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Home My WebLink About0257 PERCIVAL DRIVE - Health 257 Percival Drive West Barnstable A= 111-064 r Page: 1 of 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) Report Prepared For: Report Dated: 7/15/2015 Kristina Conaway Order No.: G1588454 257 Percival Drive W Barnstable, MA 02668 Laboratory ID#: 1588454-01 Description: Water-Drinking Water Sample#: Sample Location: 257 Percival Drive,W Barnstable Collected: 07/14/2015 Collected by: KC Received: 07/14/2015 Test Parameters ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Total Coliform Present P/A 0 0 SM9223 RG 7/14/2015 The recommended maximum contamination level for drinking water exceeded due to Coliform Bacteria. Tested negative for E.coli. Retesting is recommended. Attached please find the laboratory certified parameter list. Approved By: (Lab Director /:: 2- ND=None Detected RL = Reporting Limit MCL=Maximtjm Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 5 Page: 1 of 1 CERTIFICATE OF ANALYSIS 4 Barnstable County Health Laboratory (M-MA009) ysrACliUS�h Report Prepared For: Report Dated: 7/8/2015 Kristina Conaway Order No.: G1588212 257 Percival Drive W Barnstable, MA 02668 Laboratory ID#: 1588212-01 Description: Water-Drinking Water Sample#: Sample Location: 257 Percival Drive,W Barnstable Collected: 07/07/2015 Collected by: KC Received: 07/07/2015 Test Parameters ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Total Coliform Present PIA 0 0 SM9223 RG 7/7/2015 The recommended maximum contamination level for drinking water exceeded due to Coliform Bacteria. Tested negative for E.coli. Attached please find the laboratory certified parameter list. Approved By: (Lab Director) 7 ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, P0.'Box 427; Barnstable, MA 02630 Ph: 508-375-6605 TOWN OF BARNSTABLE LOCATIONQi' � �r. SEWAGE# VILLAGE LM,�e%!,,�ASSESSOR'S MAP&PARCEL a I 'S NAME&PHONE NO.' wjL t,l `-CO —1-1-1 0/ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) r Yc-I�o `� (size) NO.OF BEDROOMS y OWNER PERMIT DATE: COMPLIANCE DATE:Ln 11 IQ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY J ! f f f f f J f J f f f f f f f J J f f J \fv 9 ISQ/'*Q4 \ \ \ \ \ \ t 4 t \ \ 4 t t •-1 4 4 \ h 4 \ 4 \ f f f f f f f f ! f f f f f f f f f f f f f f f f F l f f f f F F F F J f•'f f F J+J f f f f f,f f f J J J f f f f J'f f 19 46 w 51 27 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. Cityrrown Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information �I forms on the computer,use 1• Inspector: CD only the tab key - to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. , Company Name 189 Cammett Road Company Address MA 02648 Marstons Mills state Zip Code , ream Cityrrown 508.428.1779 SI 12855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority May 11 2010 Vinectolrest&gnat'ur(ele"� Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 t5ins•09108 r l� Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. Cityrrown B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Tank is not in need of pumping at this time, leaching trenches show no signs of surcharge or saturation. B) System Conditionally Passes: ❑ one or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11, 2010 required for State Zip Code Date of Inspection every page. City/Town B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. Cityrrown B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than_day flow t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11, 2010 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or. obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. El ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 15ins.09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. Cityrrown C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® El approximation in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No N/A Well Water Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Unknown Last date of occupancy: Date Commercial/Industrial! Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t51ns•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. Cityfrown D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): I General Information Pumping Records: Tank pumped 6/09 Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1995 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1' Depth below grade: feet Material of construction: ❑cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 3" Depth below grade: feet Material of construction: ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 10 5' long x 5.8'wide- 1500 gal. Dimensions: 2" Sludge depth: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form x Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .'' 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) 30" Distance from top of sludge to bottom of outlet tee or baffle 2" Scum thickness 6" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 12" Measured How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is not in need of pumping at this time, liquid level was found at bottom of outlet invert. Tees were intact and clear. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts w Title .5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments '< 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11, 2010 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11, 2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box had no solids or high stains present, liquid level was found at bottom of both outlets. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 112 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11, 2010 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: Two 40 foot ® leaching trenches number, length: trenches. ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching trenches show no signs of surcharge or saturation. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-09f08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11, 2010 required for State Zip Code Date of Inspection every page. Cityrrown D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 t5ins•09/08 1' Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 257 Percival Drive Property Address Christopher Adams Owner Owner's Name _ 02668 May 11 2010 information is West Barnstable MA required for City/Town State Zip Code Date of Inspection every page. D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately / \/ / / / J \/\/\/♦/\/\/\/\/\ \ \/\/\ I ! / / / J / / / / \ \ / / / ! / / \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ / / / / / \/\/\/\/\/ / /\/\ \/\r\/\r\/ \/\ 19 46 ay„ 51 27 r. Ehli':a'.P Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells 20+ Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Low point at front of property with no surface water is considerably lower than SAS. Before filing this Inspection Report, please see Report Completeness Checklist on next page. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 t5ins•09108 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 257 Percival Drive Property Address Christopher Adams Owner Owner's Name information is West Barnstable MA 02668 May 11 2010 required for State Zip Code Date of Inspection every page. CityRbwn E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 l5ins-09/08 N COMMONWEALTH OF MASACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI `'' DAVID B.STRUHS Govemor ", Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 257 PERCIVAL DR.WEST BARNSTABLE, MA 02668 MI I I P064 L019 Name of Owner CIO JACK NICOLETTI Address of Owner: 1582 RT 132 HYANNIS MA 02601 Date of Inspection: 11/6/00 �0 Name of Inspector: JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02636 Telephone Number: 508-564-6813 FAX 508-564-7270 . CERTIFICATION STATEMENTS I certify that I have personally inspected the sewage disposal system at this address and that the information reported.below is true,accurate and complete as of the time of inspection.;The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes _ Conditionally Passes _ Needs Further EvaluLation By the Local Approving Authority Fails Inspector's Signature: Date:1117/00 The System Inspector shall s mit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.if a 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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer;if applicable,and the approving authority. NOTES AND COMMENTS "The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.I inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its component's useful life." THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM NOW AND EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. 3 . ea °1r revised 9/2/98 Paoe 1 of 11 "SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 257 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 L019 Name of Owner C/O JACK NICOLETTI Date of Inspection: 1116/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. B. SYSTEM CONDITIONALLY PASSES: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completio the replacement or repair,as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances. If"not determined",explain why not. nla The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or th septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiitration,or tank failur is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approve by the Board of Health. nla Sewage backup-or breakout or high static water level observed in the distribution box is due to broken or obstructed pipes due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health) _broken pipe(s)are replaced _obstruction is removed _distribution box is levelled or replaced n/a The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced _obstruction is removed PAIL erg, <�Ex 41 bf ti; revised 9/2/98 � ' Paae 2 of 11 rst� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 267 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 L019 Name of Owner C/O JACK NICOLETTI Date of Inspection: 1116/00 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public heal safety and the environment. 1) SYSTEM WILL PASS UNLESS.BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEIII NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 FUNCTIONING IN A MANNER THAT,PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributar to a surface water supply. _ The system has.a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, . r The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply,well,unless a well water analysis 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 ppm,Method used to determine distance n1a (approximation not valid). 3) OTHER nla S revised 9/2/98 Paoe 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 257 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 PO64 LO19 Name of Owner C/O JACK NICOLETTI Date of Inspection: 11/6/00 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.. Yes No - X Backup of sewage into,facility or system component due to an overloaded or clogged SAS or cesspool. - X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. - X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, - X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped n/a. - X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. - X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. - X Any portion of a cesspool or privy is within a Zone I of a public well. - X Any portion of a cesspool or privy is within 50 feet of a private water supply well, { - X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: 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: lti 4 The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No - X the system is within 400 feet of a surface drinking water supply - X the system is within 200 feet'of a tributary to a surface drinking water supply - X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2/98 €., Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 257 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 L019 Name of Owner: C/O JACKNICOLETTI Date of Inspection: 1116100 Check if the following have been done aYou must indicate either"Yes"or"No"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health. X _ None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during tha period.Large volumes of water,have not been introduced into the system recently or as part of this inspection. 5� X As built plans have been obtained and examined. Note if they are not available with N/A. X _ The facility or dwelling was inspected for signs of sewage back-up. X _ The system does not receive non-sanitary or industrial waste flow. X _ The site was inspected for signs of breakout. X _ All system components,excluding the Soil Absorption System,have been located on the site. X _ The septic tank manholes were`uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,materia of construction,dimenfsfohs,'aepth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X _ Existing information,For example,Plan at B4O,H, 2Y•� X _ Determined in the field(if any'of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b)] X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Dispose Systems. E+t l ti�c�.i Ft a . Cxt i ±r" 1) revised 9/2/98 Paoe 5 of 11 I 'fl SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 267 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 L019 Name of Owner C/O JACK NICOLETTI Date of Inspection: 1116100 _ FLOW CONDITIONS RESIDIENTIAI Design flow: 110 g.p.d./bedroom Number of bedrooms(design): 4 Number of bedrooms(actual):n/a Total DESIGN flow: 440 gpd Number of current residents:3 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system Inspected(yes or no): NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): n/a gpd Sump Pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL , Type of establishment: n/a Design flow: nla gpd(Based on 15.203) Basis of design flow:n/a Grease trap present:(yes or no): NO Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: n/a Last date of occupancy:n/a vl'. OTHER: (Describe) n/a GENERAL INFORMATION PUMPING RECORDS and source of information: n/a System pumped as part of inspection:(yes or no):NO If yes,volume pumped n/a gallons Reason for pumping:n/a TYPE OF SYSTEM ,, X Septic tank/distribution box/soil absorption system _ Single cesspool _ Overflow cesspool _ Privy _ Shared system(yes or no)(if yes.attach previous inspection records,if any) _ I/A Technology etc.Attach copy of up to date operation and maintenance contract _ Tight Tank Copy of DEP Approval Other:n/a ; APPROXIMATE AGE of all components,;date installed(if known)and source of information: APPROXIMATELY 5-10 YRS OLD Sewage odors detected when arriving at the site:(yes or no): NO revised 9/2/98 Paoe 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 1-019 Name of Owner C/O JACK AICOLETTI Date of Inspection: 1116100. BUILDING SEWER:X (Locate on site plan) Depth below grade: 8" Material of construction: _ cast iron X 40 Pvc _ other(explain) Distance from private water supply well or suction line: n/a Diameter: n/a Comments: (condition of joints,venting,evidence of leakage,etc.) TOWN WATER SEPTIC TANK: X (locate on site plan) Depth below grade: 2" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: n/a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 1000G L 8'6"H 6'7"W 4'10"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How dimensions were determined:,,MEASURED Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,etc.) X THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING NOW AND EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL;LIFE GREASE TRAP: (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ imetal_ Fiberglass _ Polyethylene_other Explain: n/a Dimensions:nla Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a Date of last pumping: n/a Comments: (recommendation for pumping,conditicn of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,etc.) nla lk'n X '-N! 46 revised 912/98 Paoe 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 267 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 L019 Name of Owner C/O JACK NICOLETTI Date of Inspection: 11/6/00 n;r TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other Explain: n/a Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm present: NO Alarm level:N/A Alarm in working order:NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n/a . u DISTRIBUTION BOX:X (locate on site plan) t;I_ Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. PUMP CHAMBER: _ (locate on site plan) Pumps in working order:(Yes or No): NO Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n/a A _e. revised 9/2/98 Paoe 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 267 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 L019 Name of Owner CIO JACK NICOLETTI Date of Inspection: 1116100 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number:(n/a)n/a leaching chambers,number: (n/a)n/a leaching galleries,number: (n/a)n/a leaching trenches,number,length: (n/a)n/a leaching fields,number,dimensions: (1)LEACH FIELD overflow cesspool,number: (n/a)n/a Alternative system: n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH FIELD APPEARS TO BE FUNCTIONING PROPERLY,THE SYSTEM SHOWS NO SIGNS OF FAILURE. CESSPOOLS: _ (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer. n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a PRIVY: (locate on site plan) Materials of construction: nla Dimensions: n/a Depth of solids: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a J (' revised 9/2198 Paoe 9 of 11 ID SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 PERCIVAL DR.WEST BARNSTABLE, MA 02668 M111 P064 L019 Name of Owner C/O JACK NICOLETTI Date of inspection: 1116100 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) Dec . o p Ui CC 11 'S �4 a3 C;f fy� revised 9/2198 Paoe 10 of 11 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 PERCIVAL DR.WEST BARNSTABLE, MA 02668 MI 11 P064 L019 Name of Owner C/O JACK NICOLETTI Date of Inspection: 1116/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep_ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record _ Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions _ Checked with local Board of health Checked FEMA Maps _ Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET ` - j74 x4i revised 9/2/98 t .. Paoe 11 of 11 _ TOWN OF STABLE Ln ATION � Cal v �� SEWAGE # F� VILLAGE n'5_Jr4SSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNERS�C ' PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by AA AC i� TOWN OF BARNSTAB E -713 ,L(CA-,ION �� `��VAX a SEWAGE # 5 r- VILLAGE AXNS4a4pA��' A�SS,,ESSOR'S MAP& L�OT c, INSTALLER'S NAME&PHONE NO. 20 A010', e Z®lS� f o ` 9-$`IL L SEPTIC TANK CAPACITY } LEACHING FACILITY: (type) S 00 (size) NO.OF.BEDROOMS BUILDER OR OWNER ' �+ PERMIT DATE: -a N 4!� COMPLIANCE DATE: / "1.7 Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 op Gov6 11 ( . 060 No.... .. '3 Fss.... v............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphratiou for Divjipoottl Work owitrurtion Prrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: 4 oZ �,r,f-e-bu ..�T 1a Y- �:iU. S.�-... �_ 1.4?.�.�.. ""° f�!�N4P t.�1 �F� `n(.�_.. � .. J�.. •-...... ---------•----•- -- - . Y" r Location-Address Lot No. S?.CL1 - `o�^?.�.! C: Z .s��.�•t_'. �-•-•-•-------- ---•-- ---- ------ )-- .: nit_..--I................. Owner Address -1T37�t._� ls�vS x - �wlrR. �'UrS..f�11_c�S,. Installer Address UType of Building Size Lot_.�� jS`J_.._..Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QOther fixtures ------------------------------------------------------•••-•-------------....------•----.......---•---••••--•--•-•--•-•............-•----......----•-- W Design Flow....... per person per day. Total daily flow........5.so.......................gallons. 'll V. Septic Tank—Liquid capacity 1`.,1.90—gallons Length-.-.-'!..._.... Width......C........ Diameter---------------- Depth. .�9 r x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....11_ ;.� ---- Diameter...K0_.......... Depth below inlet-_-�`........... Total leaching area..`7£'.(.,::?....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed ...... c-z_ ._i _i 1��1,_ Date----�v'� aS _ l Test Pit No. 1<z-----minutes per inch Depth of Test Pit....!`{1{_.__.__. Depth to ground water.Ar.,i.PF......... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••-••--•--------------------••--•. .......••-••--••--•--••-•••-•••••--••••••••----••--.............--•-----•-•--•--------•---•----•-- Description of C2A`l Soil-di- � " .... � 5� __`-T x' ..--•-... . ..0. ._..� 4.V �. W -------------------------------------------------------------------••-•-•.......-----------•••••••--------•---------•---------------•••------------•-------••••••••••--•--••-•-•••••-•-•-•............. U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ----------------------------•------•---•••--•-----------------------------------•---•-•--------•--------------------------------------------•--•---------...------...-•----------------.........--.-•••• Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place he system in operation until a Certificate of Compli has b en ssu by,t bar health. Sine 3 C? _...... . ... .. .. ... ........... ......... ....-... ........ ......... Da e Application Approved By -------------- ------------- -' ......................................................./-- J �--� -y^ .......... .......... ..Da.................... Application Disapproved for the following reasons: ............................... ------------------------------------------------------------------------------- ---t.. Permit No. . — .7/ \ 3_�. ��— Dace ........ ...... Issued ............................. . ...................... Dace 1 No.. , t, /Fic . s..-- 'AF THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE AVV iratiott for UhnVoottl orkq/Tonitrnrtion ramit Application is hereby made for a Permit to Constructdor Repair ( ) an Individual Sewage Disposal System at: c�� 2 S7oak,rJ1�b� T-� 0.t> v on -\ P Ili V()e c� L Location•Address or Lot No. ' j c..S...vF' �... ....... - = s Owner Address s............... ��`-J �_. x.� _ �l 1�°�. �'lstt>i: r�{-crz-c( Installer Address Type of Building Size ......Sq. feet .� Dwelling— No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- -- ------ W Design Flow.......1I.D..............................gallons per person per day. Total daily flow........5.5.v.......................gallons. WSeptic Tank—Liquid capa6ty15.0_0-gallons Length----.'._....... Width......(_v:--. Diameter................ Depth_:+:'.!':i7 x Disposal Trench—No. .................... Width.................... Total Length----------.......... Total leaching area....................sq. ft. Seepage Pit No..__LS,_."?_------- Diameter---!C�............ Depth below inlet---4-'........... Total leaching area..7B.(......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..T�=�_f.!-. Date........................................ .Test Pit No. 1< .....minutes per inch Depth of Test Pit----44. .......... Depth to ground water...f:�_P.F......... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ cs4 •---•---•-----------------------------1-----------------------•---•---------------.............._......•--•--•-•-----------...------......•...-----•--•--------- O 'Description of Soil 1 - `�-;-'/---...... 1•`7P 5, 1.�'Sn! �— 2`+/t "�A6" F' -= /------- U ........ :..��—.--.....��`�� `�_�.�?.:....�i1 ��.... .............................................................. 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ..... ..... � Dace Application Approved By .............. .. t.. - -- 7•c,- -- --------- / ---- —-- ----- -'-------------- ace.................. D Application Disapproved for the following reasons: ..... ....... ...................... . .......... ......... .......... . --.--......... .................. . ........ . ................................ ........ ........ ..............--------------------------- ............................... Permit No. - --- 7-/.'3........... Issued ...........�3— -�s Date Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF,HEALTH TOWN OF BARNSTABLE ( V,Ertifirate of �V-IIittpliance THIS IS TO CERTI-Y, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by _t it^ L------�7------ -,=C- .CCa..c.` i. . .� -T < - - - . .................................... ..................... / r.. � tnsrauec at .a �^� 1{ ...`" /'Cl raG( /tJ��'.. ........... ....... ; 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. - .....7� 3 - ........... dated 3... ..^..�............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SVTISFACTORY. ? v---------------------------------------- Inspector ---........ ------- DATE.. f....�...'............. �..- ..... ......... ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH q TOWN OF BARNSTABLE v No....../ : �DD ..--- - FEE.... io�ro �t1 ork Tonatrurtion "rrmit Permission is hereby granted _.�c lr,-:..- fr_•� --=- ----•------------•----------------------------- to Construct (/f or Re air ( ) an Individual Sewage Disposal System _-� at l ,�, . ��r �� -/ Tyr Street /� as shown on the application for Disposal Works Construction Permit No...9...___...�__ Dated.._...... ��..._�......---....... --•------•--=--•----•-------------------- .............................................................. Board of Health DATE=----------------------•---•----•-----••----------------••--------------------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS = 9 A I -- _'_j_ ---�J-`-- -------- No. BOARD OF HEALTH Fee TOWN OF BARNSTABLE Application-*rVell Con5tructionpernut Ap .ica on is hereb made for a permit to Construct , Alter ( ), or Repair ( )an individual Well at: ------------ ------------------------------------------------------------- Location — Address Assessors Map and Parcfl --------- -------------- �w r Address Installer — Driller Addresel Type of Building__ &7---------------------------------------- Other - Type of Building -------------------- No. of Persons------------------------------------------------- Typeof Well- � - - - --- -- Capacity--------------------------------------------------- - -—— Purpose of Well-----E=C -- - — -- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The To wn of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation un ' a rY is pliance has been issued by the Board of Health. Signed., --- j�� --- ------------------------------------------ ---- date Application Application Approved By- - -- date Application Disapproved for the following reasons:------------------------------------------------------------------------------------- ------------ -- ----- ---_-_------ — --- ------ ---- -- - -------------- - -------- -------- �j date Permit No. -- --k �--�-�—---— ---- Issued ------------------------ date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed V, Altered ( ), or Repaired ( ) by------------ --------------------—---- ------------------------------------------------------------------- ------------------- /� Installer at------ ------- � � —__-- -- ---has been installed in accordance with the provisions of the Town of Barnstable Board ofHealth Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated- ��---= THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE --- -- - ----------------------- -—- Inspector----------------------------------------------------------- ^f ' s ---- ------- No.--�;--- --- t I BOARD OF HEALTH TOWN-� OF BARNSTABLE _-: i 1 Applicat ion for Meft Coot ftttt ion VVermit t "� `' Ap/licat'°n is.herebmade (or-a permit to Construct" , Alter ( ),.or Repair ( )an individual Well at: _lr`-__77__f- ----- '-�_at2�i( ��/ =- —-— -- - --- --- - ----=---------------- ----- Locahon Address Assessors /Map and Pardil �}----------------- --- �`` Own r Address - -- ---- -----------` � .�Q Installer — Driller _ Address , T Type of Building 4 Dwelling ,.''tither - Type of Building ------ No. of Persons------=----------------------------------------- Type of Well ——- ------------------------------- Purpose of Well ----I'"-�?- ��-'--`--:------------------------=------ Capacity------------------------- --------------------- ----��----------- J { 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 Certi is to . •mpliance has been issued by the Board of Health. I � %C� -�`" ? /d Signed = ' --------- — date 4 i Application Approved By date ij Application Disapproved for the following reasons:----- ----------------------------------------- --=_—-------------------------______ i � r -------------------------- ----_------ ------- - - - ----------------------------------- - - date ` Permit No. a � , — -- Issued date i x BOARD OF HEALTH TOWN OF BARNSTABL.E ertificate Of Compliance THIS IS TO CERTIFY, That the Individual Xell Constructed ( y, Altered ( ), or Repaired ( ) -_ ------ by----- --------------------------------------------------- '. Installer _ _ _— '- -s�axck _ '__-_--_-_ _;______ has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in.the application for Well Construction Permit No. ----Dated-� ---= THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL i SYSTEM WILL FUNCTION SATISFACTORY. s DATE-------------------—=------------------ --- - -- Inspector= - - - - = --- i+narw nnsrsn ryrse�+era�e u..s+on..-�.cs�-.ro-wse:nr�n�auw��.r�+.1�-.1��•�W�+rw..mr�.�a+re wens�we.�mu..rs.rrv,,�.�bn.ameu r.w.e�a�r..�..�.®.r.a��r.�..mma.++�mi.auw ws�o.-wxs;:�J BOARD OF HEALTH TOWN OF BARNSTABLE let[ Con5tr ' dionPermit No.. f- --=-� Fee-- ----��--�------ i Permission is hereby granted--- -=-- --- -- ------ - - --- - - i to Construct ( ), Alter ( ), or Repair ( ) an Individual Well at No. cam! �/5� - - l s �'r - ---- ----- ------- treet - -- - ------------ ` as shown on the application for a Well Construction Permit No. --------- -d�-�--- ---------- - - // �� - `�-= 1 Dated--- --1 - --� 5------------ ` ----------------- —------------------------------------ ..-.------ DATE Board of Health f ----------- �``------ ------ r , ENVIROTECH LABORATORIES, INC. MA Cert. No.: M-MA 063 1 t, 449 Rte. 130 • Sandwich, MA 02563 (508)888-6460 • 1-800-339-6460 FAX(508) 888-6446 CLIENT: Reef Realty LOCATION: Lot 18 Percival Dr. P.O. Box 186 W. Barnstable, MA W. Dennis, MA 02670 SAMPLE DATE: 3-21-95 COLLECTED BY: Clifford Well Drilling DATE RECEIVED: 3-21-95 TIME: 11:00AM LAB I.D. NO. : E3-293 JOB TYPE: New well SAMPLE I.D.NO. 18 WELL SPECS.: 72, RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100m1 (MF Method) 0 0 pH pH units 6.0-8.5 5.98 Conductance umhos/cm 500 108 Sodium mg/L 28.0 9.20 Nitrate-N mg/L 10.0 0.26 Iron mg/L 0.3 LT 0.05 Manganese mg/L 0.05 0.006 Volatile Organics See enclosed report. EPA 601/602 ug/L Yes No WATER IS SUITABLE FOR DRINKING PURPOSES TPR PARAMETERS TESTED. XXX Date 3 R ald J. ari Laborato Director IT = Less Than t GROUNDWATER ANALYTICAL EPA METHODS 501 and 502 Volatile Organics (GC/PID/ELCD) Field ID: E3-293 Lab ID: 10224-01 Project: Reef Realty/Lot 18 Percival Batch ID: VG2-0578-w Client: Envirotech Sampled: 03-21-95 i Cant/Prsv: 40mL VOA Vial/HCl Cool Received: 03-21-95 Matrix: Aqueous Analyzed: 03-23-95 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) (ug/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL Chloroethane BRL 5 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL 1 trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethane BRL cis-1,2-Dichloroethene * BRL 1 Chloroform BRL 1 1,1,1-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL i 1,2-Dichloroethane BRL Trichloroethene BRL 1 ro ane BRL I 1'2-Dichloro p p BRL 1 Bromodichloromethane 2-Chloroethyl Vinyl Ether BRL 5 cis-1,3-Dichloropropene BRL 1 Toluene trans-1,3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL Tetrachloroethene BRL 1 Dibromochloromethane BRL 1. Chlorobenzene BRL Ethylbenzene 1 BRL meta-and Para-Xylene * BRL 1 ortho-Xylene * BRL i Bromoform BRL 1,1 ,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 30 102 % 87 - 113 % 1,2-Dichloroethane-d4 30 30 101 % 83 - 117 % BRL = Below Reporting Limit. * Non-target compound. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986). -------------------------------- a-. . ---- --------------------------------------- - � . -- -----j a , I N , ASSESSORS MAP. 111 PARCEL: 64 T.E'ST HOLE LOGS NOTES: v 1. VERTICAL DATUM: ASSIM_F.D FROM�"QUAD NGVD + -) �o CURRENT ZONING: RF ENGIN.�'ER: DOYLE ENGINEERING (�+ 2. MUNICAPAL WATER IS NOT AVAILABLE. �9 BUILDING SETBACKS: WITNESS: THOMAS MCKEAN R.S. 3. SCHEDULE 40 - 4 PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. h'Jc F: 30 S: 15' R: 15' DATE: 10=2-86 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20 R�r PERCOLATION RATE: < 2 MIN/IN LOADING SPECIFICATIONS. FLOOD ZONE: C TH-2 5. PIPE PITCH = I/4 PER FOOT,(UNLESS NOTED OTHERWISE). 97.0 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL. •� Y TOP 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE IL ELEV SUIsO Locus 24" 95.0 USE OF A GARBAGE DISPOSAL. FIDE 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE 'SA�ltD STATE OF MASS. ENVIRONMENTAL CODE TITLE FIVE AND LOCAL LOCATION MAP WIT ( ) LOT 18 GRAVEL HEALTH REGULATIONS. 60" 92A 35359 SF 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR CL AN TO CONSTRUCTION. (0.81 AC.) MEDIUM 3� o SAND g6 0 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE 1 WITH MASTER PLAN ON FILE WITH BARNSTABLE HEALTH DEPT. 106 LOCATION OF SEPTIC SYSTEM HAS BEEN REVISED SLIGHTLY FROM 144" 85.0 MASTER PLAN BUT STILL MEETS ALL SETBACK REQUIREMENTS. \104 - � - NO GROUNDWATER ENCOUNTERED 11. D BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. 102 ` R EN NTERED 108 { ' 100 . :. SEPTIC SYSTEM DESIGN 98 FLOW ESTIMATE: BEDROOMS-AT 110 GAL/DAY/BEDROOM = 550 GAL/DAY 96 SEPTIC C TANK. ,'• s' r QGAL/DAY 1.5 DAYS = R2,� GAL DIC 94, 1 .r , 108 60' � ,` USE 1500 GALLON SEPTIC TANK r ✓a . : � �I PROPOSED } l�drj 28' S BEDROOM 24 sz : ;` d °Ap d'fy r LEACH. ING AREA: DWELLING 90 GARAGE � r - �g USE TWO LEACH PITS 6' x 4' WITH 2' OF STONE 24' ,�, , ,. , ' EFFECTIVE DIAMETER x 4' .,� •., •. �-. r0 y � . . , �, DEEP) 84 . E ez ` . �. iy" FIDE AREA:` 10�x 4 x PI =_126 SF _(2.5) 314 GAL/DAY PROPOSEDDWELLING - . .. - 106 { ,� , 7 r i, i � • T >. _ 7L? GAL, fn,� ' _ s0 _ _ 7.8 (`� s, 1 '" = 6Z GAL DAY PROPOSED WELL � ^ � . `/ ` -• . "` .' ' " ' r 104 4 x 2 S - (198' TO LEACHING) 76 �. `� . . `` , r r r PIT 786 GALIDAY 74 PROPOSED WELL � r r r � r 102 S E F T I C SYSTEM SECTION 2" PEASTONE - (LOT 1'7) 74 ` r , ► r , `r r , 100 i r t 76 , r r 98 COVERS WITHIN 12" OF 314' 1 V2' - - ; 100.0 OF FINISHED GRADE r , , ► ► , r WASHED STONE iTlILI TY CLUSTER _ ;_ , ► , , , ►- r , 9s TOP OF FOUNDATION .. r92 80 r . . r t 90 r ' op76. B r •�✓88 p /Q� t 86 EDGE OF DRIVE 78 \96.43M 84G7s. 0 96.68 ELEV. 1500 GAL D-BOX 96.2 82 ELEV. 1 SEPTIC TANK 96.37 ELEV. ' 92.0 L�'hj • t 97.0 .--� ----, ELEV. 1• � ELEV. 96.0 ELEV. J TEE SIZES. <QL ----� ` INLET. 6' UP, 110 ELEV. 10' DOWN BENCHMARK AT 1� EXISTING WELL OUTLET. 6" UP, 19" DOWN TWO LEACH PITS (6 x 4) WITH CATCH BASIN 2' OF STONE (10' EFF. DIAM. x 4' DEEP) (H-20) ELEV.-- 75J BREAKOUT CALC.: 96.5 - 80 125 x 150 = 20' SITE AND SEWAGE PLAN KEY: EXISTING CONTOUR: LOCATION.' ......................... PROPOSED CONTOUR. • " >:�� , LOT 18 PERCIVAL DRIVE . tr• EXISTING SPOT ELEVATION: 25.5 PROPOSED SPOT ELEVATION: 25 - ti,> .. L� WEST BARNSTABLE, MA TEST HOLE.. PREPARED FOR.- UTILITY POLE: -O- r �.'; .• .; ; _ � ..: ;f� j FENCE LINE. .. REEF REALTY 0 .• , HYDRANT: �?• . �;..,,� ,..<, , A:° DEMAREST-McLELLAN ENGINEERING SCALE: 1" = 40' DATE: 3-9-95 RETAINING WALL. 24 SCHOOL STREET P.O. BOX 463 �`; G WEST DENNIS, MASSACHUSETTS 02670 " -- JLREFERENCE: PLAN BOOK 413 PAGE 99 DM # .4=312=18 THOMAS McLELLAN, P.E. J10HN Z. DEMAREST JR., P.L.S. l� 1 . - I - N ASSESSORS MAP. 111 'TEST HOLE LOGS NOTES: PARCEL: 64 � '0 >. VERTICAL DATUM. A ___ Ej1 FROM QUAD (NGV I ENGINEERING CURRENT ZONING: RF ENGINEER: YLE N DO 2. MUNICAPAL WATER IS NOT AVAILABLE. WITNESS T OMAS MCKEAN R.S. _ " $ es BUILDING :SETBACKS. H 3. SCHEDULE 40 4, PVC PIPE TO BE USED THROUGHOUT:.SEPTIC SYSTEM. 9 , DATE. 10 2-86 �►f - F. S.,S R. 15 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20 sf PERCOLATION RATE < 2 MIN/IN LOADING SPECIFICATIONS. " PER FOOT UNLESS NOTED OTHERWISE). 9 FLOOD ZONE. . C 5. PIPE PITCH 1/4 .( � TH-1 TH-2 97A 6. FIRST 2' OF PIPE OUT OF D—BOX TO BE LAID LEVEL. 5 Top d ate' 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE A , d' 24" SUBSOIL Locus 95A USE OF A GARBAGE DISPOSAL. � / ? FINE 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE SAND STATE OF MASS. ENVIRONMENTAL`CODE .(TITLE FIVE) AND LOCAL WITH LOCATION MAP GRAVEL HEALTH REGULATIONS. _ 60' 92A LOT 18 9.` CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR 35,359 SF - 3 GLEAN TO CONSTRUCTION. o (OBI AC. MEDIUM o g E SAND f0. PROPOSED SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE 1g$• WITH MASTER PLAN ON FILE WITH BARNSTABLE HEALTH DEPT. LOCATION OF SEPTIC SYSTEM HAS BEEN REVISED SLIGHTLY FROM 1Os 144" 85.0 MASTER PLAN BUT STILL MEETS ALL SETBACK REQUIREMENTS. \104 11. D BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL'FLOW. NO GROUNDWATER ENCOUNTERED 102 . 108 "f 00 \ \ SEPTIC SYSTEM DESIGN ` ` t FLOW!.ESTIMATE: Ot ' 5 BEDROOMS AT._.110 GAL/DAY/BEDROOM _. 550 GAL/DAY to t t �• ,,p t t tO SEPT.TC TANK. ss . 1 * GAL ., +•. s •o + � �0.GAL/DAY 1.5 DAYS •$� DK 6tY ? + 108 94 ► . t , USE 1500 GALLON SEPTIC TANK fi PROPOSED \ ► �o- : + , ,Q t r 28' S BEDR003! 24 92 :' ,o .1+ }• : : t ACE \ �� os ,� LEACHING AREA: DWELLING GAR 6' x 4' WITH 2' OF STONE 24' USE TWO LEACH PITS ( ) 36' . CE + r ('10' EFFECTIVE DIAMETER x 4' DEEP) a 84 86 � •. • •. \ '• dip ♦ ' .� 9G+ .t SIDE AREA. 10 x 4 x PI — 126 SF (2.5) 314 GAL/DAY PROPOSED DWELLING ♦ .. . . + 106 BOTTOM AREA: 5 x 5 x I = 78 SF (1.0) 78 GAL/DAY ♦ \ \ \ t 80 � s.�.,. ��r .�",^ CITY =` 2 GAI, DAir 1 lit ,w r. Lil""A / 78 , , t x 2 PITS = 786 GAL DAY PROPOSED WELL . \ \ `�' '. ., , f 04 / (199 TO LEACHING) ` \ \ , , n 74 + ' 2 PEASTONE t t r 102 SEPTIC SYSTEM SECTION PROPOSED WELL \ ` ' ' ► t t (LOT 17) 74 _ � ♦ . , , �; t t � \ r , t 1100 ♦ r r r t 98 OF 3/4" - 1 1/2" t � COVERS WITHIN 12" 76 � � ✓ r t t , of FINISHED GRADE WASHED STONE 100.0 96 TOP OF FOUNDATION v?7LI TY CLUSTER 94 J 1 92 IT, e • t � .. r t t � 80 �' r 't, 90 Lich. p ' 76. 8 86�EDGE OF DRIVE \96.43 78 ' + 4, o ` _ o 84 96.68 ELEV. D BOX 7s. 0 1500 GAL96.2 ELEV. 96.37 92 .0 e2 SEPTIC TANK ELEV. . 97A ELEV. ELEV.2 CI ELEV. TEE SIZES. _ 96.0 2' ELEV. do- f0' L INLET: 6" UP, 10" DOWN _ •�- EXISTING WELL � OUTLET. 6" UP 19" DOWN TWO LEACH PITS 6 x 4) WITH BENCHMARK AT v f 2' OF STONE (10' EFF. DIAM. x 4' DEEP) (H 20) CATCH .BASIN � f ELEV. 75.1 BREAKOUT CALC.. —(96.5 80) / 125 x 150 = 20' j SITE AND SEWAGE PLAN ' KEY: LOCATION. EXISTING CONTOUR. :PROPOSED CONTOUR. ...........................• ;.-, . .. �;,. .•,� ,� LOT 18 PERCIVAL DRIVE EXIST ING SPOT ELEVATION. 25.5 WEST BARNST BLE. -MA - A OPOSED .SPOT ELEVATION. 25 PR M. S HOLE: TE T H PREPARED FOR , UTILITY.POLE. ,—}- . .. . " FENCE:LINE. DM _ �� . . .., 1�4 REEF REALTY HYDRANT. -C'� DaYAREST-YcLELLAN ENGINEERING SCALE. 1" - 40' DATE.. 3 9 95 RETAINING WALL. 24 SCHOOL STREET P.O. BOX 463 ti HEST DENNIS, MASSACHUSETTS`02670 REFERENCE: PLAN .BOOK. 413 PAGE 99 . DM # cLELLAN P.E. JOHN Z. DEMAREST JR, P.L.S. 94-039-18 THOMAS M , i k r N , / A SSESSORS MAP. f1f PARCEL: 64 TE ST�'ST HOLE LUGS NOTES. SStTILIF,D FROM G7D _ . 1. VERTICAL DATUM. ASSUMED-_-- QUAD (N +/ ) ENGINEER: DOYLE ENGINEERING W AVAILABLE. CURRENT ZONING. RF 2. MUNICAPAL WATER IS NOT A A $ WITNESS. THOMAS MCKEAN>a BUILDING SETBACKS. , R.S. 3. SCHEDULE 40 4 PVC PIPE TO BE USED THROUGHOUT:SEPTIC.SYSTEM. 9 � 15 fc� - � F. S. R. 15 DATE. 10 286 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H--10 8c`H-20' s PERCOLATION RATE < 2 MIN/IN LOADING SPECIFICATIONS. OTHERWISE). '0 FLOOD ZONE. C _ 5. PIPE PITCH PER FOOT.,(UNLESS NOTED TH-1 TH-2 5 97•0 6. FIRST 2' OF PIPE OUT OF D BOX TO BE LAID LEVEL. , ELEV SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE A TOP � � 7. THE.SEPTIC SY TE SUBSOIL d' B o � 24" s5.o USE OF A GARBAGE DISPOSAL. f r iocUs FINE 8. ALL CONSTRUCTION DETAILS ARE. TO BE IN CONFORMANCE WITH THE SAND STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL WITH LOCATION MAP GRAVEL v HEALTH REGULATIONS. szo LOT 18 60" LOCATIONS OF ALL UTILITIES PRIOR 5 59 SF , - 9. CONTRACTOR TO VERIFY LOCATI N 3 s CLEAN TO CONSTRUCTION. c C• F.DIUY (0 81 A ) M g1 o SAND 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATION ARE ,IN ACCORDANCE 1�'f'' WITH MASTER PLAN ON FILE WITH BARNSTABLE HEALTH DEPT. LOCATION OF SEPTIC SYSTEM HAS BEEN REVISED SLIGHTLY FROM ros 144-1 85A MASTER PLAN BUT STILL MEETS ALL SETBACK REQUIREMENTS. it \104 R ENCOUNTERED 102 11. D BOX TO BE WATERTESTED TO ENSURE LEVELNESS AND UAL FLOW. EQUAL N > NO GROUNDWATER ` 108 � 100 ♦, SEPTIC SYSTEM DESIGN 1 r , 98 , , 1 1 FLOW ESTIMATE. = 550 .� BEDROOMS AT 110 GAL/DAY/BEDROOM GAL/DAY clor , , • .• , r ems, �O SEPTIC TANK. 96 + 1. to , 1 GAL DAY * 1.5 DAYS = GAL + s 550 / �� DK 60' 94. + ' �.� 1 + 108 USE 1500 GALLON SEPTIC TANK ♦ df- 1 + PROPOSED 24' 28' 5 BEDROOM S �O 1 ' 92 ♦ : ;� ,00 1,1, , LEACHING AREA: DWELLING GARAGE 90 riA- tC d , ► Ag , , l��dr : . , �- USE TWO LEACH PITS (6 x 4) WITH 2' OF,STONE ss'88 24 • h°' (10' EFFECTIVE DIAMETER x 4 DEEP) 84 86 ` •' '� , ♦ ♦ . .• ♦ SIDE AREA 10 x 4 x PI = 126 SF '(2.5) 314 GAL/DAY PROPOSED DWELLING . • . ► ;BOTTOM AREA 5 'x 5 x PI = 78 SF (1.0) 78 GALIDAYl 80 TOTALAL ,APACI TY .GAS/DAZ ` ♦ > ' PROPOSED WELL 78 � � . . , , l 104 x 2 PITS = 786 GAL/DAY (198' TO LEACHING) ` ♦ ` ♦ ♦ � � C 74 , � SEPTIC SYSTEM 2 PEASTONE PROPOSED WELL 102 I LOT 17 74 _ ' ♦ ► ► 1 + r , r ► ► 1 ' OF 4 3 " — f 1 2•• 76 , , � � ♦ 1 � � , , , , 98 COVERS WITHIN 12" / / ' , , ♦_ ' ► , , , l , , r OF FINISHED GRADE WASHED STONE 100.0 lll7Ll TY CLUSTER . - - _ - _� , , , 1 ► , ss TO P OF FOUNDATIU94 • .♦ . l , , 92 j 80 ! l _ 1 90 o ff, 76. 8 , 86 EDGE OF DRIVE �, \,96.43 78 84 �� 96.68 ELEV. D—BOX 14 79. o t s 51 ,00 GAL 96.2 60 �\ ELEV. 96.37 92.0 A 82 SEPTIC TANK ELEV. ELEV. •� ` 0 97Z ELEV. J96.020 2 CI ELEV. TEE SIZES: � ELEV. .----- 10' -� `4L INLET: 6,' UP, 10 DOWN j) �, TWO LEACH PITS 6' x 4' WITH �•j EXISTING WELL t OUTLET. 6" UP, 19 DOWN ( ) BENCHMARK AT 2 OF STONE (10 EFF. DIAM. x -4' DEEP) (H-20) CATCH BASIN ffi 2 x 50 - 20' ELEV. 7.,,J BREAEOUT CALC.. (96.5 80) / 1 5 1 SITE AND SEW AGE PLAN KEY: LOCATION. EXIST ING ING CONTOUR. .�_, ,�.,,.-.w, .�,... ��• LOT 18 PERC VAL DRIVEPROPOSED CONTOUR: ......... ..... :.... EXISTING SPOT ELEVATION: 25.5 ` STABLE MA ELEVATION: 25 'WEST BARN STABLE, PROPOSED SPOT s . z , TEST HOLE + _. . � ,<....., �- ,, , .. ... .: , ,.:.. PREPARED. FOR. UTILITY P --C}- S .. .. cE LINE: REEF REALTY FEN .. . ._ , • �, HYDRANT. DEYAREST-YcLELLAN ENGINEERING � (}*.�yfi �, I� ,. SCALE. J" - 40' DATE. 3_9 95 RETAINING WALL. 24 SCHOOL STREET P.O. BOX 463 H REFERENCE: PLAN BOOK 413 PAGE 99 EST DENNIS, MASSACHUSETTS 02670 DM # 94=099-18 THOMAS McLELLAN, P.E. JOHN Z. DEMAREST JR., P.L.S.