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HomeMy WebLinkAbout0037 HEATHER LANE - Health s 37 Heather Lane Marstons Mills A= 149-130-007 IA � ;Y `R. yly 6•. AP i a �Y •t n � 4 C , A¢ y j _ Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments t 44 .; 't 37 Heather Lane - y Property Address , J. Delaney Owner Owner's Name information is �—)yl S i l required for every eenernitle MA' 02632 08/15/2013 page. City/Town /J I ��_ OV p f Inspection - _I State Zip Code Date o 5 Inspection results must be submitted on this form. Inspection forms may not be altered in an < way.Please see completeness checklist at the end of the form. ' 1 Important:When A. General Information � n filling out forms M x on the computer, ,�L , use only the tab 1. Inspector: key to move your p J A0 c.� cursor-do not �B 7A ✓use the return A. Riker key Name of Inspector µ' Riker Land Construction '. _�I Company Name «, PO Box 726 Company Address .r South Yarmouth MA 02664 • .n City/Town State Zip Code ' y 508-776-6460 S14590 ° 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 sited ter- sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5,(316 CMR 16.000).The system: » ® Passes,:' w ❑ Conditionally Passes ❑ 5,411 a :-= « ❑ Needs Further Evaluation by the.LocalApproving Authority 08/15/2013 In s Signature sj .Date The system inspector shall'Submit a copy of this inspection"report to thd Approving Authbnty(Board of Health or DEP)`wiihin'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-` x .report to the a ppropriate.regional office of the DEP.The onginal should be sent to the system'owner� v�N ._and c9pies;sent to the buyer, if applicable, and the approving authority . 4 ;,. €; , " fix G: Z F . *Thle report only describes conditions at`the time of inspection and under the conditions of"uses? 14 at that time:This inspection does not address how the system will perform in the future under ' the same or different conditions.of use t , v ���. t5ins 3/13- + h t Title 5 Official Inspection onn:Subsurface Sewage Disposal System Page 1 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 37 Heather Lane Property Address J. Delaney Owner Owner's Name required fo is Centerville MA 02632 08/15/2013 required for every page. Citylrown State Zip Code Date of Inspection t 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: On observation of septic tank,distribution box and S.A.S. there were no failures observed. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be, replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health: *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ `Y ❑ N ❑ ND(Explain below): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "t 37 Heather Lane Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. Cityfrown 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 (cunt.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): El broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, 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 t5iris•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 N, ... .: Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments < 37 Heather Lane Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. cityrrown 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: **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: . I D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No. El ® Backup of sewageinto facility or system component due to overloaded or clogged SAS or cesspool ❑ ED 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 Y day flow t5ins-3/13 Title 5 Official Inspection Form:'Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts a W Title 5 Official Inspection Form: Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r� 37 Heather Lane Property Address x J. Delaney t, Owner Owner's Name x ' information is required for every Centerville MA 02632 08/15/2013 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) r 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 El ® tributary to a surface water supply. 41, 1.4 '. ❑ ® 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 _.s , ❑ 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.] S p; ® 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 H== system owner should contact the Board of Health to determine what will be � µ R Z necessary to correct the failure. Y E) `Large Systems: To be considered a large system the system must serve a facilitywith a- gym. ..:des i pn flow of 10,000 d to 15,000 d. ,4 J For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the F :questions in Section D.I. ` Yes<, No jf ❑;." ❑ Kthe,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 ❑ = .:3°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 systemis considered a significant threat „ . or answeredyes' in Section D above the large system has failed. The owner or operator of anylarge 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 F-° re Iona) ffi g o ce of the`Department. M1 t5ins•3/13 Title 5 Official Ins a ,r on F rm:Subsurface Sawa Disposal System•Page 5 of 17 �, ° � ham* a. Commonwealth of Massachusetts a .. .. Title 5 Official Inspection Form''t Subsurface Sewage Disposal System Form Not for Voluntary Assessments4,1 S f s y" 37 Heather Lane E ' Property.Address J. Delaney Owner Owner's Name _ v information is required for every Centerville MA 02632 08/15/2013 page. Cityrrown State Zip Code Date of Inspection C. Checklist 3k 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 ❑ [9 Were any of the system components pumped out in the previous two weeks. 1 ® ❑ Has the system received normal flows in the previous two week period'?" ry E] ® Have large volumes of water been introduced to the system recently or as part of o y' this inspection? ® 1-1 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? 4P � ® ❑ Was the site inspected for signs of break out? F ,. ®' ❑ Were all system components, excluding the SAS, located on site? ®_ _ ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank t a r inspected for the condition of the baffles or tees, material of construction, ," 44 dimensions, depth of liquid, depth of sludge.and depth of scum? _ Was the facility owner(and occupants if different from owner).provided with .a ` ®° information on the proper maintenance of subsurface sewage disposal systems? Vim, 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. , _ . El 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)] x� D: System•Inforiination, Residential;Flow Conditions f + �.' a. three ", .. 3 w three x Number of bedrooms(design) Number of bedrooms(actual): - " •. t� fit .�' � iet ` . ,�' -. m s•A ?e ��'' �� as�r' , � f 330GPD °�� DESIGN flow based on 31o%CMR 15 203'(for example,. gpd x#of bedrooms) { _ . ¢ 4. F. � sFfP #M t5ins 3113 n Title 5 Official Inspection Ins n : �:. '•; .. � Form subsurface Sewage Disposal System Page 6 of 17 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a 37 Heather Lane r Property Address J.'Delaney Owner Owner's Name information is n required for every Centerville MA 02632 08/15/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: System was installed in April 2010 using existing septic tank. New distribution box and two 500 gallon s leach chambers with stone were used for construction of S.A.S. 'Number of current residents:. 2, = 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.) 14`. Laundry system inspected? ❑ Yes NO ° q. Seasonal use? ❑ Yes No Water meter readings, if available(last 2 years usage(gpd)): 2011=1876PD 2012=170GPD Detail: z.t COMM water records used Sump.pump? ❑ Yes" ® No " F currentr Lastf date of`occupancy- Date M w Commercial/Industrial Flow Conditions: ,- • s. Type`of Establishment. . z � ..� k �F`.1'-- •,� { any .. Design flow(based on 310 MR 15 203): ` Gallons per day(gpd) Basis of design flow,(seats/persons/sq.ft: etc.): i' Grease,trap-present? ,[I;Yes ❑¢ No Industrial waste holding tank presents j ,; =°❑ Yes ❑,':No Non-sanitary waste discharged to the Title 5 system? t ❑ Yes ❑N No Water.meter`readin s If v Ir a ai able: t5ins•3113. *b Tide 5 Official Inspection Forth:Subsurface Sewage Disposal System Page 7 of 17 a Commonwealth of Massachusetts Title 5 Official Inspection- Form x Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 37 Heather Lane r Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. Cityrrown State Zip Code Date of Inspection a D. System Information (cont.) t � z Last date of occupancy/use: Date Other(describe below): General Information ~ Pumping Records: r Source of information: _ homeowner g Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: To be completed after inspection gallons How was quantity pumped determined? y home owner pumping after inspection Reason for pumping: Type of System: ®, Septic tank, distribution box, soil absorption system Single.cesspool Ove. Elr rflow cesspool „ � e p ❑a Pnvy r ❑=< 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'contracf(to be obtained fro' system owner)and a copy of latest° inspectionmof the:l/A'system by system,operator under contract a >- .+f' - � f ' tin. r ' �,, '•' a e Tight tank`Attach`"a copy of the DEP`appcoval. . Other(describe): .r , t5ins s 3/13 «y " Title 5 Orficial Inspection Form:Subsurface Sewage Disposal System Page 8 of 17 c. _ . __ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 37 Heather Lane K Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: Tank original with home construction ,d-box and S.A.S. installed April 2010 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: town water line>10' feet Comments(on condition of joints, venting, evidence of leakage, etc.): dry with no leaks observed Septic Tank(locate on site plan): Depth below grade: 2 feet Material ofconstruction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) Precast 1000 gallon septic tank with risers on inlet and outlet and PVC tee'sin place If tank is metal, list age: years x. Is age confirmed by,a Certificate of Compliance?(attach'a copy of certificate) ❑ Yes ❑ `No ` Dimensions: 10" Sludge depth: t5ins•3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 rs , p y Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "< 37 Heather Lane Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 12.. Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was observed to be in sound condition with no failures observed. 41, 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 g :a, Commonwealth of Massachusetts ,_ , Title 5 official InspectionForm' F Subsurface Sewage Disposal System Form-Not for Voluntary Assessments < 37 Heather Lane Property Address e J. Delaney Owner Owner's Name information is r required for every Centerville MA 02632 08/15/2013 ' page. Citylrown 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.): , , .. � .. y> 53 rye.,..� f+•�'• - x- t Tight or Holding Tank(tank must be pumped at time of inspection):(locate on site plan): Depth below grade: Material of construction: ` El concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) " x Dimensions: Capacity: a ¢ gallons Design Flow: ;a gallons per day . Alarm present El Yes ❑ No Alarm level Alarm in working order: ❑ Yes ❑ No Date of last pumping: ; Date Comments(condition of alarm and float switches, etc) F ,' r rh Or. - r. ✓ x -' '�+, k ¢ Sri s c ' J"` iV *Attach copy of current pumping eontract(required) Is copy attached? ❑5 Yes " ❑ t5insr 3/13 3 Title 5 Official Inspection For Subsurface Sewage Disposal System Page 11'of a. z x to bc Commonwealth of Massachusetts oTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary.Assessments ".7 tF " . 37 Heather Lane 8, Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. Cityfrown State Zip Code Date of Inspection . D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): t Depth of liquid level above outlet invert equal to two outlets w/speed levlers 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.): ti jw No indication of failures observed at distribution box with riser in place and equal flow observed to ' both outlets. , s z x , , 5 r . Pump Chamber(locate on'site plan): o Pumps inworkmg;order: _• El Yes ❑ No Alarmhs In working'order A x ❑ Yes F ❑ Noy Comments(note condition of pump charnkier, condition of pumps and appurtenances, etc.): r _ *If pumps or`alarms are not in-working[r order, system`is'a conditional pass a 'Soil Absorption System(SAS) (locate on site plan, excavation not required) - If=SAS not located,�explain:why': . Y+" 3 7 L' 14. t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System R Page 12 of 17 t ' a ,u r, Commonwealth of Massachusetts t Title 5 Official Inspection Form ` 4 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments N_ M , ' 37 Heather Lane Property Address J. Delaney Owner Owner's Name information is enerve A 02632 08/15/2013 require d for every Ctill M " page. City/Town State Zip Code Date of Inspection D. System Information (cont.) r Type � ❑ leaching pits number: 2x500 gallon ® leaching chambers number: w/4'stone u ' ❑ leaching galleries number: � ❑ leaching trenches number, length: , ❑ leaching fields number, dimensions: El overflow cesspool number: , ` ❑ innovative/alternative system Type/name of technology: ` Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition4of vegetation, etc.): % Y Area of SAS was free of effluent effects on vegitation or soil stainings. Chamber was observed'to be leaa then 1"of standing water in base. .' . a t U R Cesspools (cesspool must be pumped as part of inspection)(I ocate'on site:Nlan). ; a Number and configuration ; 2 Depth'`-,top of liquid to inlet invert; a r Depth of solids layer. Depth of scum layer z Dimensions:of cesspool 2 r . e A �- a Materials of construction s Indication of^ roundwater inflow }' p 9 ❑' .Yes` ❑ 'No t5ins•3/13 bb r k Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 a .�' 0i .fi e Y ✓ 4 . P. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments g 37 Heather Lane Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. Cityrrown 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.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 • Commonwealth of Massachusetts r _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,A " 37 Heather Lane Property Address �. J. Delaney r Owner Owner's Name information is Centerville MA 02632 08/15/2013 L required for every page. Cityrrown 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 4. - a T a , s_ 3 4 t5ins?W3 , Title 5 ORicial Inspection Forth:Subsurface Sewage Disposal System•Page 15 of 17 w a Commonwealth of Massachusetts n `` Title 5 Official Inspection Form,, x- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ' M 37 Heather Lane Property Address , J. Delaney Owner Owner's Name information is "x re uired for eve Centerville MA 02632A 08/15/2013y 4 every page. CityITown State Zip Code Date of inspection �T.. D. System Information (cont.) � `z Site Exam: ® Check Sloe P , n� Surface water Check cellar Shallow wells r 12.39+feet Estimated depth to high ground water" a 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: 09/18/2009 Date w v ^� ❑ Observed site(abutting property/observation hole within 150 feet of SAS) 1: ® Checked with local Board of Health-explain: � mY test hole on file r" ❑ . Checked with local excavators, installers-(attach documentation) y'1 ❑, . Accessed USGS database-explain; You must describe how you established the high ground water elevation: [ .m test hole on file-from 2009 plan - - ^ IV N AN Before filing this!Inspection Report, please see Report Completeness Checklist on' next page.'. t5ins 3113 z M 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 't 37 Heather Lane Property Address J. Delaney Owner Owner's Name information is required for every Centerville MA 02632 08/15/2013 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked 4 ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 a a Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 17 of 17 TOWN OF BARNSTABLE LOCATION 37 �Je:.44e.— L z�nC --SEWAGE#�in L6 VILLAGE 1JtP ASSESSOR'S MAP&PARCEL ' e O-cp INSTALLER'S NAME&PHONE NO. L C. S�'u' 77G`lo�lln�1 SEPTIC TANK CAPACITY /oo o rm/�i eS LEACHING FACILITY:(type) i,t du. j�,Tdcll (size) ,;7.S L X 1) .iai 3 d r� D r NO.OF BEDROOMS %is-=c OWNER Pe 16,1 PERMIT DATE: 07w p COMPLIANCE DATE: Separation Distance Between the: ' 3 q Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility I 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 71 o 3 y� =�9 r 2 TOWN OF BARNSTABLE LOCATION 3 7 gec.7A4, L cw%c, SEWAGE# ),3 /6 —Oy VILLAGE M 'Y f ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. C. Ste' 7A,- '&0 SEPTIC TANK CAPACITY /W O T47/445' LEACHING FACILITY: a (type) .2 y SGG�4 X. �e vT l� (size) Y NO.OF BEDROOMS TA.-c e _ OWNER pe 16,1 e PERMIT DATE: "COMPLIANCE,DATE: (� ti . Separation Distance Between the: y 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 y� E =39' o Q L-0 CAT ION SEWAGE PERMIT NO. VILLAGE i5f► 31 �is£ '� -7 INSTALLER'S NAME i 'ADDRESS ,T Pld VIA 0 U I L D E R OR OWNER cl"m/,*I e..Jlyl �� -T h G�&Aj f-r DATE PERMIT ISSUED DAT E COMPLI ANCE ISSUED r� FRO N'f 48 ----------------- �3 yy No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpfication for Misposal *pstem Construction permit Application for a Permit to Construct( ) Repair(�,�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.3 7 14,C,.4 h pr L G,y_, Owner's Name,Address,and Tel.No. 5vl4, _ _c 14— peleA1 37 HC144— LtinG Assessor's Map/Parcel L/ p✓ 3 - 00 y C e—�ev..1 b )-4 o L Q Installer's Name,Address, d el.N clot) 776'G y60 Designer's Name,Address,and Tel.No. R L. cl< jud ►� .S. Pv1?ox13IS rck Type of Building: Dwelling No.of Bedrooms Lot Size v PO 3.7•Sl7 sq.ft. Garbage Grinder( ) Other Type of Building re.A'4eA 1A No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 U gpd Design flow provided y rg gpd Plan Date q Number of sheets �2 Revision Date Title Size of Septic Tank /D 40 Jlc,.. Type of S.A.S. 2 X SG d Jr." pextiC)I i y` S/&l n A Description of Soil Me ur- �0 Coe- c SGn /�fl 16a,,y Me d e Am 560C,P ��I � 10,5 Nature of Repairs or Alterations(Answer when applicable)Ayeti; 'd 1sint'hw. &X !7.J l h.✓ S'H• s ('�S{✓�� �c( a I� �y SGO ���w� �sy�.x��S tir�4) ' c�c✓�e X a 'el tQ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date °' A CIO Application Approved by Date frU Application Disapproved by Date for the following reasons t Permit No. 6LO 10 o (� Date Issued C�o 0 No. QhD` Ir; Fee V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN_OF BARNSTABLE, MASSACHUSETTS Yes 21ppliLation for Misposal 4�pstem Contitnittlon permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 NcA,4 h Pr GdC Owner's Name,Address,and Tel.No. 3V $3G'`VGI Assessor'sMap/Parcel ( J 134 juk� £ 1alNa De 37 laney Installer's Name,Address,landJTel;N� rG Pi,776.49(0 Designer's Name,Address,and Tel.No. 5vb-ell(,-44 ' ;Ck Yu �l 12 . ;. V000x 131S L. C. S b ,� .-jig Type of Building: Dwelling No.of Bedrooms al ram Lot Size 0140 3,).qJ7 sq.ft. Garbage Grinder Other\ Type of Building tP_Si 4e4>A No.of Persons Showers( ) Cafeteria( ) ;_ Other F tures Design Flow(min.required) 130 gpd Design flow provided ?q Eg gpd Plan Date 9 �� Number of sheets a Revision Date Title ' Size of Septic Tank 6 a Type of S.A.S. y 50 0,0 Q)k, P,,y 6)e)I J. Description of Soil ;, CGG rSc Shn d & 16L4�_Ml'e�i 1441 4'„j :2 Nature of Repairs or Alterations(Answer when applicable) ���,,� �,5�, �y1,X �Q �,G2✓ �! ro 51 jar,! ,I h f ay �C�,> jr tl,�^l aT� e I 1 , � �.nC X 0 '6►c ern Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date A 1.7 G Application Approved by Date LI—"ol—go U Application Disapproved by Date for the following reasons Permit No. L- .- — U) A 0 10 0��•— Date Issued -` � �,. a 0 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certific ate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposals t�m Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by A Q;�' `e f at ;3 7 L 6I-c C. 0c_ has been,constructed in accordance f -r with the provisions of Title 5 and the for Disposal System Construction Permit No.,gotO- 0°��dated L' Installer K. L_C Designer #bedrooms i�r cc Approved design flow 33 0 gpd The issuance of thi permit shall not be construed as a guarantee that the system t ncj ifon as designed. Date S b Inspector /il y K05 No. a o 1 U `0 f 2-- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS 0sposat *pstetn (ConstrULtion Permit Permission is hereby granted to Construct( ) Repair(>0— Upgrade( ) Abandon( ) System located at d� — Noe A 113 4 [ 9;14 s C'E� I-g , i))n and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this perm_ Date �-�- a 0 Approved by Town ,of Barnstable Regulatory Services Richard V.•Scali,Interim Director • BARN srnst.e. M^� 'Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 -Office: 508-862-4644 Fax: 508-790-6304 Installer.&Designer Certification Form Date: 5-?_7-10 Sewage Permit# zo 1 p- t)g Z Assessor's Map\P.arcel I I 0-007 Designer.: 1 L -IZD :TV 17D, R S• Installer: ,Ang.PA RiKF-R Address: P. 0, Address: p.p, 60X 77-(p t�g_ 11 U-1 ) MA-, 0 Z(nHS S,YARr QV rk4 i MA• r,>2_& AJ On 4 0) -Zoio ADAM was issued a permit to install.a (date) (installer) septic system at 3'+ REANF-P, yA}Jf�_ based on a design drawn by (address) E104A -: VDD ,R.S. dated nl115)o�) / (designe•) ✓ 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. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the IAA approval letters (if applicable) 'SN oFMq� RIC ARD J. ' (Installer's Signature JUDD JR. , No. 1125 01 S T E.R�O (Designer' lgnature) (Affix 13e�1gi3eriOStamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc ' Town of Barnstable w y ►$ Department of Regulatory Services Pr Public Health Division Date An Street,Hyannis MA 02601 Date Scheduled Time Fee Pd. Spoil Suitability _ Suitabilli ty,A�ssessment for Sewage Disposal PerfomedBy: Witnessed BY:JD92A(&YZ Location Address ? opsif^a�rsas•/! .y A a off• Owner's Name OVA)kAZ44 q gyp—4V" A 1EY .41?i&-�j^, 1ve--�e - C NEW'CONSTRUCTION _/ REPAIR 16� Telephone# Oy eMp 0 3; f•cam Land Use &✓ L12 Slopes N 3-f Surface Stones t40 Distances from: Open Water Body.?'�ft Possible Wet Area—?J' Gb ft Drinking Water Well� ft Drainage Way y'�!fi ft Property Line > J, ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) r Parent material(geologic) Depth to Bedrock >2cO r Depth to Groundwater: Standing Water in Hole:PAV 4!t—207. Weeping from Pit Face l64/90c - 1 Estimated Seasonal High Groundwater iZoZ 15EI..L7V.0 5l9 ;�y� Method Used `9 2&JwI ��_ A�/^"x' --�G C�. r02a Depth Observed standing in obs.hole: A41* in. Depth to soil mottles:_ ,q in. tl��� ve �s Depth to weeping from side of obs.hole: A in. Groundwater Adjustment ft. 45o"Toz— /ram./—, O'`D Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level 0�t��'S�#��,'�za3.dnD&tC Titgg z Observation Hole# r► Timeat9" !°c � �✓ ZZ°d Depth of Perc Time at 6" p Start Pre-soak Time Qa azy Time(9"-6")Z>Z �I vztil End Pre-soak 0 / Rate MinAnch Site Suitability Assessment: Site Passed V-- Site Failed: - Additional Testing Needed(Y/N) . Original:Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC r rt ti � Depth from Soil Horizon Soil Texture Soil Color Soil Other j Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency-%Gravel) 3 Ask S V `76YX.k rho 4(az A u l&t r t�ytt5/0 AID mYF I D� �_ LfylS zrSX 'Jr to ldl Ef$ 02'I C hl-C 5 2t5Y�/3 n(o L f DEEP OBSE1tYATY,( 1 HOLE I;(�Gx� �I0&1,#;s 2 �2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency-%Gravel) /®ylz`f& � Q0 M y F Iio " C �.wIS 2-,5y yy ✓a C [A-C 5 2t Y Y3 nf�o A Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) - (USDA) (Mansell) Mottling (Structure,Stones,Boulders. - -- Consistency%Graven n Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% aver Flood Insurance Rate Man: Above 500 year flood boundary No_/Yes Within 500 year boundary No +/Yes_ Within 100 year Flood boundary No_ Yes_ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? A�> If not,what is the depth of naturally occurring pervious material? Certification I certify that on .(date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date 'r?01 Q:VSEPTIC)PERCFORM.DOC j ,ea 1 bu,trom z HEATHER LAME E.O.P. E.O.P. lY� W 99 — — S46'43'06"E UP, OH C (ASSUMED) / PLANTING BED H CONCRETE / 2NER) 'F FOUNDATION M OF DWELLING. W I : PAVED:: E.O.L. DRIVE I EXISTING U. P. S. TANK BM 99 caves W i. PORCH C/❑/ j �Z A w EXISTING 3-BEDROOM-006 / ATER DWELLING w T.❑.F.= 100.59Lo / Jo d- N N tD M I W � z T GAS /C/o r.: E0 LINE �� �n T- N 99 WOOD / \ DECK w 1•s. WOOD neck N Eil - 1, J p \ — / 60 w LAWN AREA / 35.5' v' 2 — 98,15 RESERVE N E.O.L. 97.54 e5. 10.0' L®T 1 I W WOODED AREA w 20,032.47 .SO. FT. 0.460 ACRES 125.55' PCL. 130-037 N48'16'24"W PCL. 130-038 TOWN WATER / TOWN WATER 'ed Sanitarian U GARAGE a a_ BATH BEDROOM 1 BATH LIVING ROOM LAUNDRY HALLWAY CLOSET KITCHEN DINING ROOM BEDROOM 2 BEDROOM 3 FAMILY ENCLOSED ROOM PORCH 1 st FLOOR Basement FLOOR PLANS JUDD SEPTIC SERVICE Rick Judd, R.S. d P.O. Box 1315 LOCUS: 37 Heather Lane I f Harwich, MA 02645 Centerville, MAC 508-896-9316 PREPARED FOR: John & Elaine Delaney MAP:149 PARCEL:130-007 37 Heather Lane JOB NUMBER: 09_077 SCALE: not t0 scale Centerville, MA 02632 DATE: 9/18/09 SHEET: 1 of 1 ©2009 Richard Judd Registered Sanitarian /•7 No / ....%_„ F�$.............................. ( THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH 1`�" o v _0F. ... ------------- ... , ppliration for Uhipoiia1 Work Tonstrurtiun rruat Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ' CAij- - s` .................................................. ILL Lo ................. .............��. . .. Lot No.• dr...0 ..o- ner Address W s..l... .e............. ----------------------------- --••__.• - Installer Address Type of Build in Size Lot.a._��...Sq. feet Dwelling—No. of Bedrooms............... ._.........._..___-__.-Expansion Attic (Ab Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------•----•-- -------•------------------------------------- Desi n Flow..................... .............gallons per person r a Total ail flow.__.........._....6 ......._..._ 1�°�s. WSeptic Tank—Liquid capacity_0P.gallons Length.... yWidth_ _- �... Diameter................ Depth... ."�. Disposal Trench—No..................... Width........ Total Length.................... Total leaching area..._...____. _.-.sq. ft. Seepage Pit No ------------- Diameter........ ®p.. Depth below inlet.... ......... Total leaching area. ..sq. ft. Other Distribution box ( ) Dosing nk.(' ~' Percolation Test Results Performed by__.....�C�r� .1.- ......LUr....._.... Date.... ................ ............ a �- �`j No. I................minutes per inch Depth of Test Pit........ ...... Depth to ground water.AU_°�---B Gz, Test Pit No. 2................minutes per inch Depth of Test Pit-----------_-------- Depth to ground water........................ � ----•--� -- ------------•-•-............... ¢... ® = sic �' x Description of Soil---- _sT.._. .... - m- -E .. / U ----------•------------------•------------------------------••---•-•--•-••-----•-------------------------------------------------------------------------•--•-•----------------••---•-----------•----• W --- -------------------- -------------................................................................................--------•----•--.._.------•-----------------•-----•-----------------•---•---- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ .................................................----•--•--•--------•------------•..........-•---------••-------•----------------•-----•----•--------•---•--•......................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI'L i E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been>3sqed by the oard of health. gned. 7, Application Approved By-------'following -•-••-------------------•--..............................--.-•---- --3( !............... Date Application Disapproved f o he reasons:..........................................................................•---------------------------.--------- -•-------------•-------•---•-----------•--•---•-------------------•------••--•--.....----------.....---•-------•---------•---•------------•............................................................ Date PermitNo.............................................. ......... Issued....................................................... Date r Fimig.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARP OF HEALTH ........ ... _.... ........................ .................................... Application for Dispaiial Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct (/) or Repair an Individual Sewage Disposal System at: ............ ..................... ------ ---------------------*------­-------------- ff.ion. esr or Lot No. � ' -I- ........ ....C.> Vd_ c.... .............. .............................................................................................. wner Address . ...... ......... Installer Address UType of Building- Size Lot_0._P,1 3s?,.-..Sq. feet Dwelling��No. of Bedrooms.............._.......................Expansion Attic (1.)6 Garbage Grinder Other—Type of Building ............................ No. of persons........_.__........._______ Showers Cafeteria Other fixtures Design Flow.....................155...............gallons per person el ay. Total dail b flow............_.B��...C�.............. Ions. Septic Tank—Liquid capacityA�._gallons Length__----- Width!tlh...... Diameter________________ Death__ .. Disposal Trench—No..................... Width._.................. Total Length................. Total,leaching area .... ............ ....sq. ft. sq f t. Seepage Pit No....I-------------- Diameter......ZQ.�.... Depth below inlet.... .......... Total leaching area.. Z Other Distribution box Dosing ,a Percolation Test Results Performed b, .......... Date_..._' No. I----------------minutes per inch Depth of Test Pii'.j----f 3...... Depth to ground water_G u . ............ G;4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.._.._.................. ...........I.................................................................. ..6..... IF— ................ ....... .­--/ .............................. ...72� _ ;P ( 0 Description of Soil.... loo -----------------------*------------------------------ ................................................................................................................................... I ..............................................................................................................................................................I----------------------------"------------- 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 T I T a- 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. ned. ........................................... ApplicationApproved By.._.... ... ... . . .................................................................... Date Application Disapproved f o th f ollowing reasons:............................................................................................................... ..............................L..........................................................................................................................................•............................... Date PermitNo-------------------------------------------------------- IssuedL....................................................... Date' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................................OF.................................................................................... Trrfifiratr of Tompliatta S TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired by.... . . ............... e%!r- --------------------------------------------------------------------------------------------------------------- -10.... Installer at. .. ....... .. -A -----------I---------- has been installed in accordance with the provisions of TITLE he State Sanitary as cr' ed in the application for Disposal Works Construction Permit No.-r ......... dated_..... --- .. .......................... .. ......... �0 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................................... ................. Inspector......fltt.'61. ................................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... ..........................................OF.................................................................................... FEE. No......t................. S ....................... Bhlpvs�a Ylarkg TwOnstrurtiolt pamit granted.. ;00 e Permissionjp -by nted --------------------------------- ............... ......................to Construe or;Repaid ------- jVWu_a1­Sewage Disposal System at Now---��/......?47--------- �� Street as shown on the application for Disposal Works Construction Permit N ............. Dated._____.__.._____.__.__....._....._........ . .............. .. ............................................................................... goard of Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC.. BOSTON �,giL.yFLox/=//o -t'3 = 33o G.R.D. �, � Gp•3 ell C574 e— V/-Z17 gaT'To�f,4.P��i = 7� -S•F -s9• S � I �~ 525-3 , y Cry. 3 _ �G' �' ° /•v✓. 57.3 I: lai►1 r t-/- z" 3,(• , ///✓, /�+/✓ Fri�•,U 7. r;,� .'; s " WILLIAM G1�J K 7NULIN a .42GY.Nl� rh" 19334 �.t ! SST= Z' r,p c�''�� ;;�' � �• / i ,� �t/a K/ s u z ,C3 y7 3 I j I ° L 0 6.4 7 10,4-1 1�=;�7��it/S /V//L L S ! p IA 7 S,�1oWIV yE,eEO.c/ .2EQt/i,E'EME•c//S o� T.�,�E Tow/VaF 17 ,(�•4,�✓vv�'T.46L-c- .4N� /S /S/GT-" [.4i✓FO,��/G1/a.G"L tom. o�t/,�/L.r .�OCA.TEo W177y1-V Th� .zLoanPG41W f I a.'1T�Z� OA TE. 4.,VIS 1/oT BASSO o// .eEG/STE.eE� L eo SU.2Y6yz'r l /N.ST,2UM.�it/T,$'U.e�/EY � Th'E' .C�,T.E,2✓/�.,L.�� MASS. i D�.�S'E'TS Syvy✓.y Ss�ov�� IV07- B� AP�,� /Cfl��/�Co c7i�YG�✓✓iTj�/ , ///G. Wells not shown exceed 150'from LOCUS the proposed SAS , HEATHER LANE E.O.P. E.O.P. PUMP & FILL EXISTING PIT, INSPECTION REQUIRED. E ` W ;c f 99 - - - S46'43'06"E r U.P. `� i `,/4 �. U.P. / 125.50' ❑H { - - - - - /- BENCHMARK: EL. 100.74 (ASSUMED) / f PLANTING BED T.O. COVERED PORCH CONCRETE SLAB (NORTHEAST CORNER) BACKUP BM = TOP OF FOUNDATION EL. 100.59 AT SE CNR OF DWELLING. W / PAVED:: / DRIVE E.O.L. EXISTING ----- - � S. TANK LEGEND 19.3' rn /en \ ` 99 TEST HOLE o { ;; EXISTING SEPTIC CEIVEZ aR`" W C/❑ „D" BOX LiOZ \ 3 EXISITING WELL � s3 PROPOSED WELL SEPTIC TANK z EXISTING 3-BEDROOM PCL. 130-006 ___ DWELLING _ - � ELLING PCL. I30 008 32 EXISTING CONTOUR W J TOWN WATER N T,❑,F,= 100,59 o TOWN WATER M PROPOSED CONTOUR / LJ MC.0 = W WATER LINE U z GAS - �C ❑ n co OH OVERHEAD UTILITY LINE LINE �� ►0 / BUG UNDERGROUND LINE 9g WOOD / HYDRANT \ DECK / N ;/ SITE AND SEWAGE PLAN va®mac N / �X,- nfilC Hr�E!\��s — _ t LOCUS: `fE w o \ �/ 35.5 37 Heather Lane ' Centerville, MA No. . 75FC a _ LAWN AREA V 2 PREPARED FOR: 98,15 O -� PROPOSED SAS (H-10) - 98_ - _ — — — - 1 25.0' x 12,8' x 2.0' John E. & Elaine M. Delaney - - N 97.54 37 Heather Lane A�gss 10.0' RESERVE E,❑,L. E❑L Centerville, MA 02632 �o RiCH RD tiff 25.0' �• NOTES: A J• 'y . " JUDD,JtR. c,+ WOODED JUDD 5EPTIC SERVICE LOT 17 - �-s,Y AREA I �` ;• Rick Judd R.S. 20,032.47 SQ. FT. I ') ' P.O. Box 1315 0.460 ACRES i{ l Harwich, MA 02645 125.55' _ - e�: NA - — — 508-896-9316 PCL. 130-037 N48'16'24"W PCL. 130-038 MAP:149 PARCEL: 130-007 TOWN WATER / TOWN WATER JOB NUMBER: 09-077 SCALE: 1 — 201 ©2009 Richard Judd Registered Sanitarian DATE: 9 `1 8/09 SHEET: of 2 1 I EXIST. SEPTIC TANK "D" BWH-10) LEACH FACILITY PLACE ON STABLE COMPACTED BASE 500 GALLON DRY WELLS EL 99.30 I ACCESS EL. 100.59 Top OF FOUNDATION COVER TO.BE WITHIN 6' OF GRADE EL 98.00 MIN 2% SLOPE PORTS-2 ACCESS PORT r ACCESS PORT MIN. 9' COVER a"SCH.40 P.V.C. 3' MIN 2" LAYER OF 1/8' NOTE: FILTER FABRIC MAY BE 5=o.ozMrN. + MAX 36' COVER TO 1/2' DOUBLE USED IN LIEU OF 2' LAYER OF EL 95.93 WASHED STONE WASHED STONE EL. 97.42 4"SCH.40 P.V.C. 5=0.02 MIN. 3• 5=0.01 MIN. - .,�? Q M10, 14, s I� i S� i•' + 2' EL. 97.20 -1 ,-I- EL 98. EL. 9 EL. - 1,000 GALLON 4,0 95 5.40 95.20 EL. 95.10. i EFFECTIVE INSTALL BAFFLE t" ;ar 0 �� O O - DEPTH o . E 4• T0 1-1 L. 93.10 3 2 DOUBLE WASHED STONE .0 10.7"+/- 6' OF STONE UNDER TANK 95 0' + ` 8 0' STONE 17' LENGTH INSTALLED STONE TO BOTTOM PLACE ON STABLE COMPACTED BASE '+. 12,39' OF D.O.H.1 SEP11C TANK NOTES "D" BOX+NOTES 1. Extend inlet tee 10"min.below flow line;extend 1. When system is dosed or slope of inlet pipe EL 80.71 outlet tee 14"below flow line. exceeds 0.08711.install inlet tee cut-off one Estimated de th to round water inch above outlet invert. NO WATER ENCOUNTERED 9 2. Provide 20"manholes over inlet and outlet with readily removable I. 1 below SAS = 7.1' impermeable covers. 2. Install outlet pipes level 2 feet minimum. ESTIMATED GROUND WATER 22.0'BELOW GRADE. 3. Install access port over inlet and outlet 3. Provide a minimum sump of 6"below outlet invert(12"min.inside APPROXIMATE SURFACE ELEVATION:EL.62.0 with precast concrete or equivalent watertight dimension). GROUND WATER CONTOUR(35-40): EL.40.0 riser within 6"min.of final grade. 4. Install access port over"D"Box with precast concrete or equivalent ESTIMATED DEPTH TO GROUND WATER: 22.0' watertight riser Within 6"min.of final grade. DEEP HOLE LOGS DESIGN GENERAL NOTES DATE: 9/18/09 , 1.) ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE W/TITLE 5 OF THE SANITARY CODE& Pit 12705 DEEP OBERVANON HOLE# I TEST BY: RICK JUDO ME 10:00 DESIGN DATA ANY APPLICABLE REGULATIONS. 2.) PRIOR TO BACK FILLING THE INSTALLATION,THE SANITARIAN&HEALTH AGENT SHALL BE NOTIFIED FOR ELEV. Prom COLOR SOIL STRUCTURE 1.REQUIRED FLOW 3O BEDROOMS X 110 GPDB.R.=330GPD INSPECTION. 97.54 sunfoce M=RE (MUNSELL) IUOTnrNO CONSIS7ENCY, OTHER 3.) ANY ALTERATIONS OF THIS DESIGN MUST BE APPROVED BY THE SANITATION&BOARD OF HEALTH,IN 9729 3" AIE sandy loam 7.5YR 312 NO granulad WRITING 95.54 24" Bw fine sandy loam tOYR 516 NO massive,very friable 2.SEPTIC TANK CAPACITY 330 GPD X 2=660 GPD 4.) SYSTEM IS NOT DESIGNED FOR A GARBAGE GRINDER. 88.79 105" C loamy medium sand 2.5Y 514 NO Loose,10%gravel&cobbles USE(1)1000-GAL EXISING SEPTIC TANK 5.) THE INSTALLER IS TO VERIFY THE LOCATION(S)OF UTILITIES,CESSPOOL(S)AND SEWER INVERTS PRIOR 80.71 202" 2C medium to coarse sands 2.5Y 7l3 NO loose,single grain TO CONSTRUCTION. 3.LEACH FACILITY DESIGN:25.0'L X 12.8'W X 2.0'D 6.) ALL UNSUITABLE MATERIAL WITHIN 5 FT.IN ALL DIRECTIONS FROM THE SOIL ABSORPTION SYSTEM -- - SIDE WALL AREA:2(25.0'+12.8')X 2.0'X 0.74 GPD/SF=111.88 SHALL BE REMOVED&REPLACED W/CLEAN,COARSE SAND. BOTTOM AREA: 250'X 12.8'X 0.74 GPDISF=236.80 7•)ALL FILL MATERIAL UTILIZED FOR THE SOIL ABSORPTION SYSTEM SHALL BE CLEAN,COARSE SAND FREE Bat. of Pert . 62" FROM DELETERIOUS MATERIAL AND SHALL HAVE A PERCOLATION RATE OF LESS THAT 2 MIN./IN.BEFORE& RATE:< 2 MIN/INCH: 15 min pre-soak. 12"-9"= 1:55. 9"-6"= 2:26 TOTAL =348.68 GPD AFTER PLACEMENT. WITNESS Donald Desmarais, IRS, B�rstable Health Department 348 GPD PROVIDED>330 GPD REQUIRED 8.) EXISTING CESSPOOL(S)TO BE PUMPED AND BACK FILLED PER TITLE 5 ABANDONMENT PROCEDURES. DATE 9/18/09 9.) DURING INSTALLATION,THE CONTRACTOR IS RESPONSIBLE TO PROVIDE A SAFE EXCAVATION AREA. P 12705 USE:(2)8.5'L X 4.8'W X 2.0'D(H-10)CHAMBERS WITH 4.0'OF DOUBLE 10.) GROUND COVER OVER SEPTIC SYSTEM COMPONENTS SHALL NOT EXCEED 36". DEEP OBERVARON HOLE 12 TEST BY: RICK JUDD TIME 10:00 WASHED STONE ALONG BOTH ENDS AND SIDES. 11.) ALL GRAVITY SEWER PIPE SHALL BE 4"DIA.SCH 40 PVC UNLESS OTHERWISE NOTED. THE MINIMUM SLOPE OF 4"DIA.SCH 40 PVC SHALL NOT BE LESS THEN 0.01 FT/FT. ELEV. From COLOR SOIL S7RUCTURE " 12.)WHEREVER SEPTIC LINES CROSS WATER SERVICE LINES OR WHEN WATER SERVICE LINES COME WITHIN e 98.15 Surloce NOR• TEXTURE (MUN-SM) UOT7UN0 CONSISTENCY, OTHER 10'OF THE PROPOSED S.A.S.-PIPES SHALL BE CLASS 150 PRESSURE PIPE&SHOULD BE PRESSURE TESTED TO 97.90 3" AIE loamy sand 7.5YR 3l2 NO granular Ik f ASSURE WATER TIGHTNESS. COORDINATE WITH LOCAL WATER DEPARTMENT. 95.48 32" Bw loamy fine sand 10YR 416 NO massive,very friable 13.) PLACE MAGNETIC MARKING TAPE OVER ALL COMPONENTS. 88.98 110" C loamy medium sand 2.5Y 614 NO loose,10%gravel&cobbles 84.15 168" 2C medium to coarse sands 2.5Y 7/3 NO loose,single grain CONSTRUCTION NOTES y SUBJECT: 37 Heather Lane -- - 1.) office Contact oce(508)896-9316 a minimum of 5 days prior to start of project. -- - 2.) Pump septic tank and leachin pit. Fill leaching pit(inspection req.). Centerville, MA Bat. of Perc: N/A 3.)Provide a minimum of two 4"PVC cleanout(C/O)caps to grade PREPARED FOR: RATE ASSUMED AT <2 MINUTES PER INCH IN THE C HORIZON between the septic tank and distribution box. John E. & Elaine M. E)elatley WITNESS: Donald Desmarais, IRS,Barnstable Health Department ' 4.)Proposed distribution box(H-10)requires a 6"base of crushed stone. P ASSESSOR'S SCALE: 5.)Raise septic tank covers(2)&distribution box cover to within 6"of finished grade.Raise two SAS inspection port covets to within 3"of MAP: 149 Not to Scale PARCEL: 190-007 finished grade. Magnetic tape required on the covers of all components. 6.) Loam and hydro-seed all lawn impact areas. Any and all landscape DATE: 9/18/09 SHEET 2 of 2 considerations are to be in writing between the owner and contractor. 7.)Final grade inspection is required. Rick Judd, R.S. (e P.O. Box 1215 1 Harwich, MA 02645 10 2009 Richard Judd Registered Sanitarian 1. 508-896-9316