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HomeMy WebLinkAbout0038 BRIAR LANE - Health 38 BRIARLN. ,W. BARNSTABLE A = 136 055 002 --v r m 0 I Pere Test P-9453 Date 6/22199 NOTES se P.SuiYvan BoHeafth Dom&Miorandl Test Water ForThis Lot is a Private Wel I. 1 0"-1" O Pine Needles&Leaf Matter t0YR311 of Utilities Shown on This Plan Are Approx. 11-40" A Loamy Med.Sand,some roots 10YR516 t 72 Hours Prior to Any Excavation ForThis 10--34' B Med.Sand tOYR eB The ContractorSholl Make The Required Notification to Dig Safe(1-600-322-4844) 34'-120" C Med.Sand 2.5YR6/4 ntractor is Required to Secure Appropriate Water Encountered®96 From Town Agencies For Construction •r Pare®43" Pre Soak 15 Minutes Defined byThis Plan. prop 12"-9" 25 Gallons In less than 15 min. 4 Install Risers as Required to Within 12"of 9"4" 25 Gallons In less than 15 min. Finished Grade. craw t matte 5.All Structures Buried Four Feet or More or Subject' Test Hole y to Vehicular Traffic lobe H-20 Loading. 0%1" O Pine Needles&Leaf Matter 10YR311 6 Septic System to be Installed in Accordance With 1%12" A Loamy Med.Sand,some roots t0YR516 310 CMR 15.00 Latest,Revision And The Town of t2"-32' B Med.Sand 10YR 8l8 Barnstable Board of Health Regulations. 32'-120• C Med.Sand 2.5YR6/4 7. All Pi ping to be Sch 40 PVC Water Encountered Q 96" DESIGN DATA Single Family-4 Bedroom Chas f M'terfid With no Garbage Grinder Daily Flow=110x4a 440GPD Septic Tank:440 GPD x 200%=880 GPD Finish Use 1500 Gallon Septic Tank Grade LEACHING AREA 01 2 Filter 440 GPD/0.74=595 SF Required '--- --co 3'Maximum Use Bottom Area Only Bottom Area 12'x 50=600 S.F. Provided. Poa Storrs LEACHING BED DESIGN ,0 4"0Perforate All Pipes tabs Schedule 40 PVC to PVC Pipe Wooled oash ed V2 Ooutile Wed Perforated With Capped Ends.Use IT 3-4'0 Distribution Lines in al2'x50, 3'-0" 3'-0" 3'-o" '-0' Washed Stone Leaching Bed as Shown. CROSS SECTION OF LEACHING BED Not to Seale F G.16.0 F.G.14.0 14.0 13.8 1500 Gallon 13.6 13.0 Septic Tank I 4 Bot.E1.12.5 13.2 Bedding as Per Title 5 5.0' 12' Adjusted Ground Water Elev.7.5 DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM ' ®FA � Not to Scale r ' PETER SULLIVAN N0.29733 CIVIL LISGS High Ground Water Calculation .c+ �Po Cape Cod Commission Technical Bulletin 92-001 ' Index Well SDW-252 AL Zone A l Date June 22,1999 Tr i Ca Gilligan Water Level Adjustment 1.5 38 Briar Lane(Lot 2) Observed Water Elevation 60 1 U N E 14,1999 W.Barnstable,Mass. SULLIVAN ENGINEERING INC. SHEET 20f2 Corrected Ground Water 7.5 OSTERVILLE,MASS. �goL4q Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information `��1qu+++Inpp�i on the computer, pN 'lH OF use only the tab 1. Inspector: A'' key to move your b-6 cursor-do not James D. Sears = JA M ES m use the return Name of Inspector key. CapewideEnterprises,LLC , . % Company Name '�., T'� ,R � ` — 153 Commercial Street pi��4jF 5 INS?le `\��.� Company Address Mashpee MA 02649 City/Town State Zip Code 508477-8877 S1623 Telephone Number License Number B. Certification _ . F I certify that I have personally inspected the sewage disposal system at this addr ss and tQ they.; information reported below is true, accurate and complete as of the time of the°inspection.IT-fie inspection; was performed based on my training and experience in the proper function and maintenance of o gsite sewage disposal systems. 1 am a DEP approved system inspector pursuant t Section5.340Kof Title 5(310 CMR 15.000).The system: --s ® Passes M ❑ Conditionally Passes ❑ Fails 4:�:c-)� ❑ Needs Further Evaluation by the Local Approving Authority 4-11-13 spector'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. I � t5ins•3/13 Title 5 OfficialIns on Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 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 3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y . ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 9 C) Further Evaluation is Required by the Board of Health: " ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Citylrown 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 El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in is less than 6" below invert or available volume is less than %day flow elviAua t5ins•3113 Title 5 Official Inspection Form.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 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ • ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 Official Inspection 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 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ 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): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 or 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: The system is a 1500 Gal Tank D Box and three pipe field. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d well water 9 ( Y 9 (gP ))� Detail Sump pump? ❑ Yes ® No Last date of occupancy: present Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 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: 7-09/9-12 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 F ❑ Privy ❑ Shared system (yes or no) (if yes"attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M s� 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 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: 1999 Permit # 99-637 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18"feet 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.): Pipeing is 4" PVC SCH 40 Septic Tank(locate on site plan): Depth below grade: 9'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: 1500 Gal Precast Sludge depth: 2" t5ins•3/13 Title 5 Official Inspection 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 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every west Barnstable MA 02668 4-9-13 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 28" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt Plan Tape Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank and cover's at 9" below grade wloutlet tee. Tank at working level. No sign of leakage or over loading. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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 resent: Yes No P ❑ ❑ 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 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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 is 16"x16"-20" below grade w'three lines out. Box is clean and solid. No sign of overloading or solid carry over. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments rt 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 12'x50' ❑ 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.): Leaching is a three pipe field 12'x50'x1',camera out lines from box line's are clear. No sign of over loading, solid carry over or holding water.Drain holes in pipe are clear. 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 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every west Barnstable MA 02668 4-9-13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 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 P1 EAR � O O /3-3 /9 -V: ❑3 so s t5ins•3/13 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 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 page. Cityrrown 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: 6'-5"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: 6-22-99 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: SDW-252 You must describe how you established the high ground water elevation: T.H.onDesign Plan 6-22-99. Water at 8'ADJ 1.5' Per T.H. A.D.J. G.W.'at6.5' Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 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 38 Briar Ln. Property Address Tricia Gilligan Owner Owner's Name information is required for every West Barnstable MA 02668 4-9-13 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE LOCATION SEWAGE # G V7 VILLAGE ASSESSOR'S MAP& LO _ INSTALLER'S NAME&PHONE NO. � SEPTIC TANK CAPACITY I s-6,0 bad LEACHING FACILITY: (type) r e.0 (size) I I,.X t0 NO. OF BEDROOMS ' 'BUILDER OR OWNER 1 r:r.., PERMUDATE: 6lzalm COMPLIANCE DATE: /2 62d Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility t Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) 0 Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) efq Feet Furnished by JQG'�� O`Y �E9v gC go` tee. i 1� S 1 1 � No. �-- '� ,.. z; -'" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes Ra( ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zippitration for Mioogaf *pgtem Cougtruttiott Perron pplication for a Permit to Construct( Repair( )Upgrade( )Abandon( ) Qeomplete System El Individual Components Location Address or Lot No. e-tbvt,. [ Owne 's Name,Address and /Tel.No. Assessor's Map/Parcel /3G s oS_S _ 0 0 Z_ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: L� Dwelling No.of Bedrooms / Lot Size V 7 sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 4(ctc gallons per day. Calculated daily flow_ q q �allons. Plan Date g—ZY �7��Number of sheets `Z Revision Date 7 Title Size of Septic Tank�c�,`� ® Type of S.A.S. / Z X Z Description of Soil / ZS-3 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Tie of the Environmental Cod and not to place the system in operation until a Certifi- cate of Compliance has beep i ued Bo of�lth. Signed Date y Application Approved by e f Date '- 7 Application Disapproved for the following reasons Permit No. ?7 Date Issued J, Fee v ;. THE COMM6NWEALTWOF MASSACHUSETTS Entered'in zftputer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS " C 0(pprication for Migo!gar *pgtem Con.5truction Vermit pplication for aPermit to Construct(: repair( )Upgrade( )Abandon( ) complete System O Individual Components Location Address or Lot No. Owne 's Name,Address and Tel.No. Assessor's Map/Parcel S' 0 O Z Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. S L Type of Building: L/ u ` Dwelling No.of Bedrtooms / Lot Size 79sq.ft. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) �- Other Fixtures 1 r ; r Design Flow qq V gallons per day. Calculated daily flow =, alIons. Plan 'Date 6—/y—j� Number of'sheets' ' Revision Date —T C` Title r Size.of Septic Tank of S.A.S. Dcriptioii of Soil �7S1 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: ""' Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Ti e 5 of the Environmental Cod and not to place the system in operation until a Certifi- cate of Compliance has be i ued Bo of a th. Signed Date N Application Approved by ley Date Application Disapproved for the following reasons �• Permit No. - 6 ? r' �+ a ,,t. ate4s ued '�M---- ----- T _ .Y�.''"• -- d ----------------.-- r: THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MArSSACHIJ- ETTS Certificate f Com ance THIS IS TO CE Ma?te,0,n,-,sitp Se�j'a s o System Constructed( Repaired ( )Upgraded( ) Abandoned( by L at J tZ j9,- L n has been constructed in accordance h"w 3 7 dated with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 Installer Designer The issuance of this p t h t e cotrs ed as a guarantee that th s ste �11 fun tion a sign Date Inspector / _ _— __ No. --------------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS migotar tem Conotruction Vermit Permission is hereby granted to Construct Repair( ) pgrade( .;)Abandon( ) System located at !A-t l H , l� • ��h_r1�✓h and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Co ctio must be completed within three years of the date,of this p t. 1- Date: Approved by TOWN OF BARNSTABLE LOCATION 95Z 7,�- 1. SEWAGE # 9% VU-LAGE ASSESSOR'S MAP & LO INSTALLER'S NAME&PHONE NO. ' . w' SEPTIC TANK CAPACITY /,-QO dad 1 LEACHING FACILITY: (type) T;ejs (size) I'Z� X 16,01 NO. OF BEDROOMS BUILDER OR OWNER 1 Ca �1 i PERMIT DATE: !I2 e%,,l COMPLIANCE DATE: Z J a Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility f Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) C Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by .I Z b � — o5x ,z1 � b I i nfi Page: 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Dated: 08/31/1999 Report Prepared For: Conrad&Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 1 1 Laboratory ID#: 9903410-OI Description: Water-Drinking Water Sample#: 0341001 Sampling Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/1999 Collected by: Stiefel Received: 08/24/1999 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB: IC Lab Nitrate 0.8 mg/L 0.1 10 EPA 300.0 08/27/1999 LAB: Metals Copper <0.1 mg/L 0.1 1.3 SM 3111B 08/27/1999 Iron <0,1 mg/L 0.1 0.3 SM3111B 08/27/1999 Sodium 11 mglL 1.0 20 SM3111B 08/27/1999 LAB: Microbiology Total Coliform Absent P/A 0 Absent P/A 08/24/1999 LAB: Physical Chemistry Conductance 126 umohs/an 1 EPA 120.1 08/25/1999 pH 5.5 pH-units 0 EPA 150.1 08/25/1999 .Note: Water sample meets the recommended limits for drinking water of all above tested parameters. Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 M. CERTIFICATE OF ANALYSIS Page: 2 Barnstable County Health Laboratory �1f,`ltl.`.. . Report Prepared For: Report Dated: 08/31/1999 Conrad&Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 Laboratory ID#: 9 903 4 1 0-02 Description: Water-Drinldng Water Sample#: 03410-02 Sampline Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/1999 Collected by: Stiefel Received: 08/24/1999 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS MDL MCL Method# Tested LAB: GUMS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 08/26/1999 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2, 08/26/1999 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,1-Dichloroetbene BRL ug/L 0.5 7.0 EPA 524.2 08/26/1999 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 08/26/1999 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2-Dibromo-3-chloropropan BRL ug/L 0.5 0 EPA 524.2 08/26/1999 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 08/26/1999 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,3,5-Trimethylbenzene BRL ugfL 0.5 EPA 524.2 08/26/1999 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 1,3-Dichloropropane BRL ug/L 0•5 EPA 524.2 08/26/1999 1,4-Dichlorobenzene BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/26/1999 2-Chlorotoluene BRL ug/L 0•5 EPA 524.2 08/26/1999 4-Chlorotoluene BRL ugfL 0.5 EPA 524.2 08/26/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 9; CERTIFICATE OF ANALYSIS Page. 3 Barnstable County Health Laboratory Report Prepared For: Report Dated: 08/31/1999 Conrad&Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 Laboratory ID#: 990341042 Description: Water-Drinking Water Sample#:. 03410-02 Sampling Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/1999 Collected by: Stiefel Received: 09/24/1999 Benzene BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 Bromobenzene BRL ug/1• 0.5 EPA 524.2 08/26/1999 Bromochioromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Bromodichloromethane BRL uPf- 0.5 EPA 524.2 08/26/1999 Bromoform BRL ug/L 0.5 EPA 524.2 08/26/1999 Bromomethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Carbon,tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 08/26/1999 Chloroethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Chloroform BRL ug/L 0.5 EPA 524.2 08/26/1999 Chloromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 08/26/1999 cis-1,3-Dichloropropene BRL ug/L. 0.5 EPA 524.2 08/26/1999 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Dibromomethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Dichlorodifluoromethane BRL ug/L. 0.5 EPA 524.2 08/26/1999 Ethylbenzene BRL ug/L. 0.5 700 EPA 524.2 08/26/1999 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 08/26/1999 Isopropylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Methyl-tert-butyl ether BRL u€JL 2.0 EPA 524.2 08/26/1999 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 n-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Naphthalene BRL ug/L 0.5 EPA 524.2 08/26/1999 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 08/26/1999 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Styrene BRL ug/L 0.5 100 EPA 524.2 08/26/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605 Page: 4 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Prepared For: Report Dated: 08/31/1999 Conrad&Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 Laboratory ID#: 9903410-02 Description: Water-Drinking Water Sample#: 03410-02 Sampling Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/1999 Collected by: Stiefel Received: 08/24/1999 - tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Tetrachloroethene BRL Ug/i, 0.5 5.0 EPA 524.2 08/26/1999 Toluene BRL ug(L 0.5 200 EPA 524.2 08/26/1999 Total xylenes BRL ug/L 0.5 10000 EPA 524.2 08/26/1999 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 08/26/1999 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 08/26/1999 Trichioroethene BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 08/26/1999 Note: Approved By: S<�A...�.., (Lab Director) Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 C No.- :=----- n Fee----------`'--- -� BOARD OF HEALTH _ v TOWN OF BARNSTABLE App[itationArVell Con5tructionpermit Application is hereby made for a permit to Construc , Alter ( ), or Repair ( )an individual Well at: Location — Address A (� Assessors Map and Parcel Owner Address i/,1� - �� -i�-Ae ------------------------------ Installer — Driller Address Type of Bu- welling ------------------------------------------------- Other - Type of Building ---------------- No. of Persons--------------------------------------------- Type of Well— _ � - -- ---- - - --------------- Capacity------------------------------ Purpose of Well---------��/ �-- --= --- ——- 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 place the well in operation until a Certificate of Compliance has been issued by the Board of Health. p Signed Cow=�G ,� date (� Application Approved B39: —- --— — g -=9-£ date Application Disapproved for the following reasons:------------------------------------- •----------- ,— - ---- ----------------------�-------�--_---------------- y� Permit No.�, - ---- Issued------,?- -1-` -'F date— ate date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (./), Altered ( ), or Repaired ( ) by---- --- ---------- ------------------ - -------------------- ---------- Installer at-- has been installed in accordance with the provisions of the Town of Barnstable Bfo�arro of Health Private Well Protection Regulation as described in the application for Well Construction Permit No6%( f 6-:�7L&Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- -------- —- —-- Inspector---------- ------------—- r _ ... l No. - Fee-- -- _ BOARD OF HEALTH 1 TOWN OF BARNSTABLE [nation, rWell ongtruction erutit t, Application is hereby made fora perrriit to Construct ', Alter ( ); or Repair( )an individual Well at: Location Address A �� Asses•sors'Map.and Parcel ' Owner //J��L//j .�/J - Address Installer Driller Address i; Type of Bu'ding r, D ellinrg-------=----------------------------- ---------- I Other - Type of Building----- --'_------- No. of Persons---- ---------_ of Well- -� - - -- -- -- Ca acit YP -- P Y-- — Purpose of Well.... ---- ti -----= . -------- : s 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 place the well in operation until a Certifica�tee ,off Compliance has been issued by the Board of Health. D Signed--' --�� --1- date Application Approved date r- Application Disapproved for the following reasons:-=—=---------- -------------------------- - ------------------------------------ I date Permit No. "�- �fy =--- Issued ------ n date .ram: iF.v3i9�iS3!i4i Ri}i}iawYiRiYSl�!i!i?iT:4datl!e!6!6Ti.!'uRb4I�Y6}i?ifiYiR6YLYG}SG!ik4SYZaEiYd93lillfSiiQGYiNNRi�Ti�Ri9i!i'f!iR<3AS41'1Y61�itM_mab'fgSiY6F64iZiAtiYA!}!tLlRY1i?i4Yi0. n!�• BOARD.OF HEALTH TOWN OF BARNSTABLE ter tif irate Of Compliance THIS IS TO,CERTIFY, That the Individual Well Constructed (-!), Altered ( ' ),_or Repaired ( ) by ------------- - ------=--- ----- ' Installer at has been installed in accordance with the provisions of the Town of Barnstable Bpard of Health Private Well Protection Regulation as described in the application for"Well Construction Permit No -11-_&Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE Inspector-= - - - - - -- — ---- - t ��!fF!i'Pe+G1tiAi.R.YYIiTilNilil��i4i9.ititli!GYYOiRiTiT!?MiN1GrYkGl�i-1PfrliliMTi�illiirifsiY�Do`NYifilltifitiRieiRy4i TiYH}i9YRY4�M i!i!irYGliNlii�i�2G!i!i4b4'G4i`!iBfiTiY4!GLiAilYiRillsN!•i?i IY±O.* BOARD OF HEALTH TOWN OF BARNSTABLE Yell Contruct ion Permit 0. Fee . Permission is hereby granted 2�% I of to Construct ( ); Alter'(. ), or Repair,( an Individual Well at-' ` No. Street- as shown on'the application7fo, a Well Construction Permit t-No.--- � � -�------- Dated ,� f9 9/-- _-------- ----------- --- DATE-- � Board of Health I -- L Perc Test P-9453 Date 012" NOTES SEI P.Sulllvan BoHeallh Dome Miorand Test Nola 1 L Water Supply ForThis Lot is a Private Will I. 0"-1" O Pine Needles 8 Leaf Matter t0YR3/1 2.Location of Utilities Shown on This Plan Are Approx. 1140" A Loamy Mad.Sand,some roots 10YR516 At Least 72 Hours Prior to Any Excavation ForThis 10"-34" B Mad.Sand 10YR 616 Protect The ControctorSholl Make The Required Notification to Dig Safe(1-800-322-4844) 34•-120" C Mad.Sand 2.5YR8/4 3 The Contractor is Required to Secure Appropriate Water Encountered ra 96" Permits From Town Agencies For Construction t Pero®43" Pre Soak 15 Minutes Defined byThis Plan. Drop 12"-9" 25 Gallons In less than 15 min. 4 Install Risers as Required to Within 12eof 9"41" 25 Gallons In less than 15 min. Finished Grade. Cis"f Material 5 All Structures Buried Four Feet or Mare or Subject- "tHds y to Vehicular Traffic to be H-20 Loading. 0"-t" O Pine Needles 3 Leaf Matter t0YR311 6 Septic System to be Instolled in Accordance With 1"-12" A Loamy Mad.Sand,some roots 10YR51e 310 CMR 15.00 Latest,Revision And The Town of 12•-32" g Med.Sand tOYR eIe 'Barnstable Board of Health Regulations. 37-120" C Med.Sand 2.5YR814 7. All Pi ping to be Sch 40 PVC Water Encountered®96" DESIGN DATA Single Family-4 Bedroom Clau f Mate" With no Garbage Grinder Doily Flow=I10 x 4 a 440 GPD Septic Tank:440 GPD It 200%=880 GPD Finish Use 1500 Gallon Septic Tank Grade LEACHING AREA "o 440 GPD/0.74=595 SF Required M -Compacted,Fill 3'Maximum Filter Use Bottom Area Only , Bottom Area=12'x 50=600 S.F. Provided. - Pea Stone LEACHING BED DESIGN 4"0 Perforate 3/4"-1 V2'Doutile All Pipes tobe Schedule 40 PVC 0 PVC Pipe iu Washed Perforated With Capped Ends.Use 3-4"0 Distribution Lines inal2'x50 3'-0" 3'-0" 3'-0" '-d' Washed Stone Leaching Bed as Shown. 12'-O" CROSS SECTION OF LEACHING BED Not to Scale F.G.188.0 F.G.186.0 186. 185.8 1500 Gallon 185.6 185.0 � Septic Tank IB 4 185.2 Bot.E1.184.5 Bedding as Per Title 5 5.0' 12' Bottom of Test Hold Elev.176.0 - Adjusted Ground Water Elev.179.5- DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM PETER Not to Seale " SULLWAN NO.29733 CIVIL USGS High Ground Water Calculation ` Cape Cod Commission Technical Bulletin 92-001 Index Well SDW-252 �` l Date Jun-99 Water Level Adjustment 1.5 ,tV - 1 ✓�� Tr i ca Gilligan Observed Water Elevation 178 38 BriarLane(Lot 2) JUNE 14,1999 W.Barnstable,Mass. Corrected Ground Water 179.5 SULLIVAN ENGINEERING INC. SHEET 2 Of 2 OSTERVI LLE,MASS. '9 r)L-( U Town of Barnstable PH Department of Health,Safety,and Environmental Services T Public Health Division Date G - /1:51 17 ,> Q, 367 Main Street,Hyannis MA 02601 i d►rwar,►ar; b U rFe IAA+" Date Scheduled �o/tea 9 Time �(Jc �YY7 Fee Pd. /B D• OCI Soil Suitability Assessment for Sewage Disposal F ,. Performed By: &rCYWl/" /0r Witnessed By:"0Oruwi4 Y•02ANP 1 Location Address Owner's Name e�o .......7r 7�1..a.-�'r� .Lt • v tov-tst �arrzs 1e r �. Address Assessor's Map/Parcel: mid/36 A_r e Engineer's Nam j1,'Vam NEW CONSTRUCTION. REPAIR Te:ephone# A Land Use L,OnSi• 6'�}/G• O Rhm,&bAtoX(y) 3Yo Surface Stones �o►mil t Distances from: Open Water Body IUD * R Possible:WetArea 0AJ R Drinking Water Well n . 5EE M,4&¢C-e Drainage Way SET GA(V 'R Property Line Id R Other R �� �AaSt'utet srU -. j. ..< SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) 11t / • I o I o N . Parent material(geologic) 0Ls T`v 4S t•1 Tt_A.YnJ Depth to Bedrock Depth to Groundwater: Standing Water in Hole: g G Weeping from Pit Face Estimated Seasonal High Groundwater k Z r Fog. %AAA-f t'—eo.Dt rU6 seE !6644,� E L Gl 'V��1> E..... . a..... .. S.Qr ►..:. .... .:........x.. .x. .. .. ........... ........... Method Used: 4.1.93-MW -001'::;; Depth Observed standing In obs.hole: °✓tiv" in. Depth to soil mottles: u E "�r G�''ln'i�'�' Depth!e lveepinn from side of obs.hole: 9�'' _ln. Groundwater Adjustment�.2! R. M�OQ.t? ta2L-tiSS .-index Well N SD1A> -Reading Dale: Index Well level Adj.factor Adj.Groundwater Level Nt o Tb UPPASE i-ol2 Jt)u>E Ei�Dltro6 t�r+�f411.,�Bc c� R4s►*t Tl+ , :,........ :...:::::::..:::>:::::::PERCC)LATLUNTEST:;>:::<::;::<::<:;<<b,(e: Observation Hole N i Time at 9" Depth of Perc _ Time at 6" Start Pre-soak Time Q 10'•1 Z 2 Sdo A t. ,o.al s t tJ Time(9%6") L.CSS T;IAM 1$NAtA1 End Pre-soak 10 Z• RateMinAnch Site Suitability Assessm 1.ent: Site Pasied E S Site Failed.'K-IA `" Additional Testing Needed(Y/N) 1A 0 Original: Public Health Division Observation Hole Data To Be Completed on Back rnnv Annlieanl 4. l[ole AV Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes. t AA _ 1Q� - Z ,I to _ ..LOst: SA O (p. ru©K� )At>t L rr .DEEP QBSERVATION HOLE LOG Hole#: 2. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell), Mottling (Structure,Stones,Doulderes. e O_ k a (� L eA it -s O eD 16y Z. M G-D SAS t D t2 �w, �,eaN ea+u 01G ,t � C120 32- �2o G M E05 1-5 C, . ,D�EI�' Depth from Soil Itorizon Soil Texture Soil Color Sml Other Surface(in.) (USDA) (Munsell) ~Mottling' (Structure,Stones,DouldereS. DEEP OISERVATION HOLE. LOO : Hole# .: XX :. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes. 0 Flood Insurance Rate Man: Above 500 year flood boundary No— Yes X 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 pervi us material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material?, Certificatipn nn s _ I ci tify that on"/�Qi?I(--9� (date)I have passed the soul evaluator examination approved by the ntal Protection and that the above analysis was performed by me consistent with Department of Environme the required training,expertise and experience described in 310�CMR 15.017. Signature Date 612-ZID9 1 CD wry m m VII m ® 1 JrORN Fm - 9 i + �s two mom u1." m ® _ iii N1.411J111 t SECOND R" PLAN SCALE: 1/�• � �•-Q• ww.w.` ~= A-02 � Illllllllllihullll• ■• Il�iflil ����l�ll►�►►il►illl►►►i►�►►ii llli���+i----- --',�! ►I►�II►►I►►►►►ii�l►►►illl��!�,���•��_ _ : .14111111 �IIIIIIIIII(�II��I.IIU .. •• 1 I��i i! ,IIII" _����IIII11116��������������� IIIIII�IIIIIIIIIIIII�i ��� �P �! III -�� • . . _.. _ I. _, �I „ f(q .LI+I,IIIIllllllllll�ll_� __� __ . Imo; ���■ r. CERTIFICATE OF ANALYSIS Page. 4 Barnstable County Health Laboratory Report Dated: 08/31/1999 Report Prepared For: Conrad &Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 Laboratory ID#: 9903410-02 Description: Water-Drinidng Water Sample M 03410-02 Sampling Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/1999 Collected by: Stietel Received: 08/24/1999 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 Toluene BRL ug/L 0.5 200 EPA 524.2 08/26/1999 Total xylenes BRL ug/L 0.5 10000 EPA 524.2 08/26/1999 trans-1,2-Di chloroethene BRL ug/L 0.5 100 EPA 524.2 08/26/1999 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 08/26/1999 Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 08/26/1999 Note: az Approved By: - «•-�--�-- (Lab Director) Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 F ai, r. CERTIFICATE OF ANALYSIS Page: 3 Barnstable County Health Laboratory Report Prepared For: Report Dated: 08/31/1999 Conrad&Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 Laboratory ID#: 9903410-02 Description: Water-Drinlong Water Sample#: 03410-02 Sampling Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/19" Collected by: Stiefel Received: 08/24/19" Benzene BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 Bromobenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Bromochloromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Bromodichloromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Bromoform BRL ug/L 0.5 EPA 524.2 08/26/1999 Bromomethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 Chlorobenzene BRL ug/L. 0.5 100 EPA 524.2 08/26/1999 Chloroethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Chloroform BRL ug/L 0.5 EPA 524.2 08/26/1999 Chloromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 cis-1,2-Dichloroethene BRL ug/L . 0.5 70 EPA 524.2 08/26/1999 cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 08/26/1999 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Dibromomethane tVRL ug/1_. 0.5 EPA 524.2 08/26/1999 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 08/26/1999 Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 08/26/1999 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 08/26/1999 Isopropylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Methyl-tert-butyl ether BRL ug/L 2.0 EPA 524.2 08/26/1999 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 n-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Naphthalene BRL ug/L 0.5 EPA 524.2 08/26/1999 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 08/26/1999 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 Styrene BRL ug/L. 0.5 100 EPA 524.2 08/26/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: z CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Dated: 08/31/1999 Report Prepared For: Conrad&Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 Laboratory ID#: 9903410-02 Description: Water-Drinldng Water Sample#: 03410-02 Sampline Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/1999 Collected by: Stiefel Received: 08/24/1999 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS MDL MCL Method# Tested LAB: GUMS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 08/26/1999 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,1-Dichloroethene BRL ug/L 0.5 7.0 EPA 524.2 08/26/1999 1,1-Dichloropropee BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 08/26/1999 1,2,4-Trimethylbenzene ;,#RL ug/L 0.5 EPA 524.2 08/26/1999 1,2-Dibromo-3-chloropropan BRL ug/L 0.5 0 EPA 524.2 08/26/1999 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 08/26/1999 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 08/26/1999 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 08/26/1999 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/26/1999 1,4-Dichlorobenzene BRL ug/L 0.5 5.0 EPA 524.2 08/26/1999 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/26/1999 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 08/26/1999 4-Chlorotoluene BRL ug/L 0.5 EPA 524.2 08/26/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Y: CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory Report Dated: 08/31/1999 Report Prepared For: Conrad&Sullivan Order Number: G9903410 Conrad Sullivan Box 272 Dover, MA 02030 Laboratory ID#: 9903410-01 Description: Water-Drinldng Water Sample N: 0341001 Sampline Location: 38 Briar Lane,Lot 2,W.Barnstable Collected: 08/24/1999 Collected by: Stiefel Received: 08/24/1999 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB: IC Lab Nitrate 0.8 mg/L 0.1 10 EPA 300.0 08/27/1999 LAB: Metals Copper <0,1 mg/L 0.1 1.3 SM3111B 08/27/1999 Iron <0.1 mg/L, 0.1 0.3 SM 311113 08/27/1999 Sodium 11 mg/L 1.0 20 SM 311113 08/27/1999 LAB: Microbiology Total Coliform Absent P/A 0 Absent P/A 08/24/1999 LAB: Physical Chemistry Conductance 126 umohs/cm 1 EPA 120.1 08/25/1999 pH 5.5 pH-units 0 EPA 150.1 08/25/1999 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 4. 4- r'JA \ \ \ \ \ \ \ P\ Locus Plan o a -- Ground Water Overlay Dist rict AP Zoning w District R Setbacks:30715715• I I 1 , 1 I 1 ', '1 �, \\ \\ \\ \ Well-septic Layout Conforms to '' and I 1 I , 1 1 1 1 \ \ \ ---- \, I I ' ' , I 1 `, 1 , ` \ \ Master Plan as filed at the Board of Health I I III I I 1 1 \ 1 1 \ Assessors Map 136 Parcel 55-2 . Ezisting , I 11 I 1 I \ \ \ \ 1 1 \ '\ A. * A A 1 DJainoge Easement 1 I I r 1 , 1 1 \ 1 \ \ \ \ - / - W 2 Area=44,175sf r 1 1 \ There are no wetlands within 100 feet of thb proposed leaching facility. There are no prvate wells within 150 feet of the proposed septic system. O a \\ o There are no variances requested or needed. 04 The proposed foundation shown hereon complies with the Sideline and Sel'back requirements for the Town of Barnstable. \ For landscaping and architectural details please J \ \ \\ / •s \ \\1 '` \\ \\\\ \`\ \ \\ see plans by Du ckhan&McDougal Architects q[ Q q ,'� Jt PCi PoS�D 4�(Z• ` \ ' A' � k >�16 is � N�� r �T C ! �'41-1 \ �•off ro4 R ti \Q / loo 1 b RESQR,� - , Site Plan PLAN VIEW r \ � �, � 1 � PRIMA Ry \; s 38 Briar Lane (lot 2) Scale-I = 40 `� . ",-- , \\ West Barnstable Mass. \ For:Tricia Gilligan. Scale: 1"—4W �I a. 1 a i ,' Date June 14,1999 -96.07,-- Sullivan Engineering.Inc. A, 7g-4 W t / Plan Revision July 20,1999:Existing Well Location Lot g Osterville, Mass. SHEET I of 2 99oyy Ni A Locus Plan Ground Water Oveday District AP Zoning District RF Setbacks:30'/15'/15' 1 Well-septic Layout Conforms to — F sq,� Master Plan as filed at the Board of Health ci , 1 \ 1 1 \ \ \ A. Assessors Map 136 Parcel 55-2 ' I , ` 1 1 ` y Lot 2 Area=44,175sf 41'r�v/ • I I I � I I , 1 1 1 1 1 1 \ There are no wetlands within 100 feet of the proposed leaching facility. There are no private wells within 150 feet of the proposed septic system. There are no variances requested or needed. \C \ QO The proposed foundation shown hereon complies with the �� m'\ a r Sideline and Set`.•?ack requirements for the Town of Barnstable. \ 1 m I 1 For landscaping aad architectural details please 'see plans by Duckhan&McDougal Architects PTEI; P�OSQLLiVIII ' \ HOUSE \ \ I,�Q.29733 �, ` 5 C1ViL Is i o dv R,° \ \\ \ •\ \\\ ry0 Otis\ ,:�� " PL AN VIEW h Scale:I"=40' sox SIMPTIC 1 \ \ • TAN K Site Plan 38 Briar Lane (lot 2) PRI West Barnstable Mass. For:Tricia Gilligan. Scale: l"a 4W Date June 14,1999 Sullivan Engineering Inc. ' IV Osterville, Mass. / 'e 42'se w tan Revision July 20,1999:Existing Well Location Lot 1 SHEET I of 2 ' 99oy . y