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HomeMy WebLinkAbout0058 WILLIAMS PATH - Health 58 WILLIAMS PATH. West Barnstable A = 111 - 039 TOWN OF BARNSTABLE LOCATION s c C��, �`Q q,rv�S \� SEWAGE# VILLAGECSJ ,.� , ASSESSOR'S MAP&PARCEL S�8 E&PHONE SEPTIC TANK CAPACITY LEACHING FACILITY.(type) LcdGln �.—C -� (size) NO.OF BEDROOMS ( OWNER .4vr�( Q �` o ©V r o S PERMIT DATE: COMPLIANCE DATE:. %S 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��A� tg r, Z C N 2 0 �� 1 I o 1 ; . t c Commonwealth of Massachusetts Wip Title 5 Official Inspection Form ; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path ,u - Property Address - Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection' 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 forms A. Inspector Information on the computer, use only the tab Dan Hawkins key to move your Name of Inspector cursor-do not B&B Excavation use the return Company Name key. 374 Route 130 m Company Address Sandwich Ma 02563 IL ff City/Town State Zip Code rra�+ (508)477-0653 S114324 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 16.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑■ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Dan Hawkins t Digitally signed by Dan Hawkins Date:2020.oz2307:08:32-04•00 7-15-2020 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc rev.7/26/21M Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form w Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 58 Williams Path V� Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System.,Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 31,0 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: - The system was in working order at the time of inspection. Garbage grinder was removed and 2" pipe daylighting into woods was tied back into system. 2) 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. 1 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form h 0 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) - ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ a Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Y Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path u— Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ a Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ Q Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ El Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. EI ❑ Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ Q Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ 0 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.] ❑ 0 The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ El 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. 5) 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 CA. ' 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 t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form = , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments l 58 Williams Path Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (Cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following p for all inspections: Yes No El ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ n Were any of the system components pumped out in the previous two weeks? 0 ❑ Has the system received normal flows in the previous two week period? ❑ a Have large volumes of water been introduced to the system recently or as part of this inspection? El ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ E] Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components, excluding the SAS, located on site? El ❑ 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? ❑ Q 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: El '❑ Existing information. For example, a plan at the Board of Health. ❑ a Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)) t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts �n ,p Title 5 Official Inspection Form r_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 6 5 Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 660/GPD Description: Number of current residents: 2 Does residence have a garbage grinder? [I Yes H No Does residence have a water treatment unit? ❑ Yes No If yes, discharges to: Is laundry on a/separate sewage system? (Include laundry system inspection ❑ Yes F21 No information in this report.) Laundry system inspected? ❑ Yes F!] No Seasonal use? ® Yes CR No Water meter readings, if available (last 2 years usage(gpd)): See below Detail: 'WELL WATER' I Sump pump? ❑ Yes ❑Q No Last date of occupancy: currentDate t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c Commonwealth of Massachusetts �n Title 5 Official Inspection Form '= l4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c. 58 Williams Path V� Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: NA 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 Water treatment unit present? ❑ Yes ❑ No If es discharges to: Y 9 Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner- last pumped 2 years ago Was system pumped as part of the inspection? ❑ Yes ❑■ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: 0 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): Approximate age of all components, date installed (if known) and source of information: 1994 per permit Were sewage odors detected when arriving at the site? ❑ Yes 0 No 5. Building Sewer(locate on site plan): 111011 Depth below grade: feet Material of construction: ❑ cast iron ❑■ 40 PVC ❑other(explain): Distance from private water supply well or suction line: 172' from well to SASfeet Comments(on condition of joints, venting, evidence of leakage, etc.): t5insp.doc-rev.7/-6/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 c Commonwealth of Massachusetts Title 5 official Inspection Form �1� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path V� Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 10" Depth below grade: feet Material of construction: X 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 1 Dimensions: 500gallons 311 Sludge depth: 3311 Distance from top of sludge to bottom of outlet tee or baffle 411 Scum thickness 611 Distance from top of scum to top of outlet tee or baffle 1311 Distance from bottom of scum to bottom of outlet tee or baffle 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.): The tank was in working order at the time of inspection. The tank is in need of pumping at this time and should be pumped every two years for maintenance. t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path V Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): NA Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness ` Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): NA Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7%26P2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts ll p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments x. �� 58 Williams Path try Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): o„ Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The d-box was in workingorder at the time of inspection. P t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4- 58 Williams Path Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): NA * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: El leaching pits number: (2) 6'x6' pit ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.726/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form 71 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path -. Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The SAS was in working order at the time of inspection. First pit had 1' of standing water and the second pit had 2'6" when viewed . 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): NA Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate cn site plan): Materials of construction: NA Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts �y Title 5 Official Inspection Form + is Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path V� Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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: ❑o hand-sketch in the area below ❑ drawing attached separately � r rl' ACCy ,�wg f A. Sl �t "i f r e t5insp.doc•rev.7/26/2018 P Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path V Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (coot.) 15. Site Exam: ■❑ Check Slope ❑■ Surface water ❑� Check cellar ■❑ Shallow wells Estimated depth to high ground water: No GW @ 12'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) 0 Checked with local Board of Health -explain: Permit dated 11-28-1994 ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: A permit on file at the local Board of Health was used to determine high groundwater. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 a c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path u� Property Address Joseph Holland Owner Owner's Name information is West Barnstable Ma 02668 7-15-2020 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ■❑ A. Inspector Information: Complete all fields in this section. ■� B. Certification: Signed & Dated and 1, 2, 3, or 4 checked C. Inspection Summary: 1, 2,3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist)completed 0 D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspectlon Form:Subsurface Sewage Disposal System-Page 18 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form pCorT, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ff '< 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is West Barnstable ✓ MA 02668 May 23, 2012 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any p p Y way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out I forms on the computer,use 1. Inspector: only the tab key to move your Patrick T. Sullivan cursor-do not Name of Inspector use the return key. Ready Rooter, Inc. Company Name P.O. Box 371 Company Address , !{ Sandwich MA 02563 1� Cityrrown State Zip Code 508-888-6055 SI 12843 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority May 30, 2012 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use.t5ins•11/10 Tige S Official Inspection rm:Subsurface Sewage Disposal Slysl tem-Page 1 of 1 r , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: 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, ) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or th septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration r exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced ith a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it i structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less th n 20 years old is available. ❑ Y ❑ N ❑ ND(Expla' below): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 2 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ..'~ 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt.) 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 pumpi more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspectio If(with approval of the Board of Health): ❑ broken pipe(s) a e replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by t Board of Health: ❑ Conditions exist which require furth evaluation by the Board of Health in order to determine if the system is failing to protect pub' health, safety or the environment. 1. System will pass unless B and of Health determines in accordance with 310 CMR 15.303(1)(b)that the system ' not functioning in a manner which will protect public health, safety and the environme ❑ 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-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path ,p.",I-- Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tri utary to a surface water supply. ❑ The system has a septic tank and SA and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and AS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS d 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 nalysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent an the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that o 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 ❑ to Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•11/10 Title 5 Official Inspection Fonn:Subsurface Sewage Disposal System-Page 4 of 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. City/Town 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. ❑ ® 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 ithin 400 feet of a surface drinking water supply ❑ ❑ the syste is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the sy m 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 "ye "to any question in Section E the system is considered a significant threat, or answered "yes" in Se tion D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 5 Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate "yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 6 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 854.5 GPD t5ins•1 f/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 6 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. Cityfrown state Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Private Well 9 ( Y g (gp ))� Detail: Well located 172'from edge of SAS. Sump pump? ❑ Yes 0 No Last date of occupancy: Date CommerciaUlndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) s Basis of design flow(seats/persons/sq.ft., c.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank presen . ❑ Yes ❑ No Non-sanitary waste discharged to he Title 5 system? ❑ Yes ❑ No Water meter readings, if avail le: tSins•11110 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is requi red for West Barnstable MA 02668 May 23, 2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Ready Rooter records: Pumped March 2010 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 8 Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: System installed January 12, 1995. Certificate of Compliance on file at Board of Health. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 17"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. 100+- P PP y feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 9" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: Mrs Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 11.5'X 5'X 4.5' 1500 gallons Sludge depth: 21' t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 9 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Y 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 38" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 8" lilt Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Tape measure and dip tube. Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet PVC tee and outlet concrete baffle in place. Liquid level at outlet invert. Recommend maintenance pumping March 2013. 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 t top of outlet tee or baffle Distance from bottom of cum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 10 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal fiberglass ❑ polyethylene ❑ other(explain): 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 11 f•Y - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M , 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barns y +table MA 02668 May 23 2012 every page. Cityrrown 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.): One inlet,two outlets. Equal flow. No solids carryover. No sign of high water staining over outlet inverts. Riser brings cover within 6"of grade. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pum 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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 12 Commonwealth of Massachusetts Tide 5 Official Inspection 'Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barns y Barnstable MA 02668 May 23, 2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2-6'X6'w/ 1'of stone. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number. ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pits located and inspected with camera.#1: Liquid level 3.5' below invert.#2: Liquid level 2.5' below invert. No sign of past hydraulic failure in either leach pit. Leach pit#2 localed partly under driveway. Plan does not show H-20. Recommend blocking off driveway over#2 leach pit. 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is West Barnstable MA 02668 May 23, 2012 required for y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of s/ignsofulic failure, level of ponding, condition of vegetation, etc.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 14 Commonwealth of Massachusetts Tale 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Williams Path Pmperty Address Mary Biliouris Owner Owner's Name inf0nnati00 is reqWred for West Barnstable MA 02668 May 23,2012 eveyy page- Cihdrmm State Zip Code Date of Impection 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 i II B3_g0Y sy use s� �► v - o � OAY \ s P � � r s Y y o ; 1 a � 1 f t5ins 1111t1 Tile 5 Otriiat Inspection Fomr.gubsurtace Sewage Disposal System•Page 15 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Flame information is required for West Barnstable MA 02668 May 23,2012 every page. Cityrrown state Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: '5 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: 06/06/1991 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: ma.water.usgs.gov terraserver-usa.com You must describe how you established the high ground water elevation: Test hole to 14' (elv= 84+-)found no ground water(1991). Base of leach pits at elv= 89+-. Accessed local ground water contours and topo mapping. No high ground water in area of system. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Williams Path Property Address Mary Biliouris Owner Owner's Name information is required for West Barnstable MA 02668 May 23, 2012 every page. City/Town state Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i t5ins r 11/10 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 t,,,4,w-O i A".v 4, 4' TOWN OF BARNSTABLE LOCATION low to �,,�;��� q,,,,,� Y� SEWAGE # 4 40e VILLAGE Ljc3T" "JW6(-f ASSESSOR'S MAP & LOTZj /�-Q' 3 INSTALLER'S NAME & PHONE NO. R, J. Z ejI lc,.cQUA 417-(o 7J J SEPTIC TANK CAPACITY LS:U y p LEACHING FACILITY:(type) /CFC'C k (size) r t i (o K NO. OF BEDROOMS � RI ATE WELL R PUBLIC WATER —0 I �R OR OWNER ''�% Jr faw /� / DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ""� � 4 VARIANCE GRANTED: Yes No l ID Ll 3-� yC), e (ob,Y No.___l.�t-OR Fwa........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Diupuuttl Works Tomitrnrttnn Frrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal, System at:...................................................................W....................... ­e ....... .............. G� Location-Address or Lot No. t 77 - r. `l ......!J_._`�A.i................. •--•--..----__-- AA..,,..CC L ((��,�,, Owner Ad/'drelss ' a ... D ........... -0.6.t .u& --••----•'--------.... s a ��a � 1�> U>�� fl '--Qd'(�` �-•- Installerf Address d Type of Building Size Lot..s�d`60 Sq. feet U Dwelling— No. of Bedrooms______________________________ _ _ _____Expansion Attic ( ) Garbage Grinder ( )u aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ _ _ W Design Flow....0..........1515--------------------gallons per person per day. Total daily flow------------- ..................gallons. WSeptic Tank—Liquid capac>ty___._._PgalIons Length___ Width-_ Diameter________________ Depth_ _-B.... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................Sq. ft. 3 Seepage Pit No................... Diameter.....5----------- Depth below inlet..... Total leaching area..�Oz:.!..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by_.Z__ K ............................................ Date....___ '_�.� �__...____.. Test Pit No. 1.G�.....minutes per inch Depth of Test Pit._.__.. !---------- Depth to ground water---------'-411 ----- Test Pit No. 2..-~...__._minutes per inch Depth of Test Pit------- (...... Depth to ground water......__..g1A----- a ••.................•-------------------•----•---------'---...-••---•-------------•-..._...................---•---'------••--•••---......_............ 0 Description of Soil---- ----c' •?-s.------.1 -r-S ) - _i1 - M . .. U ......... - -------------- ------- . - . -` .� W ................1A...;7!..'T.... ��-.14......-N--�............. boa-.2_Sf... .__ '^ ... 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 bee ed by the board of health. Signed -------------------- ------ ....................................................._. icy ........................................Dace Application Approved By ----------C`1 1J �..:.. Cure Application -----...........................-------------------------'----.. Da[e Application Disapproved for the following reasons: ................................................................................. ---------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------- ........................................ Permit No. ....... ..TLi..-.... p 1. � J � - ......... Issued ............................................................. ............................................... . . [e - Dace THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA FEs.......... d:.......... '77 If —7 THE COMMONWEALTH OF MASSACHUSETTS" BOARD OF HEALTH TOWN OF BARNSTABLE 4 ,��r�lirtt#i�ait fvx �i��u�ttl �nrk� C�la�t�#rnr#iun �.ernti# Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal System at: VA f .. , .. ,i . �r\3Yf I . f1.jL .. 7 Location-:\ddress or Lot No. ' ....�_:7..i.t_``_-.G �.i, t _ nth .t.+ ✓.�i.J t c1�- _ ......................_. ..---'--•--------------•-•-___- - - Address a ' L? ..........'�?C_CAI +tanlle U-�••--••........................ R 1)---r k /1! nE�Cf f..yLA, a}W vCr.. Address Type of Building Size Lot___`�4_a.g0.......Sq. feet 61 Dwelling—No., of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T 'e of Building No. of persons---------------------------- Showers — Cafeteria 0.1 Other fixtures --------------- ---------------------- - - - W Design Flow...............`.:`?.....................gallons per person per day. Total daily flow--------------6 G^ ..................gallons. WSeptic Tank—Liquid capacityl, .: AgalIons Length----lt;_:.<.• Width.-. __- Diameter________________ Depth---S...�`"7... x Disposal Trench—No. .................... Width.................... Total Length._____....._._.____. Total leaching area....................sq. ft. 3 Seepage Pit No------- 1. ----------- Diameter-----= --------- Depth below inlet____('.____._..._. Total leaching area..`r?.:.!..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '~ Percolation Test Results Performed by--- ?"............................................. Date.......t': : r� - -- ,aa Test Pit No. L`_l minutes per inch Depth of Test Pit------- ............ Depth to ground water......... Gi, Test Pit No. 2.jK.1........_minutes per inch Depth of Test Pit.........`.. ....... Depth to ground water.........!-./A..... p4 / n• ---------------------------................................................................................... Descri tion of Soil......-i ........................................... ,n , - � .. W ln, rAi LZ I f� . 1LF. Il r ''_ t !� jai ?/ .ti/,^^ -------------------------------------------------------------------------------- ...... _____..-_---______-_-.__.__..------.-1_....__________.............._............._.._........._._._......... V 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 the system in operation until a Certificate of Compliance has been-ins_ ed by the board of health. Signed ---- ----------_--- ---------- ............................................:..... . .........Da...te.............. ApplicationApproved By ............ �...... .............................. .................................... ........1'r.. ..5..... Date Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------- . ..................... .................. . ............................................................... ............................... Da Permit No. ---------- q.t`i........6---F- Issued .......................................................-............ Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THI IS TO C RTIFY, That the Individual Sewage Disposal System constructed ( ) or.Repaired ( ) Ye c.1 I ------------- ---------- --------------------------------------------- --��^^ - at --------1Zi�i..t..- ------ V f.1 _c.�tti!_..... ..... . - - 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' ..---- ------_. dated ---_-_.---------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. v DATE-------- .",,.' ---------------- Inspect r -� /....................................... ---- � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �, TOWN OF BARNSTABLE No.. _-.. �• � FEE....Lan....... . �i��rn��1 nrk �un�#�nr#uan �rrmi# Permission is hereby granted.......,3vh......... aria C ueet-------------------------------------------------------------------------------------- to Construct ) or Repair ( ) an Individual Sewage Disposal System - ••_ 00 Street as shown on the application for Disposal Works Construction�Pe�r�mit Dated___ ,_............................. � � Board of Health DATE---- --;;f--------------.......................................---- FORM 38808 HOBBS&WARREN.INC..PUBLISHERS - Department of Environmental Management/Division of Water Resources WATER WELL CONIPLETIbN REPORT 6j(? O r t- WELL_LOCATION Address!l r i t o r-r i; X r)mo City/Town t; 6) 1��ARIb�fR/h f GI )C G.S.Quadrangle Map Grr�r Grid Location /r r�� / Owner &= Ab 1/C,T Address WELL USE CONSOLIDATED WELL Domestic®�Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones Method Drilled R. 1) From To 2) From To Date Drilled G/ 3) From To r 4) From To CASING // Depth to Bedrock Length Diameter C!J Type Pr UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials i Feet below land surface/y a Sand: fine❑/'medium❑ coarse❑ Date measured /47/9'(/ Gravel: fine Q( medium❑ coarse o , a : GRAVEL PACK WELL S Screen: � length f from fZ6 to/7340 Yes ❑ No Split Screen (or 2nd screen) .WATER? ALITY TESTS MADE. Slot# length //from to Chemical ❑7 Biological ❑ Depth To•Bedrock N/14 PUMP TEST _ Drawdown feet after pumping days � hours at GPM. How measured lfir-4... Recovery '?a feet after /� hours. LOG of FORMATIONS COMMENTS: (On well or water) MateYrials From T /1 o n' r I�/t.t' � ` m !0 41fJ. ' J DRILLER— Fir I L L E R— Firm llf +/t t (✓,^.^� g o Address1 1/') k/7 v C / /City lt?!7/1Zf- 44 JF r Registration No. kmu � , � �a perators Signature Please print firmly BOARE'&HEALTH COPY 25M-10-85-807101 � I OFFICE LABORATORY 1498 HIGH STREET 176 PLYMOUTH STREET BFIDGEWATER.MA 02324 BRIDGEWATER.MA 02324 OLIVEIRA ENVIRONMENTAL LABORATORIES, INC. WATER-WASTEWATER-FOOD-DAIRY PRODUCTS CHEMICAL&BACTERIOLOGICAL ANALYSES Telephone(508)697.2650 FAX(508)697-0163 November 17, 1994 L. Wile & Son Drilling P.O. Box 236 Plympton, MA 02367 Source: Well Water - 6 inch PVC Well - 130 feet deep - producing 20 gals/min. (static water level 74 feet) Located on the property of Mr. John Agricola - Lot #10 58 Williams Path - West Barnstable, MA Analysis Number: 94-11-8659 Analysis Date: 11/18/94 Compound (Regulated) Result MCL Detection Analytical ug/L ug/L Limit ug/L Method Benzene ND 5.0 0.5 502.2 Carbon Tetrachloride ND 5.0 0.5 502.2 1,1-Dichloroethylene ND 7.0 0.5 502.2 1 1,.2-Dichloroethane7 ND 5.0 0.5 502.2 para-Dichlorobenzene ND 5.0 0.5 502.2 Trichloroethylene ND 5.0 0.5 502..2 1,1,1-Trichloroethane ND 200.0 0.5 502:2 Vinyl Chloride ND 2.0 0.5 502.2 Monochlorobenzene ND 100.0 0.5 502.2 o-Dichlorobenzene ND 600.0 0.5 502.2 trans-1,2-Dichloroethylene ND 100.0 0.5 502.2 cis-1,2-Dichloroethylene ND 70.0 0.5 502..2 1,2-Dichloropropane ND 5.0 0.5 502.2 Ethylbenzene ND 700.0 0.5 502.2 Styrene ND 100.0 0.5 502.2 Tetrachloroethylene ND 5.0 0.5 502.2 Toluene ND 1000.0 0.5 502.2 Xylenes (total) ND 10000.0 0.5 502.2 OFFICE LABORATORY 1498 HIGH STREET 176 PLYMOUTH STREET J BRIDGEWATER.MA 02324 BRIDGEWATER,MA 02324 OLIVEIRA ENVIRONMENTAL LABORATORIES, INC. WATER-WASTEWATER-FOOD-DAIRY PRODUCTS CHEMICAL&BACTERIOLOGICAL ANALYSES Telephone(508)697-2650 FAX(508)697-0163 PAGE 2 Compound (Unregulated) Result MCL Detection Analytical U /L U /L Limit u /L Method Chloroform ND ---- 0.5 502.2 Bromodichloromethane ND ---- 0.5 502.2 Chlorodibromomethane ND ---- 0.5 502.2 Bromoform ND ---- 0.5 502.2 m-Dichlorobenzene ND ---- 0.5 502.2 Dichloromethane ND ---- 0.5 502.2 Dibromomethane - ND ---- 0.5 502.2 1,1-Dichloropropene ND ---- 0.5 502.2 1,1-Dichloroethane ND ---- 0.5 502.2 1,1,2,2-Tetrachloroethane ND ---- 0.5 502.2 1,3-Dichloropropane ND ---- 0.5 502.2 Chloromethane ND ---- 0.5 502.2 Bromomethane ND ---- 0.5 502.2 1,2,3-Trichloropropane ND ---- 0.5 502.2 1,1,1,2-Tetrachloroethane ND ---- 0.5 502.2 Chloroethane ND ---- 0.5 502.2 1,1,2-Trichloroethane ND ---- 0.5 502.2 '4 2,2-Dichloropropane ND ---- 0.5 502.2 o-Chlorotoluene ND ---- 0.5 502.2 Bromobenzene ND ---- 0.5 502.2 1,3-Dichloropropene ND ---- 0.5 502.2 MCL = Maximum Contaminant Level ND = None Detected (Below minimum detectable level - MDL) Tested by Lab #M-MA.022 Surrogate Recoveries Compound % Recovered QC Limits 2-Bromo-l-chloropropane 89 80-120 4-Bromofluorobenzene 100 80-120 Sample collected by Mr. L. Wile of L. Wile & Son Drilling - 11/17/94 at 0700 hrs. Sample relinquished to laboratory by Ms. Kellie Wile - 11/17/94 at 0915 hrs. Director OFFICE LABORATORY 1498 HIGH STREET 176 PLYMOUTH STREET BRIDGEWATER,MA 02324 BRIDGEWATER, MA 02324 OLIVEIRA ENVIRONMENTAL LABORATORIES, INC. WATER-WASTEWATER-FOOD-DAIRY PRODUCTS CHEMICAL&BACTERIOLOGICAL ANALYSES Telephone(508)697-2650 FAX(508)697-0163 November 19, 1994 L. Wile & Son Drilling P.O. Box 236 Plympton, MA 02367 Source: Well Water - 6 inch PVC Well - 130 feet - producing 20 gals/min. (static water_ level 75 feet) Located on the property aof Mr. John Agricola - Lot #10 -58 Williams Path - West Barnstable, MA Analysis #94-11-8659 Coliform Count /100 ml @ 35 C Absent Membrane Filter S.P.C./ml @35C 47 Color (APC units) 30.0 Sediment slight Turbidity (NTU) 2 0 Odor N.O.O. Taste satisfactory pH 5.90 Specific Conductance micromhos/cm 60.0 mg /liter Total Alkalinity (CaCO,) 10.0 Free CO, 24.5 Total Hardness (CACO,) 22.0 Calcium (Ca) 4.80 Magnesium (Mg) 2.01 Sodium (Na) 7.82 Potassium (K) 1.35 Total Iron (Fe) 0.17 Manganese (Mn) 0.01 Silica (SiC,) 21.3 Sulfate (SO,) 10.7 Chloride (CI) 9.00 Nitrogen - Ammonia 0.19 Nitrogen - Nitrite 0.010 Nitrogen - Nitrate L 0.50 L = less than N.O.O. = No Odor Observed Sample collected by Mr. L. Wile of L. Wile & Son Drilling - 11/17/94 at 0700 hrs. Sample relinquished to laboratory by Ms. Kellie Wile - 11/17/94 at 0915 hrs. Bacteriologically, this well water is of a satisfactory sanitary standard and is suitable for drinking and domestic purposes. Chemically, this well water is acidic (will be corrosive) . . The color and turbidity are due to the sediment and should improve with usage. All other chemicals tested meet the standards. Director F83384-1 J The Standard Plate Count indicated the general bacterial population of the well at the time of collection. Coliform Group Bacteria: Significance The coliform group bacteria includes organisms found in the intestinal tracts of warm blooded animals, birds, decaying organic matter(hay, leaves,wood, etc.),the top 2 to 3 feet of the soil, lakes, ponds, brooks, rivers,drainage and types of vegetation. Because the organisms can cause some illness; because the presence of coliform organisms in the water suggests that other more harmful organisms may be present, water containing one or more coliform group bacteria per 100 ml of sample should not be used for drinking or cooking purposes unless boiled 5 minutes or disinfected by other means. This bacteria is of animal origin(intestinal tract)and may be considered as closely associated with disease causing organisms.On this factor, none should be present. olor—APC Units-Ground water ought to be practically free from color. For attractive water-color should not exceed 15 units. Turbidity.—NT Units-Recommended limit not to exceed 5 units. Odor&Taste—For water to be of high quality,the water should be odor free and taste good. pH—The pH value defines the concentration of free hydrogen ions in solution. Expressed on a scale extending from 0 or very acid to 14 or `—'very alkaline with 7.0 being neutral. Recommended range 6.5 to 8.5. Specific Conductance—Conductivity is a good criterion for measuring the degree of mineralization and assessing the affect of diverse ions of chemical equilibria. Total Alkalinity—The alkalinity of this water represents its content of carbonates and bicarbonates. Free Carbon Dioxide—Well water having a low pH and a Free CO, level in excess of 50. mg/I will be corrosive to iron, bronze, brass and copper tubing and fittings. Total Hardness—Waters having a hardness range of 0 to 75 soft, 75 to 150 medium hard,over 150 very hard. Calcium —Calcium contributes to the total hardness of water. Appreciable amounts of calcium salts break down on heating and form scale in boilers, pipes and cooking utensils. Magnesium — Magnesium is a common constituent of natural water. Magnesium and calcium ions are principal contributors to water hard- ness.Concentrations in excess of 125 mg/I can exert a cathartic and diuretic action. Sodium—Recommended Limit-28 mg/l. Potassium—Potassium concentrations in drinking water seldom exceed 20. mg/I. Total Iron—Standard not to exceed 0.3 mg/I. Manganese—Standard not to exceed 0.05 mg/l. The principal reason for limiting the concentration of manganese is to reduce esthetic and economic problems. Silica — Silica content of natural water is most commonly in the 1 to 30 mg/l. Silica in water is,undesirable because it forms difficult to remove silica scales. Sulfates—Standard not to exceed 250 mg/I. Chloride—Standard not to exceed 250 mg/l. Nitrogen—Ammonia is present in variable concentrations in many surface and ground waters. Its occurrence in ground water is generally a result of natural reduction processes. Nitrogen - Nitrite — Nitrite in water poses a health hazard, but fortunately seldom occurs in high concentrations. Waters with a nitrogen- nitrite concentration over 1 mg/I should not be used for infant feeding. Nitrogen - Nitrate — Standard not to exceed 10. mg/l. Nitrate, in high concentrations can and do cause methemoglobinemia or so-called nitrate poisoning-in infants. Water with 10 or more mg/I of nitrate is unsatisfactory and is not considered safe for drinking or cook- ing. It is especially dangerous to children and should never be used in infant formulas. Copper—Standard not to exceed 1.0 mg/l. Lead—Standard not to exceed 0.015 mg/I. Arsenic—Standard not to exceed 0.05 mg/I. Tannin—Tannin may enter the water supply through the process of vegetative degradation. Fluoride—Standard not to exceed 4.0 mg/I. F83384-2 OFFICE LABORATORY 1498 HIGH STREET 176 PLYMOUTH STREET BRIDGEWATER,MA 02324 BRIDGEWATER,MA 02324 OLIVEIRA ENVIRONMENTAL LABORATORIES, INC. WATER-WASTEWATER=FOOD-DAIRY PRODUCTS CHEMICAL&BACTERIOLOGICAL ANALYSES Telephone(508)697-2650 FAX(508)697-0163 November 19, 1994 L. Wile & Son Drilling P.O. Box 236 Plympton, MA 02367 Source: Well Water - 6 inch PVC Well - 130 feet - producing 20 gals/min. (static water level 75 feet) Located on the property aof Mr. John Agricola - Lot #10 -58 Williams Path - West Barnstable, MA Analysis #94-11-8659 Coliform Count /100 ml @ 35 C Absent Membrane Filter S.P.C./ml @35C 47 Color (APC units) 30.0 Sediment slight Turbidity (NTU) 12.0 Odor N.O.O. Taste satisfactory pH 5.90 Specific Conductance 60.0 micromhos/cm mg /liter Total Alkalinity ICaCO3) 10.0 Free CO2 24.5 Total Hardness (CAC03) 22.0 Calcium (Ca) 4.80 _ Magnesium IMg) 2.01 Sodium (Na) 7.82 Potassium (K) 1.35 Total Iron (Fe) 0.17 Manganese (Mn) 0.01 Silica (SiO2) 21.3 Sulfate (SO4) 10.7 Chloride (CI) 9.00 Nitrogen - Ammonia 0.19 Nitrogen - Nitrite 0.010 Nitrogen - Nitrate L 0.50 L = less than N.O.O. No Odor Observed Sample. collected by Mr. L. Wile of L. Wile & Son Drilling - 11/17/94 at 0700, hrs. Sample relinquished to laboratory by Ms. Kellie Wile- 11/17/94 at 0915 hrs. Bacteriologically, this well water is of a satisfactory sanitary standard and is suitable for drinking and domestic purposes. Chemically, this well water is acidic (will be corrosive) . . The color and turbidity are due to the sediment and should improve with usage. All other chemicals tested meet the standards. Director F83384-1 The Standard Plate Count indicated the general bacterial population of the well at the time of collection. Coliform Group Bacteria: iSignificance The coliform group bacteria includes organisms found in the intestinal tracts of warm blooded animals, birds, decaying organic matter (hay, leaves,wood,etc.),the top 2 to 3 feet of the soil, lakes, ponds, brooks, rivers,drainage and types of vegetation. Because the organisms can cause some illness; because the presence of coliform organisms in the water suggests that other more harmful organisms may be present, water containing one or more coliform group bacteria per 100 ml of sample should not be used for drinking or cooking purposes unless boiled 5 minutes or disinfected by other means. This bacteria is of animal origin(intestinal tract)and may be considered as closely associated with disease causing organisms. On this factor, none should be present. _Color—APC Units-Ground water ought to be practically free from color. For attractive water-color should not exceed 15 units. Turbidity—NT Units- Recommended limit not to exceed 5 units. Odor&Taste—For water to be of high quality,the water should be odor free and taste good. pH—The pH value defines the concentration of free hydrogen ions in solution. Expressed on a scale extending from 0 or very acid to 14 or very alkaline with 7.0 being neutral. Recommended range 6.5 to 8.5. Specific Conductance—Conductivity is a good criterion for measuring the degree of mineralization and assessing the affect of diverse ions of chemical equilibria. Total Alkalinity—The alkalinity of this water represents its content of carbonates and bicarbonates. Free Carbon Dioxide—Well water having a low pH and a Free CO, level in excess of 50. mg/I will be corrosive to iron, bronze, brass and copper tubing and fittings. Total Hardness—Waters having a hardness range of 0 to 75 soft,75 to 150 medium hard,over 150 very hard. Calcium —Calcium contributes to the total hardness of water. Appreciable amounts of calcium salts break down on heating and fo•m scale in boilers, pipes and cooking utensils. Magnesium — Magnesium is a common constituent of natural water. Magnesium and calcium ions are principal contributors to water hard- ness.Concentrations in excess of 125 mg/I can exert a cathartic and diuretic action. Sodium—Recommended Limit-28 mg/l. Potassium—Potassium concentrations in drinking water seldom exceed 20. mg/l. h Total Iron—Standard not to exceed 0.3 mg/I. Manganese—Standard not to exceed 0.05 mg/I. The principal reason for limiting the concentration of manganese is to reduce esthetic and economic problems. Silica — Silica content of natural water is most commonly in the 1 to 30 mg/l. Silica in water is undesirable because it forms difficult to remove silica scales. Sulfates—Standard not to exceed 250 mg/l. Chloride—Standard not to exceed 250 mg/l. Nitrogen—Ammonia is present in variable concentrations in many surface and ground waters. Its occurrence in ground water is generally a result of natural reduction processes. Nitrogen - Nitrite — Nitrite in water poses a health hazard, but fortunately seldom occurs in high concentrations. Waters with a nitrogen- nitrite concentration over 1 mg/I should not be used for infant feeding. Nitrogen - Nitrate — Standard not to exceed 10. mg/l. Nitrate, in high concentrations can and do cause methemoglobinemia or so-called nitrate poisoning in infants. Water with 10 or more mg/I of nitrate is unsatisfactory and is not considered safe for drinking or cook-. ing. It is especially dangerous to children and should never be used in infant formulas. Copper—Standard not to exceed 1.0 mg/I. - Lead—Standard not to exceed 0.015 mg/l. Arsenic—Standard not to exceed 0.05 mg/I. Tannin—Tannin may enter the water supply through the process of vegetative degradation. Fluoride—Standard not to exceed 4.0 mg/l. r F83384-2 y r O EXISTING Ro SEPTIC � l SEPTIC PROFILE (NOT TO SCALE) EXIST. WELL 4 T.O.F. AT EL 98.5 BRING COVERS TO WITHIN 1 OF FINISH GRADE OCUS I o •� m N PROPOSED HIGH STREET ; ....INVERT AT. .: 7 IN 96.5 (EL 9 .8) MINIMUM 1 OF COVER OVER PRECAST (EL 98.0) . \-a6.50 27 PEA7ONE PERCIVAL BREAKOUT: ( (H10) LAY PILE LEVEL DRIVE R�Ot, I 98.5 - 95.0 FOR FIRST 2' EL. 96.63 102' (150r) 5.2' FROM EL 96.6 1, - PROPOSED 1500 - 96.22 GALLON SEPTIC 95 7 poop { • TANK (H10) 0000 opO SYSTEM IS 82' FROM EL 96.6 r 1/0 0 0 0 0 95.76 °o°oo0 6'x6' c°o°� 95.93 c�Onn,�o oo°o LEACH oo°O °oo° LOCATION MAP (NO SCALE) DEPTH OF FLOW 4' 1% SLOPE : 95.63 °o o°a o H 0 °o p p O TEE SIZES: o 0 00 ( ) °o°o o° �. o0 0000 ' ASSESSORS MAP ] 1 1, ;PARCEL 39 INLET DEPTH 10" MIN. 6" CRUSHED 1% SLOPE o°o°oo 0000°o EL 8 BUILDING DISTRICT: RF \' 2% SLOPE OUTLET DEPTH IT STONE UNDER o, 9 63 - o' Box 1 MINIMUM LOT SIZE 43,560 S.F. of MINIMUM FRONTAGE` = 150 R � 3/4" TO 1-1/2" 9.63' SETBACKS: 9pp�t CLEAN WASHE _ EXISTING -s '� 74 A A STONE FRONT 30 - �1 sEPrlc -� 3s4,'I'�oF� SUITABLE SOIL AND NO WATER AT EL 76.0 SIDE = 15' REAR 15' , cF LEACHING FLOOD ZONE C 2 FOUNDATION 14 SEPTIC TANK 4 D BOX 13 F MAX. BUILDING HEIGHT 30' "� FACILITY w TEST HOLE LOGS 84 ^ SEPTIC DESIGN: DISPOSER ALLOWED 8 (NO GARBAGE ) ..� •' AR E. K = 86 LA r ENGINEER. EDW D E ELLEY �o� DESIGN ,.FLOW: 6 BEDROOMS (110 GPD) = 660 GPD WITNESS: EDWARD BARRY (B.O.H.) _�� 87 \ \ LOT 10 \ S �rn DATE:, DUNE 6 1991 , � $ ti 9 Area 54,040 sq SEPTIC TANK: 660 GPD (1 .5) 990 GPD = 8 t.24 Acres e PERC. RATE < 2 MIN/INCH USE A 1500 GALLON SEPTIC TANK g shy 1 - PERC. #7767 l , LEACHING: 9.2-- EXIST. g 2 �•pc� \ I � SIDES:` 2(8,rr 6 ) 2.5 = 754.0 GPD WELL '�� Q � ' g4�'\., �, PROP. 8 BOTTOM: 2(16Tr)(10) = 100.5 GPD 73 EL. 90.0 -o - a "j WELL _0 EL 9 �0 _ � � gs - � _ I \ TOTAL 402.1 S.F. 854.5 GPD o o TOP AND I � � 96 SUBSOIL 'TOP AND 97 • g USE 2 6 - R 2.5 EL. 94.8 �SUBSOIL � _ ( j x6 P ECAST CONCRETE LEACHING PITS WITH EL 86.0 98 J' 1 OF STONE ALL' AROUND. ' _ r • I MED. ,� t MED. D FINE �p ¢ r SAND I , SANG NOTE. c� t WITH ( •� ,r- 1 ` N ROCKS PROPOSED WELL. AND SEPTIC / ,�s SYSTEM ARE AT LEAST 150 ! A !yq� FROM ALL EXISTING WELLS NOTES. g' EL._81.0 AND SEPTIC SYSTEMS FINE O Q V ME FROM SANDWICH QUAD :MAP. SAND 1. DATUM IS NG D ASSUMED: WITH 2. MUNICIPAL WATER IS NOT AVAILABLE9e �, SILT / 'S 3. MINIMUM PIPE PITCH TO BE 1/8" PER. FOOT. 12' EL 78.0 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO--H 10. t 1' EL. 86.3 MED. ' E WATERTIGHT. NO COARSEti..•` 5. PIPE. JOINTS TO BE MADSAND WATER ' - ' --- �T�- ;`, .� o �.� 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. FOUND .t4' EL 76.0 9 o ENVIRONMENTAL CODETITLE V. No e ., �t'� o N WATER •o`� °° � WORK ONLY AND NOT, TO BE USED 7. THIS PLAN FOR PROPOSED FOUND �. (a °` FOR LOT LINE 'STAKING. O \'� ti �'� 7TH1 \°�%1,`t 2 , , f $. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. o J 9. D'BOX IS TO `BE WATER TESTED FOR LEVELNESS. �R% « caLto�Z-�ot�15 AT F r 0 1 �0. co rat tzAc-ra R -� v FY So •A •' � ' 00 L.�Rc�+IN� ,aReC-� P�tott, t� �r4auSc: CotlStt2cxT'lo�y • KEG' c EXIST. CONTOUR - - - .. - '�� e ...`o.•''" i ? ,-.` 9 V PROP. _CONTOUR s3 R.; 4 EXIST. WATER LINE ------w----- - ------w--- lj ��.� sEcG a_ EXIST. ELEV. , ............ 32.50 C7 ,�o �95 SITE AND SEWAGE PLAN 96 FOR PROPOSED DWELLING ON LOT 10 WILLIAMS PATH IN: ��. � � �,. NOTE: q poi PROPOSED WELL AND SEPTIC (WESTh BARNSTABLE � ' MA EXIST. off 508-362-4541 SYSTEM ARE AT LEAST 150' FROM ALL EXISTING WELLS WELL fax 508 362-9880 PREPARED FOR: AND SEPTIC SYSTEMS _ o � JOHN AGRICOLA down cape engineering. inc. �ENCHMARK: <. TOP OF CONCRETE 0 120 Feet BOUND EL. 100.66 40 0 40 8 CIVIL ENGINEERS SCALE. 1 40 SEPT. 211, 1994 LAND SURVEYORS off oE. 939 main st. yarmouth, ma 3M �t EXIST. A ARNFE H WELL its OJALA .. EXIST. -o - O ALA ;; a3 CrVIL w WELL BOdRD 01r HEALTH Aepq� (`sal uet kc� EXIST. -o = BARNSTABLE WELL ' � -- -- I APPROVED DATE . . J LA .S. DATE -o H 0A , 6 94-32 - _