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0065 BONE HILL ROAD - Health
f4 t 65 Bone Hill Road Barnstable �� / A = 336081 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 65 Bone Hill Road, Cummaguid `�'B&'? N STA13 06 M -336 P-81 W Property Address Vt Gregory Conigliaro Owner Owner's Name information is 52 Sears Road Southborough MA 01772 February 8, 2017 required for every ry M page. City/Town State Zip Code Date of Inspection ►r W 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. General Information S/# /0/3 9.- on the computer, use only the tab 1. Inspector: key to move your cursor-do not Troy Williams use the return Name of Inspector key. Troy Williams Septic Inspections Company Name 19 Hummel Drive Company Address South Dennis MA 02660 City/Town State Zip Code (508)385- 1300 S1682 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 , S February 8, 2017 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 65 Bone Hill Road, Cummaquid M -336 P-81 r Property Address Gregory Conigliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. Cityrrown 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: System meets minimum standards set by Massachusetts DEP at the time of inspection only.This inspection is not a guarantee or warranty on the future working conditions of leaching, pipes, components or the future structural integrity of said components and only represents conditions found at the time of inspection only. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments lug 65 Bone Hill Road, Cummaquid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(g)are replaced ❑ -Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑,Y : ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ 'Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: . - ❑ Cesspool or privy is within 50 feet of a surface water '❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M r 65 Bone Hill Road, Cummaquid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. Cityfrown state Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form 10 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °( 65 Bone Hill Road, Cummaquid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is 52 Sears Road, Southborough MA 01772 February 8 2017 required for every ry 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 within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any;large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 65 Bone Hill Road, Cummaquid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. CitylTown 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): 5 Number of bedrooms(actual). 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 t5ins•3/13 Title 5 Official Inspection forth: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 65 Bone Hill Road, Cummaquid M -336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is 52 Sears Road, Southborough MA 01772 February 8, 2017 required for every g ry page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 15=48,000 gals. 9 ( y 9 (gP )) 16=44,000 gals. Detail: Sump pump? t ❑ Yes ® No Last date of occupancy: occasional use Date Commercial/industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/A Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A 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: N/A t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 65 Bone Hill Road, Cummaquid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) N/A Last date of occupancy/use: Date Other(describe below): NIA General Information Pumping Records: Source of information: No pumping info available. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts ; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 65 Bone Hill Road, Cummaguid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is 52 Sears Road, Southborough MA- 0.1772 February 8, 2017 required for every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Tank, d-box and leaching were installed on 10/18/06 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18 + 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.): Lines were found clear at the time of inspection. Septic Tank(locate on site plan): Depth below grade: 2''ewith riser to 6" fe Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 6'X10.5'X6' 1500 gallon 4,. Sludge depth: t5ins•3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 65 Bone Hill Road, Cummaq uid M -336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is g required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 2'8" Scum thickness thin layer 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 14" How were dimensions determined? probe/measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet and outlet tees were found present and in working order. No evidence of leakage or damage was found. Tank was not in need of pumping at this time. Grease Trap(locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A 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 Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts , • ; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments V.y�< 65 Bone Hill Road, Cummaquid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is 52 Sears Road, Southborough MA 01772 Februa 8, 2017 required for every ry° 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: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Capacity: N/A p ry' gallons Design Flow: ' N/A gallons per day Alarm present: ❑ Yes ❑ No Alarm level.' N/A Alarm in working order: Yes No Date of last pumping: N/A Date Comments(condition of alarm and float switches, etc.): N/A *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage)isposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 65 Bone Hill Road, Cummaquid M -336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is 52 Sears Road, Southborough MA 01772 February 8, 2017 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 level 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.): D-box was found level and in working order with equal distribution to outlet lines. No evidence of solid carry-over or backup in the past was found at the time of inspection. 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.): N/A * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 65 Bone Hill Road, Cummaquid M -336 P-81 Property Address 3 i Gregory Conigliaro Owner Owner's Name information is 52 Sears Road, Southborough MA 01772 , February 8, 2017 required for every � page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type. ❑ leaching pits number ® leaching chambers number: 4-500 gallon with stone Elleaching galleries number: 42'X 13'X 2' } ❑ 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, danp soil, condition of vegetation, etc.): Soil was sandy. Chambers were dry at the time of inspection. Checked stone anVound dry and clean. No evidence of hydraulic failure or problems in the past were found at.the'time of inspection.- Cesspools (cesspool must be pumped as part of inspection) (locate on site play',): Number and configuration 'N/A r Depth—top of liquid to inlet invert N/A Depth of solids layer N/A s Depth of scum layer N/A N/A Dimensions of cesspool Materials of construction N/A Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13of 17' Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w ' 65 Bone Hill Road, Cummaguid M -336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A Privy(locate on site plan): Materials of construction: N/A 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts ugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 65 Bor-e Hill Road, Cummaguid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is 52 Sears Road, Southborough MA 01772 February 8, 2017 required for every ry page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: . ® hand-sketch in the area below ❑ drawing attached separately Wes`*✓' 1,� / I (•�` Li O O • 3 = S ► ► 3 aa ' t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 65 Bone Hill Road, Cummaquid M-336 P-81 Property Address Gregory Conigliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells �I Estimated depth to high ground water: 13.0'+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. 8/23/06 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: AIW 247 Zone B 25.9' 5.2'adjustment You must describe how you established the high ground water elevation: Test hole recorded on plan showed no water found at 12.0'. Hand augered 6' below bottom of leaching with no water found at a depth of 12.0'. Groundwater adjustment at the time of inspection was 5.2'. Bottom of leaching at 6.0'was found not to be located in the high groundwater elevation at the time of inspection. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 --- Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '< 65 Bone Hill Road, Cummaguid M -336 P-81 Property Address Gregory Con igliaro Owner Owner's Name information is required for every 52 Sears Road, Southborough MA 01772 February 8, 2017 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D,'or E checked ; ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information-Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate"file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNSTABLE LOCATION �Qrhe ` ,�j'1 /L,ff SEVbAGE# per(- VILLAGE tQ-rr*S 1')I ASSESSOR'S MAP•&PARCEL INSTALLERS NAME&PHONE NO. l [�, S rZi7�,y,•� C� J'�� (ry�-(�a3 !� SEPTIC TANK CAPACITY 50-0 1 LEACHING FACILITY:(type) CgAt"59-r-.5(size) F 3 �/X�:iL�O NO.OF BEDROOMS J OWNER-FO V/') LL 9 r'j 01i i'-h-h PERMIT DATE: �' `�`lCf 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 Q L rk I r 1 0 (� TOWN OF BARNSTABLE LOCATION Jl ' W"' "1 SEWAGE# —^ VILLAGE ,i`OI ASSESSOR'S MAP&PARCEL 3 0 INSTALLERS NA &PHONE NO. U— o SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BEDROOMS S aP P . �� Al C 6-tr t OWNER 1,pj rn-n 1 �1'e PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the Maximum Adjusted Groundwater/Table to the Bottom of Leaching Facility Feet Private Water Supply Well atid,/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 9. 2/ 9 t�4u 1Aof Ao �u 11 oe _ vI jptr , ,U , G A q�j ► n� �� i Y. PW � �J w Town of Barnstable Regulatory Services Thomas F. Geiler,Director r I" Public Health Division 659, Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer & Designer Certification Form Date: T I-4fcA0 Sewage Permit# a0l) - 3 W Assessor's Map'Parcels.36 Jr 51SI�G � Q Designer: D W — Installer: 93 Address: /`� \ C Address: 9,3 /gin d ec v YSe Arceel Cc� �'l � 7 On ©9 l QS f adG6 r�i.S &0,e rS C�ir S�. was issued a permit to install a (date) (installer) septic system at �`g 0 y�k �l ,�(' based on a design drawn by �p (address) 0__V � V a- dated (de er) I certify that the septic sy stem referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. ; H Of I/,,4SS-9 0 < r.�_.p�0 �o ARNE H cticN OJALA (Installer's Signature) CIVIL y No. 30792 ��CISTER�O�� �y �SS'ONAL ENG\ (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. 0:Health/Septic/Designer Certification Form 3-26-04.doc COMPLETE ■ Complete items 1,"2,and 3.Also complete . Si nature ' item 4 if Restricted Delivery is desired. X Agent ■ Print your name and address on the reverse dd essee ` so that we can return the card to you. Rece' ed by rinted Name) to D, H I E Attach this card to the back of the mailpiece, ,, or on the front if space permits. D. Is delivery address different from item 7 Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No M%Torvo+—amminen E- I[ FrE �BOX 487 n W0t to Biamstable, MA 02637 3. Service Type ❑Certified Mail ❑Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2.. Article Numb i r 7005 1160 0000 0191 1802 ; (Transfer from service label) b= estic Return Receipt toz5s5-02-M-t5ao UNITED STA! A.• ::a :O• ti .. _ ku,x... NlY:fn • Sender: Please print your name, address, and ZIP+4 in this box• I PUBLIC HEALTH DIVISION TOWN 0F.-B:aRtgST•ABY;El!►. I 200 MAIN STREET HYANNIS, MASSACHUSETTS 02601 I iFF 1 1 Ii is FF F i F is : Affi e -",� #!lFFFFFIFlF!!FF!lFFFFFF!!FF#�FlFlFstIFFFI:Fit`IFlFF1F;F;F�Fc#{ a .0 . •. • Lot r9 Mamma Ir -OFFICIAL , C3 Postage $ o C/ 01��'* a0 = Certified Fee S( Off'/ — Return Receipt Fee v`/�/1'i // * (Endorsement Required) -Y V! S ,� re cC O Restricted Delivery Fee 0r . (Endorsement Required) �6� J pp Total Postage&Fees $ ► "! � �Y pSent T o ;P./ t'/1 a rT Iti Street,Apt N., or PO Box No- - 0 ..... - -- :rr .r f Certified Mail Provides: o A mailing receipt (asianaa)eooz aunr'009£wJod Sd o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-DDelivery". e If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPos. t r �� . � r �� - - ---- �_ Town of Barnstable Regulatory Services Thomas F. Geiler,Director 9 Public Health Division prFp Mp`�7 . 4i Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 . Office: 508-862-4644 Fax: 508-790-6304 August 29, 2006 Mr Toivo Lamminen " P.O. Box 487:. Barnstable, MA 02637 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 65 Bone Hill.Road, Barnstable,MA,was last inspected On July 28th 2006 by Reid C. Ellis, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system has "Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: The sewage waste level was 4' above top of pit and into the riser. You have 30 days from the date of the of the system failure to bring the system in to compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department.' a ABLE HE TH DEPARTMENTA. McKean,R.S., C.H.O. Agent of the Board of Health Town of Barnstable F IME �° do Regulatory Services Thomas F. Geiler, Director BARNS1ABLE, % 9 •��' Public Health Division. . ArFo. ,�s Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 29, 2006 Mr Toivo Lamminen P.O. Box 487.. Barnstable, MA 02637 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 65 Bone Hill Road, Barnstable,MA,was last inspected On July 28th 2006 by Reid C. Ellis, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system has "Failed"under the , guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: The sewage waste level was 4' above top of pit and into the riser. You have 30 days from the date of the of the system failure to bring the system in to compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. a6mas TABLE HE TH DEPARTMENT A. McKean, R.S., C.H.O. Agent of the Board of Health f C Town of Barnstable F1HE t� �° do Regulatory Services ; ns Thomas.F. Geiler,Director BARNSr� F MASS. ,•0� Public Health Division Thomas McKean,Director 200.Main Street,Hyannis, MA 02601. Office: 508-862-4644 Fax: 508-790-6304 August 28, 2006 Mr Toivo Lamminen P.O.Box 487 Barnstable, MA 02637 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,.Title 5 The septic system owned by you located 65 Bone Hill Road, Barnstable,,MA,was.last inspected On July 28`t'.2006.by, Reid C..Ellis,'a certified septic inspector for the State of Massachusetts. _ . The inspection of your septic system showed that your system has "Failed"under the.::: .:, . guidelines of 1995 TITLE 5 (310 CMR 15.00) due to.the following: System is in hydraulic failure You have 2 years.from the date of the of the system failure to.bring the system in to compliance.. If there are any questions.about this reminder,please feel free to contact the.Barnstable Health Department. BARNSTABLE HEALTH DEPARTMENT Thomas A. McKean,.R.S., C.H.O. Agent of the Board of Health COMMONWEALTH OF MASSACHUSETTSmom + ExECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION a TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION / Property Address: 65 Bone Hill Road,Cummaquid-Barnstable,MA Owner's Name:Toivo Lamminen Owner's Address: P.O.Box 487,Cummaquid,MA 02637 Date of Inspection: 07/28/2006 1 Name of Inspector.Reid C.Ellis Company Name:Ellis Brothers Const.Co. �;; ;\) =i Mailing Address:23 Enterprise Road Yarmouth Port,MA 02675 T Telephone Number.508-362-6237 CERTIFICATION STATEMENT -- I certify that I have personally inspected the sewage disposal system at this address and that the Jormatioldireporied 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: Fndi tionally Passes Further Evaluation by the Local Approving Authority Fails Inspector's Signature: 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:65 Bone HUI Road,Cummquid,MA Owner. Toivo Lamminen Date of Inspection:07/28/2006 Inspection Summary: Check AAC or E/ALWAYS complete all of Section D A. System Passes: have not found any information which indicates that any of the failure criteria described in 310 CMR 1 .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 ii the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacem nt or repair,as approval by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old* r the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltrAon r tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank a s approved by the Board of Health. *A metal septic tank will pass inspection if it is sauctiv ally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is avail le. ND explain: Observation of sewage backup or break out or I'gh static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution lox. System will pass inspection if(with approval of Board of Health): broken pipe(s)arc replaced obstruction is rem 3ved distribution box iss leveled or replaced ND explain: The system required pumping more than 4 tnn a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Heal ): broken pipe(s)are laced obstruction is ved ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 65 Bone Hill Road,Cummaquid,MA Owner. Toivo Lamminen Date of inspection: 07/28/2006 C. Further Evaluation is Required b the Board of q y Conditions exist which require finther evaluation t y the Board of Health in order to determine if the system is failing to protect public health,safety or the environme 1. System will pass unless Board of Health determ nes in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which i protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surfs water _ Cesspool or privy is within 50 feet of a bordej ing vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the ublic health,safety and environment: _ The system has a septic tank and soil absorpti n system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface watei 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 deten rune distance **This system passes if the well water analysis,pe formed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates hat the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitro Yen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysii must be attached to this form. 3. Other. 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 65 Bone Hill Road,Cummaquid,MA Owner: Toivo Laminen Date of Inspection:07/28/2006 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Y 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 'quid level in the distribution box above outlet invert due to an overloaded or clogged SAS or ces ool '—f d depth in cesspool is less than 6"below invert or available volume is less than%Z day now pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number f ' es pumped _ portion of the SAS,cesspool or privy is below high ground water elevation portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface imly. y rtion of a cesspool or privy is within a Zone 1 of a public well. 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 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] ,�{Yes/No)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 m serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of t ke following: (The following criteria apply to large systems in ac dition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply — _ the system is within 200 feet of a tributai y to a surface drinking water supply _ — the system is located in a nitrogen sensi' area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Sect on 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 65 Bone Hill Road,Cummaquid,MA Owner:Toivo Lamminen Date of.inspection: 07/28/2006 7NO the followin have been done.You must indicate` es"or"no"as to each of the followin : Pumping information was provided by the owner,occupant,or Board of Health W any of the system components pumped out in the previous two weeks? — — the system received normal flows in the previous two week period? _ ve 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,dluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank' Of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge meted for the condition eP udge 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? e size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes n Existing information For example,a plan at the Board of Health. . Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)j Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 65 Bone.Hill Road,Cummaquid,MA Owner: Toivo Lamminen Date of Inspection: 07/28/2006 RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 C .15.203(for example: 110 gpd x#of bedrooms): � Number of current residents: Does residence have a garbage grinder(yes or no);4.1V Is laundry on a separate sewage system es or no (yes o Laundry system inspected o) 'f yes separate inspection required) Seasonal use:(yes or no):--- Water meter readings,if available(last 2 years usage ) _ •f Sump PUMP(yes or no):,�- Last date of occupancy: COMMERCLUANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):— Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(y or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): Pumping Records GENERAL INFORMATION Source of information: �✓/(% �(/ Was system pumped as part of the inspection(yes or no): If yes,volume pumped:/S-� How was ti Reaso or pumping. �. Fpujnp�ed;deternnined?_ E 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) —Tight tank _Attach a copy of the DEP approval Other(describe): f Approximate age of all components,date installed(if known)and YWere sewage odors detected when arriving �at the site(yes or no): 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 65 Bone Hill Road,Cummquid,MA Owner. Toivo Lam minen Date of Inspection:07/28/2006 BUILDING SEWER(locate on site plan) Depth below grade: 2.11 Materials of construction:_cast iron Z40PVC_other(explain): Distance from private water supply well or suction line: Comments(on oonditign of joints,venting,eviden of 1 e,etc SEPTIC TANKS locate on site plan) Depth below grade: Material of constructional/concrete metal fiberglass polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):certificate) ,(attach a copy of Dimensions: < y-����'y AL�d7 Sludge depth: ti Distance from top of sludge to bottom of outlet tee or baffle: y Scum thickness: 4Z-' Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet Yee or baffle: l How were dimensions determined: r Comments(on pumping recommen ons,inlet and outlet tee r baffle c ditto integrity,liquid levels as related to outlet irwe eviden of?akage,etc.): L2VE /'J GREASE TRAP:_(locate on siteplan) Depth below grade:_ �'"' -�i���t� Material of construction:_concrete_metal_filX rglass_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 o baffle: Date of last pumping: Comments(on pumping recommendations,inlet and o et tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 f Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:65 Bone Hill Road,Cummaquid,MA Owner:Toivo Lamminen Date of Inspection:07/28/2006 TIGHT or HOLDING TANK: (tank must be�a�'time of inspection)(locate on site plan) ) Depth below grade: Material of construction: concrete metal fib rglass____polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: galllons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX-elf present must be opened)(loc ate on site plan) Depth of liquid level above outlet invert. Comments(note if box is level and distribudon to outlets equal,any evidence of solids carryover,an evidence of leakage into or out of box,etc.), � PUMP CHAMBER l(ocate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition o pumps and appurtenances,etc.): 8 ... .. r Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE:SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ' SYSTEM INFORMATION(continued) Property'Address. 65 Bone HiltRoad,Cummaqufd,MA a Owner.Toivo Lam miuen " Date of Inspection:07/28/2006- 50II ABSORPTION SYSTEM(SAS): ovate on'ske plan,excavation not required) If SAS not located explain why thing Pits number: leaching chambers,number. _leaching galleries,number: _teaching trenches,number,length: _leaching fields,mtmber,dimensions: _overflow cesspool,number: , _imOvative/altemative'systeen r. yWname of technology: Commems(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etcyGCS v 6� �✓� W—ZL2 ;s CESSPOOLS:_(cesspool must,be pumped as parfof inspecti nxlocate on site plan) Number and configuration: .. Depth—top of liquid to inlet inveR:'. Depth of solids layer: Depth of scum layer ' Dimensions of cesspool Materials of construction Indication of groundwater inflow(yes or no). 1 �v' Comments(note condition of soil,sigus,of hydrauli_c 'ure,level of pending,condition of vegetatio d' PRIVY: (locate on site plan) Materials of constriction:' Dimensions: Depth of solids: Comments(note condition of soil;"signs of hydraulic level of ponding,condition of vegetatioz Y 9 ' ti l�'�"�" f Page 9 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 65 Bone Hill Road,Cummaquid,MA Owner. Toivo Lamminen Date of Inspection:07/28/2006 SOIL ABSORPTION SYSTEM(SAS): orate on site plan,excavation not required) If SAS not located explain why: thing pits,number: � � ���✓ !94/ 112 i 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.):- , CESSPOOLS: (cesspool must be pumped as of inspecti n)(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 or no): Comments(note condition of soil,signs of hydraulic Alure,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 f ' ,level of ponding,condition of vegetation;etc.): i 9 I • Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 65 Bone Hill Road,Cummquid,MA Owner: Toivo Lamminen Date of Inspection: 07/28/2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public wa supply enters the building. I �Al Ali fl A . Oak-, S ( " 10 l L) i Page 11 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 65 Bone Hill Road,Cummquid,MA Owner. Toivo Lamminen Date of Inspection:07/28/2006 SITE EXAM Slope Sumac-water �- Check cellar v Shallow wells ---- "'� 7 � Estimated depth to ground wateC�20feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) —__Xhecked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: L� (' �•f,/1�,( �,; �Ob You must describe how you established the high ground water elevation: Y , CD X -7 1 P � ll No. �(� 6 Fee — THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH nIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Mioogal *raem Congtructiun Permit 71 Application for a Permit to Construct( )Repair(' pgrade( )Abandon( ) ❑Complete System/ ❑Individual Components Location Address or Lot No. S�'�dl kd Owner's Name,Address and Tel.No. 'E - .36�' - 7 Assessor's Map/Parc 1 / ����S�YA�I L't I VC) 1'� n�.t�vl�h �� If O � A"t) Installer's Name,Address,and Tel.No. �G� �/�r�-� Designer's Name,Address and Te o. J?G(;L Type of Bud ding: Dwelling No.of Bedrooms `� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �© A f ` S`ram d )/gallons per day. Calculated daily flow gallons. Plan Date S�-/D4' 6'Of Number of sheets ' Revision Date Title Size of Septic Tank ( Type of S.A.S. dl Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1'"e f Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue y this d of Si ed Date , Application Approved b K Date S Application Disapproved for the following reasons Permit No. 3 Date Issued � _', - /�.•1—.. _�..- r _ u: . ,� ... _ 4t` ,:ewe: 1 No. :.,_.. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ' -PUBLIC HEALTH!bt N - TOWN OF BARNSTABLE,' MASSACHUSETTS Application for Mi.5po!5a1'ibpgtem Con5trurtion Vimit Application for a Permit to Construct( )Repair(Po pgU rade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. $0�, - 3Ga- G 093 - 6S /3c�h ,c. 1 r1 2� . Assessor's Map/Parcel e ��"'S � rG 1 !/U t-`1 � � /0, G Li �-7 3G6 rI fi yi 4-4 Installer's Name,Address,and Tel.No. 09 Designer's Name,Address and Ter '7 Gd- -L0, / a312nki 937 h?y n f,�- A-+^.J- A .-.-► Type of Building: ` Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(. ) Other • Type of Building No.of Persons Showers( ) Cafeteria( ) ,d Other Fixtures Sf!/ �1 . Design Flow ) 10 h S 1/0o gallons per day. Calculated daily flow gallons. Plan Date 9./ -6&A 6/ Number of sheets 1 Revision Date Title Size of Septic Tank I $00/ Type of S.A.S. Ll - So V e 5 J , L *'-)c/I Chi•;�-� Description of Soil S P sc; L��/ 4 S J g 1/ / ,�► i s Nature of Repairs or Alterations(Answer when applicable) S,-P nj. C. l��4 1` Date last inspected: Agreement: ' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system w ''N in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue by this oard of ealth 1, Si - ed �n - -"�-- r't Date "`"` •a Application Approved fk Date "Application Disapproved for the following reasons a Permit No. Date Issued t 4` ; THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( pgraded( ) Abandoned( )by 171j, at S oaelt 14 0 has been constructed in a cordance with the provisions of Title 5 and the for isposal System Construction Permit No a -3 F`$dated b Installer Cc„ cd, Designer >. •. 6- The issuance of this permit shall of be Eonstrued as a guarantee that the syrm wi 1 functiro as es gned.O- Date �1 �, Inspector r e p - -_ . ''��� --------—------------------ No. �"l Fee /0 C) THE COMMONWEALTH OF MASSACHUSETTS r PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po5ai *p5tem Construction 3permit r 4 Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at 6S 8 /v I fi t w. �n � -,,� Lzi 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction ust b completed within three years of the d ,e of this p- Date:_._ Approve by } C �� � C �� r _ � � � i Qr r No r FEB, THE COMMONWEALTH OF MASSACHUSETTS BOAR® 9F HEALTH .............0 F.... . . ppliratinn for Disposal Works Tunstrur#iun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an. Individual Sewage Disposal Q� System at: Loatio �� ----•------•---------•---••------•---- -•-•�yy•--JJ- . - or N - ....._. ..................... c .Address .......... � ................... ------------------------------------------------------------ Owner Address ... Installer Address Type of.Building Size Lots�yj� ----•-..---Sq. feet U DwellingNo. of Bedrooms....... .................................Ex Expansion Attic— p ( ) Garbage Grinder (P aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------•--- --•---------•-•---------.--•--•-----•-•--•-----•--------•------•--- W Design Flow......r?.5'...............................gallons per person per day. Total daily flow-------------_-------_--:-•--------------•--gallons. WSeptic Tank 4L-Liquid capacity/.S"..gallons Length................Width................ Diameter.................Depth................ x Disposal Trench—No..................... Width..................... Total Length......._.. _._._.... Total leaching area....................sq. ft. Seepage Pit No._._l---------------- Diameter.&/Llo .._ Depth below i et_.(. __ __..... Total leaching area_ ..�......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by_____... (f+-aa.... . ......................... Date_...9."/?.........��...... Test Pit No. 1................minutes per inch Depth of Test Pit............_...... Depth to ground water........................ (s, Test Pit No. 2................minutes per inch Depth of Test Pit --------- Depth to ground water........................ O Description of Soil•-••...... ..... ....... �.......... tT"' t? . ...._..:... x U ------------ �± .. --- - •-------------•---•------------•-------•--•---------.........-•----------.....----•---•--...--- 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 i1TT7.i?. _ p 5 of the State Sanitary Code—The undersigned further-agrees not to place the-system-in- operation until a Certificate of Compliance has been issued by the board of health. Sigd=---•---..•. .................................................................... Date Application Approved BY -• ----------- ---------- ----Y�7//:7 Dat Application Disapproved for the following reasons:................................................................................................................ ..---•-•...••••..................•••----...-•-•--•••---•••-•-.....-----• ; -••---......._................................................................................................. Date PermitNo............................................................. Issued......----•---------•-------------k-.................. Date N d( THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH A -- -- OF.... .............. Appliration for Disposal Works Tontrurtion Fumit Application is hereby made for,a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..., __. - ........----••---•-•................... ..........•-•......•--....................._ .................................................. Location-Address or Lot o OwnerAddress a = r .......................................... . ... Installer Address UType of Building Size Loth ............Sq. feet 1—� Dwelling—No. of Bedrooms...... ..................................Expansion Attic ( ) /��Garbage Grinder (N �`4 Other—Type T e of Building No. of persons............................ Showers YP g --------•------------------- P ( )--- Cafeteria.(_.). dOther fixtures -----------------------------------------------------•.-•••••------ WDesign Flow...:5.�►,..".�"5.'T............................... per person per day. Total daily flow......................._....................gallons. WSeptic Tank--°—Liquid ca.pacit3f.5"...gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length..........._....... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diamete4 ' ..------ Depth below il#et.(A Total leaching area!Al. ......sq. ft. Z Other Distribution box ( ) Dosing tank Test Pit No. 1:...............minutes er inch Depth o �� - � """"' �"/.............�l._..... Percolation Test Results Performed b ___.._. .., .- Date.... p p f Test Pit................... Depth to ground water........................ FZI Test Pit No.2................minutes per inch Depth of Test Pi Depth to ground water........................ ----------------- O Description of Soi]� .___ _ "`... ....... .... I. ' U ......................... .%"..— -_...../d.......--------...................................................................................... UW ...............------------•-----•-........------------------...... Z....----•----------.....--------------.-.................................................................................... 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 T I:'L, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of. Compliance has been issued by the board of health. Sid ...............•--------•-------..........-••-••-•---••--••--•---- _.... Date Application Approved By....... •-•-•- ---Y�// _ - r ............... Dat Application Disapproved for the following reasons:................................................................................................................ -• -•.............•-•••---•••-•...--•-.....-•-------•--------------.....----•------------------•----••---••--•--•.... Date PermitNo....................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD )!,Z HEALTH .........................................OF..... C rrtifir e of Toktpliatirr T S I TO CE-,TkFY _ t the Individual Sewage Disposal System constructed 4j-trr<epaired ( ) byr ..................................... ------ ----------- Inst er has been installed in accordance with the provisions o Th 5 of The State Sanitary Code as descri ed in the application;for Disposal Works Construction Permit I 1 1 .................. dated.__6- A - •-;,............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SAT ACTORY. DATE............ •v // ector �/ ..... v_. • = .....•-•---•-•-••---...--•-•-..•... p --_--- ... '----......-•------•-•............... THE COMMONWEALTH OF MASSACHUSETTS 4. BOARD OF EALTH .......O F.............. ... No......... ;........ FEE...............••-•..... io r 1 Works Ala`- ion, rrntit 'q Permi�3!o i re by granted_---• --- S. .. to Constr` t� ) WVepair ( ) an Indi l�d>t 1 Sew ge posal S f --- :: - j •...............•-- Street as shown on the application for Disposal Works Construction Per :if"To.... '. _-------------- -- -----_ Board of Health DATE.......... ........................................ FORM 1255 HOBBS & WARREN. INC.. PUFLISHERS Z SNITS / Q Le , P,o �2 �- V Epb AM, E. KRLEY H ; S- A16 ",7 645ez o.v /�$S(/hv'a �iYlLM CERTIFIED PLOT PLAN / LOCATION l�i�etics �L M�s s. SCALE . DATE M.�.•A j 157Y PLAN REFERENCE .QE7?Y0?. . .l-o?r' '�. . . . . .Si,6W V O V A PGA. os-e, Z,�sLlE 8 CERTIFY THAT THE SHOWN ON THIS PLAN ISCIROUND AS SHOWN.HEREON ORMS TO THE SETBACK REQU HE TOWN OF `. . . . . . . . . . .. .. . . . . . WHEN CONSTRUCTED. fin//GC/f}i`! f�• WiE7V�'S' TUX � PETITIONER: 98 LaNG�Euv I^/ De/V� DA TE . . . C�'l✓T�AC ViG•GE' M•�1 5 S.. REGISTERED LAND SURVEYOR N59345 " SNE�'T Z c7F Z S'N&�'T3 L. TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 0 4' CAST IRON PIPE (OR 12 MAX. 12"MAX. "'°r' • PI PE )— MIN. 4"ORANGEBURG(OR EQUIV.) ` PITCH 1/4"PER. PIPE- MIN. LEACH PITCH 1/4"PER.FT. PIT PRECAST 0 0INVERT a Q LEACHING ° EL.t94.r,.Z- .. INVERT INVERT o . e PIT OR SEPTIC TANK DI ST. ° INVERT EL.4Z,. . . BOX EO?r 7s7. j= ;:; EQUIV. /Soo. . .. .. GAL. INVERT �-a 0: °' o; EL.4►3�.Q'•S. INVERT � v :::� 3/4"TO I V, EL4z•% L W W QELQZ•Zo �� WAS W STONE PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE PREIRMIN SOIL LOG WITNESSED BY : DATE !?A?•. !z 197?. TIME.?'TO,4A* . P�-G• Mv2 r9�/ BOARD OF HEALTH TEST HOLE I TEST HOLE 2 Ti��!7A5 . �r -�`� �`y.?�t ENGINEER ELEV. . 48-.7. . . . . ELEV. .48.C. . . . I-o� �''' ' c`� DESIGN DATA 7i,, NUMBER OF BEDROOMS J. . . pe= TOTAL ESTIMATED FLOW . . �- Q. . GALLONS/DAY 9c u BOTTOM LEACHING AREA 78-s SO.FT. /PIT Cosnz.�E- Sao co*esE SIDE LEACHING AREA . . 186),59. . . SO.FT./ PIT SAC GARBAGE DISPOSAL .NdNE. .(50% AREA INCREASE) G,egv� TOTAL LEACHING AREA Z67ac? SQ.FT PERCOLATION RATE GS.? '4?`! .Z . . MIN/INCH LEACHING AREA PER PERCOLATION RATE �. . SO.FT. !YO. .WATER ENCOUNTERED NUMBER OF LEACHING PITS .1. .w�.� Two• APPROVED . . . . . . . . . . . . BOARD OF HEALTH �F-57a!�!EoNAtL5 � s;� OF S7 DNE TA2 P.T. ENGINEERS—SURVEYORS. DATE . . . . . 346 LONG POND DRIVE AGENT OR INSPECTOR SOUTH YA.RMOUTH,MASS. 2664 OFM T �',' E+4�I? Fes( ^' v KELLEY y ._Ly_ Na24260 9B 4^ c)FTe4W Z>wv/e 90 FG/sTit E�� PETITIONER _ '�'ra& �'� �FSS�ONAL�aG\� paTKde' �y ° � i;XrQ�Ft@5° R°Fn�> �PtauQii F as g a J :� PIP..'R J O A, S9� z gg $ $ $ $ m $ gym= 03 INI 40 -"" I, &H , g. ip AP P e$ 1j2,1P egg g121, ® i I1� P4 „� A x Ire, ORS z m 1 !A log Rill ;A ol 1 9 IJR J� pis A N H Eb g a g �RAM pal > g Al n 8� � !, m ® O IN P ° w g p T il. p€ P e a Ill guO b O y � , l m - r a` a z 0 z u Oil \ \ '4/ ., � l� -- / / � \ �• . 0. tj '-�,,\�. 'moo_\ \ \ �Lti�``�i E�'•'' _ .'••�.. 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I� IIII _ I kI¢�i�� I I ® (IIIII ® � - - I' EII it 17 illy IIII j' (ill, . Illlil t ;I ;L ,l IiII II. • _ � ll - I' II III' II113 !I it IjIi,I IIIII __ IL y TWO TALL TREES DESIGN X SULLIVAN STRAUS RESIDENCE °zg11g€ o ELIZABETH&RICHARD P.O'LEARY,JR. 65 BONE HILL ROAD E3 �I 9.-,l BARNSiABLE,.MA55ACHUSElTS N F 56g m o 0 ROTON rtE22 P.O.Bo 1057 v =� pR,k§ 6 � aCRo7oN FALLS,NEW YORK.I05I9 p s rEL./,w 914.669.0014 OI.OA1017 FJ051P/C fXpm.'MP5 ort m s .., ON EMAIL:TWOTALLTREESOOPONLINE.NET 7- i� w w ❑ ❑ N ❑❑ o� \ - y O IN --1 Nw i o M \ E6 Lq \ \ � 1 II m y II TWO TALL TREES DESIGN SULLIVAN STRAUS RESIDENCE N o ELIZABETH&RICHARD P. O'LEARY,JR. 65 BONE HILL ROAD 637 ROUTE 22 P.O.Box 637 ^ BARNSTABLE,MASSACHUSETTS V CROToN FALLS,NEwYoRK 10519 l\ TEL./FAX 914.669.0014 - EMAIL:TWOTALLTREES@oPTONLINE.NET F SYSTEM PROFILE NOTES Barnstacble Harbor TOP FNDN. AT EL 57.7' ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT To SCALD 1. DATUM IS APPROXIMATE NGVD ACCESS COVER (WATERTIGHT) TO ACCESS COVER TO WITHIN 3" OF FIN. GRADE LOCUS WITHIN 6' OF FIN. GRADE 2. MUNICIPAL WATER IS EXISTING 56.7' MINIMUM .75' OF COVER OVER PRECAST 2X SLOPE REQUIRED OVER SYSTEM .; 56.5' o 2' DOUBLE WASHED PEASTONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. �, o RUN PIPE LEVEL OR GEOTE)TILE FABRIC o S \*54.7' FOR FIRST 2' I z PROPOSED 155?Q 3' MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO GALLON SEPTIC 54.0' H- 10 a 54.25 TANK (H- 10 ) GAS 54.23 boo a BAFFLE53.74 �� 53.57 O D O O 0 1-] 0 O 5. PIPE JOINTS TO BE MADE WATERTIGHT. 2.5 0 53.43' p p p p � p p 13 p o 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH Roufe sq ( X SLOPE) �6' CRUSHED STONE OR MECHANICAL ED O 0 O C3 O 0 0 O COMPACTION. (15.22t [2n 2► Q Q Q Q Q Q Q o MASS. ENVIRONMENTAL. CODE TITLE V. �a ► 51.43 DEPTH OF FLOW = 4 - 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO oiyrood TEE slzEs: 3/4" TO 1 1/2" DOUBLE WASH"D STONE -BE -{USED -FOR-LOT LINE -STAKING OR -ANY-OT14ER PURPOSE- INLET DEPTH _ _ 0 0 OUTLET DEPTH = 14" ( 1 x SLOPE) ( 1 x SLOPE) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. FOUNDATION 18' SEPTIC TANK - 26' D' BOX 16' LEACHING 6.93' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED „ , FACILITY WITHOUT INSPECTION BY-BOARD -OF HEALTH AND PERMISSION SCALE: 1 = 2,000 *THE INSTALLER SHALL VERIFY THE OBTAINED FROM BOARD OF HEALTH. LEGEND LOCATIONS OF ALL UTILITIES AND 10: CONTRACTOR SHALL- BE RESPON-SIBLE-FOR CALLING. ASSESSORS. MAP 336. PARCEL.81 . ALL BUILDING SEWER OUTLETS AND DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION LOCUS IS WITHIN AP OVERLAY DISTRICT 100.0 PROPOSED SPOT ELEVATION ELEVATIONS PRIOR TO INSTALLING BOTTOM TH-1 EL 44.5' OF ALL UNDERGROUND & OVERHEAD. UTILITIES PRIOR TO ANY PORTION OF SEPTIC SYSTEM COMMENCEMENT OF WORK. +100.00 EXISTING SPOT ELEVATION 11.EXISTING SEPTIC SYSTEM SFKLL BE PUMPED AND)- 100 0 PROPOSED CONTOUR REMOVED. - - t170 = - EXISTING CONTOUR LOT 3 �26�6' 12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE 38,186 SFt REMOVED 5' BENEATH AND AROUND THE LEACHING FACILITY. w EXISTING. WATER LINE c EXISTING GAS LINE ; SYSTEM DESIGN: GARBAGE DISPOSER IS NOT ALLOWED TEST HOLE LOGS �,, OH WIRES` �� DESIGN FLOW: 5 BEDROOMS ® 110 GPD = 550 GPD USE A 550 GPD DESIGN FLOW ENGINEER. DAVID FLAHERTY, R.S. ,� ' \ ��^ i SEPTIC TANK: 550 GPD (2) = 1100 WITNESS: DON DESMARAIS, R.S. -- - a - , r / l SHED iy1cF A _1500 GAL: SEPTIC TANK AUGUST 23, 2006 BENCHMARK DATE: COR-CONC STEP s \ � LEACHING: PERC. RATE _ < 2 MIN/INCH ELEV = 57.25' STONE �� SIDES: 2 (42-+ 12.83) 2 (.74) = 162 GPD CLASS I SOILS P 11418 \ DRIVE # I w BOTTOM 42 x 12.83 (.74) = 398 GPD 14 2f,8• EXISTING S.T. 1 ! I ;r TOTAL: 75& S.F 560-. GPD) ELEV. ELEV. 11. O" 56.5' w 56.9' EXISTING I I ;o USE (4) 500 GAL -LEACHING CHAMBERS <ACME .OR EQUAL) . A A ROPOSED S.T. 5 BR DWELLING I I WITH 4' STONE ALL AROUND LS LS \ r_-- TOP OF FNDN=57.7' 1 I /. / o / 1 OYR 5/2 1 OYR 5/2 TH_2 I DECK 1 ► I 12" 56.5' 14" 55.7' ) F \\ - L ___ ; I I I APPROVED DATE BOARD OF HEALTH WA B B " 10YR 7/6 10YR 7/6 G --G; TITLE 5 SITE PLAN 32 53.8 34" 54.1 s , xzl B• w / OF c r /C, - 65 BONE- L L R D: . . SILT LOAM SILT LO AM / / / / WUMMAQUID�7/2 O . . -- :RARNS�TAB . E,: -MA - " 2.5Y 7/2 " 2.5Y 89 49.1 76 50.6.- m PREPARED FOR TOIVO . . LAMMINEN . C2 PERC c2 5' REMOVAL OF UNSUITABLE SOIL ' MCS MCS REQUIRED AROUND PERIMETER OF p DATE:. AUGUST 28, 2006. LEAF F ACR.(i Y, DOW-TUFT O' T 2.5Y 7/4 2.5Y 7/4 SUITABLE SOIL LAYER. REPLACE OO 144 " 44.5 132" WITH CLEAN MMUM SAND. , .45.9- "'> > NO GROUNDWATER ENCOUNTERED h /�' ����HOF t�ss9c �tHOFM4,7. off 508-362-4541 o �o� ARNE H. ti� ��° A H E _ 5oa 3s2-988�. . . C0 U OJALA n 0 OJALA CIVIL y No. 30792 o No.26348 down Cape.. engineering,: inc. = UNSUITABLE MATERIAL o�o�4�c, TE��`° �`�� ��° ss\�`'� ClVX ENGINEERS a . SS NAL EN \ URVE'I° - LAND SURVEYGIRS:- Scale: 1 = 20 939 Moin Street - YARMOU 7NPOR T, MASS. 0 10 20 - 30 4o e•o FEET DA ARNE H. OJALA, P.E., P.L.S. DCE #06-196 06-196 LAMMINEN.DWG (DDF)