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0055 BRENTWOOD LANE - Health
55 Brentwood Lane Barnstable A = ,333'- 024 I ' i ti SMEAD No.2-153LBE UPC 12034 smead.com • Made in USA 0 v TOWN OF BARNSTABLE LOCATION S,5 ,Gccrcl WocrL LQ SEWAGE# ZO 11, VILLAGE Curnrrlo_q u, cL ASSESSOR'S MAP&PARCEL 333.0Z t4 INSTALLER'S NAME&PHONE NO. Q ExeQV0.-{ O y`7 1' DG 53 SEPTIC TANK CAPACITY LO 00 LEACHING FACILITY:(type) 500 L)c (3) (size) //'x SIO'x Z NO.OF BEDROOMS 'y OWNER aP f1 C PERMIT DATE: COMPLIANCE DATE: s Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Al-3a'/, B-2 A3 3 y f33' y a 2 AQ - 'Ios"�' iL j f'ron� No. I z1 THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH �10 Wr) OF a rns d a b Cc__ APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components 55 78renrW000 LANE" r C�j 3 33 Loc Kcjue. Owner's N me M MD F Map/Parcel# Add r ss 3(0 G - oD 'B-t Lot# D IV Telephone ^ ins t Iler's Nasi ner Na e rn 0� br _609- 4-7-7 � V�A r V D g �3/0 2- �k ( Telephone# Telephone# Type of Building: Lot Size Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required).L440�gpd Calculated design flow gpd Design flow provided gpd Plan: Date Number of sheets ( Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation .3 1 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further a snot to place the stem in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date A+ Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 IVo.2a1� THE COMMONWEALTH'OF MASSACHUSETTS FEE BOARD OF HEALTH OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair (+ ') Upgrade ( ) Abandon ( ) - ElComplete System ❑Individual Components LAN �4ahor) pu Low Name f o I y(lworsLn t..) ,'U'W6)L) ' Map/Parcel# Address - Lot# Telephone#}� 1nst Iler's Na Des! ner' Name -,J i!S - 4 -7 M7 �A r re`�� Telephone# Telephone# Type of Building: e t) I CW1 r -Q-- Lot Size Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) v gpd Calculated design flow gpd Design flow provided/ gpd Plan: Date 1 f� Number of sheets ( Revision Date f Title _s Description of Soil(s) Soil Evaluator-Form No. Name of Soil Evaluator e.f f.-ou Date of Evaluation-3 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in o or tion"u_ntil a Certificate of Compliance has been issued by the Board of Health:% % Signed _ U Date - _ 1 1 C s Inspections FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 --'-- No. 2alb , � -s -- aw���ry S ��� ���THE COMMONWEALTH OF MASSACHUSETTS FEE �/�00 � - r\ ( CIS ( Cc_h ,BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby rtify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: `1 � ,( `� ( ri V Gl_- U C) ` has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans rela i ag to;application NojOD'6-l7-4 dated y I ?gib AI Approved Design Flow (gpd) Installer �-� U /1 ( C( Designer: 110i-lj rl Inspector I, ) Date The issuance of this certificate shall not be construed as a guarantee that the sys m will function as designe . FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM,5/96 No.�/ f TH E COMMONWEALTH OF MASSACHUSETTS FEE /Oy BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at 5`5 1-�r',t?c�A V&i o o r) cc 1_r(,..._._ as described in the application for Disposal System Construction Permit No. / - dat-etb Provided: Construction shall be completed within three years of the date of zhisrft�ii�tAlp ocal q nditions mus' be met. Date � Board of Heals — FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) (SW) HOBBSB WARREN TM PUBLISHERS- BOSTON FROM FAX NO. May 10 2016 11:10AM P1 o70 ,,Regulatory SeWices. T34mm F. Gamer,;maser Public EleaU Nybion ab�g. 200 mitja awed,]8[YR.A.Viig,:@L.k 02601 Office: 509..9624644 , yam SQR7790-6304 tiler&Des w C sl�llnml + spa l� �Pegu,�a O ����- � Desi �V 1[rns�ll'icen:: �� �CAit/A. o'h•--" x: .� Address: AM—_ I q�__j <,•. ►MA A17 wM issued a pez t to bldaa a � �' � g ](iC,Sy51e�18t YJ r�� �" �ya5el� 07Ct I�BBJ I1 t�Ta�J3� p tadctre�s) . I Lf dated r f, 1 ) I certify-that the sepdr,Vstom jefwmued above was itiia'�ecl .�ubst .a3iy accq.diug to the desip,whiob.may inakada minor lapirrOved. ('1Jm 0s .�►sb.as lateral rela�catiou a the distaabution box Dn-4/07:sc;p G tatk I aaTbfy that the septic syutew,rGfere"Cled above was installed,70,&ijox chmgeg (i.e. scat Batt l 0°lateral,rcloeatic>n,of 11Le SA.►l ur any vertical relor,Iition.of any campoa ee of tho septic system)trot in eccoxdance with.;state 8,Local.Rag: a'don s. Plan revi"iu nx c.ra�ifaed,a.�-b'uilt ESq desigoer'to ollova. . N OF MAS,�^� . DANIELA. OJALA { 5311F�'Sz e) CIVIL Na 46502 O t4 I S T S 1��k r- NAL�•�� (I�e.9ignC.:�°5 3j6WLD.0) �.�T. '. ���—•� ��R �',�1>a;�JE s'I . �C. a,�+ dl�f a�a'�o�b r¢l� Td ,Z��bcA�.�,�� down cape engineering, inc. SIEVE SOILS ANALYSIS 55 BRENTWOOD LN CUMMAQUID, MA DATE OF REPORT: 3/22/15 .JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 55 BRENTWOOD LANE, CUMMAQUID LOCATION: DCE TEST HOLE SIEVE ANALYSIS Weight Sample(Grams): 153.0 SIZE :WEIGHT RETAINED % RETAINED % PASSED (sum ) I------------- --------------------4------------------or------------------ ------ -- ----I--------3/4" --- O.OA_ --00%: 100.0% -------------!------------------- ----------- - --------------- 1/2" 0.0: 0.0%: 100.0% --------------i--------------------------r---------------------r------------------ 3/8" 0.0; 0.00 100.0% ....----..................v---------------------r---���-������----- #4 0.0: 0.0%, 100.0% --------------•--------------------------b---------------------'-----.------------- #10 8.4: 5.5%: 94.5% ------------- -------------------------- ---------------------� --------------- #20 27.9�_ 18 2%0 81-:8% ------------- ------------------ ----------- --------- #40 59.7: 39.0%: 61.0% --�..........................Y- ---------------T'o................... #50 ; 86.7 56 761: 43.3% #80 11.6: 7.6%: -------------- --------------------------b---------------------.----------- - #100 122.6� 80.1%� 19.9% . --- -��-��--{..........................A--------------------- ------------------ #200 134.5: 87.9%: 12.1% -------------- -------------------------- ---------------------------------------- PAN: : 150.5: ___________100 0%: 0.0% --------------r-----------------_____0.5: ---------- SAMPLE: 153.0: NOTE:TEST ON PASSING #4 ONLY,2.3% RETAINED ON#4<45%O.K. _ RESULTS: SOIL CLASSIFIED AS AASHTO A-1-b (GRAVEL&SAND)'(UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK #200 0%-5% DOES NOT MEET SAMPLE DOES NOT MEET TITLE 5 FILL SPECIFICATION >87%SAND RESULTS: PERMEABLE MATERIAL-CLASS I<6 MIN./IN. MATERIA /.SF) NONCOMPACTED �, DANIEL ctiG SOIL DESCRIPTION: FINE SAND W/SILT o� A. OJALA cn ° No.40980 S\ EL S RV Town of Barnstable P# DeprtirigritofHealth,5afty;aridEnvtrommenSecesytil f;Q lieHP a�laah D,iva o )Date Pub AM. '367 Main Street,I-Iyaanis MA R 1 1 �artaiearE. reruaa n a ►63q.".e�� 6A/t Fee�¢�". rf�J rg®yu�t" Date Scheduled Time ��� � =- SOU Suitab"ilio Assessment for Sew " ge Disposal Witnessed ���`"(� 'V • iM1 G` ; t�.`,.'A. Performed By: B}�'" Location Address /J Owners Name Y,55 /1 �� . �3r L--�' e t7 GC '�' oil , ,c;,�� C k M Wit:-"a .u,l Assessor's Map/Pascel:-33312. _ Englnee['§`Name NEW CONSTRUCTION REPAIR Telephone# Y 0d �60� `• 7".1 ' Land Use Slopes C/o) Surface-Stones Distances from: Open Water Body 7 Z40,ft Possible-Wet Area ?�_&Qft Drinking Water Well� ftr �j Drainage Way' C ��� ft Property Line Other ft : dimensions of lot'ext locations of test holes&perc tests,locate wetlands in proximity to holes) SKETCH:(Street name,di , ac ._ _ _ , _4 " :4Kt�5 Y'1 �._ � ���.nc x �• v:. ��,.j.y # 9'Y„4ar` - e�y F�- AJ - ry Parent material(geologic) �a, tr w��� Depth.to Bedrock Depth to Groundwater: Standing Water in Hole:" Weeping.from Pit Face i Estimated Seasonal.HigkGrougdwater_" •::::::.::.;:;:;<.::.;;:.;::.;:.�. • :.::: : .. +l��t.:"Seal.�() :�lC:. .;'�?�.::::::.�::::.�.:-•:��:•::�;:.»:.::.:.�:::.:�.�::..;:.;;;;:::•;:";:>:•;:"..:.::: "Method•Used:»::>::»»::�.�'�.�f:::.;;;:;.;;;:;;:::;;::::::::::::::::::::::::::. • Depth.Observed standing in obs.hole: in. Depth,Ito soilOmottles Depth to weeping from side of obs.hole: in. Groundwater Adjustment ,ft: Index Well#___._._ •Reading Dale:_•___ Index Well level_.,_''" Adj?factor ft—P VAdJ,;Qrb0ndw_at6f Level - ;;;;: >;;;:. ......:s;;a<:;•': •5::;:: ::'. Gi•:.'•i :.::::.:::............ ::::::::::......PE 2...: ...........:.:::::.::::::::::::..:...::.;:::::::::::::::::::........:::::..::::::::::...:..:...................._.. ............................ ......................^.I........................... Observation Time. Hole•# ati9;vt , - Depth of Perc . -- - -.Tune ac�6" � ';?> - "• _ . Start Pre-soak Time® a End Pre-soak Rate Min./Inch Sife`Suilabitity^Assessment:'Site Passed :Site;Failed: * r Addition�alTwest�ng Needed(Y/N) _ », Original: Public Health Division Observation Hole Data'I<o ite t;ornpleted on DaeOc— Copy: Applicant . • •o. . . y �o Vs y. _..� .. :'::i4:•i:}i:'iv:•:J::i':<:v:i:iii'ii. - t �' :'':4'<';;:;::>si D :tll rom :Soil Horizon ` lot, ± Surface(in.) (USDA) (Munsell). Mottling (Structure,Stones,Boulderes. q � = x :•.s i srs.', .fir Si.: gi.y_pt Y��j ✓�` a a 9 C >:. >:.>:;.;:.;:.:< ::.� )GP:;:�B. . .N:...;HO►.LE L!D:�.;:.::.>:.:::::.;;;;;;;:.:;.::.;;::<:;.;»;:.:;:::;:.; ..;':::::::::.:::::::.:::.....:.::. Depth from Soil Horizon SoilTexture Soil Color Soil Other 5u face(in.) (USDA) (Munsell) Mottling :(Structure,Stones,Boulderes. Consistenev,°oGravel) eW p e � i it) 1 ::...::::.:: :::::.::.:::::::::.: :.:..:..:.::. :: ��#...... ::::.::.:::::::::::::::.::::::::.::.::::::::::::::.:::::::::.......................... . 'Depth from Soil Horizon ( Soil Texture Soil Color Soil Other Su face(in.) (USDA) (Wiunsell) Mottling. (Structure,Stones,Boulderes. Consislengy.%Gravel) ...:................::::::.:::::::::::.�..............:.::::.:...::.�.�:::::.:;.:<........:. Depth from Soil Horizon Soil Texture Soil Color Soil Other `!•%face(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°°Gravel) tF ooilpnsuance Igat�la� .- t x 4. Above 500 year iloodtboundary.•,No._ Yes (� 4iehin 500,.yeanboundary 'No; Yes thin'. a tl`.0Gyearoo fld4bo4�undai?"Nok lfig,pth of Naturally occurring Pervious 1Vlaterial Toes at least four feet of nattifti'ly occurring pervious aterial exist in all areas observed throughout the Aea proposed-for the soii'absorption systerh? IPhot,what is the depth ofinaturally occurring pervious material? G�ertitecation II ceriify that'on S/ (dhte)I have passed the soil evaluator examination approved by the j�epartmen4 of nviron yental-,Protection and,that°thd,��above analysis was:perdformed.byane,consistent,w•ith e required�training,.expertise and experience described in 310 CMR 15.017. Signature Date I� Vol UNITED STATEI:} F MAk '9°`ir os a �d 'c, I Sender: Please print your name, address, and ZIP+4®in this box* I Town of Barnstable I, Public Health Division 200 Main Street Hyannis, -AV 02601 I USPS TRACKING# I I 4{'' 9590 9403����52 1 5117� t 83���� • mill; • • • • o Complete items 1,2,and 3. A. Signature ® Print your name and address on the reverse XA Agent so that we can return the card to you. ❑Addressee ® Attach this card to the back of the mailpiece, B• R, e-ive b (Printed Name) C. D e of D livery or on the front if space permits. % 1• Articla_nddra_c¢a_d_tn• D. Is delivery address different from item 1? ❑Yes Gerard J. Mahoney, Tr. If YES,enter delivery address below: ❑No Gerard Mahoney Family Trust ;I 130'sBox 656 Canton,.MA 02021 :I I II I II'I'I Ifll I�I I I I I I II I I�I I II I II II I I(II II I�II 3. Service Type ❑Priority Mail Express® ❑Adult Signature ❑Registered MailTM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted) 9590 9403 0521 5173 2836 75 ❑Certified Mail@ Delivery ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation"' ,_2. Article Number_Mransfer_from service label) ❑Signature Confirmation �=s i ❑Insured Mail � 9 7 D 15 15 2 D' D D 01 2 2 7 3 2 6 6 4 r ❑Insured Mail Restricted Delivery Restricted Delivery (over$500) I. PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt � M e , r- C fed Mall Fee nJ $ru N� Extra Services&Fees(checkbwx add fee as appropriate) OA � F N AV ❑Return Receipt Quvdeopy) $oRetum Receipt(electronic) $E Certified Mail Restricted Delivery $O ❑Adult Signature Required $ '�Adult Signature Restricted Delivery$ rnl7 Postage cul Total Postage and FeesrU S Gerard J. Mahoney, Tr. �/ l %Gerard Mahoney Family Trust PO Box 656 - `I Canton, MA 02021 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. - associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted -mum receipt for no additional fee,present this delivery. USPSO-ostmarked Certified Mail receipt to the,. ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service" Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for _ requires the signee to be at least 21 years of age international mail. s and provides delivery to the addressee specified.. ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a- certain Priority Mail items. USPS postmark.If you would like a postmark on in For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office-for the following services: postmarking.If you don't need a postmark on this Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply : f 1 You can request a hardcopy return receipt or an— appropriate postage,and deposit the mailpiece. „ electronic version.For a hardcopy return receipt, ^r complete PS FOnn 3811,Domestic Return Receipt attach PS Form 3811 to your mailpiece; IMPORTANT.Save Nrts receipt for your records. Ps Farm 3800,April 2015(Reverse)PSN 7530-02-000.9047 SJ • � r Town of Barnstable Barnstable Regulatory Services Department ""Anaft 1 ' Public Health Division Q D 61 1 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 4 7015 1520 0001 2273 2664 February17, 2016 Gerard J Mahoney Tr. %Geraldine,Mahoney Family Trust P O Box 656 Canton, MA 02021 • The septic stem located at 55 Brentwood Lane Barnstable MA was last inspected on p Y p 1/02/2016 by Mark Polselli, a certified septic inspector for the State of Massachusetts. k .. The Health Division has determined that the system "Fails" under the guidelines of 1995. TITLE 5 (310 CMR 15.00)DUE TO THE FOLLOWING: • It is recommended that you have another inspection six (6) months after re- occupancy of this dwelling. You are ordered to repair or replace the'sep_tic system within the time period of six(6) months upon re-occupation. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH S;as McKean, R.S. CHO Agent of the Board of Health Q:/Septic/Letters Septic Inspection Failures or Future Eval/55 Brentwood Ln Bam Feb 2016 4 Parcel Detail Page 1 of 3 yy Y jry �p ,i+t,1t$>. /1.9'.. ,o'9X =L .3H gid,'v`` o 'S• _ v'W Logged In As: Parcel Detail* Monday,February 1 2016 Parcel Lookup Parcel Info Parcel ID 1333-024 Developer LOT 38 f Location t55 BRENTWOOD LANE .) Pri Frontage F,00 Sec Road I Sec Frontage village BARNSTABLE I Fire District FBARNSTABLE Town sewer exists at this address No Road Index ,2220 �I a •� xis Asbuilt Septic Scan: p Interactive 333024_1 MaP Owner Info Owner.. AHONEY, GERARD J TR co-owner GERALDINE MAHONEY FAMILY TRUST I Streetl rP0 BOX 556 I Streetz city,CANTON ( State MA Zip 02021 country Land Info Acres p.1.377 Use DL'Single Fam M -01 zoning RF-1 Nghbd 0106 � ___ Topography Level Road Paved Utilities Public Water,GaS,SeptiC' ' Location ' Construction Info Building 1 of 1 Year t _ Roof «�-. Ext ». " "®' Built 1989 I struct Gable/Hip ' wall;Wood Shingle , Living Roof r.�..�. AC �.�.., Area ,2584 cover'Asph/F GIs/Cmp Type fNone ) viiK� r. Int ".�."_'" Bed Style IColonial � wall Drywall .Rooms F4 Bedrooms __ It BathSAS* ° Residential � Carpet � 2 Full-1 Half Model �B qua Floonr Rooms , 2 EUSt qe � 6 6�AR 72 Grade Average Plus Heat Hot Water Total 7 Rooms .�.4. ° " err Type Rooms, stories 2 Stories Fuel Gas ' �F ation JPOured Conc. �. 4 T Gross Area 6166 J Issue Date Purpose Permit ti Amount Ins p Date Comments 4/1/1989 Dwelling B32812 $120,000 1/15/1991 12:00:00 AM BA 2 STOR http://issgl2/intranet/propdata/ParceiDetail.aspx?ID=28046 2/1/2016 Town. of Barnstable KAM ' ; a�xnrsrAsr.E, ,�� Regulatory Services Department ` '°TEn ram►{" . Public Health Division 200 Main Street;Hyannis MA 02601 Office: 508-862-4644 Richard Scab,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6,'2007 • Rev. 7/6/15 DEADLINES TO REPAIR-FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"?"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground ❑Pumping more than 4 times during the last yea-c not due to clogged or obstructed Pipe. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA. ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or.cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑Any portion of the cesspool withiri*a Zone 1 to a public well ❑Any.portion of a cesspool within 50 feet of a private water supply well with no acceptable water.quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool , ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components; etc) q Leaching pit or cesspool with high liquid level,<12"below inlet(per Town Code §360-9.1) • A OTHER IM Repair'deadline: AJ WSEPTIMDEADLINES TO REPAIR FAILED SYSTEMS.doc / Page 1 of 1 Stanton, David From: McKean, Thomas Sent: Tuesday, January 26, 2016 8:21 AM To: Soto, Kathryn Cc: Malkus, Karen; Stanton, David Subject: RE: Yes, it has been under review. I telephoned Brian Dudley at DEP and was informed that there should be other indications other than just a stain to fail it. Some towns automatically fail it if there is a stain and others don't. The decision is to be made here locally. Karen Malkus also telephoned a DEP representative,and received similar information. This dwelling has been unoccu ied for approx.three years. My recommendation is t require another inspection six months after re-occupancy. r From: Soto, Kathryn Sent: Monday, January 25, 2016 2:21 PM To: McKean,Thomas u Subject: Tom, Are you reviewing a septic inspection report that"needs further evaluation for 55 Brentwood Ln in Barnstable? The real estate is calling for an update. Thanks, Kathryn r 1/26/2016 Commonwealth of Massachusetts 3`33 Title 5 Official Inspection Form Subsurface Sewage Disposal System Fcorm-Not for Voluntary As'sessments s-S z— Properly Address Ow ner information is Owners Name -'. — _'-"- ..� Do�to�� �s required for every C�►r✓1 S l �/? / i oZ / Gra Page. Cily/Tow n State Zip Code Date of Indpectidn 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. filling npooutf form A. General Information Bing out forms on the computer, use only thelab 1. Inspector. key to move your / J , cursor-do not a r rS P/f use the return P1 Name of Inspector i �G ff Cony Name �0o Company Address A'tyfrown 11 Zip�0?� Cd�Q ���� State �0 Z Code Telephone Whiber License Number B. Certification I certify that f 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 1&340 of Title S(310 CMR 16.000). The system: ❑ Passes ❑. Conditionally Passes.� ❑ Fails 2 Needs Further Evaluation by the Local Approving Authority lnspeaWrf 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 iG,GGG god 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 seent 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. t6ns•3/13 Title 50rfidal lns pectionForm SubwfawSewageoisposal Symm•Peg e f off? �' V Commonwealth of Massachusetts Norma Title 5 Offi�,ial Inspection Form Subsurface Sewage Di System System Form -Not for Voluntary Assessments Property Address Ss dery / ✓00 Z_ if/ / Ow ner G� N ki-e information is CW oar's Nan required for every page. City/rown State Zip Code Date Inspection B. Certification (cost.) Inspection Summary: Check A,B,C,D or E/alwayscomplete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR'15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box 1br"yes"{ °no"or"not determined"(Y,.N, ND) for the following statements. ff"not determined,"please exVain. 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 meta l septic c tank will ass inspection if it is structurally n ra sou d not leaking i#Pt ., P eak and a Certificate of l� Y � 9 Compliance indicating t6t the tank is less than 20 years old is available.. ❑ Y ❑ N ❑ ND(Explain below): , --------- t tyre-3M3 TitlebOfficial Inspection Form Subsuface SavageDisposal System-Page 2017 Commonwealth of Massachusetts Tide 5 Official Inspection Form JSubsurface Sewage Disposal System Form a Not for Voluntary Assessments S�j wf°li f wo fly✓ z Property Address / Our ner Ow pees Name information is 1 required for every 124m r/ 4 le' Od 60/ . page. CGy/row n State Zip Code Date 6f Inspection B. Certification (corn.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(coat.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ ' broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y, ❑ N ❑ ND(Explain btslow): ❑ distribution box is leveled orrepiaced ❑ 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): Elbroken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) F er Evaluation is Required by the Board of Health: Conditions exist which.require further evaluation by the Board of Health in,orderto 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 mannerwhich 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 Mrs•313 Tito 5Official Impecfim Form Subsurface SevM8 Disposal Sysiom•Page 3 of 17 Commonwealth of Massachusetts r c Title 5 Official Inspection Form. , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments SS Property Address U' k ati y ' QN nor QN REPS N2ltle . inforrTWon is required for every ✓N f a �,� Do2 6 0 / d page. 5Wf own 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 sal 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, fir 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. G4 /'l l S �40L4 , 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 ❑ 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6°below invert or available volume is less than%day fl ow, Ons•3M3 TideWfficlallnspecfimFum:SubsufawSevggeDisposel System-Page4017 U f • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address / Ow ner Ow nees Name information is O�(o O/ �Al �6 requ'vedforevery &-nj(1-r41e_ page. Q'tylrown State Zip Code Date of 4mp&tbn B. Certification (cunt.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or, obstructed pipe(s). Number of times pumped: ❑ U Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 fleet of a surface water supply or ^/ tributary to a surface water supply. ❑ L7 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 fleet 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.] ❑ he system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ The system ils. I have determined that one or more of the above failure criteria exist as described in 310 CM 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. Mrs•3113 Title S Official Urepecficn f omt Subsurface SaoMe Disposal System•Page 5017 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 67rei Property Address 1�19:2.4akle Ow nor Om nees Name / / to required ie 7 A requQedforevery �/y1S 6�-e page. Ckyrrown State zip Code Date offinspe6tibn C. Checklist Check if the following have been done. You must indicate`yfes°or"no"as to each of the following: Yes No ❑ mping information was provided by the owner, occupant,or Board of Health ❑ W re any of the system components pumped out in the previous two weeks? ` ❑ the system received normal flows in the previous two week,pedod? i ❑ 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? fn C�HeINZ , Were all system components,exekK iRg-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: lnl�x. 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)1310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Lf Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Z11i0vi b 1.9rs-W13 Tile 5Of dInspection Form SubsLasce Sewage Disposal System•Page 6of17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -_Not for Voluntary Assessments ors L�r 2✓�T G✓00 0� N Property Address 141 4011e Om ner ON ner's Name e,forrnation ���s le _ , D�6 0I . squired for every page. Cityfrown State Zip Code we Wirispection D. System Information Description: / DO,� �c.6/D✓� JP 1 L O Number of current residents: Does residence have a garbage grinder? 0 Yes 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 Lt�No Water meter readings, if available(last 2 years usage(god)): Detail: Q 0 0 a Sump pump? Yes No Last date of occupancy: ©(„i yl��s• e� Date Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM R 15.203): Gallons per day(gpd) Basin of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑. Yes ❑ No Industrial waste holding tank present? : ❑ -Yes.❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5 s-3M3 Title5Official Inspection Form Subsirface Sewage Disposal System-Page 7of17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address ho4-e if Oav ner ow ner s Narne information is c/✓1 S�o• �e .4 0�6 0 l / oZ /,, required r ev ery� gY page. Cityfrown State Zip Code Date of h(spectron D. System Information (coat.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of intbrmation: 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 Sy .., •• 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 UA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(descri be): I t9fis,3M 3 Tide 5Offieial Inspectian F anrc Subsufaee Se'WOO Disposal Spwm•Page Sof 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System FormJ-Not for Voluntary Assessments �j� • �BdITGvOJc� �� Property Address— Ow Olil�G►!�l Ow ner Owner's Name 12 infometion is �J / requiredforevery Ci✓HS7 ble— ad 6o� �)�71v page. Cdy/Town State Z�Code Orate n D. System Information (corn.) , Approximate age of all components, date installed(if kno )and source of informatio - t Were sewage odors detected when arriving at the site? ❑ Yes No Building Sewer(locate on site plan): Depth below grade: feet ° Material of constructi;4�Op�vc cast iron ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth�Dbelowde: feet Mate' ruction: 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: `5 rl Sludge depth: Nns-3f13 Title SOffidel ins pectianFartrc SubsufaceSevngeDisposal Sysmm•Page 9of17 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Fora a Not far Voluntary Assessments Property Address a l7o�Ie Owner Oar ner's Narrae 1 information is &':�i✓N S T� DaGO/ / a & requaedforevey � page- Cdyrrown State. Zip Code Date Inspection D. System Information (coat.) Septic Tank(coat.) ? }l cJ �. Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle o-- Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? , Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): e(A Oj2,V7 43Flo � ✓ Oo 60�' ��T�0P7 Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of,scum to top of outlet tee or baffle Distancefrom bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Mr.•Y13 Title 5Official Inspection F arm subSxfece Sewage Disposal System•Page 10 d V f Commonwealth of Massachusetts Title 5 Official Inspection Form ti Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. SS - 9.,-et.4 A/0 5 xl Property Address Owner o' 0 ki e Ow ners Name information is I / required for every 44. b / Ud 601 /"d, page. Cd crown State Zip Code hate of nspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal r ❑ fiberglass ❑ polyethylene ❑ other(explain): ,L Dimensions: Capacity: gallons Design Flow. gallons per day , Alarm present: ❑ Yes ❑ No Alarm level: Alarm in worldng order: ❑ Yes ❑ No Date of last pumping: gate Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). is copy attached? ❑ Yes ❑ No tors-3113 Titie SOf5cal l epeotion Form Subsurface SsvA9eDisposal System-Page 11 d 17 r Commonwealth of Massachusetts_ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments Property Address //-- oar ner Cw ner's Name information is / �/J required for every -- �Q or✓1 S IC'b /" �02(o C? page. Cityfrown State Zip Code Date of In pection D. System Information (cont.) a Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert vir 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.): 0 Ste/ C& Z_L/0 Pump Chamber(locate on site plan): Pumps in working order. ❑ Yes ❑ No' Alarms in working order. 171. Yes ❑ No' Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): " If pumps or alarms are not in workingorder, system is a conditional pass. Soil Absorption System (SAS)pocate.on site plan,-excavation not required): If SAS not located, explain why: _i tyre•3113 Me s oftew trepwt en Form Subsurface Sevage Disposal System•Page 12 d 17 Commonwealth of.Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments SS Property Address / 1414 lil ON ON ner ow nees Name requiredforevery 96,r4sl4a page. Ckyfrown State Zip Code Date of pe tion D. System Information (corn.) L✓ Type: C � � , S�o leaching pits / number ❑ leaching chambers number. ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool ' number. ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil,.signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): eV- Cy60v� lo vet G �r Cesspools(cesspool must be pumped as part of inspection)pocate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Ons-3M3 Me5Of@asl lnspeotianFarm Suweaae SeyMeEhgmd Sy0m-Page 13 d 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a Property Address Ow ner ;ONe's Name I a� V'0 k7 eOwner tion 7�requQedforevery Q7✓✓iPage• Town State Z�Code Date f Ins n D. System Information (coat.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding,.condition of vegetation,. etc.): 19rs•3113 Tite5Of ial InspectianFarm Subseace Sewage Disposal Stem•Page 14d17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address / O.v ner / G ✓!0 N Q tj information is Ory ner's Name _ / required for every ✓►'1 S t�/-e / " ,'� �6 page. ( y/Town State ZIP Code Date of Ospection D. System Information (cons.). Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two rmanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where lic water supply enters the building. Check one of the boxes below: hand-sketch in the area below ❑ drawing attached separately t2o N 1 x � i3 /4 l-/ 3 �-a - 3a ISa -.11.E --� X3 M l 65ns•3M3 Title50ffidef IrrepectmForm SubwfaceSevageDisposal System-Page 15d17 f Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for VoluntaryAssessments Property Address•ss L Om ner G 0 k? information is Ouv naps Name / required for every J-/r- page '�01N° State Zip Code Qate of Inspection D. System Information (coat.) Site Exam ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells ' Estimated depth round Pt to high g g water. feet Please indicate all methods used to determine the high ground water elevation:. ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ served site(abutting property/observation hole within 150 feet of SAS) Checked Wth local Board of Health-explain: s 4- J L=s ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the hi ground wafer elevation: 1.S I�vvc�L C AS r s Qo 64 it ` L41Gvl o✓► M Before filing this Inspection Report, please see Report Completeness Checklist on next page. 3H3 TWe 50f eW Inspection Form sasteace sewage Disposal symem•Page 18 or 17 Commonweaf h of Massachusetts Title 5 official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ss �QH "o j Roperty Address ON ner ON ner's Name WOMIa6on is requadforevery ✓h s ®a 60/ OL i Page• y/Town St ZiP Code Orate peck E. Report completeness Checklist : ins on Summary:A, 6, C, D, or E checked ,-� Inspection Summary D(System Failure Criteria Applicable to All Systems)completed uQ ay era Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t6as•91r3 TiCe50tkW IMPOCOWFam SbEsi We S-WDtsposel Sy"-AGO 17 d V f ��- - TRAINING MANUAL FOR SEPTIC SYSTEM INSPECTORS TITLE S STANDARD REQUIREMENTS FOR.THE,SITING, CONSTRUCTION, INSPECTION, UPGRADE AND EXPANSION OF ON-SITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND FOR THE TRANSPORT AND DISPOSAL OF SEPTAGE . :; EXtCLTTIVE OFFICE OF ENVIRONMENTAL AFFAIRS TRUDYCOXE, SECRETARY DEPARTMENT OF ENVIRONMENTAL PROTECTION. DAVID B. STRUHS, COMMISSIONER MUNICIPAL ASSISTANCE GROUP JOHNJ. HIGGINS,DIRECTOR SEPTEMB 1998 i surface waters, and other indications of failure as they are listed in the failure criteria in Title 5 . .2 . All components prior to the leaching facility must be located and inspected. In a conventional component system, this would generally require inspection of the septic tank and distribution box. 'If a cesspool system, the single cesspool or, if an overflow cesspool system, all cesspools prior to', the final leaching system must be exposed for inspection. 3 . Determine high groundwater elevation at the site through non-intrusive means unless the system owner grants permission to initiate more extensive investigation. (See page 5-13 for more detail on this important determination) . Ideally, an inspection will be performed on a system that is receiving normal flow. Thus, the inspection gives a representative view of the .system under normal operating conditions. However, if the system is serving a facility that is unoccupied or the system is dry or not receiving normal flow, then the inspection becomes more problematic. Once again the inspectors must .keep in mind that their job is to "record conditions at the time of inspection and not to predict future performance. Accordingly, under these circumstances, there may be certain information which 'is impossible to: obtain, such as .. depth of sludge and scum layers if .inspecting a dry .septic tank or determining static water levels in the distribution box if there is no standing water. A more complicated example involves the inspection of a dry cesspool that has not received flow for an extended period. Sometimes staining along the. walls of .the cesspool- will indicate that at some point during the active life of the cesspool the liquid level was high enough to have violated the failure criteria. Since =this stainin ;was. .observed directly, this r constitutes a fai ure. However, i :failure: .:conditions are nit observe direct y, the system does not fail . The only exception to this general rule relates to the separation of groundwater and. the bottom of the soil absorption system. The regulations are specific that the historical high groundwater level, obtained by .:acceptable: methods -(but not necessarily by direct observation) , ' 'be used for determining if the system violates the. ,requirement that the bottom of ..the soil absorption system be above high groundwater. Preliminary activities Inspections of onsite systems should begin with a records search at the local board of health or other appropriate sources I (Revised 9-8-98) Page 5 - 2 .1 //r J Barnstable Town of Barnstable kyllkri .. • aFamnleaCd� Board of Health 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scab,Director FAX: 508-790-6304 Thomas A.McKean,CHO November 18, 2015 -_ Notice to all- Septic Inspectors- -� -- REMINDER Check leaching pits and/or cesspools in the future for the observed liquid level within each leaching pit and/or cesspool and note what the liquid depth is on the inspection report. "Staining" alone is not a q p p p g failure criteria. (Attached is the State Code 360-9 and 360-10) A� oven '� Also, attached is our H-10 Components under Driveway Guidelines adopted in October 2012. QISEPTIC#3 INSPECTORS-State\Let Insp Reminder Leach Levels Nov 2015.doc L . I - Town of Barnstable,MA Page 1 of 1 Town of Barnstable, MA Tuesday, November3,zo75 Chapter 3 60. On-Site Sewage Disposal F Systems Article V. Upgrading of Substandard Systems § 3 60---9:1. Upgrading systems consisting--of leaching pit with high liquid level. w . [Added 2-19-2oo8; 4-9-20131 Septic s stems consisting off a leaching pit or cesspools) with a liquid depth 4less than 12 inches below the invert shall be upggraded to conform to 310 CMR 15.00, the State Environmental Coae, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and Town of Barnstable Board of Health. Regulations. § 3 60-10. Inspections conducted in accordance with state•law. This regulation shall apply to any septic system inspection conducted in accordance with 310 CMR i5.3o1 of the State Environmental Code, Title V. �,+�„•//Pr��P�F,(1 n'm/nrint/RA20419miid=9923514.6561714 11/3/2015 _ �: ` ,, i LvT s TOWN OF BARNSTABLE LOCATION —SEWAGE /I VILLAGE ASSESSOR'S MAP & LOT-3t3 INSTALLER'S NAME 0PHONE NO. � w,f �.ot� tSEPTIC TANK CAPACITY LEACHING FACILITYAtype) (size) AM ENO. OF BEDROOMS-,. PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER__0��� �L� DATE PERMIT ISSUED: Y DATE COMPLIANCE ISSUED: -2 VARIANCE GRANTED: Yes No ,:,� J __ __ __ _ �� �6, �. �® y SI �y i i W, APPLICATION FOR PERCOLATION TEST. AND OBSERVATION PITS LOCATION ��AA�iy �J - �� Q DATE VILLAGE kd APPLICANT . FEE ADDRESS ' TELEPHONE 90.• (Non-refundable ) ENGINEER TELEPHONE NO. , DATE SCHEDULED ` 3 r (Applicant' s signature) : • • • • • e • • • • • s • • • • • o • • • • • • • • . • • • • • o 0 0 • • • • • • e • • • o • • • . ... . . . . . . . • • • • • • o • o • • • o o • o • • • • • • ASSESSOR'S biAP LOT NO: SOIL LOG SUB-DIVISION NAME A IA2y DATE �GY /7 iSBe TIME EXPANSION AREA: YES NO _ ��/rd � Lr. e&__Zzt ENGINEER TOWN WATER ✓PRIVATE WELL // S /IG��Lsx}xJ BOARD. OF HEALTH 4.1-(n-z EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests,. locate wetlands in proximity to test holes) NOTES: G� 7L}sr \ � a N ti \ 1 � 1 Lo7�38 �m 7aWti 'r- PERCOLATION RATE: 4_-vs rwo TEST HOLE NO: 'l ELEVATION: TEST HOLE NO: . ELEVATION: �- WooDCoA-" l 2 % 2 36�i 3 3 Sril�-So�G 4 4 5 5 6 Gr.v� Sin 6 7 Wi r!-/ 7 g 9 9 10 10 11 Mom, 12 12 13 13 14 14 15 15 16 16 / SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS ✓ LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P• E. AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT ` Y . Soil Absorption System It is extremely important that the inspector locate the leaching system.However,excavation of the soil absorption system, once it is located, is typically NOT required. It maybe appropriate to expose a portion of the soil absorption system(especially if the leaching system is a pit),to determine its condition if other indications of failure, such as evidence of breakout,ponding; sewage backup, condition of the distribution box,etc., suggest that a failure of the soil absorption system may have occurred. If the system is a leaching pit, it will generally make sense to open the pit and pump the liquid out of the pit to determine if ground water infiltrates back into the pit. Approximate layout should be determined by examining the topography and noting drain arrangement from access at distribution box.Location of the leaching system can often be accomplished by running a snake down the line(s)coming from the distribution box. Determine condition of soil(e.g. clogged;hydrogen sulfide crust, etc.). Determine level of ponding within disposal area(visual inspection). Determine if leaching system is below the high ground water elevation. It should be noted that a soil absorption system that fails because it is clogged;.CAN NOT be made to pass by application to the soil absorption system of physical,chemical or biological agents or treatments. Generally,these kinds of failures can only be corrected by upgrading or replacing the system.The Local Approving Authority should be consulted before any effort is made to repair or upgrade a failed soil absorption system. L LEGEND SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE . NOTES MARKED WITH MAGNETIC TAPE OR � 6A SYSTEM DESIGN. PROVIDE MIN. 20' DIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS ASSUMED a 99-- . EXISTING CONTOUR ACCESS COVERS TO WITHIN 6' OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE 2 MUNICIPAL W EXISIIN p p EXIST. SPOT ELEV. GARBAGE . IS NOT ALLOWED P 107.1 2" PEASTONE OR GEOTEXTiLE )( 99.1 FILTER FABRIC OVER STONE WATER IS G ` G- • 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. -=[99]-- PROPOSED CONTOUR MINIMUM .75 OF COVER OVER PRE ?ai SLOPE REQUIRED OVER SYSTEM 'I 04.5rB EXISTING 4 _BEDROOM DWELLING ��: PROPOSED SPOT EL. NOTE. 2' MIN. WALL BLOCKS OR 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS DESIGN FLOW: 4 BEDROOMS 110 GPD - 440 GPD THICKNESS REQUIRED MORTAR ALL PRECAST RISERS TO BE AASHO.H-IQ TH1 104.3 4'OSCH40 PVC COMPONENTS H-10 INV'S EL USE A 440 GPO DESIGN FLOW ,, or MIN. SUMP PIPES LEVEL 1ST 2' 5. PIPE JOINTS TO BE MADE WATERTIGHT. TEST HOLE. . �2.5 5' 100.7 3' p ,- 12 MIN. TNT. aM. ENDS BET. SIDES 101. 3 6. CONSTRUCTION 27�• SLOPE OF GROUND = 10 14 o .,,:. �> DETAILS TO BE IN ACCORDANCE WITH SEPTIC TANK: 440 GPD 2 880 o o •. ._ ,....: e�. ;.;. •: ., ,. ` 310 CMR 15.000 (TITLE 5: a { ) EXISTING '� ° ° ° ° $o � ,00�o�o�o oRt a� *102.9 °° ° Y' ': 'o�o�o�o�o�oQ WATERT ST O'BOX >°o°o°o°o q°o°G° o°o°o°°o° �, urluTY POLE USE EXISTING 1000 GAL. SEPTIC TANK SEPTIC TANK** cAs eAFFIe ,0000a000000, >°°°°°°°° °°°°°° oil��� ,°°°°°°°° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO °.�.. FOR LEVELNESS a o 0 0 0 0 ° o ° ° FIRE HYDRANT LEACHING: ° ° ° ° °° ° ° ° ° ° ° BE USED FOR LOT LINE STAKING OR ANY OTHER j :. 100.9Z' 100.80' ;�o000 oog000 0000gogo 98.7, PURPOSE. ° ° ° ° .•••� _.•..-e�- .. --;.:.-;:..- .••: . � Exit ? •�r•� Route 6 N0 - NOT A L snWA MW APPM Mr°NANO SIDES: 2(40.5 + 10.83) 2 (.7) _ 143 GPD B. PIPE FOR.SEPTIC SYSTEM TO SCH. 40-e PVC. LH-10 500 GAL LEACHING CHAMBERS BY ACME PRECAST BOTTOM 40.5 X 10.83 (.7) 307 GPD 3/4'-1-1/2' DOUBLE WASHED STONE (3) .UNITS REQUIRED 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED Yarmor�th m o 6 .CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO. OUTSIDE OF STONE: 40.5 X 10.83 WITHOUT INSPEC71ON BY BOARD OF HEALTH AND Campground TOTAL: 643 S.F. 450 GPD tOMPACTION. (15.221 [2]) PERMISSION OBTAINED FROM BOARD OF HEALTH. Locus *THE INSTALLER SHALL VERIFY THE �' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING LOCATIONS OF ALL UTILITIES AND ALL USE (3) 500 GAL. LEACHING CHAMBERS .(ACME OR EQUAL) DIGSAFE (1-88B-344-7233) AND VERIFYING THE BUILDING SEWER OUTLETS AND WITH 2.5' STONE AT ENDS 5' BETWEEN UNITS AND 3' AT SIDES LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. ELEVATIONS PRIOR TO INSTALLING ANY ( 9 x SLOPE) ( 1 x sLoPE) LOCUS .MAP PORTION OF SEPTIC SYSTEM 89.0, BOTTOM TH-1 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ** FOUNDATION EXIST. SEPTIC TANK 21' ' LEACHING NO GROUNDWATER FOUND REMOVED 5' BENEATH AND AROUND THE PROPOSED NOT TO SCALE INSTALLER SHALL CONFIRM MINIMUM SEPTIC MA D BOX 12 LEACHING FACILITY. TANK SIZE AT 1000 GALLONS_ AND ITS SUITABILITY APPROVED DATE BOARD OF HEALTH FACILITY FOR RE--USE. REPLACE WITH 1500 GALLON 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND ASSESSORS MAP 333 PARCEL 24 SEPTIC TANK APPROPRIATE TO SITE CONDITIONS IF REMOVED. NOT SUITABLE ' p 13. ENGINEER TO INSPECT SOIL REMOVAL AT TIME OF INSTALL. 24 HR NOTICE REQUIRED. i� (C- e r`��o 40 TEST HOLE LOGS \ ` ENGINEER. CRAIG J. FERRARI, SE 1.3871 E . 102� \ aQ WITNESS: DAVID W. STANTON RS 41 DATE: 3/1/2016 PERC. RATE < 6 MIN/INCH J ' • CLASS I SOILS P 14967 w �O \ w � \4- ELEV. . EL � ELEV / 104 0" 104' Q„ V' 103.5' w i 04 24" FILL 24". FILL 104 lJ r � / A A SL Sl. TH2` 30 10YR 3/2 101.5' 32 10YR 3/2 00.8 Qr /;off 3 ti B B .. I J�� 1 1 � 5L SL w O 5 REMOVAL .OF UNSUITABLE SUL REQUIRED �/ AROUND PERIMETER OF LEACHING FACILITY, „ cos �s 4 DowN To suITABLE.saL LAYER. REPLAc UNSUITABLE SOIL 34 10YR 4/3 101.2' 36" 1OYR 4/3 00.5' WITH CLEAN MED. SAND, TO MEET w $/ SPECIFICATIONS OF 310 CMR 15.255(3) C/1 / C 1 /SiL /SiL 60" 1OYR 5/4 99- 58" 10YR 5/4 98.7' C2 C2 11.2• SIEVE 1 C2 MS 21 BENCH MARK - TOP STEP „ (TRACE SILT) (TRACE SILT) , EXISTING DWELLING AT BRICK LANDING. EL = 107.9 132 1 OYR 6/6 93' 126 1 OYR 6/6 93 TOF = 107.1 _ C3 C3 �. SIEVE 2 MS MS 180" 1OYR 8/6 89' 174" 1OYR 8/6 89' NO GROUNDWATER ENCOUNTERED co LOT 38 0 59,656 S.F. N TITLE , 5 SITE FLAN OF #55 BRENTWOOD LANE CUMMAQUID, MA PREPARED FOR GERARD MAHONEY DATE: MARCH 23, 2016 Scale:1"- 20' 0 10 20 30 40 50 FEET .Q�, �fMClf A�iic ' N.OFA4 off 508-362-4541 00 �4� ` ���� AS59c fax 508-362-9880 DANIE�A. o� DA�,'IE ti�N I downcape.com o� OJALA i� down C� d ineeri� me.CIVIL �. , . N,• A ,B' g, 0 02 q No.4t� o civil engineers 3�Z3"I ss aa ' z uR land surveyor's' 939 Main. Stree t ( R to 6A) DICE DATE DANIEL A. OJALA, P.E., P.L.S. YARA40UTHPORT AM 02675 16-048