Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0241 PERCIVAL DRIVE - Health
241 Percival Drive West Barnstable A= 110-001 = 002 4 r' No. 2�21^' Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2pplicattou ifor Vern Cou5tructtou Permit Application is hereby made for a permit to Construct(X), Alter( ), or Repair( an individual well at: 241 perc i vaI fir. , �GYi� I�Pi I1�I Ool obZ r Location-Address Assessors Map and Parcel Ma_ rTx rciyaI 0r W ,6off0 It-, M,A Owner Address leSM6h 2)r llina 2753 . 0 I n< M•A 0 9 ,B Installer-Driller. T Address Type of Building Dwelling x Other-Type of Building No. of Persons Type of Well d,=�h0- -C,(,f}-4D I?VG Capacity Purpose of Well OLVwffe 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 Certi cate of Compliance has been issued by the Board of Health. Signed ate Application Approved By J )7 1f'q' Date Application Disapproved for the following reasons: Date Permit No. � l � � Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of (Compliance THIS IS TO CERTIFY,that the individual well Constructed(V), Altered( ), or Repaired.( ) by ry,011-6� 1001h G Installer at 2 C r �(IM9 b 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.W20Zj-O51I Dated -z oLl THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector t i No \N107- , Fee ° f lr BOARD OF HEALTH {O TOWN OF BARNSTABLE ' 2ppricatiou jFor Yell Construction Permit "' .Application is hereby made for a permit to Construct( ), Alter( ), or Repair O an individual well at- -r)c:: iv(4l `v . Zi{J i It ICoe` k Location-Address Assessors Map and Parcel (�t1 a i 4 v C . erc i v c� ) b r 1�1 . -al oS�t b1�c A x 1 4� , Owner IAddress c,eY.l�rl V�1P11�T,r`I II►r�� , hC• b' b� 27g3 (3 Ir M-A 02(n 5 Installer-Driller Address Type of Building Dwelling X Other-Type of Building No. of Persons Type of Well (J �,��rj(, =C,(A 4 r VC, Capacity ,.,. Purpose of.Well �' Yet s� , 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 CertiAcafe of Compliance has been issued by the Board of Health. Signed A1_) .a C�hn -OZ Date Application Approved By fl�j Date -Application Disapproved for the following reasons: Date Permit No. �l� � oSq Issued Date I _ J BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of CompYiattce THIS IS TO CERTIFY,that the individual well Constructed Y), Altered( ), or Repaired( ) by Ir r ti c . (7 ! Installer at 2� � 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.WZCr4 -()Su Dated 1'J AZ.I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL Y SYSTEM WILL FUNCTION SATISFACTORILY.`' Date Inspector ...mo.a.+:r+.....�.+�+�ar<y�f•.:�rar�r..,e!•4.►At' r..Mnp4�+n.�a!'~M,dF'r:►'wa.�J.nw�rfMh•►w f:a•�.W. .. ..., `5. *t.. +ilkM+rtF+B�.WMr,rir rM!}.!ra,oer Ww.*Syr,W+ae�+.�•wiwMMI�+M+M.S�ra+M+wsfi►.,�4.wrf'+�►�er+M�NwN+.rw+a+�w,Meh Mrr+cw+rc-Mr+hw'. BOARD OF HEALTH TOWN OF BARNSTABLE Yell Con.5tructiou Permit C No.\A1102i—C5y Fee ? Permission is hereby granted to Installer to Construct N, Alter( ), or Repair( an individual well at: No. 2'-1 1 p ro kfaA Ur t G'M C_t JI lo- Street as shown on the application for a Well Construction Permit No.V LGZ1 i j (N Dated 17 1 Z 1 Date 1 1 }``� i fl7 t Approved Byy, ` �- A AN A. r{lb.p�` w. t Y I,' (� er,s. tii�l x�I�uiM+ t { ` '�' � �' — s � y, a" � �t�'�s` ��„� � S�3 rain sr �� �'� � q 's• 1-4 1,14 e PJWJ (210 1'RD3!'LEACH PI?') M Massachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports Well Driller Please specify work performed: Address at well location: ENew Well Street Number: Street Name: 241 PERCIVAL DRIVE Please specify well type: Building Lot#: Assessor's Map#: Domestic _......._...__._ Assessor's Lot#: ZIP Code: Number Of Wells: 02668 Cityrrown: Well Location BARNSTABLE In public right-of-way: GPS C'Yes C'No North: West: 41.71871 70.39687 Subdivision/Property/Description: Mailing Address: rvl click here if same as well location address Property Owner: Street Number: Street Name: COX 241 PERCIVAL DRIVE City/Town: State: Engineering Finn: BARNSTABLE MASSACHUSETTS ZIP Code: 02668 Board of health permit obtained: t Yes (7�Not Required Permit Number: Date Issued: W2021054 ........ . .................................................................................. r Massachusetts Department of Environmental Protection t Bureau of Resource Protection—Well Driller Program "�. Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock Auger Choose Bedrock— WELL LOG OVERBURDEN LITHOLOGY From(ft) TOM) Code Color Comment Drop in drill Extra fast or slow Loss or addition stem drill rate of fluid r 0 20 Sand And Gravel u� Brown it+ �"�Fast t''Slow YES NO � Loss Addition 20 30 Sand And Gravel Brown i'u YES Np `Fast Slow Loss Addition __....-. . _............. ....... ..... .......... - ._... _ — (30 50 Fine To Coarse S + Brown f". f Fast r Slow YES NO Loss Addition 50 �70 Fine To Coarse S Brown LT, �'°Fast f`Slow YES NO 1 Loss Addition I+ t -.._.. —_ f� f' FL FineFastf Slow.._ oss Addition 80 90 Fine To Coarse S i Reddish Brown YES NO ("Fast f Slow =A, a 90 100 Fine To Coarse S Yellowish Brown i.,;Fast r Slow �� C � t YES NO Loss ...Addition WELL LOG BEDROCK UTHOLOGY I Drop in Extra fast or Loss or Extra Visible Rust � From(ft) To(ft) Code Comment addition of Large drill stem slow drill rate fluid Staining Chips Choose Code r Yes; �Yes ---- YES NO Fast Siow =Addton ADDITIONAL WELL INFORMATION Developed r-)Yes r No Disinfected ( (%Yes r,No f.-- -.............._-.._..-_....- Total Well Depth 100 Depth to Bedrock i Surface Seal Type None Iracture Enhancement f 'Yes t No CASING f-Is Casing above ground? From: 1 To: 0 From To Type Thickness — Diameter Driveshoe Polyvinyl Chloride Schedule 40 E+ 4 ;r Yesj L� SCREEN ( 'No Screen From To Type Slot Size Diameter 98 100 Stainless Steel Well Point lip. 0.012 L"______,_.I WATER-BEARING ZONES Fr DRY WELL Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) From To Yield(gpm) 73_ ._ .... �................._..........._.... PERMANENT PUMP(IF AVAILABLE) 2 Wira Constant Speedy_ Pump Description Horsepower Submersible Pump Intake Depth(ft) 80 Nominal Pump Capacity(gpm) 10 ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material 2 Weight-]'Water Batches Method Of (gal) (count) Placement F� � [_Choose Matenal ,.... � [Choose Material , !—Choose One— WELL TEST DATA Date Method Yield(gpm) Time Pumped Pumping Level(ft Time To Recover Recovery(ft (HH:MM) BGS) (HH:MM) BGS) 09/20/2021 Constant Rate Pump 10 1:30 74 0:01 73 WATER LEVEL Date Static Depth BGS(ft) Flowing Rate(gpm) Measured ................---.................................................................... . 09/20/2 221 COMMENTS WELL DRILLERS STATEMENT This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report is complete and accurate to the best of my knowledge. DESMOND THOMAS E Monitoring[M] Supervising Driller Signature III, DrillerDESMOND III Registration# 764 THOMAS,E DESMOND WELL Firm DRILLING INC. Rig Permit# 0089 Date Job Complete 09/20/20 11 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. ENVIROTECII LABORATORIES,INC MA C.ERT. NO.:M-MA 063 8 Jan Sebastian Drive(Trot 12 SandwicI4 MA 02561 (508)888-6460 1-800-339-6460 FAX(908)888-6446 Client Nance: Desmond Well Drilling Location: Address: PO Box 2783 241 Percival Dr Orleans, MA N.Bamstabie 02653 Lab Number: DW-214578 Collected By: Client Date Received: 09/21/21 Sample Type: new well Well Specs: 4"-100773' ( r;b licted. v u� :r1�Ye 'is'rltt4*tl ttw ; s?e^ n :-o- .+' .. n "'" A Analysis Requested Units Recommended Limits Analysis Result. Method Date Analyzed Analyzed By Total Coliform CFU/100mL 0 0 SM9222B 09/21/2021 CF(di 14SO pH pH units 6 5 8 5__..am� 6.43 SM 4500-H-B 09/21/2021 SD ......, _... _ _._.._. ..: _... 1- ..___... 1 .,.m_ m._.-. Specific Conductance= umhos/cm 500 214 EPA 120.1 09/2112021 SD _._,... _ . _ __: . ........ _..... Nitrite-N mg/L 1.00 <0.006 EPA 300.0 09/21/2021 SD _... Nitrat._�.._,.....,, _. ____M _ .. .. ..... _ _. ........ e-N mg/L 10.0 <0.01 EPA 300.0 09/21/2021 SD _... _..._.. ...-......�....m,-..�.... ........................._-_.__� ..,--_. ....; _ .. _.� .. . ,. -1- . .. __W..�..�-,. _._� ....... Sodium mg/L 20.0. 15 EPA 200.7 09/23/2021 KB Total Iron mg/L 0.3 9.83 EPA 200.7 09123/2021 KB Manganese mg/L 0.05 0.321 EPA 200.7 09/23/2021 KB Volatile Organic Compounds* ug/L See comment. *See Attached EPA 524.2 09/22/2021 NEC* Comments: pH is below recommended limit and may have corrosive characteristics. Consult local Board of Health regulations concerning Iron level. Over a lifetime,the EPA recommends that people drink water with manganese levels less than 0.3 mg/L and over the short term,EPA recommends that people limit their consumption of water with levels over 1.0 mg/L *2-Butanone and acetone are found in the PVC glue used for well construction. *Limits:2 Butanone 4000 ug/L,Acetone 6300 ug/L *Trace to low levels of chloroform are occasionally detected in groundwater in coastline areas, All samples were analyzed within the established guidelines of US EPA approved methods with all requirements met, unless otherwise noted at the end of a given sample's analytical results. We certify that the following results are true and accurate to the best of our knowledge. Water meets EPA standards and is suitable for drinking for parameters tested. Date 9/29/2021 RottatdJ.Saari Laboratory Director BR.L Below Reportable Limits *See Attached Page 1 of 1 ❑Certification is not available for this analyte for potable water samples.. New England Chromachem 6 Nichols Street Salem,MA 01976 978-744-6600 Sample Information _. EPA Method 524.2 Rev 4.1 Volatile Organic Compounds in Water Lab ID: -109313 _ Client: Envirotech Laborato ,Inc. Client ID: — DW-214578 State: Liquid Date Sampled: 09/20/21 Date Received: 09/22121 Date Analyzed-, 109122J21 _ _._ C Regulated VOC's Results(uglL):, (ugly)::: Unrogulated VOC's-® Results(ug!L) Benzene ., _ ND 5 Acetone" 212 Carbon_Tetrachloride ND r 5 Bromobenzene ND 1,1-Dichloroethene ND 7 Bromochloromethane NO 1,2-Dichloroethane ND 5 Bromodichloromethane_° . ND 1,2-Dichiorobenaene NO ". 600 Bromoform ND 1,4-Dichlorobenzene.,. .. ND 5 : _; Bromomethane ND Trichl.oroethene ND 5 2-Butanone 111 1,1,1-Tdchloroathane ND 200 N-Butyibenzene ND Vin, Chloride ND 2 Sec-But benzene ND Chlorobenzene_ . ND� 100 Tert-But.benzene ND cis-12-dichloroethene Na- 70 Chloroethane ND trans-l,2-dichiomethene ND 100 Chloroform 1.98 1,2-Dichloropropane ND 5 Chloromethane ND Ethylbenzene ' ND_ _700..._ 2-Chlarofoluene ND Styrene ____ ND.-_._ 100 4-Chlorotoluene ND Tetrachloroethene ND 5 Dibromochloromethane ND Toluene ND 1000 j1,2-Dibromo-3-Chloro ropane ND Xylenes(Total) ND 10000 1,2-Dibromoefthe ND Methylene Chloride ND 5,._,_:. Dibromo rothane- ND 1,2,4-Trichlorobenzene JND 70 1,30016robenzene ND 11,2-Trichloroethane NO 5 D-ichlorodifluoromethane ND .1,1-Dichloroethane ND Acetone Detection Limit=10 ug/L 1,3-Dichl6ropropane _ ND ND=<Method Detection Limit 2,24D2111oropropane ND NA=Not Analyzed 1,1-Dichloropropene ND MRL=0.5 ug/L cis-1,3-Dichloropro ene ND Dilution Factor= 1 trans-1,3-Dichioro ropene ND Hexachiorobutadiene .ND Isoprop'lbenzene ND P-Iso rop toluene ND 'Methyl-tert-butyl ether ND Naphthalene ND . N-Pro yl.benzene` ND 1,1,1,2-Tetrachioroethane ND 1,1,2,2-Tetrachloroethane ND 1,2,3-Tdchlorobenzene ND Trichlorofluoromethane 1,2,37T66hooropropane ND 1,2,4-Tdmethytbenzene IND _._ __-.._ 1,3,5-Trimeth ibenzene ND Surrogate Standard Recoveries % Benzene-d6 100 MCL TTHM's=80 ug/L .4-Bromofluorobenzene 97 Method Detection Limit=0.5 ug/L 1,2-Dichi6robenzene-d4,_ _ 94 - 1 Analysis performed per 31 OCMR42 Electronically signed and approved by Mr.Bruce A.Bornstein,Lab Director Date: 9/23/2021 COMM JNWEALTH OF MASSACHUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION c, TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION w A Property Address:QV1 Owner's Name: Owner's Address: { �� t o Date of Inspectpplea = ry - Name of Inspegprint) iCompany Nam .E'� �P' aj Mailing Address: Telephone Number: 0 �` +` CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at tris address and that the information reported below is true,accurate and complete 4,of the time of the inspection. The inspection was performed based on my . training and experience in the proper firlction and maintenance of on site sewage disposal systems. I am a DE.P approved system inspector pursuant`�o'Section 15.340 of Title 5(310 CMR 15.000). The system: /Passes Conditionally Passes s Further Evaluation by t-ie Local Approving Authority F ails Inspector's Signature: --` Date: The system inspector shall sub if-a-c-opy 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. t Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 :i � w . Page 2 of 11 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ° SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) m n Property P y t 1 y - Owner: Date of Inspection:F: ChYecCA,]3,C,D Inspection Summa or LJ ALWAYS complete all of Section D A. S stem Passes: I have not found an a 'c 'y information which h indicates that any of the failure criteria described in 310 CMR: 15.303 or in 310 CMR 15.304 exist.An'v failure criteria.not evaluated are indicated below. Comments: } B. System Conditionally`Passes: One or more system components as described in the"Conditional lass section need to be replaced or repaired.The system, upon completion cf the replacement or repair; as approved by the Board of Health, WilI pass: Answer yes,no or not determined (Y,N,ND) in the for the following statements. If"not determined"please explain. The septic,tank is metal.and.over 20.years old* or the septic tank(whether metal or'not)is structurally unsound, exhibits substantial infiltration or exf ltratiori'or tank failure is imminent.System will pass inspection if the existing tank is.replaced with a complying'septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain:. Observation of sewage backup or break out or high static water level in the distribution box due to.broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are.repl.aced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than-4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with.approval of the Board of Health): broken pipe(s)are replaced obstn-iction is.removed ND explain: Page 3 of 1 l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION':FORM PART A CERTIFICATION (continued) h , Property Address: '+ C / . ,✓ � Owner: Date of Inspectio , C. Further Eval tion 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 Boarc;. of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in e;manner which will protect public'health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tahk and soil absorption system (SAS)and the SAS is within 100 feet of 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 aseptic tank and SAS and the SAS.is within 50 feet of a.private water supply well. _ The system has aseptic tank and SAS and the SAS is less.than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is'_free from pollution from that.facility and the presence of ammonia nitrogen and nitrate nitrogen is equal n or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attaihed to this form. 3. Other: ' elf 3 Page 4 of I 1 OFFICIAL INSPECTIOv FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A. CERTIFICATION(contin',red) Property Address: Owner: Date of Inspection: D. System Failure Criteri applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes NVBackup.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=ess than 6"below invert or available volume is.less than %day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped d/) 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 o-privy is within'a Zone 1 of a:pub.lic well. Any portion of a cesspool o_privy is within 50 feet of a.private water supply well. Any portion of a cesspool o_privy is-less than 100 feet but greater than.5 0 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pprn; provided that no other failure criteria are triggered. A.copy of th,e'analysis must be attached to `his form.l (Yes/No)The system fails.1 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• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is.within 400 feet cf a.surface drinking water supply - _ the system is within 200 feet cf a tributary to a surface drinking water supply — _ the system is.located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped Zone I1 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 syste_-rr has failed.The owner or operator of any large system considered a significant threat under Section 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. ,A f Page 5 of 11 OFFICIAL INSPECTIOq FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST . Property Address: ! f Owner: VP-P a 7'd'L'ek'5 Date of Insp ction: 06 Check if the following have been done. You must indicate"yes"or"nd'.as to each of the followine: Yet' No y/ Pumpine,information was provided by the owner,occupant, o-Board of Health 1, 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 ? V 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 breakout? V Were all system components, excluding the SAS, located on site _ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,depth of sludge and depth of scum? Was the facility owner(and:occupants if different from owner)provided with information on the proper . maintenance of subsurface sewage disposal systems .The size and location of the.Soil Absorption System (SAS)on,the site has been determined based on: Yes ,no 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(3)(b)] 5 Page 6 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SENVAGE DISPOSAL SYSTEM INSPECTION.FORM 'PART C SYSTEM;INFORMATION Property Address: a Owner: Date of Inspectio FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_3 Number of bedrooms(actual): DESIGN flow based on 310 C , R 15.203 (for example: 11.0 gpd x#of bedrooms):,= Number of current resident2 Does residence hare,a garbage grinder,yes or no): Is laundry on a separate sewage system. (yes or no):y-a f if yes separate inspection required] Laundry system inspected Nep or no):A&) ' Seasonal use: (yes or no): Water meter readings, if a�ail ble(last 2 years usage(gpd)): � - Sump pump(yes or no):- 0 Last date of occupancy: / , E U ' COMMERCIAL/IND USTRIAL�I6 Type of establishment: YP , Design.flow(based on 310 CMR 1.5.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):— Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as art of the inspection(yes or no): If yes, volume pumped: gallons-- How was quantity pumped determined Reason for pumping: TYPk�,017 SYSTEM /Septic tank, distribution box, soil absorption system _Single cesspool _Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection recordsrif any) _Innovative/Alternative technology:Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval (; _Other(describe): - - proximate age of all components ate in ailed i o vn�nd source,of information`. e g odors mr7ng at the site(yes or no):;d Were.swa e d rs detected when a 6 Page 7 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 4 Property Address: t / Owner: v Date of Inspection BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron 40 PVC other(explain): Distance from private water supply well or suction line: . Comments (on condition of joints; ventis g; evidence of leakage,letc.): SEPTIC TA (locate on site plafj). Depth below grade: j t-t Material of construction: 7/concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) a Dimensions: k(_r° Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: . 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: How were dimensions determined: /'0-u ® ('Q �Q s �t�d �(✓j� Comments(on pumping recomme ations,inlet and outlet tee or baffle condition, structural integrity, liquid levels s rrelated to outlet invert,evidence of leakage,etc.): GREASE TRAP- (locate on life plan) Depth below grade:_ Material of construction:_concrete metal fiberglass_polyethylene_other (explain): -- Dimensions: bld Scum thickness: Distance from top of scum to top of outler,tee or baffle: Distance from bottom of scum to bottonii of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendatios, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of lf:'ik'age, etc.): t, Page 8 of l 1 OFFICIAL.INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEIN AGE DISPOSAL SYSTETVI INSPECTION FORM PART C SYSTEM-INFORMATION•(continued) Property Address: %' ��l�Q Owned,e.11 Date of Inspection:~ TIGHT or HOLDING TANK/ O (tank must be pumped at time of inspection)(locate on-site plan) Depth below grade: Material of construction: - concrete metal fiberglass__polyethylene other(explain): Dimensions.` Capacity: gallons Design Flow: gallons/day Alarm ptesent.(yes or no),- Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments (condition of alarm and float switches,etc.): - i•: DISTRIBUTION.BOX: V (if present must be ope'ned)(locate on site plan) Depth.of liquid level above outlet invertlakbo'�j Comments(note,if box is level and distribution to outletqual, any evidence of solids carryover, any evidence of leakage into or out o box,e �. ek �1 a Gar P PUMP CHAMBER/ (locate'on site plan). Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and-appurtenances,etc.): R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM .INFORMATION(continued) Property Address: / , ./" Owner• r Date of Ins ction.e SOIL ABSORPTION SYSTEM (SA ;) ()ocate on site plan, excavation not required) i If SAS not located explain why: Type pits,,leachinb g number: leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields, number, dimensions: overflow cesspool,number: .inn ovative/a item ative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, rg CESSPOLSI' (cesspool must be pumped as part of inspection)(locate on site plan) aPa Number and configuration: Depth—top of liquid to inlet invert: O Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of.groundwater inflow(yes or no): Comments(note condition of soil, sigr,� 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.): 9 Page 10 of 11 OFFICIAL-INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART C ' . i W SYSTEM INFORMATION(continued) Property Address:cy� Owner Date of Inspection: _ i SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a'sketch of the sewage disposal system.including ties to at least two permanent.reference landmarks or benchmarks.Locate all wells within.100 feet.Locate where public water supply enters the building. i 1 ` 00Cr C ci ttoo Bt. du ' in Page 1 1 of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SENN AGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: .Owner:l' Date of Inspection: _ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water ✓� 'feet Please indicate'(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: /Accessed hecked with.local excavators, installers-(attach documentation) USGS database-explain: You must describe how you establishes'j the high ground water elevation: i 1 l 1 Permit Number: Date: Completed by: HIGH AROUND-WATER LEVEL COMPUTATION Site Location: ¢ Lot No. Owner. (.-(— Address: Contractor: d _ lc� . Address: � Notes: STEP 1 Measure depth to water:'able to.r.earest 1/10 ft. ..._.... .. �} ` Date r` month/day/Year STEP 2 Using Water-Level Rarge+Zone and Index Well Map I:ca-,-e =""site and determine: _ A' Appropriate inde: well......................_.............. ✓�J µ, B Water-level range _cce ........................:...............:....c ........ STEP 3 Using monthly report'Current Water Resources._Cond-ions" determine current.depth to wa ter ter level If r in g _ month'/Year STEP ableAdjustments 4 Using T of Water- Evel'Ad ustments " for index well (STEP 2A). current depth to water level for index:well (STEP 3), and.water-level zone (STEP determine water-level adjustment ................................................ ................................... .... --,tYM•` - 'y=' `- - STEP 5 Estimate depth to high water g by subtracting the water- level adjustment (STEP 4) from measured depth to water ~' - level at site 1) .............................. l 'n _ (STEP _. ......... ...... sfig,.=' a=; Figure 13.--Reproducible computation form. 15 :,:� 00 ............... .... r'lijtl I,,r,, l II i, 'TOVR�OF BARNSTABLE V ORATION, / QJL SEWAGE # ' ILLAGE l Z ASSESSOR'S MAP & LOT1060-6012- NAME&PHONE N SEPTIC TANK CAPACITY _ '7117 � o LEACHING FACILITY: (type) —(size) (• NO. OF BEDROOMS BUILDER OR OWNER Zee &a—hjzzQ 'CJPERMITDATE: 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 i .Furnished by _ r �5 o . p TOWN OF BARNSTABL` L_oCATION ,-�'� �r-���t✓. i Z SEWAGE # VILLAGE ITV. 2&-tZJ4-L A-9tC—ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.� �°; SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) "10-1 14- NO. OF BEDROOMS' PRIVAT WE OR PUBLIC WATER BUILDER OR OWNER P-El:L-r DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: .-- a VARIANCE GRANTED: Yes No E4 �f ASSESSORS MAP NO- PARCEL NO- 04 f 0,0;?, F�$.........�. ......��. THE COMMONWEALTH OF MASSACHUSTTrs BOARD OF HEALTH TOWN OF BARNSTABLE Appliratimit for Diivipwml Wnrka Tomitrnr#'inn Urrmit Application is h reby made for a Permit to Construct (� ) or Repair ( ) an Individual Sewage Disposal y ••- S stem at 2.1......P �!y D'(_.iVg -�... A55 _ o ....M''�° ! a PA ice�.. =z ` ( Location-Address / Lot No. 1 owneriP/! A ess I_ oa Installer65� �,fce by, l Q Type of Building ? Size Lot....3 j.�.�1........Sq. feet a Dwelling—No. of Bedrooms--- .......-�1-------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building -------------------------_- No. of persons---.---------..------------- Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- ---------------------------------------•-----------•--------- W Design Flow................J J5....................gallons per person per day. Total daily flow.......... ..............--....dons. WSeptic Tank—Liquid capacity]060...gallons Length.-R-y1----- Width.-. .��Z.... Diameter---------------- Depth... .�E...F. x Disposal Trench—No. .................... Width.................... Total Length-----------_........ Total leaching area-------........ ...sq. ft. Seepage Pit No.-.1Q.N.f5_...... Diameter......).2. ...... Depth below inlet------q�......... Total leaching area.11.. -b.sE,4t. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by_'t6'f L'E--- (ar.11� .2(N.�i'................. Date.... .".�.4?..^g ............ .a Test Pit No. 1.............. minutes per inch Depth of Test Pit-.--..`. ....... Depth to ground waten—N-01.4 ...... fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------------------- ---------------.....................--------------•-----------------•-•••---•-•-...------••. 0 Description of Soil... .�.� � ��P 5v,��Q)_�.......1 '.�'� Glr°`( 8`�.yy,. Fl!���--'- M�....---- W UNature of Repairs or Alterations—Answer when applicable.............................................................................................--. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Env-ron ental Code—The un ed further agrees not to place the system in o erat' n it a C rtificate of Co pli e has ee issued b t e bo of h Signed . ... J .. to Application Approved By -- ---- ----------- --.�---------------- -----.�- �q,.................... r ....�� .................... . Dueo Application Disapproved for the following reasons: ........................................................................................................................................ - - - ----------------------------------------------------------------------------------- ------------------------------------------------------------------------ --------- --- -------------------- Permit No. �'.... .. �.------------------- Issued ---------..._- .... �.. ....1 ....... .......--- Dat No... THE COMMONWEALTH OF MASSACHUSETTS X BOARD OF HEALTH TOWN OF BARNSTABLE - Appliration for Diti-pnsttl Works Toustrtir#iun 1Prnti# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: C�'V/ ..... .....2.l.....r'E ��v' -ar t, K__(•( .. A S a .s M^ 116 :�ti r.cE ----- --------------••••••-- �t /j ( Location-Address � - `r Lot No. tc��l�at. }/.0 — , IkI'- .U1:.._ J� ,, , - 1... -_ q ----------------•-•--•--•-----••-- --------------------------..... .. l I T Owner r r Address Installer '�6s h//y� ?✓�j/t ��// ddress UType of Building Size Lot.... . ........Sq. feet a Dwelling—No. of Bedrooms._..._.._._______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --------------- ----------------------------------------------------------------------------•-----------•-•-------•-•-------------••---•---.....•--- w Design Flow................s.,5__-_-_-____._.-_-__-gallons per person per day. Total daily flow--------- _.-----_--__--_-_----gallons. WSeptic Tank—Liquid capacityJ.0.0---gallons Length y n.... Width---J.ht---- Diameter---------------- Depth..y:_EFF. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area........---___. ...sq. ft. Seepage Pit No..AmN ------- Diameter......�_0......... Depth below inlet.._..14........... Total leaching areal.VZO� .sq_4t. Z Other Distribution box ( ) Dosing tank ( ) ` a Percolation Test Results Performed ................... Date.....�-' ............ Test Pit No. 1.....-----------minutes per inch Depth of Test Pit____�_`f ..... Depth to ground water...Z. O-A/ ------ GZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ UA O Description of Soil-- ��� - d�� ...5.056LL.....��� 4 G --------- 1T".1- .... 1 E--'- I U�YI_...._.. w A�'''� ! 1. 1 __co_3f .� ------------------------------------------------------------------------------------------------------------------------------------------------- UNature of Repairs or Alterations—Answer when applicable...._._......................................................................................... --------•---------------------------•----------------------------------------------•--------------------------------------------------------------...--•-------------------------------•--------------- Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Env�'r>o mental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be ' issued by the board of he.a'th. Signed ApplicationApproved BY a.w - .........!..................... ... ............................................. ..--- .... Dare Application Disapproved for the following reasons: ..... ...... .................................... --.........................._..... .................. `.. ------ Due Permit No. ..................................................5 ' S - Issued � .: .-.......... .... �.�... ......: �..- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE V erti irate of Curaptianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) by ....... -.'---"tT-�-�--7.4----------- ----------- ......ZAC.............................................. 1 sr:d�er 21 at ................ ............................ 1....---------- ------- .........---------� `� ............. has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ------------ dated �. _. .. ' y - --- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED-AS A_GUA ANTEE THAT THE SYSTEM WILL FUNCTION SATIS A.CTORY. t DATE ----.�........ � ---. ` ----------------------_...... Inspector'' ------------- ....----------- .-_---_--------- ---- - - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 TOWN OF BARNSTABLE U �� 00 No.................... FEE.........__............. Disposal Works Tnns#r4inn rp nti# Permission is hereby granted-__._._.__'; !.-.•. ®�.�`�-�'� �-C®�.�. .�... to Construct �Re' it Individual Sew /e Did osal System S7- � 1; ( ) g p street Y te at No. � , ( lam G�ii l`!tl_.:..d. <- - ` as shown on the application for Disposal Works Construct P_ W No... . `-5.ion Dated?.._.� _.3 .- .__ hoard of Health M DATE. ...._ .... FORM 36508 HOBBS♦!e WARREN.INC..PUBLISHERS No.- - -- -- ---- Fee---- - ------------- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rVe[C CootructionAMtnit Application is hereby made for a permit to Construct X), Alter ( ), or Repair ( )an individual Well at: 7" vl ��2C'{�J �`"��- - -- -- - -------------- -— - -- --— Location — Address Assessors Map and Parcel ------------------------------------___- "--� _V!_____----w��C��____�'/_Sirj J-------------- wner Address << -- ----------- � --y ---.--a z ------e-2• s Installer — Driller Address Type of Building Dwelling------------ ----------------- Other - Type of Building ------------- No. of Persons--------------------------------------------- Type of Well Capacity -A �- ---- --- Purpose of Well-- - - - - Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Cert' iiccatte .o i e h een issued by the Board of Health. Signed t� date Application Approved By— ----- ©--- - -- - --------- date Application Disapproved for the following reason -----------—-- -------- --- - ---- -------------------------------------------------------------- date ---_----- Permit No. -----_--- ------- ---- Issued--- -- - - - --- ---— -------------- date BOARD OF HEALTH TOWN OF BARNSTABLE - Certificate ®f Compliance THIS IS T9JCE/RT That the Indivi al Well Const uct dv( ),eq t ed ( ), or Repaired ( ) by----------�- - 2? --------- --- -- -- - - ------ - Installer atP66--- —- --------—-------------—-------——-- has been installed in accordance with the provisions of the Town of Barnstable Boa d of Hea th Private Well Protection ,-/ ]� Regulation as described in the application for Well Construction Permit No.�lr = -----Dated--------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------- - ---------—-------- ------ Inspector------------------------------------------— -- ------------ (� ..i •r✓ f'k:�+-�«•4'�„-�i�,r,....'�'�r �.r+M.^.+.-satJ'.i'"'. iV'ru+.w'�..1(1•ll,�i7`�•r�,i•��..��„!-�,��,�w/l�r.� ''p•-�.+^F'��tvtAi"V �i."y�lj"�''.7��. ,p-.`'�'is- f!'�1`'4 r'^:F ' No.- --- -- ---- Fee---- - ------------- BOARD, OF HEALTH TOWN OF BARNSTABLE Applicat ion ArVeir CongtructionPermit Application is hereby made for a permit too Construct K), Alter ( ), or Repair ( )an individual Well at: -------------------- --- - -- ----------- Location - Address rn� / �.�,L/Assesss�ors Map and Parcel A ,� — S� — .✓�_C1��ls�._?�__-__ d� ��i/� —— - fir---- —— --------------------------- �wner Address - --------------- © Installer — Driller Address Type of Building f Dwelling-------------------- ------------------- Other - Type of Building ---------------- No. of Persons----------------------------------------------- --TYPe of Well -- Capacity- ----------0 Purpose of Well---y�/ '� ` `' =_ - - - - 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 .o li e h een issued by the Board of Health. Signed- -- -----T- - -- date Application Approved By- ---- ---------- date, Application Disapproved for the following reason .--------------------------_------__----_____--_____ date PermitNo. ---—------ --- ------------------, Issued-------------------------------- -------------------------------------- I date BOARD OF HEALTH TOWN' -O-F '_ BAAR-NSTAUL'E _. Crrtifitate Of Compliance THIS IS TQ CERTIFY, That the Indiiviidual Well Constructedo( ), Altered ( ), or Repaired ( ) N by----------- RD------ /ter. 1�/ - - - —- nstalle 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. "r -____Dated--- ---------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------— -- ----------- - - -- Inspector------------------------------------------—- - ------------ BOARD OF HEALTH TOWN OF BARNSTABLE Yell Construct ion Permit �. No. --.L --- a Fee-o ------------- (3 Permission i� herebyranted---- --�l F�-(-�)K�-�'---�ad6l—L-- ��✓- !__"-"'_ ________ 8 to Construct ( Alter ( ), o e air ( ) an Individual Well at: No. --- / -- - - �- - _- , . � '/� ------------------------------ Street as shown on t e application for a Well Construction Permit / �� J — Dated ------------ ----------------- No.- -- - --- = - ;- -- --- - y ,. r: i rr //ff11� A c �f 1 Board ofrHeal h DATE —-- z —!_`� _-------- — 1 r AS>` t x ,r kw4Y ter C 9 xl rW 15� S`44 IT x ,a$e •,� _ r .: i "�r {u"z.� a3 r t .J xy r,.?rr � s 3' \ n O^ ♦\ \\ .. � �I ... `1 ram.•� fir`'.\ Yc � ";� rr"4, a�y 1 �, r. V — lb Zvi m \ ff77 •' - — — :, t . a S'3, .�,� a�r,E � Yl: 10�t ry} 1+; a>r - rb` F Y `r •�r�. +.S !.Wk P ggn � ` .�. •.�• j! � — t ��9 r Kr;r� ;�3�'�k`8sd-Y'sh-+�i�` Li'fi•u '? �� � dui. gg _ � \ \ 1 �•• � /r I AF~ t, �t�z, <K �r <�#a-Ji'a a I�•,�� 1„,r)jM:Y r !q�Ed'd°3i"�r�3Fi r"ke*`a"a''$��Kr t "eke` :�`" IS £� � '1 ,1/,\ \`\ `� \\\/ r� — � � / t.t�Ot°sr rl,kr�k.r - ���t��•}v':.K 7 � +.; , y3h a`��Y.`y F:. - t � / \ � / � - as ttt'��rir•.•.v*'r# '�s' +s.. 4}�� �� TM r .,3 t' '� �^�'..s � ' ` 1 �\ � /L_ — — — f 'tly � �"�4y r�}s•°�''�., \ \ \ / 4 .�'"'Yrt�pats Kf" f° y 9 '+,'•y-Y'S1.r'Sk`a Ir r` 1 1// ` \ ` \ , ��t..•'�ft k'tb`o 'a"''rt a= t ` , //�\ \` \.` `` — •� Q1 -,•� tr� ... ; t r^#.,3{ YS r "4 r+"`,`r`I 1rni2 a g \ r 4 on •'S t 111 \ \\ , , I r � k t s r �'�u t'>; K. 3Ci d.Y"� .* a• .. .+ J PItoPOSRDTE1.L��,°�r�� b (210 FROM LEACH \%%;`�``\ ' //� �/ A SOW e �3 !> r t 'i� r x / , t % ? " ° OIL EXISTING WELLZo { k ,I P % _ �I ����/ 4LV VlJ ifR i. :: V(IL/Il! .4 tb"r EoYd' S i ? ri'w rat tt,�gt't tr', a,5{reSr'd'Y tib �`rPya t}�tr #k '`x,.r';.K�f �SR ' � E�r!, v' y�1,'3as�'$ :* try � ;, '�s,�r• {I L .� fi"3 �,�'�^r ram.°}' YSt,��r M:' "� P.�4{4•» y,�+p xr a.1 3,�fia?�4:1�,r,r`g�' -: y�'��e�}i�Y'Qw5 of y � 1 r } a! 4�"e' ��r J+�' '� r��`s.�,tN•�1 s � .Z, (" �+ F&u+M ''`A�,Y. P'�#�' �€.i K.41 . a� w L C HOLE EIJi6N. �AN r � ;.r'fi-•"X i {f y i z4 ">�,�'trY:vy 4�rr �'r a'i'h ski F' .fir ^� .9 ,y,:. '�j ''t e ;,h 7�, . yr#I"+ra.:'#lat +" zlr' " ,r'YYa24,+ u,'•'ltf 4�(F 'L* -�, 5"Agoyng EEATIfARS r t { : � x�� ZBASIN^ r1j°•ei tikS :a i BaD. 4 m r tkiYvww A YP,' rrS t yarn r zky�My�?yr � 5 .7,ty �• irro')r �� r1 "$'�.1k ' � t � r r75. � ; c.�t r �y�, ^! 1 wS• .-� 2 r R.t�,�, } ;.,�M t7•'�yr ? fart'', �. ~H' CONTOUR'. ^1 G {iON�O��• rtl keh sii 'If 2 � trJd�X'Y YC nr r t at e ty= fi i SKttr siJ Bs ._ � I,R gjp a art S ,-..LK.r c.r. S + R f k 1 Nei EDCONTOUR'.. d �=-:wrt�Y ,� ak' 4 i g {rONJ ... ;/r 2+ - a tt,y �+ + 1'-(a�A ATION• 25.5 '�<� � + a tt�� G SPOT:_ELEV al •y 9�(�(.. � s'-;�,.y a 4¢w4y { r 5 i�4fti �� d�k 3 � f o- `�a }k '+�� ":' ! LD SPOT 'F;LI�'PA?'ION• ,25 - r ta+' 2 .f•�yr4'4�5`ds''tr'rF'r r^t s a �-� � !c`S.�?,y r { a,a �^T�� t���pZ�a s�.t�t t �,'ty�. ,�� :,ly� �+' POLE. —L}— e� [ x s gr rw t fv'r c s ( yy�.t�/ k yt r 3 fkt s ras �i LINE: � Y�1'. t a. a kp r drgr�#ur� .,,s `•r yu �.D � �W��D �� ! ,s 5' �z 4 'rtt � rSGDt�OL3'!'JR3' 1' 1'A 1NG WALL: ' �: �a �r '�.,� 'fir' �F r�cr���,w�TM � '+�w'"�'���� r�rf��' "�' ,� � - ,�• 41 Y. 9�2/ Sq y� K��e^ y,3r `.1. xa'i4 f f 6S�T'+4 .a+ •j „S_ � �. °� f�, �. l�u' }fi,R,"�• �?',I.s 3 .'- t•Y Q t : - d` .s"m axr,. '� ♦,X"1ya i�r.i"G T��,r,�" r"k'r f `?:'f "• �'' t`''•yrt-sz.' Y{�p ri �;151�6�tK ^��"Y'"'�� a«! i�'' - , .. t •i x.�i r4 Ctt �s..r��$.� ��#�t< x{'Q,-' b ° „• ,s 4 ;! 's �,." M1.# r R i`•t� ,, `� �'Sr�r ,Ec e��'lt^' t tt �"`a ad3l}�.. 'x a r.,, ,S°.{•� �� 2 r' a��r w t 4ti-���. iski,V '"�s{tY h ��, .�.?wr .r' - t r' ,!:. x a::.;y, ` at+ ,�yY'"y,{e,,tt,. fk«; �Z: ,t'� N,glr��r'4�`8 '"'%.�$:�•- '�' 'kt*� ?t;4".;y y.,.,>t.� 4it ���5 .., � Nc'My3s.. _ N`,'.:''�, A ie L�i%r z eS.;'w 9S,!k* 47 f* h3:,J,iSy-?:a irt J v�e t c.C.t+•1�"k*r�!'Li t��"'i�'�'t"+`S I+q!�'4'.!�''Ghtt r .,�t r/�r,•yty+'#'a:,P+':�1l✓S 1Sa�+��it`_ti3��.';,�,:4^'1"':'��+,,���d rj,i�!r��'y+��++:''�.H.;Y�fi".Pr��y/T,l#t��t!.r d�S�ar.v c��F4{,"4�„`+•f-•>"wKc,fi�q,'ff 4$�W'trf'R My.-`tt.'y3:tF...p4.µ.7���r;C5ty°.{'-�r.�t�irv��l,Lo�t�,C'+�f�-F�,.�`�.4'��`;y«„3srtMfi'..�rt,���.�'cY�p,''a'��Ls,-F-'�XYa 04,.y- 4 , '{v k0� 1L a�r aO Mow -�. ,f.,t '{ ; .�.r t yyww +�, ,+� �Y �h t'� Sg t .�,.�' ,,k5,_.� +¢,..tmD:-� �:•.,.�a.f:., I N ASSESSORS MAP: 110 PARCEL- 1-2 TEST HOLE LOGS NOTES. ENGINEER: 1. VERTICAL DATUM: ASSUMED FROM QUAD (NGVD +f-) I DOYLE ENGINEERING �. CURRENT ZONING: RF WITNESS: THOMAS McKE R.S. I 2. MUNICAPAL WATER S NOT AVAILABLE. AN �o & BUILDING SETBACKS: 9 F. 30' S. 15 R. 15 DATE: 9-16-86 3. SCHEDULE 40 - 4 PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. Afc� MIN PERCOLATION RATE: < 2 IN 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20 sTR� ,/ LOADING SPECIFICATIONS. FLOOD ZONE: C = W , . TH-f TH-2 5. PIPE PITCH 1,�PER FOOT(UNLESS NOTED .OTHER ISE). ,,.; 5 103.0 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL. TOP dt ELEV A SUBSOIL 7'. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE ` LOCUS 18" 1015 USE OF A GARBAGE DISPOSAL. T CLAY 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE LOCATION MAP 4e 99.0 STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL HEALTH REGULATIONS. FINE— LOT V S O UTILITIES PRIOR LOT 21 yLrDIU�! 9. CONTRACTOR TO VERIFY LOCATION FALL 35141 SF + SAND TO CONSTRUCTION. WITH COBBLES 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATIONS ARE IN ACCORDANCE WITH MASTER PLAN, ON FILE WITH THE BARNSTABLE HEALTH DEPT. 144" 910 �Sy oo. j, NO GROUNDWATER ENCOUNTERED �T SEPTIC h- T C SYSTEM DESIGN ,g 60' DECK FLOW ESTIMATE: - - _ 3 BEDROOMS AT 110 GAL/DAYIBEDROOM = 30 GAL/DAY PROPOSED 28, ,0\ — 24 3 BEDR,0OM _ _ DWELLIjW SEPTIC TANK: I o- - - , s � , _3�Q.,.;GAL/DAY * 1.5 DAYS = 495 GAL 24 14 22' USE 1000 GALLON SEPTIC TANK PROPOSED DWELLING � � , - _ - , • ,�o LEACHING AREA: t USE ONE LEACH PIT 6' x 4') 'WITH 3.0' OF STONE �o- - - - - , mod, - - _ _ �o (12' EFFECTIVE DIAMETER x 4 DEEP) - , • .., SIDE AREA. 12 x PI x 4 151 SF (2.5) 377 GAL/DAY BOTTOM AREA. 6 x 6 x PI 113 SF (1.0) 113 GAL/DAY g g � .�.... ................ ., TOTAL CAPACITY = 490 �A�, DAY r -�,•.-- — --- ---__ 9'y i r 9 RETAINING WALL - ` - - SEPTIC SYSTEM SECTION z" PEASTONE WELL 0 , ,, - - - - OF 3 /4" COVERS WITHIN 12" < 6 9 107.0 �� OF FINISHED GRADE WASHED STONE o , TOP OF FOUNDATION trri r ► ,, s► g 4' PROPOSED WELL 6 �� . 9, (21,P FROM LEACH PIT) R = 9091' 103.41 EDGE OF 6 0 4' o 103.66 1000 ELEV. D-BOX PAVE GAL 103.18 ,`� �- EXISTING WELL ELEV. 99.08 SEPTIC TANK 10335 ELEV. g UTILITY CLUSTER ELEV. ELEV. . -- K ELEV. .a 103.08 3 IT TEE SIZES. C+ " ELEV. . 12' > •rT� INLET: 6 UP, 10 DOWN ONE LEACH PIT (6 x 4)�l . 6" , " ' ' WITH OUTLET. SUP, 19 DOWN jj 3' OF STONE (12' EFF. DIAM. x 4' DEEP) (H-20) �Ijr ELEC. MANHOLE Gt' BREACKOUT CALL: (103.6 - 100)/60 x 150 = 9 BENCHMARK AT CATCH BASIN ELEV.— 900 SITE AND SEW AGE PLAN KEY: LOCATION. EXISTING CONTOUR. • PROPOSED CONTOUR: ............................... E x.. LOT 21 PERCIVAL DRIVE EXISTING SPOT ELEVATION: 25.5 y PROPOSED SPOT ELEVATION. 2s EST BARNSTABLE MA TEST HOLE. UTILITY POLE , PREPARED FOR FENCE LINE: DM REEF REALTY 0 HYDRANT. DE'MAREST—MCLELLAN ENGINEERING , ,y1' , SCALE: 1" = 40' DATE: 12-14-94 RETAINING WALL: 24 SCHOOL STREET P.O. BOX 463 , WEST DENNIS,MASSACHUSETTS 02670 REFERENCE: PLAN BOOK: 421 PAGE: 57 =' —0 DM # 94 39-21 THOMAS McLELLAN, P.E.JEJOHN Z. DEMAREST,JR., P.L.S. I I