Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0960 MAIN ST./RTE 6A(W.BARN.) - Health
960 MAIN STREF;, West Barnstable A = 156 - 025 5 M E A D No.53LBE UPC 12043 amead.com • Made In USA fmuw11mffaoucr m (O'cocumm wwwmagoommAm SFI Pao d � , f� 1 l 1 1 A 00 No. Fee THE COMMONWE,�LTH OF 4ASSACHUSETTS Entered in computer: Ll PUBLIC HEALTH DIVISION -TOW I OF B RNSTABLE, MASSACHUSETTS Yes 2pplitation for,VspoBAY 6pstrm Construttion Permit Application for a Permit to Construct( ) Repair Upgrade ) Abandon( ) El Complete System El Individual Components Location Address or Lot No. kol 60 r Owner's Name,Address,and Tel.No. Assessor's Map/Parcel .� @ f /1 i Ake Installer's Name,Address,and Tel.No. P 9-(3 - q Designer's Name,Address, Tel.No. Jenn�S �.QIZC I�Z, v° SAk%bivIci4 4 .�W/O r'��450 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building i)wec 1,W K No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 9 4 0 gpd Design flow provided qLj gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank /Sy0 t3 U nl-.) Type of S.A.S. _�e C :t L-,#i9J Description of Soil Nature of Repairs or Alterations(Answef when applicable) i�✓ 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 e Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Bo d of ealth. Si d Date Application Approved by Date /z 2,0 1 Application Disapproved by Date for the following reasons i Permit No. 15 Y6 7— Date Issued 0 r/so No Fee ;? +. -THE COMM:ONWEA AS ACHUSETTS Entered in computer: LT1-I OF Jli � Yes PUBLIC HEALTH-DIVISION - TOWN p 2PATABLE, MASSACHUSETTS application for iMis#osal 6pstem Construction Permit Application for a Permit to Construct( ) Repair i Upgrade r) Abandon( ) ❑Complete System' ❑Individual Components 7tocation Address or Lot No. %v �� 660 Owner's Name,Address,and Tel.No. Asses�sor''s-Map/Parcel � J /\)C#4k40 f11 � �W,�11;lP Installer's Name,Address,anof Tel.No. SJ Designer's Name,Address,an Tel.No. g �e+1n�S �q12 l Ib2 (R-c� 'S4Wb191( wbc j �d�/ yYI�OSo Type of Building: T N Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building D//{/Q(_( 1W(, No.of Persons Showers( ) Cafeteria( ) 'Other Fixtures Design'flow(min.required) 440 gpd Design flow provided q4 gpd Plan Date Number of sheets Revision Date Title 1 Size of Septic Tank /.SOD` ��� ,, i Type of S.A.S. 5e C :PL,P w Description of Soil f ` Nature of Repairs or Alterations(Answer when applicable) ✓4 h/ + Date last inspected: � p Agreement: �r - i The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i accordance with the provisions of Title 5 e Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boa d of ealth. Sig d Date ?&-2,/ Application Approved by Date ///g. 2D r: Application Disapproved by Date A for the following reasons �'- + • a Permit No. Z.D(-5 7 6 2 Date Issued Zo Z�13 It I ---------------------------------------------.----------------------.---- -.- ------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) 'Repaired(✓) Upgraded( ) Abandoned( )by 7/em Y) 1 q p at 'I 4,9 T 414 /A/ egg� !!�TXKZ-f has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.Za I3'y b Z dated It t21 1 Z.a 13 Installer Designer #bedrooms q Approved desi flow y y 0 gpd The issuance of this permit shall of be co strued as a guarantee that the system ill func'o de i ed. Date Inspector ---------------------------------------------------------------------------------------------------------------------------------------- No. ��(� 10 Z Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Ve-po8al 6pstem ConetrUction Permit Permission is hereby granted to Construct( ) Repair( V� Upgrade( ) Abandon( ) System located at U0 't 4,4 /z/PC T ,4A:kz� el C 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. t Provided:Construction must be completed within three years of the date of this permi Date b o/Z-o 1- Approved by .,r TOWN OF BARNSTABLE LOCATION 9(0 0 �� to� f���SEWAGE# VILLAGE $.S'r dA &5 P a C3ESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.:P, e ee, 1� r4'2_L e SEPTIC TANK CAPACITY 45-00 V i41— LEACHING FACILITY:(type� PC 179 j rcky(size) !Z> TZ, NO.OF BEDROOMS y OWNER NA 4 q 44CrZyk 1° 14 PERMIT DATE: `� C MPLIANCE DATE: a /5 Separation Distance Between the. Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .5 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) iS� Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BYYi I r 5 r tal wet( d�Ck��1 So 1 Town of Barnstable t"Er0"yti Regulatory Services yam? °•� Richard V. Scali, Interim Director * snxxsrnei.e, 9�A MASS. �0 Public Health Division lEnrA Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 �^ Installer &Designer Certification Form Date: /��� Sewage Permit# Assessor's Map\Parcel l fp Designer: Installer. 1�A Address: � Address: On � lo�t �was issued a permit to install a (date) s ller) septic system at9 YJU 1 1- t1"M (A based on a design drawn by ( dress) dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed ' nce with the terms ,)the IAA approval letters (if applicable) /4 \A 0`4,f,I ;Vro�l DAVIT V. B. m (Installer s Signature) MASON —a .3 No.1066 c �fi 11 AA A—.,A, R slg SiX a ) (Affix Desi,, Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc TOWN OF BARNSTABLE LOCATION .'9�0 0 T l'n A = 1YlA64-�'� SEWAGE#��3 aVILLAGE T lJ�1^rS�k?�C ESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.J)C r.,n '2 L V52i, SEPTIC TANK CAPACITY /,BOG G,41 LEACHING FACILITY: r✓Ui�Gky(size) 1 Z Jt 3L (tYPe� �1C i/�,(j v ' NO.OF BEDROOMS OWNER 11'1A r q W PERMIT DATE: C8MPLIANCE DATE: Separation Distance Between the: i 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 P 0 y� \i Town of Barnstable Regulatory Services °p 1NE Tp� ' ti °s Richard V. Scali, Interim Director ■ARNSTABLE. Public Health Division 9 MASS. �Ar 1639. a`� Thomas McKean, Director fD MA'S 200 Main Street Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Homeowner Certificationi �cna't'i`on Form or Alternative Systems Property Address: ZW LC--AA4V (j `nI"`t �O�'1 Assessor's Map\Parcel: Z Property Owners Name: 4 VW � /Y P_ In accordance with Massachusetts DEP alternatives stem approval letters, the following certification information is required by the Owner of record. The Owner of record must place an "x" in the applicable box next to each line certifying the information. Yes N\A ❑ ❑ I have been provided a copy of the Title 5 I/A technology Approval letters. (15 page Standard Conditions letter and the specific technology letter) ❑ ❑ I have been provided with the Owner's Manual ❑ ❑ I have been provided with the Operation and Maintenance Manual ❑ ❑ For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) and the Approval ❑ ❑ For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5) ❑ ❑ If the design does not provide for the use of garbage grinders, the restriction is understood and accepted ❑ ❑ Whether or not covered by a warranty, I understand the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303 �)4-Ry 4,oA-) &6 "l agree to comply with all terms and conditions above. P,vpe 9Vrsigtri — oL1, � 13 Property Owners Signature Date Note: This form must be submitted along with the septic system disposal works permit application for all I\A systems including new construction, repairs\upgrades, with and without aggregate (stone) and with conventional design criteria or credited design criteria. Q:\Septic\IA homeowner certification.doc y��„ZH aF/bgss�9 o DAVID �y MASON y lVo.1066 0 � F � Q/STEM` sgNrraR�t�' f. 0 o o � IVu- l- E° l ® Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs DeP artment, of Environmental Protection One Winter Street Boston, MA 02108.617-292-5500 DEVAL L PATRICK RICHARD K.SULLIVAN JR. Governor Secretary TIMOTHY P.MURRAY KENNETH L.KIMMELL Lieutenant Governor Commissioner APPROVAL FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: Infiltrator Systems,Inc. P.O.Box 768 6 Business Park Road Old Saybrook,CT 06475 Trade name of technology and model: High Capacity chamber, Quick4 High Capacity chamber, Quick4 Plus High Capacity chamber (8-inch invert), Quick4 Plus High Capacity chamber (13-inch invert), Standard chamber, Quick4 Standard chamber, Quick4 Plus Standard chamber (5.3-inch invert), Quick4 Plus Standard chamber (8.0-inch invert), Quick4 Plus Standard LP (Low Profile) chamber (3.3-inch invert), Quick4 Plus Standard LP (Low Profile)chamber(8-inch invert), Infiltrator 3050 (Storm Tech SC- i 740) chamber, Equalizer 24 chamber, Quick4 Equalizer 24 chamber, Equalizer 36 chamber, Quick4 Equalizer 36 chamber, Quick4 Equalizer 24 LP (Low Profile) chamber (6 inch invert), and Quick4 Equalizer 24 LP (Low Profile) chamber(2 inch invert) (hereinafter the"System"). Schematic drawings of the System and a design and installation manual are a part of this Certification. Transmittal Number: X228042 Date of Issuance: June 6,2013 Date of Revision: August 22,2013 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Certification to: Infiltrator Systems, Inc., P.O. Box 768, 6 Business Park Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described herein. The sale, design, installation, and use of the System are conditioned on compliance by the Company, the Designer, the Installer and the System Owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Approval constitutes a violation of 310 CMR 15.000. August 22,2013 David Ferris, Director Date Wastewater Management Program Bureau of Resource Protection This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617-292-5751.TDD#1-866-539-7622 or 1-617-574-6868 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper I Infiltrator-chamber-Infiltrator Inc, Approval for General Use August 22,2013 Page 2 of 9 I. Design Standards 1. The models listed in Table 1 are covered under this Certification. Table 1. Chamber Dimensions Dimensions Invert Model W x L x H Height Inches Inches Equalizer 24 15 x 100 x 11 6 Quick4 Equalizer 24 16 x 48 x 11 6 Quick4 Equalizer 24 LP 6-inch invert 16 x 48 x 8 6 Quick4 Equalizer 24 LP 2-inch invert) 16 x 48 x 8 2 Equalizer 36 22 x 100 x 13.5 6 Quick4 Equalizer 36 22 x 48 x 12 6 Standard Chamber 34 x 75 x 12 6.5 Quick4 Standard 34 x 48 x 12 8 Quick4 Plus Standard 5.3-inch invert 34 x 48 x 12 5.3 Quick4 Plus Standard 8-inch invert) 34 x 48 x 12 8 Quick4 Plus Standard LP 3.3-inch invert 34 x 48 x 8 3.3 Quick4 Plus Standard LP (8-inch invert) 34 x 48 x 8 8 Infiltrator 3050 or StormTech SC-740 51 x 85.4 x 30 22.25 High Capacity Chamber 34 x 75 x 16 11 Quick4 High Capacity 34 x 48 x 16 11.5 Quick4 Plus High Capacity 8-inch invert) 34 x 48 x 14 8 ILQuick4 Plus High Capacity 13-inch invert 34 x 48 x 14 13 I Includes Infiltrator MultiportTM invert adapter attached to the side of the end cap. 2 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in- One 8 Endcap. 3 Only systems installed with this invert height shall be allowed to use the effective leaching area associated with this model in Table 2 4 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in- One 12 Endcap. 2. The System is an open-bottom leaching unit molded from polyolefin resin. It can be installed without aggregate or distribution pipe as an absorption trench in accordance with the requirements in 310 CMR 15.251 or as a bed or field in accordance with the requirements in 310 CMR 15.252. 3. The total effective leaching area for any Chamber Model shall be calculated by multiplying the Effective Leaching Area per square foot of chamber times the total length of chamber from end cap to end cap including end caps. 4. For new construction, the applicant can size the System in a trench configuration without aggregate,using the effective leaching areas presented in Table 2. Infiltrator-chamber-Infiltrator Inc Approval for General Use August 22,2013 Page 3 of 9 Table 2. Effective Leaching Area in Trench Configuration for New Construction and Remedial Sites5 Effective Effective Model Leaching Leaching Area Area SF/LF SF/LF Equalizer 24 3.76 NA Quick4 Equalizer 24 3.90 NA Quick4 Equalizer 24 LP 6-inch invert) 3.90 NA Quick4 Equalizer 24 LP (2-inch invert) 2.78 NA Equalizer 36 4.73 NA Quick4 Equalizer 36 4.73 NA Standard Chamber 6.53 NA Quick4 Standard 6.96 NA Quick4 Plus Standard (5.3-inch invert) 6.20 NA Quick4 Plus Standard (8-inch invert) 6.96 NA Quick4 Plus Standard LP (3.3-inch invert) 5.65 NA Quick4 Plus Standard LP (8-inch invert) 6.96 NA Infiltrator 3050 or StormTech SC-740 NA 6.71 High Capacity Chamber 7.79 NA Quick4 High Capacity 7.93 NA Quick4 Plus High Capacity 8-inch invert) 6.96 NA 12uick4 Plus High Capacity (13-inch invert) 7.93 5. Effective April 21,2006, 310 CMR 15.251(1)(b)maximum trench width is 3 feet. 6 Effective leaching area is equal to 1.67 (bottom width+(2x invert height))for Systems 3 feet or less in width. 7. Effective leaching area is equal to 1.0(3 +(2x invert Height)) for Systems with a width greater than 3 feet. 8.The maximum trench width allowed to calculate effective leaching area is 3 feet. 5. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Table 2 above or additional reductions in soil absorption leaching area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 6. For new construction, the applicant can size the System in bed or field configuration without aggregate,using the effective leaching areas presented in Table 3. I� Infiltrator-chamber-Infiltrator Inc, Approval for General Use August 22,2013 Page 4 of 9 7. In accordance with 310 CMR 15.240 (6) absorption trenches should be used whenever possible. When the System is installed for new construction without aggregate in a bed or field configuration, as defined in 310 CMR 15.252, the System shall be designed using the effective leaching area for the bottom width presented in Table 3. Table 3. Effective Leaching Area for Bed or Field Configuration New Construction and Remedial Sites Effective Model Leaching9 Area SF/LF Equalizer 24 2.09 Quick4 Equalizer 24 2.23 Quick4 Equalizer 24 LP 6-inch invert) 2.23 Quick4 Equalizer 24 LP 2-inch invert 2.23 Equalizer 36 3.06 Quick4 Equalizer 36 3.06 Standard Chamber 4.73 Quick4 Standard 4.73 Quick4?lus Standard 5.3-inch invert) 4.73 Quick4?lus Standard 8-inch invert 4.73 Quick4 Plus Standard LP 3.3-inch invert) 4.73 Quick4 Plus Standard LP 8-inch invert 4.73 Infiltrator 3050 or StormTech SC-740 7.10 High Capacity Chamber 4.73 Quick4 High Capacity 4.73 Quick4 Plus High Capacity 8-inch invert 4.73 Quick4 Plus High Ca aci (13-inch invert) 4.73 9. Effective Leaching area is equal to 1.67 times bottom width only. 6. The System_. when installed in a bed or field configuration without aggregate on remedial sites, shall utilize the effective leaching areas presented in Table 3 above or additional reductions in soil absorption system area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system area required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. Infiltrator-chamber-Infiltrator Inc, Approval for General Use August 22,2013 Page 5 of 9 II. Special Conditions 1. The System is an approved Alternative Chamber for use as an Alternative Soil Absorption System. In addition to the Special Conditions contained in this Approval, the System shall comply with all the"Standard Conditions for Alternative Soil Absorption Systems" ("Standard Conditions"), except where stated otherwise in these Special Conditions. 2. New Construction This Certification is for the installation of a System to serve new construction or an existing facility with a proposed increase in flow, for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the Approving Authority and the site meets the siting requirements for new construction, as provided in Paragraph 6 (b) in section II Design and Installation Requirements of the Standard Conditions. 3. Remedial Site This General Use Certification also applies to the installation of a System for the upgrade or replacement of an existing failed or nonconforming system,provided that the facility meets the siting requirements for upgrades, as provided in Paragraph 7 and 9 in section II Design and Installation Requirements of the Standard Conditions 4. When installed without aggregate, the System shall be exempt from the minimum inlet spacing requirements of 310 CMR15.253. (Systems installed with aggregate are not exempt from this requirement.). 5. When installed without aggregate, the System shall have a minimum of one inspection port through the top of one of the chambers. The inspection port shall be capped with a screw type cap and accessible to within three inches of finish grade. When installed with aggregate in trench,bed, or field configuration,the System shall have a minimum of one inspection port consisting of a perforated four inch pipe placed vertically down into the stone to the naturally occurring soil or sand fill below the stone. The inspection port shall be capped with a screw type cap and accessible to within three inches of finish grade. When installed with aggregate in accordance with the design specifications of 310 CMR 15.253(1)(a)(c) for Pits, Galleries, or Chambers, the System shall comply with the inspection access requirements of 310 CMR 15.253(3). 6. Whether installed with or without aggregate,when installed in trench configuration, the System must be installed in accordance with the trench requirements of 310 CMR 15.251, except 15.251(5)-(9)which pertain to effluent distribution piping requirements and 15.251(1)(b)which limits trench width to 3 feet maximum. The system shall comply with these requirements: a) Length(each trench) 100 feet maximum(31.0 CMR 15.251(1)(a)); Infiltrator-chamber-Infiltrator Inc, Approval for General Use August 22,2013 Page 6 of 9 b) Width(each trench)2 feet minimum(310 CMR 15.251(1)(b)) - Chambers greater than 3 feet wide, when specifically approved, are subject to other Special Conditions and limitations; c) Effective Depth: shall be equal to the depth of the trench below the invert of the chamber inlet with a minimum of six inches up to a maximum of two feet (310 CMR 15.251(1)(c)); d) The minimum separation distance between any two trenches shall be two times the effective width or depth of each trench,whichever is greater, or where the area between trenches is designated as reserve area, three times the effective width or depth of each trench, whichever is greater(310 CMR 15.251(1)(d)); e) The effective leaching area shall be calculated using the bottom area and a maximum of two feet(per side) of side wall area for each trench(310 CMR 15.251(1)(e)); f) Trenches shall be situated, where possible, with their long dimension perpendicular to the slope of the natural soil. Where possible they shall follow the contour lines (310 CMR 15.251(2)); g) Trenches constructed at different elevations shall be designed to prevent effluent from the higher trench(es) flowing into the lower trench(es) (310 CMR 15.251(3)); h) The area between trenches may be designated as system reserve area only where the separation distance between the excavation sidewalls of the primary trenches is at least three times the effective width or depth of each trench, whichever is greater(310 CMR 15.251(4)) - Chambers greater than 3 feet wide, when specifically approved, shall be separated by three times the actual width and are subject to other Special Conditions and limitations; and i) Effluent distribution lines exceeding 50 feet in length shall be connected and venting provided in accordance with 310 CMR 15.241 (310 CMR 15.251(11)). 7. When approved Alternative Chambers are installed surrounded by aggregate in trench configuration, the effective leaching area required by Title 5 for a conventional system shall apply to the System and shall not be reduced, as provided in the Standard Conditions. The System shall also meet the following requirements when installed with aggregate in trench configuration: a) the maximum effective depth shall be 2 feet,measured from the invert of the chamber inlet to the bottom elevation of the aggregate b) the total maximum effective width, including the width of the chamber plus the aggregate, shall be 3 feet; and c) with the use of aggregate, the minimum inlet spacing requirements (20 feet) of 310 CMR 15.253(6) shall apply. Infiltrator-chamber-Infiltrator Inc, Approval for General Use August 22,2013 Page 7 of 9 8. When installed without aggregate in trench configuration, approved Alternative Chambers greater than 3 feet wide: a) shall be installed with a minimum separation distance between any two trenches of two times the actual width of the chamber, or where the area between trenches is designated as reserve area, three times the actual width of the chamber; and b) shall only be entitled to a maximum effective width of 3 feet for the purposes of calculating total effective leaching area. 9. Approved Alternative Chambers greater than 3 feet wide shall not be installed with aggregate in trench configuration and shall only be installed with aggregate: a) in a"bed or field configuration"in accordance with the Special Conditions pertaining to all Alternative Chambers and the Special Conditions which reference"bed or field configuration". No credit for sidewall area is allowed in this configuration; or b) in accordance with the design specifications of 310 CMR 15.253 (1) (a)-(c), the Special Conditions which apply to such designs, and the Special Conditions which apply to all Alternative Chambers. 10. Whether installed with or without aggregate, when installed in a bed or field configuration, the System may be installed without distribution piping,but must comply with the following requirements in 310 CMR 15.252: a) the use of leaching beds or fields is restricted to systems with a calculated design flow of less than 5,000 gpd per leaching bed or field(310 CMR 15.252(1)); b) the maximum length of chambers in series shall be 100 feet(310 CMR 15.252(2)(b)); c) Separation distance between adjacent beds/fields shall be ten feet(310 CMR 15.252(2)(f)); d) The effective leaching area shall include only the bottom area, not the sidewalls (310 CMR 15.252(2)(i)). 11. When approved Alternative Chambers are installed with aggregate in a bed or field configuration the effective leaching area required by Title 5 for a conventional system shall apply to the System and shall not be reduced, as provided under the Standard Conditions. The System shall also meet the following requirements: a) the aggregate base under the chambers shall have a minimum depth of 6 inches and maximum depth of 12 inches. b) the area between chambers shall be filled with aggregate meeting the requirements of 310 CMR 15.247 up to the crown of the chambers with a minimum of 1 foot of aggregate to the outer edge of the bed; • Infiltrator-chamber-Infiltrator Inc, Approval for General Use August 22,2013 Page 8 of 9 c) to prevent the intrusion of fines the System shall comply with 310 CMR 15.247(2); d) the maximum distance between chambers shall be 4 feet; and e) the horizontal distance from a chamber to the outer edge of the bed shall be 4 feet maximum. 12. The System, when installed with aggregate, may be installed in accordance with the design specifications of 310 CMR 15.253 (1) (a)-(c) for Pits, Galleries, or Chambers, which state: a) Effective Depth-A maximum of two feet of sidewall depth below the invert of the inlet of the unit shall be used when calculating the effective leaching area; b) Surrounding Aggregate-1 foot minimum per side. 4 feet maximum per side; and c) Separation Distance Between Units-two times the effective width or depth, whichever is greater. 13. When installed with aggregate and installed in accordance with 310 CMR 15.253(1)(a)-(c),the effective leaching area required by Title 5 for conventional chambers shall apply to approved Alternative Chamber Systems and shall not be reduced; as provided under the Standard Conditions. The System shall also meet the following requirements: a) The Alternative Chambers must be installed on an aggregate base of at least six inches deep. The maximum allowed total effective sidewall depth shall be two feet when calculating the effective sidewall leaching area and shall be measured from the invert of the chamber to the bottom elevation of the aggregate; b) The effective width of the Alternative Chamber or Alternative Chambers in series shall include at least one foot of surrounding aggregate per side,up to 4 feet per side. The effective bottom area will be increased by two to eight SF/LF with the corresponding addition of one to four feet of aggregate per side; c) The area between adjacent units may not be used as reserve area when the System is installed in accordance with 310 CMR 15.253 (1) (a)-(c); and d) Adjacent units (Alternative Chambers with surrounding aggregate), separated by undisturbed soils of less than two times the effective width, shall be considered a multiple bed configuration and shall not be entitled sidewall area when calculating the effective leaching area. Infiltrator-chamber-Infiltrator Inc, Approval for General Use August 22,2013 Page 9 of 9 14. For Systems constructed in fill and installed without aggregate,the System shall be installed as specified in 310 CMR 15.255. Construction in Fill, except the minimum 15 foot horizontal separation distance to be provided between the soil absorption area and the adjacent side slope shall be measured horizontally from the top of the chamber. nt� Town.of Barnstable P# � �r Department of Regulatory Services RARNS SM : Public Health Division Date Se Pf- y 20 i 3 MAM 200 Main Street,Hyannis MA 02601 tf[t{yt[a`t A r Date Scheduled_ ima Fee Pd. Soil Suitability Assessmentfor S e Disp® � Performed By: Witnessed By LOCATION dui GE,N EIAL I1VF®It1VIA.TI®ITT Location Address 960 �(I�X/ � Q.7' J [� Owner's NameAj6P.49V e� uJ R�.vv, "�V,Z'!e-(Q/' Address [ I w 5l��� Assessor's Map/Parcel: ' Engineer's Name �j�(/>r NEW CONSTRUCTION REPAIIt Telephone# Land Use Slopes(TO) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SIMETCLI:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) i LJ 0 Parent material(geologic) Depth to BedKhck - Depth to Groundwater. Standing Water in Hole: Weeping from Plt Foce N ?"Sk7 Estimated Seasonal High Groundwater DETERMINArHON FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: la. Depth to loll mottles: ln. Depth to weeping from side of obs.hole: �•__�bt, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj,factor- AtU.Gruundwam Levc! I YE RC®L,A.TION T ST Date� 'rote Observation Hole# Time at 9" Depth of Pere (% Time at 6" Start Pre-soak Time @ Time(V-6") End Pre-soak �� - r Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you niust first notify the e Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPI'IC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sail Color Soil_ Cher Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. onsigtency,%t36vel) DEEP OBSERVATION HOLE, LOG Mole# Depth from ,� t Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) ` 1 (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,`Io ravel .DEEP OBSERVATION HOLE LOG Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in-) (USDA) (Munsell) Mottling (St;Jcture,�$toges,Boulders. Consistency,%Gravel) DEEP®I$SERVATION BOLE LOG Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, --consistency, 6 a L___ •F r + Flood Insurance Rate Map: �/ Above 500 year flood boundary No_ Yes y____ "Jvitiva-Gu y=boundary Nov ' es� _ 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? If not, what is the depth of naturally occurring pervious material? Certification14 6 I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environtlental Protection and that.the above analysis was pert rme by me consistent with the required training,expert' and p 'en a described in�10 CMR.15.017. Signature Date ®� Q:)SHPTIC\PERCFORM.DOC -) No. �Q v ( ��' Fee Vl� BOARD OF HEALTH TOWN OF BARNSTABLE ZippYication _for Yell Con5truction Permit Application is hereby made for a permit to Construct('Alter( ), or Repair( an individual well at: Loc tion-Address Assessors Map and Parcel C n Owner �Addr�ess a f j Installer Driller Address Type of Building / Dwelling y Other-Type of Building No. of Persons Type of Well �,�;, (� /��; .c fJ� Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described 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 vw to Application Approved By t2 2- 11) ate Application Disapproved for the following reasons: Date Permit No. ZG ��/0 a, Issued Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(-)-"/ Altered( ), or Repaired( ) by Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No.�,/��j� Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector J ,r r e rQ No. I _ 01 , GU (. r' Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2pprication _for Yell Con6truction Permit Application is hereby made for a permit to Construct( , Alter( ), or Repair( an individual well at: � N01, 0, 5 C Location-Address ss Assessors Map and Parcel F VN Q J Fri Owner Address _A _ Installer-Driller ,� Address z Type of Building / Dwelling Other-Type of Building No. of Persons Type of Well 0. ,�� �7� to Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described 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 h /V to Application Approved By Uin. V� 1 )-, 2 bate� Application Disapproved for the following reasons: Date Permit No. 6 I` 00 Issued /a r Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance Y^' THIS IS TO CERTIFY,that the individual well Constructed( Altered( ), or Repaired( ) by Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well P tection Regulation as described in the application for Well Construction Permit No. ►„)ld f -ud l Dated 1 ! -- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE _ Vell �tCon�truction Permit No. I,.J a d �� —out _ Fee � Permission is hereby granted to d O (tdO Installer llto Construct( Alter( ), or Repair( an individual well at: No. tlW il Street as shown on the application for a Well Construction Permit No. t Dated Date I 'J / >/ Approved By i to uv 1 C.ERTIFIC, TE OF A AL1fS'I Page: 1 of 1 o� Barnstable County Health Laboratory (M-MA009) Ass��HyS�! Report Prepared For: Report Dated: 2/18/2015 Matthew Gray Order No.- G1585467 P b Box 751 Centerville, MA 02632 —� Laboratory lD#: 1585467.01 Description: Water-Drinking Water Sample#: Sample Location: 960 Main St,West Barnstable, MA' Collected: 02/10/2015 Collected by: Customer map 156 parcel 025 Received: 02110/2015 Routine ' RESULT UNITS RL TESTE MCL METHOD# ITEM D 2.7 mg/L 0,01 10. EPA 300.0 2i1012015 Nitrate as Nitrogen 2 Copper 0.090 mg/L 0.003 1.3 EPA 200.7 /12/ 015 2 Iron 0.04 mg/L 0.01 .0.3 EPA 200.7 2/12/2015 i P H 6.0 PH AT 25C NA 6.5-8.5 SM 4500-H-B 2/10/2015 Sodium 22 mg/L 1-0 zo EPA 200.7 2I12/2015 Total Coliform Absent PIA 0 0 SM 9223 2f10/2015 EPA 120.1 2/10I2015 Conductance 200 umohs/cm 10 Sodium level is above the maxium contaminant level: Those on a low sodium diet may wish to consult a physician. Approved By: ,,�� ���,•-a �. Attached please find the laboratory certified parameter list. (Lab oirecior) ) = RL = Reporting Limit MCL=Maximum Contaminant Level NO None Detected Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph:508-375-6605 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) -----------Recipient: matrix: Water-Drinking Water Matthew Gray Sampled: 02/10/2015 11:20 P 0 Box 751 Received: 02/10/2015 11:58 Centerville, MA 02632 Collection Address: 960 Main St,West Barnstable,MA' 10rder#: G1585467 Sample Location: map 156 parcel 025 Description: Sday-R E Kit Lab ID: 1585467-01 Date Analyzed: 2/11j2015 @ 14:28 Sample#: Analyst: yn Method, EPA 524.2 Dilution,Factor: 1 Comment: Sodium level Is above the maxlurn contaminant level.Those on a.low sodium diet may wish to consult a physidan. EPA 524.2 Volatile OrgankS by GCIMS I Result 1 MCL MIDL Result MCL MDL Parameter ug/L -Ug-IL u-cj/L Parameter ug/L ug/L ug/L IDichlorodifluoromethane ND 0.50 [Chloroform NO 80 0.50 0.50 ND 70 0.50 lChloromethane ND jcis-1,2-6�cklo ethene Vinyl chloride ND 2.0 0.50 ds-1,3-0ichloropropene -j ND E 0.50 Bromomethane ND 0.50 Dibromochloromethane NO 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane NO -0.50 11,1,1-Ttichloroethane NO 1 200 0.50 18thylbenzene NO 700 0.50 1,1,2,2-Tetrachloroethane ND i 0.50---j.Hexkhlorobutadiene ND 0.50 1,1,2-Tdchloroethane ND i 5.0 0;50 lsopropylbenzene 0.57 0.50 1,1-Dichloroethane ND 1 0.50 Methylene chloride ND s.o0150 ; Methyl test-butylether ij-Dichloroethene ND 1 7.6 0.50 ND 0.50 1,1-Dichloropropene ND 0.50 INap thalene NO 0.50 I r 0.50 ND 0.50 in-Butylbenzene 0.66 11,2,3-Tdchlorobenzene i -LE 00-50 j ND 0.50 U,2,3-Trichloropropane ND in-Propylbefizene 0.50 0.50 11,2,4-Tdchlombenzene ND p-Isopropyttoluen 0.50 i e 0,52 l ND 0.50 i sec-Butylbenzene 1.0 0.50 il,2,4-Trimethylbenzene ................ 100 0.50 11,2-Dibromo-3-chloropropane ND 0.50 IStyrene NO 0.50 0.50 'tent-Butylbenzene I il,2-Dibromoethane(EDB) NO NO 5.0 0150 :1,2-Dichlorobenz ne NO 600 0.50 Tetrachloroethene ND I T, 5.0 0.50. Qluene 1.7 1000 0150 11,2-Dichloroethane ND �T' i ND 1 0.50 Total xylenes NO :1:00:00i: 0.501,2-Dichloropropane 1,3,5-Tdmethylbenzene ND 1 0.50 trans-1,2-Dichloroethene NO 100 0.50 I 1,3-Dichlorobenzene ND 0.50 t-ans-1,3-Dir-hloropropene i NO o.50 ethene I NO 5.0 0.50 -Dichloropropane ND TrIchloro 1,3 1,4-Dichlorobenzene ND 5.0 0.50: iLrichlorofluoromethane ND 0.50, 2,2-Dichloropropane ND 0.50 Surrogates Recovered. I QC Limits 2-Chlorotoluene ND 112% 1 . 0 130 0.50 p-Bromofluorobenzene 4-Chlorotoluene ND 1,2-DichIorobenzeneod4 t 1070% 76' Benzene. ND 5.0 I 0.50 Bromobenzene ND 0..50 lBromochloromethane ND 0.50 !Bromodichloromethane NO -- 0.50 ............- Bromoform NO 0.50 Carbon tetrachloride I ND 1.1 0.50 Chlorobenzene ND 100 0.50 Chloroethane 0.50 Approved Attached please find the laboratory certified parameter fist. (Lab Director) CD q-- NO=None Detected RL = Reporting Limit MCL=Maximum Ctamin nt Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page I.of I -- �` eb. 5. 2C15 11 .2CRM N0. 1785 P. 1 CERTIFICATE OF ANALYSIS Page: 1 of 1 Ise~ 7� Barnstable County Health Laboratory (M-MA009) �� �� R000rt Prepared For: Report Dated: 01113/2014 Shaun F. Harrington All Cape Well Drilling Order Na.: G1378277 PO Box126 Brewster, MA 02631 Laboratory ID#: 1378277-01 Descriptlon: Water-Drinking Water Sample 0: Sample Location: 950 Rte 6A W.Barnstable,MA Collected: 12123/2013 Collected by: Customer Recalved: 1 212 3/2 01 3 Routine ITEM RESULT , UNITS RL MCI. METHOD p ANALYST TESTED NOTS Nitrate as Nitrogen 1.9 MG4- 0.010 10 EPA300,0 LAP 12/24/2013 Copper 0.D10 mg/L 0-003 1.3 EPA200.7 LAP 01/08/2014 Iron 0.46 mg/L 0.010 0.3 EPA200.1 LAP 01/08/2014 PH 6.9 PH AT 25C NA 6.5-8.5 SM 4500-H-0 0C9 12/23/2013 Sodium 19 mo/L 1.0 20 EPA200.7 LAP 0110812014 Total Coliform 0 PIA 0 0 EPA200.7 RG 01/08/2014 Conductance .220 umohslcm 2.0 EPA 12(11 DG0 12123/2013 Based on the results of the pararmeters tested,the water Is suitable for drinking,but may present aesthetic problems {taste,odor,staining}-due to iron. Attached please find the tary borate certified pa remaler list. Approved By: 4-0�1 ;Lab Manager) ND=None Waded RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375.6605 z -. deb. 5. 2C15 11 ;2CAM No. 1i85 P. 2 ®R& CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) Reciplene Shaun F.Harrington Malxbr Water-Drinldng Water All Cape Well Drilling Sampled: 12/23/2013 11:00 P 0 Box 126 Received: 12/23/2013 14:10 Brewster, MA 02631 collection Address: 960 Me 6A W.Barnstable,MA Order#; G1378277 Sample Lotion, Lab ID: 13752?7.O1 Description: di-960 Rte 6A Date Analyzed: 01/03/2014 0 14:02 sample#: Analyst yn Mellrod: EPA 524.2 Dilution Factor: 1 Comment: Based on the•results of the parameters tested,the water Is suitable for ddnldng,but may present aesthetic problems(taste, odor,staining)due to Iran. SPA 524.2- 1/vlatile Or gankS by GC/MS Result JKL Ma -Resu t MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Didhforodifluoron%*ane ND 0.50 Chloroform NO 80 0.50 rhloromethane ND 0.50 ds-1,2•Dlchloroettrerre NO 70 0.50 vinyl chloride ND 2A 0.50 ds-1,3-1)lchioroprapene ND 0.50 Bromomethane ND 0.50 Dlbromochloromethane ND 0.50 1,i,1,2-Tetradhlorcethane NO 0.50 DlbromOmethane ND 0.50 1,1,1 Trichloroethane NO 2D0 0.54 1 jEthylbeivene ND 700 0.50 1,1,2,2-Tetradhloroethane ND 0.50 lHexa&lorobutadiene ND 0.50 1,1,2-Tr1diloroethane NO 5.0 0.50 'Impropylbenzene ND 0.50 ij-Dtohloroefane NO 0.50 Methylene chloride ND 5.0 0.50 i j-Dldhloroethene NO 7.0 0.50 Mettgl-tert46utyl ether ND 0.50 i,1-101chloropropene ND 0.50 Naphthalene ND 0.50 1,2,3 Tdchlorobenzene ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Ilidhloroprapane ND 0.50 ri-Propylbenzene ND 0.50 1,2,4-TrfMomb&vene ND 70 0.5o p4sopropyltoluene NO 0.50 1,Z,4-T!mett-ylbenzene ND Me sec-Butylbenzene ND 0.50 1,2-Dibromo-3-chlompropane ND 0.50 Styrene NO 100 O.So 1,2-Dibromoeftne(LDB) : ND 0.50 tent-BWbenzene NO 0.50 1,2-10ichlarobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichbrvethane NO 5.0 0.50 Toluene ' ND 1000 0.50 1,2-Dlchlompropane NO 0.50 Total xylenes ND 10000 0.50 1,3,5-Tdmethylbenzene NO 0.50 trans-1,2-Dtchloroethene. NO 100 0.50 1,3-Dlchlorobenzene ND 0.50 trans-1,3-Dlchtoropropene NO 0.50 1,3-Dichloropropane ND 0.50 Trichlomethene NO 5.0 D.So 1,4-Dichlorobenzene NO 5.0 0.50 rlchlorofluoromethane ND 0.50 2,2-DicHoropropane ND 0.60 Surrogates °lo Recovered QC omits(4�0) +C:hlormluene NO 0.50 p-Bromonuorobenzene 1089/n 70 130 4-t lorotnluene ND o.s0 1,2-Dlchlorobenzene-d4 1100i6 70 130 Benzene NO 5.0 0.50 Bromobenzene ND 0.50 emmoMloromethane ND 0.50 eromodichloromethane ND 0.50 BromolOrm ND 0•90 Carbon te"chloride ND 5.0 0.50 &orobemme ND 1D0 0.50 Chloroethane ND 0.50 Attached please find the laboratory cerfifled parameter list Approved By: -- (Lab DuedOr) .----j ND v.None Detected RL = Reporting Mrnit MCL=Maximum Contaminant Level Superior Court House, P0.Box 427, Barnstable, MA•02630 Ph:508-37"605 Page i of i i oFBq�y CERTIFICATE OF ANALYSIS Page: 1 of 1 Barnstable County Health Laboratory (M-MA009) Report Prepared For: Report Dated: 2/18/2015 Order No.: G1585467 Matthew Gray P O Box 751 Centerville, MA 02632 Laboratory ID#: 1585467-01 Description: Water-Drinking Water Sample#: Sample Location: 960 Main St,West Barnstable, MA" Collected: 02/10/2015 Collected by: Customer map 156 parcel 025 Received: 02/10/2015 Routine RESULT UNITS RL MCL METHOD# TESTED ITEM 7 mg/L 0.01 10 EPA300.0 2/10/2015 Nitrate as Nitrogen 2. mg/L 0.003 1.3 EPA 200.7 2/12/2015 Copper 0.0 Iron 0.04 mg/L 0.01 0.3 EPA 200.7 2/12/2015 pH 6.0 PH AT 25C NA 6.5-8.5 SM 4500-H-B 2/10/2015 Sodium 22 mg/L 1.0 20 EPA 200.7 2/12/2015 Total Coliform Absent P/A o 0 SM 9223 2/10/2015 Conductance 200 umohs/cm 10 EPA 120.1 2/10/2015 Sodium level is above the maxium contaminant level. Those on a low sodium diet may wish to consult a physician. -� Attached please find the laboratory certified parameter list. Approved By:(Lab Director) 2 L ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 OF� h, CERTIFICATE OF ANALYSIS h Barnstable County Health Laboratory (M-MA009) s�C . Recipient: Matrix: Water Drinking Water Matthew Gray Sampled: 02/10/2015 11:20 P 0 Box 751 Received: 02/10/2015 11:58 Centerville, MA 02632 Collection Address: 960 Main St,West Barnstable,MA' Order#: G1585467 Sample Location: map 156 parcel 025 Description: 5day-R E Kit Lab ID: 1585467-01 Date Analyzed: 2/11/2015 @ 14:28 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Sodium level is above the maxium contaminant level.Those on a low sodium diet may wish to consult a physician. EPA 524.2 - Volatile Organics by GC/MS Result MCL MDL Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 ds-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Tdchloroethane ND 200 0.50 Eutylbenzene ND 700 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Hexachlorobutadiene ND 0.50 1,1,2-Trichloroethane ND 5.0 0.50 Isopropylbenzene 0.57 0.50 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND o.50 1,2,3-Tdchlorobenzene NID 1 0.50 n-Butylbenzene 0.66 0.50 1,2,3-Tdchloropropane_ ND 0.50 n-Propylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene 0.52 0.50 1,2,4-Trimethylbenzene ND 0.50 sec-Butylbenzene 1.0 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene . ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.5o Tgluene 1.7 .1000 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Tdmethylbenzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichlorobenzene . ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND 0.50 2,2-Dichloropropane ND 0.50 Surrogates %Recovered QC Limits(%) 2-Chlorotoluene ND 0.50 p-Bromofluorobenzene 112% 70 130 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 1n70/o 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene PJD 100 0.50 Chloroethane ND 0.50 Approved Attached please find the laboratory certified parameter list. (Lab Director) . L ND=None Detected Reporting RL = Re ortin Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 Jeb. 5. 2C15 11 : 2CAM k 1785 P. 1 aF"4 CERTIFICATE OF ANALYSIS Page: 1 of 1 Barnstable County Health Laboratory (M-MA009) nvAcxLsw Report Prepared For: Report Dated: 0111312014 Shaun F. Harrington All Cape Well Drilling Order No.: G1378277 P0 Box 126 Brewster, MA 02631 Laboratory ID#: 1378277-01 Description: Water-Drinking Water Sample 0: Sample Location: 960 Rte 6A W.Barnstable,MA Collected: 1 212 312 01 3 Collected by: Customer Racatved: 12123/2013 Routine . ITEM RESULT UNITS RL MCL METHOD ANALYST TESTED NOTE Nitrate as Nitrogen 1.9 mall- 0.D10 10 EPA300.0 LAP 12/24/2013 Copper 0.010 mg/L 0.003 1.3 EPA 200.7 LAP 01/08/2014 Iron 0.46 mg/L 0.010 0.3 EPA200.7 LAP 01/08/2014 pH 6.9 PH AT 25C NA 6,6-6.5 SM 4500-H-B OCB 12/23/2013 Sodium 19 m8/L 1.0 20 EPA200.7 LAP 01/08/2014 Total Coliform 0 PIA 0 0 EPA200.7 RG 01/08/2014 Conductance 220 umohslcm 2.0 EPA 120.1 DCB 12t23/Z013 Based on the results of the pareavters tested, the water is suitable for drinking,but may present aesthetic problems (taste,odor,stolning)-due to Iron. Attached please find the tary borato certified pam raeler list. Approved By: :Lab Manager) ND None detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, P0,Box 427, Barnstable, MA 02630 Ph: 508.375.6605 Feb. 5, 2C15 11 ;2CAM k 1785 P. 2 s CERTIFICATE OF ANALYSIS i y Barnstable County Health Laboratory (M-MA009) Redplenu Shaun F.Harrington Matrk. Water-Drinking Water Al Cape Well Drilling Sampled: .12/23/2013 .11:00 P 0 Box 126 Received: 12/23/2013 14:10 Brewster, MA 02631 ColleWon Address: 960 Rte 6A W.Barnstable,MA Order#: G1378277 Sample Location: Description: rkct-960 Rte 6A Lab M: 1378277.01 Date Analyzed: 01/03/2014 C 14:02 Sample#: Analyst; yn Method: EPA 524.2 Dilution Factor. 1 Comment: Based on the'results of the parameters tested,the water Is suitable for ddrddng,but may present aesthetic problems(taste, odor,stalning)due lo Iron. EPA 524.2- Volatile 4ngan0cs by GCIMS Result JJCL MU Respit MCL MDL Parameter ug/L ug/L ual- Parameter ug/L ug/L ug/L Dlcirlorodifluornmethane NO 0.50 Chloroform ND 90 0-50 Chlaromethane NO 0.50 ds-1,2-0[chlomettiene NO 70 0.50 Vinyl chloride NO 2,0 0.50 ds-1,3-01chloropropene NO 0.50 Bromomethane NO 0.50 Dlbromochloromethane NO a.5o 1,1,1,2-Tetrachloroethane NO 0.50 Dlbromomethane ND 0 50 1,1,1 TrIchloroethane NO 200 0.50 Ethylberuene ND 700 0.50 1,1,2,2-Tetmchlorcethane NO 0.50 Hexachlorobutadene ND 0• 0 1,1,2-Tdchloroethane NO 5.0 0.50 'Isopropytbenzene ND 0.50 ij-Dichloroethane NO 0150 Methylene dhlortde NO 5,0 0.50 i,1-Dtdhloroethene NO 7.0 0.50 McUM-bert-butyl ether NO 0.50 1,1-Dtchkoropropene ND 0.50 Naphthalene NO 0.50 1,2,3 Trldrlorobehzene NO 0.50 n-BuWnzene NO 0.50 1,2,3-rIchloropropane NO 0.50 n-Propylbenzene NO 0.50 1,2,4 Trichlorobenzene ND 70 0_50 p-Isopropyltoluene NO 0.50 1,2,4 Trimemylbenzene ND 0.50 sec-Butylbenzene NO 0_50 1,2-Dibromo-3-chlompropane ND 030 Styrene NO 100 O.So 1,2-Dibrmmoethane(EDB) : Np 0.50 t-ert-BWbenzene NO 0.50 1,2-Dichlorobenzene NO 600 0.50 Tetrachloroethene NO 510 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluem NO 1000 0.50 1,2-01chloropropane NO 0.50 Total)*ries NO 10000 0.50 1,3,5-Tdmethylbenzene NO 0.50 trans-1,2-DlcHormthene NO 100 0.50 1,3-Dlchlorobenzene NO 0.50 trans-1,3-Dlchloropropene NO 0.50 1,3,01dhlompropane NO 0.50 ITrichloroethene NO 5.0 0.50 1,4-oiailorobenzene NO 5.0 0.50 rgchIoro0uoromethane NO 0. 00 2,2-uftropropane NO 0.50 surrogates %Recovered QC umlts(51h) 2-Chlarotoluene NO 0.50 "romofluorobenzene 109% 70-1 130 4-Chlorotoluene NO 0.50 1,2-Dlchloroben2ene-d4 1100/6 70 1 130 Benzene NO S.0 0.50 Bromobenzene NO Q.50 Bromachloromethane NO 0•50 Bromedldtloromethane ND 0.50 Sromdbrm ND 0•50 Carbon tetrachloride NO 5.0 0.50 Chkorobuume ND 100 0.50 Chloroethane NO 0.30 Attached please find the laboratory cer9fled parameter list Approved By: - (Lab DQectOt) ND=None Detected RL = Reporung I belt MCI=Maximum Cont&minant Level Superior Court House, p0.Box 427, Barnstable, MA 02630 Ph:508-375-8605 Page i of i : ,I F ASSESSORS MAP : r .. - TEST HOLE LOGS /f" PARCEL : 1 The installation shall core ' with Title Valid Town of ►roard of. Z ) I ~�` l SOIL EVALUATOR, I�'/ "t �' � l lealth Regulations. FLOOD ZONE: !.�C)I (,�� _ - WITNESS : 1,1u } b �� 2) The installer shall verify the location of utilities, sewer inverts and septic REFERENCE'j� �r' p p % C1 T�& Z,,9� DATE: 6mn, � 2 com onents rior to installation and settiu base elevations. PERCOLATION RATE' Ih'tl I 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first two Ieet out of the d-box to the ieaching shall be level. 4) This plan is not to be utilized for property line determination nor any other TH- I TH-2 purpose other than the proposed system installation. 4 p,qrX 0 n rr,� 5) All septic components must meet Title V specirtcations. /O4 / I �r � t 6) .-Parking shall not be constructed over H10 septic components. 7) :The property is bounded by property corners and property lines. 8) The property owner shall review design considerations to approve of total Z$ Z3 -- design flow and number of bedrooms to be considered for design. Receipt LOCATION MAP of payment for the plan and installation based on the plan shall be deemed c a .� riW approval of the design flow by the owner. 9) The existing leaching or cesspools shall be pumped and filled with material per Title V abandonment procedures. "Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean sand per 10)System components to be 10 feet From water line. Sewer lines crossing the f , wT 1 M water line shall be sleeved with 4 inch SCII 40 PVC with ends grouted if ,I applicable. The proposed SAS is being installed below the water service Gtir� l,lz'�-'� line. The line is to be sleeved as aforementioned and maintained in place. 1 j tw � w! X S E P T l C S Y S T E M I DES I G N 11) If a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such.. 1 2)"The installer is to take caution in excavation around the gas line if such FLOW ESTIMATE exists. 13)The installer shall verify the location, quantity and elevation of the sewer BEDROOMS AT,�/O'GAL/DAY/BEDROOM -'�k GAL/DAY lines exiting the dwelling'brior to the installation. 14)"This plan is representative only that a system can fit on a property meeting SEPTIC TANK Title V requirements. X�w , Ala. 40o - /y�O GAL/DAY x 2 DAYS -06D GAL USE A!C60GALLON SEPTIC TANK .w qukouj SO I L AB=70RP-#r I ON SYSTEM S O q fj ti � J�`�m+a-, E "i O� 'O� �h.TST—Jc ' S�� - - t� f�� G - ��1�qk�� � � � � 5 - ANi fQ� t 0_, E`Is�' 7 ID �- SEPT�I C SY'STEM SECT I ON .>r /e 1 t� v � �-LrI y , I , — --- — --- h � lJ „ . . D BOx > o I - - r� f n _ / f l ,. GAL _ d — , R r U —Al i , eL PT i C TANK Lo _l �- „ ne , \ S -k �l r AND SEWAGE to- 1 y 4 SiT _ - M f c_ l' e r 1 r1G3 _ , E R 111 � ,_ Pry✓._ L '�,,. : �- _ , =►�t� e „ w SCALE _r Q A V f,Q • B . MASON' l -- J� DuJ c ..,, tl - UBC EN'.0 I fUNMkNTAL UES I GPJS - �LpS`f' SANllW I CN .. MA IpaTE HEALTH AGENT E > x. t50�3 ) a33 2I77 � ; x.; , 1 \/Al f a O L�4z _ .,:., ... •._. a a, '`. - -: " ,,,. ., ." _ - - - - c , -`r,+9AeY�LIAX , i ASSESSORS MAP : 'l` 1 ' TEST 1--101- L0GS PARCEL: ) .1„ , r � ,� -R - �.� _ 1 I lre instal t��tion small con,;,,, �v�tli .Elie a:� l "I ow�� o� ,- I oard off. !I SOIL EVALUATOR .. �( 1 - I Iealth g FLOOD ZONE:— =fir I Iriations. 1�i = 1 1 )�, WITNESS :_ G.t�_.�1�} {� ��- 2) "1'I1e insta ter shall verily the location of utilities, sewer inverts and septic REFERENCE'i " �' 0 com one , is prior to installation and setting base elevations. . ' = �� DATE ? p 1 g 3) All gray.i -septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first -c PERCOLATION RAJ : �. Z. V�, 1 two lect id of the d-box to the leaching shall be level. P © '� 4) This plan is not to be utilized for property line determination;tor any other TH- 1 TH-2 purpose oilier than the proposed system installation. 5) All septic components must meet Title V specifications. Q r �D �`r' � wit I 6), Parking h!iall not be constructed over II10 septic components. 7) The property is bounded by property corners and property lines. /L' • to� ,�� ` p ,� 8) T'lie property owner shall review design considerations to approve of total ! Z$ design fll)w and number of bedrooms to be cousld red for design. Receipt LOCATION MAP r of pay,,; for the plan and installation ba.,�zd on ;:e plan slk! be d- ,=d t -- a roval of the design flow b the owner. � PP b Y 9) The existing leaching or cesspools shall be pumped and tilled with material per Title V abandonment procedures. Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean sand per � 0 Title V pF.cs. i 1l It -4 _ ��j. 10)System components to be 10 feet from water line. Sewer lines crossing the � Y' water line shall be sleeved with 4 inch SCII 40 PVC with ends grouted if a �lic�l? "The proposed SAS is being installed below the water service ��Al/ , pl l 1 if a a line is to be sleeved as aforementioned and maintained in place. line. .'?��� SEPT 1 C: SYSTEM D E S I G N ) g f rage grinder exists it is to be removed and is the responsibility of the owner o fmRire such. 12)The in Miler is to take caution in excavation around the gas line if such FLOW E S i 1 MATE exists. 13)The installer shall verify the location, quantity and elevation of the sewer BED t)C)MS AT� �% GAL/DAY/BEDROOM -�GAL/DAY lines eAtin the dwellingprior to the installation. � g gP �• ��.-"ry `- M" .., - -- 14) This p . is representative only that a system can fit on a property meeting SEPTIC FANK Title V requirements. t150 G C . '?,G.A�)d?frj _ G/,?./!7AY x 2 DAYS - GAL USE A,�: '� GALLON SEPTIC TANK 1— ----- SOIL Ab ;ORPT i ON SYSTEM___.__.__ --_-___ I--" ., 1 ! .•.��'.. -.- ' i ! 11`' ' 4b �^! J1 1XY� �°",,. y OF \,. � 11 .3 - � 01 A `Jll1' U ,( > . - .+'y�p ��� ` _'1.�/. /�,�-' �• Q��J!�///�1/ Ir/���f/�/_ •O_ �� (�� � ... f "..ems ,�-.—. ,�� � :, , ,`� � `•. .. �j� -�.._._._�._..�-- �,.��..�... S E P T.I C . SYSTEM SECTION 11 s , .. � `i . f 4� �,� ,j q,01D 1—J i - - , ._ t:�GAL �46 �. -- a N SEPTIC TANK • a. fi V. SITE AND SEWAGE PLAN 4 LO CAT I ON : �� � Vim , �• R e 9 a FOR : 4. o` 14, ��L �k -�� �, f s SCALE: n,\I' l R� �. A 1 o t� c� / low .' _ -. y ArF: � �a _ ., f. .: - ---, — �>B t, E 1~ U L 5 1 (,a 1�{5 A S H MA ^ J_L-AL . - T HEALTH AGENT L 1' SANDW ! C - f z • I r