HomeMy WebLinkAbout0017 MOSS PLACE - Health 17 MOSS PLACE, MARSTONS MILLS
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1 ,9BORTOLOTTI CONSTRUCTION,INC.765 WAKEBY ROAD,MARSTONS MILLS,.MA 02648
508-771-9399 508-428-8926 FAX: 808-428-9399SUBV.
SURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR
PART A -
CERTIFICATION
Property Address: SS' �j / S
Date of Inspection:,&,� Inspec 's Nam : 71 ,
®wner's Nagie and Address:
G '
_CERTIFICATION CTAT .M NT•
I certify that I have personally inspected the sewage disposal system at this address and that the informa-
tion reported below is true,accurate and complete as of the time of inspection.The inspection was per-
formed based on my training and experience in the proper function and maintenance of on-site sewage : t
disposal,systems: The System:
Passes.'
Conditionally Passes
Needs Further E luation By the ocal Aproving Authority
Fails
+Y+
Inspector's Signature: Date:
The System Inspector hall submit a copy of this inspection report to the Approving authority within thin-
.
ty(30)days of compl g 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:
INSPECTION SUMMARY-
A)SYSTF,iGI PASSES: Y.
V I have not found any information which indicates that the system violates any of the failure
criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated
below.
B)SYSTEM CONDITIONALLY PASSES;
One or more system components need to be replaced or repaired. The system,upon comple-
tion of the replacement or repair,passes inspection.
Indicate yes,nor,or not determined(Y,N,OR ND). Describe basis of determination in all instances. If N..
"not determined",explain why not.
The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or
exfiltration,or tank failure is imminent. The system will pass inspection if the existing sep-
tic tank is replaced with a conforming septic tank as approved by The Board of Health.
Sewage backkup 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):
Y f
SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Broken pipe(s)replaced
Obstruction is removed
Distribution Box is levelled or replaced
The System required pumping more than four times a year due to broken or obstructed i s). 4
P Pe.( :
The system will pass inspection if(with approval of The Board of Health):
Broken pipe(s)are replaced
Obstruction is removed
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 >r�• �
the system is failing to protect the public health,safety and the environment. Y , '
1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE y, f
!y;
SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE
PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: 'f"t
Cesspool or privy is within 50 Feet of a surface waters `
Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh, r its
2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER ,r
SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION
vh ;xT r
ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT: Es
The syskem has aseptic tank and soil absorption system and is within 100 Feet to a surface « ;.
wate Py tributary l or tributa to a surface water supply.
The system"�has a septic tank and soil absorption system and is with a Zone I of a public
water supply well.
The system has a septic tank and soil absorption system and is within 50 Feet of a private zf$` `
water supply well.
The system has a septic tank and soil absorption system and is less than 100 Feet but 50 z� E
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
the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less
than 5 ppm.
D)SYSTEM FAILS:
I have determined that the system violates one or more of the following failure criteria as defined `s
in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health ,f
should be contacted to determine what will be necessary to correct the failure.
Backup of sewage into facility or system component due to an overloaded or clogged SAS � .
or cesspool.
Discharge or ponding of efluent 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 clog-
ged SAS or cesspool. 4 a �
Liquid depth in cesspool is less than G'below invert'or available volume is less than 1/2
day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructedk
PiPe(s)• Number of times pumped
-2 i
t
+c
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .
PART A
CERTIFICATION(continued)
Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater
elevation.
Any portion of a 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 I of a public well. v 1 ti
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. If the well has been analyzed
to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic
compounds,ammonia nitrogen and nitrate nitrogen.
E)LARGE SYSTEM FAILS:
The following criteria apply to a large system in addition to the criteria above:
The design flow of a system is 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: '
The system is within 400 Feet of a surface drinking water supply
The system is within 200 Feet of a tributary to a surface drinking water supply t
The system is located in a nitrogen sensitive area Interim Wellhead Protection Area
(IWP )or a mapped Zone II of a public water supply well.
The owner or operatoupf any such system shall bring the system and facility into full compliance with the t.
groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local
regional office of the Department for further information.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST rd', fi,�zfi.
Check if the following have been done: y
ping information was requested of the owner,occupant,and Board of Health.
Soo None of the system components have been pumped for atleast two weeks and the system has
been receiving no
rmal ormal flow-rates duringthat period. Large volumes of water.have n
P g of been
introduced into the system recently or as part of this inspection.
/As-built plans have been obtained and examined. Note if they are not available with N/A.
/'The facility or dwelling was inspected for signs of sewage back-up.
—The system does not receive non-sanitary or industrial waste flow. kH
__Zfhe site was inspected for signs of breakout q '
/All system components,excluding the Soil Absorption System,have been located on site. t3j;
he septic tank manholes were uncovered,opened,and the interior of the septic tank was in-
spected for condition of baffles or tees, material of construction,dimensions;depth of liquid,
depth of sludge,depth of scum. ,
'�'T I size and location of the Soil Absorption System on the site has been determined based on
existing information or approximated by non-intrusive methods.
3-
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST(continued)
The facility owner(and occupants,if different from owner)were provided with information on
the proper maintenance of Subsurface Disposal System
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION.
/ FLOW CONDITIONS
V
RESIDENTIAL:
Design Flow: q1h9 —gallons Number of Bedrooms: �L. Nui�n}}�r of Current Residents:-,r
Garbage Grinder: Laundry Connected To System: !l S Seasonal Use:
Water Meter Readings,if vailable: ;
Last Date of Occupancy(,(/('/_C/)f
COMMER AL/IND T IAL: �j� 3:
Type of Establishment:
Design Flow: aallons/day Grease Trap Present: (yes or no)
Industrial Waste Holding Tank Present:
Non-Sanitary Waste,pifcharged To The Title V System:
Water Meter Readings,If Available: Last Date of Occupancy:
OTHER: Describe)
Last Date of Occupancy:
GENERAL INFORMATION
P MP U ING REC
ORDS and source of iiiformat'oii: /�'(� !'
rf
System Pumped as part of inspection: If yes,volume pum fallons
Reason for pumping: {
TYr OF SYSTEM:
teSeptic Tank/Distribution Box/Soil Absorption System
Single Cesspool
Overflow Cesspools
Privy
1
Shared System(If yes,attach previous inspection records,if any)
Other(explain): �4
RO TE AGE of components,date install d.(if known)and source of infp tion: y� L ¢ °
O comp
n G�i' J
Sewage odors detected when arriving at the site: f
_4_
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C.
GENERAL INFORMATION (continued)
SEPTIC TANK:—/
Depth below grade: 3 3 ,j Material of.Construction: ✓concrete metal FRP_Other
(explain)
Dimisions: �S'X Co' ,Y,� Sludge Depth: / " Scum Thickness: 3
Distance from top of sludge to bottom of outlet tee or baffle: 3 7
Distance from bottom of scum to bottom of outlet tee or baffle:
Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid
ffl
level in relation outlet invert,structural integrity,evidence of leakag etc.)- fys44
P
J
GREASE TRAP:_/ O
Depth Below Grade: Material of Construction:_concrete_metal_FRP_Other
(explain)
Dimensions: Scum Thickness: e*,
Distance from top of scum to top of outlet tee or baffle:
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.)
TIGHT OR HOLDING TANKiM
Depth Below Grade: Material of Construction:_concrete_metal _ FRP_Other(explain)
Dimensions: Capacity: gallons Design Flow:_ gallons/day
Alarm Level: c.
Comments: (condition of inlet tee,condition of alarm and float switchec.
s,etc.)
DISTRIBUTION BOX:_
l
Depth of liquid level above outlet invert:1,Q��/ -
Comments: (note if el and distribution is a evid nce of soli s carryover,eviden of 1 ge i toy#�
or out of box,a
- Li °�
firei..'m+
....,.r i�"
tra 9 y^fd 4'
t 4 y1 ,
PUMP CHABER:
M
Pump is in working order:
2j.<
Comments: (note condition of pump chamber,condition,of pumps and appurtenances,etc.)
5 xU+
-5-
5
2•, i lst `+
x t.!
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C,
SYSTEM INFORMATION (continued)
SOIL ABSORPTION SYSTEM(SAS):
—z
(Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive
methods) If not determined to be present, explain:
Type:
Leaching pits,number: Leaching.chambers, number: Leaching galleries,number:
Leaching trenches,number,length:
Leaching fields,number,dimensions: 1
Overflow cesspool, number:
Comments: (note condition of soil signs of hydraulic fi dur level f ponding,condi 'on of vegetat�' n,
etc.) S
U. �,, �� G 7/oc
r G0 VE2T0 " :.
f�
CESSPOOLS:
Number and configuration: Depth-top of liquid to inlet invert: r} '
Depth of solids layer: Depth of scum layer: Dimensions of Cesspool:
MateriVs of construction: Indication of groundwater:
Inflow(cesspool muss bg pumped as part of inspection)
Comments: (note condition of soilk,signs of hydraulic failure,level of ponding,condition of vegetation,
etc.)
t
PRIVY: `
Materials of construction: Dimensions:
Depth of Solids:
Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, 4 r
etc.
J
3. '
J �t1r'
y
x,
;3
-6-
a 3 i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
SKETCH OF SEWAGE DISPOSAL SYSTEM:
Include ties to atleast two permanent references;landmarks or benchmarks.
Locate all wells within 100 Feet.
1
t.
4
o
DEPTH TO GROUNDWATER: i
Depth to groundwater:- 7-1 Feet
Meth of Determination or Approximation:
-7-
t
COMMONWEALTH OF MASSACHUSETTS
t�
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
z DEPARTMENT OF ENVIRONMENTAL PROTECTION
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TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648 coA- 13 i
Owner's Name: TAMMY FAGANS
Owner's Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
e
l
Date of Inspection: 11/10/00
S.:
Name of Inspector: (please print) ,s JOHN GRACI 6iC•(; �0�
Company Name: SEPTIC INSPECTIONS
Mailing Address: P.O:BOX 2119 TEATICKET,MA.02536 NOV 2 9 2000
rOtfi}pFd4ANSTq
Telephone Number: 508-564-6813 FAX 508-564-7270 r �%NCFP,
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is
true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and
experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system
inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
X Passes
_ Conditionally Passes
_ Needs Fu Evaluation by the Local Approving Authority
Fails
Inspector's Signature: ' Date: 11/10/00
The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within
30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the
inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be
sent to the system owner and copies sent to the buyer, if applicable,and-the approving authority.
"t.
Notes and Comments
THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS TO
PROLONG THE SYSTEM'S USEFULL LIFE. RECOMMEND RAISING COVER TO LEACH PIT.
****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.
Title 5 IncnPrtinn Fnrm 6/1 S/?000 1
Page 2 of I I
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes: ;
yf!f
X 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:
THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS
TO PROLONG THE SYSTEM'S USEFULL LIFE.RECOMMEND RAISING COVER TO LEACH PIT.
B. System Conditionally Passes:
_ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,
upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND).in the for,the following statements.If"not determined"please explain.
n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits
substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced
with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating
that the tank is less than 20 years old is available.
ND explain: n/a
n/a Observation of sewage backup,,or break out or high static water level in the distribution box due to broken or obstructed
pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of
Health):
_ broken pipe(s)are replaced
_ obstruction is removed
distribution box is leveled or replaced
ND explain: n/a
n/a The system required pumping moi-61han 4 times a year due to broken or obstructed pipe(s).The system will pass
inspection if(with approval of the Board'of Health):
_broken pipe(s)are replaced
_obstruction is removed
Nl3 explain: n%a
It
,Li7ri: '
!
Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
;Izx CERTIFICATION(continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
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 whkch',will protect public health,safety and the environment:
_ Cesspool or privy is within 50 feet'of a surface water
_ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water
supply or tributary to a surface';water supply.
_ The system has a septic,tank and SAS and the SAS is within a Zone 1 of a public water supply.
_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water
supply well". Method used to determine distance n/a
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and
volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal.to or less than 5 ppm,provided that no other failure criteria are triggered.A copy
of the analysis must be attached to this form.
ii
. t
3. Other:
n/a
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1.%
.`(fit
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all-inspections:
Yes No
X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged
SAS or cesspool
_ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool
X Liquid depth in cesspool is less than 6"below invert or available volume is less than''/2 day flow
X Required pumping more than 4 times in the last year NQZdue to clogged or obstructed pipe(s).Number of times
pumped 9/00 BY ARCO.
X Any portion of the SAS,cesspool or privy is below high ground water elevation.
X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone 1 of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well.
X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with
no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP
certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free
from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm,provided that�no other failure criteria are triggered.A copy of the analysis must be
attached to this form.]
(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310
CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd.
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to largAystems in addition to the criteria above)
yes no
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes"in Section D above the large system�has failed,The owner or operator of any large system considered a significant threat
under Section E or failed under Section Usliall upgrade the system in accordance with 310 CMK 15.304. The system owner
should contact the appropriate regional office of the Department.
P 1, d
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
Check if the following have been done.You must indicate"yes"or"no"as to each of the following:
Yes No
X _ Pumping information was provided by the owner,occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks?
X Has the system received normal flows in the previous two week period?
_ X Have large volumes of water been introduced to the system recently or as part of this inspection?
X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X _ Was the facility or dwelling inspected for signs of sewage back up?
X _ Was the site inspected for signs of break out?
X _ Were all system components,excluding the SAS, located on site?
X _ Were the septic tank mdnholes uncovered,opened,and the interior of the tank inspected for the condition of the
baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
X _ Was the facility owner(and'occupants if different from owner)provided with information on the proper maintenance
of subsurface sewage disposal systems`?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no
X _ Existing information.For example,a plan at the Board of Health.
X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is
unacceptable) [310 CMR 15.302(3)(b)]
5
Page 6 of I 1 3
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 4 Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203 (for,example: 110 gpd x#of bedrooms): 440
Number of current residents: 2
Does residence have a garbage grinder(yes or no): NO
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(yes or no): NO
Seasonal use: (yes or no): NO
Water meter readings,if available(last 2 years usage(gpd)): n/a
Sump pump(yes or no): NO
Last date of occupancy: n/a
COM MERCIALANDUSTRIAL
Type of establishment: n/a
Design flow(based on 310 CMR 15.203)a n/agpd
Basis of design flow(seats/persons/sgft,etc.): n/a
Grease trap present(yes or no): NO
Industrial waste holding tank present(yes or no):NO
Non-sanitary waste discharged to the Title 5'system(yes or no): NO
Water meter readings, if available: n/a
Last date of occupancy/use: n/a
OTHER(describe): n/a
GENERAL INFORMATION
Pumping Records
Source of information: 9/00 BY ABCO
Was system pumped as part of the inspection(yes or no): NO
If yes,volume pumped: n/agallo6s"'7-How was quantity pumped determined?n/a
Reason for pumping: n/a
TYPE OF SYSTEM
X Septic tank,distribution box,soil'A'6sorption system
_Single cesspool
_Overflow cesspool
_Privy ,
_Shared system(yes or no)(if yes,attach previous inspection records, if any)
_Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from
system owner)
_Tight tank Attach a copy of the DEP approval
Other(describe): n/a
Approximate age of all components,date installed(if known)and source of information:
1989
Were sewage odors detected when arriving at the site(yes or no): NO
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
" PART C
SYSTEM INFORMATION(continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
BUILDING SEWER(locate on site plan)
Depth below grade: 42"
Materials of construction:_cast iron X40 PVC_other(explain): n/a
Distance from private water supply well or suction line: n/a
Comments(on condition of joints,venting,evidence of leakage,etc.):
THERE IS TOWN WATER
SEPTIC TANK: X(locate on site plan)
Depth below grade:36"
Material of construction:Xconcrete_metal_fiberglass_polyethylene other(explain)n/a
If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate)
Dimensions: 1000G L 8' 6" H 5' 7" W 4' 10""
Sludge depth: 1"
Distance from top of sludge to bottom of putlet tee or baffle:33"
Scum thickness:0"
Distance from top of scum to top of outlet tee or baffle:6"
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
How were dimensions determined: MEASURED
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related
to outlet invert,evidence of leakage,etc.):
THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING
EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE.
GREASE TRAP:_(locate on site plan.)
Depth below grade: n/a ' `'
Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a
Dimensions: n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
Date of last pumping: n/a
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related
to outlet invert,evidence of leakage,etc.):
n/a
F r.
`1
41+
ie.
I ,
.f{
;1} 6
, 7
Page 8 of I I
. 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: n/a
Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a
Dimensions: n/a
Capacity: n/a gallons
Design Flow: n/a gallons/day
Alarm present(yes or no): N/A
Alarm level:N/A Alarm in working order(yes or no):NO
Date of last pumping: n/a
Comments(condition of alarm and.float switches,etc.):
n/a
DISTRIBUTION BOX:X(if present piust be opened)(locate on site plan)
Depth of liquid level above outlet invert LEVEL WITH BOTTOM OF PIPE
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into
or out of box,etc.):
THE DISTRIBUTION BOX IS STRUCTURALLY SOUND.
PUMP CHAMBER:_(locate on site plan)
Pumps in working order(yes or no): NO
Alarms in working order(yes or no):NO
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
n/a
aF:
R
. 1
i
R
Page 9 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
SOIL ABSORPTION SYSTEM'(SAS): X (locate on site plan,excavation not required)
If SAS not located explain why:
n/a
Type
1000 GAL 6'X 6' leaching pits, number: 1
n/a leaching chambers, number: n/a
n/a leaching galleries, number: n/a
n/a leaching trenches, number, length: n/a
n/a leaching fields, number: n/a
n/a overflow cesspool, number: n/a
n/a ;innovative/alternative system
Type/name of technology: n/a
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.):
THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT
HAD 3' OF WATER IN IT AT THE TIME OF THE INSPECTION.
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration: n/a
Depth—top of liquid to inlet invert: n/a
Depth of solids layer: n/a
Depth of scum layer: n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater inflow(yes or no): NO
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
n/a
PRIVY: (locate on site plan)
Materials of construction: n/a 9
Dimensions: n/a
Depth of solids: n/a
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
n/a
`t.
4
Page 10 of 1 l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.
Locate all wells within 100 feet. Locate where public water supply enters the building.
�rcn�
o
a
�C 3l
Cc v1d
3
a
in
Page 11 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 17 MOSS PLACE MARSTONS MILLS,MA 02648
Owner: TAMMY FAGANS
Date of Inspection: 11/10/00
SITE EXAM
_Slope
_Surface water
_Check cellar
Shallow wells
Estimated depth to ground water 12+feet
Please indicate(check)all methods used to determine the high ground water elevation:
NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a
NO Observed site(abutting property/observation hole within 150 feet of SAS)
NO Checked with local Board of Health-explain: n/a
NO Checked with local excavators,'installers-(attach documentation)
YES Accessed USGS database-explain: n/a
You must describe how you established the high ground water elevation:
USGS MAPS AND CHARTS- 12+FEET
it
TOWN OF BARNSTABLE l�
L!JCATION )7 � /_I�� y 0,1,o E P_ SEWAGE#
�')Z.LAGEO // //fS`0�' 9/�, �/S ASSESSO ' MAP&LO
s, 7 s
:�S NAME&PHONE NO. ���� ��'� /per—� �
SEPTIC TANK CAPACITY A! 0 45,-\6z C, //
LEACHING FACILITY: (ty ) �"� �/� (size) �f���'Gl 4S.
NO.OF BEDR
BUILDER (RO
WNE
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist r
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facili f any wetlands exist
within 300 feet of leaching facili /� /4- Feet
Furnished by arvk6
x
70
�? TOWN OF BARNSTA iLE
133 '
LOCATION c'•O� f�y� m�111, J _ ' SEWAGE #.
VILLAGE nw56%ts m, ls_ ASSESSOR'S MAP & LOT /00 Q� �3
INSTALLER'S NAME & PHONE NO_6 rtsir—Al 71� 0
SEPTIC TANK CAPACITY_ O— C? q,+
LEACHING FACILITY:(type) � �7i� _ (size)_
NO. OF BHDROOMS . PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER 6rdOtj. .6Ci'tj' ��V yp� corp"
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: -
VARIANCE GRANTED: Yes No
�� �� �� y�
I" " I
..
j� TOWN OF BARNSTABLE
LOCATION L-o`� l 7 Ll VVI62S s p 1'4", SEWAGE # �9 - 5'9
,!�N%!LLAGE Wti y� 'dmm Vw ASSESSOR'S MAP & LOT - 00 �f
\INSTALLER'S NAME Cz PHONE NO. �•��. i)<�56A SEPTIC TANK TANK CAPACITY_ 16OCO�n ��d�S
(::�L.EACHING FACILITY:(type) L-C a L�`_ (size) `,000
140. OF BEDROOMS PRIVATE WELL 0 PUBLIC WATER
BUILDER OR OWNER
T
DATE PERMIT ISSUED:
DATE COLIPLIANCE ISSUED:
VARIANCE GRANTED: Yes No ✓ `
Lo
t
J _ G
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TotvA/ A.-<nNs-A13 c6
. ............OF..........................................................................................
Appliration for Dispno al nx Tomitrnstijrn 1hrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
/_er /3y ess t�e�� ,?A 5rov3 lets
.....-- --..._..............•..?!...------�----_c_%'....�................. .. •-----........-•-----•--•--•---------•---•----...------------.........--•------------
// Locat 6Ad
L e�ss �• No,S/t w r'7tvsL
-- 2 .. Zl�
...............•------•---------..._..............----------
17 ZS etld C kPwner5�^ Address
Installer Address g
Type of Building Size Lot_._.___.,..______..._••---__Sq. feet
Dwelling—No. of Bedrooms...........�..............................Expansion Attic (V) Garbage Grinder (/✓)
pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures .................................
gallons per person per day. Total daily flow....... ................................gallons.
W Design Flow--------•----------r3--5....................g P P P Y• Y ��Q
WSeptic Tank—Liquid capacity.JAU V.gallons Length................ Width................ Diameter................ Depth..._............
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No-_------------------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
'-' Percolation Test Results Performed.by._�Eyy;.E��� F� c,��GA"O.._..__.... Date__/�/G.� .................
-�_ / S--
a Test Pit No. 1._�_a_'__minutes per inch Depth of Test Pit----1.2.___.__--- Depth to ground water_.__.VON--------
Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------
--------------------------------- •----- ------------------••....................................................................
O Description of Soil_?.
V ---••-••------------- ------••-------------•---•----•--•••-••-----•-•-••-•--------•---•-------
W
--------------------------------------------------------------------------------•-•---------------------------------------------------------------------------------------------------------------------
VNature of Repairs or Alterations—Answer when applicable...............................................................................................
.........--.
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
�"1T nlc.�
the provisions of :i: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b issue e boar'd " health.
Signed.-----•--•-
------------------------------ -----t
Application Approved.By._11).1-'...XV.. ---- ------•-- /........"
Date
Application Disapproved for the following reasons:------••-•-•----------•----------------------------•--•--•---••-•-----------------•••-••--••-------••........••.
------•-----•---•-•-•--------•-•-------------••-------------------•-•--•....------------•-----•----------I------•---------•--••••---•-••-••-•------•••-------------•-•----------------•--••--•-----......
Permit No........ A
- `��............................ Issued Date
— -
D�te
<, No.. . �.. iFEs.......Z) ..............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR®, OF HEALTH
w
,e IV,s r'4 . [
. ppliration for Dispas al Works Tonstrurtion Prrmit
Application is hereby made for a Permit'to COnSt.— ( ) or Repair ( ) an Individual Sewage Disposal
System at:
..v.j. ..............5 �✓.t..I.�< S ..._._.-..._ -...__.....__ ----
d ..._. !
Loca Ndess l
° Celt�o. tf
/rk lsC t e3il, 4 -. ..........................................................................................................»..•. ....... ........ .. - • . /
® Owne Address
..............•---..__._._......_._..........Instal ler-•-•_•--...__......-•-•-------......---•- ----------------•------._._..........----•-Address---.�_3_�'�.�_..-----•-'--•-•----
Type of Building Size Lot_______ _________________ q. fe
aDwelling—No. of Bedrooms___.....................................Expansion Attic Garbage Grinder ( )
p., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P4 Other fixtures ..................................
W Design Flow.................. ........................gallons per person per day. Total daily flow............................................gallons.
ty Septic Tank—Liquid'capacity` ?'Q.gallons Length................ Width................ Diameter---------------- Depth................
Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft,
Seepage Pit No____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ) o
Cc�wtl �cnrtt�ilC` la s,rn <*� Date_1`Percolation Test Results Performed bY........... ......................�..-_-----_----------.__ - -- ----------------•-_---..
Test Pit No. 1__6k ____minutes per inch Depth of Test Pit...L p_.-_... Depth to ground water.... ........
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------
O Description of Soil' f M �'�fl` �'J{-----•-�t•� 3 t- ..--------------------------•--------•----.-•------------•--• ---—--•--•----
x
U ---•-
UW •--•---•----• ......... .............••-•----------------------------•---------•--•--•-•-•-----••--•--••.-----•-----------------------•------------•-----------••-•-•-•••-•-----•-•••----------------•-
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�TTi l i LZ 5 of the State Sanitary Code—Th undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b n issue y tl e
! -•- bo'-aird , health.
Signed.... -••--••___ . -••______________________•••-___•.____ .___//* .....
.........
,F 1 �� I to
Application Approved By.A._k.._ '
- -----------------------••--••- = --------------
Date
Application Disapproved for the following reasons:................................................... ..........................................................
..---•...................................•--------------...--•---------....-•---------•----•-•-------------•---.-----------••----•----------•-•--------------•--••-•-•---••-•-•---------•---•--•----...
Date
Permit No. - r -------------------•------- Issued----------/--.. 1: --------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................................OF..-... - ....... ..................................................._....--_...
C rrtif it atr of Tomplitanrr
THIS IS TO CERTIFY, That the In di idual Sewage Disposal System constructed (d ) or Repaired ( )
0'. J"y +.��t,r )C,o L.C. 'g S6s
by --•••-•--••-
• Installer
..............................................•----•---------•------------------.............._.._.._._................._.....
G a' 0 i f 4S.S i/"Ctr i¢ 5I , 5
at ? ------••--•--- ----------•------•----•-•----------------------•----------------------••-••-----------
has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No------ _____ ________ dated..... -:-".!__ . ...._....._._.__._.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARAN' E THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................. Inspector................................................................`.....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD. OF HEALTH
7.
r w OF7 a
................. ...
FEE.-- ..........
Disposal V ks Tottstrwtiort Vandt
Permission is hereby granted_.__' . .....
�'---------- --� - .. .... ".
to Construct (N�) or Repair ) an Tidivi.,ual'Sor
.wage Disposal stem
atNo.--------•------•-- .............. .................
.
Street ,� f
as shown on the applicationfor •sposal Works Construction' Pe t Nojl:Or ....... Da&ed_.__�_.. �" 1 �
--- -----------------
AD1
- --•--- .-----•------- .
DATE_ ------ --•----....---- Board o- alth
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
sMEET 7A OF 7
f1 wL•1 M•INN NI RAM
tMARSTONS
/ A oww mow n M
000NNM •
nnNs
*.�ys ,® ... ® ® DESIGNCALcuuTwws:
I A 1 • ONOM or O
WONl)wM rt ♦NIL•rr•r•O
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f; 1Lrm am
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V OMLO)••*(•At•L•)
Il MT Room IfA0 IO Gwktcm JAL
Box
® 1. ALL Mwempow AID Imia"N•ILL Ottleter to LULL
TmL O AM Im"m or-Am um "a AIO
wouAtwes no wa OwOwrAa owo•K a umm
1g00 OALlON SEP11C TAWI I'-I • I + I a ALL Ali ON TO MMY•AoM OVAL K ewalwr to
l AN
L ti I ► Y MAXOM UMM YM 10§00 0rMS A OVM
_SEPTIC S 1t VSTE Pgga F s1ALL K ItMTAIOI N rtAM
♦ ALL 001/0011i A TMI Wormy fYLlal llwL K erAaL
A•r w NS•i a0110Y OF IEST MOLE to WNWAMOS w-a Lawn IOOOt My AK coal an
EMI 10 R.Or 0w1O ON PIIANN•MAL N-M LOMIN
LEACHING PIT emu Iwo Wool O.0om sort O<0W=OR .
L 4K AM 1 uma"00IU0.1Q QN 6imimK j
MOM rOe PLm/00F/1
i
LN
ELEVATIONS LEGEND:
nYl!OT106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132133i 4�i135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 es�A eox o•KAMIY ILAonw rR 0
0.F0UND.
A 71!•s 19,0 71.0 7►0 700 11a s•• 7A1.0 711E $.Y lie 1Z• 7t1.f ep.• p b74 !L• q0 f1.1 !o• - p1.o qLo •otonFAMUM��MtnlMT yr
,f
7�f 110 74,E 7f,6 7so I74.•,I�.e 7y,T 7ro 7te r1.o �.o ns yi.f 7f.o 7�0 73.0 �.0 7GS 73• 7!f A Alo�.190MMUM all
it
9 1o.s N.f Noe 641 464 00.0 611 1F0 1t.o 7e.9 730 74•I 76-P 7r,f 71.5 17.5 1" loll 104 0.6 - 70,0 7N 1!A f 71.► 721 7bb jMf,I1" 19.0 7" 10,4 70,4 741 70A 79.1 WA 7G4 1 o4 A 64,11 640 r10 SO 8
C v•1 b .s 60:1 1 ba'0 6A& 617 &4t,I 7LL 7L1 7t.1 1 7t,1 74•9 7f.1 I tb.t. 71.S11.1. 7#. 77,0 716 -M.S. - 71-7 »7 14!t 713 1t.6 71•s �•� I �
7 }.t 1G7 7>t 7i•r 7fi 4 7A4 7t.Y 1i.1 71. w•1 ir• Yfc rb.1 �•7 C
D 7e0 H� rs ►i!. ►f.4 67.9 i1,e 7L• mg d 7&6 ".0 79.9 7A0 •e 77.0 lone "to 17 76 0 - 77.! 71f
7f.e o ibl It.f 71•I p'1e.0
7Gf 1�0 1s4 7s,o 741 7S4 114 11.1 10. bo.1 1r►'•o yfo 60.6 *5 D
E NM 1.9.6 6,5.'3 ►t.4 KA ft! &40 1•0 71.3 n► 7t.; 70,• 71.3 ti•f lw•s 7S.e 1s1 77.s ?s3 71.% - 7fj 77.3 14S 7 lb-91 70A 71.f• 10.1 61•6 N,y 7L4 ldm.s 71. 748 74•S 70.3 ms 11•6 'M.•14,11.9 bf.b 64.0 wj) 7ir3 E
F 1.16 •16 66.1 r3.s 6,94 blot• yo.b 70•6 11.1 71.1 7t,,l 7s.y 7f.1 71141 7Lf 7r.N 1%7 771 77,1 7#(. - 77.1 7.1
7410 IMP I 7••1 1 70.1 16•V1 M L 71•L 7t.► IN 74,1 74.1 , 7a.1 4b 7•.tr K4 64 Y Lf.l 71r 1 F
G r4a ia.f ►f.0 ►►O ►e.0 ►10 r0•f 10.E 7L0 7tA 1i•0 7t•3 7fa TJ.f 7••3 7r.34 125 71.0 •(n.• 7f,f - 77.•77.0 � C
74f 13.f 7.f 1t.o 7o.f ►1•S_ M.S 1i,o 18•e .0 745 746 714. rs.o 11•f 1e•f ►oS bf, 64.4 ►f.o 10 G
H 63.6 by5 01•9 floe f1•I �I,e 14•f Mf 1140 44.9 /lo 67.5 1,1e M•! 10•15 70. 71.0 '11•• -a,0 71.0 71,0
so.* t t•f 64.E ► e rot "Ivs•s IRIS bf,e r►•f sy0 WIRE Y!0 1 too bf.6 64.5 yt•f 61.E -461 rt.o 640 H APPROVED: BOARD OF HEALTH
J fls 0011 fs•o i00 %o fT.o h0 yAf 6L0 11•o it. YAf ys.• ►f.5 ►e.e Yi•f 67.5_ rla yL• L4f _ r7• "-f 644t: bs.f 60•0 at.• M•S i!1•> f1•i bh• rt.c •ire 1i4,f s4.o ts4• yt.o WS p.f Jbs 41,E f.o o Ae.o J
K 71L 7K9 7►.0 1 rto µ• 70-0 11.0 70.3 734E 7A% 7f.t 76.o 77.E 70 14.,5 PFf M.• olao 60.0 71•5 • •AIt AKn
Soo bs f 1t.3 11.0 74•b #. 73• 3•) 10•S 71i•0 74 7►S 77.0 1f:s 746 1*5 1• 61.0 70.0 12.o 7A.o K
L 7t.! 71.5 •e•o ►*e $'11 N•e 1e.1 70,0 7&6 144 7s•.o N4 77.o 1 70.E W-0 ".0 1740 740 74•e 71•0 - 1 8 7f•S 71.0 7y.• 76,5 744E 1" 1t.b 71,0 73,E 74.1 .0 7fo -4• 1f•$ 1Af 740 1%.e 11.e 70.0 7Rf 70S L
M 7ri•0 77,0 67f rt,s H0 NS Two 71t.e lt,o w,3 U.t' 700 70.6 71.E Me 700 79.r 79-► 71•1 7Le - 7Rf 1 710 11" 7ro 7L ,e 71EI
1t4 72.6 7••0 743 64•f AI
7 o t 7e,4 74.4 7l 7 .0 71r. 7Lo 13.5
N 19.0 71e y7. rfe le.o 7e.9 7Re 70.e 730 741! sAo 7f.e 7t4b 71S leo 7640 7e•4 /44 b,e 71.0 _ 7f.771,9 1r.o A•o 71.0 1►t.5 7i.f 7}T
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70A AII(r b►.e 61,0 1yf 1t.S N
1 12 INITIAL ISSUE MCT
NO.I OATS I DESCRIPTION I BY
PERC TEST 1 PERC 10T 2 PERC TEST 3 MC TEST 4 PERC TEST 5 SEPTIC SYSTEM DESIGN
LOT 116 LOT 125 LOT 131 LOT 149 LOT 146 MARSTONS MILLS WOODLANDS
- � "" M•.��•. -rAr M •w
Ar smimmo n NAq A.N•Na wr An NKi► t•An now >•AI•�rR
N
=WARM
N,.Mw.• A�.•..r...ne BARNSTABLE. MASSACHUSETTS
me w w" `• "' "� ` �`�` WOODLANDS ASSOCIATES REALTY TRUST
•Ae Wi•wl. •A• ENt N O MIN• MI/Aft t On Wont 1•N�IR•IN w'AN
N. •••WOOL•ww MAa On new one
"m � •� SCALE 1' >• 40' JOB NO. 133r!/•sole
••• iftMAUL an n•Aw► At4.
INO INMUM NI.OI Iwam aSON i+ ►AGO
AO • •• OD s
_ t yr
Mwll/iM BY IOTMA: MN11oM r A�� M K 1llT� Ww��n IM� M1f N W OY�T� A ,Ae,C.IF
ustieo tr
raOtA•NI OATL=L1M./M0I raleAAllOe ILLT[St_IwL/•tol 00paA1101■ATL SL1111,0101 raeta/nwol 1Mlt 3Liot•/•tell tELI14ATge MTL SL-�A� _
PERCOLATION SOIL TESTS LM MUDGE & •AMMM 111c.
Mm 1aa niiiiIIIII M Lame
Bea TM Um STIM czwfzw= to ot0.1s•
j
SHEET y OF 7
tMARSTONS
LOT 130
taw r
LOT 129
i•/ h Ia0/7 D
- LOCATION MAP _ � �f �\\ � lot � I�1 ry �•
0►� 7b f `„ a LOT 123 i
Ga1M�'�� O6s ate' '�� �•' ?.. 8I. . 14.1174:
f v
lei
LOT 31
,■ / \w9� !
♦ ��.. � ens taws ANOT 'y„ `�I % lil`" •c
♦ 1�P �4 a a»137 � / t �i LOT 124
t
,etP LOT 108 11 �� 111� 4 'l \`" ri `p •S 40 4
LOT 128 125- LOT 123`
/ lei
\
I, �40 LOT 13 ,aew s
/ \\ LOT 149
P tatty 11r •- a LOT 138
LOT 34 i LO 135
LOT121 M
\� LOT 107 +' LOT 148 sue= `:1 <
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