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HomeMy WebLinkAbout0093 COUNTRY CLUB DRIVE - Health 93 Co'untry .flub Drive Barnstable P A '= 350 041 OT G Y { e - �. ,. r 4.. •� a °. � m o 0 Commonwealth of Massachusetts . lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cumma uid• Property Address M-350 P-41 Paul Reiss Owner Owners Name information is required for every 93 Country Club Drive, Cummaquid MA 02637 p page. city/I own September 17, 2014 State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. ` Important:When filling out forms A. General Information • on the computer, use only the tab 1. Inspector. key to move your cursor-do notv use the return Troy Williams key. Name of Inspector Y —Troy Williams Septic Inspections ray Company Name 19 Hum - mel Drive �I Company Address South Dennis t Cityrrown MA 02660 State Zip Code (508) 385- 1300 S1682 Telephone Number License Number. B. Certification I certify that I have personally inspected the sewage disposal system atthis address and that the . information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the'proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes El Conditionally Passes _ ❑ Fails3 r ...� Q ❑ Needs Further Evaluation by the Local Approving Authority � c �y Se tember 17, 2014 Inspetor s Signat.,r N -- -- Date5-4 The system inspector shall submit a copy of this inspection report to the Approve g Authontyi(Boaec� of Health or DEP)within30 days of completing this inspection. If the system is a shared system o d has a design flow of 10;000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under . the same or different conditions of use. a t5ins•3/13 Tit Form: I Subsurface Sewage Disposal System-Page 1 of 17 5' f Commonwealth of Massachusetts Title ®ifocia�l Inspection Form 6 t Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaguid M -350 P-41 Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country umma4 Club Drive, C uid MA 02637 September 17, 2014 page.e. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System meets minimum standards set by Massachusetts DEP at the time of inspection only.This inspection is not a guarantee or warranty on the future working conditions of leaching, pipes, components or the future structural integrity of said components and only represents conditions found at the time of inspection only. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of t• Compliance indicating that the tank is less than 20 years old is available. ❑ Y ® N ❑ ND(Explain below): t S t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 ' Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country Club Drive, Cummaquid MA 02637 September 17, 2014 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 3 B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ,ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y . ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y • ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: w ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. h 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: Cesspool or privy is within 50 feet of.a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated.wetlandor a salt marsh t5ins•3113 ' r Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country Club Drive, Cummaquid MA 02637 September 17, 2014 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is 93 Country Club Drive Cummaquid MA 02637 September17 2014 required for every � ,.,, . page. Cityrrown State - Zip Code Date of Inspection B. Certification (cont.) , Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ .® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. - ❑ ® Any portion of a cesspool or privy is'within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a_design flow of 2000gpd- . t ❑ ` ® 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner,should contact the Board of Health to determine what will be necessary to correct the failure. E) .Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or."no"to each of the.following,,in addition to the questions in Section.D. Yes No El ❑ _ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should 'contact the appropriate regional office of the Department. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-•Page 5 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is 93 Country Club Drive Cumma uid MA 02637 September 17, 2014 required for every � -q p page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information. Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country Club Drive, Cummaguid MA 02637 September 17, 2014 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: e Number of current residents 2 r Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No, Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): 13=165,000 gals. 12=162,000 gals. Detail: Sump Pump? ❑ Yes ® No Last date of occupancy: occupied Date Commercial/Industrial Flow Conditions: 9 <; Type of Establishment: N/A Design flow(based on,310 CMR 15.203): N/A ' Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A Grease trap present? ❑. Yes ❑ No Industrial waste holding tank present? ❑.Yes ❑ No Non-sanitary waste discharged to the Title 5 system?_ ❑ Yes ❑ No ' Water meter readings, if available: N/A t5ins•3/13 a Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts u title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country Club Drive, Cummaquid MA 02637 September 17, 2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: N/A Date Other(describe below): NIA General Information Pumping Records: Source of information: Last pumped in April 2014 per info from owner. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts MOU Title 5 Official Inspection Forma Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaquid - M -350 P-41 Property Address Paul Reiss V Owner Owner's Name information is 93 Country Club Drive, Cummaquid MA 02637 September 17, 2014 required for every p page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Tank, d-box and leaching were installed in 2005 per BOW Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18"+ feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Lines were found clear at the time of inspection. Septic Tank,(locate on site plan): Depth below grade: 1' riser to 2" 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: 6'X10.5'X6' 1500 gallon Sludge depth: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M -350 P-41 Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country Club Drive, Cummaquid MA 02637 September 17, 2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) 21811 Distance from top of sludge to bottom of outlet tee or baffle Scum thickness A none 61' Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? probe/measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet and outlet tees were found present and in working order. No evidence of leakage or damage was found. Filter in outlet tee was clean. Tank was not in need of pumping at this time. Grease Trap(locate on site plan): Depth below grade: N/A p g feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: -N/A Date t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts ugTitle 5 Official -inspection. Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M -350 P-41 Property Address Paul Reiss t Owner Owner's Name information is 93 Country Club Drive, Cumrriaquid MA 02637 September 17, 2014 required for every p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank tank must be pumped at time f in 9 9 ( p p e o section locate on site Ian 1 N Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: N/A gallons Design Flow: N/A gallons per day Alarm present: ❑ Yes ❑ No Alarm level: N/A Alarm in working order: ❑ Yes { ❑ No Date of last pumping: N/A Date Comments(condition of alarm and float switches, etc.): N/A Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 • 4• Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is 93 Count Club Drive, Cumma uid MA 02637 September 17, 2014 required for every Country q page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box if present must be opened) (locate on site plan): Depth of liquid level above outlet Invert level Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was found level and in working order with equal distribution to outlet lines. No evidence of solid carry-over or backup in the past was found at the time of inspection. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): N/A * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts ' Title 5 official Inspection Form' . Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is 93 Country Club Drive, Cummaquid MA 02637 September 17 required for every p , 2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type. ` I ❑ leaching pits number: r ❑ leaching chambers number:" El leaching galleries number: . 2-34' infiltrator ® leaching trenches number, length: trenches ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of , vegetation, etc.): No evidence of hydraulic failure or problems in the past were found at the time of inspection Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert N/A Depth of solids layer - N/A N/A' Depth of scum layer , Dimensions of cesspool Materials of construction' N/A Indication of groundwater inflow ❑ Yes ❑ No. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Count Club Drive, Cumma uid M-350 P-41 Country q Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country Club Drive, Cummaquid MA 02637 September 17, 2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A Privy(locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M-350 P-41 Property Address Paul Reiss Owner Owner's Name information is 93 Country Club Drive Cummaquid MA 02637 September 17, 2014 required for every � p page. Cityfrown `. State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately , t I 1 C_ i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Country Club Drive, Cummaquid M -350 P-41 Property Address Paul Reiss Owner Owner's Name information is required for every 93 Country Club Drive Cummaquid MA 02637 September 17, 2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ` ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0+ feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: AIW 247 Zone C 23.5' 3.7'adjustment You must describe how you established the high ground water elevation: Hand augered 4' below bottom of leaching with no water found at a depth of 10.0'. Groundwater adjustment at the time of inspection was 37. Bottom of leaching at 6.0'was found not to be located in the high groundwater elevation at the time of inspection. USGS estimates groundwater at 297. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 official Inspection 0=orrn Subsurface Sewage Disposal System Form Not for Voluntary Assessments 93 Country Club Drive,Cummaquid M -°350 P-41 Property Address Paul Reiss Owner Owner's Name ion is re equir wiredd for every 93 Country Club Drive, Cummaquid MA. 02637 September 17, 2014 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A,-B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file Y - -- °* - a •. - III t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 /�J� 2 ]TOWN OF/BARLNSTABLE �. LOCATION _ SEWAGE # SP VILLAGE �� •�-� v= ASSESSOR'S MAP &.LOT 3�-0 O H I INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY `"T—' J,a3ACHING FACILITY: (type) �t�-� �'`` (size) rX G NO.OF BEDROOMS ` BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet I Furnished by �'�A; ^1 � 6 (� 7� j J TOWN OF BARNSTABLE LOCATION CCvkfA 61 SEWAGE #c2W 5 VILLAGE ASSESSOR'S MAP& LOT 5® 0q f INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching.Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by , J f! /Z -. --�-� 3Y i . s No. Q20 5 L THE COMMONWEALTH OF MASSACHUSETTS ~ FEE Bo BOARD 'OF HEALTH &o.l ni OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair (p/f Upgrade ( ) Abandon ( ) - 1?K-mplete System ❑Individual Components g 3 �v�� Cwr3 Del ✓� 1Q,tt�A2►� S�"P Locat`'on Owner's Name CL01-4 be/09- Mapfflfarcel# Address Lot# Telephone# b11,4it'fT� �e�'f�Pi'�t✓IDS ^; t Installer's Name Designer's Name 2jssr�� Sr. A-1, dy114. M�k ddress Address �+-- .s' Telephone# Telephone# Type of Building: 1?"i bC t-I'n AL_ Lot Size-201 9049•f' Sq.feet Dwelling—No.of Bedrooms 3 Garbage Grinder (N0 Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) 3�gpd Calculated design flow 3 30 gpd Design flow provided ? 0 gpd Plan: Date257 MAa Number of sheets Revision Date 2</kA4e Titled} LAeT-6jr 54-avv1Ne�092dno vPc,ekDg c>t%- 6stow-r b S Description of Soil(s) SAIA Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation d�' P 2-06 DESCRIPTION OF REPAIRS OR ALTERATIONS" -Aho o reo*uv r Kvls'n M Poat-S 1500 G a _CaPMti T?1r 7»7- b ` To 2 t►i D,nE24Vf& tJ( t o E 14 WM.t-u TX !=J& r+f M _IPA�CttC— The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 a agrees not"ce the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspects FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 q No. I�-i,1 THE COMM-0NWEALTH' OF MASSACHUSETTS FEE N5i " .., BOARDFIEALTH OF 15d4, N S rA GL,tr— . APPLICATION FOR DISPOSAL SYSTEM.,CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair (yf Upgrade ( ) Abandon'( ) - ERI-C-11omplete System ❑Individual Components g 3 4?6y t4 Tw-y ei-o a ?het ✓L R)4-JIA2 G 56rr V ty Location Owner's Name 349:01 0 % 3 -Q v M n2 r CLLJ1;5 be/t/42- Map/lfarccl# ^Address Lot# Telephone# J rv� Installer's Name Designer's Name "t61'q.reu I l Kid ssr4c. Q- RL'v-A4 aid T-7! M Address J Address 7 5- 5;,A I+- kn`/, 50? -9e1:7-l l S S! :. Telephone#" `,� Q Telephone# Type of Building: Ric j big r-1 T1/'rLr Lot Size-O,45030 Sq.feet Dwelling No.of Bedrooms Garbage Grinder (A0 Other-Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) gpd Calculated design flow 3 30 gpd Design flow provided :340 gpd Plan: Date'25 MA to -Zoo T Number of sheets Revision Date 2!5 /AAO- Title- rrg UkYaor P2aPtL-C - l:swlnl<, P2o(ao��VPt���l�° b� nSc.tw9° Description of Soil(s)/t„ LDS - ' �ty Soil Evaluator Form No. TName of Soil Evaluator �_ P. 2 E` Date of Evaluation +<�' • 7. oa'-r D.ESCRIPTION OF REPAIRS OR ALTERATIONS A j�j/tA Nib 0 6 tG 12 0-rM eVC., F-r.,sp AEI G C!9 Ss PA al-S I VLA-L 0r-t The undersigned agrees to install the above described Individual Sewage Disposal.System in accordance with the provisions of TITLE 5 and"fu'rdier agrees not to plpce the system in operation until a.Certificate of Compliance has been issued by the Board of Health. Signed M Date '3 Inspects FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. �(J5 r�0 ` THE COMMONWEALTH OF MASSACHUSETTS FEE (�I�iS7" C�aI BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired(v4pgraded( ),Abandoned( ) by: � l at G13 ddo.-4-ne Ci-VO be ►/P.. has been installed in accordance with the provisions of 310 CMR 15.00 Title 5) and the approved design laps/as-built plans relating to application Noo G° dated �� j Approved Design Flow` (gpd) Installer --;� Designer: ' & Inspecto� �.,.-"�- Date `- The issuance of this certific to shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 l No. �)C0 5 -/09( THE COMMONWEALTH OF MASSACHUSETTS FEE �00 I�,QQHSA&X, BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair (Upgrade Abandon ( ) an individual sewage disposal system at JI as described . in the application for Disposal System Construction Permit No. .�C)C,S fU dated 3 ?10-5 Provided: Construction shall be completed within three years of the date of thjs..pe�it �H-localconditions must be met. Date Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON Town ofBamstable K°F Department of Regulatory Services r • Public Health Division, Date T � �o q • .xutarneis MARML 3 e� 200 Main Street,Hyannis MA 02601 Time 0' iv► Fee 1Pd. 0 Date Scheduled �` O ,. _ Soil Suitability Assessment f®r Sewage Disposal Performed By: L- Witnessed B)r �✓�r LOCATION&GENERAL INFORMATION 11"- Owner's Name S�4n Location Address �.3 C�n�M CI J J '�e / Address, �Inrns�a�le P� Assessor's Map/Parcel: 3-5-0—62 g t Engineer's Name 6 NEW CONSTRUCTION REPAIR Telephone# S-U b' 7 L/7 /1 Land Use RGS{A sebst—tom_ Slopes(%) d — 5 Surface Stones *PX Distances from: Open Water Body' t�+� ft Possible Wet Area_Bki*_ft Drinking Water Well _ft= ._ Drainage Way 66 4' ft Property Line l6 i ft Other ft 11 A SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Parent material(geologic) I LP_ Con cpllt r.wo k� „ ` Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WA'TICI R T"LE Method Used: Depth Observed standing in obs.hole: _ - in. Depth to soil mottirs; ln, Depth to weeping from side of obs.hole h), Groundwater Adjuskmenk fL Index Well M 1 U 2yNeading Date: //-26*Vglndex Well level T g Adj.factor, ,2 - Adj.Grouudwater Level��•�-��' PERCOLATION TEST Date NY& Time •�/y30. _ Observation Hole# 0 D 3 Time at 9" t•�PZ Depth of Perc I'$'7!o Time at 6" .... Start Pre-soak Time @ I I:ZZ Time(9"-6") �- End Pre-soak Rate MinJlnch 3 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. r Q:ISEPTiCtPERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole#J-!2�L- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i tenc %Gravel o t I �o - 5 b L°YR *V3 �izab1 S' G2 SM0, tom ' Gd �k ►► aQ o-a !o DEEP OBSERVATION HOLE LOG Hole#—�. Depth from Soil Horizo n Soil Texture Soil col or Soil Other DA (Munsell) Mottling (Structure,Stones,Boulders. Surface(in.) (US ) • on istency.%Gravel brw 9 4*yy AMb -.fro On 1 lea, DEEP OBSERVATION HOLE LOG Hole# 0(.- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munselp Mottling (Structure,Stones,Boulders. Con''s--isttenc %Gravel �w d 3 A LtaArrwY SA-Lib ! ! 1.,oa-( SANK to 9 - CZ DEEP OBSERVATION HOLE LOG Soil Other # Other Depth from Soil Horizon Soil Texture Soil Color Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. WEM. E Flood Insurance Rate May Above 500 year flood boundary No_ Yes Within 500 year boundary No V/. Yes / , t Within 100 year flood boundary No v Yes Depth of Naturally occurring 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? Ye I -- • . If not,what is the depth of naturally occurring pervious material? ,.,....:� Certification I certify that on 10 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required.training,expertise and experience described in 310 CMR 15.017. Signature Date g 2ftl Q:\,SEFTIGII'ERCFORM.DOC Town of Barnstable I"E T° ,> Regulatory Services Thomas F.Geiler,Director :_ , + BAMSTABLE • - MASS- Public Health Division { N i639 �m Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 .. _. Fax: 508-790-6304 Installer & Designer Certification Form Date: Z 2.vo Designer: k7"C_ c4ekc ?le, Installer: Address: . 65 Gc 1 *tt t Address: 5 S(114 2o6�' P, I wow D 23(0� �, '"�,_a �t' /Y.A On 3 MPv� 20jq-,J'*� YC was issued apermit to install a (date) (installer) septic system at �Vn, Gdwb k dhi based on a design drawn by (address) dated 40 S (desi er) . V/ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. ' I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. SH OF,,, n,q., q , PAUL c�c a EDWA N� AR N. (Installer's Signature):,, iv 4 _ c N 4 7 F; NAL s y' t ' ' (D signer's Si afore) (Affix Designer's Stamp Here) s PLEASE RETU�4TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. -� Q:Health/Septic/Designer Certification Form TROY WILLIAMS SEPTIC INSPECTIONS Certified by MA Department of Environmental Protection 1 3 19 (508) 385-1300 19 Hummel Drive rOwN pF 91 South Dennis, MA 02660 S4 Common wealth of Massachusetts Cr U Executive Office of Environmentai Affairs x epartment ®f Environmental Protection William F.Wald oowmw - Trudy Coxe Argeo Paul Cslluccl David B.Struh Convrisdorwr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION / 'I Property Address: / 3 L(i•J N L ✓D I,�^. C S �C % , ,' ,N h ��G k/G 7 •�a,✓.at Address of Owner. j Date of Inspection: c/��[)// c� 7 (If different) �O D"� "( V-, .bG Name of Inspectort�v yy L.l; (�: f //3 a✓{` ,q,J� 15 Company Name,Address aifd Telephone Number. / CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: / S Date 7 The System Inspector shall submit a copy 6f this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A B, C,or D: A] SYS PASSES: - ve not found any information which indicates that the m viola - system tea any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: /V`i, k One or more system components need to be replaced or repaired. The system upon completion of the replacement or repair,passes inspection. Indicate yes, no, or not determined(Y, N,or ND). Describe basis of determination in all instances. If"not determined",explain why hY not) The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a Conforming septic tank as approved by the Board of Health. (revised 11/03/95) t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A /CERTIFICATION (oontinued) Property Addre" 93 C oo y.4--, Owner. 3/' L k le— Date of Inspeo.on; V/,2L//7 7 BI SYSTEM CONDITIONALLY PASSES (oontinued) / V /' / Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(#) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(&)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions'ezist which require further evaluation by the Board of Health in order to determine if the system is failing to protdh the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface wafer,., Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3) OTHER (revised 11/03/95) 2 i� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 3 CO'j / C ✓4 r , Owner. / L k Date of Inspection: -7 DJ SYSTEM FAILS: ^/d//� I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for failure. this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the Backup of sewage into facility or system component due to an 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 1/2 day flow. Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipe(s). , Number of times pumped Any portion of the Soil Absorptidn System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: A111-9 The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the m is a s health and safety and the environment because one or more of the following conditions exist: system � significant threat to public the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface r drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (1WPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 11/03/95) 3 " SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Addresec 9 C_ap/v h f C 1 J �r . Owner. L Date of Inspeetion: '1/-2y^ -2 Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. A/j�?As built plans have been obtained and examined. Note if they are not available with N/A. YlThe facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste now ZThe site was inspected for signs of breakout. - All system components, excluding the Soil Absorption System, have been located on the site. / A The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge,depth of scum. 6/The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. V The facility owner(and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTE PART C M INSPECTION FORM �y ? SYSTEM INFORMATION Property Address /J C—a 1111 i-✓y C(v� 01. Owner. Date of Inspection: I Y/ay/? RESIDENTIAL: FLOW CONDITIONS Design flow: 6 2211ona Number of bedrooms:oC Number of current residents: Garbage grinder(yes or no):_O Laundry connected to system(yea or no): VAE S Seasonal use(yea or no): //V Water meter readings, if available: 6 _ y uu O Last date of occupancy: V 1.L-C�-h COMMERCIAL/INDUSTRIAL• Type of establishment: Design ilow:_gauons/day Grease trap present: (yea or no)_ Industrial Waste Holding Tank present: (yea or no) Non-sanitary waste discharged to the Title 5 system: (yea or no) Water meter readings, if available: Last date of occupancy: OTHER (Descrbe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: /Vu {11 pumped as part of i v ystem nspection: (yea or no) /VO It , volume _ 9� l�k�� _______gallons Reason for pumping-. TYPE OF SYSTEM Septic tank dktribution bca/soil absorption system Single cesspool �c Overflow cesspool Privy Shared system(yea or no) (if yea, attach previaus inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: y�y i ex uj Sewage odors detected when arriving at the site: (yea or no) /VO (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (oontinued) Property Address q�3 Civ fr,7 G f v �v Owner. Date of Inspection: y//aLl SEPTIQ K: (�7 TAN (locate on site plan) Depth below gra&: Material of construction:_concrete_metal_FRP—other(explain) Dimensions: Sludge depth: 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: Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) r GREASE TRAP. I� (locate on site plan) Depth below grade: Material of construction: _concrete_metal_FRP—other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or battle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage, etc.) (revised 11/03/95) g SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: 73 Owner. Date of Inspection: (J / TIGHT OR HOLDING TANK:-II1/9 (locate on site plan) Depth below grade: Material of constriction:_concrete_metal_FRP_other(explain) - Dimensions: Capacity: ¢allons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:LV/� (locate on site plan) Depth of liquid level above outlet invert: ' Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER: IV /9 (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Addr ac 3 C-6 0 4 L 1-ry Owner. 131 `k l e- / Date of Inapeotton: SOIL ABSORPTION SYSTEM (SAS/h� (locate en rite plan, if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present, explain: leaching pits, number:©-.e- !? �tr L e-ram- leaching chambers,number._ leaching galleries, number. leaching trenches, number,length: leaching fields, number,dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.) -So'. W L d) 6, 01-0 C_.k C'jKJ a t Iti+wr Ck �. CESSPOOLS: (locate on site plan) Number and configuration: D"t vti uc�a o 1 Depth-top of liquid to inlet invert: 6 Depth of solids layer. 3`� Depth of scum layer. /Va-/V/- Dimensions of cesspool:_ ' Gl Materials of construction: c-w y -3- c.o , c.r c J- Indication of groundwater: ND NE' inflow(cesspool must be pumped as part of inspection) �Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) o c� �.�s r�stv.� o..% Opt ✓�1.� &. - 3 h o !� �1 I L �e-� c�✓ o (� /trs. I wLrL F I1., Spcc.fjo�.. K PRIVY: (locate on site plan) Materials of construction: Depth of solids: Dimensions: Comments: (note condition of soil: signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 11/03/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 93 C o✓�. ,� C v 6 Dr, Owner: 6; r Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to at least two permanent.references landmarics or benchmarks locate all wells within 100' c2V /+4� � A oEPTH TO GROUNDWATER Depth to groundwater: feet — adjusted high groundwater level jvthod of determination or approximation: h o2 „` o �� t. L.�S o r.✓� h a LAJ 9 j ;. TOWN OF BARrNSrT_ABLE LOCATION �l+���' C b SEWAGE # J VILLAGE �'.` ASSESSOR'S MAP & LOT . 0 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /.S® LEACHING FACILITY: (type) 'LN (size) NO.OF BEDROOMS / BUILDER OR OWNER �' 4A. ` PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist ' on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist " within 300 feet of leaching facility) ; Feet Furnished by 22,10 �" �-..• '���I � /. � , �a rr " r I I I I I I proposed ROOF 4 I PROPOSED NEW MAIN ROOF 6 SHED DORMER ADDITION S1 I S2 � 4 4 36-10"+L f I 3'-G" 5'-O" 8'-O" 6 1z --- O O b B O O existng ROOF Va F SKYLIGHT __... prop. \ / Z m BATH L__v__J n r(; < -- ---- ---- ---- ---- ---- ---- - .. _________________ ._ 3 1-____________ z m L REMOVE IXI5T KNEE WALL m i0 W 0: 2 a Z 2 exist./enlarged � �r=� � L' z exist./enlarged � BEDROOM#2 0 �� \ o� �b BEDROOM#1 UNFINISHED ATTIC / REMOVE IXIST.WALLS,INSTALL q 55 CENTER A R.RIDGE ABOVEDOORS 8 w' F-T—I b NOTE: REMOVE EYI5TING ROOF ___1=111 T REPL WIT H TH NEW: n n W G 200 ROOF RAFTERS®I G'O.C. ———t KIJEE WALL 'L— W/STEEPER I D 12 ROOF PITCH _-------_— -- O REMOVE -------------1 4l AND REBUILT U15TING GAEIE WALLS ------ ———— ———— — — -- -- —IXISTIJG---,J-L--------- (� PROPOSED SCREENED IN PORCH ADDITION PROP.4'KNEE wnu t KNEE-ALL L Y/J Z_ _ __ ,!,In,ROOF W,^ W PROP.4'NJEE WALL Ih -- ---------I �E�a/0 y m -- ---------I------------ ------ IL `a I '------- y � m u L - ----� O N o m Is S3 p 0 _ proposed 4 SHEAR WALL NAILING PATTERN(X-O.C.) ¢ d ifa existing + WOOD DECK SCREENED IN PORCH CUSTOM SCREI PAJES proposed EDGE NAILING SPACING o IXISTIIJG BULKHEAD 24'"a WA. ON OUTSIDE SHOWER SECOND FLOOR PLAN v X Inaan new eonatuEoslrooJlnpa an4 — support bea.rm,soe fouMaYon plan 12 FIELD NAILING SPACING 1/4"=1'-0" -STING WALLS _____ DEMOLITION NEW WAILS INSTALL NEW HEADER ®IX15T.51-DING DOOR: u SOLID WALL (2)1 3/4'x71/4'LVL DO 3K21 3K•2J Q W/IJEW KING t JACK 5TUD5 -—CLOSET D BREAKFAST WINDOW&EXTERIOR DOOR SCHEDULE o BATH BATH w❑ KEY ROUGH OPENING W x H ITEM# STYLE MATERIAL O DINING O 2'-61/6'x 4'47/e" 3U`x52' HARVEY 616DOUBLE-HUNGNANDOW WMITEVINYLClAO QQ O2-61/8"x 3'-07/B" 3dk4V• NARVEY 6MDOUBLE-HUNG WINDOW NMITE VINYL CLAD c I C 44 3/4••X 46 7/E" 606 VELUX VENTILATING 6KVLIGMT O W u ® DOUBLE-HUNG WINDOWS-GRILLE3 BETWEEN THE GLASS HALL �® I Z �® m W m « 0 > KITCHEN Z. p MASTER BEDROOM a IN m GARAGE m �' J II cV9 > g I Z 11 o0 LIVING PORCH . W C l a C 0C V O m G ULL U w I D a 1= DATE: 05/11/2015 SCALE: AS NOTED existing/proposed FIRST FLOOR PLAN DRAWING#: • va"=r-o" A2 4 -- Commonwealth of Massachusetts DEEP OBSERVATION HOLE LOG 104 (- 2. TOF OF END. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-2 Barnstable, Massachusetts Other (.� ENEKAL NC) -rE !3 I I . . . . ELE\;. GO 00 . . . . . . . . . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * I Soil Suitability Assessment for On-site Sewacte Disposal Depth from Surface, Soil Texture Soil Color Redoximorphic (Structure,Stones,Boulders,Consistency '+, 1 . ELEVATIONS REFER TO AN ASSUMED DATUM (TOP OF FOUNDATION- ELEV. GO.00). (A551LIME-D) NOTE: Performed By: Paul Carey, P.E. Date: 8-Dec-2004 Inches Soil Horizon (USDA) (Munsell) Features Gravel) ALL PIPING SHALL 5E 4-[NCH 5CHE). -40 RESTORE EXISTING PVC UNLE5 OTHERWISE SPECIFIED ON P. ALL CONSTRUCTION TO CONFORM TO TITLE 5 OF THE MASSACHUSETTS STATE C . I I . . . GRAPE . . . . . . . . . . . . . . . . . . . . PLAN . . . . . * - , . . . . . . , * , * , ' * . . . . * . . . * . . . . . . . * ' . . . . . . . . . . . . . * ' ' ' - - 0 Witnessed BY: Donna Miorandi Health Inspector ENVIRONMENTAL CODE (3 1 0 CMR 15:00) AND THE BARNSTABLE BOARD OF HEALTH. ,C). . . . . . . J�57_90 I . . SIET CODERS TO-W.ITdIN i - . . G SOUTH .,. Or FINAL GRADI LOAM 4 SEED ALL RESTORE E,<15TING SEWER - ��. "', i-­-, DISTURBED AREAS GRADE P,f-STORff EXISTING GRADE IT -I _X "-1,1- ..Tf�l 1,, � - 21,� ,FIT ,f..-T �.`�.11_ "� -1 li`_ U'1­11T - SEED ALL LOAM * SEED ALL "''11 � L= ,ii,i, LOAM ,r 3. IN CASES WHERE LEDGE OR BOULDERS ARE PRESENT, WASTEWATER ALTERNATIVES, ,I I t�,� PISTI.)KDEDA,Rt�A�5 . . . . . . . . . . . . . . . . . . . . . . . Pl!�5T�JRE3.El? AREAS.. . . . . . . . . . . . . . . . . . . . . . . . . 58 DEEP OBSERVATION HOLE LOG 101 I I I I I - I . . . . , j :��a,iT�� � "I I ,1­111- I.- -,Ii­-�T1--'i,i,,._ j",_.i - T COVER . . . . . . . . I 55 , 1 7 4��­ ;1 , ":--�,���,i-�-,�i..-.-�,.�,-, .1 - 5E ,TO L.C., WILL NOT DE RESPONSIBLE FOR THE AMOUNT OF POCK ENCOUNTERED. — �, � , ""�,�_�, I . �. _� "D, ,��i 3 ­� W 4 - — , _L� - I � I I .1"'ff,� �71,1 4 - _- - _ 11 11 1. ". i- _`J;.P1 ��i )rF­"_h"M-,,r �T,� WITHIN G" OF Other I,- _. ­__­� . .1 NORTH _. L�35, NA7TVE..'5A�C�r,rf4:L ' :-,,, ,1.­_ ­- " FINAL GRADE �'JJI\j FIRST 2-FEET LEVEL f � ��, , 11 Depth from Surface, Soil Texture Soil Color Redoximorphic t8tructure.Stones,Boulders,Consistency,% -4 -ONSIBLE FOR THE PERFOFwANCE - _,_,_____", 11 - . �.- � I., I- I'll 1. - _"I__­ -- ,I_ I I , �, . WASTEWATER ALTERNATIVES, L.C., WILL NOT BE RESPONSIBLE SEWER, � .-__ I- ,ip -­�,l� ,,,,,,�,'' �� � ,_ ,� - ).; ", ��, , ,"lh,-g,�,�,,,1'. ,I,,,'- , "�', " Inches Soil Horizon (USDA) (Munsell) Features Gi -_-1 ,- I I I . I 1 5 - I 11;�, _', . 'e,", , 1�1 C. . . . .. . . . . . I . . . . . .",�1.11 111-1 I'll 1___... � r.,,.�,�f,,,,�'.�P'-"�,,'-�,;-�:�i , - . I � I. . . . � . . . . . I '3��Ij�-�,�11 i��. . " . � I - ­ � 5G _3LI—,_,.,�%. . . , " j� � I I oi�±T7=777i . ­ �Z:l . - - ."� - - - - OF THE SYSTEM UNLESS CONSTRUCTED AS SHOWN. ANY ALTERATIONS MUST BE � -_� �'� , " ,� � .0.4 ­�i 1 r"', I. �'!�_� . ,.4, .11 1.11 1��,III.1..11... � ;,-.I ,I 1�1 � '- : � ... . . .. . . . . . 1,,L,)i�'J�1��,�­1 �_ -I I � I— �,�6­4­� -I -I I I I....��I ­�'_ I'�, .. , L�23' , IC_ 11 1.1- .. � I I "I I, - I � , : , APPROVED IN WRITING BY WASTEWATER ALTERNATIVES, L.C.. r `-,�,<',:,� "�,,`��,��, ­----- I " :_._­11"� N/VTIV�- F'4CI`_,1 If I I I t L '­ , "" , , '', , "",I, 0,1_1111 A Loamy Sand 10 YR 313 HOLE ABANDONED-NOT SUITABLE TO 5-FEET ,, I,-� .;,, "" e ; _= ___�j L=23' 5� 1 1 i 1(�,-,,�­,­­ I _--.-- F �, '', ; , , , '' , ,_<'I'. . . - - -1 I , ,, 11 1, "<�,,, 7 __ L= I I .1 I -" I I I : F . VIDF M(-)DffL Al 12 � _�-0.02 . -1 . ­- J 1�11_1_� ,­ I I ­ �- I I ,> ", ", I I 1-1 I "I �'11v ' ',.� � ZAi CF)o �,_1111 �1 ,4.��I i ,,, , � I � I 11� 2 4,-,i ­4,, "...... - , , - - ' _y - I ­ ­1 1. I . . I . . I � -�-; 'AN'D' , 1��11 �I - , - � _ I ,"I", 54 11"-39" FILL @ 39" " - ," 5. PURSUANT TO 3 1 0 CNAK 1 5.02 1 (3) THE DISPOSAL SYSTEM IN5TALLEP, 15 REQUIRED � " . I - I I-1 il,,, Ir 1 , . ,1 ,� ''I , -�i�`� " ,��',�, . I I I 111'� I �I 11 I I , .- 5 , I "" ,� ,,,,,, I � � " �11'111'1'11 "If- - ,(NO-i F1 FLJ F.1,�_-) . . .� . I -I I- I I I . I� - ," P, I I " 11 I—_ -11 I - 1)­ I TO CERTIFY IN WRITING, ON A FORM APPROVED BY THE DEPARTMENT OF ENVIRONMENTAL , ,1�1�., 1-1­��.� ,� ,y, '. - I I - I I -1 , � 111� 1 I I I 51� 5-4 - - - . . ,.1� . , 11 I NLffT Tffff ��, - -- __ - _____-I—-___- [:41__1kRC-RArE '3 miN, 1114 , ?. MIN. J 0''BELOW "­­ �__11,1.1/­"'i-, � '�1�01- 5,34 :,� ,,, 11 I I , 11, . .1 ­1 ­ -�- � ,;,.",_ I I, - I fl-P I I I ­,�,I ��41,41.,,�,, I I . I I I 1, I I I "I , , , - 11 I I 11","r,I . -1,""',",1,­, 'I'll I , - _Nq,fl,"0�", I - I I I 11 39"-65" Cld SiltLoam 2.5'�/5,-1 firm FKOTECTION. THAT THE SYSTEM HAS BEEN CONSTRUCTED IN COMPLIANCE WITH 3 1 0 . IN ff. * I 1,11"1�11 I ,P I� ,41, 1 ""',,"" �. � , , _ 11­1 I , I - I I � 1­­1X/'* I"-1 I,AN�, 11, 1 4 i L � � ;,,. 11 , L I 11Y>.i,/�, " � , , .� I , , , ,,:,,��,,,�1111111.11/�1111 ___7 7�71117 ­ ��,,,�, , , � - CMR 15.00, THE APPROVED DESIGN PLANS AND THAT ANY CHANGES TO THE DESIGN I ", U�­ 11 I . , , /,�)'­ 11 , PROVIDER 5C"D 40 , ,,,'V,,�<�,,',,,.��,,��',�,'.`� 1 3 1 .2 5 I ��'. . � . , � , � � � . , L . . . . �- .- IF !=.5 .50 , - � ­.1 I 1. � . � . .� I . I I I . . . I . . I . I . I I . I I .I 4 C2 10 YR 714 edam.� , ,,11,,,-,.',�,, � -� , .11��'---�,­­-',1.7 1 1 1 1 1 _iA[110 I I I - - I I - - 52 52 - - - - . . . . . . I'll. .i FICPIF10#11�-T!Ei�ji 0RT. I . ,'I,�> ,,, " i'����,:,',�� , I . . � . . -:7 1�,`��,!.�_3��,' , I-,". ­' __ . I�� I LJ N Dl'�-��J KDtfD I I � 65"-78" Sand PLANS HAVE BEEN REFLECTED ON TI-IIE RECORD DKAWING(S) PREPARED BY THE DESIGNER. . . -� I I ���_��'e"/,I It'" - I _A gjjTPC_C,1, ,4 I PROVIDE MIN. I 11 I I I I LAK-f" , , 1, I I �,:�' I,- I 11 I 11 I , . ­--­7-­-,-­-­­­.'-.,- I 1, I ­ I'll'' , I I • I - !7 G" GRAVEL BASE I G. SUBSURFACE COMPONENTS OF THE SYSTEM SHALL NOT BE DACK'FILLED, OR - i ',�,�" . ���­- �.� . . ., . � . ,. . , � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I - , - - . . . . . . . . . . . . . . . . . . . I . � . . . . . . . . . . . . . . 50 * , ' ' FK-)110311ED C ) TL ET P E3-) I I I I I I I I - I I PROVIDE MIN. G�,,,,�, ,, " ,- "I I I OTHERWISE CONCEALED FROM VIEW, UNTIL A FINAL INSPECTION HAS BEEN CONDUCTED , ,�,,�,,"I",,,­,�'­� __" , ­;�,­, c 5-L L.1 - .CX I, , �5.1 -j— PERMISSION HAS BEEN ", ,,_,-,�', ��Z .,,-,, � I SIGN ENGINEER AND THE APPROVING AUTHORITY AND F'FP,MI - ,_/ ,"; , -11 I ,_ . . ''I 11 I BY THE DESIGN\�,,,;­�",4�, ," , , ,, 5 . ", ', '?,`,"'1; � .1 -_ 1,"I,, , - GRAVEL BASE �:: ,� 11, ,,,�,,,,,,,""",""�,,,���"""�,.�, ,,,,��n,',",, X�,, - ,�­ "I I � _;,�_�_ F'051LOCK IffIND CAF' 7.3' L I ----------I-4',5 GRANTED BY TI-1F APPROVING AUTHORITY TO 5ACKFILL T1­-IE5Y5TIfM. ITISTI-1E ,A�­ 810, - CAVING 481 - I I - I . . . I . . . . . . . . . . . . . . . . . . . . . I . . I . . . . . . . . . . . I I . I I . . . . I . . . . . . . . I . 11­1­/�l . .1 . . . . I I . . . . . . . . . . . . . . . . I I . . . . . . . . . zl-e� RESPONSIBILITY OF THE INSTALLING CONTRACTOR TO NOTIFY THE DE51GN ENGINEER AND SYSTEM I P- I oc� , , * * * * , * , * Parent Material igeologic) Ice Contact Ouftvash — Depth to Bedrock: - rK0F'0'_,-EP 1,5 0 0 O-ALLON 0-El"'TIC TANK '_--Yc_--TEM F'KL)FILE . 52.88 HIGH CAPACITY INFILTRATOR.CHAME3EIRS, Depth to Groundwater standing Water in the Hole: Weeping from Pit Face: _ THE APPROVING AUTHORITY AT LEAST 45-HOURS BEFORE ALL OF THE FOLLOWING C-CALE: 1" = C-' . I I 5-EACH FER, 2-TRENCHES F'051LOCK END CAP REQUIRED INSPECTIONS: -4r. . . . . . . . . . . . . . . . . . NOTE: -IT-15 THE RE51"ON5151LITIr'OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . * . . . . * . . . . . * * ' . . .1 1. . I . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . .4G Estimated Seasonal High Ground Water THE INSTALLING CONTRACTOR TO Notes a.) TO INSPECT THE LIMITS OF EXCAVATION AFTER REMOVING ALL UNSUITABLE MATERIAL ENSURE THAT THE SEPTIC TANK 15 1 I ,C;I __�__L 44.7 15.0 ;ESHGW(ffRIMFITER ADJ.) L-- I I I t I I DEEP OBSERVATION HOLE LOG 105 Off NECESSARY) FROM THE AREA Of THE 501L ABSORPTION SYSTEM. WATER.-TIGHT AFTIFFP� INSTALLATION CAVING 15-4 . . . . . . . . . . . . . . . . . AND-FK(OR T-O-U!5F.. . . . . . . . . . . . . . . . . . . I . . . . . . . . . . I I 1 4 1 1 1 1 1 , * . . . . . . . TP- 1 03 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Other b.) TO INSPECT THE INSTALLATION OF THE 1 ,500 GALLON SEPTIC TANK, FOR DEPTH OF j: 111�`Ylq,W`111�,4.1w,01,M1�. ,13Mmii, Depth from Surface. SoilTexture Soil R�djyinialplhic 15trurture,Stones,Boulders onsi,,i, INLET TEE AND INSTALLATION OF THE SPECIFIED EFFLUENT FILTER. IT 15 THE 1�no-11 �'�,".���,'�(,�,'I�,����,",,5��.��C' � � RESPONSIBILITY OF THE INSTALLING CONTRACTOR TO ENSURE THAT THE SEPT C TANK S �117 , , ,t�,,,,,,,�"M _F­',� � � , �", M .". Parent Material igeologic) ice Contact Outwash Depth to Bedrock NIA �1'4',ff,,%A, "t"I [,'.��i��,V,, ,,'�jm I , - S I G N C R I T E R I A�`�"`�""` 1�. _�,' Of f LI�D_',�, , , - - 5 DE Ili 'S­­11­� '' ," � , . WATER- * EX15TING F`P,0P05ED A5-BUILT FLOW FOR 3 BEDROOM DWELLING G2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G2Death to Groundwater: an i afar n e e: NIA vVeeping am I Face . NOT WATER-TIGHT AFTER INSTALLATION THE INSTALLING CONTRCATOK WILL BE REQUIRED IF IT IS DETERMINED THAT THE SEPTIC IS TOP Of FOUHDATIOII: 1i ____ - —— Estimated Seasonal High Ground Water 39"-Redoxim orphic Feature s _­_ - -__ - USE: RESIDENTIAL ONCE INf`IL_TRATOR.CHAMBER Notes: TO REPAIR THE TANK ONSITE TO THE SATISFACTION OF THE DffSIN ENGINEER AND THE SOUTH 5DA/EiR,INVERT AT DUILDRIG: 57.90 57.90 _____- - __ HAS BEEN INSTALLED E5ACKFILL LOCAL APPROVING AUTHORITY OR REMOVE THE TANK AND REPLACE IT WITH A NEW NUMBER OF BEDROOMS: 3 GO - . . . I . . . . . . . . . ''IffITH'CLEAN GRANULAR'SAND. . . . . . . . . . . CO DEEP OBSERVATION HOLE LOG 102 WATER-TIGHT TANK. IAORTh 5EVVER li IVERT AT E,UILDING: 5G.70 5G70 DESIGN FLOW: 1 10 GPD/BEDROOM____ . _ AS SPECIFIED IN 3 1 0 CMR Other C.) TO INSPECT THE INSTALLATION OF THE INFILTRATOR H- I 0 HIGH CAPACITY ______ ___ -- - 5FPTIC TAI 11i- 11 ILET: 55.21 TOTAL DAILY FLOW: 330 GPD 2.55. Depth front Surface, SoilTexture SoilColoi Redoximoiphic (Structure,Stones,Boulders,Cons INFILTRATION CHAMBERS. 5EFTIC TANK- OUTLET; 543G GARBAGE DISPOSAL: NO 55 1 ' ' * . . . * . . . . . . . . . . . . . . . . . . `2F­5TOF� F�XI,5TING.Gfii - 51) Inches Soil Horizon (USDA) (Munsell) Features Gravel) __ ___ LOAM * SEED ALL D-BOX - INLET: 54,50 ------- /_ D�15TUKDtfD AREAS 7. NO CONSTRUCTION SHALL TAKE PLACE UNTIL A DISPOSAL WORKS CONSTRUCTION OUTLET: 54,33 SEPTIC TANK , - _ - 1 ,� " , I I I--1­11 HOLE ABANDONED-NOT SUITABLE TO 5-FEET PERMIT HAS BEEN ISSUED BY THE BARNSTABLE E30AP-D OF HEALTH. , '. I " �,� :­,:,7���I�,"I Y­­ "�Z,�� � - I , ­- I I , .�r-,�l'.�,l��. ,Ir.'r,;rl_"�f ��' ��,��11.,::�,:�, 'I., r. - 5G - - - ­,,',,,,,,N,� . . . . I I . '. � , . I ,-:;�;­O'\",�', ..H . . . � _I. '.�., I ,1;''� , . . . 5G ., . - I 1'�,�,N��.,,,�_ 1- 11 . 1- I INFILTRATOR H-I 0 HIGH CAPACITY CHAMBER TRENCH ELEVATION5 ��,,,5',,, I ��,",., 200%OF TOTAL DAILY FLOW . ""","I '"COMI"A-TffD �',,,,,",­­ -00N4F1AC_T-E`0 � - : , 8- THE PERIMETER OF THE SOIL ABSORPTION SYSTEM SHALL BE STAKED AND FLAGGED, "I, -0, 1 1 , ,�':� ,- I �,�,, I ' I � �­�,,7 -15AClr��,'iLL �' 1, IHFILTRATOR INVERT: - 53.50 660 MIN. ," � E�ACKf L - ,-, �_, I FROM THE DATE OF INSTALLATION UNTIL THE ISSUANCE OF A CERTIFICATE OF 2 X 330 GRID: , - ­ 1. , I I , BREAK,OUT: 53.50 1 1 . 1,_0�"_ . ",:�.�,, , �, _.. .1 ''1�,�. 0 " . , - " ---------- USE 1,500 GALLON SEPTIC TANK 54 - - - - ',"':, - -I�, , I . . I 1� I � ` �.,�,I.''. . . . 54 COMPLIANCE. VEHICULAR TRAFFIC AND PARKING, STOCKPILING Of MATERIALS AND e I_,'111 I �', 1� ,� '' , 1�1'/,"­','�r'_��, I ,,.��,�,,__ ,� , ABSORPTION SYSTEM SHALL BE PROHIBITED AT , I" , "", ��',,,,,�� STORAGE Off EQUIPMENT OVER THE 501L ABSOF, ,, , ,_,� , ,�, ., DOTTOIVI Of 5Y5TF[,,I: 52,85 " , I-)N D,-,I LJ ii LD vl�l , _ , , , I 11 I I , ,,��', �"" V 11%K I r I I 11 11''. I , ALL TIMES. , ,ATIOIA fROI\4 E511GW, FEET: SOIL ABSORPTION SYSTEM ,�','�', 5EPAP 34.68 ," 1 5�_? HOLE ABANDONED-NOT SUITABLE TO 5-FEET, E5TI IdATED SEA501 AL HIGH GROW I D'A'ATEP (E511GW); 18,00 52 - - - - I . . . �. . . 1. - , .I ' �'I I. . . * , " * * , *' , * . . . 1, , , , , , , .11 I 11- 1� LEACHING SYSTEM USED: INFILTRATOR TRENCHES I I 11 I 0. LOCATION OF ALL UNDERGROUND UTILITIES SHOWN HEREON Is APPROXIMATED AND 15 � OUI,ID',A/ATFF`,E_5T1t,A,'kTI01 I E,A5F0 ON F`P,if,jPTfP ���,,,Tf--103 1 1 1 1 1 1 1 1 BASED ON FIELD LOCATION OF VISIBLE STRUCTURES SUCH AS CATCH BASINS, 11 , — SOIL CLASS: I SAND . 34"'. 8151. - 34" -) MANHOLES, WATER GATES, ETC. THE CONTRACTOR SHALL NOTIFY IN WRITING ALL UTILITY FIELD PERCOLATION RATE: 2 MIN./IN. 50 - I I I . I . I I . . . . . . . . . . . . . . . . . . . .Dc COMPANIES AND GOVERNMENT AGENCIES PRIOR TO ANY EXCAVATION WORK AND CALL LONG TERM ACCEPTANCE RATE(LTAR): 0,74 GPD/S.F. . Parent Material igeologic) Ice Contact Outwash Depth to Bedrock: "DIG-5AffE" AT 1 ­500-322-4844. TOTAL AREA REQUIRED-LOCAL CODE: 446 S.F. '�, E C T I 0 N . . . . . .iN'i­if_TR.ATi'ON TKEr-�CFI'415 Depth toGfoundwater Standing Water in the Hole: Weeping from Pit Face: I O. INSTALL ALL NEW UTILITIES UNDERGROUND. LJNLF-55 SPECIFICALLY INDICATED TOTAL AREA REQUIRED-TITLE 5: 446 S.F. -4,5 . . . . . . . . . . . . . . . . . . * , , I. . . Estimated Seasonal High Ground Water --- -_ ':- 0 1 L A 13 C-3 0 K Ill 0 N 'E-3 ) '-:- T E M TYF'. FOR. 2-TRENCHES OTHERWISE. TOTAL AREA PROPOSED: 15CALF--N-T-0 OF 5-EACH INFILTRATOR Notes: .- H-I 0 HIGH CAPACITY 4G . . . . . . . . . . . . . . . . . . . . . . . . . . . .CHAMDILKS. . .(� . 4G DEEP OBSERVATION HOLE LOG 106 1 1 . CONTRACTOR 15 RESPONSIBLE FOR SAFETY MEASURES, CONSTRUCTION METHODS TOTAL AREA(i OF CILTEP_TRENCHES x 7,79'SQ.FT./L.F.): 486 S,F, _ 1,5.0 •;E5MGW (f`RIMF'TER. ADJ.) Other, AND CONTROL OF WORK. — __ 'TOTAL ALLOWABLE FLOW: 360 GPD ___ -- '# Parent Material(geologic) Ice Contact Outwash Depth to Bedrock: — Depth from Surface. SjITex1ure SoilColor Redoximorphic (structure,Stones,Boulders,iconsistei 12. REPAIRS AND/OR REPLACEMENT Off ANY EXISTING IMPROVEMENTS DAMAGED DURING MINIMUM DESIGN FLOW: 330 GRID - - 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 - Deoth to Groundwater Standing VVaterin the Hole: Weeping from Pit Face: Inches Soil Horizon (USDA) (munsell) Features Gravel) _ CONSTRUCTION THAT ARE NOT DE51GNATED FOR, DEMOLITION AND/OF;Z. REMOVAL HEREON PROVIDE�-TREt4,t�lfi , -, Estimated Seasonal High Ground Water 0,1_111 0 fibric ARE THE RESPONSIBILITY OF THE CONTRACTOR. REPAIR, SUCH DAMAGE TO THE . '71,;'�;PTWITIR FCHAN7.,7r�-.,;�, ,.",,,��,�,�,,,.,�"""��,,,,,,� "',�,,�', 1, Notes: , _,7 "":77_13_T SATISFACTION OF OWNEK(S). ­ 1 V-91. A Loamy Sand 10 YR 313 NONE friable I V A R I A I — DEEP OBSERVATION HOLE LOG 103 9'-27" 8 Loamy Sand 10 YR 5/6 friable I 1 3. PRIOR TO IMPLEMENTATION, SEEK ENGINEER REVIEW AND APPROVAL OF ANY Z,Q,N,.]�NG NOTES other � INTENDED REVISION OF HORIZONTAL AND/OR VE.KTICAL DESIGN LOCATION OF L. 1_=_Ic_�_ t:-_ r_j Imo" - ,ASSES,SOPS tAAF:1350 I I � I LOCAL C00C k1NVtR& I I I 1:�A � Depth from Surface. Soil Texture Soil Color Redoximorphic (Structure,Stones.Boulders Con�rstency,n4. I IMPROVEMENTS SHOWN HEREON. - __ PARCEL.041 __ ____ P,_��ULATIOIN ___ _ _ . -R - __ - _____,,U Inches Soil Horizon (USDA)_ (Munsell) Features Gra,.'elh 27"-95" C I Sand 10 YR 616 friable,so.silt and gravel THE SUBJECT SYSTEM HAS BEEN DESIGNED TO PROCESS ONLY DOMESTIC SEWAGE fl'-i0: F1 FLf_ 5 TEST PIT LOCATION - ZONE: RF-2 -_ - I(�'Llf�'�,_[_) PROP01", - 0"-1" 95"-84' C2 Sand 10 YR 714 loose 1 -4. T1 1111111111111111111111 AREA:20,908+/-SO.FT. - -_ _ _ - - — n fibric AT THE INDICATED LOADING RATE. THE SYSTEM 15 NOT DESIGNED TO ACCOMMODATE A _]!� __ - FRONTAGE: 125-Fr. ,,, - ------- - - -_ IL- -_ -1: -_ --------- - - - - ­ III-911 A Loamy Sand 10YR313 NONE friable GARBAGE DISPOSAL. 1"KOFF-1 [ INF_ REQUIRED SETBACKS Ili,1 7= 1 N?�R,AlDe I I I�M�,,,�� I---- ­ FRONT:30-FT. 11",.1 CABLE TV LINE , :� � I I � - 1 9"-26" B Loamy Sand I 0 YR 516 friable 15. THE INSTALLING CONTRACTOR IS REQUIRED TO NOTIFY THE DESIGN ENGINEER UPON I .��� 57 1 .. l REQUIRED PROPOSED DISCOVERY OF ANY UNFORESEEN SURFACE OR SUBSURFACE CONDITIONS THAT MAY I C � EMS TING P05T 4, RAIL L FENCE N C E " \ %.. APPROX. LOCATION PtGUfAili IMPACT SYSTEM INSTALLATION, REGULATORY APPROVAL, OR FUNCTION. ­ I REAR:l 15-FT.I 1, _I_--,1P t N..�,�� _ _ —� *:'Nt- --,--- 26"-36" C? Sand 10 YR 616 friable,so.silt and gravel - 11 FX15TING WATER 5ffRV[Ctf I 11 I I, %.,�)� " - - I I G. THE INFORMATION SHOWN ON THESE PLANS 15 FOR THE SOLE PURPOSE OF I - \ Ii /_-, 36"-56" C2 Sand 2.5 Y 616 friable.so.silt and gravel I / IS), I PERMITTING AND CONSTRUCTING THE PROPOSED ON51TE WASTEWATER TREATMENT , - 1. 11 77 , � ''Ill F I �� ��tl�� ; ­1 I , 15 G , I lymp�W��� . ��,�W9111,:1�1�,�'M�91�11M', ' ` � - / - "I C',Z�',�� I .',,,,,�,� I I L_ I I I I SYSTEM SHOWN ON THE'PLANS. THESE PLANS SHALL NOT BE USED FOR ANY OTHER I )TING ELECTRICAL SERVICE . -% C), i - I I I E_Xl�. .4 ,,� % , IV - 56"-140" C3 Sand 16 YR 714 loose — I I , I G', %,��t:-_ /0 I -i,[JLATi - ____- - : ---.-_,_ - -fl- __- PURPOSE WITHOUT WRITTEN APPROVAL FROM WASTEWATER ALTERNATIVES, L.C.. 'I �11 I � .�, ON i REQUIRED Roll(",�[) -, a", Ir -_ - - - -_ - -_ - EXISTING CA13LE TV SERVICE ,� I � "I , — I -_ - I I j...... ,' - —_- -_ --- -I---- I / 7�, ",.� L�l 7­ ,, ___7_7�7_ ____--- : -_ - --- Parent Material(geologic) ',eGontactOutviash Depth to Bedrock: NIA - I . , F�I'll I ­ --- ____ f - I I -1 -_ I -_ I I .1. 4� ­i, , - --------- _____ � , , � I , -TO U P-5 _,� -, - , �-,,, � 1, I 11 al, � ,9,5 , FXI�-_51 ING CON �,..,Y , �­ ,,, - ,- I A"'-, Depth toGroundwater Standing Water in the Hole: NONE Weeping torn Pit Face: NONE " - , 3,1� f , I 11 ­ I I I I , I ,"�)j�0", -� I I I RNW.� , - Estimated Seasonal High 6round Water GROUNDWATER ADJUSTMENT CALCULATIONS-93 Country Club Drive,Cumm(jquid Mcissachuseffs I" I, ,, - PK01"05LD CONTOUKS r- \ ; �,'15,9��_!',,, :�­ � , .11,11,1 � -�_& / ______L96 I—�_ Notes: --- / �I �� ." � 1,ir,I . . I . I . I . Location Address or Lot No.Q3 Coui Club Drive Curantaquid WELL! 11 , - - - � NIS/ W I, ��, I I , � , , / ,11 J I -4 \ IND SURFACE FROM TOWN OF BARNSTABLE GIS: I GF01 60.4 --I-- A-/ I I'�'.. , rr � I (V 5 , I",-,­1 " I I I 1 -, I I � I......�,�'_� I Parent Material(geologic) Ice Contact OutIvash Depth to Bedrock: NIA Pf5k00gqP4j04r2LaLLLLLLLLjLL�L GROUNDWATER ELEVATION: 15.00 / �1' I � .11 ,I I�: "�,�,'­,,_�,� Depth to Groundwater Standing Waist in the Hole: NONE Weeping from Pit Face: NONE ZONE: C -1 11 �' KEL-30LIKCE FKOTECTION N 0 TEL-:::, 1 1 . 1511 1, M_­'­� �, . - , Date: 12t8/2004 Time: 1 1!30:00 AM ___- — — "rr, a - '" , -".)/ I I r I��, Je I ,. / -, f I� -,,,,;�,��,,'­,' ,,, Observation Hole No.- -103 ADJUSTMENT RANGE: 2-3 FEET . I � I I ". Estimated Seasonal High Ground Water See Frimpter Calculations TP , 1, . -�: , ,ii;'i ­" I / .-Al 11 �11` I d i I , ,',-,- Notes: Depth of Perc- 18'-36" ADJUSTMENT FACTOR: 3.00 FEET . ,�� 11 , - 141" - -_ - , -, � ,V r I, i , I " :, , 1� - _� """,' ' ;tart , 11:22:30 AM 5 7 > /C I 4 _)i /, I ,I, - I� 341, /,-",- ,,�,, 1/1' \"1qi1AJ_1f 0, I , I, ADJUSTED GROUNDWATER ELEVATION: 18.00 1 .) THE SUBJECT PROPERTY 15 NOT WITHIN A NITROGEN ", '.1 -,,,,,� / I -, "",I __ - I- - ,��', 1-1! �� I I � �') ­1 I�­ " ,�i'�tl - - End Pre-soak- 11:37:30AM SENSITIVE AREA AS DEFINED BY 3 1 0 CMR 1 5.2 1 5 ,''� �­,�, - / __ , ,� 1'�kl�V�,_­4' � � -1 , � " 6.5' .4 ":� ji� -;��� ,. � / 'I',�I,,,,i )`//\/ I I�I.,I6,��,i­Y4'�, Time at 12"- 11:37:30 AM ___ , 1�7­ K �-��, '4"_ -_ - ESTIMATED DEPTH TO PROBABLE HIGH GROUNDWATER AT SITE: 42-40 "I"1, " , I , - Time ate"- 11:42:15 AM - -11N ZONE C - AREA SUBJECT 11) i III "",", , " �,;,1,,*,_,:"'A�k,,,,,, �,,, 2.) THE LOCUS IS LOCATED WIT[ � , -,�,- ,,,, � -----, -, �2,,-4 �, TO MINIMAL FLOODING - AS SHOWN ON FIRM PANEL I ....... /,; I I ... I ,'."� 'A"O'l-, --- Time at 6"- 11:49:15 AM I�,� ", �,­ - ,&,_J--�I... ,,��-,� e ,e 2 1 7_52 -1 U" ",- 20 _ - -_ FM25000 I 0005C DATED REVISED AUGUST 10, 1985. 58 "'y If - I 1 3 1f I/ 1, ­���� I 0 Time(9%6")- 7 NAINS. ::± - - BOTTOM OF SOIL ABSORPTION SYSTEM:___-, _ 52.88 1... , /___­ , , ,,*"-� , - " , I ­_11 f, � � I �11... � , I�, - , I - l '� �,, I -1�,z -1-4) I ­­­� , I Rate Min./Inch 2.33 MIN/IN ." . I - ____ 3.) STATEMENTS RELATIVE TO OTHER 5ffT5ACK, I I I 1 � ') I 1 14 X� "I "I,- I :, c , ," tc) ­ 11 .- 1. --1.- 1­1 �� ... , ., I I I ACTUAL SEPARATION FROM ADJUSTED GROUNDWATER ELEVATION TO 34.88 FEET REQUIREMENTS: / k/ ",I "I'll"",",i. I I 1�% I 11 "I I � Site Passed:El Site F.jI.d:F 491, - , t , � I I ELVEATIOH OF BOTTOM OF SOIL ABSORPTION SYSTEM: 0 Z/) *(,4/ 1 11�) ,%% F I _] II'll �� �, 11 q/-- ___­---� I� TO OUR KNOWLEDGE THERE ARE - C, ., e ,\, I I I �I,'11� ... � Performed By: Paul Carey,P.E. .. I , �1/1(�, . T',� 20-i� ', I , ,/ �1�_ ", "t e D 11 Witnessed BY:Donna Mlorai Health Inspector "I NO PUBLIC WELLS WITHIN 400 FT. OF THE PROPOSED Iii f 4/3 1 1 :,) Y I * " 1� ( ) 'I"'? 4 1 1 , _. -E3. F_ D- Comments - I � YI,, �,,r I , � - NO PRIVATE WELLS WITHIN 200 FT. OF THE PROPOSED �11/ -, I 'v-1 I I I , 1­I,1it­­­­_.1'_P ,i.,,�,��, ,�� 1�1, , � - �, I i N - ,*,.,I= -­­r � _F:_1 -"� ,_5,__;�'; - - ,r�­_ " 1�,_ "'j41" , .�, - 'I, I 1;, , I : ,,."�­_'�,7�­� _*��"'I", ­ I . . ��A F , ­ I I r _,�A_ ., I �� I� I �.-­ �'t,��,i__ _1§11� I , . , , - -1 I - _ A I I - . ­ -,-.,-- , - __%,� I I ,�d I �, � -Sr,N "�� '!il� IQ) ♦I -- - . �I I ,r 42;�.;, I *"'.�Timf�Nl - � I ;V,�., *# I ,:, .,-== ­.�,� I __11 �,,� - 5 SYSTEM. , __ _,'?�,� ,- ­ , , 11 . 1 - 1 4$��I,'�,��'�­ ­11 I ii,�, ", * , 11 � I I � ,� ii ­ I- - r, , ,�1­t",.-,- . I� I � ,, '' ,�, , . , � 1, .1 , ­ I . — . ,-, L I I , I I _, , �_, , 1� I . ,. � I � - 111-r- - ­ ,-�i� ,-I I ­/', , - , _Ii) ` "�I- -, -1� V-*.i .4- -10 I/ '4_ilii`�"I �.�, �" � - ­ - ­- 11 *� 'N . . 1i �` '�,�,,,�,- '.��", 1i , 1, �_ , "� , I I *�'��_ ," - - I I - NO LEACHING � ­11 I __ � 1� "A , ­,­ - I. I I - 11 "k, A' I� *, G CATCH BASINS OR DRYWELL5 WITHIN I -) �), , ,--,, � 00bimi , - �N, t , - ­ , -FT. Off SYSTEM COMPONENTS � ko _,� I , , 11 .Q , .1111111��1111 N,1111­,­`��"'���,� ­1 50 / I 11 / 11 . , _Auao, _-, , � ­11 I 11 _� � � 4_r_1c`% ,� 1, ll,��: .;,�".,,,,,,�.,�1'r,�" .�', ��l , a��!,�; ? ; ,��, 4 , � - NO REGULATED FLOODPLAINS OR FLOODWAYS LOCATED If _11� I fit / _` ."-,."!�"1";"",�l,,,'�'�tl''z', " , , : � � ,\ �1, _' �� 1. � ."�__, , �;?. I � I.,�­* I IF -­­:,­_.",�",�',,',�,,���`, 11, ,,, ",, It , ,,,,, - 1; iti . �j !-­- . " -�,,� 7.,­�.> \ � " I ." - ,� -1 - I , - ----.----- , - � - � , , --� .--,------ ,- -,-,- �-.-- , � - . , , ,1 111 , �., I .. r __, If � 6�', * ­` � ,� , I ,", I � _'i ;;��. - . � . � I I - , - � I 11, _rr�',�', "��,�,,,;�.�,�,�,,�'ll;��7,r,3;.�,,�,, --- I 4 � I I ,I ,-_�', ,,�� - -- , 1, "F -i1-.� IN THE AREA OF THE PROPOSED SYSTEM. C) .1 ��5, " F�',,',,`��� , ,,_ i , , � , , ,�. . �;,� , I " . ,,iz . 7� , .) e��,. 7,-�-��,,, I I Z;r. ��;�11­1111 ,; - , 4 , � I \ 11, I) 1, ,�,,'.�' / , 4, _1111 "�'I'll"�"e�q"�"",�,,�,,,,�k"�'ll�i��,:i 7,7' i " 1� � %�4�V_ -,.1 I . � i,si� - �, , 14�- . � 4 ­ - - NO STREAMS, SURFACE OR 5U55 /I I ­�_'/o 1� li� - I- _. %*� , I I I" �:,,�., 1, �, I I I :: 1, '­��- � �j -. I �,,I ,11_­11­1­,__,....... _��4 .� ,- %��, _', - .) 11 r�l �'11­ -_ I� `�`,�-`_,.�,i�,,­­�1:r',',��,,,%,�, - , , ;p I, . * 1 �41- �. I AM-_ ft BORDERING VEGETATED WETLANDS OR OTHER REGULATED I I f � ­,�,'� ­�,,,- , ,.�, , - " ,.W,_ � 1p-- - , �, ,7,0 : � � .1, ,P, ii i�v , ", �!,v -_�'4" � . , -4 1 " ,X - . - # � I I 1, .to . I J;1 I -I�, ��,-,�-_'­�".,:O, � (, -,��, . "'47 �-.,,--. ,� � I'll, � , i I '­ "I 111' 1 �,t " - � , � , I . - I I � --l",­ IF I � " ....�� - I � - ,, 3, ­�,, P. A:� 1-1. -4-Psi,,t� .­ ,. 1. -,Ie,- / I �1`1� ,��3_,. � _�� `�'Z�� ,; � � I I I r, � , f �1, -" WATER COURSES WITHIN I 0i Off ANY SYSTEM , _ , �� i�",,,6, 1, , !�_,�­, ,1, 1000 0 1000 Fli!ET I �� �, A* ,ii I , --,7"' ' , - �� - E30 \.",� ,, ", - ��',� , 'i, 1., i � /it _�_� APPROXIMATE SCALE . I N, , W ,,� ,e t;z SUBSURFACE ,AI l �� 7 , �Ivl ", 7'4 Ii � ,FACE DP .� . , _. , ", � I � , -.11 - " '' % � � J� - - - -� %1. :"N '. '* , % ^ '' , .,,,Ill.1 . ­­ 1��, "I". t� """, .- I ��- , ,� 1 � �•, .� !Z�','[ / � "I 1, �tl -_ I I I I 4. 1 � ( o I - ,­- ­ ,. , I � " / "I ,. �- "�' , �Z�_Afo.0 .'D "5;o�T -, -11. --k- '101 1_11 ., 11 S, I ­ _- / . 0 �,,.-,�,� / -, "I", . — , A I I" ,,, ,;,r',: I-.�­V .1 I " __ I - COMPONENTS. -6 1 ""j�'11 11 1��11,�,."", I I 1,�,­ , - �^ I I "Ill � 11 '4 4j'tr . ii, �A �, 11 ,��,�",: .,�,"'I"f'a oi 1_1;11 ,, , -,- . �. .* _,11 "_i - 'I-, J� , , �, 1 ,41 11,p�,;i�� I // , '' I �� � I I I -jr � - ,; 1 . I A�i, � 141 'W" ' -4'/ � y ,I . , W " ,� �11-,ff, ♦� � I 11 1, , I � I 11 �, 0, I , ,;,,,i��,I�'. ", Z"�� / IF Co " 11 11 I 4 I � - I *�'. -A, � � �I, , A,�� "I _N1 - ­k , ,-:� - ­�- -i V 41;.- -.'�.'� "Iii, $__, e"m,l N11.1% ,V� /0,Z,l, ,�,',i i 4 1 1 UAI I . -.Coii ��,�, -" )611, ,1,, . I . �I ,,� � .X " I� "; ,� " I , ­ 11'X0 I " ,,­�*ftt 1-1 - 'T ­ 1."11"N.. -W,"- _��,` 1. �fl", ­,. -�", � % I , 0 __ ,:�LUA?�y 4 , .,j % , ­!O.� ,?., 4DI. 4, 1 04u, * '% 0 -In-; .0 . � , ,?,.-- - �. -­"',i _�, — i ,. , - A , ", � 11 I , � I I • 4ii ��r� 'j*V1 ,,,, - of qIT V­ . , 11 , I 1��, " - � . - , , ,''�A , - / �r�4 ., - I ,� ,, —� " � 4, ,- � ') I� -,-,--Q1/i , A� ( I ��'", "C,/" ,,,, 0 .- � ".- I v .I,,' � "_ I TE FLAN K E Y N 0 TEt3I N, .I ,'C;, � 11, ­__:`�_ N,____ , ____. ,I -1 - If,-- ,� , _A.4iqlt .-Ai': 4� . ­ 4 1 1 _4� . , � �, -•-�i � , ♦ _ �A' , ��­ . . , ­rj, - _",�,_ � I � .. 1�1 '/C�14C 7' % I � ,� ��'% _" ,_ � - , 7, I �� U � ­-­ - N I�Q,- ,k � ,� � .A-- 11'' ,,_n -I-- 1,1111 I � 11 -1 ", 't 3 I � I 11 -.1 , / � V �_�� , ill NATIONAL FLOOD INSURHCE PROGRAM t � ,-, - 1�, q 'r.� ,,, " , :,.:��,�:�', 4 "�,,V, / ,I � - . 1 V4. �'" "�r V,� - .e, 6 '' , I ..I�. � ,, 1, , ., �i � " I I �, , , - ! .- � -- '11, � - �,;:,� �,.,�4_ I , ., � -1, ', .I I", " ,I � - � I � �,_ �t I �. � -_ , ,,7T_73�,­�. , "I'lln, .11,11111-11 . V I ,; - I �L" , ---," - , ___ _*-ii ­ --M..��',",',-,�l�'�I,��,�,,, VIP . ,, " ­,­ 40 11,I, , ; �,,.��,,�,�,",��'.1r:,�.,"�,�,,',A,,,? I _�jr� , "t�, � �_ .1 - ­11'i " ­ ' I-";,I � I V .� I �. - , �11,� , 'I 'L � I , - , �D f, � _­­,�,� "�, - l I­­1 11 - , " ­ , if k � �; (APPF,-_OXI MATE LOCATION SHOWN i�5����,'���,�,��_� I It'l-11, � � I I 11 11'W A��, I Xzf��''p ."­­ I li % 1�1'lz , ,- , NrM , , , �. ,,- _4 I Pt - L 0 C, L I ".- 1-1 -1 �, 1, ,-I- = .a . ; Y! I I" Z , ri --" I% I I�,,��,?",���: I I ,: -'_.�,� '. -4 . .e - _ EXISTING BUILDING SEWER TO BE REMOVED 0) �,,, ?,Zt , , , � -, I J ', 1P -, - , * � �. 0 - � , '' , , IIA4� L(-JF U ZONE I ,* � I , 5 . N� "� I) , I - .- I .- 6 0) , 0 I'll 1,111, : I 11�I;l;ii i � ­ 11 ?, �__ -,� " " ­� -, "I.N1. -1 11 , � ", ,,�, L� ;.�:__?:_�-1_LI11-'_,_:", &W,-, , - % 4 " ",111111,'111"?1`1,11"'��111,�,� ,_,�",��","��11,';­ e . I I il,. -, j ! 14 ,�� t . Z��,r 11 I I FIRM 4I4Z , " _',�_ �, 4I�l - -,� -;4 q; -`5;T,--7­'-4 '�' " , � � - - , - i ­�- � %q�,_*,,,, 7 ' iL ., f,-,�,' / _/ I , , - I - . ­,­ " *_ � 1� � I 111. ­ 's ," __ 1, . " , \ �1" ,,,,,,, , , ­_-­ , I Tr" �;-��-,, -, Z, ,W �t`l 11 I .i PROPOSED 4" 5CHD. 40 PVC BUILDING - I I 11`1 , , " , ,� I __;� ,C­ ­-_ 1, I - .. ,;�_ ,_ ­,� -,LT ­�,,�, " � _: I I � - ,, , � ,_, , , - � X � I I 1 14�i 11 % 11111111�� . ­ ;,_�­,,-,A _,,� � / I I I 1-1 , '' " P1 ro�� �I i OP4111 �SL,, '�_, - , -, .,I . ­-, I I " , -1 , 'il I 1: �,"' �," L� �Ii i ­1 ­­ 1!i L I 4,;. � SEWER. PROVIDE WATER-TIGHT CONNECTION NN�l \ , '' FLOOD INSURANCE RATE MAP .a, .r 1" -,. ,�` , I- ""��,,�* _�, ­��,,4­;Ij 0 ", , - �j ­111 I ,­11�1 " _ -,, I ­� I // I ; It _ I ft� 4r *� f _11.1',_,­�- 11 ... ....1 7 ��,,_": " . � ! 1 � , , � �� I'Llill, ,, I 1"Z_ - I I 0 AT SUITABLE PIONT IN EXISTING SEWER AND %% � `I I I / ­,,, Y� 1 I I � � --,-_-^-,;W. 1.r .," - �� . t'-�'IE,IstW tkta- '. � I I , 'A ?*' �, �: i�,�, �-._ 11 -,.�A ,ZaI­A.­; ,� - I "j'' , - - , '. tv", ­I , ,�, L,'' I I I , _ ,­ I !R�l " , ; �i�- / (It"," I / I I I )�/,//' 1� '4 V � � - " ; -� ­� 1. I di,r . 177!t�� ____ RUN WITH CLEANOUT5 AS SHOWN ON PLAN � Z I � -Gon , I i 1 le .1 DAM. I TOWN OF I,". -, �Ir , .�,, I ,� ,,, , I �yjoj,pft-*: !'��,. it� � I � / � III 11 I � i . 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I I � 11 ­ 11 I 1 22����L: - SITE LAYOUT & PROFILE 1 1 russell street, plymouth, ma 02360 � SHOWING PROPOSED UPGRADE OF ONSITE phone: 508.747.1 1 58 _ _ - - - - __ ___ 10 CPF i : e-mail: info 04wastewateralternatives.com i . ____ -_ - ____ - - WASTEWATER TREATMENT AND DISPERSAL SYSTEM- ______ - __ - __ -F E PAII 11 m url: wastewateralterncitives.cOrn __ - ----—--—,- __- ___ - � - _____ __- ___ _ _ - - U , : CAREY - _ __ ____ - - SCALE: DATE: CML : I .41 AS NOTED 25 MAK. 2005 -"'�"' ", \ "��'­"�' '"�'' f � " - "' ' " U T.1p 77-77,77_--7 1 ­1 I-I I-- 11, I �Ml ji'M__ -) \11 I I, _ ,0 ,'F- ,,,, ," , ' 4 3:3 , ` \\\ ' * )� . . - I. 05,LO__BOTTOM OF - - - - - -L I I I—. -Al `."i' .' Af'A,- ,�K_ _., ,-- - I I [ \1/ 1� I I I _______ __ - __ - __ _ _ -____ __ - __ __ __ — 93 COUNTRY CLUB DRIVE PROJECT: PROJECT 04- 140 - _ - - - — - __ -I—— _____ - I - -------- _ _ ______ - CUMMAQUID, MASSACHUSETTS 93 COUNI-PY CLIl DRIVE, CUMMAQUID, MA I 1 3!25/2005 PC I ir�(- RELFA5ED FOR BOARD Of !­1FALTE1 PERMITTING- NOT fOK C0N5TRIJCTI ON PREPARED FOR: MR. RICHARD SEXTON DESIGNED BY: DRAWN BY: APPROVED BY: ­ I � 1 11, ,,i� � 4 11, N � 11 I I I I 11 ," SHEET I OF I I 'I'l-, -"',x�,�i'By ��,�, I I 1. PC rc PC " 11� I 11 I �f,'.,,`�, � APPW: I�M�� , I I 11::�,�� I - _........ - I IL I I I "�­', I *T� , I � ,��: MMMMMMM IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11-