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0090 BURSLEY PATH - Health
?90, Bur-s(ey Path W. Barnstable -A =11101-025003 r . • v .. ,. ^, a - � .. ... a ., r y$ 1, CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory \ss�cHLic��' Report Prepared For: Report Dated: 11/14/2008 Dick Martin ERA Cape Real Estate Order No.: G0849957 965 Route 28 Yarmouth, MA 02664 [Laboratory ID#: 0849957-01 Description: Water-Drinking Water Sample#: Sampling Location '90 Bursley Path,W.Barnstable,MA) Collected: 11/5/2008 Collected by: A.Ryan Map 110 Parcel 025/003 Received: 11/5/2008 Routine +Ammonia ITEM. RESULT UNITS RL MCL Method# Tested Ammonia ND mg/L 0.20 EPA 350.1 M 11/5/2008 Nitrate as Nitrogen ND nig/L 0.10 10 EPA 300.0 11/5/2008 Copper ND n g/L 0.10 1.3 SM 3111B 11/14/2008 Iron ' ND mg/L 0.10 0.3 SM3IIIB 11/14/2008 Sodium 18 mg/L 1.0 20 SM 3111 B 11/14/2008 Total Coliform Absent P/A 0 0 SM9223 11/5/2008 Conductance 82 umohs/cm 2.0 EPA 120.1 11/5/2008 pH 6.8 pH-units 0 SM 4500 H-B 11/5/2008 1 .Water sample meets the recommended limits for drinking water of all the above tested parameters. Approved — -----... - — (La rector) i!1 K7 F t..l� rrrl N ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court Mouse, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 L� CERTIFICATE OF ANALYSIS �,•: Page: 1 Barnstable County Health Laboratory Report Prepared For: Report Dated: 11/7/2008 Dick Martin ERA Cape Real Estate Order No.: G0849966 965 Route 28 . Yarmouth, MA 02664 Laboratory ID#:1 0849966-01. Description: Water-Drinking Water Sample#: Sampling Location 90 Bursley Path,W.Barnstable,MA `c Collected: 11/6/2008 Collected by: J.Schildge Map 110 Parcel 025/003 - Received: 11/6/2008 EPA 524.2 - Volatile Organics by GUMS ITEM RESULT UNITS RL MCL Method# Analyst Tested Note Dichlorodifluoromethane ND ug/L 0.50 EPA 524.2 vn 11/6/2008 Chloromethane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Vinyl chloride ND ug/L 0.50 2.0 EPA 524.2 yn 11/6/2008 Bromomethane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,1,1,2-Tetrachloroethane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,1,1-Trichloroethane =•'• ND ug/L 0.50 200 ;EPA 524.2, yn 11/6/2008 1,1,2,2-Tetracllloroethane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,1,2-Trichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn 11/6/2008 1,1-Dichloroethane,_ ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,.1.-Dichloroethene ND ug/L 0.50 7.0 EPA 524.2 yn 11/6/2008 1,1-Dichloropropene ND ng/L 0.50 EPA 524.2 yn 11/6/2008 1 2,3,-Trichlorobenzene ND ng/L o.so EPA 524.2 yn 11/6/2008 1,2,3.-Trjchloropropane ND ug/L 0.56 CPA 524.2 yn h/6/2008 1,2,4-Trichlorobenzene ND ug/1- 0.50 70 EPA 524.2 yn 1 Ii6/2608 1,2,4-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,2-Dibrorno-3-chloropropane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,2-Dibromoetllane(EDB) ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,2-Dichlorobenzerle ND ng/L 0.50 600 EPA.524.2 yn 11/6/2008 1,2-Dichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn I l/C�/2008 1,2-Di:bloropronane ND ug/L 0.50 EPA 524.2 i yn ll-(W2008 i 1,3,5-Trimethylbenzerie ND ug/L 0.50 EPA 524.2 Fyn 1 1/6/,2008 y''n �` 1,3-Dichlorobenzene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 1,3-Dichloropropane ND ug/L 0.50 EPA 524.2 vn 11W2008 1,4-Dichlorobenzene ND ug/L 0.50 5.0 EPA 524.2 C n I I/F/�008 2,2-Dichloropropane, ND ug/L 0.50 EPA 524.2 „ 11!(ez'008 2-Chlorotoluene ND ug/L 0.50 EPA 524.2 y 11/(t/-£008 %.- . N-1 fTt 4,Chlorotoluene ND ug/L 0.50 EPA 524.2 y, 1 v6!26ba B NI) ng/L. 0.50 5.0 EPA 5?42 yn 11/6/2.009 enzene, 7tc,z. �• ,F,.,�a .• ; .Brornobenzene ND u;/I. 0.50 CPA 524.2 yn 11/6/200.s 8 Bromochloi:omethane ND ug/L 0.50 EPA )24.2 yn 1/6/2008 Bromodichloromethane ND rig/L 0.50 EPA 524.2 yn i v6/_iirig Bromoform ND ug%L 0.50 EPA 524.2 yr: 1 1/6/2008 ND=None Detected RL = Reporting Limit MC:., Maxnniu,l Contaminant Level ,' 3'- Superior Court.Rouse, PO.Box 427, Barnstable, MA 02630 Ph: 508-3'75-6605 CERTIFICATE OF ANALYSIS Page: 2 o �s Barnstable County Health Laboratory STtryty Report Prepared For: Report Dated: 11/7/2008 Dick Martin ERA Cape Real Estate Order No.: G0849966 965 Route 28 Yarmouth, MA 02664 Laboratory ID#: 0849966-01 Description: Water-Drinking Water Sample#: Sampling Location 90 Bursley Path,W.Barnstable,MA Collected: 11/6/2008 Collected by: J.Schildge Map 110 Parcel 025/003 Received: 11/6/2008 EPA 524.2 - Volatile Organics by GUMS ITEM RESULT UNITS RL MCL Method# Analyst Tested Note Carbon tetrachloride ND ug/L 0.50 5.0 EPA 524.2 yn 11/6/2008 Chlorobenzene ND ug/L 0.50 100 EPA 524.2 yn 11/6/2008 Chloroethane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Chloroform 1.8 ug/L 0.50 80 EPA 524.2 yn 11/6/2008 cis-1,2-Dichloroethene ND ug/L 0.50 70 EPA 524.2 yn 11/6/2008 cis-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Dibromochlorometliane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Dibromomethane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Ethylbenzene ND ug/L 0.50 700 EPA 524.2 yn 11/6/2008 Hexachlorobutadiene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Isopropylbenzene ND ug/L 0.50 EPA 524.2 ,vn 11/6/2008 Methylene chloride ND ug/L 0.50 5.0 EPA 524.2 yn 11/6/2008 Methyl-tert-butyl ether ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Naphthalene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 n-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 n-Propylbenzene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 p-Isopropyltoluene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 sec-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Styrene ND Lig/L 0.50 100 EPA 524.2 y11 11/6/2008 tert-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Tetrachloroethene ND ug/L 0.50 5.0 EPA 524.2 yn 11/6/2008 Y Toluene ND ug/L 0.50 1000 EPA 524.2 yn 11/6/2008 Total xylenes ND ug/L 0.50 10000 EPA 524.2 yn 11/6/2008 trails-1,2-Dichloroethene ND ug/L 0,50 100 EPA 524.2 yn 11/6/2008 trans-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 11/6/2008 Trichloroethene ND ug/L 0.50 5.0 EPA 524.2 yn 11/6/2008 Trichlorofluoromethane ND ug/L 0.50 EPA 524.2 yn 11/6/2008 ' Approved B (Lab D ctor)i. ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '( 90 BURSLEY PATH Properly Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. Cltyffown State Zip Code. Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. lmpO1ta"t` When filling out A. General Information forms on the computer,use only the tab key 1. Inspector:to - cursor-do not move your DOUGLAS A. BROWN c t� use the return Name of Inspector C7 pM1y key. D.A. BROWN Company Name - `-; te6 P.O. BOX 145 a.v Company Address ' CENTERVILLE MA � 02632 Cityrrown State Zip Code 508-420-4534 S 14297 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10-29-08 pec r' atu Date Th stem inspector shall submit a copy of this inspection report to the Approving Authority(Board of ealth 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. Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE MA required for 10-29-08 every 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: SYSTEM INSTALLED IN 2002 B) System Conditionally Passes: ❑ One or more system components as described,in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed Title V Inspection Form.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. City/Town State Zip Code Date of Inspection B. Certification cont. B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: 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 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. Title V Inspection Form.doc•08/06 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments y` 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE MA required for 10-29-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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 '/day flow ❑ ® 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. Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments r 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 f regional office of the Department. Title V Inspection Form.doc-08106 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments Y` 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. Citylrown 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)] Title V Inspection Form.doc•06/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE MA required for 10-29-08 every page. City/Town State Zip Code Date of Inspection 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 Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): WELL Sump pump? ❑ Yes ® No. Last date of occupancy: CURRENT 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: Last date of occupancy/use: Date Other(describe): Title V Inspection Form.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: PUMPED LAST IN 2006 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: MAINTENANCE 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: S.A.S INSTALLED IN 2002 BY ROBINSON SEPTIC Were sewage odors detected when arriving at the site? ❑ Yes ® No Title V Inspection Form.doc•08/06 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments y 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 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.): Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El 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 GALLON Sludge depth: 811 Distance from top of sludge to bottom of outlet tee or baffle @26" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 3" Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Title V Inspection Form.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachu setts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE MA required for 10-29-08 every 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.): TANK COULD USE PUMPING 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 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): Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form.Subsur face dace Sewage •Disposal System Page 10 of 15 P Y 9 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments '( 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 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.): BOX LEVEL NO LEAKAGE Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Title V Inspection Form.doc-0=6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r` 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE MA re uired for 10-29-08 every page. Cltylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: NO RISERS INSTALLED CHAMBERS ARE DEEP Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ 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.): NO EVIDENCE OF HYDRAULIC FAILURE, COULD NOT TELL LEVEL OF PONDING Title V Inspection Form.doc•08f06 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is required for W BARNSTABLE MA -08 every page. Ctty/Town 10 State Zip Code Datea of f inspection D. System Information (cont.) 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 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.): Title V Inspection Form.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA -08 every page. Clty/Town 10 State Zip Code Datea of f Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 5� 4G o Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s 90 BURSLEY PATH Property Address PARKER Owner Owner's Name information is W BARNSTABLE required for MA 10-29-08 every page. Cltylrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to ground water: 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: Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 TOWN OF B�ARNSTABLE LOCATION �� 1611 YL�Str'(/ T/yi SEWAGE # (5;?- 4 VILLAGE Zc./ bI 1p ASSESSOR'S MAP & LOT 110-02s-A3 INSTALLER'S NAME& PHONE NO. , ob�.41 SEPTIC TANK CAPACITY 'LEACHING FACILITY: (type),,r°°' c�`� e"Z L (size)/3 NO. OF`B.EDROOMS �L 4 BUILDER OR OWNER GCiC� zU I i PERMITDATE: nt — I '�'"6 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 site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by b Q4 Fr r No. 02— U{7 - % y FQt50 -00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppfication for Migpogal bpgtem Congtructton Permit Application for a Permit to Construct( )Repair(x4 Upgrade( )Abandon( ) l Complete System K7 Individual Components Location Address or Lot No. 90 Burs 1 ey Path Owner's Name,Address and Tel.No. Assessor'sMap/Parcel W. Barnstable Joseph Wojtkowski _ o Installer's Name,Address, d Tel.No. Designer's Nvne Address and Tel.No. Wm. E. 1 `obinson Septic Servic Daniel Johnson P,-O. Box 1089 804 Main St. , Suite B Centerville MA 02632 O A 02655 Type of Building: Dwelling No.of Bedrooms t'� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building re s-,den t; a 1 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) We will install a new Title-5 leach system to' the plans of Daniel Johnson #J-805 dated 9/6/02. 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 Certifi- cate of Compliance has been issued by this and Health. P/ _ Signed , I, 'tom Date Application Approved by Date 61-0 7a2 Application Disapproved for a following reasons Permit No. `�SL62 —�6� Date Issued -02- 9 y . DO ' Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Zlppricatton for Migogal *pztem Con!truction Permit Application for a Permit to Construct( )Repair(X4Upgrade( )Abandon( ) .j6 Complete System X1 Individual Components Location Address or Lot No. 90 Burs 1 ey Path Owner's Name,Address and Tel.No. Assessor's Map/Parcel W• Barnstable J Joseph Woj tkowski Installer's Name,Ad ress, d Tel.No. Designer's N e ddress and Tel.No. Wm. 1 . 1oobinson Septic Serv4b� Dan e Johneon t . . P,.©. Box 1089 804 Main St. , Suite B Centerville MA 02632 Osterville. NIA 02655 Type of Building: Ll Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building rpa i oripnt-i As'h No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. v Description of Soil Nature of Repairs or Alterations(Answer when applicable) We will install a new, Title-5 leach system totthe plans 66 DaniellJohnson #J7805 dated 9/6/02. 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 Certifi- cate of Compliance has been issued by this Booard Health. Signed - I ,,✓Cr Date Application Approved by _ e5 Date q—/a-0� Application Disapproved for Re following reasons Permit No. !;L U 0;2 -qd b Date Issued -r?-O.Z. THE COMMONWEALTH OF MASSACHUSETTS Wo j kkowski BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(xx*Upgraded( ) Abandoned( )by Wm. E. Robinson Septic Service at 90 Bursley Pshh, W. Barnstable has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Odd �04 dated 61-0-d a Installer=,'Wm. E. Robinson Sr. Designer Daniel Jo ns` The isgtua ce'jof this permit shall not be construed as a guarantee that the s s il functio designed. Date I 1;21 t)2 Inspector J No. o -L�d6 450.00 Woj tkowski THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 1i9;po5a1 *p5tem Congtruction Permit Permission is hereby granted to Construct( )Repair(xx)Upgrade( )Abandon System located at 90 Burlsey Path, W. Barnstable 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. 3. Provided:Construction must be completed within three years of the date'of this permit. p Date: /z-ci a Approved by i TOWN OF BARNSTABLE E LOCATION JVd T/�j SEWAGE # 60�-'- VELLAGE ,. / ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEAGHING,FACILITY: (type) cs`- 1; oZ L (size)/3"3 NO. OF BEDROOMS BUILDER OR OWNER 1 09 PERMIT DATE: z�— J �-"6 COMPLIANCE DATE: 6�- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Frame� 1� u ,y >. a 5MI01 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, y'4'J` �` J'rF-ter rJ , hereby certify that the engineered plan signed by me dated s/6���, , concerning the property located at 9� e meets all of the following criteria: — • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. (SeB" 9-4) • The bottom of the proposed leaching facility will not be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. (Adjust the gi-oundwater table using the Frimptor method when applicable) Please complete the following: A) Top of Ground Surface Tlevation (using GIS information) < a A B) G.W. Elevations +adjustment for high G.W. ��14j� DIFFERENCE BETWEEN-A and B 6 f X T7ZrsT /aiT Pe �a•ti.,.�9 SIGNED : C� DATE: 9 Z6 o X _ j NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. a _. q:health folder.percexmp 6 a%�I /% 0 ;2 5 � No.�e ---_�`�� F>zs.... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD' OF HE/A' LTH C.e ...............OF..... .J� a 14 ...._...-_..................... Appliration for Dis 1 Works Toni rurtion Vantit Application is hereby made for a P r Con r ct ( or Repair ( ) an Individual Sewage Disposal Sygem at: Loc n ddre or Loi f ._.." I- �?'. _ 6._ :.tz:. -` In ....... g] O ner Installer ,a Addfess Q Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixturos W Design Flow...................... . _. gallons per person per day. Total daily flow--------------------------.__._____._......__..._gallons. 1:4 Septic Tank—Liquid capacit 5_00.gallons Length................ Width................ Diameter-----------------Depth---------------- Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. 3. Seepage Pit No-----------_--_---- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z `' Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... D th to ground water........................ P.', --•-----------•-----------•-•------•--•-•-•----•-•---•-----------------••---•-•........... •. ------. ------ ........................................�.�_.. ._Description of Soil -------- ------------ x V --•-•--•----------••-•-----------------------•-----------------•-------------------- = ----------------•--------------------------------------------- ---- W •------------------------------------------------------------------•----•--•-------- ......------.... ---•----•--••-••••---•••--•••••••--•••••••-•---•......•--•---••••--- U Nature of Repairs or Alterations—Answer when applicable_ _ __________________________________________________________________________________________ -•------•---------••-•--••--•---------•----------•----•------•---••-•-•-----•-••-•-----•-------•------................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITi p 5 of the State Sanitary Code=Tie un`fic ers ned further agrees not to place the system in operation until a Certificate of Compliance has been ' y the oa ealth. gne - � Lac 1��...-' t Application Approved By....- -- ..... •. • ••-••.............•••-.....--•-----......-•-•------ l 7 -----...... Date Application Disapproved for the following reasons:••-•----••-----------------•------------•----------•-------------•-------------------•-••-............-•--.----- ........................................................• .... .-----------•-----------•--. --•-•------------------------- --- • Permit No... .�.��....... -----•--•----------. Issued-........................................... a e ............ Date THE COMMONWEALTH OF MASSACHUSETTS r OARD OF" HEALTH aW .OF..... .. .1 .. ..L ....... z (� Trrtifiratr of Toniplitanrr THIS IS TO CER Y t th jai 'KI Sewage Disposal System constructed ( ) or Repairedby--•---•--•-•-•----- !_t�1 y ' YJ. - --------------------- --------------------•------------.- y at............ has been installed in accordance with the provisions of TIT E Th tate Sanitary Code rs es ed in the application for Disposal Works Construction Permit No _."'� sue_ __ ____ ____________________ PP P u S�i Ca ENS I. THE ISSUANCE OF THIS CERTIFICATE SMALL NOT B,549 !f �a T YAW� �tPHE WRITI G SYSTEM MfILL N I N SATISFACTORY. rHE SYSTEM VJAS INST D I�T IG 6 G_�j �CCORaAN DATE. � TD.V.... P Ins ector-----------••_....CE..7.Q.PLAN-. .�- -7 �' �� NO. Fps............_............... THE COMMONWEALTH OF MASSACHUSETTS BOARD-OF HEALTH ............................. Apptiration for Disposal Warks Tontrnrtion Permit Application is hereby made for a Permit to Construct (}( ) or Repair ( ) an Individual Sewage Disposal Systprn at: T,ocat i- /dyes or I,ot N,o. t w"er��r� ��.-•• �GCV � �� — j•-•• I}�/'� < ��Address"fit � �4��rr l z Z l _-__ _ f.�Y�'sCC�i�c"lt -- -- -- - ---- nstalier Ad reSs _�..._..._ lam_+ Type of Building Size f,ot............................Sq. feet U Dwelling—No. of Bedrooms--------- T _._..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _______________"__--- ...... No. of persons............................ Showers ( ) Cafeteria ( ) dOther fixtures ---------------- -------•--------------------------"--••••---•-•••-•-•---•-•••......--- ------.._._...----•••--•-•••••-•......--•-----•-•-••----•--•- W Design Flow............... ___ ___ __________gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid ca a -gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—No. ______-_-_I-50OWidth.................... Total Length.................... Total leaching area___."_---____---•---s . ft. x a q Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by............-.............................................................. Date--------------------------------------- Test Pit No. 1_---------------minutes per inch Depth of Test Pit.................... Depth to ground water-___"..___-__-____-____. LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... D pth to ground water.________-_____-_._.__.. P4 ----------------------------------------•-••----•••...-• --••-•-••--------1�--- pp l� D Description of Soil .fE-� ............................................................. .;-... 1 x :�-•••. -•-••-•--•-•••••-•--••---•--••-••----•-••----•-------•-•............. U Nature of Repairs or Alterations—Answer when applicab le.U________________--------------------------------------------............................. ..-----""--------------------------------------------------•-•-•.........._.._..•--•••...............••......-•---------------••---•••-•-••••-•._...-•-•-----•---------•••------•---•-•-.........--•---. Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with the provisions of'TT LE j 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. Signed.--. ................. Date Application Approved By....._. .. _ _. ._ Application Disapproved fort a f llowing reasons-----------------------------------------------------------------•-......•---- ----•-•-- ...••---•-•-•-••----•-•-•••--••----•-•--••--••--••--••-•----•--•---•-•••--...---•-----••-....-•-•--....-- Date i Permit No F 7.7.-----=q.................... Issued....................................................... —� Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........4r.V . #�. OF......... ... . ..: .... ... ./'.-�.'. ..:......./.....C......... THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } bY•---•-••-------•-. ----------------------------------•----------------••------•-•-----•••- -V.._ q � ,ey.. Vy.--y-¢--•--•--Installer-----.. hl at ]��1 -�L/' , )` , ,,�,, f---- t ---- has been.`°'x'lled �dOYaaf1CC wii�Mlle ia�mi�i t r. e to ain" e application for Disposal Works Construction Permit No..-•-. - -".... _ .__.__ dated_...-----!�-----��------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FU T10,N1 SATISFACTORY. �r � DATE.....•.....-----•_.....V. ---..................................... Inspector................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 0,A7 H/E,AL�T�H� ��.���tl.. .0F.......8A, `:�1�.A.%".. u,1 ...................... N0........ ' �- 37 FEE......... ........... CVJ Disposal Works Tonstrwtio mermit Permission is hereby granted.............. - =�r .'�• i`-..i t)�.............................................................. _ to Construct ( or Repair ( ) an Individual Sewage l� ) feet-ys �' r� 1 'su as shown on the application for Disposal Works Construction Permit No..... �D' ted ._.4....... .......... ---------- ------ DATE..................../-fi-=--1::1C--n�1................................. Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISKERS 1 � r Department of EnvironrC4ntal Management/iJivision of Water Resources i WATER WELL COMPLETION REPORT WELL LOCATION Address 6 +3a r ` fi �(�t/ J✓�J City/Town l..l a< 60 r f1 'e_ G.S.Quadrangle Map Grid Location / Owner l&--k r J4e,r,11Pt1 W r-- Address#cb6�,, _--�/(7. '�S�f1�r.•�, ^h WELL USE CONSOLIDATED WELL Domestic Q Public ❑ Industrial ❑ Type of Water-bearing Rock Other � Water-bearing Zones Method Drilled � 04/Z I,u 1) From To Q . 2) From—To— Date Drilled M—r1 — 3) From To 4) From To CASING Depth to Bedrock `/i/ Length �la 1 Diameter "�' Type /C UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials O Feet below land surface 70 Sand: fine❑ medium® coarse Date measured /O— 99 Gravel: fine❑ medium❑ coarse❑ GRAVEL PACK WELL Screen: ❑j Yes El No Slot# AR length � from to Q' Split Screen (or 2nd screen) WATER QUALITY TESTS MADE r Slot#F length from to Chemical icy Biological ❑ Depth To Bedrock PUMP TEST Drawdown C) feet after pumping days hours at 6?0 GPM. How measured_ 00 1 rW M/!1 Recovery feet after hours. x LOG of FORMATIONS COMMENTS: (On well or water) Materials From To. 0 m 'f DRILLER/ f �T(YI Firm r�O�!� (J)f�11 /r if G ° Address_ Ph t�k woo `J City Registration No. /41k Aerators ignature Please print rrm y BOARD OR HEALTH COPY 2SM•10•85•807101 tt}T• •SS7'!2SSt!!t .!STt lSSiiT lT2TSS!lt2SS!lSt2SilTT2T fiT!l2tT2S2221TSTTT2ST2tS2T!}!!l2S2t!!!!ilti2tilt2t!lS22!!2SSSt !t!T!t!t!!!2tlt!!SltTtSi!lTT22ttLSSitlSSLLitli!lLii ti!Lt!LliiilSiSlS2SSfSt22722l242t22T2t STT :::: `:` T:::'}i ::::p::��:e :a��::::::�:::::::::::::n:::::::n�.................... n:::::�;.. .. � :: ::. .. •, ... ENVIROTECH LABORATORIES 449 Rte. 130• Sandwich,MA 02563• (617) 888-6460 CLIENT: Peter Hawley LOCATION: Lot 32 Cedar Street ADDRESS: Box 317 W. Barnstable,MA E. San wich,MA 02537 .: COLLECTED BY: Meehan Well SAMPLE DATE: 10/20/87 TIME: 8:35 AM DATE RECEIVED- 20 87 SAMPLE ID: ET A JOB #: New Well WELL DEPTH: 130 ft _ RESULTS OF ANALYSIS: Parameter Units Recommended limit Result E6E Coliform bacteria/100 ml (MF Method) 0 0 PH PH units 6.0-8.5 6.71 Conductance umhos/cm 500 79 Sodium mg/L 20.0 14.4 = Nitrate-N mg/L 10.0 <.05 Iron mg/L 0.3 .16 r Manganese mg/L 0.05 x Hardness mg/L as CaCO 3 500 Sulfate mg/L 250 Potassium mg/L 20.0 Alkalinity mg/L 200la Chloride mg/L 250. EE' COMMENT: EEE: YES NO X)RX ❑ WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TEST D DATE U » '}r• i�t i:at lti r tli t. i.:t t ill . 1 isss#:##i##:#####I###:#i##siiii###ssi:ss##sssss##.s.ui#Ifii#iiss#iii####ii######i###sssf i.s:::#iii#i#isss:#ss:lssss#ssls..usss:sssi###isssi#s#s::slssssus##s#i#i#i#Iti� SOIL LOG NO. 1 0 NO. 1 SITE PLAN F 5111L L Q G, A S k ..N;T A CT , �. f r 3 t�Czr�►JQ D t � .tk.; is 3t �� # C �" ,i ,. TOP OF FOUNDATION El.. ___..____. ,,� ,� s � � ��.� E !a R s(, n1 A r try" 1`►tIE .; • s '!" •• ot • • -` ( M{�X �'`� -- �2 CanAvc t_) :.' wit. �..� 5g 1 •'� 10 IN.EI. . IN.Et. 58 I Ma / SZ4 1 2 COVER 1/i-3/B WASHED STONE n)6 Vj A rCk, . 4 11 { / W/ i" MP IN. Et _.z_�!,:0*0 p I•r•�s� 3/4"-- 1-1/2 WASHED STONE . 13 4' LIQUID LEVEL D A SU �; • ; • °,` 14 J ° i'EFF. DEPTH ; � - 1 S Le,!�-lll 'P67- PERC TEST RESULTS s • •ol�fPRECAST SEPTIC TANK WITH PRECAST LEACHING PITS PERC RATE :CAST IN PLACE INLETANDEl. � NO.: 2- SIZE : . ':' x � 'E _.,.e�........_... WHITNESSEO BY: OUTLET T 'S PER TITLE Y W-As+1�G y�;,T,v �' a = Iry E BAeA)57'�3LE —BOARD OF HEALTH SIZE : F ' OIA . _ " �F , �.+c� DATE: L�GTO�'3E 25, sc7 1f926 L 3 f.-_— C-7 LL0tJ ` o® — , t- 4- 1 Nam. , .. n + , ICE no des ��LL 1"YE C %J? 005 (5 Lv�'5' 5o►� • Loan) � IATtkt Fx , 13' AL-L ARvooO � '► .....,r. PROFILE OF PROPOSED SEWAGE SYSTEM ��D LNLL W IT 4 �L_ EhN C SYSTEM DES16NED BY THE TOWN Of 3A � 57 � REGULATIONS AND � � +43�E.c�. .EQ �c= . Rt STATE TITIf FOR SUBSURFACE DISPOSAL Of SEWAGE . SCALE : 1/4"= 1' 0" � �0so NeBe �> � - ✓c kT VA Tip�J `' /R JAN • --�'` I. ALL PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPE {G"'`�` Lo�rrLA.) ; 2._ ALL PIPES SHALL BE SLOPED 1/4" PER FOOT EXCEPT FOR .. THE FIRST 2 F ET OUT OF THE O / B WHICH SHALL BE LIVE! 1 r 3.. DESIGN FLOW BEDROOMS AT 110 GALOAY PER ON. GAL/DAY '" ~�--���.r ,,, ' �?o eL "oo` SEPTIC TANK SIZE 4- 40 X 1� 5 a ��� GAL. USE 1 o GAL. W/ Q.L,2� GARBAGE DISPOSAL f �� �' `t LEACHING SYSTEM. USE L ) - x�okb � EFFECTIVE AREA: SIDE BOTTOM iT� ion=� x , �3a = 49 r3ro= 15 .. _ r TOTAL FLOW ,v = 11.5 0D TOTAL REQ O FLOW X W/�._. GARBAGE DISPOSAL I v o RESERVE FLOW 76 - 4.4o ter 1 8 /Al/BAy ,. Gs � ;/c � � 4 .REFERENCE PLANS : a ng} JJ w. I# - — APPROVED BY : asa s _ra s t fv � • BOARD Of NEALTN DATE : S AN K �A �,✓Z_ - r TE D SEWAGE R—AN PROPERTY OWNER . �' _ .,_.. — ..��,. j"'G) J/ l+ l\ ■ ... .��n. • r a f iV rA A VJ L- E' l lU G T / 4 4- BED R.OWth Ail P1AM FAWA ILM l w G ELL_ c P't wt. ( ^ _ f= ✓� `� _ 'f %�s4 TM i G� r� A iJL W T IF 23 � tAsa 1e } i AL -S �j „ . .. .. .:,✓:c a r€' .. ,. +f*-., . , a t rr,,7:.- r` C^y .;,. "9r. :..',:r ,. .., .qe^. n .., ........_. ,, . .. 6S" •.. .fie ,,.+1-Y1+,...""'a e„ _.. a: • .. s.,.,ar F. _. Y°. ,, ,.. ,. _--:.!` w ,,; ., ,:- a .. -:+..*.T e, -. vi':m .. ,ta .. irk .. _'� _ ?"”? .„ ;, .,, ,.. ,. .. 4 .. _ ,-, "fit•:" ' . .- � ar.,, , QEPT16 S Y STEM DISTRIBUTION Box ABurtElt H 10 S(/k LE : I "7 2-0 I REMOVABLE COVER (AttrwX� TEST PIT DATA I / 4"SCH 40 OUTLET LATERALS DISTRIBUTION BOX TO MEET �t % SHALL BE SET LEVEL FOR A — ------ '- % REQUIREMENTS OF 310 CMR J MINIMUM OF THE FIRST TWO Performed By: Daniel B. Johnson j 15,232(WATERTIGHTNESS. / FEET AND CONNECTED TO CONSTRUCTION,ETC). r• EACH DISTRIBUTION LINE Date : August 1, 2002 I ��` j f f + N0. OF flUTLE1S 3 4„SCH 40 WITH SOLID SCH 40 PVC PIPE I 6., I TP-1 (EL. - 98 .9) O 11"0 6"(MINI o 0 0 o S OHANICALLY CRUSHED f r, ,. I � - �4 A/Fi ll Sandy loam , STABLE LEVEL BASE f 34" 52" 8wB, 10YR5/8 Loamy fine sand 52" -132" Cl, 2. 5Y8/2 Fine sand LEACHING DRY WELLS 500GALLONS No Observed BSHWT w Observed No Obsed Groundwater u '1vND"CROSS SECTION ^Q' •. �'1� / S�� ` MODEL. SHOREYPRECA5T CONCRETE � rn rS S },1 PERCOLATION TEST DATA I FINAI,GRADE TO BE STABILIZECr , y FINISHED GRADF(SLOPE - 02) /e7,4 5+ Da L e. ,Ats q u t 1, 2002 � � Soil C),a : Class (0.74 WSF) 1 .. . _.. ,. . ._ �H ,10 96 LEACHING DRY WELLS 3 �.C/,OQE ji / nS b' �✓1 Pere Rat"; < 2 MPI (TP-1. ) � B F"I-X4'1WWXZ1"W � WASH STONE j.E��l+tE 7 _ :-. - y> N plE o { I r1VERA ,LEACHING AREA 4 � 4' r.. •+ ,� 3I4" 11/ 'DUUBLfi 9�iot {---- 13 Lit 13'WX2 H , 4: 2°�' e WASHED TONI" 9 / rB (S66 n/erE $Stow) -- _ e JIu SCHEDULE OF ELEVATIONS at _ .- we IC. ' 1 D,2v tdFf.�S ^•pro 9� ` U ��/ „' i f JII)MF'l`UWITtWE Snv. jat.i(n i3 :r ;,rrl bENCHfAA K T1t? . 4-tptic Tank (+91s ,c t,o ; j . ' - ---� _ .._ B,B„ -_,...._ ...r x_ _ 1 REQUIREMENTS OF '' 9 91 ti 9yr� 99 A!s.MC EL:,o0.00 I 41Pt is Tank tex131: 1 tiq )10CM1415252 " * d ,Sa roP of co„cc,z�rlr 1 Is°v I ri. tt`l,b-ut•lon Box 0 1nv . ow Cs.�: t�`It�u� l�rs l��aF: •pis �. SAS /h ,/00 woos Al'+ 3 CX r t i ,S!; i A° 4� �!? r f,'!Wi''"HW f _. PAZ-E fir s TrM(r P,gr�o .�,��_/CLIPfE� ( ---•-- •-----____.__..__._.___-.____. __ ..... �,� - - _..____. . ...._.. __ ____-._. ..._.__._.____._._,_._._...._ r lSoo 6AJLor4 a ,� xp SEpt L BANK _ j NOTES /OUXb �� Q Exist n Cott our 'd/ `Lq _ All construction methods shall conform tc., t-he Title V ( 3 _ } /K ON Prop sod Contour � 9` - CMR 15 ) and the Barnstable Board of Health Regulations . f b 1 Tes'. Lit: 2 . 'There are no known private or public wells within feet/400 feet, respectively, from the proposed leaching W[ �') o � 'm.,6 ,' -scq� .� "1 Fini. 4e+d Floor elevation yrr area. There are no known wetlands withir: 100 feet of the I o proposed leaching area, nor is the proposed leaching area Basem;11,.- nowt Elevation BIB"F � within 200 feet of a riverfront . { Water Line - 3 . Existing leaching pits to be pumped and removed prior to 1 t50 ► x i installing the Dry Wells . ti^. c sa a 0 a -,_& tGa3 L n e 4 . No changes are to be made in the field without the approval � Tel . & ( able T & C of the Board of Health and the desa n engineer. ' Electric 5 . Proposed leaching area is not designed for use with garbage disposal . L Contractor to noL i fy trig Safe `12 hours prior to v t"oI' 3rrt4t,;1" ion . 7, P t ry tin¢ rsYcaZM4Lzan taken from "West, Parri:3h Acres" ir-, I y wr, 4:a ie, ;.x f,n<1 rl�art-7 ,', iNBFi . Refs ren�- Book 418, pago i /' \` x �• o T 5 . Sept.tc, Plan not: to be used as a property l ine gurvey. EF . ` WEIt ja o Mrrchrvb v ' i 2 T ABrrEQ I /<1r�nox) parr , o ! R , C;ot1I".>va&.or shall Vera �+ a 1 r 'K fy al l plumbing tram existing structure ono Otiripir c i -1e will be connected t o the new Septic qy t,em prior., to r �r fRa o'r a., , sac._t ion . I>~ any existing plumbing exiting the O� r �fMT wt- r � t.urw is found r.,(-) be different the that: shown can the a" .1 rt;)v�?<d MrA ,t: tC' 4 Stern plan, the contract,,-, shall' notify the �FNo� . �°= w � ° ��' � Y 1; r Y ar ♦ e., "OON O CNN y' •N, .des. (In or All internal plumbing shall be ,. c)nnact�acd to new J�' v +rM,.., �dhc ✓ e p eoJc~a'dv S. sq i.A O,� W ( t:.1i" yf3t'�lTt1, tltllrass cat !'14'1 Wi`3f s9Cwj,t ird. J b fib h r a t emt v+ teat: hor'i zont.e4 L l y around the propose•d leac.•htnq ai-1-i '*mot. +0 ti r x t oti w Mwc++ And veld- Atop` , aX?pronl".t11AT"oly 4 . 5 I+faPt:. ( FE)ptgoi.1, sub c)j.,j, }� wit11 1 l.e V till fH ►i`e [Ic`'+ alp (:rMR pp�1-BEET / RTN �� �,t `� `X y , 1� 1 �'♦� �' NAB '� � Jt t t° f� � P • • i l,' �'�,a 1 �'t 1 � si.�f ��.� �. a�It�� I'!`i� t �`1t �ITtc7�� :; � , (sand) �1 ` _ - rd ,��` �:L.j .1 i" rlta • ; a•� ! i +��l;t:)k��1�1t;�1 1C�O i;`°Lik�i�.: yards . �> '°X RoF((. of SEED lS 6- :� �, I t":�la�l t'lrw�� ai{�,.sat ;:�'�' : 'l.), ti1a�` V`a�'�/ due Cis t"IaI'td�` l, 1�eola�a+t�l�'' - , ,� o ChAnga ttlat. con ex.i� throughout th ughout the proposed lw.kk hl;n �c.4LE AS .0td- Jt4 A Ott M•A " 1„ 04 ,a� ANC VARI E , VIA LOCAL UPGRADE APPROVAL �, �c a `� «r` � t#*OttA t 1 ,M.c too 1II1 —.� . P tf�.„f0 AM rqw 1 Request ,. r .e:achlnt area 1_h tctltri ri `;r: wall tx m 10 feet to 15 feet. is i ~�•.... - , :* O * ` , q , r t - «.1 se i d r,d i..n t.. ' , 1 0, "]0, 1 ? (b) AN d 14 �' l 'vr� ,a'�s, ��� �0 r rxifr, � o . W . F 7k s ids +r x '�,t, '. r <c ; CALCULATIONS r r! C 'r OI ! aw vrR Ch A 1� ` I: A�` r r 4°1+a �� I r i 9�,3 t I \ '"'' r a r""^ '�'� CANTER- �' 0.`, ta. i�tEa': � y Bs?drOCIt1S (Existing' IrPBfl 96a � e � Y ,- C- ! 110 GPD/Bedroom X 4 Bedrooms 440 GPD �, ENtr„vj V I L L E \ P.t ' w ir�zM F AAEN zS So cwrpur,y Rp ti �` ,-�, h ' AND-eEr �.'x"t,G7sc"it iOT`i Rate �^ K: MP (;P-1 1 r 1 SON a1 0 y A Soil Class : Class T {0 . 74 11:' ) < �o* `,--'1� ►p MSr tks 9r r r �►.v,^c' rti... ` ,'"�� F E Z'`: t � R FC'PLAGf « xn � { PROPOSED LEACHING AREA _ , s 1 Dry Wells: 3 at 33. 5' L X 13' W x 2' H y� 9q -t Cec� BoX 3 A)Xy wEas �(' 1 Side Areas l$6. 0 SF X Oa74 G1SF 137 . E GPD dFE- 93Sr fi 33,5+- * 13�w ILa►N �,o_ Bottom Area: 435 . 5 SF X 0. 74 G/SF - 3 GPD � C� 4 Total. beaching Capacity: 459 . 9 `1PD 9T0* I 1 1 /sea �A �on1 } l A v rn£�Bt>4NS r}7 Fl.= SGATrG rA K tArV Vrgw F� I.oCrtT7enl •e V a 6rb � } 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM 90 Bursley Path Drive, le /,Jd o r3i, ,SDI,+r SCALE: AS gZyoee APPROVED BY DRAVWM 8Y 4t C6 DATE: 9/6/02 Dani*l a Johnson s. Jshasoa t am� No.I cm ed Joseph WojtkoMski roc: 90 3=sley Path Drive Centerville M 01432 " •`l_ T_ otoo 0+10 0420 ot3o pf�to o�S+o a+bo Q+7o p�>Qo a*,)o rtoo r+ro r+moo - j //Jj 9tlb�o: r DRAWING MUMMA By: 904 Main Street, suits D, ostesville, 1W 02653 J-NS