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0051 BOULDER ROAD - Health
51 Boulder Road, Barnstable t. A = 315 027 { TOWN OF BARNSTABLE Lam,2�, LOCATION �� l��U�/��2 f�l� —53 SEWAGE # w Ic VILLAGE_ // N���� ASSESSOR'S MAP & LOT _D j INSTALLER'S NAME&PHONE NO. i9¢tf �75 SEPTIC TANK CAPACITY LEACHING FACILITY: (type)'/A,6YJe 4/A(_30 _5 S (size)a1'5,3S*dJl0 7t A� NO.OF BEDROOMS l BUILDER OR OWNER PERMITDATE: D COMPLIANCE DATE: ®"/9 6 Separation Distance Between the: Maximum Adjusted Groundwater Table-and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility .(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i Commonwealth of Massachusetts . ^ Titlel ' 1 -- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments " 51 BOULDER RD -- _. -----� Property Address JOHN GARRAN --.. Owner .............__— Owner's Name information is M/� 02630 AUGUST 26 2Q11 required for every BARNSTABLE — ._-_....--_-. _..__.-.. . - page, Cityrrown — y T T State Zip.Code Date of Inspection Inspection results must be submitted on this fore..Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:when A. General Information filling out forms +r 1 on the computer, I only the tab use o y e 1, inspector: - _ key to move your cursor-do not MARK L WHITE _ use the return ,_.......--- --..... .. ......_-- ---....., -----.... ....._.. Name of Inspector key, A.B. CAIVCO -- --- Company Name Company Address WEST YARMOUTH MA ._;. _-.-.--- 02673 — - State CitylTown Zip Code 508-775-2820 S=13381 ..__...: 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 DiEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: t?< ' Passes ® Conditionally Passes41j� C7 Needs Further Evaluation by the Local Approving Authority- (MARK -c�LP= o: WHITE No.S13381 AUGUST 26 2011' �� R7►FGn¢, _ Insp ctor's Si reJ .. Date ��/Ziq®S IN 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 DES'. 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 inspections does not address how the system will perform in the future.ender the same or different conditions of user Title 5 Official Inspection FOM:Subsurface Sewage Disposal System°?age 1 of 19 t5ins•11110 °��� /Zo Commonwealth of Massachusetts sped'on Form" `4 Subsurface Sewage Disposal System Pow Not for Voluntary Assessments Property Address JOWNGARRAN _.._.._.... ..,. - — -- '._..-._._ ............... --- Owner Owner's Name information is MA 02B30 AUGUST 26 2011 required for every BARNSTABLE -- -- -.---- P n page. tY State Zip Code Date of Inspection /Toyer , a i Bo Certification (cone.) _ Inspection Summary: Check A,B,C,U or E/always complete all of Section n A) System Passes: I have not found any information which indicates that any of the failure criteria described iri 310 CMR 15.303 or in 310 CMR'15.304 exist. Any failure criteria not evaluated are indicated below. Comments: .A . 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 Wealth,will pass. Check the box for"yes„ "no"or"not determined"(Y, N, NO)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years olds or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exflltration 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,`nbt leaking and if a Certificate of Compliance indicating that the tank is.less than 20 years old'is available. ❑ Y ❑ N ❑ NO (Explain below): t5ins•11110 Trtte 5 o foW trtspec6on Form:Subsurface Sewage Disposal System•Page 2 of 19 Commonwealth of Massachusetts --PR Title iInspection Form _-- - A `s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 51 BOULDER RD Property Address JOHN GARRAN _._.__.. Owner Owner's Name -- information is BARNSTABLE MA ry._. 02630 AUGUST 26 2011 required for every --�_._.......:._._...----- -------------- .....__......__............. ...... page. City/Town State Zip Code Data of inspection F B. Certification (cont.) 13) 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): 13 broken pipe(s)are replaced ❑.Y D N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y 9 N ❑ ND(Explain below): ❑ distribution box is#eveled 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 0.N ❑ ND (Explain below): 11 obstruction is removed 0 Y N ❑ ND(Explain below): [Sins•91/10 k Title S Official inspection Form:Subsurface Setiage Disposal System•P39e3 Of 19 - 4 Commonwealth of MasSaehuSeft -- _ Titlei Subsurface Sewage Disposal System Form m Not for Voluntary Assessments Praper_ty Address JOHN GARRAN . ----- - Owner Owner's Name information is BARNSTABLE MA 02630 AUGUST 26 2011 required for every � _...__..........- ---- page. City/Town - State Zip Code Cate of inspection C) Further Evaluation is Required by the Board of Health: C7 Conditions exist which require further evaluatior, 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 C€ R 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 B. Certification (cont.) 2. System will fail unless the Board of health (and Public Water Supplier, if arty) determines that the system is functioning in a manner that protects the public health, safety and environment: CJ 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. D The system has a septic tank and SAS and the SAS is wi thin 50 feet of a private water supply well. C) 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 ®EP 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. tSins•11l10 Title 5 Official Inspection.Forts;Subsurface Sewage Disposal System•Pago 4 of 19 . t Commonwealth of Massachusetts =� n' Form o Subsurface Sewage Disposal System Form b Not for Voluntary Assessments Property Address JOHN GARRAN X. Owner -----_......_ ___.._.......,... . ..... . -.- o«rner's Name " information is MA 02630 AUGUST 26 2011 ip Code _ required for every BARNSTA13LE ._- —____-- page, City/Town State Z Dare pf inspection 3. Other: . F 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 0Q Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS,or cesspool F Liquid depth in cesspool is less than 6'i below invert or available volume is less than %day flow B. Certification (cunt.) Yes No Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipes). Number of times pumped.- 0 Any portion°of the ISAS, 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 FRI tributary to a surface water supply. n xx� Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ 0 Any portion of a cesspool or privy is within 50 feet of a private water supply well. t5ins-11/10 Title 5 official inspection Form:Subsurface Sewage Disposal System-Pago 5 of 19 Commonwealth of Massachusetts -- Title 5 OfficialCForm' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 BOULDER.RD- _ . _ ------ — Property Addrdss JOHN GARRAN ........... .... . ..__ _.-- -- Owner Owner's Nam information is - _.....__-- MA 02630 AUGU_.ST 26 2011_. requited for every BARNSTABLE -___._ page. _._.. Cityffown T State Zip Code Date of inspedtion El 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 chairs of custody must be attached to this fora.) 0 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, 7 ® 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 rest serve a facility with a design€low 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 [� rl the system is within 400 feet of a surface drinking water supply n 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 11 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. „ C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® (ox Pumping information was provided by the owner, occupant, or Board of Health [] M 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? Q Have large volumes of water been introduced to the system recently or as part of this inspection? t5vts 91/10 _ Title 5 Official Inspection Fanny Suhsutface Sewage Disposal System Page 6 of 19 Commonwealth of Massachusetts - it!itle 5 Offidal Inspection to Subsurface Sewage Disposal System Form-Not for Volunta►j Assessments 51 BOULDER RD w: Property Address JOHN GARRAN --- Owner owner's Name information is BARNSTABLE tlllA 02630 AUGUST 26 2011 required for every _._.__...... ._�;..,._ ` �------............__ ..........._.__..— page. City/Town state Zip Code .Date of Inspection Were as built plans of the system obtained and examined? Of they were not available note as N/A)N/A D (� Was the facility or dwelling inspected for signs of sewage back up? x ❑ Was the site inspected for signs of break out? ©x ❑ 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'. [�] Q Existing information.For example, a plan at the Board of Health. Determined in the field(ifany of the failure criteria related to Fart C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 - Number of bedrooms(actual): ...,_...__ 330 DESIGN flow based on 310 CNIR 15.203(for example: 110 gpd x#of bedrooms): . 3 D. System Information _ Description: 0 Number of current residents: ixl Yes V Does residence have a garbage grinder? No t5ins•11110 7r6e 5 Official Inzpeciion Forn:Subsurface Sewage Disposal System•Page 7 of 19 f Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal Systems Fora -Not for Voluntary Assessments 51 BOULDER R®.. .... :.. . _— .__ Properly AAddress JOHN GARRAN -- Owner Owner's Harr - information is MA 02630 � AUGUST 26 2011 required for every BARNSTABLE __... --------- page. Citylrown state Zip Code Date of inspection Yes L1 Is laundry on a separate sewage system?[if yes separate inspection required] No C7 Yes C7 Laundry system inspected? No C7 Yes Seasonal use? No 2009--42000 Water meter readings, if available (last 2 years usage(gpd)): 201 --69000 Details Yes Sump pump? Flo JUNE 2011 Last date of occupancy: Date Commerciallindustrial Flow Conditions'. Type of Establishment:, _ Design flow based on 310 CAR 15.203): y(gp_---- -- g ( Gallons per day{gpd) Basis of design flow(seats/persons/sq.ft., etc.): --- --- --- Yes CJ Grease trap present?' No i El Yes ❑ Industrial waste holding tank present? No Yes ❑ Non-sanitary waste discharged to the Title 5 system? No Water meter readings, if available: - -- _....._.__.. _. ....... .., .,. _ D. System Information (cont.) . Last date of occupancy/use: Date ------ Other(describe below): t5ins•11/10 Tdie 5 Offs b)Inspectttm Form:Subsurface Sewage Disposal System•Para 8 or 19 Commonwealth of Massachusetts w� Title Subsurface Sewage Disposal System Form Not for Voluntary Assessments a t 51 BOULDER R® _...•._....--- --- --- - Property Address JOHN GARRAN T- ----- - -- -- Owner AUGUST 26 2011 puvner's hlante information NIA A on is 02630 required for every BARNSTABLE _ A — ----------- page. Cityrrown State Zip Code Date of Inspection General Information Pumping Records- Source of information:'-- -Was system pumped as part of the inspection? ® Yes No If yes, volume pumped: gallons How was quantity pumped determined? — --- ------- :..__..._._.__...._.._-.-.-_— Reason for pumping, Type of System: ❑x Septic tank, distribution box, soil absorption system ❑ Single cesspool ® Overflew 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): D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: OCTOBER 132004 tsins•41110 r Title 5 oflicial Inspection Form:Subsurface Sewage Disposal System Page 9 of 19 .- Commonwealth of Massachusetts ;^ y Title Subsurface Sewage Disposal System Form Not for Voluntary Assessments 51 BOULDER Rb -- Property Address JOHN CARRAN ---- Owner Owner's Name information is [��A 02630 AUGUST 26 2011 13ARNSTABLE required for every 0 ---------------- page. City/Town State Zip Code Cate of Inspection Were sewage odors detected when arriving at the site? Yes No Building Sewer(locate on site plan)-. 7 Depth below grade: feet- Material of construction: ®cast iron O 40 PVC 0 other(explain): Distance from private water supply well or suction line: feet---- Comments(on condition of joints, venting, evidence of leakage, etc.): NO ROOTS,ALL JOINTS LOOK TIGHT _-- 'Septic tank(locate on site plan): 6 1/2 . Depth below grade: feet - - - Material of construction: n concrete ❑ metal fiberglass ❑polyethylene 0 other(explain) If tank is metal, list age: years ® Yes a Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) No Dimensions: O -----.........._._... ._._ ..._.. .. Sludge depth: D. System Information (cunt.) ;S ns•1i110 Title 5 Official lnsi,:ecvc n Form.Sutmrfa-Sewage DispesaI System•Paoe 10 of 19 Commonwealth of Massachusetts �- �- Title 5 Officialf . c 6 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments .y 51 BOULDER RD _,. ... .. _._...- . Property Address JOHN GARRAr _.. ----- - -- ----- Owner .__ Owner's Name ' information is MA {J263Q AUGUST 2B 2�11 required for every BARNSTABLE — _.... .. _ .._.. . .- page, Gitylown State Zip Code Date of Inspection Septic Tank(cunt.) 3 Distance from top of sludge to bottom of outlet Lee or baffle 0. Scum thickness 4 0 . _ O Distance from top of scum to top of outlet tee.or baffle --------___- Distance from bottom of scum to bottom of outlet tee or baffle 0 SLUDGE.JUDGE, TARE How were dimensions determined? MEASURE Comments(or, pumping recommendations, inlet and outlet tee or,baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.), TANK WAS AT OPERATING LEVEL WITH NO VISIBLE SOLIDS AND NO SCUM,OR SLUDGE APPARENT Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑metal CJ 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 I Date of last pumping: Date. t5irrs•11I10 Title 5 official Inspection Form:SuhsuRaoe Serowe Dismal System•Page 11 of 19 Commonwealth of Massachusetts Titleicyal Inspection Form Subsurface Sewage Disposal System Forma -Not for Voluntary Assessments 5BOULDR D --. - FropertyAddress JOHN GARRAN Owner Owner's game information is .� ► ( A Q263t AUGUST 26 2011 required for every BARNS,ABLE M - -- - page, Cityrrown state Zip Code Date of Inspection D. System Information (cons.) Comments(on pumping recommendations; inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc). _right or Holding Tarok(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 Alan 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 T ffic Title S oral Mspecnon Form:Subsurface Sewage Disposal System•Page 12 of 19 t5 ns•11110 Commonwealth of Massachusetts -- its t "oh Form Subsurface Sewage Disposal System Foam-Not for Voluntary Assessments •= _` 51 BOULDER RD _ . ------ Property Address JOHNGARRAN ---- _..:.............._.... .,... Owner Owner's Name information is MA 02630 AUGUST 26 2011 requires!for every BARNSTABLE - ---__--- page. City/Town- 4 __ State Zip code -Date of Inspection D. System Information (cont.) Distribution Sox(if present must be opened)(locate on site plan): ...__._.--- Depth of liquid level above outlet invert AT INVERT .._._ .._._....... .. Comments(note if box is level and distric�ution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): NO EVIDENCE OF ANY SOLIDS CARRY OVER AND NO SIGNS OF LEAKAGE. D BOAC WAS CLEAN AND APPEARED IN NEW CONDITION STILL Pump Chamber(locate on site plan)- Pumps in working order: Yes ❑ No Alarms in working order. Yes ® No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11l10 TMe 5 official Inspection Form:Subsurface Sewage Nspasat Systen•Page 13 of 19 Commonwealth of Massachusetts - Title 5 Official Subsurface Sevrage Disposal System Form®Not for Voluntary Assessments �r-- 51 BOULDER RD Pzop4 ty Acidness JOHN GARRAN Owner Owner's Name , information is MA 02630 AUGUST 26 2011 required for every BARNSTABLE page. Gityrrown State - Zip Code Date of inspection D. System Information (cunt.) Type [� leaching pits number: ---- (�x, leachin chambers number. 3-3050 9 INFILTRATORS leaching galleries number; ❑ leaching trenches number, length: — ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovativetaltemative system ` Type/name of technology` Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): LINES WERE INSPECTED WITH CAMERA AND NO ROOTS AND LINES WERE CLEAN Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert tsins•11110 Titin s oNiciai Inspection Form:Subsurface Sewage[disposal System•Page 14 of 19 - Commonwealth of Massachusetts — Subsurface Sewage Disposal Systems Form-Not for Voluntary Assessments <,w 5_1 BOULDER_ RD Property Address - JOHN GARRAN ---- -. Owner Owner's Name information is IViA 023 _...- AUGUST 26 2011 required for every BARNSTABLE ------.-._.__ page. city�owri _. __..-- State Zip Code Date of Inspection Depth of solids layer • --_---..�.__...�_.._._-_�_ Depth of scum layer ~_ ...- Dimensions of cesspool --� Materials of construction - Indication of groundwater inflow Yes No Do System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of pending, condition of vegetation, etc.): Privy(locate on site plan.): Materials of construction; Dimensions Depth of solids — Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.); • t5ins•11/10 Idle 5 Offz; L7speZian Form:Subsurtaoe Sewage pispaSst System•Page 15 of 19 Commonwealth of Massachuseus - Title 5 Officloal Inspection Form Subsurface Sewage Disposal System Forma-Not for Voluntary Assessments 51 BOULDER RD Property Address - ^ JOHN GARRAN Owner ....._...............,.. ......_. ..__ .,....__..._.,.._._......_ --_--------- -_---- — -- --- Owner's Name information is }� 02630 AUGUST 26 2011 required for every BARNSTABLE —____--- _. page. Cityfrown state Zip Code Elate of Inspection t D. System Information (cant.) 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 pudic water supply enters the building. Check ope of the boxes below: - C� hand-sketch in the area below drawing attached separately t5ins•i vio - Title 5(Aciai Inspection Form:Subsurface Sewage Disposal System-Page 16 of 19 Commonwealth of Massachusetts Title 5 Official Inspection Form — — Subsurface Sewage Disposal System Form-Not for Voluntary Assessments =' 51 BOULDER RD Property Address JOHN GARRAN owner's ------ _._.�- -- — owner _ .. , .. .. r Name ' information is required for e MA 02f 30 AUGUST 26 2r311 very BARNSTABLE _. --- page. city/Town -- state Zip Code Date of Inwction i ' 1 D. System Information (cent,) Site Exam: Cl� Check Slope Surface water t5irrs•11190 Title 5 Official Insowdon Foam:Sutnsurface Sewage Oisposal System•Pa®a 17 of 19 Commonwealth of Massachusefts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 51 BOULDER RD ...... :_..... --- Froperry Address JOHN GARRAN Owner owner's name information is MA 02630 AUGUST 26 2011 required for every BARNSTABLE ----- -- — - - ----- page. CitytTown State 'Zip Code Date of inspection Check cellar xi Shallow wells NO GROUNDWATER AT 12 FEET Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation:: ® Obtained from system design plans on record ; If checked, date of design plan reviewed: 920-2004--- _ Date Q Observed site(abutting property/observation hole within 150 feet of SAS; Q Checked with local Board of Health-explain: Q Checked with local excavators, installers-(attach documentation) Q Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection.Report, please see Report Completeness Checklist on next page. Ea deport Completeness Cheoklast Q Inspection Summary: A, B, C, D, or E checked Inspection Summary D(System Failure Criteria Applicable to All'5ystems)completed t5 ns•11l10 Title 5 Official Inspection Form:Subsurface Sewage Dispose-(System Page 16 of 19 ti A c, T� .[ � � � ti ` . "e - r � .. ' \ ti� '��.- ti� �\ 1. £ £ \, _�l ' uV � !» N� �e �_\ �\ .f �' - � •1/,` X�. � _ � — - U W � � � -..,. � - .. I „� _ ` � _ � N&% Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for loi000l *paem Congtruction Permit Application for a Permit to Construct( , )Repair( Upgrade Abandon( ) ❑Complete System El Individual Components Location Address or Lot No.�� ' ner's Name,Address and Tel.No. Assessor's Ma /Parcel u t C 0 p 3i5'_ oa7 &Uer (�j . s Installer's Name,Address,and Teel.No. Designer's Q�Address and Tel.No. A 0 Mey e n 350 Main Street Type of Building: Dwelling No.of Bedrooms_— Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 9 , l 3 gallons per day. Calculated daily flow 3 3 gallons. Plan Date Number of sheets Revision Date Title S�11-e ^ Ze�A -e— Size of Septic Tank tfZr Sii4g IOV-6 Type of S.A.S. /a - Description of Soil t,-C r- A Nature of Repairs or Alterations(Answer when applicable) 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 nviro en 1 Code and not to place the system in operation until a Certifi- cate of Compliance has been i by this Bo d f H. th. Signed 1 Date l6 7 41(4 Application Approved by Date Application Disapproved for the following reaso,64 Permit No. Date Issued Fee l�� ,THE COMMONWEALTH OF MASSACHUSETTS 1 +Entered in computer: I Y PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE MASSACHUSETTS . Y' Z(vuYication for Oizpozar bpztem Con!5truction Vermit Application for a Permit to Construct( . )Repair(' Upgrade Abandon( ) O Complete System 0 Individual Components Location Address or Lot No. Ow'yelr's Name,Address and Tel.No. Assessor's Map/Parcel t C v r (> '/ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. eyR r CC) Cy Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) `Cafeteria( ) Other Fixtures Design Flow v'J 9 ( � -gallons per day. Calculated daily flow 3 U gallons. Plan Date —J U - Number o sheets Revision Date ✓ . Title 7�- -e G/.4 e. Size of Septic Tank /G?PC) Type of S.A.S. Description of Soil; Pe r {�n Nature of Repairs or Alterations(Answer when applicable) / /7 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 nviro tri ent I Code and not to place the system in operation until a Certifi- cate of Compliance has been i�sul by thi Bo d Huth. / Signed _ ,A' /I - Date 7/�t Application Approved by Date Application Disapproved for the following reasons/ V v v Permit No. Date Issued --------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY., that the On-site Sewage Disposal System Constructed( )Repaired Graded( ) Abandoned( y at Wo7et -e -has-bee constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer The issuance of th•s permit snail not be construed as a guarantee that the sy to will`Allnction as `es}gned: Date tY t 3I o y Inspector 1W. —...•33 �1. —�-;—-----------------------Fee Inc) THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS MiZpo!6a[ *pgtem Construction Permit Permission is hereby grAatfd to Cords_ ct( ) epair( ade( )Aba, on( ) System located at 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 conditionsfWrm., Provided:Construcfion !usst�be ompleted within three years of the date oft. - Date: / / Approved v by ' U I Town of Barnstable �oF "E'O`y Regulatory Services Thomas F.Geiler,DirectorHAM . snxxsrnBre. Public ]health Division ArEoA Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: CTO�� u. 1004 Designer: C{,✓'�°✓1 Installer: A 1✓ l��'" Address: . �. • hjDX -1 S Address: Mb M O S 1- -�',�►�p w cc M A 02s3� W, g9Q6 l M A A & B CANCO On et--was issued a permit to install a (date) W, Ya u ,�e 1A 02673 septic system at �� PO0 U GQE'R 0A-0 based on a design drawn by (address) dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. t greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Loc Plan revision or certified as-built by designer to follow. o=� F MA ER o, 1140 (Installer's Signature) o �.�8TE�� �NITAR\�'a (Designers Signature) (Affix Designers 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. Q:Health/Septic/Designer Certification Form TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. f &O9C!> SEPTIC TANK CAPACITY LtXcS I16a 0 c„¢/ LEACHING FACILITY: (type)3"1 ��(,Y�pSb S (size)es��S (�•Igo 71,E �► NO.OF BEDROOMS.t BIJII,DER OR OMRMgC O PERMTTDATE: :::COMPLIANCE DATE: Separation Distance Between the: Maximum'Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by \ 1\YY A 3 �S.3Sx 11 Ito x 4�0 3i�� L4CATION � SEWAGE PERMIT NO. Q Ud y 3 (7 VIVA E 7,- 13a y�� Z-, INSTALLER'S 4AME S ADDRESS 8 U I L D E R OR OWNER AJ- L -tr7 p ` DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ,. W m" ,�` O� n �• � .. ................... 0 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................................O F......497?;NS�•�4 ---------------------------------- Applira#ion for Dhgpoii al Works Tontitrurtion ramit Application is hereby made for a Permit to Construct (e_�or Repair ( ) an Individual Sewage Disposal System at: ---•�®vGDG� IZdd,�Yt� --- . .�....... l0� .........--•••-••...............•--......... ...-------...�.............•-------- ••-•-•--- --•--••-----•-•-•--------- ----•--.._..---•---•-- Location-Address or Lot No. Al.��T. :_.... G s'iG� M` 5.:................ --- . •.._..._. .......-•-••-------------•--•-------•. --.._.. Owner Address .. . H....- `� .....Installer Address D f Type of Building Size Lot_...____r--�------_---Sq. feet— V Dwelling—No. of Bedrooms._.._._. .................. Expansion Attic ( ) Garbage Grinder ( )►-, ....•--- '� Other—Type of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -----•------------------•----------•--........_ W Design Flow............- - -......................gallons per person per day. Total daily flow............. ...................gallons. WSeptic Tank—Liquid capacity./ gallons Length.$�-('/... Width.4X/.._ Diameter................ Depth_S''6*". x Disposal Trench—No. .................... Width.................... Total Length.....................Total,leaching area....................sq. ft. Seepage Pit No......Z------------ Diameter...__�.`.... Depth below inlet.....G__�.._.____ Total leaching area...'�Z 9....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by-_.�_�.�_-.4.14____��_.. SVO)Z-7.......P.49............ Date��.Z9............... Test Pit No. 1... ..minutes per inch Depth of Test Pit--- - _...... Depth to ground water----- ------------------- GL, Test Pit No. 2_j!�=i�q...minutes per inch Depth of Test Pit---- Depth to ground water........................ Q+' •---•-•---------•------•-------------------------- 0 Description of Soil... ••_8" 7`0�:Sod c ���6" S'v6-,Sc,�-�------ 3G• "-8¢!�--- �ict ----`�-��a.-•----. - - - $"__77C.../....-5 __1.Vi.....5!-.......{!...5---......._.... .~-/S... ---•- .... -`.....------=`.............=S..................-- W --•----------------------------------------------------------•--•--•------•-•----------------------------------------------------•------------------•---••----•-••...---------------•-----••••--•.--••-- UNature of Repairs or Alterations—Answer when applicable............................................................................................... ------....-•----------------•-----------------------•----•-•----------------•---............------------......----------------------------------------------------------------•-•----•--•.......--.•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complianc has been issued by the board of health. Sign .....................................•-•--.....................-------------------- ............... ApplicationApproved By......... . •------••-•.•-------------------------------------•••-•--..._......---•-- -- -....... .... .-----•-••-•--- j Date Application Disapprov f o -the following reasons----------------•--...---------------------------------------------------------.....---••--------••--------.---•- ..------•-----------------------•-•-------------------------•--•••••---••---------•----...........:----- Date PermitNo...................................................-.... Issued-....................................................... Date a .._............ ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Applira#ion for Bhipoii al Marks Tilmtrnrtiun Vamit Application is hereby made for a Permit to Construct (4,of or Repair ( ) an Individual Sewage Disposal System at: .... ovG daG� �d.4 �i72r.c Ti9.��'4. ....... .....-7............................................................... • Location-Address or Lot No. .............................1 L�'G72 7- ✓. /�vG Si =G:7Z-•--------------••-----------.. A........................G} L l:...-:...M!'1-S•5......-------•-••---......... -- s / CoOwner Address a 1117zaA/ C A/ ................. ._.............. Installer Address Type of Building Size Lot....____� ...Sq. feet— U Dwelling—No. of Bedrooms........_��................................Expansion Attic ( ) Garbage Grinder ( ) 404 Other—T e of Building No. of persons............................ Showers — Cafeteria aI Other fixtures --------•-----•-•-•---•---••.... . W Design Flow...............`3._........................gallons per person per day. Total daily flow..__......._-9-G?....................gallons. WSeptic Tank—Liquid capacity.%o°a-.gallons Length.U.'d".... Width.-i�:4'___- Diameter................ Depth. !�F.". x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area------------_.......sq. ft. Seepage Pit No....../............ Diameter.....1._`-_".... Depth below inlet.....4............. Total leaching area..15FIA....sq. ft. z Other Distribution box ( ) Dosing tank ( ) _ `-' Percolation Test Results Performed by--- '� 6__--k=_-_-5A zz_--.,••f G......... Date u!✓�'. �:S _��1�� Test Pit No. I... ...minutes per inch Depth of Test Pit. Depth to ground water ....._.. Test Pit No. 2.:�-_jp...minutes per inch Depth of Test Pit... y_?._..... Depth to ground water-------.............. a ------------•---------------------•-................••--............-----•----------..._....._......••------------ --------------------------------- O�/ Description of Soil... ' ~_ �PrSOiG c0 .%G'"✓'v�3-..5of( 36'"- c'��"F�r!✓E a;�-�. F4 Pi .�1-0, '" 1!a!i/f�� i�-'�"h/.J I.A�I�s�J �i`A'�f .1 �"/'"4__ /,�/.3 G „ ._... -/�`�i U ......V........................................................................................................................................................•.--......-"_.--.--.--._..._.............. W .............................................................................................................................................._.__..................._._............_.................. UNature of Repairs or Alterations—Answer when applicable............................................................................................... ---------------------------•-------•------------------------------------------------............------------------------------------------------------------------------------------............._••---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIL 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. ,. ` Sign ---....•---------------------------------------------------------------------------- -/.t—. ••-•-------- �_-. ..✓Application Approved Byc. .: r .. ------------------------------•-------..........------------------... f ' ,' ------------. Date Application Disapprov f the following reasons:................................................................................................................ ---------------------------•---•------------•------------------------------------•------------------.....----........_...------------••-•---•------•-•-•--•••------•---•--•---•--------•-----••--......_ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS is RD OF HEALTH 7�ln/n ............OF............. A7�ti �'.G. . ..................... ..................I... Tntifiratr aaf TaampliFanrr X-MS I O CERTIFY, That the Individual Sewage Disposal System constructed (,,-for Repaired by ------- Zat /GUANTEE ---::... x -... - -- -•--------------------------------------------------has been installed in accordance with the provisions of T LF 5 of The State Sanit scribed in the application for Disposal Works Construction Permit No. __: _.. . . date - THE IS5 ANCE OF THIS CERTIFICATE SHALL NOT BE CONST D AS THAT THE SYSTEM /Wl F NCTION SATISFACTORY. DATE....Ff' Q T)....................................................... Inspector......... .........._.........-----•--.....................-•--------•------....-- THE COMMONWEALTH OF MASSACHUSETTS. BOARD OF HEALTH ............... i ln��/........OF........li� S? 13G-G' ........ ...................................... FEE.,..S•--•-•.......... �t��aa� '� �a� �aQn�#rnr�uan rrmi# Permission is hereby granter. ...-•-•-• ---......... ---- --•...------...-•----------•------•--•---------•----------•----••-•.........................•..........•- to Construct or air ( an Idu gage Disposal System ' atNo.. ........ ----------- -- ....... •---....-•_.. .............. Street - ----- ------------------------------------------------------------------ -- Street as shown on the application for Disposal Works Construction Permit No........... .. at" .. _.. .. ... .. ... ......... -------------------- Board of Health DATE----- FORM 1255 A. M. SULKIN, INC., BOSTON ' TCST hbLE w/ EZ. /oy,7c, 'f`z EZ. /,¢3o TPsT A4�l.E j —'Z. /13.8c 726T,4646 '4 6Z- rnp-So.C Tap-SoiC a lap-SoK. Tvp-50/ ez. oz.L'¢ ff de./i3.Ao Ao \ - 1 s l9 Svi�isWe-soil., 3L" 76N' tk'.b/.3o '-� B./•v.47► Sua-sv.L. I 4z. r,ct+, rf�/ NdrsD- 3gw.p Jr►R.i> ��,NIiS 1 �41vC� HdrD/ I 57i'm N F.,v E" jJfs4 roz.7, y4` R./v5.90 SA+ia v" y--xy I ._._.... w 7w • F,n/F ��NF 5 r b W 7WD 7ie/a S 'y��F,�/c dL , N � � :o" �� G.,wEs C��'y Sq•>t,o Z i 77P/1Gt'3 �U �\ /a< �t�> /- '44 .17 7a /44 �e r/2. i w avy \ � G L.B'f /`G•C'c c�''r'F .�� �• / L.E• .'" -% GIsAA.. CGb7Fa.+ ! � Flit/E.' /�7, " ' ? �c.:j T t • Pi T /6�" NG L. SM.iD U,�1(.76 Kt a��tiiv I ,, SA-+v D IN CT: � I lr• nti I 0 G--.5 T .Tom A/ 1-;4C4 / I ACW-P .yE�LT7� AtLG inI G of by 1 10 LOr 49 /9 t / C, n u 9 3 P/� 7 r u �' T• s•Fi<e E '" TO N � m Mw ,1 2a/o WiTNIM ONE FGO'T OF F #J lfi" (3RA�E OVER LEAGN AREA a Z�r of pfA STONE F� 016s 1Btlfia�i MPEQVIOv S CGVF-,R. Tb � .yt4"/F�QPr _ 1NI,�. 15T21FV �t. n1F TktATi/JW�`o FZOM ci14 MH TP o��vvv:• _ --__ � ��,�fl,- fl` y4 F00r L EA G1-f v�lA s N E O /000 , /a/.G! ji' Pl.r SToNS GALLON 4�MIr1 ' ( T A LL 1 SG 4� OA. .CTAN Q EWATERTIk2I __1 i No G AR SAC2E G KINDER °° .tiG �lI i STEM D rr e .i. DES lCa N C1aN\PUTA? ON 5EP't"i G 5Y5TEM CoNSTRuc.?yaN ;: ;� 'z�ALL CONFOR/h T fb-rO HE MAS6. �� F�� �, NUM � OF �t RONMENTAL Cope TITLE Y .<`r R V SE:� 7- 1-7� �, -t'�sr� TwVN '0 �' x D E-g�U rJ �1-ova/ : /o _ -- — _ 'OOAfLD Of: NSAL*4 REcAu1.^-nor lep A/ -sc:%4LG- / " _ ¢o / LEAGN lrlla RATE ► AND LF-^CH1Nfa PIT -t'o aE OF REQ O. Lrr,AGW• CA�PACI"V� — lmFZS C-O*A*TE� r4cAn� 5000 % PROP05�O LEAGI� CAPpG iTY - `' :�' ,p� 7 M�N , — — < Z L 7/h T! U A'S >�N D G}�t/ S SCIM�� L. 'f�7Z,�9 �L' 1 1 20000 P51 N 10 L OA D I nl CA Pat,-JE*-# Y Nor To 0E Loc.4rmv oNEft Wso'r&A �1N L.F � I.-}- 2p "AYrr{CXyL PLAN Q :- DEfoRt 4-IN LOADINGS Au- Pr PE-5 To Oc- WJA M9 r G HT z � ,©f e . — gy�T� Tb �S ort '�� elo►5� , _...,_ i R�FER�NGE• — — — — RN5. R90. 4F DEEDS i CAgr tR& l M PRE-c o y-r ENGINEERING C. R. DESIGNING BUILDING INC. H f ALTN A430J'r APMONZAL ORT DENNIS, MASS 385m2831 WE ALBANENE�' 10 5455 MADE IN R ARCHITECTS' STANDARD FORM i µ Nti " a � �r ASSESSORS MAP : � NOTES: � �1 �'� TEST HOLE LOGS M I ' 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH PARCEL : 0? S M wn SOIL EVALUATOR : Y4f �r��•�• �5 HIS PLAN, 19 5 MASSACHUSETTS TITLE V & TOWN OF " n FLOOD ZONE: R "-`. BOARD OF HEALTH REGULATIONS. ND � 2�,R.ra WITNESS : o't" �uocrNe w logr� UMMAQUID. REFERENCE: ej y. �' ,�, DATE: E.PT. 14.1 u 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, ot PERCOLAT ION RATE: G 2.M IN 1t4a SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO W T 211 INSTALLATION. SWAY CLASS .Z ,�to L:Tww - ��O, 9 K l IOU RG '� _ , - HALL BE USED FOR SEPTIC SYSTEM INSTALLATION A � TH ) �- (�,,,,.'�a - TH 2 3) THIS PLAN S ► ONLY, AND SHALL NOT BE USED FOR . PROPERTY LINE ' sop&LI ,. �lA�R•d,7 ► fr - � S�� ID � DETERMINATION. ... 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS SPECIFIED OTHERWISE) `,� ►t F'f�j ^�� j 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A LOCATION MAP 6E'`I, `t , J _ GARBAGE DISPOSAL. Pi tic " 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON 516") A BASE OF 6"OF CRUSHED STONE. Z,Syro/¢ Z Extantl L&-ACH- 'Pt`C' - --�-- $, N'o KNow14 . 15016F' POOP- LECtfteyW�_- _ " SEPT I C SYSTEM DES I GN 9.) No we--&oyi vibi 15o (or✓ 16 (�o V> - ►c4 F"m� r 7/ tz lE t/ Q D OULD FLOW ES 1 MATE 1 a3. 41 �'+ A .711 B ER R0 11) 4& tom., �� 7� �€����✓ , c�>�.r EDGE OF PAVEMANT �--- -- BEDF`.00MS AT �� GAL/DAY/BEDROOM - 330GAL/DAY _---- --_-- -\ I20 - �----_ \ 144.80 ft� _ �.:7124 2 ' ,_..----• --r SEPTIC TANK 3�4 GAI./DAY x 2 DAYS - loC7 GAL USE I� GALLON SEPT l C TANK-- F-KV5ntj L,c.C- wr 11900 G -�i.t 120 6 ------ SEA-'T�I 1c-� !� f-jtt L Cif t OA-M 4t7 e» SOIL ABSORPTION SYSTEM 11Nv&-A--St2x--rp„ 122 128 U S f 3O S-c> tN F! . T0,a a rJ►T-5 w 4 'Sizrj E o ► ! <' a ..N. L5. � - 1 SIDE AREAVU 3S)2 O.7y- I t 1 , d3 12413 e �i BOTTOM AREA: 2'S.'3S' x 1244. x 6.7't 2 8;ID BENCH MARK SEPT'I C SYSTEM SECTION CORNER OF STEP Q, \. \ ELEVATION -134.50 AQ ` � ✓ USGS DATUM ASSUMED 126 \ EXIS TING NN�i ` ls� DWELLING ,,�� �J TOP OF -V'f_ _F� ,3(d nI S PoI¢C EL - 134.07+- �IClSTI N Iws{at ( ,�---, w ik vFI U'316 I2l.Zb 1 3 V SltDAe D-BOX 12t,Sp C �" -_-- - (, II GAL MI.I.67 wt '✓ 1 SEPTIC TANK . 1 EY4 5-M 1�(N t''GIfGIh�sS� �18.7a �----- Z ,3s ' i 49.27 Ft x ! -1 NG GAS 5eC[ 0&.1 o a 'r3oTT a K o F- `tF-STH-O L r,- C-.L. a " 318� s SITE AND SEWAGE PLAN 0 3l4`'-t*��," jbvble LOCAT ION : S/ ov�.p , LOT 49 A AREA - 43907 of 50 4t PREPARED FOR � �N OF A},gssgc DARREN (7-46 o a M. R DARREN M. MEYER R.S. SCALE 151.06 ft 43 VINE STREET DATE: FG/STEa�O DUXBURY, MA 02332 W SgNlTAR�P� 3 DATE HEALTH AGENT (781) 585-0293 W 2