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0149 HIGHPOINT ROAD - Health
149 HIGH POINT "' A = 027 ,3 ` •.` L t i Town of Barnstable P# i Departitnent of Regulatory Services i Public Health ' 'DivisionMAM Date J t439 200 Main Street,Hyannis MA 02601 C.t� tEn� I � I �} Date Scheduled Time—, _ Fee Pd. a LN Soil Suitability Asswment for Sew-age Dispos IL Performed By:_ A4 1"►i r4 L—k RZ Witnessed By: � I �4 LOCATION&.GENERAT,INT'ORMATION Owner's Name Location Address *30tAt4 ?54 4PAWkapr h0,9-5TCx-/'S 1u(uS N4 o;691T Address SO4+4E Assessor's Map/Parcel' ` 24 l-iiir 43c) Engineer's Namo /�- l�tT� NEW CONSTRUCTION REPAIR X Tele hone ft WB` 400 00 ;3r0 Land UsoES/QC�✓T11�(� �El�1/1/�i Slo slopes 96 /�— p ( ) Surface Stance Off✓ Distances ftum: Open Water Body IDe ft Posslblc Wot,Arca —R Drinking Water Noll 'll $ Dcalhage Way _ft Property Une `n'� ft Other ft (64riO. 8AS1At> SKETCH:(Stroot name,dimensions of lot,exact locations of test holes&pero tests,locate wetlands jn proximity to holes) ��ryV S'n H(, �iE 4Q G LZJELLIr!(T Ll • I •DEc.K l I TP ` SSE ��5 c L�o�l ',�.•r9-� Paront material(geologic) 60i W,4Sa Depth to Bedrock I,t Depth to Oroundwatcr. Standing Water In Hola: N Q H E-- Weeping from Pit JIM [�oN Estimated Seasonal High Groundwater DETERMINATION FOR SEASONALMIGH WATER TA LE Method Used: De th Observed standing In obs.hole: In, Depth to loll mottle!: ►a,' . D:�th to weeping from sido of obs.hole: In, amundwater Adjustment Iih. Index Well# Rending Dato: Index Well lmvel �, AdJrthotbr, ,�. Adl,grtiundwamr•i aval,,_ PERCOLATION TEST Data I 'Than! Observatlon Hole# Time at 9" Depth of Para •5 Time at 6" Slart Pro-soak Time 0 )01 1(o Time(9"•6") End Pro-soak 101•2Z j Rate Mln./Inch L M IH i Sho Suitability Assessment S►to Passed _ Site Palled: Additional Testing Needed(Y/N) Original: Public zenith Division Observation Hole Data To Be Completed on Hack ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conseirvation Division at least one(i)week prior to beginning. Q:ISBPTICU'BRCPORM.DOC I DEEP.OBSERVATION HOLE LOG Hole#T Depth from Sell Horizon Sall Texture Shcl Color Sall. Other Surface(In.) (USDA) (Muneell) Mottling (Stnueture,Stones;Boulders. o lsistency.%- ava1) a"- 14' s "o we 10 Y,- 1%3 — 6AA4 LX A4 wl- JOAAA 5 NO) I D Me MED /0 !� �� — 6MU6&A1N tat DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. lilt � t0�4w� 10Yo sG 1.4 i ,-7„_ y n 5d4�NQt' — G, NF..D. 5N1-10 /Diose DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Soil Texture Sall Color Sall Other Surface(in.). (USDA) (Muneell) Mottling (Structure,Stones,Boulders, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Sall Texture Sall Color Sall Other Surface(in.) (USDA) (Muneell) Mottling (Structure,S;opes;Boulders, Flood Insurance Rate Map: Above 500 year Mood boundary NOA Yea-X— , Within 500 year boundary No-X,— Yes AA- Within t00 year flood boundary No,.X., Yee ))ertth of Naturally Occurring Pervious Materlal Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the area proposed for the soil absorption system? , Z'5S If not,what is the depth of naturally occurring pervious material? Certlfleation I certify that on IIAI W- (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, orNse nd experience described In 10 CMR 15.017. Signature Datts 30 / Q;%SBPTI0PB1tCPORM.DOC TOWN OF B LE LOCATION C! /"b Jh,�1 O 1 11 IL SEWAGE # VILIJAGE ASSESSOR'S MAPS& LLOT L INSTALLER'S NAME&PHONE NO. C) 7—,-"-3o j SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) �l NO.OF BEDROOMS BUILDER OR OWNER cbe i S �-- PERMIT,DATE: COMPLIANCE DATE: �:ZC�C?u Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I Ila AO Ag31 3S CC oil 036 -Property Address 'Map section parcel ;lot Type of building . �• Per init number /J► e'/1 C .(Residential/Commercial) , we 1 '^c) 17 1 r7 j Number of bedrooms (residential)or square' footage(commercial) Date of Installation Spxial circumstances: Capacity required and Min.G.P.D.required: Alternative Technology/ provided(G.P.D.) 33 a G.P.D.provided: ,Var•iance(s)etc.. Please specify Sd 1 LTAR(application rate) Installer Name cc KAaw.. Leaching facility component 2 500 G�von beer description and dimensions. Designers Name A j tTl • Water service (Town or well) L✓ 1 I)taller Signature* Depth to Groundwater �Q �C�/1C.[i(,Lit+e� *Installer's'signature above indic a system was installed substantially as proposed in permit plan and is the installers certification as required in Title V CMR State Zone H? (yes/no) 15.02 The septic system location must be placed on the reverse side. Use two permanent landmarks(such as house corners)to locate system components. These landmarks should be identified with letters and the system component should be identified using numbers. At a minimum,two septic tank covers,the d-box,all four comers of the leaching facility and its inspection ports must be concisely measured from the chosen landmarks. i Yi Jl 5 POD Y/A 9 9 ,5c� btu . I� p i 'r No. Fee U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rppfiration for Disposal *pstrm Const urtion VPrmit Application for a Permit to Construct( ) Repair([�pgrade( ) Abandon( ) El Complete System Individual Components Location Address or Lot No. � Owner's Name,Address,and Tel.No. ??V fill i G 310 � 0 Assessor's Map/Parcel 0z 3� /L�i�I✓f1/S�(OeXWSl/' 6 Installer's Name,Address,and fel.No. .S� Designer's Name,Address,and Tel.No. S 4�� JOffih �36 1��e�ce+rwN 4'L1E5rri/4tO Doety� k S c 50� 7 6 q 46 3 5►� Sa7 DES/�� 1 )-f M4 025 3 7- Type of Building: Dwelling No.of Bedrooms 3 Lot Size W,, 341 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3q? gpd Plan Date Number of sheets Revision Date Title u v ,4 L Sk r�1 gt2r /4r/i Size of Septic Tank 6 0,0V Zook- Wks!'Z N6i Type of S.A.S. / � $00 (P4t— CM4MsZWj z Description of Soil LOP " - 5AW A44>luP-4 SA^/D Nature of Repairs or Alterations(Answer when applicable) �E(J !;As '04.40 Z)-$ox, �83 o /rI�L�-one wt�F 2 p-F—Zo 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 Boar dt'o*f Fl th. Sigqed Date 6 2 Application Approved by 4SDate !%D Application Disapproved b Date for the following reasons Permit No. 0 Date Issued 161 No. Fee u o THE.COMMONWEALTH OF MASSACHUSETTS Entered in computer: >. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ,-- ,• application forlDisposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair(I. pgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. lV f H��`f !�!T,y Owner's Name,Address and Tel.No. 77N�F9y l/ Assessor'sMap/Parcel 01:7 030 f,A1P,1f/di51-1U Installer's Name,Address,and tel.No. gyp„ SAS Designer's Name Address,and Tel.No. C��In' S c 50R TZ Cc CK63 75 I0E.Si0A/ j C-)i MA 0253z Type of Building: Dwelling No.of Bedrooms Lot Size 20` 34 sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures r Design Flow(min.required) 330 gpd Design flow provided 3y / gpd Plan Date Number of sheets Revision Date 0 / Title u uAAC_F_ 57,j5C.,,,4&e P1,S,46514L St'S c"�► S l4i•!i /�r� ,a'Of=/G/_ Size of Septic Tank l� 060 &A (F=tts 77 N61 Type of S.A.S. lZ� 500 =(744- 6lr54w►3�,Q1 T � Description of Soil f ar4,—i- 51440 µlFJicJn-� 5�4�/Q Nature of Repairs or Alterations(Answer when applicable) J4^4a D-,6OX B3 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 Boardrof He th. Si ed ' ' Date (4, Application Approved by Date / Application Disapproved b Date r for the following reasons Permit No. 6 - Date Issued t? -7 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of CouYtlYlallce THIS IS TO RTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by , -71'1 n f at LM j/� M, / has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2-o/7 ldated LA tl 7 Installer Designer #bedrooms Approved design flow U gpd The issuance of this permit shall of be co trued as a guarantee that the syste ill func d sign d. Date (O J�� � Inspector�� No. 0 r J Fee /U!/- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstent Construction permit Permission is hereby granted to Construct( ) Re rl1r�, y�,rair(V( Upgrade( ) Abandon � ( ) U System located at � l;(� ,( l � �, 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:Construction77e completed within three years of the date of this permit.Date G Approved by \IJ C)) /�l �VJ1 V�fiT � r dr ��(� lfG �1 v� f(l�s ✓iu ruUt jV"r� �111)e 01 In s// � Town of Barnstable � l Regulatory Services Richard V. Scali,Interim Director BAMSTABM MASK. Public Health Division t639• �� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Ci7 lv / Sewage Permit# 6J7-—1 Assessor's Map\Parce 0 Designer: 'j �� (TC %�GSIL/��/<L Installer: Cc�Nt7oNSC14U.4►�1►I(T 7 Address: 69Gs 1 04,) De. Address: ] MC440'r iz") j5AS�S i�r��c�h� D7 3� S,a�iDcv,c':y E!!tk'0' t6 On 6 14 !'7- 6;K6A 1'T-y-1&_was issued a permit to install a ate) (installer) septic system at .Iy9 kP19011'Ir Q40114AV-9Dr(S 1USbased on a design drawn by (address) A to 6/TF- day b,4, 1 LG dated 5 130 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 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 th t�fhe system referenced above was constructed 'i ith the terms o�the , pproval letters(if applicable) ���N OF MAss' qy FO ASA J.MINTZ N m e0V(Installer's Sign ure) c0i CIVIL. -� y NO.52659 �G/S TER�'0 e ' s ignature) (Affix Des e- 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 N07T OW 6F t✓i�i i L 5 � � OAS �.�LFo2ru�1� D�✓ ��u�� /A A!rA,4- t J/45 /cam �4 DEP 72-f pf= hWd /Yo S r&.A/ OF 1,461 SHE Tp�� Town of Barnstable Barnstable . . : Regulatory Services Department BARNSTABM MMMNicaciw 9 MASS.: ,�� Public Health Division Im 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 2380 May 11, 2017 FARRENKOPF, BRIAN S & CHRISTY 149 HIGHPOINT ROAD MARSTONS MILLS, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 i The septic system located at 149 Highpoint Road,Marstons Mills was inspected on 05/03/2017 by Asa Mintz, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching pit or cesspool with high liquid level,<12" below inlet (Per Town Code 360-9.1). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF TH BOARD OF HEALTH omas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\149 Highpoint Road Marstons Mills.doc THE A i Town of Barnstable REAM • HAANSTABLE. • . Regulatory Services Department '°tfn ram'' Public Health Division 200 Main Street, Hyannis MA•02601 Office:,508-862-4644 Richard Scah,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5111116 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground w ❑ Pumping more than 4 times during the last year not due to clogged or obstructed Pipe ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone l'to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water civahU •s system passes if the water analysis t di a es the well is free from pollution . TWO 2 YEAR DEADLINE CRIT p Single Cesspool ❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components, etc) Leaching pit or cesspool with high liquid level, <12" below inlet(per Town Code §360-9:1) o Leaching facility with standing liquid level at or,above the invert pipe (per Town Code§360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc . ©z:�--�030 V4 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Highpoint Roads Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills ✓ MA 02648 5/3/17 +r page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Asa Mintz use the return ,I key. rab 4 Crestview Drive East Sandwich MA 02537 508-400-2365 4449 B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority K 18/2 0j J The system inspector shall submit a copy of this inspection report{{to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc`•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts r w Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 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: 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.doc•rev.6116 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 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town 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): ❑ 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): 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 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: "* 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: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ,T)Fe. SEcnoH 3too — 4. 1 ® ❑ Liquid depth in is less thanYbelow invert or available volume is less p s d CODe— or—�6- TCLJ-4 °F than '/2 day flow. OAPH fc-r—rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town 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. ❑ ® 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 n flow of 10,000 gpd to 15,000 gpd. For large Sys - s, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Sectio Yes No El the system is with) 00 feet of a surface drinking water supply /N ❑ ❑ the system is within 200 feet o tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sens' a area (Interim Wellhead Protection Area — IWPA) or a mapped Zone II of a publl ter supply well If you have answered "yes"to any question in Section E the system is consi - d a significant threat, or answered "yes" in Section D above the large system has failed. The owner or o for of any large system considered a significant threat under Section E or failed under Section D shall u de 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 4 w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town State Zip Code Date of Inspection D. System Information Description: 1,000 Gallon Tank, 1,000 Gallon Leach Pit Number of current residents: 4 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)): 2015-48,000 2106-50,000 Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Currently Occupied Commercial/Industrial Flow Conditions: Type of blishment: Design flow (based o 10 CMR 15.203): J� Basis of design flow (seats/perso ft., etc.): I 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: 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 - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: t !777 General Information Pumping Records: Source of information: Board of Health,Pumped in 1998, 1999,2004, 2008,2011 Was system pumped as part of the inspection? ❑ Yes R No If yes, volume pumped: How was quantity pumped determined? Reason for pumping: Type of System: . ® Septic tank,4istFibutlen b soil absorption system - 1,oo0 641 , W cq -Pl T ❑ 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 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 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: 34 Years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: —181, Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: >100, Comments (on condition of joints, venting, evidence of leakage, etc.): Piping looks to be sound from inside the dwelling and observation in the tank. Septic Tank (locate on site plan): Depth below grade: �l8" Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: 2" 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 ,M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 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 22" Scum thickness 5" 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 24" How were dimensions determined? Direct measurement Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Structural integrity of tank appears to be in good condition. Both inlet and outlet tees appear to be in good condition and liquid level in the tank appears to proper. No evidence of leakage was present Reconunend pumping at a minimum every three years. Tank is currently due for a pumping due to heavy scum layer ase Trap (locate on site plan): Depth bell o rade: Material of construc ' ❑ concrete ❑ meta ❑ 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: t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c�M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) omments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, 146tid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank ank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: Design Flow: Alarm present: ❑ Ye ❑ No Alarm level: Alarm in wor ' g order: ❑ Yes ❑ No Date of last pumping: Comments (condition of alarm and float switches, etc.): *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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 'siribution Box (if present must be opened) (locate on site plan): Dep of liquid level above outlet invert Comme is (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence f leakage into or out of box, etc.): \� Pump Chamber (locate on sit\plan Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of f pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a cond\requid)�.: Soil Absorption System (SAS) (locate on site plan, excavatio If SAS not located, explain why: 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 ^M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: (1) 1,000 Gal. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): When leach pit was opened liquid level in pit was approximately 1"above the inlet invert elevation. System was still functioning without backup to the tank or dwelling. esspools (cesspool must be pumped as part of inspection) (locate on site plan): Number an nfiguration Depth —top of liquid to i invert layer Depth of solids la P Y Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Highpoint Road qM Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) omments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, c.): \ Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic ilure, level of ponding, condition of vegetation, etc.): t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c,M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 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 t5ins.doc•rev.6/16 4 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °7M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope A % 7-0 .961" S Lo ® Surface water g.lo 5u2F►ac-E QAi-E--P— Ht44�"L ® Check cellar HO Stuf-'S a F E3�c9 P ® Shallow wells rlco S LR- LJ45 --s Estimated depth to high ground water: 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: ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: See below ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: High groundwater was not established as the system has failed. Percolation tests will be performed at which time high groundwater will be established for the design of a new Title 5 compliant system. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149 Highpoint Road Property Address Brian and Christy Farrenkopf Owner Owner's Name information is required for every Marstons Mills MA 02648 5/3/17 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 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 t 149 HIGHPOINT ROAD SEPTIC SYSTEM AS- BUILT FRONT C EXISTING DWELLING 149 HIGHPOINT ROAD A B ,.r DECK O 1,000 GAL TANK O O 1,000 GAL LEACH PIT SWING TIES A B C TANK IN 26.5' 23.0' TANK OUT 31.0, 27.5' LEACH PIT 74.0' 35.5' 54.0' Page: 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Dated: 7/29/2005 Report Prepared For: Order No.: G0531989 Brian Farrenkopf 149 Highpoint Rd. Marstons Mills, MA 02648 Laboratory ID#: 0531989-01 Description: Water-,J).jinldn'g W:i.ef r"—'—'" ^�---- Sam le#: 31989 "•��•�-r� '�r- P Sampling L cation: l49 Higlipoint.Rd.Marstons Mills,MA Collected: 7/27/2005 Collected by: Brian Parcel 027-03 Received: 7/27/2005 Routine ITEM RESULT UNITS RL MCL Method# Tested LAB: Inorganics Nitrate as Nitrogen 5.9 mg/L 0.10 10 EPA300.0 7/27/2005 LAB: Metals Copper 0.14 n,g/L 0.10 1.3 SM3111B 7/28/2005 Iron BRL mg/L 0.10 0.3 SM 31 11 B 7/28/2005 Sodium 12 mg/L 1.0 20 SM 3111B 7/28/2005 LAB: Microbiology Total Coliform Absent P/A 0 0 309 7/27/2005 LAB: Physical Chemistry Conductance 140 umohs/cm 1.0 EPA 120.1 7/27/2005 PH 6.2 pH-units 0 EPA 150.1 7/27/2005 Water sample meets the recommended limits for drinking water of all the above tested parameters. Approved By:. _ i (L irector) i T� C'D co ,RL =,Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 COMMONWEALTH OF MASSACHUSETTS $ 1 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS John Grad DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAULCELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 149 HIGH POINT RD. MARSTONS MILLS MAP 027 PAR 032 L 34 Name of Owner ROBERT RIENSTRA Address of Owner: SAME Date of Inspection: 312199 Name of Inspector:(Please Print)JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: John Graci Title V Septic Inspection Mailing Address: P.O.Box 2119 TeaTicket,Ma.02636 Telephone Number: (508)664-6813 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes The inpection is based on criteria defined in Title V _ Conditionally Passes code 310 CMR 15.303.My findings are of how the system is _ Needs Furtheiubmit luation By the Local Approving Authority performing at the time of the inspection.My inspection does _ Fails not imply any warranty or guarantee of the longgevity of the septic system and any of its components useful life. Inspector's Signature: Date:313/99 The System Inspector shall a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. r . , NOTES AND COMMENTS THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. revised 9/2198 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:312/99 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. ND The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure Is imminent.The system will pass Inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. ND Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced NO The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection If(with approval of the Board of Health): broken pipe(s)are replaced _ obstruction is removed revised 9/2/98 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:312/99 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 the public health,safety and 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 ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance nla_(approximation not valid). 3) OTHER WA revised 9/2198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:3l2/99 D. SYSTEM FAILS: You must Indicate either"Yes"or'No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped n/a. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the invert pipe,Is in Hydraulic Failure. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems In addition to the criteria above: _ The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 912/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:3/2/99 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health. X None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined.Note if they are not available with N/A, X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout, X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X Existing information,For example,Plan at B4O,H, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) (1 5.302(3)(b)) X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal Systems. revised 9/2/98 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:3/2/99 FLOW CONDITIONS RESIDENTIAL: Design flow:-=g.p.d./bedroom Number of bedrooms(design): 3 Number of bedrooms(actual):.1 Total DESIGN flow: = Number of current residents:4 Garbage grinder(yes or no):NQ Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no):JLQ Seasonal use(yes or no):JLQ Water meter readings,if available(last two year's usage(gpd): n/a Sump Pump(yes or no): NQ Last date of occupancy: nLa COM M ERCIAL/INDUSTRIAL Type of establishment: n/a Design flow: n&gpd(Based on 15.203) Basis of design flow: nLa Grease trap present:(yes or no):JLQ Industrial Waste Holding Tank present:(yes or no): NQ Non-sanitary waste discharged to the Title 5 system:(yes or no):NQ Water meter readings.if available:n& Last date of occupancy: n(a OTHER: (Describe) n& Last date of occupancy: nLa GENERAL INFORMATION PUMPING RECORDS and source of Information: SYSTEM WAS PUMPED WITHIN THE LAST 2 MONTHS System pumped as part of inspection:(yes or no):NQ If yes,volume pumped nta_ gallons Reason for pumping: n& TYPE OF SYSTEM X Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes.attach previous inspection records,if any) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other: n& APPROXIMATE AGE of all components,date installed(if known)and source of information: THE SYSTEM IS 25 YEARS OLD. Sewage odors detected when arriving at the site:(yes or no): 11LQ r ` revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:3/2/99 BUILDING SEWER: (Locate on site plan) Depth below grade: 1.6.E Material of construction:_ cast iron _40 PVC X other(explain) Distance from private water supply well or suction line: TOWN Diameter: nLa Comments: (condition of joints,venting,evidence of leakage,etc.) nLa SEPTIC TANK: X (locate on site plan) Depth below grade: V Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) nLa If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): MQ nLa Dimensions: L 8'6"H 6'7"W 4'10" Sludge depth: A Distance from top of sludge to bottom of outlet tee or baffle: A Scum thickness:-Q Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: A How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND RECOMMEND PUMPING SYSTEM EVERY TWO YEARS E � GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) nLa Dimensions: Wa Scum thickness: n& Distance from top of scum to top of outlet tee or baffle:-n& Distance from bottom of scum to bottom of outlet tee or baffle nta Date of last pumping: nta Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) Wa revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:3/2199 TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: DIA Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) DLa Dimensions: Wa Capacity: DLa gallons Design flow: DLa gallons/day Alarm present: NO Alarm level: nla Alarm in working order:Yes_No_ NQ Date of previous pumping: Dla Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DLa DISTRIBUTION BOX: _ (locate on site plan) Depth of liquid level above outlet invert:Dla Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER: NO (locate on site plan) Pumps in working order:(Yes or No): NO Alarms In working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) DLa revised 9/2198 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:3/2199 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: Wa Type: leaching pits,number: 1000 GALLON LEACH PIT leaching chambers,number: jaLa leaching galleries,number: jaLa leaching trenches,number,length: nLa leaching fields,number,dimensions: n& overflow cesspool,number: n& Alternative system: nLa Name of Technology: j3& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALL SOUND AND FUNTIONING PROPERLY THE PIT HAD 2 5'OF WATER IN IT AT THE TIME OF THE INSPECTION.PIT HAS CESSPOOLS: - (locate on site plan) Number and configuration: Wa Depth-top of liquid to inlet invert: Wa Depth of solids layer: nLa Depth of scum layer. n& Dimensions of cesspool: n& Materials of construction: n& Indication of groundwater: nLa inflow(cesspool must be pumped as part of inspection)1va Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Wa PRIVY: _ (locate on site plan) Materials of construction:nLa Dimensions:nLa Depth of solids: nLa ..Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/A 3 . revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:3/2199 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) n/a C 1A 4 D AA 26 A931 FP a3 c cc Sys revised 912/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 149 HIGH POINT RD.MARSTONS MILLS MAP 027 PAR 032 L 34 Owner: ROBERT RIENSTRA Date of Inspection:312199 NRCS Report name: WA Soil Type: nla Typical depth to groundwater: nla USGS Date website visited: n(a Observation Wells checked: NO Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record X Observed Site(Abutting property,observation hole,basement sump etc.) _ Determined from local conditions _ Checked with local Board of health _ Checked FEMA Maps _ Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS AND VISUAL revised 9/2198 Page 11 of 11 tea. � d .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH j./ ..........OF.......... Appliratiun -fur BiiiVuiittl Workii ( otuitrurtiun Vaunt Application is hereby made for a Permit to Construct (kl or Repair ( ) an Individual . wage Disposal System at• err' e ----------- ••------..................... ........... ation-Address or Lot N ------------- ---..-..-•--•--.------ ---- - Ow er --•---•---------•...........................Address Installer Address U4Type of Building Size Lot------ ---_�67 .....Sq. feet ,.-.� Dwelling-u No. of Bedrooms..............Jr..__..._..._....._._.__.Expansion Attic ( ) Garbage Grinder ( ) a4 Other—Type of Building ___________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------------------------------- -------------------------------------------------------------•------- d - W Design Flow......................�----...__-..gallons per person per day. Total daily flow__-________-__ �-j__�. _______._.-__....gallons. WSeptic Tank Liquid capacity/P egallons Length................ Width---------------- Diameter---------------- Depth.__-_--._____--. x Disposal Trench—No- ____________________ Width-------------------- Total Length-------------------- Total leaching area...__._._-__...____-sq. ft. Seepage Pit No---------.l-------- Diameter..e__�>__"__. Depth below inlet.L.- -°p... Total leaching area_..??.-___sq. ft. z Other Distribution box (' Dosin a k ( . ) Percolation Test Results Performed by f //` �� it Date... , I � 55Twit, Pit No. 1................minutes per inch Depth of Test Pit_!�� __�_. Depth to ground water.._ CL, Test Pit No. 2------Z.....minutes per inch Depth of Test Pit--- Depth to ground water_XI& ___. 04 _________________________ __----_____________.�i�_.__.!A_..�`�__ _____ ._-F-_----.........___...._.__�,__i.,_:. . .....::SA.... O Desert tion of,�oil �'® .... = s �U �za�✓ ---- ------------------------------ ------------lt_�✓ ._.... 5.� h 'i JD_ � /c�I McGL 1f UNature of Repairs or Alterations Answer when applicable - ONE-_ i�\ -�P No:11944,0� --------------••-----------.-.--------------------•--------_------•--•-----------•--.----------------•-----•--•-----------------------------------•--•--•---•----- Agreement: �yocFs G/S T F����F� S/I ni S The undersigned -agrees to install the aforedescribed Individual Sewage Disposal System lv�accorda••ce with the provisions of Article \I of the State Sanitary Code—The undersigned further agrees not to placcre t"he�system in operation until a Certificate of Compliance has been i su dSby the board of heal h. Signed.-- .. Date Application Approved BY � ------------------------------------------ --------------- ---------7----- _ Date Application Disapproved for the following reasons:--•-••-•-•-•---.....--•-•-------------------------------- ...................................................... -------------------------------•----------------------------------------••---------------------------•--------•-----------------•------------------•---------------------- --------------------------- Dat e. Permit No......................................................... Issued----���-�- •-- ------ Date .............................. �. 1� No...-- --=--t-��'-'- ------- Fes$ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH l' ✓ .........OF.........J� '�1 .7 ....- ....-......_.......... :.: .Tj, App iratirrn -fur Dhipviittl luorkuZontitrurtion Vrrm t Application is hereby made for a Permit to Construct (4v or Repair ( ) an Individual Sewage Disposal System at* 5 .............................................. �G r1 C� r`. ` � �.'�' ,�G/• cation-Address ` ` o Lot �No. ; ` C O fl1Y ----------------------- - --------------------------- Owner Address W Installer Address d Type of Building Size Lot.._.? �' -....Sq. feet ,� �------- U DwellingT—''No. of Bedrooms--------------�_•-•---_--__--__-_-_--_-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a d Other fixtures ---•----------•--••---------------------••-•------------------------------------------------------------•-------------------------------------------- W Design Flow......................-!5rO..............gallons per person per day. Total daily flow.............. ='_-_.•_--.-_____gallons. WSeptic Tank`Liquid capacitv&4�u_gallons Length---------------- Width................ Diameter................ Depth_-_-_--_.-._.. x Disposal Trench—No---------------------- Width-------------------- Total Length-----------_-_-�-.- Total leaching area--------_-----------sq. f t. Seepage Pit No........./--------- Diameter_4_":P_"' _ Depth below Total leaching area- 0____-sq. ft. z Other Distribution box (1/�) Dosin tank Percolation Test Results Performed by V7_-_-- �__._____"_______v E____ ram`.._ Date.... �1 r s--- 9✓----- -JI u/;5:P@-gt Pit No. I................minutes per inch Depth of Test Pit ®:�. ------- Depth to ground water. r�-�-r--N!f. =..... �,A Test Pit No. 2_...._��.._.....minutes per inch Depth of Test Yit__�- .�<f_'.'.._. Depth to ground wwa� ����___---.- a+ --•-----•--•---------------- ------------------------------------------------- -s '��Z.IICIF y O Description of Soil_./oo= X f-P'7............ '�`.�»a�'._.' -r 45 � �7 t�_......�� .'.e - �+ �/_�---•s L_ _ j•D----- .� - ' s O �.</. 6r�7 ROBERT ti� (> GLO L n j ................... . - ,�'W ----•--•------- --------- ----------------------- � a lcJu......... --...�, ----- +?-.t- ---�l/'/-------- - � - - ------ � 1'vIc NE" '-' r✓, CJ Nature of Repairs or Alterations—Answer when applicable--------------------------------------------- --A. .ii34 �fl Q . ------ ---------------------------------------------- -----•----------------------------------------------•-------•-•-•------------ G� Agreement: Fss/ON T The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syste ance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bVen ' stied by the board of hea h. Signed -- a° 'P p �:. +� �„,,. Dafe./ Application Approved B �. �' "" -- PP PP y------------------------ ---'--------•- ------- ....---------•---•--•--••- ---••-•----•-- -------`� : - � Date Application Disapproved for the following reasons:....-------•---•--•-------------•----------------------•-----•--------------------------------------••--•------- -------•-•--------....•-•-•-••.............•-•----------------•-•-••••--------•-•-----••----•------------...---...--••-------------••---------------------...----------------------•---....•----------•.. Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH %:Plertif irntr of f�umplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (441or Repairedby ( ) -----------•- ----.................................................................................................. /jInst��ller / / rA'_a Jf --- ---- r has ° been installed in accordance with the provisions of ArticI XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._----- _` .................. dated......_ . . ` ` r< _...__..._.. THE ISSUANCE OF THIS CERT4FICATE SHALL NOT BE CONSTRUE© AS A GUARANTEE THAT THE SYSTEM WILL F NCTION SAT ACTORY. DATE------ 7 ---- ---�----- ---------------- Inspector------------------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD" OF HEALTjH .�� ..OF......fed S ? - / `'- No._ FEE...... ..4Z•.---�-- Di-spniittl nrk,-q Tlonitrnrtinn Vrrmit Permission is hereby granted.......-•--•--------------------------•--•-------..---.-----------•----------------------------..----•-------•--•----------------•-----.-- to Const uct /ram) or Repair ( ) V Individual S wage Disposal System at No c ? = "v �' ✓�, ` ,/ _ �aG�. t!' 7�. '--- ---------- -- /J.'l-7!{,13�✓�C' /- /---.._.^------ r - --r Street . +� t as shown on the application for Disposal Works Construction Per 't No v `. .__. Dated___ � � ....._. ------•-•-------------------•---- oard of Health DATE................................................---------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS / THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA .................. . a ,•�t.1�1 �`� ,.// - V lu • Sa�gS� � n o ' y T01, � t r r•� �,< "`y' 1 4: *• �' k'+••S.y n:2F.' w F s / V— "o hi � i N,r- � �_ 2 ,�♦ '1 2�it ,w i�}n�$� �i�.,,f',� �_.l , /urn - t aC �y, ,Sc.C f '�*'.• fi. -� # T1 KNyr �'� ,/�'' ��y_ ��� r _ - `"�' ..4 �^ ,+,r f.�' c ,� Y'`y yp ; .-Y , y-<ra �`�i''',;�•4 ///f%%VAS -s, A, :d •N- t� 3. - I. fY Z ..• .:� ,t k �� � g4 iz URVE h i �.` . ��Q2, off- Q ice RISERS TO BE INSTALLED ON RISER ON CHAMBERS TO EXISTING TANK TO BRING COVERS BE BROUGHT TO WITHIN GRADE TO BE BROUGHT BACK TOP OF FOUNDATION TO WITHIN 6" OF GRADE RISER ON D-BOX TO TO EXISTING ELEVATION BEDROOM BATH KITCHEN ELEVATION 105.11 EXISTING CONCRETE BAFFLE SHALL BE REMOVED AND BE BROUGHT TO WITHIN 6" OF GRADE APPROXIMATE ELEVATION 103.00 WAKEBY ROAD ABANDONED. OUTLET ON SIDE OF TANK SHALL 6" OF GRADE 4 BE MADE WATERTIGHT WITH HYDRAULIC CEMENT PROVIDE SPEED LEVELERS ON OUTLETS Q- .. I PIPE TO BE RUN LEVEL FOR Q<<vP t ✓ AT LEAST 2 FEET OUT OF THE D-BOX , r r G� Q, Q EXISTING �.✓' r , cn LIVING ROOM 4" PVC vENT WITH p - CHARCOAL FILTER � ELEV.-103.41 �- o BEDROOM BEDROOM Q 2" OF �" PEASTONE OR Jo SITE a- Z V) 14' OF 4" SCH 40 8 OZ. NON WOVEN P _ PVC, S= GEOTEXTILE PROVIDE ZABEL 13 OF 4 SCH 40 (LONGLR RUN o 0 3 0.010 MIN. ) ELEV.=99.75 �A 3 A1800 FILTER 14" PVC, S=0.005 MIN. ----- -- ----- SLOPE Lu <v 'p /� W PATTYS EXISTING EXISTING 1,000 GALLON O VFCS z FLOOR PLAN REINFORCED CONCRETE INV.=102.07 10POND SEPTIC TANK INV.=100.78 WASHED,STONELE :1 NOT TO SCALE EXISTING INV.=100.95 SPUR LN. Z TEE WITH GAS BAFFLE INV.=99.00 _ _ ._ _ ELEV.=97.00 Q. (CENTERED IN TANK OPENING) LEVEL STABLE BASE CONSISTING OF 6" 4 58 WIDE LEACHING CHAMBER 4' CRUSHED STONE f'"--"I- 'T "-I TANK INLET TEE SHALL BE VERIFIED TO EXTEND (SEE SITE PLAN FOR ORIENTATION) 5' MINIMUM SEPARATION TO A MINUMU OF 10" BELOW THE INLET INVERT PROPOSED 3-OUTLET (2)-500 GALLON H-20 LEACHING CHAMBERS SEASONAL HIGH GROUNDWATER DISTRIBUTION BOX LOCUS SEPTIC TANK PROPOSED PROPOSED GROUNDWATER NOT OBSERVED SCALE 1"=500' N/F DISTRIBUTION SOX SOIL ABSORPTION SYSTEM DURING OBSERVATION HOLES H86LLAURIES LAIN�E i 6'ST SYSTEM PROFILE NOT TO SCALE �O DATE: MAY 30, 2017 PERFORMED BY: ASA MINTZ, PE SITE INFORMATION GENERAL NOTES: WITNESSED BY; DONALD DESMARAIS, IRS - / ADDRESS: 149 HIGHIPOINT ROAD 1. THE PROPERTY IS LOCATED IN ZONE X OF THE CURRENT FEMA FLOOD MAP TP-1 ELEV. 103.0 po TP-2 ELEV. 103.0 SHRUB BUFFER TO BE PROPOSED SOIL / MARSTONIS MILLS MAINTAINED TO THE BEST ABSORPTION SYST /TP-1 ^ 2. THERE ARE NO STREAMS OR WETLANDS WITHIN 100-FEET OF THE PROPOSED SYSTEM. EXTENT POSSIBLE MAP/LOT: 027/030 A SANDY LOAM G A SANDY LOAM 3. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION OF THE SUBSURFACE SEWAGE 10YR 3/3 10YR 3/3 610 5" SCH 40 PVC VENT W/ DISPOSAL SYSTEM ONLY B SANDY LOAM B SANDY LOAM CHARCOAL FILTER TP-2 4. VERTICAL DATUM IS ASSUMED 10YR 5/6 10YR 5,6 /oa �� � DESIGN CALCULCATIONS PROPOSED CONTOURS ���• � (2) 500 GALLON H2O 5. ALL CONSTRUCTION MEANS AND METHODS SHALL CONFORM TO 310 CMR 15.00 STATE 27" 27" 20 �'- LEACHING CHAMBERS N N/F REGULATIONS AND LOCAL BOARD OF HEALTH REGULATIONS c 1 c 1 TO MATCH EXISTING 70' �2' 67 S CHIRSTOPHER B. & DESIGN FLOW SANDY LOAM SANDY LOAM CONTOURS IN MAN LIMIT OF DOUBLE WASHED 9 g BEVERIDGE 110 GALLONS/DAY/BEDROOM X 3 BEDROOMS = 330 GALLONS/DAY 6. ALL JOINTS IN THE TANK AND DISTRIBUTION BOX SHALL BE MADE WATERTIGHT 10YR 6/4 10YR 6/4 DISTURBED AREAS CRUSHED STONE Gy 1 MELANIEEL NIGHPOINT RD. THROUGH THE USE OF ASPHALT OR SYNTHETIC POLYMER SEALERS OR HYDRAULIC TANK CAPACITY CEMENT. 44" C 2 44" c 0 DISTRIBUTION PROPOSE BOX LET 76A 76, 2007. DAILY FLOW = 660 GALLONS; USE EXISTING 1 ,000 GALLON TANK 7• SYSTEM COMPONENTS SHALL BE H-20 LOADING WHERE NOTED AND H-10 OTHERWISE lJ MEDIUM SAND MEDIUM SAND EXISING 1,000 GALLON �. REQUIRED LEACHING CAPACITY 8. DIGSAFE AND LOCAL UTILITY COMPANIES SHALL BE CONTACTED PRIOR TO ANY 10YR 6/6 10YR 6/6 -T K-TO-REMAIN DESIGN PERC RATE = < 2 MIN/INCH EXCAVATION OCCURRING. PERC �► 54" NN , # �.- --- �'" � �� ` 330 GPD / 0.74 GALLONS PER DAY PER SQ. FT. = 445.95 SQ. FT. r / 9. THE SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE DESIGN ENGINEER 2 DAYS PRIOR PROVIDED LEACHING CAPACITY TO BEGINNING INSTALLATION OF THE SYSTEM TO ALLOW FOR SCHEDULING OF BOTTOM AREA = 25.00' X 12.83' = 320.75 SQ. FT. INSPECTIONS ` o �o \ SIDE AREA = 75.66' X 2.00' = 151.32 SQ. FT. HE c.r'� � � � "10. THE EXISTING LEACH PIT SHALL BE PUMPED DRY REMOVED AND BACKFILLED WITH, SAND. -.^� 0. o 0 .15G GRASSED AREA 472.07 SQ. FT. i EXISTING TREE o. �G TO REMAIN (TYP.) 2 \ _11. WHERE APPLICABLE, UNSUITABLE MATERIAL (A & 8 HORIZONS) ENCOUNTERED BELOW r1b - \ - .. THE INVERT.;:OF THE INLET TO THL SOIL--ABSORPTION SYSTEM.--SHALL- BE REMOVED TO ,� 0 ED, 120" 120" 2 O \ I \ \ A DISTANCE 5' AROUND THE SYSTEM AND BROUGHT BACK TO THE APPROPRIATE MOTTLING: NONE MOTTLING: NONE \ \ ELEVATION WITH CLEAN SAND PER MASSACHUSETTS 310 CMR 15.00 REGULATIONS. WEEPING: NONE WEEPING: NONE ' ��� ��� \\ \ 12. THE NEAREST PRIVATE .WELL IS LOCATED AT 86 LAURIIES LANE IS APPROXIMATELY 183' PERC RATE: <2 MIN./IN. \ \a FROM THE NEAREST POINT OF THE SOIL ABSORPTION SYSTEM AS DETERMINE BY THE e ' \ TOWN OF BARNSTABLE GIS SYSTEM PROFILE GRASSED AREA / Gl r,� 13. THIS DESIGN DOES NOT ALLOW FOR THE USE OF A GARBAGE GRINDER SOIL P UP NOT TO SCALE BULKHEAD '(\O� OHW 14. THE PRIVATE WATER SUPPLY WELL LOCATED AT THE SUBJECT PROPERTY WAS 0 �1 / OHW %` ABANDONED WHEN, THE TOWN WATER SERVICE WAS INSTALLED. THE WELL PIPING �5. / �H V� i / OHW �,�._._;y------\ _ � CONNECTION TO THE DWELLING NO LONGER EXISTS COUNTER VARIANCE REQUEST: EXISTING LEACHING STRUCTU �04 ( / o� 1. VARIANCE FROM 310 CMR 15.221 (7) - THE TOP OF ALL SYSTEM COMPONENTS... TO BE ABANDONED o (SEE GENERAL NOTES) J \ / ��' SHALL BE INSTALLED NO MORE THAN 36" BELOW FINISHED GRADE - VARIANCE / `� ""` REQUESTED TO 45" BELOW FINISHED GRADE WAYNE E. & NANCY A. MORRIS �/ 8>s, G MORRIS FAMILY INVESTMENT TRUST \ \ `` 90 SPUR LANE ` o / A oF as yG G �� 4 CRESTVIEW DRIVE \ I R sGioNP EAST SANDWICH, MA 02537 C� PHONE: (508) 400-2365 \ i� ram/ r�r // � 3� �. .w GRASSED AREA SITE DESIGN LLC LOT 34 SSA, Residential Site Design and Permitting er BENCHMARK 20,341 SQ. FT,r± / 0.47 ACRS` t // TOP OF FOUNDATION = i105.11 \ EXISTING TREE TO REMAIN/(TYP.) _ / /° l LEGEND 149 HIGHPOINT ROAD MARSTONS MILLS, MA 02648 02 PROPERTY LINE CLIENT.• GROUP OF RHODODENDRONS TO _ BRIAN AND CHRISTY FARRENKOPF i /r 104 - - EXISTING CONTOUR i BE=REMOVED FOR ACCESS - - - - - 102 STOCKADE FENCE o8AwiNc r/rcE' 41 X OHW OVERHEAD WIRES SUBSURFACE SEWAGE DISPOSAL SYSTEM -- - _ _ R 40.00' W WATER LINE SITE PLAN AND PROFILE - - - - - - - - - - - - - - A=44.76' scACE aArE oRs+wiNG No. k LINE ( P.) f 6' STOCKAD kNCE G NATURAL GAS LINE 1 "= 1 0' 5/30/2017 1 OF 1 12' WIDE GATE S "87°52 55 �' ' ® CATCH BASIN uw - - - - - - - - - - ti HYD w. ' HYD REVISIONS --100- - - - - - - - - - - - - - - - - - - _ - - - - - - 100 - ti FIRE HYDRANT NO. DATE DESCRIPTION CB •ten: - " ,. WG � WATER GATE VALVE ACCESS FOR CONSTRUCTION SHALL BE - ryy-'EW EDGE OF PAVEMENT �__._._ REQUIRED INSPECTIONS. THROUGH HE STOCKADE GATE ON WGg p- UTILITY 1 6/1/2017 ADDED SOIL VERIFICATION INSPECTION AND GENERAL NOTE 14 UP Y POLE REGARDING ABANDONMENT OF PRIVATE WATER SUPPLY WELL X 1 . VERIFICATION OF SOIL TYPE 5-FEET BELOW THE S.A.S. (ELEV. 92.00) COMPLETION OF SYSTEM Sp 0 10 20 30 2. .FINAL INSPECTION OF ALL COMPONENTS UPON 40' RI `FREE INSTALLATION. ( RIGHT OF WAY) .x. s �i SCALE IN .FEET ��.,.. .� . _.. A .. .. . ,,� 4 . 'M�