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HomeMy WebLinkAbout0035 BERKSHIRE TRAIL - Health 35 Berkshire Trail A= 109-015 -003 W. Barnstable _7 ,i i I r i TOWN OF BAq RNSTABLE fl LOCATION �zd"��hM+� I c'ca: 1 SEWAGE# 'ZC(y 2C�cd VILLAGE�Q5 {� +ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. I1 51dryl LL C SEPTIC TANK CAPACITY LEACHING FACILITY. (type) 8;nd- ,Qvws Sgr -o, 5,,tA (size) PK'X 12,6a NO. OF BEDROOMS OWNER, ��1�G`r► PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .Feet' Private Water Supply Well and Leaching Facility(If any wells exist on rdd**oo site or within'200 feet of leaching facility) c d Feet Edge of Wetland and Leaching Facility(If any wetlands exist within —300 feet of leaching facility) Feet FURNISHED BY �� �l.�l �. 32®y s, ,r r6,sl 31" No. I Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for ;Disposal 6pstem Construttion Permit Application for a Permit to Construct( ) Repair(4) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 6 &Q t,Z Try I Owner's Names Address,and Tel.No. Vas-r BDttNSTAQt.E nl.L., ) I Assessor's Map/Parcel l 3S 9J ;,c.Teal U. Qo-„llk -"Y-9?q-1S3 I Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. u8 ,sa, A lAa-,.NL MA 02645 ?Ai G 5 d1 :d 3`7 S08-360- 31 Type of Building: Dwelling No.of Bedrooms Lot Size 41 7 6_ sq.ft. Garbage Grinder( ) Other Type of Building /jJ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3 5o;1®Z-- gpd Plan Date 1 L1-1-Y DD Number of sheets Revision Date ►�/J/D Title �e-®Pasaa4 �e�fa s���� �Ta p�Cr� Size of Septic Tank 1000 Type of S.A.S. p1dsjic a b_1. /S to sa, d Description of Soil Sraa, 4ad 1'lole -14- T Nature of Repairs or Alterations(Answer when applicable) NQA S,S. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date v� ��.��Lf Application Approved by Date Application Disapproved by — - Date for the following reasons Permit No. 01-LO Date Issued ----------------------------------- --- 1No. ? � tY '. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computed Yes a PUBLIC HEALTH DIVISION-=TOWN OF BARNSTABLE,.MASSACHUSETTS „s 01pplication for -Mispo8AY *pstem Construction Permit Application for a Permit to Construct( ) Repair(!). Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 056 3eir s '''� S Owner's Name,Address,and Tel.No. ts¢T-r Qb"STA131.4 NQlsd. "re^k,As Assessor's Map/Parcel 1 q a 6-ppl 31 8..k,+7 , Tral U -774-94y-1S3 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. it 51w... LLc (yayur ZlFSQ ¢Q Anr, Qr� l�ww;ll MA OZ64S 774Z��'73eb T'�o, �8! L-' .Sa.olw,,( MA 0LS37 soa-360-3311 Type of Building: Dwelling No.of Bedrooms Lot Size Lf 3,'7 6 5 sq.ft. Garbage Grinder( ) Other Type of Building NJ f A No.of Persons Showers( ) Cafeteria( ) Other Fixtures N/A, Design Flow(min.required) 330 gpd Design flow provided 3 SQ,07 - gpd Plan Date �-/�0-��/ Number of sheets Z.. Revision Date NIA Title Pr•oQO" 5!. $yS1iQ� S E.. pia. Size of Septic Tank /coo j / I Type of S.A.S. pI -4A rjlgf,�s t� Sc-1.a1 Description of Soil -SQc_ 4n S/ A �e - �T �s t `Nature of Repairs or Alterations(Answer when applicable) NQu S Q.S Date last inspected: " f Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has-been issued by this Board of Health. Signed Date Application Approved by Date ��" / L Application Disapproved by' :--; - Date for the following reasons A Permit No. C?_ 'I '"r Date Issued - -[L ----------------------------------------------------------------------------------------------------------------------------------------- TH 1J COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CE T�(I that e AO -sitetewage�Diisposa system/C)onstruct �) /Repaired(�O/� Upgraded(✓) Abandoned( )by �! / 1' t /�7�` ��L-1%A at �j %,Pa4.-- a Tc� e , . 1�fxag k has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a61 y` a' dated I Installer r'gc\ti,C, 5j i-l� Designer Am 'c S,n r-( #bedrooms Approved desi ow 0 Z_ /V _ gpd 0 � U The issuance of this permit,shall no�be construed as a guarantee that the system w'd�ftlincti n t designed Date / C7� / Inspector ----- --- - ----. -- - ------ -------------------------------------------- ------------------------- / �G 1 L l _ ��O v--------------Fee ---�----�--'�- ------ No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS r Misposat 6pstem Construction permit a Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at LA"!k K \NPS�' Bnwi%�4k a s and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty o comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date `/"I r Approved by !rl x Tbwdof Barnstable °FIME 1pk� Regulatory Services Richard V. Scali, Interim Director i BAR.YSTABLE. 1 Public Health Division 9 MASS. `bAT ib39. Thomas McKean, Director FD MA'S 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Homeowner Certification Form for Alternative Systems g Property Address: '3� g�R —t)2-kt — Assessor's Map\Parcel: 6 Qq ZAW 0/�—` Z Property Owners Name: 61:e,- -A) v twk-t2L In accordance with Massachusetts DEP alternative system approval letters, the following certification information is required by the Owner of record. The Owner of record must place an "x" in the applicable box next to each line certifying the information. Yes N\A �❑ I have been provided a copy of the Title 5 I/A technology Approval letters. �/(15 page Standard Conditions letter and the specific technology letter) ❑ L/ I have been provided with the Owner's Manual ❑ L Y 1 have been provided with the Operation and Maintenance Manual ❑ I1For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) and the Approval ❑ ❑/For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5) I� ❑ If the design does not provide for the use of garbage grinders, the restriction is understood and accepted ❑ Whether or not covered by a warranty, I understand the requirement to repair, replace, modify Department or the or take any other action as required by the Department or the LAA, if the De p LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303 A 'L� S with all terms and conditions above. agree o to comply p Y P operty ers printed _ me Prope i y O ners Signature Date Note: This form must be submitted along with the septic system disposal works permit application for all I\A systems including new construction, rep airs\upgrades, with and without aggregate (stone) and with conventional design criteria or credited design criteria. Q:\Septic\IA homeowner certification.doc Town of Barnstable IKE?, o Regulatory Services Richard V. Scali, Interim Director • BARNWABLE, MASS. Public Health Division 039. i0reo rrw�' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: `� Sewage Permit# 2-$® Assessor's Map\Parcel l07 dly 'w3 Designer: &V"' �)(/W9C 0C. Installer: / Address: 1 U B( b IJ Address: ( y&.,\ Amy e On f3)i9)2,01 C[ ��L+ S ice-JU9_LL C was issued a permit to install a (date) (installer) septic system at ,I based on a design drawn by (address) C,,► � dated ltl i, (designer) 9W(X� I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the IAA approval letters (if applicable) OF Afgs�� f DA N M ( staller's Signature) N 11 N. 1 S FC/SiE (Designer's Signature) gNITAR,a PLEASE RETURN TO BALSTABLE 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-t3.doc I 'own of BAnstable. P# 1 114 Tim Deportment of Regulatory.Services ,, Public I3ealih Division Date 16 tee$ 200 Main Stree Hyannis MA 02601 5 �lFD M1't� �• � . / e . i hedule :9 /' I: Time I'ee Pd. Date Sc d IV I ,do(V)Suitabilky Assessk`ent for Se e asp 's . 0 Performed By:�qUl(t C9U��t �(/✓y ! Witnessed By: LOCATION &GENERAL_INFORMATION .. / Location Address � W1� -XAI wnet s Name N'l�r�/S C Zj' '( O Q _ 3� 11�3�-_�,, 6 errs n c - =� '. ,fJ ►�"�5� .`' - _i Addresses I LC S Assessor's Map/P4rcel: L C/ ` /0,t�—/Qd3- I Engineer's Name Ale-ypl� S --)qS i � NEW CONSTRU�'1'ION REPAIR Telephone# vcvl% 36d" 33 i // I �OtwC Land Use �C51�V 1 u I U1 Slopes(9'0) �� L' Surface Stonrs 1 Distances from: Cipen Water Body "�O ft Possible Wet Area `.�D u1 ft Drinking Water Well l Da� ft I)rainage Way 0 - ft Property Line O�_ft Other ft SKETCH:(street name,dimcnsio:W4lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) I I _.. •err~ t I . ore Parent material(geologic) 1 d v t S Depth t0 Bedrock Depth to Groundwater. Standing Water in Hole:: N D I_ . Weeping from Plt FAce Estimated Seasonal lHigh Groundwater Cmrter tlAh 16�;,i h from 5 rFy� - DI,TERIVIINtTION FOR SEASOVAL HIGH WATER TAr3LE Method Used: ! In. io. Depth td SOII tn9ttics Depth Cib�served standing in obs.hole: P � t toiwee m from side of obs.hole I in, ©roundwater AdJustment Depth P g P Level I .C]rnuatlwflter ...,e. Index Well# Reading Date index Well level -- _ Adj.fatfor.,.�� AdI PiERCOLATION TEST... Dite Observation �' Tittle flG�" d l Hole# i �. Depth of Pere Z.l h Time at 6" . `�. Start Pre-soak Time.@ 0 -0d Time( '-6 ) j Z End Pre-soak Rate MinJInch. W5 +wl Z►4PI i S- �V Additional Testing Needed(YIN) Site Suitability Assessment: Site Passed_ tte Failed: Original:.Public kle$lth Division Observation Hole Data To Be Completed on Back ***If pereola jinn test is to be conducted within 100' of wetland,you must first notify the Barnstable C4#servatiOn Division at least one(1)week prior to beginning. DEEP OBSERVATION HOLE LOG Hole# l Depth from Soil Horizon Soil Texture Soil Color Soil ' Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel v_• t P P 4l7`�(Z Z/z, L Wong 4 10 -q-4 C3 w l0 4 R 4/6 S:L vl Fri,,6 iP -It�-144 C t Wq R G 4 (-(�5 N,a 40 14(- I06 Cz t® 1ZC�-3 .5 �7,6Se DEEP OBSERVATION HOLE,.LOG Hole# Z • Depth from Soil Horizon' Soil Texture Soil Color '� Soil•�~- Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. D �( � 2 I Consistency.%Gravel) 0 - 10 ��" S L ��� r�A 46-i4a, C, 00 -169 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel I i I OBSERVATION HOLE LOG Hole# DEEP OBS , Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consisten ra I Flood Insurance Rate May: Above 500 year flood boundary. . No Yes —Z Within 500 year boundary No.. Yes Within 100 year flood boundary No/ Yes Depth of Naturally Occurring'Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system? 0-5 If not,what is the depth of naturally occurring pervious material? . Certification `t 1 I certify that on \v�y / (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described.in 3- 0 CMR 15.017. Signature eA, 6�k `tom'I Date 3 d hC- t 6 Z,O( Q:\SEPTICVERCFORM.DOC 1 Town of Barnstable Barnstable Regulatory Services Department AlAmotmCft ' & ' Public Health Division f I f6;9. 1� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richardd V. Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2851 4099 July 9, 2014 Mr. & Mrs. Robert Kramer 35 Berkshire Trail, West Barnstable, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 35 Berkshire Trail, West Barnstable, MA was last inspected on 1/06/2014, by Shawn Mcelroy, a certified septic inspector for the ,State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following- • At time of inspection, water was above the inlet invert. The Distribution box had historical stain lines above inlet invert indicating past back-up You are ordered to repair or replace the septic system within sixty (60) days 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 THE BOARD OF HEALTH ormn s cKean, R.S. CHO Agent of the Board of Health QASEPTIC\Letters Septic Inspection Failures or Future Evll35 Berkshire Trail Cent 20014.doc Y• Town of Barnstable Barnstable .� Regulatory Services Department P 9 `03 Public Health Division D MA'S A1� 200 Main Street, Hyannis MA 02601 2007 q9 Richard Scali Actin Office: 508 862 4644 g Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2851 1944 ' February 18, 2014 id Hol v t - r To oeal Estate 1533 Falm th Road/Rte 28 -'� -- � Centerville, 0632 RE: 35 Berkshire Trail,West Barnstable • ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 . The septic system located at 35 Berkshire Trail, West Barnstable,MA was inspected on 1/6/2014, by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system needed further evaluation under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • At time of inspection water was above the inlet invert. It was noted that the Distribution box had historical stain lines above invert, indicating past back- ups. You are ordered to repair/replace the septic system within sixty (60) days 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 THE BOARD OF HEALTHt, 1 Thomas McKean, R.S., CHO ; �1z Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\SAMPLE SEPTIC ORDER LETTER2013.doc - I A I q • Town of Barnstable Barn TF4E Regulatory Services Department 1 ' '► Public Health Division I EO MA't°,�� 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2851 1944 February 17, 2014 David Holt Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02632 • ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 . The septic system located at 35 Berkshire Trail, West Barnstable, MA was last inspected on 1/06/2014, by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following, • At time of inspection, water was above the inlet invert. The Distribution box had historical stain lines above inlet invert indicating past back-up You.are ordered to repair or replace the septic system within sixty (60) days 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 THE BOARD OF HEALTH • Thomas McKean, R.S. CHO Agent of the Board of.Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\35 Berkshire Trail Cent 20014.doc Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) y Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 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. A. General Information ILL 1. Inspector: �� Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that l 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 b the Local Approving Authority 1-6-14 Inspector's Signature Date 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 is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. L�) I t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 r ' y Commonwealth of Massachusetts W Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 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-3M3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts = Title 5 Official Inspection Form i" Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 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): r ❑ 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. • 9 -%A ♦ 4}%-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: ' ' M1 ❑ 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-3M 3 _n. Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health,(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ' , ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or.cesspool ❑ ® Discharge or ponding of effluent to the surface of.the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt c@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 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. El ® 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. y E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply EJ, El 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 - Myou have answered ".yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the F system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3/13 - - Tide 5 Official Inspecton Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 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 NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 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•3/13 Tide 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 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available Oast 2 ears usage Well 9 � y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 12-2013 Date Commercial/Industrial Flow Conditions: Type of Establishment: .Design flow(based on 310 CMR 15.203): Gallons per day(gpd) f Basis of design flow(seats/persons/sq.ft., etc.): . t f 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-3113. s Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract Y Y ❑ Tight tank.Attach a copy of the DEP approval. Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 R page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and.source of information: 1991 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18" at tank inletfeet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 12"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate), ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12° t5ins-3113 Title 5 Official Inspecfion Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. Cityrrown 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 20" Scum thickness 3" 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 14" How were dimensions determined? Tape Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GM , 35 BerkshireTrail Property Address Bank Owned (Contact David Holt c@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 176-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 .. Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): , Depth of liquid level above outlet invert 0 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.): D-box had historical stain lines above inlet ivert indicating past back-ups. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 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 y 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type:" ® leaching pits number: 1-1000 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.): At time of inspection,water was above the inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication.of groundwater inflow ❑ Yes ❑ No t5ins•3/13 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 �M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): r , t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 176-14 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 1140 • , . �. " r t5ins-3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20'+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GM , 35 BerkshireTrail Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every W. Barnstable MA 02668 1-6-14 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-3M 3 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 r + 035 TOWN OF BARNSTABLE vttf LOCATION _ �" / xe-e SEWAGE # � VILLAGE 6,�t.e tia ►�� ASSESSOR'S MAP & LOT/Qy 0)5--003 INSTALLER'S NAME 6s PHONE NO. SEPTIC TANK CAPACITY 06 e LEACHING FACILITY:(type) ,< F. /02!2� a; (size) r NO. OF BEDROOMS - RIVATE WELL R PUBLIC WATER BUILDER OR OWNER /A�,, , DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: r r VARIANCE GRANTED: Yes No I P 3 G Pao ,Jo �av� F THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF�7 HEALTH 144V# Z0 k/Aj.._0F....... .914 Appliration for Disposal Works Tonstrnrtiun Prrutit Application is hereby made for a Permit to Construct (Vr or a' �,) �n Individual Sewage Disposal System at: ��}•- ....................-• ...................................................................... ......................... ..--: /G ...���/__.... ..O..io --A dress .:.......... .... (��...��/ �LDt-�/. ..................... G�-T i< Address w � -� •� n�s alley � ..-- Address //�� / U Type of Building Size Lot..-",�.4.1". Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ') a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fix e W Design Flow............ :.- �1 ..._gallons per 1 per day. Total date flow.............--. ...................gallons. WSeptic Tank—Liquid capacity..l�gallons Length.. .__ Width..-.---.... Diameter................ Depth--- Disposal Trench—No..................... Width......_._P_._._._.. Total Length............._ _._ Total leaching area..,.................sq. ft. Seepage Pit No.........�......... Diameter......;-Q..... Depth below inlet......6i----..... Total leaching area..�a..'I.sq. ft. Z Other Distribution box (i< Dosing tank ( ) --------- Test ,.+�Dlf .�,� j Percolation Test Results' Performed by.. ..fiLl'r .. �__ 11��' . Date_�f _ .:.>.. �... Pit No. 1------ .minutes per inch Depth of Test Pit.....J.4._.... Depth to ground water........................ f� 1� Test Pit No. 2.....!ZZ_minutes per inch Depth of Test Pit...... ..... Depth to ground water........_.............. Description of Soil- 7-.!9.......-•�� 8.. � ..¢" � l =' ao_hS /),�?..e' �� -:.. U - � ,6�---- ; mil-.90a 4/ . /L f�Al .�$( � 5� `,f�Z e�� Q.F 4/� �.� '_ f ---=rv_,Sct---`-"-�s ......................��_ ..9_l� re ' UN) xble- - - .^ . s .� •-- - ��• / Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.1 5 of the State Sanitary Code—The u er 'gned further agrees not to place the system in operation until a Certificate of Compliance has been ' 'ued by r of health. gned----- ------ --• ' ......... .............. - ............................ ----•- ---- -APPlication Approved BY .... ._.. - - - ---- Application Disapproved for the following reasons:---•--•-••-----------•--••-•----•-------•-•-•-•-•-•----•-•••-----•-•-•---------•------•.............•-----•-•--- ............................................................. . ... -- -••••-•-----•--•---••------------------•-------•---•-•--•-----••-- -- ..................................... Permit No..- V-•-- f ----------------•--• Issued-........ _. Date to / C ( 1 r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ppliratiun for Disposal Marks Tonstrurtiun rami# Application is hereby made for a Permit to Construct (1/f or R pair )_an Individual Sewage Disposal Sy stem t Location-Address or Lot No. ......................_.......................................................................... ............•-----....._..........................._............_........_._....................-- Owner Address W Installer Address U Type of Building Size Lot.`7. �_ �Y�.Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g ------------------•--------• P ( ) — Cafeteria ( ) Other ---..--� d �fi1'i W Design Flow............ .:._).::._gallons per pe�een er day. Total daily flow.......•.•..5�o__________________gallons. WSeptic Tank—Liquid capacity./.gallons Length---._•_-1�-'_._. Width'T/'.. Diameter_____ _________ Depth. .......... x Disposal Trench—No..................... Width._.__.._j.__.._.___ Total Length.................... Total leaching area.._r...._•.--__.sq. ft. Seepage Pit No.._____1.____.__._ Diameter.__..f rJ...... Depth below inlet.....-......... Total leaching area.G _/..sq. ft. Z Other Distribution box (� Dosin tank ( ) $g /.e,�L oN��N 3 aPercolation Test Results Performed by_`':9 .1C11.1C1 ._ lC _� .......... Date�lt?�_ate:: `-9/... -� a Test Pit No. 1................minutes per inch Depth of Test Pit..._ ` _...___. Depth to ground water........ ............. (14 Test Pit No. 2....�z...minutes er inch Depth of Test Pit..... f___... Depth to ground water....................... �.-7--------------------------------• ........./.sli�3SUs�� De criptipn of Soil...7 ---2......... �'�= ��'` �r Gp'e-- ���� ' IE �. 5 / --------------- x '6 77�',..5-�'l�SsL,.:�iCG...../ln. -r3oe. / PS --�7 V - - W ----- s L- �'....................... .5-���----n'..... - J Nat e o ea sor — k---------6J ------- � �Esr�? �_( Cl 3 i," fif ! r/................................................. . ---------------� ---- / g- Z--------- - - Agreement: -G----2-----"---,- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signe9`d............ /-------------------------- 2------ = -------••-•----------- --------- r �.....l:'�'. 4........................ _..... 1 1,/ ?APPlication Approved BY CJ D to .._..._ Application Disapproved for the following reasons:.............................................................................................................. ..................................................................,--•----••-------------•-•-------...-------------------------•--------------------•-. ---------- •-•----------- �f �7 Date Permit No._ L/.. .l....j-----------------•----.... Issued.-----r( - .. Date THE COMMONWEALTH OF MASSACHUSETTS `BOARD64-6.L OF HEALT�F ................ .. QAl0F. . ....�........:.........:....:......:.... , ... (9rdif irtttr of Tompfianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) --at --- -=-- has.been installed in accordance with the.provisions of TITj 5 of S.ate Sanitary Code as described in the applik�tion for Disposal Works Construction Permit No.......... ........... .... dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® A G R TEE THAT THE SYSTEM WILL FUNCTIO SA 1 �C ORY. � .DATE -= ................. Inspector... = .----- --• -- THE COMMONWEALTH OF MASSACHUSETTS BQAR 1OF H AL H / � /. t/V.l..11... ......OF. `,t�L � V................. No...�.�.... ....�..._. FEE/ .... ..... .��iu�rustt� urk� �un��riun rruti� Permission 's hereby granted...............--•---•-••••-•-••..............---....•••-••••-•••••-••-••--•--•-•--......-•••••.......------•_....................---...... to Construct or epalr ) , nli�vidual Sewage > posal 'System / / at No........ . 2�-• .� ��•��'�1 St eet I as shown on the application for Disposal Works Construction Perm' Wi.a�rdof Dated..__. t--(�--�/............... Health DATE------// ..._._. ....... ............................ FORM 1255 HOBBS & *ARREN•INC.. PUBLISHERS c �� . J <1ttTf1tt1^?I!�1!t!tl?!?rrt}nrtrTrtrrrltTrrrtrtrttttr ttnrrrttnnin nrmnrrr......rrttrnrt......tnrrrn r rrrttrtttrrrnttrmm�nnrttttrr tt+rtn ttrrttr tt nn ru r+r+rrr nnrtt rrrr ttr n tt rr ttrr n rr .� :: ,t::::::::: .....T:::::::.: ,::::::::::. :: :::•::: :: ::::in.t,..;.,,..;. ................. .::ti•• : ,T ? t??t? ?::::::,1:: tr ENVIROTECH LABORATORIES -_ Mass. Cert.4t:MA063 ` 449 Route 130 Sandwich,MA 02563 (508) 888-6460 CLIENT: Frank Kelly LOCATION: Lot 8 Berkshire Trails ADDRESS: _ W. Barnstable, MA - COLLECTED BY: SAMPLE DATE: 5-15-91 TIME: DATE RECEIVED:5-15-91 SAMPLE 1D: Z266 y C= New Well 144' " JOB WELL DEPTH: _ RESULTS OF ANALYSIS: c. = Parameter Units Recommended limit Result Coliform bacteria/100 ml (MF Method) 0 = 0 :x pH pH units --- _ 6.0-8 5 6.67 ' Conductance umhos;'cm 500 68 Sodium mg/L 20.0 7.0 E. Nitrate N mg/L 10.0 0.15 Iron ' mg/L --, 0.3 <0.05 - Manganese mg/L 0.05 ;~ 0.04 Hardness mg/L as CaCO 500 26.4 - x 3 E Sulfate mg/L 250 zz 5.6 Potassium mg/L 20.0 - 0.7 Alkalinity mg/L 200 3.0 g- Chloride m 'L 250 18.7 Turbidity NTU 5.0 '? 13.1 =x Color APC units 15.0 5.0 Background bacteria H1 COMMENT: EPA 601/602 Volatile ug/L See attached Below Reporting Organics g report Limit - _ YES NO WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. ]KX Cl _ DATE ` 'lijWlllilul1111ttllllillll!!ll11U111111!liill1lUl!litll1111111111i1UlUllil!lliti!liii lllllluiIll ititi ill liiiilliUillilililiiiilitiilimil liliilliiiiiliillillliti!liiliitlUtiiillUilllllil111itiitliillluilllililliiilililliiliil\�� r GROUNDWATER ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: Z-266 Lab ID: 1333-01 Project: Kelly Lot 8 QC Batch: VGA-773 Client: Envirotech Sampled: 05-15-91 Cont/Prsv: 40ml VOA Vial/Cool Received: 05-15-91 Matrix: Aqueous Analyzed: 05-17-91 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) (ug/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL 1 Vinyl Chloride BRL 1 Bromomethane BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL 1 trans-1,2-Dichloroethene BRL 1 1, 1-Dichloroethane BRL 1 cis-1,2-Dichloroethene * BRL 1 Chloroform BRL 1 l, l,l-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL 1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichloropropane BRL 1 Bromodichloromethane BRL 1 2-Chloroethylvinyl Ether BRL 1 trans-1,37Dichloropropene BRL 1 Toluene BRL 1 cis-1,3-Dichloropropene BRL 1 1,1,2-Trichloroethane . BRL 1 Jetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethylbenzene BRL 1 m+p-Xylene * BRL 1 o-Xylene * BRL 1 Bromoform BRL 1 1,1,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC "LIMITS Bromochloromethane 30 31 103 % 83 - 117 % Fluorobenzene 30 31 103 % 87 - 113 % BRL = Below Reporting Limit. * Non-target compound. "Trace" indicates probable presence below listed Reporting Limit. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986). Department of Env,iionmgntjl Management"Division of Water Resources Of x\ r.• WATER WELL COMPLETION REPORT WELL LOCATION_ I Address es A I,- �_�. 1,< I"d City/ Town G.S.Quadr"angle Map Grid Locration�AJ ,/ Owner /r r.a/e n � (.�5 !�A ✓14 f Address 7\r.+11 WELL USE CONSOLIDATED WELL Domestic❑P ✓/Public ❑ Industrial❑ Type of Water-bearing Rock Other Water-bearing Zones � Method Drilled pc!_ 11 From /rS/l To 2) From To Date Drilled f 1 /�/ ' 3) From To r 4) From To CASING rr Depth to Bedrock 1111 Length Diameter Type A" UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface /!6 Sand: fine❑ medium❑ coarse❑ Date measured 1-//7�G-! Gravel: fine❑ medium❑Q1coarse❑ P fR Screen: GRAVEL PACK WELL ❑ Q Slot# !> length from /y/! to U� Yes No ! Split Screen (or 2nd screen) WATER QUALITY TESTS.MADE Slot length from to Chemical Q Biological ❑ Depth To Bedrock AX PUMP TEST _ Drawdown feet after pumping days S hours at 7 ✓! GPM. How measured -7-R 0-e Recovery/rr2 feet after / hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials �nj From To 5 o a !t o A �4) _7 rt c!7) `° DRILLER b 1? 101 / A. A /^ lb Firm U, d L i h o . 96Address .A F city �h.tv(7 �o !/h yp P yr � Registration No. �. qq J, -7 AA 9 .cal Operator's Signature Please print rrm y BOARD OF HEALTH COPY 25M 10.85.807101 No.-- -----v?-- Fee(Z' -----``------- BOARD OF HEALTH TOWN OF BARNSTABLE Appritation-*rWrIl Con tructioniermit Application is hereby made for a permit to Construct Alter ( ), or Repair ( )an individual Well at: ---� ----- --'-- - 1'Z I< S/N---- C (�_ �_`��U /uar1 _ ------------------------- ---------------------------------------------- --------- Locatio Address Assessors Map and Parcel �,- -- -�--------- - -- ----------------------------------- ------------------------ ------------------------------------------------------------------------------------------- Owner 4 3 Address 2 - — ----------------------------------------------------------- Installer — Driller Address Type of Building �j/�. Dwelling- / --� -------1--- M f---------------------- - -- --------------- Other - Type of Building-----------—---------_____—___ No. of Persons---------- ---------------------__________ AZ Type of Well - �..— — �� ��--- --= - - -- Capacity--------------------------------------------------------------------------------. Purpose of Well----—------— -r_ _--------'�- - - Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to plac th ell in operation until a Certificate of Comph ce has been issued by the Board of Health. r 7 Signed - --- - - - -- -....... - - - date Application Approved By ----------------- — --- - ---- — ---— - - date Application Disapproved for the following reasons:-------------------__—'_________:________________________________________:____ ----------------------------------------- ------------------------------------------------- date PermitNo.-- - -- -- - -- - -- -------------- Issued-----------------—--------------------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) - - - ---- r --- - -------- -------Z----------------- ----------------------------- — Installer ? at has een installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. - _r' -- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------------------------------------------------------------- Inspector----------------------------------------------------------------------------- ---------- r. No-------------—a= Fee BOARD OF HEALTH� � TOWN OF BARNSTAB'L`E Rpplication-forlVerr Con tructionpermit Application is hereby made for a permit to Construct , Alter ( '), or Repair ( )an individual Well at: y --° -- - -�'- I�S N!2 C-'1­4►4?°/jar1J___._- -------------------------------------------------------------------- (z 'Location — Address `\ Assessors Map and Parcel r ----------- NI�� ---------------------------------------------------------------------------------------------- Owner Address - -- - - -- - ----------------------------f ---------------------------------------------------------------------------------------------- Installer — Driller Address Type of Building � �6 L G ? �` M�` y ,' �, ..,•,,. Dwelling - -- - - — ! Other - Type of Building No. of Persons-------------------------------------------------------- Type of Well-- -_1___--- !('; � ------ Capacity--------- - ---- — - 01 Purpose of Well------- -r_S7-1 C- 1—14fi'L -- ------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to pI at the well in operation until.a�Certificate of Compl" ce ha been issued by the Board of Health. Si ned/il �_ �J dater Application Approved By---------_-__—__ ______ ---- - --- - -—------------------------- ,a.. date Application Disapproved for the following reasons:------------------------------------------------------------------------------- --------------------------------- ------------------------------------------------—----------- --------- ------------------------------------------ date PermitNo. ---------------------------------------------------------------------- Issued--------------------------------------------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) bY- - -— - - —-- -- �—- ----�-- -------------------------------- ------------------- eC Installer at _ �___ nsta fit_ has een installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ✓!'�� ated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-----------------------------------------------------------------------------—- ----— Inspector------------------------------------— —-------------------------------- fi _.4 1 BOARD OF HEALTH . TOWN OF BARNSTABLE lVell Con5tructionVerntit , - No.L �� ' Fee 'C�`�'��id -- - Permission is hereby granted----------�4�� -!'�ll L R----------------------------------- to Construct Alter ( )-,-or Repair ( / an Individual Well at: Street as shown on the application for a Well Construction Permit No.- ----------------------- - - - �-- Dated------- DATE----------- ----------------=-------------------------------------- Board of Health -�---------------------------------------------------- F i 1 } S �� Ill!� Illllflilllllllll111{ !II'lli� _ i 1 MR 11 W TO -.OF BARNSTABL Loc �iora e r k 5 4 T a: sPEwACE.U. GJ VILLAGE' . � , s .I.ERW NAArE PHON OC S-Puc.T'Al`iK"cAFAcrrx" l t'.f LF�CIffi`tG FACHM ( NO.'3FBEI3ROOms 13UI DF.,R aR flW14ER PBRRddTIyATE. C}TPIIAIdCE i?ATE separauan I3 stance_Between the MaxumumA t1ustesl GrottndwaterTable to the'Bottotri of iaac itng Fki(tty F' e4 Pnvate�Yater�uppiy well a9d Lead g Fatality {�€any Wem exist; onstta ar vrztiun-?f�feet,af leliing facilccy} feet. FA f�Rl iWd and Lcia is ng l" cility(Ff any wet}ands exist wathast 300 feet of t*hing facilityy, 74 t c / Furnished by. J�G�a�.✓.�. . � /� 06It - a F I o r ` 9 r LEGEW WEST BARNSTABLE 00 PROPOSED CONTOUR ST, LOT 6 �O 9® PROPOSED SPOT GRADE WELL IN j -- 98 -- EXISTING CONTOUR ON FRONT , � SS)• + 96.52 EXISTING SPOT GRADE R 7 q/ LOT 7 ' W— EXISTING WATER SERVICE CRO�O TEST PIT ��G,0�</ LOT 10 SCALE 1"=30' �P� LOCUS WELL IN F FRONT LOT 8 00 AREA=43765t S.F. j 150, h c WELL � LOCUS MAP O F LOCUS INFORMATION PLAN REF: 462/32 cai TITLE REF: 27959/144 PARCEL ID: MAP 109 PAR. 015-003 �V 100' UTILS ZONING: "RF" N 1�- WELL", CO FLOOD ZONE: "C" COMMUNITY PANEL: 250001-001 5-C DATED:08/19/85 SEPTIC SYSTEM e� r � d' REPAIR PLAN LOCATED AT: 35 BERKSHIRE TRAIL �� �' ; i39-5 F=140.00 l� WEST BARNSTABLE, MA. 139.4 ^� \/ PREPARED FOR GAR. \ SLAB NELSON JENKINS �� •�?rs• BM=138.74 EXIST. 1 OG Op �� 72 '• G SEPTIC TANK ^ JULY 14, 2014 F �j i OQ GENERAL NOTES: lo LP •••�•••• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL �� OF M/JS BOARD OF HEALTH AND THE DESIGN ENGINEER. �P� J'' �2 OAKS i ,Z�_ O G 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS / ti OF THE STATE ENVIRONMENTAL CODE. TITLE V. AND ANY APPLICABLE DA EN M. G1+ O j' LOCAL RULES AND REGULATIONS. EXCEPT AS REQUESTED BELOW: I Y v ••••• — D C OAKS 31 MR 15.405 (1) (B): cv - •cY• �IVO�114 M � / C •�� t) A t.61 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING TO BE 4.61 FT (MAX) BELOW GRADE VS REQ•0 3 Fr. (VENT PROVIDED)N / _�ti p, It LOT 9 -- - �` _ 3. TO INSPECTION SPECCTIION AND DISPOSAL BY THEOF HEAL HD AND THE "cC/� �} l DESIGN ENGINEER. 'sANITA190 / F 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING '��� 10" N V FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. _ ' _ _ 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 137 -- -� �\ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF D OF HEALTH FOR RPER INSPECTIONS DURIN TO NOTIFY G CONSTTRRUCTIOONN. MEYER & SONS INC. — J 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 36 \� I 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED P. O• Box 9 8 \ TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR 9. L SHALL THE UNDERGROUND Of THE CONTRACTOR TO VERIFY THE E. SANDWICH, M A 02537 LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING WORK.ESQ' 10. EXISTING LEACH PIT TO BE PUMPED. CRUSHED AND REMOVED PER TITLE 5. FipO 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION P H: (5 08) 3 6 0—3 311 M WF �. 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY FAX: (7 7 4) 413-9 46 8 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 14. ALL PIPNGWN PTOATE BEW4 WELLS 40 ®1/8*/Fr (UNLESS WITHIN 150 FT. OF PROPOSED LEACHING ECIN) meyerandsonsinc@gmail.Com ` 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A GARBAGE GRINDER 16. NO WETLANDS WITHIN 150 FT. OF PROPOSED LEACHING SHEET 1 OF 2 J 1666 1 NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:135.39 FOR A DISTANCE OF 15' AROUND THE �. PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. T.O.F. EL.=140.0 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. VENT • F.G. EL.=138.Of F.G. EL.=138.6t F.G. EL: 140.0t F.G. EL: 140.0(MAX.) �� OF Mq � G o D Atft N I M, 9" MIN COVER/ 7- ;L = 12' 36" MAX COVERL = 70' L = 1O'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) NO. 1 �40 ® S=1% (MIN.) EL. 137.30 0 S=1% (MIN.) ® S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 1P60" �/$TE�F� '• INV.=136.25 14' s 11.3" TO S�SIM\P� INVERT 48"uouI0 INV.=136.0 INV.= 135.0 LEVEL GAS BAFFLE PROPOSED 4 ROWS OF 4 UNITS AT 6.25'/UNIT = 25'/ROW D-BOX INV.=135.13 1 INV.=135.3 DB-5 SOIL ABSORPTION SYSTEM (PROFILE) EXISTING 1.000 GALLON SEPTIC TANK EXISTING SEWER OUTLETS RESTORE VEGETATIVE COVER BACKFILL WITH CLEAN PERC SAND 75" TO TOP OF CHAMBERS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION BREAKOUT=TOP ELEV.=135.39 2) D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 135.0 GRADE ON A MECHANICALLY COMPACTED SIX am" BOTTOM ELEV.= 134.06 INCH CRUSHED STONE BASE, AS SPECIFIED IN EXISTING SUITABLE 310 CMR 15.221(2) 2,83' MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC 5' MIN. ABOVE BOTTOM OF r�EXCAVATION OR G.W.P. 76.. _ TANK WITH 1500 GALLON SEPTIC TANK T. ($.66' PROVIDED) EFFECTIVE WIDTH =�4 x 2.83' = 11.32' IF FAILED, DAMAGED, OR UNDERSIZED. BOTTOM OF TESTHOLE EL.=125.40_ USE 4 ROWS OF 4-HIGH CAPACITY PROFILE 4) INSTALL INLET & OUTLET TEES W/ - ADS 16208D BIODIFFUSER (H20) UNITS-NO STONE GAS BAFFLE AS REQUIRED SEPTIC SYSTEM PROFILE TYPICAL SECTION T N f 1s" N.T.S. e.rs' 11� SOIL LOG P#: 14394 DESIGN CRITERIA DATE: JUNE 16, 2014 (PROP IS IN ZONE II) I►---34" � NUMBER OF BEDROOMS: EXISTING 3 BR DWELLING SOIL EVALUATOR: DAVE COUGHANOWR, RS CSE#461 SECTION END CAP SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: 2 MIN/INCH WITNESS: I DONNA MIORANDI, BARNSTABLE HEALTH 16" HIGH CAPACITY 1620BD (H-20,) BIODIFFUSER UNIT LTAR: 0.74 SF/GPD Elev. TP-1 Depth Elev, TP-2 Depth DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. 139.50 0" 139.40 0" SANDY LOAM SANDY LOAM MODEL 16" HICAP GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 138.67 1OYR 2/2 10" 138.57 1OYR 2/1 10" LENGTH 76" SEPTIC TANK: 330 B SANDY LOAM B NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT gpd x 200% = 66o SANDY LOAM EFFECTIVE LENGTH 75" gpd USE EXISTING 1,000 GALLON SEPTIC TANK 10YR 4/6 10YR a/s TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 135.83 44" 135.57 46" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. C LOAMY FINE C LOAMY FINE SIDE WALL HEIGHT 11.3" 1oSAND SAND s OVERALL HEIGHT 16" I DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) 127.50 C2 /4 144" 127.73 C2 1oYR /a MEDIUM SAND 13.6 CF 140" OVERALL WIDTH 34" 4640 TRUEMAN BLVD MEDIUM SAND ° PRIMARY S.A.S. HILLIARD, OHIO 43026 „ s USE 4 ROWS OF 4 - 16 ADS 1620BD BIODIFFUSER H-20 UNITS-NO STONE PE TEST 10YR 6/3 10YR 6/3 CAPACITY (101.7 GAL) ADVANCED DRAINAGE SYSM4. INC. BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.73 SF/LF OF BIODIFFUSER) PROPOSED SEPTIC SYSTEM/SITE PLAN (BIODIFFUSERS) 16 UNITS x 6.25 LF x 4.73 SF/LF = 473 SF 125.50 ,ss� 125.40 168" 35 B ER KS H I R E TRAIL, WEST BARN STABLE, MA TOTAL AREA = 473 SF PERC RATE: <2 MIN/IN. SOILS IN ("C" HORIZON) Prepared for: Jenkins DESIGN FLOW PROVIDED: 0.74GPD/SF(473.0 SF) = 350.02 GPD > 330 GPD req'd Engineering and Surveying by: SCALE DRAWN DATE: j Meyer&Sons,Inc. NTS D.M.M. 07/14/14 • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX 981 to conduct soil evaluations and that the above analysis has been performed by me consistent with the EASTSANDIMCH,MA02537 REV. DATE: CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October, 1999. 508-382Z922 D.M.M. 2 of 2 20 FEET MINIMUM . COVER MATERIAL SHALL BE FREE 10 FT. MIN. OF LARGE STONES, FROZEN CLUMPS CONCRETE 4" DIAM. SCHEDULE 40 PVC OF EARTH, MASONRY, STUMPS,OR DEEP OBSERVATION HOLES BREAKOUT CALCULATIONS COVERS PIPE- MIN PITCH 1/8"PER WASTE CONSTRUCTION MATERIAL TOP OF FOUNDATION SOIL TEST I SOIL TEST 2 SOIL TEST 3 FOOT-I/4• PER FT. DESIRABLE (WHERE APPLICABLE) �. ELEV.=LO - REINFORCED CONCRETE COVER 2"MAX. ' GATE OF TEST S-Kp-9/ DATE OF TEST S-/S'-9/ DATE OF TEST 6-/-9/ WITNESSED BY'wrx-sso/.; WITNESSED BY Ate-&9 WITNESSED BY ?F_e. _ y�n q MIN. SLOPE PERC..RATE 12 MR/INCH(2?,4 v PERC. RATE �Z MIN/INCH PERG RATE �5 MWIINCH(3 5 ELEV= /09,/ �J r-�rG LE VEL ELEV.=//Z/ vv,@ ELEV• /L2�6 NO c- EL.=392 D o 2 O Pir cLeYI EL= 3=3� EL: VB.O 7'JP(SUf. ,'�/L EL=9,�,7 TOy SUB T/u_ �07^"�'G 4"DIAMETER CAST IRON TO PSO/L; $✓BSc.%K,' fyrv/,D BGULnE�S ru) CONTOUR EL= 9B0 EL.= CONTOUR PIPE(OR EAUAU- MIN. � 97fi PITCH I/4 PER FOOT • EL=97� 76" INVERT yy. DIST. G' HING BOX ' 7. YIEG `A/,/J c/ RE /OD/7 GAL PRECAST LEACHING Az&L?. S/R.VD A,�/o BASIN/GALLEY OR ✓1 STC =S 2UVLOE,ej SEPTIC EQUAL 9 9/. /v/ED. 54AIjo 4AJ,9 9` —S E L.= 5 R TANK PROFILE OF F SOUGDEeS (SVHE OPpM EDGE LEACHING SEWAGE DISPOSAL SYSTEM L %d A,� O. SAAjj> �•vEs) c/_EAN NOT TO SCALE _ G.9'�y,°•H„�1 �, - . • J /Cps_`J''L`SO` OC BOTTOM OF TESTHOLE OR t NO WATER..T_Et.-_ ,wWAT FN�—Eb ,`oWATER AT EE. LOCI UPS 'OBSERVED-WATER-TA8[E EL.•8'/G iNLt ATER / iY ••\ , /OT - TABLE EL.-_ -%tiAL>t0= Uti/SG/TABGE Fee rH/5 Lc5=�,L/� .. GENERAL NOTES: L ALL WORKMANSHIP AND MATERIALS SHALL CONFORM ,PRECAST LEACHING BASIN, TO 310 CMR IS (TITLE V) AND THE TOWN OF GALLEY OR EQUAL 2"LAYER 896-,t/sr�£RULES AND REGULATIONS FOR THE LGTT 6 I \ - ' - .OF 1/8"- SUBSURFACE DISPOSAL OF SEWAGE. I �d I g G• ...v.. Ile STONE t ('vcd s` _ - i 2.ALL COVERS " SANITARY UNITS SHALL BE BROUGHT • TO WITHIN 12" OF FINISH GRADE. 9�r j I LOTS _ LOT '7 • SHALL REMA.N i 3EXISTING AND FINAL GRADES ' \ I + 93,7.6,5./ Aa"�� (Y4GJ _r______--___--_—___— • • 0 _ ESSENTIALLY THE SAME AL. r-` w 3/4° I I/2"WAS HED 4.NO DETERMINATION HAS BEEN MADE BY THIS OFFICE - Ir i /• / /,'^% I I �-~ a AS TO COMPLIANCE WITH TOWN ZONING REGULATIONS. \ I i I I j / ,! _ '/� I I • uo. STONE• OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION. Yio FROM THE APPROPRIATE AUTHORITY. - \ tt \ + / I �::-`�c'r �' RI — - — i ° ` w • 5 THIS PLAN IS VALID ONLY IF IT IS STAMPED AND SIGNED IN RED. TH=1� `��• `\ i. t \ \ / / �` `• / 1 FOR JI _ _ I - y/O' INFORMATIONS CONTAINED ON COPIES WH CH OFFICE AS UMES NO RESNDO NOTY HAVE 4° DIAMETER.COVERS I ORIGINAL STAMPS AND SIGNATURES. `\ \,�\ \ 1 I •. \ \ / I I Z' 6 - Z' 6.ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE Lam/'/O - n ' i '� \ •\\�' +•\' \ \ \ \ \ fsa,o I _„§ —9L ESA./ :4p I I /O, CAPABLE OF WITHSTANDING M•10 LOADING. IF UNDER AN ITY /. AREA SUBJECT TO VEHICULAR. TRAFFIC OR WITHIN 10' `x^.',' ( \• \ t ;t \ ` �. / /--� `. /- _ '-_+---- ----------� .- OF DRIVES OR PARKING AREAS, THEN THE SYSTEM t \ e \C y / '. r�• /._°G° •L 7 SHALL BE CAPABLE OF `NITHSTANDING H-20LOADINGS. ` , \ +\) ,1 , \ i \ ._ /6``/a o 5•: ._ TOP VIEW �� 1 c?ry.-ToP cf LEACHING FACILITY 7 CONTRACTOR--SMALL BE RESPONSIBLE FOR VERIF- x ICATION OF ALL EXISTING CONDITIONS INCLUDING s NOT TO SCALE UTILITIES AND ELEVATIONS. WHEN THEY ARE REQUIRED, FRAMES \ \ _ \/�\ AND COVERS SHALL BE SET WITH - '1�y \• \ \ \ / >fi .� �! MASONRY UNITS WHICH ARE TO BE OUTLET PIPES AS REQUIRED .QEFc"Q. TO t;?g2°•Y7rlATE .5/2E .Sr-'Owi1/� tv MORTARED IN GLACE - A&?'JE' 4',e4DE - �, •\szw/ +\ ' \\ \ caG.j�' PROP `�•.�cp;;z PER 3K)CMAF 3'BpQq -,� ,c /f , REMOVABLE 9 4LC L/n/s'%/TABLE MA.TER/4G..(M4TE,H/4G /•' _ i\ / /" INLET COVER Pc'.ZG y^1TE SGOWEL. TNA,V.THE OESiG,v r I 'P/o7x7 i / Y'MR4 OUTLET -TUTLET RG7E OF 2 �} Sf/4L.L 96 RCA40VXD. •cy GQ.. I „n / 6"MIN. - FLOW LINE INLET e MIN s, t / V10"MM. I„ M0o _ INEW .T=iAT HL1S A Pc L'.G..,eATE Ov GZ ' \` �/ ,c �, !�. 4' IQ MIN. .t _ INLET TEE REQUIRED WHEN /O. LOT AJe'°/BE.25= O,,q&,VS/DaJ 4A.% 41'E4•\ \� / �,K \ /".1 LIQUID S'�/• DOSED OR IF INLET PITCH S O DEPTH FQan PCAti/ Bco.r •5/62 P4GE 32 PECo2L> . EXCEEDS 8% _ .q,T :%f��. L'A,e.VSTABIE CCu�/TY R£li/rr•2Y c \ NO. OF OUTLETS 9 � OG DEEDS," _ DIST BOX DETAIL c��T NOT TO SCAL ion - _ OUTLET TEE d LO 9 ! , ! i >'c�6~ ',+ `•'S'.H LIQUID DEPTH TEE DEPTH CAPE W/DE SURLIL 11IG T - / / BELOW FLOW LINE _ o a 2177 MAIN STREET(RT.2BJ ^, \ SEPTIC TANK DETAIL 1y/ 4 FT 14 INCHES tN o:yam; SOUTH CHATHAAf MA. �� �• i NOT TO SCALE a <• :<. qcr e,M,- rov ov', / � � 5 FT. 19 INCHES �• �\ Cc-61.,r9.52 ( /� \ 6 FT. 24 INCHES s -t =r:�:er✓Ee /'C,45unso D4Tu.`f�,/ i/ ��\ 7 FT. 29 INCHES -APPLICANT: 8 FT. 34 INCHES of ,o ;��K LEGEND: DESIGN CALCULATIONS °6TE" �L={ e EXISTING SPOT ELEVATION OM . �i,te3 j 417 NUMBER OF BEDROOMS =- '/✓ur/Bc''.e O< EXISTING CONTOUR --Do---FINAL SPOT ys GARBAGE GRIT/DER n!C BY eviacEe .JF7'Ec° r.-:E r'. 4 PROJECT LOCATION: •f , •V P / .f _ _ W/TL/ HEALTH O.ef'T. -��/. LOTS L3 c R c FINAL CONTOURS NATION ®.0 TOTAL ESTIMATED FLOW / _ fi_,/+•/=eE T•2• fl0 GALJSRJDAYx 3 BR) 33D GAUDAY 'cSQ.2/JSTASGE, Mr: L— - REQUIRED SEPTIC TANK CAPACITY '/ 5 GAL. �QQ�/rJ/�/LJG ' SOIL TEST LOCATION A/v TES SCALE: / 30 DATE ACTUAL SIZE OF SEPTIC TANK GAL. UTILITY POLE O- LEACHING AREA REQUIREMENTS //. TO Y716 BE�'T OF ,"IY /ti/FaF/7NT/.apt( DR.BY JOF REV HYDRANT �- SIDEWALL AREA .2.5 GAL./S.F, i{,l/D c,/LEDGE�Ati/O �cL/,=h YNt BOTTOM AREA 1.0 GAL./S.F. _ JOB NQ= 51i-ppy TOWN WATER _=W====Wa LEACHING CAPAcWf Wc'LG5 RnJD SE PT/CS .4- LOG9 0 / S'i� CAI.. CATCH BASIN ^o, 4cH ?-GSt IOk�> /.065�;fi=516j AS SH Ok,'Aj rAJr0oe"47704j_/.5 F•PO �. o r > (" �` ti APPROVED FENCE —.—<—x— "'^'e RESERVE LEACHING CAPACITY 579 GAL. 4NDAECb `t' DATE HEALTH AGENT APPO.BY: SHEET / OF L