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HomeMy WebLinkAbout0084 COBBLE STONE ROAD - Health 84 COBBLESTONE RD., BARNSTABLE A=316-060 a o' 9 { r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 84 Cobble Stone Road Property Address l Allyson Parker _ �A c�p 1 Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for q ry every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms the 0�M computer, r, use 1. Inspector: � U only the tab key to move your David D. Flaherty Jr., R.S. cursor-do not Name of Inspector use the return key. Flaherty Environmental Services Company Name P.O. Box 81 Company Address Yarmouth Port MA 02675 . City/Town State Zip Code 508-362-1657 S14713 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: 6 ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving AuthorityJ- i�J �4r tA# January 14, 2008 Inspec or's Signature Date (41 The system inspector shall submit a copy of this inspection report to the App ving Authori)E(Board of Health or DEP)within 30 days of completing this inspection. If the system a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system ow er shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp84 Cobble Stone Rd.Cummaquid.doc•08/06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 1 or 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form 5T Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for G rY , every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components /infiltration in a"Conditional Pass" section need to be replaced or repaired. The system, 'on of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 2or the septic tank(whether metal or not) is structurally unsound, exhibits substion or exfiltration or tank failure is imminent. System will pass inspection if thexisting tank is replaced with a complying septic tank as approved by the Board of Heal *A metal septic tank will pa s inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating t at the tank is less than 20 years old is available. ND Explain: ❑ Observation f sewage backup or break out or high static water level in the distribution box due to broken o obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will- pass insp ction if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed t5insp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for q rY every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of a Board of Health)' ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Requir d by the Board of Health: ❑ Conditions exist which requi further evaluation by the Board of Health in order to determine if the system is failing to prot ct public health, safety or the environment. 1. System will pass un ss Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the s stem is not functioning in a manner which will protect public health, safety and the envir ment: ❑ Cesspool o privy is within 50 feet of a surface water ❑ Cesspoo or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System.w' fail unless the Board of Health (and Public Water Supplier, if any) determines at the system is functioning in a manner that protects the public health, safety and nvironment: ❑ T e system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet f a surface water supply or tributary to a surface water supply. ❑ he 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. t5insp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for Q rY , every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Healthpless .): ❑ The system has a septic tank and SAS and the SAS than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water nalysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the pr ence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no her failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow El ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high groundwater elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply.or tributary to a surface water supply. t5insp84 Cobble Slone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 84 Cobble Stone Road Property Address Allyson Parker Owner Owners Name information is Cumma uid MA 02637 Janua 13, 2008 required for q ry every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems:. To be considered a large syste{n 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" " s" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ the_system is w hin 400 feet of a surface drinking water supply ❑ ❑ the system ' within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the syst is located in a nitrogen sensitive area (Interim Wellhead Protection Area— PA) or a mapped Zone II of a public water supply well If you have answered "ye to any question in Section E the system is considered.a significant threat, or answered"yes" in Se ion D above the large system has failed. The owner or operator of any large system considered a ' nificant threat under Section E or failed under Section D shall upgrade the system in accordanc with 310 CMR 15.304. The system owner should contact the appropriate regional office of th Department. t5insp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments '(0 84 Cobble Stone Road /4M SyOV Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13, 2008 required for q ry every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® 0 Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue E El approximation of distance is unacceptable) [310 CMR 15.302(5)] t5nsp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for q ry every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No '07: 170 gpd; '06: Water meter readings, if available (last 2 years usage (gpd)): 140 gpd Sump pump? ❑ Yes ® No Last date of occupancy: present Date Commercial/Industrial Flow.Conditions:. Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., a Grease trap present? ❑ Yes ❑ No Industrial waste holding tank presen . ❑ Yes ❑ No Non-sanitary waste discharged t the Title 5 system? ❑. Yes ❑ No Water meter readings, if avai ble: Last date of occupancy/ e: Date Other(describe): t5insp84 Cobble Stone Rd Cummaquid.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of 15 j Commonwealth of Massachusetts W Title 5 Official Inspection . Form 4. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for q ry every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: owner,2 years ago Was system pumped as part of the inspection? ❑ Yes E No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy El Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained'from system owner) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components,.date installed (if known)and source of information: 10/9/1998 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp84 Cobble Stone Rd Cummaquid.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 L Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid required for q MA 02637 January 13, 2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): i Depth below grade: 4feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): joints good, venting through house adequate,no evidence of leakage Septic Tank(locate on site plan): Depth below grade: 3 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No ------------------------------------------------------------------------------------------------------------=------------- Dimensions: 1000 gallon Sludge depth: 3° Distance from top of sludge to bottom of outlet tee or baffle 31". Scum thickness 811 Distance from top of scum to top of outlet tee or baffle .Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? sludge judge, tape measure t5insp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 6 _ _ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13, 2008 required for q ry every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): pumping not required at this time, inlet&outlet tees in good shape, tank seems structurally sound, liquid level appropriate, no evidence of leakage Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fi rglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to to of outlet tee or baffle Distance from bottom of sc to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pump' g recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as rela d to outlet invert, evidence of leakage, etc.): Tight or Iding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth elow grade: Mat ial of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): t5insp84 Cobble Slone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 84 Cobble Stone Road Property Address Allyson Parker Owner Owners Name information is Cumma uid MA 02637 January 13 2008 required for q ry every page. Cityrrown State . Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition/armfloat switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert n/a 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.): dbox seems level, both lines have equal distribution, no evidence of solids carryover, no evidence of .leakage Pump Cham/orde Pumps in wor ❑ Yes ❑ No Alarms in wo ❑ Yes ❑ No t5insp84 Cobble Stone Rd Cummaquid.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 84 Cobble Stone Road M Property Address Allyson Parker Owner Owner's Name information is ma Cum uid MA 02637 January 13 2008 required for _ q ry , every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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: Type: ❑ leaching pits number: ® leaching chambers number: (2) 500 gallon chambers w/4 ❑ leaching galleries number: ❑ leaching trenches number, length: El leaching fields number, dimensions: ❑ overflow cesspool number: I ❑. innovative/alternative system Type/name of technology: - Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): soil dry, no signs of hydraulic failure, no ponding, no stain line, vegetation typical (lawn) ; t5insp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts w' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments :GM , 84 Cobble Stone Road - - Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for q ry every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of so', signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site Ian): Materials of cons uction: Dimensions Depth of soli s Comment (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 ., Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is a Cumma uid MA 02637 January 13 2008 required for q �. , every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I 32 � Z 43 o , 3 - 30 6 „ � Z6G 14 � 3 i3 - 5-3 , t5insp84 Cobble Stone Rd Cummaquid.doc•08/06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M s 84 Cobble Stone Road Property Address Allyson Parker Owner Owner's Name information is Cumma uid MA 02637 January 13 2008 required for G ry every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Town of Barnstable Groundwater Contour Map shows water>12'below grade t5insp84 Cobble Stone Rd Cummaquid.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page.15 of 15, • • Town of Barnstable �pF 1HE T �P o .Regulatory Services- h T ' BAMSTABM ; Thomas F. Geiler,Director' v� SS. `0g p,F1639. Public Health Division Thomas McKean,Director 200 Main Street; Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic.system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system.in the future nor does this Division agree with any technical observation s and interpretations contained within this report: In addition,by receiving this report the Town of Barnstable Health"Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. Town of liarnstabic - P il Department of Regulatory Services /Z OZ p`IW, Public Health Division Date ` t$Py p� 200 Main Street,Hyannis MA 02601 • BABN6TABrl. _ I t610 �° Date Scheduled C► Z' Time l�� ������h Fee Pd. �T Ai��r► . t Soil Suitability Assessment for Sewage Disposal Performed By: q�—= ��t-�-\V id- �-J � Witnessed By: �3\J.J 1J0 �Q ELPCPRO+AStF\P p���E 1il!1!t�1h65 iIl!1!I! In.I.I -...h II i !it r II'{!y11 11 1 1 V 1 t. 7i, 4 it !•M.!.Pifl f h!1 I�! r...,4„!.! !.e li.LLr,.+ C. !h a ... r. {` I Owner's Name Location Address 4' (p e�13&-6 S•Tbn/L R-0. Address /Z0 f.0&9 L Assessor's Map/Parcel: 31(p Engineer's Name Sv(1l t/,}�/ / I u NEW CONSTRUCTION REPAIR Telephone# �Jvg 2g 3 3y Land Use c5.,c e i' -M �y Slopes(0) 3% Surface Stones Distances from: Open Water Body 1A A ft. Possible Wet Area J4/� _ft Drinking Water Well ft Drainage Way i1 1A ft .Property Line ZL ft Other IS�,�- ft : SZ'CH:(Street name,dimensions of lot,exacClocations of test holes&perc tests,locate wetlands in proximity to holes) of ID ".ate r� ! . 1 1 il•I-\ �[��tJ•-�}„� j 1_ l 1 S Parent material(geologic) taw ASS V f Depth to Bedrock Depth to Groundwater: Standing Water to Hole: �`�� Weeping from Pit Face I�O Estimated Seasonal High Groundwater �� /ASE2 . � ........ „ .•,.r[ r,av';x:;,:i n r,rar�r!tn,r!-=ara:rgi:..y.:_.:.ta,,-,y,�rr.;_'!'-:!-yr,t,,.,�;i,!,!!7I,iP.s iariap!rn.^.ry„•�[.,,..!.:, :. �.. !: � P r. ..,;!'�. _ Y y��y;- ! !s•I{!li 7r ,''.:LILIi,' { f�( 6 !RIN I' !,•... !y�h� i D,�:7E{14.' �' ;!...vrr �... 5. Alt,:r,;a::.•:m., r.,::,.,:ra:::::.d:m:-::r::•G,.-,..r::r:!r::,r::{..r:r!r.r:,�,17,._,.-,!rr:�u:,rrr:r. ........L.......r,.,.rr,_.,.!,.::.r:,.:.,•�r.:r. �I,l .:, 4- t/ Method Used: -lb��v ry OF ` AO(U VANG �- tz=o rZ.00(0 PwA N it,Q, Depth Observed standing in obs.hole: �t4� in. Depth to soil mottles: l�o�C ft. Depth to weeping from side of obs.hole: AlDtil G in. Groundwater Adjustment d, ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ _—.............. r:.r n.... ... ,.. .. ............_. .......... ,. n..........:.........:................._.. ..r.r_..,I rr:...J...,..:n.:.s..:'::!!i:ru::'.';'il!i.�!i�r:r.,::u:..n;...'. ..I.n..:rr rJ....A., .,.:..[r..,...n.....I::?nn!:r.l:l:!vlm:mv c.. r::V....;r......:.....:..:!�._:,:..r1::.n.nr,rr ,!. ,..... ...!., ......,I....r.... .!... ,,..._..,�.... :.Ir ,.....rl:. .:.. ::::::v. ..ve.. !: rl...Lr. ..:Ir !:..: ::T..• '.:!.:,::...:.. .... 1,r I....r.,....:-....: 1 , :,.1..., r....,...rry:..p ..:.:, .,. .. .i. ::.: .. ..... :::'...'::1!.,.__nil...!rr,l i!r!:. :.I.r. :t.l.. r I L..::I. .rr.. I,.,url1.101.:LIr..l61...1 , ..,.!,1....I r d!„!I ,,, ..., .,. !... .: !.. ... ..r!.. I.. '!i.I..L..... I,u ullr5 A i �r_:,,,i.r!::,.....L......,.Ir.!,.rm a..,.::!.... I!...L..!,.I.,:,.. " .. :r..a, .L. .1 :.!,: _!..r u.......... 1 .....L,.I�.,L,.I..1.. .J...... :,.,L...,li..,G{.L..:.,r r...r,:..:L. :.AL!la, .. .. .. .. a::: :.ut.: rr.F I;:�ry�. .,tC;.4 „uir:v!a'!;,..,.,. :L! ,r..l.l._:r....rlr,,_,I,:;,...::!,:.!.,u,.:............... :.....:::..,!:,:::I:,r.:.l.... .,u!R: k r..."17 :..,,. ._ .. ..,..... ... u.. ..:..4 1:'r.r:.::,I!...1.::..11.2 r:.:.I`!!!I.:..! .I„r!"!!i,: r-9:. I::',.n .r, !_4... .{�,�r,:il '.:i :i'.I>ts`rll rau,,r:. .r,.,, 7:!.!.h.,.2,,?...�,..,,I,-u!lu:!4,1:i.!.m,!.}y ,. ,,,I,..ua�J.IL r_..r,;r I;:L!!n I n � ...I�.. .� � AF' r �� da J!r 1.r,N�491i.7 h� n , !:p:y,,:...::,,:.:-ir::r..d,.c..t...;..r..!.,..:..r n,.... _ 4: 1 . I,r ::al.::4:-a:,.,:r::,:.I. !;,a6vH:�.t ::r::I,,.r ar._,......,,6,�! !:J..r,_l,r.::..r.,,r.rn..n Observation Time at 9" Hole# Depth of Perc A6 ' Time at6" b-2-\ S Start Pre-soak Time(a3 {-� ' Time(9"-6'� v�A End Pre-soak U) Rate Min./Inch 2 VXA\q\) `i5Z- L Site Suitability Assessment: Site Passed 5 Site Failed: I�G Additional Testing Needed(Y/N) Original: Public Health Division Observation.Hole Data To Be Completed on Back--------- 0-MV.At TH/WP/PERCFORM :..:::.::::::...::::................. ... J Soil Other Depth from Soil Horizon Soil Texture Soil Color Surface(in.) (USDA) (Munsell) Molding (Structure,Stones,Boulderes. % ?V�E aiDE52 2 0 Zc�9w(os sip Q � �� �o�l��15 ;::>::::>:>:::»::::>.H Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % .. 3 G sr"VVo—4 illy CA io rz��t�,a rt,G 6, 10�( 12 � ............................................. .... ..... Depth from Soil horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. 0 Z °- d 0 -TW1.65 ry 2� CK 4 T ."Q ��vU E�csi S �S�o l�lLs�U e. rr <O SER` ATIOI :H:...:.L.....:..........::. ............ .......:.................. :::.:...............:.:::::: :: ::; ::::.:.:...:...:.......:... .. Depth from Soil Floriion Soil Texture Soil Color Soil 0(her Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. oGravel) Flood Insuranec Rate Man: Ahove 500 year flood boundary No— Yes x Within 500 year boundary No_N Yes Within 100 year(food boundary No K, Yes Penth of Naturally occueriug Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ` s If not,what is the depth of naturally occurring pervious material? Certification i certify that on h RZi L-95 (date)I have passed the soil evaluator examination approved by the _ Depar(n clrt of Environmental Protection and that the above analysis was perform me consist nt W't ��, the required training,expertise and experience described in 310 CMR 15.017. I � � r— R� cc� O j TOWN OFF BARNSTABLE LOCATION CollI s7�N e /t SEWAGE # ��✓to`�� VILLAGE_ ,tg<c/Z 57aa12F ASSESSOR'S MAP& LOT81 - Q 6 0 INSTALLER'S NAME&PHONE NO. UVZ5NAC$ SEPTIC TANK CAPACITY /UOO ifal LEACHING FACILITY: (type)o?�Sa�,��� C� f)(size) NO.OF BEDROOMS BUILDER OR OWNER ���YS6i[, �/c�.� m/►1� � PERMITDATE: /d- Cof — f8 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of le ching facility) Feet Furnished by f TOWN OFF BARNSTABLE LOCATION 00/ ��0, SfbN e /i c SEWAGE # VILLAGE BOW 51 QL34 ASSESS O*R''S/MAP & LOT"..-.. 06� INSTALLER'S NAME&PHONE NO. UeTz5R/A*2 �G��ClttaeJ�h�l�J SEPTIC TANK CAPACITY ZLO-0 iW LEACHING FACILITY: (type)o?�EW�OL/ d1v�CUA(0,4f)(size) NO.OF BEDROOMS 3 BUILDER OR OWNER /Q 13YS6N Al Ml PERMTTDATE: ld- P- f8 COMPLIANCE DATE: �O 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) 0Q14 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of 1 ching'facilitv) Feet Furnished by a ►? Ga { 1 u earl" c -sx No. ���7.� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: � PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Miopaaf *p6tem`Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(` )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. g y f j�j �3$ /J a Owner's Name,Address end Tel.No. /3ar ns�/o/Q Ali 541� � '/4��� Assessor's Map/Parcel -3 ` c O 60 Instal er's Name,Address,and Tel No, Designer's Name,Address and Tel.No. CTD2��J�S a�S Gc)oo��efic.7c% Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons 2 Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) C1 Date last inspected: Agreement: The undersigned agree to en a the construction and maintenance of the afore described on-site sewage disposal system in accordance with the prov si ns f itle 5 of the onmental Code and not to place the system in operation until a Certifi- cate of Compliance has be n i s by this Sign d Date Application Approved by Date /O--IV Application Disapproved for tlYfolloAng reasons Permit No. — Kh�S�j� Date Issued 3 1 No. - (�` `7 Fee t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0(pplication for Migpont *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. Q$ e Owner's Name,Address Ind Tel.No. 13�r as/nlo/P Ali'SOl�! a hurl,/ Assessor'sMap/Pazcel 3 �`_`© 6b Instal er's Name,Address,and Tell..No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms. 3 Lot Size sq.ft. Garbage Grinder'( ) Other Type of Building No.of Persons ;2 Showers( )/Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. f Description of Soil p� Nature of�Repairs or Alterations(Answer when applicable) l l� Date last inspected: - � I Agreement: The undersigned agree to en f e the construction and maintenance of the afore described on-site sewage disposal system in accordance with the prov sions f Title 5 of the 'v' onmental Code and not to place the system in operation until a Certifi- cate of Compliance has be n iss by this B9 Sign d I - U41h Date Application Approved by Date /O-- R' Application Disapproved for thVfollmAng reasons - Permit No. Date Issded THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ") Abandoned( )by at_ g �1 ((.'� gez p has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No./�- �7 S� dated IN Installer Designer The issuance of this permit shall not be construed as a guarantee that the systep_will function as designed. Date 1 - 01 , C/`1 Inspector — — —————————————————-------— —-- No.�G Fee O THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS &!6pool *pgtem Congtruction Permit F Permission is hereby granted to Construct( )Repair(>,-)Upgrade( )Abandon( ) System located at 6 G/ 124- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date: Approved by 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) 1, 0 , hereby certify that the application for disposal works construction permit signed by me dated Ole� S3, (9 9 , concerning the property located at �S�� �D6�l�g�1�P Af/1 S7Zc 61-e meets all of the following criteria: • There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands, the bottom of the proposed leaching facility will lei be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. _ Please complete the following: A)Top of Ground Elevation (according to the Engineering Division G.I.S. map) _�z B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED : i DATE: Q-9 LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert 4nxsie CD L RS a b 6,:::! � �- 0 CX llxd- MQco Orr�e 6 c 362-4541 926 main street rt 6A yarmouthport s mash. 02675 �(�/OW11 CQAe e'/f iftier iff civil engineers& land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys site planning sewage system May 21, 1987 designs inspections Barnstable Town Hall Board of Health South Street permits Hyannis, MA 02601 Gentlemen, Please'be advised that on May 15, 1987 Down Cape Engineering inspected the septic system installation located at Lot 83, Cobblestone Road, Cummaquid. We hereby certifiy that the installation complies with Mass- achusetts Environmental Code Title V, Town of Barnstable Health Regulations and our approved site plan #86-406 re- s vised December 1, 1986. Sincerely, V Arne H. Ojala, P.E. Inspected by: Richard R. Fairbank, P.E. LOB 93 TOWN F BARNSTABLE LOCATION COBBLESTONE R ' . ' SEWAGE #,86-548 s VILLAGE CUMMAQUID ASSESSOR'S MAP & LOT Map 85 Lot 83 INSTALLER'S NAME & PHONE NO. BCK 778-0444 n eP SEPTIC TANK CAPACITY 1000 GST d tLEACHING FACILITY:(type) 600 GLP (size) &!NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER JAMES THOMFORDE . DATE PERMIT ISSUED: 3/10/87 DATE .COMPLIANCE ISSUED: _, ` -. . 7 VARIANCE GRANTED: Yes No �-, y 4 _ a ' � � � �a �� / 3 �(3 ' `�' a Co Q.G,CC-STD�tJ� �e� . ,�4�8� 4S DESIGNING ENGINEER MUST SU?ERVISE R INSTALLATION AND CERTIFY IN VRITING THE SYSTEM WAS INSTALLED IF STRICT ACCORDANCE TO PLAN. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...7Q1►3 q................OF. 8.1.._£............................ Appliratiou for Digpuiittl lVorkg C>zontitrurtinrt Permit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: -------------------------------• --- ....... T... ................. Location- or tion-Address Lot No. o�n ------------------------ - ----------------•--•---------------........ :•---•--•---.................._..-_._..... Owner Address Ille Address nsta r Type of Building Size Lot....47t.'R9.'j.Sq. feet �-� Dwelling—No. of Bedrooms................5.......................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ........ No. of persons............................ Showers a YP g •................... p (...)--- Cafeteria ( ) aOther fixtures .----•------•------------------•---•---••-•----•---............................_-----------............••-- -: ....... Design Flow...............Ito.....................gallons per person per day. Total daily flow.............. -0._...............gallons. Septic Tank—Liquid capacity.IWDgallons Length...Sl.=&"Width:.�--I&Diameter�--..__ Depth._r�! ., n w Disposal Trench—No..................... Width..... ......... ...... Total Length.................... Total leaching area....................sq. ft. x 3 Seepage Pit No...4?-Ne... Diameter...../Z......... Depth below inlet.......4........ Total leaching areaZjG5..Cj..sq. ft. Z Other Distribution box (� Dosing tank ( ) , a Percolation Test Results Performed by....._..i L _....P .............. Date._...--5_.... _/..�.' ...... ,.a Test Pit No. 1.!.Z.......minutes per inch Depth of Test Pit.................... Depth to ground water...1O/6....... 44 Test Pit No. 2....:...........minutes per inch Depth of Test Pit.................... Depth to ground water... ---------------------------•--..............---............._ 0 Description of Soil.' l. .p.�:!:.�¢.".LQtA!j. 5l?�3 �t1�_..- _ ..`.�_^1.� '.'.-.Gl. ',q�/_Al U - w . ...A4 ...5Fa ,/ .... 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'AI TL: 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 boar f health. 11�?)ate- Signed....Application Approved " .t�� '......••...... ...........••... i�............ Date Application Disapproved for the following reasons:.............:.............................................•-•-----;----.........--•-•----••- _._ ....................•---............----.........---....----..............---•----------...................................---......---•-•--.......................--••---•--.......................... Date PermitNo.... ...... .��.......... Issued....................................................... Date No....:..I:'.. FEZ:: ....... _ THE COMMONWEALTH OF MASSACHUSETTS -T BOARD OF HEALTH :......!. .........._....OF........... k , ► 1 F.----------••................ Appliration for Disposal Works Tonstrurtion rnmit Application is hereby made for a Permit to Construct (�!� or Repair ( ) an Individual Sewage Disposal System at: 1 °r„R „ ra o,r� F s w .. ,+�,la.r► ,r. ; �,l t ra....--------•----------------•---. •-- L.- `'�. ................. ._._.... Location-Address or Lot No. W .................F..... - ..........................................................�C7 .._......-•------........_.....--•----...... _ ..--•----........_...................... Owner Address a •----....--•-•---�-•-•-•--....-----•.......:. .......................•----.......�....-•--•.✓. ._......._..---.......__._._............_...Add ---......------....._..-•-- •- Instal ler . r ress Type of Building - Size Lot.... ? `'�S` .Sq. feet �-. Dwelling—No. of Bedrooms............... ........................Expansion Attic ( ) Garbage Grinder ( ) a04 Other—T e of Building ............... No. of ersons..................._..___. Showers - -Type g ............. p -• ( ) Cafeteria ( ) aOther fixtures ...................................'.................................................................................................................. Design Flow...............in_........._._......_..gallons per person per day. Total daily flow......."'.. 3�.................gallons. Septic Tank—Liquid capacity.ln!:iclgallons Length..S..- .�„tV Width:. `:n1��Diameter_•._._........% Depth.A; -_ 1� x Disposal Trench—No. .................... Width.................... Total Length.............._.... Total leaching area.__.....--..:.....sq. ft. 3 Seepage Pit No.. In ... Diameter..... ..�...... Depth below inlet......�...... Total leaching area�(n S.- ..sq. ft. Z Other Distribution box (><) Dosing tank (. ) Percolation Test Results Performed by....... ::FA! 3 .KI/�'......�'� Date.......`�a__-.f ?.". z...... ... Test Pit No. 1..<. .......minutes per inch Depth of Test Pit.................... Depth to ground water...&O.A =:....... f=. Test Pit No. 2................minutes per inch Depth of�Test Pit..................:. Depth to ground water...A!✓?!�• °_... oi _.cJ------------.y--,---------1-----------------------------,--------------•---------,-------•'---'r-T--' ----- -O Description of Soil:#A1 ah 9� " t-1�dA ............... oa.S /J / Ll ''. •:_ , /r U Nature of Repairs or Alterations—Answer when applicable........... .......... ................................. ........r ......... ......... ---•----•-------------------•---.........................._.........----•-----.....----............---.....:--------------------------•----...•----:------......................--•-•-----•---.......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL: 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 boardaof health. Signed.. t� ,� :, „ = �!o ... Date —�'- vim'-•.......,.... ..... .`.. Application Approved By.. ................ _ -- , ............ Date `... Application Disapproved for the following reasons:.......................••--..................................................................................... -•••--...-•--•-•-•-•.....................•--•---••-•-•-•------...............-----•-------........----..................---•------•--•-----••--•--•-•---...--------...........--•---............_••.-•--•- DatePermit No.... ...... � 'X .-.-----.- Issued........................................................ -------------------- Date -- --- THE COMMONWEALTH OF MASSACHUSETTS BOARD—OE HEALTH VVIQ .......................................OF......I.............................................................................. (Irrtif iratr of faomplianu THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by....................................................................•--................-----......_.................. .......... ..................:......---•-------....................._..... �2 „--- ;.. #�a J.. !-•uC�... ................-•-•-----1................ .::^'..:...�ayf1M/T�JsJ� has been stalled in a /ccordance with the provisions of TI_I�, 5 of.The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._.�+-per__.._ � .... dated•_...-.`- ;/.&1,65 1.................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... - � ....... Inspector.- .................... ..'__:, 1�' .. . .......................... .v� e.r��.r11i a....ar...............w..a.M•.+M.....w ba nw.�n n nt•rifi x•P�:M X aY• .d� •.�.n r...x...r. sr . a+,,+n+ 4 � NNl t.,. 1 n. f•R.s>t f b. 1 Y.--. ne-W x.. ..».....-a.w..a.F> C-------be v THE COMMONWEALTH OF MASSACHUSETTS BOARD--OF HEALTH � /,,,.�I ....OF..... l t?....1......................................... N0.. S�.... `� � FFX..-.T- .............. Disposal Works Tonstrurtion f rrutit Permission is hereby granted............... to Construct ( ) or Repair ( ) an .Individual Sewage Disposal System .,� b, at No....... ,-••- --............��L�.-•----..../'��.��^Cfr � � ......-•-. �u►�----- ... •............. .......... Street J as shown on the application for Disposal Works Construction Permit No� ..�.a..��.. Dated!-...... �'��.��A(--...... A y Board of Health DATE......... ..-•-- ._....+t 362-4541 926 main street rt 6A ` yarmouthport mass. 02675 down cope engtineerill civil engineers& land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys site planning March 16, 1987 - l sewage system designs Barnstable Town Hall Board of Health inspections South Street Hyannis, MA 02601 permits Gentlemen, Please be advised that on March 13, 1987 Down Cape Engin- eering inspected the septic system installation located at Lot 83, Cobblestone Road, Cummaquid. We hereby certifiy that the installation complies with Massachusetts Environmental Code Title V, Town of Barnstable Health Regulations and our approved site plan #82-048B-revised June 4, 1986. S' Richard R. Fairbank, P.E. SECTION - SEWAGE ( 3 —SEPTIC TANK — _.,D"BOX— I' —LEACH_i�l'��TOP F =- (MSL)�► OF �ISYp/ WASHED STONE t 5 U 4 — 1 1 aMAP l/ d M ��a Q � \ 1 � F,4` #, $ .,� IN• OUT• n � rn.k/ I IN• OUT- . IN• SEPTIC r I � �L-ls�r '�r•r�,• i � � ` �' ELEV: ELEV. TANK ELEV. I ELEV: ELEV. ELEV. OF 3A"-hh" WASHED STONE i ' TEST HOLE LOG . PiAt iLk-Ile" � .��iY TEST BY �l�I�Yf/f'�I/ CB�D•f'1• ) a � L� � o° '�.,- ` , r ,. 1 , WITNESS. Y TESTU I 1�— , DATE a �y]�.j a"�•, ,wT �\`\ DESIGN BEDROOM HOUSE T.H. Cv T.H. �( r S QQ —_-u ELEV.q"f`S ELEV.gS.f r NO S M PERC RATE' Z MIN/IN. DISPOSER:, DISPOSER ® D: DIF�'r'. G q2•S 2 �. ►I,'I,. FLOW RAli TE 11(� (GAL/DAY SEPTIC.TAN.K. n 3 I n REQ'D SEPTIC TANK E D/ �; �. , A KIZ M g ,. , C LEACH FACILITY iJi SIDE WAL G/D. / — W 50M , �0 BOTTOM ,D G D., . .w , -_ _ — •,r, F _- a � , r. ` ..,pia..-•-s. ,,.. ., D ,S /� 7 * USE. ;; 8I LEACHING- P S� .. '...::. .L h. ... Z• !I RF f ATE, N .. r ..:. .. ,.,::•.. 4,.:r. ..,_, .. '.i k:: _ ��, - Y, 1<'' R'E COUNTERED. C� .. -: .. .. „. _ ,:.. - ...,: ?° t; is -a:- ie.": .:,:.. •- .. '.�'t i ( , .. y• , 41 NOTES: (UNLESS _. ES S OTHERWISE NOTED). (• , , . EI.lcNeM AR I. DATUM. M - � ) L ..:.. ..: .,,.. .' ..•:.,-.. :."r :. - :'t.(.-i: i .r. '_s .. ( SL)—TAKEN FROM � UA —aa•6.__...Q ORANGLE MAP ,.: c, ,,,• ' 2.MUNICIPAL WATER AVAILABLE - 3.PIFOOT-- .—AVAILABLE PE PITCH-4�"P - - ER r� • 4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO 'I D (1F' M, E' :•y .., GL... �G... t� 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1)FT. - �A,. „ Cy�,> � Iwi ,�„ '`<" ;, �;� - PIPE �7"" 6 E JOINTS SHALL .. ALL BE MADE WATER TIGHT: .... . ... •� .. RIVE ; , : . .. ... ,,..,: "., S. 's' i, t`.. 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. L1 4 :. .H. x T g r S ATE ENVIRONMENTAL ..:. ...: RONMENTAL CODE . ] 6.sr �.,. -.., •.. .' `: o ' ALA' r. IM _ P A 4: �.I ✓... -?- '(r115 Pt Ail Y 6346, r . K + 8 PROR7��ED b.101a 01.1E PI.1D�-iOU o: 2 C r' ,: -rav Imp N 1� i "� ° Kt7r � USerp FOI, P� LI►je e::5 `KINJIC Locus: -.' : DESIGNING ENGINE °yat lay+ REG. q WEER ! GM o uM ER..MUST,•Sll_..ERVISE At _ of aN. nvST _. ALLHTION "AND C H,REF:.� •� • t. TIFY IN M ..>. T RITIN r1E M� H ,r. E SY S TEM W f Jx A S � 06� x sT�►uE _ a, a e�, n� inee�i • CT ."' - a p' p� PREPARED FOR.��' ACCORDANCE TO b'. b CIO, PLAN. f CI VI EN r, a < L� GIN EERS { LAND:SUR ALTH? r ,',� VEYORS --- ----- Y; .Y BOARD HE r ��11 ;,¢ REG:LAND..S URVEY (EXISTING) � c?.r, a 's.m+�u ,in',. ,f' ..u;�.>e *� CONTOUR ._ a , ;. r . .. PROPOSED _"O—O—O—O ..APPROVED ,. .. ,.., ..,•„..,.... .. MA .,...,r ;.,.. M .. ,9 .) .. (PROPOSED) . . $'. DATE ,7. c.•,i,7:?L._ F., az.- .:� `T.:r,Y•r:.3"r I � ,r' { s' :•� ,, • ,�„ -,.:,, ,r:� !'r. r Ip� , �'h.. ,'� DATE _ e.