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0886 MAIN ST./RTE 6A(W.BARN.) - Health
W6 Main"Street/Rte.6A (W.Barn) W. Barnstable A = 156/ 024001 , t#, I I f i 'I , ,I TOWN OF BARNSTABLE LOCATION 9-\e- 4 J4_ SEWAGE# VILLAGE W • %" N& ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. &4L%C-- SItV4 Ilo SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) 2.0 x NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on 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 � 1 1 All 61 � zN' dP A2, 1s� � No. d`©� O D� Fee `O l✓ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS i 9pphtation for Misposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. VG '�%� ' r�s}�� Owner's Name,Address,and Tel.No. &6 {4Zt1e.+4 gg(o RaAe_ 64. +a- Bar-,,v "j e Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Mc 5tfu€1JS Designer's Name,,Address,and Tel.No. %%ikeW swj� � f6. &)0 71 mr+eszarus MILLS PkA. OZ,(Vg8� -776- �5 q39 �+dir`sv.(Rd2 6�� ,:}I+Po"r Vhrt. OU7� Type of Building: S-o - Z Dwelling No.of Bedrooms q Lot Size 60, sq.ft. Garbage Grinder( ) Other Type of Building jZe5iI"> ,3 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 9qq gpd Plan Date 5-Z 1- / Number of sheets Revision Date Title Size of Septic Tank Kb Type of S.A.S. f,ca Description of Soil Nature of Repairs or Alterations(Answer when applicable) ft Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o alth Signed Date Application Approved by Date `f` Application Disapproved by Date for the following reasons Permit No. ©I — Date Issued No. 0 1 ¢' Fee THE COMMONWEALTH OF MASSACHUSETTS - Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitatlon for Misposal 6pstrm ConstrUttlon Permit Application for a Permit to Construct( ) Repair( ) U grade,(k/ Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.VG "e ���>>����e Owner's Name,Address,and Tel.No. k&,b vi le V la RdAe. bq. W Assessor's Map/Parcel Installer's Name,Address,and Tel.No. E Q t c Si Eof uS Designer's Name,Address,and Tel.No. CaFe 1'v,� lipt✓3v fb '&)< 71 VIAK.L5 11K'A, OZ6t18 g 39 rein C2ae 6A� `�af+wv�l, OZG7 pov� r�r,. <-aA -77co- 65` S Type of Building: ropy- 36Z ySN 1 Dwelling No.of Bedrooms Lot Size sob 1 3c1 1 sq.ft. Garbage Grinder( ) Other Type of;Building ize5l 1F, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) t) gpd Design flow provided y qq gpd Plin Date 5-Z 1- /R Number of sheets Revision Date Title Size of Septic Tank /5 U o - Type of S.A.S. 4',e 1 Description of Soil ' -- Nature of Repairs or Alterations'(Answer when applicable) Pe)acr Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o ealth. Sig Date Application Approved by ��v �. r Date /k"(Xll� Application Disapproved by i,, Date for the following reasons - Permit No. O 1 Date Issued -----------------------------------------------------------------------=---------------------------------------------------------------- TH EE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by E e i c- S 1'CU EjI`S at yg(o fit,; h/�, t 1, ��r=t ti� ��,�o has been constructed in accordance } ) with the provisions of Title 5 and the for Disposal System Construction Permit No.,-a 1 / gated Installer E Ric SQL jf u S Designer Y)5X j4 r, CAna_ e r,0,rk Q of%nQ #bedrooms Approved design flows Q ` gpd The issuance of this permit shall not be construed as a guarantee that the system rill f'u ctifon a ds igned. �\ Date Inspector ) No. ?010 - / 0 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Constrnttlon Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at 1n q w. and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be pleted within three years of the date of this permit.------ �c Date 1D`I + Approved by I T , Town of Barnstable Regulatory Services Richard V. Scali,Interim Director • uterisrnate 163 $ Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Sewage Permit# O1Assessor's Map\Parcel Designer: 7N► t vLC-1 Installer: pe'ty Address: 1 Address: '.O_ 7 1 i _ vft3�- On (� — )$ ' f - � `� �-was issued a permit to install a (date) (installer) / � septic system at c 6 A �, ��OST 6 sed on a design drawn by (addres )JA (�)0 t - dated 2 5 V ( e igner) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the " distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if-required)was inspected and the soils were found satisfactory. I certify that the system referenced above was construct a with the erms RA approval letters (if applicable) sta e) 19 'D AIAMA esigner's Signature (Affix Designer amp Here) PLEASE RETURN TO BALTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL T BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc 1 t down cape engineering, incSIEVE SOILS ANALYSld`66&111AIN STREET W. BARNSTABLE, MA.xlsx DATE OF REPORT:.5/18/1.&' ---•, JOB : GRAIN SIZE'ANALY6iS-Sli'VE TEST SITE: 886 ROUTE 6A, WEST BARNSTABLE LOCATION: DCE TEST HOLE SIEVE ANALYSIS Weight Sample(Grams): 1330 SIZE :WEIGHT RETAINED .€ % RETAINED %PASSED ------- .....(sum�,.:..: =--------- -,. _ - 1 0 0% 100:0% 3/4 0.0i 0 0%i 100:0% ------ :......... .s..... ------------- —=-------- -------- 112" .0.0. 0 0%:. 10.0:0% 3L8" 0.0. 0 0% 100.0% 44 0 0. 0 0%i 100 0% ------ .......... ..... >-------------- -- ............ #10 4$; _3 6%0 96 4% ------- -... ............... - --- -- -.. .. .. . #20 17 6. 13 2%0, 86'8% ------- -�............................................. .......y-------^------ -3...................................... #40 51.3; 38 6/0 61 4/o -- ................. ° ------ ------: ....... ....... ------ ------- --.... #50 84.,8 63 8%. 36 2% ------- -,.. . ,..... ... .................. >--- -- ------- ---�... . #80 120.9 90 9% 9 1% --------------:, ....... .....:.. '-------------- ......... ....... #100 € 126 6• 95.2%• 4.8% #200 131 6 98 9%, 1.1% PAN: 132.2: 100 0% 0.0% SAMPLE 133.0 NOTE-TEST ON PASSING#4 ONLY, 2 2% RETAINED ON#4<45%O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-3 (FINE SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL,PASSING#4 SIEVE:: 44 100% (TEST ONLY MATERIAL PASSING #4) OK #5010%400% OK 9100 0%-20% OK #200 0%-5% OK SAMPLE MEETS TITLE 5'FILL SPECIFICATION _ t , >98%SAND t RESULTS: PERMEABLE MATERIAL-CLASS 1 <2 MIN /IN. MATERIAL NONCOMPACTED ��x oF'fAs SOIL DESCRIPTION:. MEDIUM SAND PAMELA`, o OJALA CIVIL N N&A.6502 _ �ss70 Town of Barnstable P# Vey y°. . Department of Regulatory Services :qI7 IARNSTA.LE. : Public Health.Division Date._ 9�Ar�essti.A`e�' 200 Main Street,Hyannis MA 02601 1`0 y,a Date Scheduled h116 Time ;Fee Pd. 17 Soil Suitability Assessment for,Sewage Disposal Performed By: Parl r d Gal Kd f l V e S Witnessed By LOCA ON"& GENERAL INFORMATION Location Address gp>/„ MAIN lGlUr&A Owners Name 6W�CQZr �4 - �lrii"8//El2fNt Address - AssessoesMaplParcel ''� /'Z — - Engineer's'Name'DOW j CW 64alkle 44 NEW CONSTRUCTION , ~ REPAIR = Telephone# Land Use L o�tNy-) Slopes(%o) 0 -5— Surface Stones #041 e Distances from: Open Water Body �Gy ft Possible Wet Area>160 $ Drinking Water Well �� ft Drainage Way ;�16U ft Property Line ine >/0 ft. Other ft SI{ET H',(Street name,dimensions of lot,-exact locations of test holes&pere`tests',locate.wetlands in proximity to holes) (.UCN" M.AP PkTrAL lo-) {ar, ,a,S way 712 too • - �� - is _ s OyelFng T A) 44 �ff -fry S OG Parent material(geologic) I G f net-e� Depth to Bedrock' Depth to'Groundwater:"Standing'Water in Hole: /'�/ Weeping from Pit Face Z Estimated Seasonal High Groundwater DVTF; I TIt`➢N.IFiyR SEASONAL;�GF[vVATE.—K TABLE;"_ Method Used: 0 52 'V e Depth'Observed standing in obs.hole: in. .Depth to soil mottles: in: 'Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft Index Well# Reading Date:. Index Well level Adj.,factor Adj.Groundwater Level PERCOLATION TEST Date Time. Observation Hole# Time at 9" Depth of Perc 1 .(/e (3 _ Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak I, Rate Min./Inch r 7. Site Suitability Assessments Site Passed .V Site_Failed:. Additional Testing Needed(YIN)/V Original: Public Health Division. Observation Hole Data To Be:Completed on Back------- ***If percolation testis to be:conducted within 10W ofwetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to`beginning. Q:ISEPTICiPERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# ) Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 2�1-30 L 5yIztpi s �; L I y q-gK 62 Coy 6 ley I �/f©y DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,°oGravel) L to P'A- L�1G- IyG clfL C2 ley 1 5110y tg - y� C3 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Graven DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency %Graven Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? \ -e If not,what is the depth of naturally occurring pervious material? Certification I certify that on /�/Z _(date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. � v l ' Signature � J Date E- Q:\SEPTIC\PERCFORM.DOC f '� Commonwealth of Massachusetts - aa�f- DdJ z Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments rrl 886 Main Street- RT. 6A 11 4d,J Property Address P+.� Alan & Gloria Clarke " Owner Owner's Name information is MA 02668 7125/2017 required for every West Barnstable page. City/Town State Zip Code Date of Inspection ;fr 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 A. General Information / a(Q o p-- filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Gordon Bum pus use the return Name of Inspector key. Company Name P.O. Box 1105 Company Address Osterville MA 02655 City/Town State Zip Code 508-862-9400 S1385 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. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7/25/17 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. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is West Barnstable MA 02668 7/25/2017 required for every 'page. CityfTown 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: ® 1 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: I I I 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): l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts t Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts t Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 886 Main Street- RT. 6A Property Address Alan & Gloria Clarke Owner Owner's Name information is West Barnstable MA 02668 7/25/2017 required for every page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No El ® 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 w, 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is West Barnstable MA 02668 7/25/2017 required for every State Zip Code Date of Inspection page. Citylrown 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? El ® 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? Z ❑ 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 El ® 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 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments �M 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. City/Town State Zip Code Date of Inspection D. System Information Description: 0 Number of current residents: 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 years usage(gpd)): Detail: private well Sump pump? ❑ Yes ® No Last date of occupancy: unknown 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: 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts u . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M v •'" 886 Main Street- RT. 6A Property Address Alan & Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. Cityrrown 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: unknown Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth & Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed -leach field added in 1985 Were sewage odors detected when arriving at the site? ❑ Yes ® No 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): 12" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal. 2 Sludge depth: l5ins-3113 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 a 886 Main Street- RT. 6A Property Address Alan & Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. CityfTown 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 2 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 10 How were dimensions determined? measure stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The baffles were present. There was no sign of leakage. Grease Trap (locate on site plan): Depth below grade: n/a 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 v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M a •''t 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): N/a 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 I5ins•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 886 Main Street- RT. 6A Property Address Alan & Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert even Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The D-box was normal 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: !Sins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts • Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 886 Main Street- RT. 6A Property Address Alan & Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 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: 2-2'x20' ❑ 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.): There was no sign of failure from the leach field. 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 !Sins•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 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is West Barnstable MA 02668 7/25/2017 required for every 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.): N/a l5ins•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 ,M 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every west Barnstable MA 02668 7/25/2017 page. Cityfrown 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 Q..._ ' n Will) t A t I Iao + - A 13 i i co aq 15ins•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 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. CitylTown 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' +/- 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: Topo and water contours map. ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above i Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•3f13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 • , Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 886 Main Street- RT. 6A Property Address Alan &Gloria Clarke Owner Owner's Name information is required for every West Barnstable MA 02668 7/25/2017 page. Cityrrown 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 ,Sins•1113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 (�-fg-r }-/o £ ' L D C A T I� ?�. . .,.� E.W A' G E P.E H M I T D UILDE.R OR OWNER T DATE, P„ili.I�1iT ISSUED DaAT.E,l,jGrQ 'MPLIANCE 15SUED � � 3 tp`� - I _ W s a3t e,xav w lr r,� I J,a xa r---► 1- -CATION SWAGE PERMIT NO. ILLAGL ; MSTA LLEU'S NAME A D D A E S S R U I L D £ R OR OWNER DATE PERMIT ISSUED i5 DATE GDM PLDRN CE 15SUED . EJwc1�1� © 606 V S�Na �F` ia► aQov�.� �'� `rwd-T2w�4crs J,b y+N; � THE COMMbNWEALTH OF MASSACHUSETTS BOARD OF HEALTH Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal on-Address Owner Address ..............Z.4=3_ JIF 0,009.(a 04 Other fixtures Z Other Distribution box ( ) Dosing tank ( ) U Nature of Repairs or Alterations—Answer when applicable------- The undersiened aerees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of I I'HE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sign:ed...... ....... ............ ... 'a'....=... Date Application Disapproved for the following reasons:.............................................................................................................. � .. ........ --------'__-_-___—..-'__---___-_—_'���___-� Pero Date ~----------------'—'--'—''—'' ''''' - liall -- ...... THE COMgbNWEi4LTH OF MASSACHUSETTS BOARD OF HEALTH ---------------------.....................O F...................................... , ppliration for Disposal Works Tnnstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage.Disposal Systeml at: � -•--� e...... .��`r ......... ..ocattiim-Addres or Lot No. .._....•1-[•-t.b e. ... .��?�=r Cl �r ... ...................� ........................................... Owner Address Installer Address UType of Building Size Lot............................Sq. feet .., Dwelling—No. of Bedrooms---.--.................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers a YP g ---------------------------- P ( ) — Cafeteria ( ) Other fixtures •------------------- W Design Flow.........:<..................gallons per person per day. Total daily flow.............. ........gallons. WSeptic Tank—Liquid"capacity............gallons Length................ Width................ Diameter................ Depth................ x 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 ( ) a Percolation Test Results Performed by......--•--------•-•-••-•-•--•-•-•---------------••--..........--•--•.... Date............... ------------------ ... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ....-------•-•-••--•••-••-•-------••----•--•-----....•--••-•--•---------------------•---•---••--••••..................................................... .... D Description of Soil............C--%--\%4 5'-_07kVe:...e Vx �''--��'3�------------•--•- .....------•-••---•---•-•••-••--• --•--•--•--•..........-•-----•--.....•-•-••----•-------------------•. --..................................... LA W ��.. G V SAZ_�.-------f� ------- `..• 5�----- ` --• ----------.C. x U Nature of Repairs or Alterations—Answer when appliclable.-----�._0.0........ ....'I.-__--_2f_..x.c��✓�-_-_�.Y�........c� ------------ Agreement:; The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board-of health. CC Signed--... L �- ------..--•-••-- 13 �� ApplicationApproved By--••-----••---••-••--••----•-------•-•--•......---••-••--•-•------•-••-•........................ -•---•---'-=-` Date Application Disapproved for the following reasons:.............................................................................................................. ......-•.........................•••-•--....•--......---•-------•---•--...._---•••----••--......----------•----•------•------•••-----•----•--•------•--•---------••••••---••--------••----•----•-••••••- DatePermitNo..................... -.........................•--...... Issued...--------------------------------••--•- ------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................OF...................................................................................... Tnr#ifirtttr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by---•-------- r'3z tr C k->—� r ................................ f Installer �C cr'7 yam.------- ' t' 7v5---------- has been installed in accordance wiVi the provisions of TITLE 5'of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.____`_a ........7 0...'a_........ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST ZUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO SATISFACTORY. ��z" gG DATE...................... •-•-•-•--•............................... Inspector............... -• ------------ •--..... ................... THE COMMONWEALTH OF;MASSACHUSETTS 1 BOARD OF HEALTH ...................................OF..................................................................................... No.. 57.S.-.'s-.?D FEE........................ Disposal Works TIn#ration Upamit Permission is hereby granted ?--.-._- :> .- E:•......... a `rrC3'i"v-----I----•----•-•----•--....... to Construct ( ) or Repair ( <) an Individud Sewage Disposal System at No......= :.. .. . Street as shown on the application for Disposal Works Construction Permit« o.. :.`p'��Dated--__-_-__ 'f `�`�' . r,.P� Board of Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC.. BOSTON LOCATION SEWAGE PERMIT 1110. V1 . LAG E iNSTA LLER'S NAMiE � r ADDAESS B U I L D R OR OWNER — - e �e Sys ,ti c� DtlTE PERMIT ISSUED to — 1 L/--i5 DAT € COMPLIANCE 15SUED co ISDO � `t'AitK G X av vzw S�A � �O IT4 I+�•_ �d i fZ�pvrv� u 1 1��,-"r w a WIN i �� x�. No.--�`-'-jo—qf , Fee— BOARD OF HEALTH TOWN OF BARNSTABLE Z[ppricationArleir Cootruction Permit 1Application is hereby made for a permit to Con truct ( ), Alter ( ), or pair (✓ an individual Well at: Location - Address �—-- _ Assesso Map and Parcel ---A_���__���opt-------------------------------- ----�-�-�-=--���-�-----���A,N �,� �- Owner Address n �«ive �-{���/� !nt)------------- �'_ __ �o(�- Q c� --- (t— Installer - Driller Address Type of Building Dwelling—�D"—S e —--- - — Other - Type of Building No. of Persons----------------- _-- T -��_Se{ � Type �y- T--------�------------------------------------- Capacity-------------------------_____—____—__ — Purpose of Well-----00-k_e3 Ti c ------— --- -- f 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 Comp 'ance has been issued'by the Board of Health. Signed— - ------- - --- ----- ------------ — �1 16 date . Application Approved By---- -- -- ---- --- ---- ale Application Disapproved foi the following reasons:----------------------------- ---------_ --- -------- -- - —___--____- ------------ ------—--------------------------- ---- date Permit No.-1 - � - -- --- -- -------------- Issued--------- —+-t--------- -- -- -� BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f- �Com�riance THIS IS pTO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired (� ------------------------------------------------------- - — Installer -- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated-!110 -- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------ —------— ------------------ Inspector-- ---- - ---- ------- (, qo-yl No. _ j -..._ Fee- BOARD OF HEALTH TOWN OF- BARNSTABLE Zipplicat ion for Vell Con!9truct ion Permit P Application is hereby made for a permit to Construct ( ), Alter ( ),�or Repair (,-/)an individual Well at: -- Location — Address Assessor -------------------------------------------------------------------------- -------------------------- -- "s Map and Parcel )o^j C 16 ii( 11t6A (13 . 466/N .1t� ---------------------------------------------------------------------- raN n,. � tOwner I� ^ Address b.A II( �<< ,�� nn Ij W 96G aua 3G kl�d LIL Installer — Driller Address r Type of Building Dwelling—— -------------------------------- Other-- Type of Building--__----------_-------------_---- No. of Persons--------- -- Type of Well— - - - . ----------------------------------- Capacity- - - ---- --- -_--_-- --——_ Purpose of 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. Signed--—-- - -- -- —- --- — �—-- date I � Application Approved By----------=--------------------- - ------- ----i date f Application Disapproved for the following reasons:-- - ----- - ---- - I f r date Permit No.- - = -- --------------- - --- Issued- --- -� ---——date BOARD OF HEALTH -� TOWN OF BARNSTABLE ``' C ertif irate Of dctompliante l THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired (��) '�-- —Installlerer at 996 4T4Y a), has been installed in-accordance with-the-provisions-of the Town of Barnstable Board of Health Private Well Protection /,.��� !l Regulation as,described in the application for Well Construction Permit No. ------;------`--------Dated - f THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. l DATE-------------------------------------------------------------------------:-- Inspector------------------ -- --------- BOARD OF HEALTH I TOWN OF BARNSTABLE Veil Con5tructioupffmit No. --------=------------- F Fee—'==------------ Permission is hereby granted - ----- -- — - - —---------- --- ------_-- ---- - --to Construct ( ), Alter ( ), or Repair (L-/) an Individual Well at: . Street as shown on the application for a Well Construction Permit No. y v - ------- - ------------- Dated- - f r,G,mot. J DATE------ Board of Health -/�/__Z�_�_��--------------------------------------- t _. i �, �-nCIA i MARK CORNERS OF SYSTEMES SYSTEM PROFILE LEACHING FIELD W/ NOTES Great LEGEND REBAR SET 4" BELOW Marshes -- -- 99 EXISTING CONTOUR GARBAGE DISPOSER IS NOT ALLOWED (Nor To SCALE) GRADE INSPECTION PORT 1. DATUM IS NAVD 88 ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2% SLOPE X 99 7 EXIST. SPOT ELEV. = TOP OF FNDN EL. 30.0' FILTER FABRIC ---y 2. MUNICIPAL WATER IS NOT AVAILABLE E IGN FLOW: 4 BEDROOMS © 110 GPD 440 GPD DES 34.8 TOP 33.98 FINISHED GRADE- 4" LOAM & SEED / o MINIMUM .75' OF COVER OVER PRECAST 3. MINIMUM PIPE PITCH TO BE 1 8" PER FOOT. -[99]- PROPOSED CONTOUR USE A 440 GPD DESIGN FLOW PRECAST H-)o WATD: I D BOX FOR MIN. 2" WALL THICKNESS 17 /` / 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS RISERS (TYP.) TO BE AASHO H-10 PROPOSED SPOT EL. 2'm 4"OSCH40 PVC % CLEAN FILL �! ° TH1 SEPTIC TANK: 440 GPD (2) = 880 PIPES LEVEL 1ST 2' USE EXISTING 1500 GAL. H-10 SEPTIC TANK w 4" PERFORATED PVC 5' o.c. S=0.005 0 5. PIPE JOINTS TO BE MADE WATERTIGHT. / TEST HOLE EXISTING 14' m ADD 1500 GAL PUMP CHAMBER SEPTIC TANK** TEE * E 3/4"-1-1/2" DOUBLE WASHED 0 6"DEPTH MIN 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH Locus 2� SLOPE OF GROUND TOE 27.1' 000o0oo0001 6" MIN. SUMP 8" STONE LEACHING FIELD ° BELOW INV. 310 CMR. 15.000 (TITLE 5.) �Oo 000*,o°°off 12" MIN. INT. DIM. 0 , UTILITY POLE LEACHING: 33.8$' 33.71' 33.65' \ LEVEL BOTTOM 0 33.5 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO FIRE HYDRANT SIDES 440 GPD (.74) = 595 SF REQUIRED o.':,.. ': :.:. ,' -: o - PURPOSE. a I K�!K�/�/,��/� �� BE USED FOR LOT LINE STAKING OR ANY OTHER 000,0;000-o-o-o-G-o-o-a-o o�o�o�o�o�o�o�o�o 0 ODOp000�0p^DOQO�Op000�0� �000�^�ODOp0�0p0�oo yY° 20' X 30' = 600 SF OK ., o 0 0 R. Q 30.0' Mill Q°A, NOTE: NOT ALL SYMBOLS MAY APPEAR IN oRAwiNc 600 SF X .74 = 444 GPD OK �33.0 �o ZABEL FILTER 6" CRUSHED STONE OR MECHANICAL ' 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. on USE A 20' X 30' PIPE AND STONE LEACHING FIELD (A1oo) ouTLET COMPACTION. (15.221 [2]) r 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED Willow �6 WITHOUT INSPECTION BY BOARD OF HEALTH AND TEE W/EXTENSION 5 0 -' PERMISSION OBTAINED FROM BOARD OF HEALTH. S( 1 SLOPE) ( 1 3� SLOPE) FOUNDATION- EXIST. SEPTIC TANK 20' PUMP -130'- 1 LEACHING 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING D BOX $ PERCHED GROUNDWATER CHAMBER - FACILITY DIGSAFE (1-888-344-7233) AND VERIFYING THE ����� ��� EL. 28.0 PROP. WATERTIGHT COVER TO GRADE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES ALARM AND CONTROL PANEL PRIOR TO COMMENCEMENT OF WORK. *THE INSTALLER SHALL VERIFY THE **INSTALLER SHALL CONFIRM MINIMUM TO BE INSTALLED INSIDE SCALE 1"=2000't PIROVIDE QUICK DISCONNECT FOR PUMP 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE MA LOCATIONS OF ALL UTILITIES AND ALL SEPTIC TANK SIZE AT 1500 GALLONS BUILDING. ALARM TO BE ON REMOVED BENEATH AND 5' AROUND THE PROPOSED APPROVED DATE BOARD OF HEALTH BUILDING SEWER OUTLETS AND AND ITS SUITABILITY FOR RE-USE. SEPARATE CIRCUIT FROM PUMP LEACHING FACILITY. ASSESSORS MAP 156 PARCEL 24-1 ELEVATIONS PRIOR TO INSTALLING ANY REPLACE WITH 1500 GALLON SEPTIC PORTION OF SEPTIC SYSTEM TANK APPROPRIATE TO SITE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND CONDITIONS IF NOT SUITABLE �8 5 REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. 13. INSTALLER TO VERIFY THE ELECTRICAL SYSTEM INV. IN 26.9' N0 LOW POINTS IS SUITABLE FOR PUMP CONNECTION. ELECTRICAL PROVIDE WATERTIGHT BOOTS 1500 GAL. H-20 S/ 2" PRESSURE LINE -�- PERMIT REQUIRED. ALARM ON 500 GAL.+ SLOPE TO DRAIN BACK TO PC FLOAT SWITCH RESERVE SETTINGS: PUMP ON 0.25" WEEP HOLES CHECK VALVE ` 4" WORKING RANGE 8 MYERS SRM 4 PUMP OFF 8" SYSTEM (ORE EQUAL)4/10 HP PUMP 0000 000000 o BUOYANCY CALCS: 000000 0000 0 0 000o H-20 1500 GAL. PC WEIGHS 21 ,230 LBS PUMP CHAMBER 4.4' x 11.0 x 6.17 X 62.4 18,635 LBS UP (OK) TES T HOLE LOGS Lam✓ ��� /_- (NOT TO SCALE) WATERPROOF/WATERTIGHT ENGINEER: # I f� \ DANIEL E. GONSALVES, SE 13587 DON DESMARAIS, RS WITNESS: J r DATE. 5i 3/18' i PERC. RATE = < 2 MIN/INCH I \ c CLASS I SOILS IP 15657 GRANDMAS WAY C / ELEV. ELEV. o„ 41 30.0' Q , LS - - - BLS N34'06'14"E �\ GJ 24" /10YR 3/2 18 /10YR 3/2 178.31' // 0 7, B g 0 \ �LS / BLS 00 �� LOT 1 \ / 0 36 /10YR 4/4 27.0 40 1OYR 4/4 26.7 �b 60,391± S.F. C1 I /S j UNSUITABLE 144" 10,Y4 5/,1 18.0' 140" /10Y4 5/1 18.3' I SOIL C C \ I CLAY C LAY / C �\, � 198 GLEY1 5/10Y 13.5 198" 'GLEY1 5/10Y' 13.5' ...� X x X x 9 C C X 3 1 2 3 I I SIEVE 5' REMOVAL OF UNSUITABLE SOIL REQUIRED `SO AROUX DOWNNTTOPSUITABLE SIMETER OOILLLAYER.GREPLACE �� EXISTING WELL MS MS WITH CLEAN MED. SAND, TO MEET 6, �, 2.5Y 7/3 2.5Y 7 3 , U SPECIFICATIONS OF 310 CMR 15.25;5(3) 246 / N 9.5 2 46" 9.5 C� W PROVIDE 132' OF 40 MIL LINER AT 5' OFF BENCHMARK I SAS IN AREA SHOWN. TOP AT ELEV. 34.0', PERCHED GROUNDWATER ENCOUNTERED @ 24" EL. 28.0 COR CONCRETE PAD - BOTTOM AT EL. 29.0 t _ EL. = 29.3' sNiy�E m 1 0' � -o n 50 C p C --- 29] -� L---------- OHE 186.5' rrn [33] 83��4� E IT, LE 5 SITE PLAN L-- J X ---___.._OHE C"1 - 24 O( �� � 31 .4 ------ ------ N, 0 F E 6 A --- -------------- 886 ROU / _ F WESTBARNSTABLE, MA [34.8J X _ -X 2� o���L �� N PREPARED FOR - - �� CAPE o c�, - - .r� S36.3 >, COD q �, \ i 210.41' / 262 93' W l DATE. MAY 21 , 2018 REVISED: 6-25-2018 (ADD ZABEL FILTER) C \ Scale: 1"= 20' \�HOFMA 9 4�t n r$5 0 10 20 30 40 50 FEET OF MAS �ti� cy ' Sq� Fp��HOFMAss ",moo DANIELA. Al o`er DANIELA. 9� �s� gcti o OJALA "� ; A. DANIEL G U � . 0 OJALA �� ��� CIVIL OJALA off 508-362-4541 CIVIL o A' a No.46-02 q No:4098o fax 508-362-9880 F No,46502 v OJALA Pp �� �� A n�o C,Y �r q No.�40980 C'/STAR ;' F ss�o downcope.com P ct 5 r1I` t �qN 10� 1sT �' � ° 5S �� ' 'c� A' X' C' a en Iaeef/ft M C. SU �O 1 -� civi/ engineers land surve-YOrs 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02575 DICE # 18- 122 µ 18-122 CC SEPTIC-HALLETT.DWG -:3 ` F n 3 n+..