� N BOTH$! NATURES ARE REQUIRED FOR PERMITTING 2'e'Xee" a ; D W h m Pnss nw a o EXISTING STRUCTURE O $ e u LIN GLST 9•• a O if o 1> 7 m o � n / L3/4' 5 IS b odi ° ado uTG _ 8 u cm .N O Lo TRIDLE 2'4 X2'<'AWNINGS TRIPLE 2'♦'X2'4 AWNINGS 2'4'OH -5 U STEPS TO BE LL Iol 1 I x DETERMINED BY EXISTING GRADE a STEPS TO BE DETERMINED BY EXISTING GRADE W 5'-4 3/4" F- ♦ LLLI Li Lu go Q Z —�I i----- z LL OL iy O FLOOR PLAN �PS� e�\ate 2n' x z(�� Fes-d0- Scale: 1/4''z 1' -0". s<o 1/4"=V o�n.y w } 1 '. of 4 lg 'F a c - �q" H FOOTING FOUNDATION °C y O EXISTINGr�-- -------- - -- --- ------------------------------ ;-- ----------------------------- -----------------------• o FOUNDATION Z I I I I 1 i .............. I ; I I i ry +. I I I o------------ �m w... FL I�n $� i rn •----•---•-a a > I � r .................... FULL BASEMENT CRAWL SPACE o g =v . NE E NG CUT - ------------? INTO ATION I II I I I ......UP............ I I \ a CRAWL SPACE a e (a Q ACCESS' s e E { An w op I I I L_____________________ I I I I I 18,_8" 22'-0" Co a 0 o Co FOUNDATION o,n 2"X 6"TREATED Scale:1/4"=1' -0" d SILL AND SILL00 t SEAL 0 ' m i STEEL SILL BOLTS 6'OC PER CODE STEEL SILL BOLTS 6'OCs 0 PER CODE 2"X 6"TREATED SILL C AND SILL SEAL l _ Lu LU POURED CONCRETE *®e ". r� W "r Q Z SLAB dy `% G ���_ POURED CONCRETE W Q lr� DUSTCOVER �- o 0 11 Tfy t - 81r, W O COMPACTED EARTH a o Q &GRAVEL w= 0 Fes--oo ,• ®o R. ` .I. ' 0 0/ r _ y `,-C , _ \,,;.a p?..:,[' COMPACTED EARTH 6 "0- `+ .41`-` / _, ' �- of • r.,}`<-�.. - _-i y. '-' ..Y �.��. GRAVEL T Sk o � 16" KEYWAY IN FOOTING KEYWAY IN 1/4n-1' FOOTING 16" �/y�( Droving No. V i\`, l 1, FOUNDATION SECTION 2 FOUNDATION SECTION _ Scale: 1/2"=1' -0" Scale:1/2••=1'_�I, • _ - Of-4 V ! 3 i g. IMPORTANT - UPGRADE REQUIRED ALL DOOR& STATE BUILDING CODE REQUIRES THE UPGRADING OF WINDOW h SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN LOCATIONS Tel)By HOMEOWNER 18'-0" 6'-10" 15'-2" ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. A SEPARATE PERMIT IS--R)=Qj71RE[J MR THE 15'-71/2" 4'-21/2" 3'-3" 6.4" 6'-11" 3'-11 INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL o PERMIT DOES NOT SATISFY THIS REQUIREMENT. STEPS TO BE r z DETERMNED BY aF ETECTORS REVIEWED EXISTING • _ '• EXISTING GRADE d L Z 3 o F t - _ 2ui r �x' j d E BUILDING DEPT. z'a•°""DATE2'4"xra"AW IN6 2'a"DHREFEPARTMENTd �DATE ,I PALL-DOWNS STAIRWAY MOUNTED ES ARE REQUIRED FOR PERMITTING SINK N EXISTING STRUCTURE Dw O Pass "R 3 s o a v m r LINCLBT a'c.o. cm - F o N W ' I U % . ... ' b ,� LLI L . i J II p M 3'-9 3/4" IS b a 0 m .. .. - In 0 co ovtP, u .. - ♦i TRIPLE 2WX2'V AWNINGS: - - TRIPLE 2'a•X2'4"AWNIN65 2'a•DN V µ (�5 I)C f z�l STEPS TO BE LL Q DETERMINED BY _ - EXISTING GRADE " o STEPS TO BE. DETERMINED BY d .. EXISTING GRADE a • � W • W 18'-4" ' - 22'_0„ >gx � a W O w= 1Ji FLOOR PLAN �PS� ode` � '2 '-Y -2- Scale:1/4-1' -0.. i 1/4"=1' - ' 0-1,g No. 1 F ..r Of 4 a I FOOTING FOUNDATION ---- - - ------------- -- ---- ---- - --------------- -- ----------------------- -------------------------------- EXISTING « -------------------------------------------------- ---- -------------------------------------------------- 46 FOUNDATION Z i N _........---...i o � ... 5 o ' .................... roLu � P � N ................... FULL BASEMENT . CRAWL SPACE € V o pp i NE E NG CUT ................... INTO DATIONP ............. i up ------------------- ' CRAWL SPACE y o ACCESS ' s 8 ----------------------------------- -------------- ------------------------ 22'-0" o a co FOUNDATION `i a,L 2"X 6"TREATED Scale: 1l4"=1' -0" d SILL AND SILL a SEAL o } 00 a u m s �'. L STEEL SILL BOLTS - � � u 5 ¢ 6'OC PER CODE }' STEEL SILL BOLTS 6'OC a• PER CODE 2"X 6"TREATED SILL AND SILL SEAL Lli POURED CONCRETE v *b o® w�9, S ® r ;. .i.. LULLJ SLAB x ��® 'ro , :� ri ° !L' POURED CONCRETE W p w d�. DUSTCOVER/ p[ y - - o a,� <• 8,, Lli Z O Q p COMPACTED EARTH s .vb , %.^; -- ----r _ Q $GRAVEL w= O y - ' Co LL �° ®°, ® , = ai -�� o '�-�'�;�_- _ '�•' :�. i Y ,:"��� `� Y COMPACTED EARTH$ GRAVEL �{, F 0 S ale KEYWAY IN 16' KEYWAY IN FOOTING 1/4°c L' FOOTING 16" V - oaWmyw. FOUNDATION SECTION '^ 1�� FOUNDATION SECTION 2 Scale:v2-=r� Scale: 1/2"=l' - 0" Of 4 i NOTES: M: 103 1 . THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH THIS PLAN, ° r +rgr"in U . " 1995 MASSACHUSETTS TITLE V 4�TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS. 2. THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, L: 47 SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO INSTALLATION. 3. ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 7FOOT. (UNLESS 5PECIFIED OTHERWISE). • = FLOOD ZONE: 250001 00015 C • ' : . , . '� o� ,• 4. THE DESIGN OF THI5 SYSTEM DOES NOT ALLOW FOR THE USE OF A GARBAGE DISPOSAL. 1 9AUG85 5. SEPTIC TANKS AND DISTRIBUTION 'BOXES (WHEN INSTALLED) MUST BE PLACED ON A MECHANICALLLY COMPACTED BASE OR ON ABASE OF 6" OF CRUSHED STONE. • ,3h abaci, '. 584°56'00"E ' _ 1 130.00' TEST HOLE LOGS 20,800±SF SOIL EVALUATOR: D. MEYER R.S., C5E WITNESS: DON DEMARAI5, BARNSTABLE B.O.H. DATE: MAY 25, 2005 PERCOLATION RATE: < 2 MIN/MCH / CLASS I SOILS LTAR= 0.74 GPD/FT^2 EXISTING GRADE cs # 1 # 2 SHEDS _ 0„ - 99.30 LOAM SANDY 9.30 - 0„ \ 8" A 98.63 10YR3/3 98.47 A 1011 I3.0 --� 20.0' I-�.- PROPOSED SANDY B LOAM B 26.8_ I5. I'+ ADDITION 10YR6/8 o - 0 \ 0 26"- 97.14 96.30 36" cn 1 O O TH-1 \ 10.0' o f C1 SILT C1 0 33. ' o <o -p LOAM O B O - 45"- 95.55 2.5Y6/3 94.80 - 54,, z = - E 10.0' R MEDIUM - SAND 34.8± C2 C 93.55 2.5Y6/4 C2 BITCONC No. 48 1.-57 DRIVEWAY STY. /WD. FRM; of M T.O.F. I0I .02' 132 132 ��N ,4 BENCHMARK: BULKHEAD CORNER - -88.30 88.30 - D RR ELEVATION = 100.00' NO GW OBSERVED NO GW OBSERVED (ASSUMED DATUM) � NO. 11 p ' \ SEPTIC SYSTEM DESIGN SgNiTAR\P rn/ FLOW ESTIMATE 7i✓ VJVJ p ' 130.00' \, 4 BEDROOMS AT I 10 GAUDAY/BEDROOM = 440 GAVDAY 3 EXISTING/I PROPOSED N84°56'00"W o / SEPTIC TANK OF 440 G.P.D. X 2 DAYS = 880 GALS ������ �gss9�y REPLACE OLD WITH NEW 1 500 GALLON SEPTIC TANK RICH RD EDGE �Of PAVEMENT HOOD N HARTfORSOIL ABSORPTION SYSTEM D AVENUE USE(3) 500 GALLON H2O LOADED PRECAST NO. 3500331 e FIRST FLOOR LEACHING CHAMBERS W/4'STONE �ST�`" OI ��VV/I D�J\ ON ALL SIDES(33.5'L X 13'W X 2'D) SITE PLAN ``t SIDE AREA: [(33.5)2 + (13)21 X 2 X 0.74 = 137.G4 2-F:l 077 TOP OF WALL 1 01.02 VENT REQUIRED BOTTOM AREA: 33.5 x 13 x 0.74 = 322.27 IF> 3 FEET OF COVER, 459.9 GPD > 440 GPD REQ'D It 2%SLOPE EL 99.30 ACCESS Wl IN 6';OF GR. \\,\,\ \;'\; \\��\,\\,\;\`l\\,�\;�\;�\;�\\, \\,�\\,�\\,�\\,, SITE AND SEWAGE PLAN \/ 9"MIN. COVER "" �A t�VER i 98.0 .- EL95.50 48 HARTFORD AVENUE TEST2'LEVEL °° 2"-3/8"DOUBLE WASHED STONE o0 98.02 I I O" 14" rfOR EVEL 97.58 97.33 2'LEVEL O 0 ° MARSTONS MILLS MA D-BOX Out of[).BOX ,0 O 0 0 [ M . n.,...:- .. , P.C. CONC. 0 0 0 08 gY�j t�0 0 / 94.80 e•�•�• �a•.= 0 � E] 0 IF 0 SEPTIC TANK(H- I O) GASBAFFLE G"MIN. a ��b0 ��� $ PREPARED FOR: ----- 96.33 °�8 8°8.8 � 0 � � � � �»�8°88Y8 9�.80 ' • 808 � 96.50 0�8 �8,g PAT ELAI N E VERM ETTE 1 500 GALLON G"CRUSHED STONE OR COMPACTED I O'MIN 3/4°- 1 1/2°DOUBLE WASHED ST ENGINEERING BY LAND SURVEYING BY 4.59 `(ENGINEER TO 20MIN. 33.5'LX 13'W 1 VERIFY5'SEPERATION DARREN M. MEYER, R.5. hood survey group, 11C AT TIME OF INSTALLATION) 18 old kmrJ5 higghway - p.o. box 231 P.O. BOX 981 Sandwich, ma 02563 BOTTOM OF TESTHOLE: EL 88.30 EAST SANDWICH, MA 02537 HEALTH AGENT APPROVAL DATE Ph: (506) 362-2922 Ph: (508) 588-1090 PROFILE OF DISPOSAL SYSTEM N.T.S. DATE: 23JUN05 SCALE: I" = 20'