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HomeMy WebLinkAbout0017 CRANBERRY LANE - Health 17 C RANSERRV LANE V ` ARNSTABLE 234-045 III.. i i i I Commonwealth of Massachusetts Title 5 Official Inspection Form subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address l ON ner Cw ner's Name information is Z y / 'l� ��� G required for every city(Town _ State Zip Code bate Ins action Y page. `� _ C N,a (aru 4k4 0 �S 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. M t:When A. General Information fillingng out out forms I on the computer, use only the tab 1. Inspector: key to move your / / cursor-do not al, l O�se- . use the return NU me of Inspector -key. C°rrpany Marne Company Address / / City/Town ��D ^n State /(¢� Zip Code o--7/jfl � Telephone Nkunber 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 16.340 of Title 5 (310 C -5.000).'The system: Passes [I Conditionally Passes ❑ Fails . ❑ Needs Further E aluation by the Local Approving Authority Inspectors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is ashared system or has a design flow of 10,000 god or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies 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 I� the same or different conditions of use. t5ins,3n3 TiUe5Official iris pec bon Form!Subsurface Sew ,?DSposai System.Pape 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments C Property Address � o >f�2✓]� Av ner ON ner's Name information is ?� rt / ��6 required for every (o A�e page, City[Tow n Slate Zip Code Date of l spe tion B. Certification (cont.) Inspection Summary: Check A,B,C,D or E / always complete all of Section D t a A) System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally passes: ❑ One or more system components as described in'the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined".(Y, N, ND) for the following statements. If"not determined," please explain. , The septic tank is metal and over 20 years old* or the septic,tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of . Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank.is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): . t5ins 313 Title 5 Official iris pac Um Pam:Subsurface Sewage 01spbsal System,Page2of17 Commonwealth of Massachusetts µ Title 5 Official Inspection Form F Subsurface Sewage Disposal System,Form /- Not for Voluntary Assessments Property Address �a 6e Cw ner Ov ner's Name information is requiredforever y page. City/Town State Zip Code Date of spectfon B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health.approval if pumps/alarms are repaired. B) System Conditionally Passes(cont-.): Y i 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): ❑ removed ❑ Y ❑ N ❑ ND Ex lain below obstruction is r emo ( :p ) ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).,The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation bystheBoard of Health in order to determine if the system is failing to protect public health, safety or the environment: 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a mannerwhich will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t9ns°M 3_. Title 5 015cial Irks pec Lion Form Subsurf we Sewage Disposal System-Page 3 of 17, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Z_ All Property Address �o�C,✓Ts . Ow ner ON ner's Name information is � O�(o ) required for every � � Ile / /N ✓✓! � page. Cityffown State Zip Code Date of Intp9iction 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 town overloaded or clogged SAS or cesspool ❑ ❑.1/1� 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 15iru•3113 TIU e 5 01 ficial ins pec Ucn Form Su bsurf ace Sewage Disposel system•Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments `7 � 7i Gr��err Property Address �o fie,f s ON ner Ovv ner's Name r n information is CQH ✓!i!�lQ � / 6 required for every page. Cityrrown State Zip Code Date of Ins ection B. Certification (cost) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ a 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. ❑ L� Any portion of a cesspool or privy is within a Zone 1 of a public well ❑ CR Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ . 2 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. [2 � The system bj . 1 have determined that one or more of the above failure criteria exist as described in 310 CM 15.303, therefore the system fails. The system owner should contact'the.Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition_ to the questions in Section D, Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply' ❑ ❑ the system Js 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. 15 M•313 TIUe 501ficial Inspectlon Form Subsurface Sewage Dispcsat System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �% 6r✓r (dry^ Property Address / Ow ner Owner's Name / information is (�N required for every ✓- .page, City(Tow n State Zip Code Date of lnsXectiofi C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No El 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? ze 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): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): i t9ns•3113 Till 5 Official inspection Form Subsurf ace Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments rG0 �er/ , Property Address / 1>4_ CN ner CN ner's Name information is Cep, it✓V6 required for every c7— page. CityRown State Zip Code Date of Inspe lion D. System Information Description: • � lS�ir (�.rToh '.S E�.� I Number of current residents'. j Does residence have a garbage grinder? ❑ Yes ' No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes E5- No information in this report.) _ Laundry system inspected? ❑ Yes L&"iVo Seasonal use? ❑ Yes No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes 15- No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM R 15.203): Gallons per day(gpd) Basis of design flow(seatslpersonslsq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: N t5ins-3113 Tide 5 Official Inspection Form Subsurface Sewage Disposal system-Page'7of17 l I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form1/- Not for Voluntary Assessments `ao / CiGv� b��i' �✓' Property Address / �0�2✓Tf Ow ner ON ner's Name information is required for every page. City/Town State Zip Code Date o nsp ction D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): r General information • I Pumping Records: Source of information: w Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons Howwas quantity pumped determined? ' Reason for pumping: Type of S m: 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 l/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): Ism•313 Title 5Official Inspection Form Subsurface Sewage Disposal System•Peg 8of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r - / Property Address / ON ner Owner's Name ? information is required for every �jQvt k✓�!Ile ,� �/le 4 ,� �,��J� 216141 page. City/Town State Zip Code Date of In pecton D. System Information (cost.) Approximate age of all components, date installed (if known) and source of information: . a Do t Were sewage odors detected when arriving at the site? ❑ Yes No Building Sewer (locate on site plan): Depth below grade: feet A; Material of construction: ❑ cast iron n 40 PVC ❑ other(explain): �t) 7 Distance from private water supply well or suction line:; feet Comments (on condition ofjoints, venting, evidence of leakage, etc,): t Septic Tank(locate on site plan).- Depth below grade: 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: Sludge depth: t5ins-3113 Title 5 0Mci al ins pec ticn F orm Subsurface Sewage Disposal System•Page go(17 C, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Cw ner ON ner's Name information is Cle,4 �Qd� l)e- 0,)6✓ / 0 required for every page. Cityffown State Zip Code Date o Insp ction D. System Information (cont.) Septic Tank (cont.) O Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top scum of to to of outlet tee or baffle P Distance from bottom of scum to bottom.of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.)' U w! ✓I C 0 --1 7` 471- 4, DIS 770 Ze. Grease Trap (locate on site plan): Dept h bel ow g ra de: feet t Material of construction: ❑ concrete ❑ metal ❑ fiberglass (D polyethylene ❑ other(explain):. Dimensions; Scum thickness Distance from top of scum to top of outlet tee or baffle r Distance from bottom of.scum to bottom of outlet tee or baffle Date of Fast pumping: Date t5ns•Y13 Tioe5o"cial irlspectionform Subsurtace Sewage Disposal System•Page 1001 17 i r Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - / 7 z— Property Address /�<?V �2✓ Ow ner ON ner's Name information Is / t?� ✓�` `� ` .7� /yc requiredforevery l / � �/T O. page. City/Town State Zip Code Date of/nsptrction D. System Information (cont.) Comments, (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass. ❑ polyethylene ❑ other(explain): 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 of alarm and float switches, etc.), ' Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No i t5ins•3113 Title 5Official Inspection F orrn Substrface Sewage Disposal System•Page 11 of 17 - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System;Form - Not for Voluntary Assessments rY o / ✓ 4 N Property Address / Ow ner Owner's Name information is G g✓V�e✓�I !le / / 6 �a,2 G �� required for every page. GtyrTown 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 i 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.): v �11 �s 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.): 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: 15ins•3113 T050ffldal lmpscUonForm Subsuface SewageDlsposal System-Page 12 a 17 I� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments z 2 / Ir r �GhJ2 / Property Address / ner O+v ner's Name inf 2� / 6 information Is required for every page. town State Zip Code Date of Ins CBpec ion D. System Information (cont:) Type: ��0 �-�+�l io � �7'�V2 ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number:. ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology; Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): ll J .. �14dtki c,rt , 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 1.5n,3/13 Tile50fflcial Inspection Form Suixulace Sewage Disposal System•Page 13 d 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form a 'c Subsurface Sewage Disposal System Form - Not for Voluntary Assessments (r/��t✓►6 err• ,�— Property Address /�� / ✓Tf . Ow ner Ow ner's Name information is et, �! /le ✓i required for every i ` page. Cityfrown State Zip Code Gate of In pe ton D. System Information (cont) Comments (note condition of soil; signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction; Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5 ris•3113 Title 501ficial l u poctim F am Subsurface Sewage Disposal System•Page 14 01 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address �� ?✓TS C7� Owner Owner's Name vt 7�✓✓! I /�� �o`6�v� information is required for every 2A'A page. Cily;Town State Zip Code Date o Ins ection 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 i Q,* C�✓ �ar a % QLor✓ 8 " Fae t✓ q�..�. v_— 3,> ve r /� 3 - `�D - 3) �a `7 { 493 M t5im-3113 Title 501ficial Inspection Form SubsLrfxe Sewage Disposal System-Page 15 of 17 I' Commonwealth of Massachusetts Title 5 official Inspection . Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments lug / Property Address ✓ Owner Ow ner's Name information is / f required for every page. CiF own State Zip Code Date of I spec lon D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water t ❑ Check cellar Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: pate ❑ 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 desc a how you established the high ground water elevation: � Ci✓� Chga 41 G', r Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ns•3/13 TWe5Official Impec bon Form Subsurf ace Sewage olsposel System-page 18d 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form 6 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address ���✓ 1 Ow ner Owner's Name /L,r information is / /� U required for every CeN�'� �� r l� ' ' ���'�' A' 1� page. City/Town State Zip Code bate of Ins p ction E. Report Completeness Checklist R'lInspection Summary: A, B, C. D, or E checked 2 Inspection Summary D(System Failure Criteria Applicable to All Systems) completed [9 System Information— Estimated depth to high groundwater ff Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 15irs•W3 7iUe50ffl A Inspection Form Subsurface SewageDisposef System-Page 17 of 17 T NOW, THEREFORE, r-rsdoes hereby place the (owner's name) following restriction on his above-referenced land in`accordance with his a,g.reement with he.Tzwa•af ,w • s*0 run•with the land and be binding upon all.successors in title: 1. 17 1 A may have constructed (address upon the lot a house containing no more than of o bedrooms. M ,bC'0&' RAW agrees that this shall be permanent deed (owner's name) restriction affecting located on MA, and being shown on the plan recorded in Plan Book_, Paged Or on Land Court Plan For title of see the following deed: Book , Page Or Land Court Certificate of Title Number Executed as a sealed instrument day of Owner's signature Owner's signature Owner's signature n COMMONWEALTH OF MASSACHUSETTS fl/uY� � ss 2015 Then pe nallg a peaVth4 rVe - v known &me to be the person ho executed the foregoing instrument-and acknowledged the same to be free act and deed, before me, -,DTWA ., . , � Notary Public- � , y con stun a ire t� a'f IP d �,z>,"' eeds. �! � (A-��'4• •rc�y':.�3�l13Y' DEED RESTRICTION WHEREAS, M , o s .� "�c� ��r-�, s of (o moes name) v-r %-1 �. o—%e7•e� MA (addressY is the owner of o J 'ems located (address) 1/ at MA (hereinafter referred to as and being shown on a plan entitled 'Subdivision of Land in MA, Property of et at, duly recorded in Barnstable County Registry Of Deeds in Plan Book 1 Z 7 L4 (�3 Lj :D , Page __ ?)4 7 ; Or on Land Court Plan Number WHEREAS, as the owner of said lot has (ownees name) agreed with the Town of Barnstable Board of Health to a.restriction as to the number.of bedrooms which can be included in any home built on said lot as a " pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Bamstable Board of Health, as a pre-condition-to granting a disposal works construction permit for a septic system in compliance with 31°0 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, r`p party, is requiring that the agreement for the,restrio �.o���,tie.dumber of bedrooms in any house constructed on the lot be put on F "d th.'thi, Bamstable County Registry of Deeds by recording thie°ctp' 4h,T. J ' Town of-Barnstable P# a 9eo ` �P`oF1HEro� o - Department of Regulatory Services s BA Public Health Division a - t6'9• 200 Main Street,Hyannis MA 02Gq C 22 P�! 12: Z f A$D MAt A ( c1 f`�GD R Date Scheduled - D Tithe r Fee Pd. DIVISION } Soil Suitability Assessment for Sewage Disposal Performed By:_Hcc_ kVa PCMW 4 d E,T,'T.'. G,.S, E. Witnessed By: v r LOCATION& GENERAL INFORMATION Location Address I I C',t'&nbn-r r j 1 _ Owner's Name LoU i^j � +5 ' Address . . (������Gcc�1 Assessor's Map/Parcel: �P "1� w�IQ p d�te-3`� Mq a39 Lo+'is Engineer's am 2fI NEW CONSTRUCTION REPAIR x Telephone# ����Alm c;C-b g g 50y L�L? 5 Land Use �ie5i d2 n{t a Slopes(%) 2 Surface Stones Distances from: Open Water Body 7 JOy It Possible Wet Area. .7 °o It Drinking Water Well 7/ 0 It Drainage Way 7 too ft Property Line '7 10 It Other ft SKETCH:(Street name,dimensions of lot,exact.locatiols of test holes&perc tests,locate wetlands in proximity to,holes) See Pton SeDAC, S'yst-ern ulp5c,,,de PCePare� Foc M zouise uA 17 CrovO er ry Lone Ceri-erv(ile. .1 N0 D 2 Iv 3 Z cl-t e_et' µe y kb ZOOS, cmnJ Pce�orecl b�, 5C Ei)5;,ieer-;e) zvt c. Y Parent material(geologic) Depth to Bedrock N 1 \ Depth to Groundwater: Standing Water in Hole: �U f A Weeping from Pit Face• N1 /� Estimated Seasonal High Groundwater R�` DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: P1 A in. .Depth to soil mottles: N 10 in. Depth to weeping from side of obs.hole: ulft in. Groundwater Adjustment IN I,A ` ft., Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date 11-05 Time io Of Observation Hole# t7 ( Timeat9" /0 25 Depth ofPerc Tiine at 6" Q �' v Start Pre-soak Time a . Time{9"-G') End Pre-soak. /Q Rate Min`./Inch 3e .3�j' C vseyd r 2 r pr fo, 'tescyn {u PeovicJe 5, s Por bfion'i Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) •� 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)weelc prior to beginning. Q:HEALTH/W P/PERC FORM DEEP OBSERVATION HOLE LOG Hole # 1 Depth.from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. — .30 32 5L._. . 16Yr 312 32-.`12 „ 6 S-L 16Y��518 DEEP OBSERVATION HOLE LOG Hole # Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depthfrom Soil-Horizon-- -Soil Texture - Soil Color..-.-,. .. Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) i Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes X Within 500 year boundary No x Yes Within 100 year flood boundary No X 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 soi.1 absorption system? 1'eS If not,what is the depth of naturally occurring pervious material? Certification I certify that on " 27- `� (date)I have passed the soil evaluator examination approved by the Department of Enviromnental'Protection and that the above_analysis was.performed by me consistent with the required training,expertise an xperience described in 310 CMR 1.5.017. Signatut e Date Q:I-IEALTH/W P/PERCFORM AUG-15-2005 09 :08 AM JCENGI14EERING 5e8 273 0367 P. 02 - ` lown of Barnstable - . Regulatory Services r Thomas F.Geller,Dirset-or des ;`Public Herltb Division Thomas NICKS&m,Director 200 MAh Street,$yanals,MA 02601 MO.' $09-1624644 ram; S0e-79a6904 Date: Designer: J'C Cz!ACedn Tn C;py) Address: 25-5Lt Grunbz(i X,9e�wo Wo,w1noon N Q 15 3 .�] ' ©low 1�a® l Wee issued aparrui4 t0 aastall a . ` (date) vx septic system at,.,, l c ranloe.s r Laoe C&nk e,1uA L' based on a design dra Wn by adddress) eecrnh .TAIL dated_k a -2 0C, 5 I cer*that the sTdc system;referenced above wws installed substar:tiallyy acoorditsg to tts desi;n, wbW4 may include miner approved changes such as WOW tetocataon of the distribution box and/or septic Ink. I Certify that to septic. syystem Teferenced above was Installed with major changes (i.e. greater than.IQ'lateral relocation of the SAS or any vertioal relooatiou of any aomppneut of the septic aystzm)but in accordance with State& Local Regulations, Plan revision ox certified aa-buiIt'by►dagi.gaer to follow. 'Jo OF 04"', JRNNI. AlIff' a gtlatttjro JR CIVIL NO 41407 Ob1saff B ignaturC x tamp ere N.EMU N H HUI -ITNTIUM-IMIA I Q�Heatfi/BoptldD�istaes Ctf4il9natfow►Frrn, _ 1 J i J ` T No. �(>D_� r S'/ iyn �/p ry1 j,�d{ Fee THE COMMONWEALTH OF MASS/A(CHUS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 3ppfication for 0i$pozat *pztem Con!5trurtton Permit Application for a Permit to Construct( )Repair N Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1 G{�J� U 1Q�• Owner's ame Addre s d Tel.No. Assessor's Map/Parcel Installe's Nqe,,Address,apd Tel.No. Designer's Name,Address and Tel.No.�'1Dq),9,7 3 0377 tx�fA�1 r► 5 o n J.0, C n o�tXleeru� O ro kl�:A& � ratL. n �.e Sa CH"aY tgh�.�y Type of Building: Dwelling No.of Bedrooms Lot Size_, 3�_bAL,_fU— Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 220 gallons per day. Calculated daily flow 0.4 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs orAlteratio s(Answer when applicable) OO _ II Sg10 alp i rt SJ© I Q_Vr_3 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is this B ard_. ealth. Signed /L— Date 3 /,0J6 Application Approved by Date Application Disapproved f the following reasons Permit No. DUS—. 3!�3 Date Issued rw. .- .-. .-. �.w•M6 ' 'u£� S-.�-L'""ors .=���. ....... rlR..i I ... . , �;:. -� Jr. n .�� No.�tiv�_ �S�� ,, �"/ Fee : t a" �°r °) E-COMMONWEALTH OF MA A HUS S Entered in computer: - ; Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEx MASSACHUSETTS , a t , ZIppYication for.Mis;.PO�A[ 6p.5tem Co ttruction Permit Application for a Permit to Construct( , )Repair Xj Upgrade( )Abandon( ) O Complete System El Individual Components Location Address or Lot No. Owner's Name,Add Assessor's Map/Parcel u�3� y 17 '1 �1Fifl Installer's n�Address,1qnd TeL No. � � g E=f1 t,�'I ��i,a7�' "7 (�.� "333 Designer's Name,Address and Tel.No. 03 7 �on J.0 P o o X, to al �`b SDI G�0. '1mrq co QC64, 'Type of Building: Dwelling No.of Bedrooms C Lot Size ��..sq ft Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures s Design Flow P-2.0 gallons per day. Calculated daily flow a-4 jallons. r. Plan Date Number of sheets Revision Date !. Title Size of Septic Tank Type of S.A.S. Description>of,Soil „ . 1 - i Nature of Repairs or Alterations(Answer when app icable) , C Date last inspected: 1 _ Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued_by this B.and of ealth. �_ Signed o - I i Date Application Approved by Date a Application Disapproved the following reasons Permit No. Do Date Issued 94. rr ' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance d THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed( )Repaired( X\)Upgraded'( ) Abandoned( )by 1�', at has been construct d i accordance with the pr visions of Title 5 and the for Disposal System Construction Permit No. 2M S-3�3 dated 0 Installer 'P ' Desi ner g The issuance of�this permit shall not be construed as a guarantee that the s will Pan t' n as desig Date InspectorAi j No. E�'� — 3 3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migoar *pgtem Construction Permit Permission is hereby granted to Construct( )Repair())Upgrade( )Abandon( ) System located at 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons cti n must be completed within three years of the date of Date:_ a d�� Approved by A Mv, �S 4 AVI"1 DEED RESTRICTION `w j g (o WHEREAS, G L,_i s .e_� "}�c� r s of (owners name) C'«r� e r 1 c� rLs fat f0�-P MA V- (address) is the owner of J located (address) a G_y-A e cx MA (hereinafter referredto as and being shown on a plan entitled "Subdivision of Land in MA, Property of et al, duly recorded in Barnstable County Registry Of Deeds in Plan Book i.7 7 Lj ( _, Page Or on Land Court Plan Number WHEREAS, c�u i 5 � ,o ear -5 as the owner of said lot has (owner's name) agreed with the Town of Barnstable Board of Health to a.restriction as to the number.of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; , WHEREAS, the Town of Barnstable Board of Health, as a pre-condition-to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this roe p p rty, is requiring that the agreement for the'restriction,on,tfie number of bedrooms i Feeo n any house constructed on the lot be put on rd wit'ri the Barnstable County Registry of Deeds by recording thin°d.__�ume 'S n CX r r TOWN OF BARNSTABLE LO''ATION 7 C R A/ Y L A A/&SEWAGE # VILLAGE C ew fee y/1 L C ASSESSOR'S MAP & LOT015 Al O (o INSTALLER'S NAME&PHONE NO. Ji 4A A C D�Ai IS e R t- 5 O A," SEPTIC TANK CAPACITY /.,S. O D LEACHING FACILITY: (type) `� r y ui eL1 S (size) -I,/- NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: 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 290 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any'wetlands exist within 300 feet of leaching facility) Feet Furnished by i Can TOWN OF BARNSTABLE LOCATION 1 Clr4,ibc.^r�l k4l, SEWAGE # VILLAGE ASSESSOR'S MAP & LOT* 3Y"r09'�, INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) <72 (size) d v-- NO. OF BEDROOMS c� PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER / 714 t\x SCo el B c DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r _ E X�sTir�G /focrSr TOP OF FOUNDATION = 105.1 1' FINISH GRADE OVER D-BOX= 102.00' FINISH GRADE OVER CHAMBERS = 101 .88' - 102.00' REMOVABLE CONCRETE COVER SLOPE @ 2% MIN. OVER SYSTEM FINISH GRADE OVER TANK EL.= TO WITHIN 6"OF FINISHED GRADE 4" SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE GENERAL NOTES FINISHED GRADE 103.5'± 5" DIA. OUTLET(S) 2"OF 1/8"TO 1/2" DOUBLE WASHED STONE @ FOUNDATION = VARIES 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION I� EXISTING 4" 20" MIN. ACCESS COVER 12"LN. I ' PLACE RISERS ON ALL CHAMBERS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE TYPICAL FOR 3) TOP OF SAS= 99.58 ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. � C.I. PIPE ( 36" MAX. 36"MAX. , 9" MIN. TO 6"OF FINISHED GRADE 12"MIN. 98.75 36" MAX. BREAKOUT EL - 99.25' 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD � PROPOSED 4" - OF HEALTH AND THE DESIGN ENGINEER. SCHEDULE 40 PVC 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL ALL - 2" DROP MIN. MIN.SLOPE@1% 6 3 3" DROP MAX. 3�� 9�� BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. PROVIDE WATERTIGHT - 102.10'± * 10" JOINTS (TYP.) O 000 � O ao 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 14" t0011 00.75' 4 PVC IN FROM o ELEVATION = 99.25' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS `CONTACTOR SEPTIC TANK O 4" PVC OUT TO o\ o A 40 MIL GEOMEMBRANE LINER IS PLACED AT LEAST FIVE FEET FROM S.A.S. AND THE TOP TO VERIFY LEACHING FACILITY o OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 0 ' 2' o o0 0 o0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 101 .00 48„ LET TEE gg•17' MIN. 99.00, o00 0 000 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 14.0' BEL FILTER 6" CRUSHED STONE oo 0 0 0 0 0 0 0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO MODEL#A1801 HIP(GAS OVER MECHANICALLY 2.0' 2 0' BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR BAFFLE ON BOTTOM) �` COMPACTED BASE - 8.5' (TYP. FOR 1) 2.0' 4.9 2.0' INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING „ ��,��� > 5 OUTLET DISTRIBUTION BOX 21.0' (TYP ) APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. 6 CRUSHED STONE 8. ELEVATIONS BASED ON ASSUMED DATUM OF 100.00' OBTAINED FROM A OVER MECHANICALLY n�, TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= � 91 .70 8.9' - BASE. FIRST TWO FEET OF OUTLET 96,7rj CB/DH AS SHOWN ON PLAN. COMPACTED BASE $�°` .�� PROPOSED 1500 GALLON CONCRETE SEPTIC TANKS \i,l PIPES TO BE LAID LEVEL. 2 - 500 GAL. CHAMBERS 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION LENGTH 10.5' WIDTH 5.66' DEPTH 5.58' ' CROSS SECTION VIEW CHAMBER END VIEW AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY 5' MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE DISTRIBUTION BOX DETAIL TYPICAL CHAMBER PROFILE CHAMBER DETAILS DISCREPANCIES TO THE DESIGN ENGINEER. SEPTIC TANK PROFILE NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE STRUCTURES SHALL BE MADE WATERTIGHT. NOTE: ENTIRE PROPERTY IS LOCATED t ry �- TEST PIT DATA 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR WITHIN A DEP APPROVED ZONE II. + ° ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. INSPECTOR: Don Desmarais, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS SOIL EVALUATOR: Michael Pimentel, E.I.T. OTHERWISE NOTED ON PLAN. o DATE: 5-11-05 a 40TEST PIT#: 1 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND � «- � FINES. •, • ELEV TOP = 102.70' tj 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND * �, 4 ELEV WATER= < 91.70' UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF PERC RATE _ <2 MIN/IN LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN • ', -' DEPTH OF PERC = 42"-60" ACCORDANCE WITH 310 CMR 15.255(3). TEXTURAL CLASS: 1 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. r ~ ear • ® 0" 102.70' 16. PROPOSED PROJECT IS LOCATED WITHIN: C6 ASSESSORS MAP 234 PARCEL 45 • (+ • • . • 0 Fill OWNER OF RECORD: M. LOUISE ROBERTS o CB/DH ' EDGE OF PAV ME (FND/HLD) E NT +� ADDRESS: 17 CRANBERRY LANE CA 30" 100.20 CENTERVILLE, MA 02632 R_ NBE �R _E • " A Sandy Loam ' ^ �. . = - 10YR 3/2 FEMA FLOOD ZONE C L_ 3 8 8 �� -.� \ ` (40,w�D RRY�`1 N He ' • (.,, is 32" 100.03' GG \�_ F KAYO T o r '" AS SHOWN ON COMMUNITY PANEL# 250001 0005 C ,� g Say Loam ac \ 5 8'4p��F \ w } Sandy 10YR 5/8 17. PLAN REFERENCE: / 001 Nyes Perc 42" 99.20' 1. BOOK 178, PAGE 127 ha p' '' 18. DEED REFERENCE: 60" ' 97.70' 1. BOOK 17741, PAGE 343` t'� • " • " F- . and o \ + • + ,,• \L C 2.5Y 6/6 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. N M EXISTING y. I +� { 20. PROPERTY LINE INFORMATION IS APPROXIMATE, ONLY. THIS PLAN IS TO BE USED ONLY J DRIVE FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY _ / f FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. PROPOSED 1500 No Groundwater 91.70' GALLON SEPTIC TANK \ i� LOCUS PLAN 132 or Mottling serve 21. NO VARIANCES OR WAIVERS REQUESTED FOR THIS PROJECT. k � #17 I CARPORT EXISTING SCALE: 1" = 1000' I k 2-BEDROOM DWELLING MAP 234 PC TOF = 105.1 V / LEGEND PARCEL 31 ' 1r;:$ PORCH I N/F FITZGERALD CD "' � - `-' - O HC � � DESIGN DATA EXISTING CONTOURS �CID o ��ry ,moo• 102 PROPOSED CONTOURS PROPOSED GALLON LEACHINGNG CHAMBER �42 0 I �ry �. NUMBER OF BEDROOMS (ASSESSORS) 2 102 PROPOSED SPOT GRADE C 89, _ - (PROPERTY IS TO BE DEED RESTRICTED) __ CP -�" DESIGN FLOW 110 GAL/DAY/BEDROOM - L/T/C EXISTING OVERHEAD UTILITIES TOTAL DESIGN FLOW 220 GAL/DAY GAS EXISTING GAS LINE �- DESIGN FLOW X 200 % = 440 GAL/DAY EXISTING CESSPOOL TO BE W W - EXISTING WATER LINE USE PROPOSED 1500-GALLON SEPTIC TANK PUMPED AND FILLED WITH CLEAN B.M. � TP1 � a � SHE SAND (TYP ) � TEST PIT LOCATION CB/DH 102x70 ,` Elev. = 100.00' d O O O Assumed h INSTALL 2 - 500 GAL. CHAMBERS PROPOSED 1500 GALLON SEPTIC TANK CB/DH °Q FND/HLD CB/DH i MAP 234 PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE (FND/HLD) SIDEWALL CAPACITY N52°48'00"W� PARCEL 45 7.3T A � 15,246 S.F. ± MAP 234 PROPOSED DISTRIBUTION BOX (LENGTH +WIDTH)(2)(2' HIGH) (0.74 GPD/S.F.) = GAUDAY PROPOSED ,�` �_.� PARCEL 44 ' MAP 234 "D-BOX" N�1°3�� `ttL,�'b (21.0 +8.9) (2) (2') (0.74 GPD/S.F.) = 88.5 GAL/DAY PROPOSED 500 GALLON LEACHING CHAMBER 4p N - N/F JOSEPH PARCEL 32 84.13, f � BOTTOM CAPACITY N/F CURRIER MAP 234 ( LENGTH x WIDTH ) (.74 GPD/S.F.) = GAUDAY PARCEL 43 #17 (21.0'x 8.9') (.74 GPD/S.F.) = 138.3 GAL/DAY REV. DATE BY APP'D. DESCRIPTION N/F BROBOVOSKI PC PROPOSED SEPTIC SYSTEM UPGRADE TOTALS: PREPARED FOR: He M. LOUISE ROBERTS (1) TOTAL NUMBER OF CHAMBERS: 2 LOCATED AT TOTAL LEACHING AREA: 306.5 SQ.FT. (2)DESCRIPTION PC HC (6) (3) 0 TOTAL LEACHING CAPACITY: 226.8 GAL./DAY 17 CRANBERRY LANE CENTERVILLE, MA 02632 SEPTIC COVER IN (1) 13.7' 26.9' SEPTIC COVER OUT (2) 20.9' 33.7' 0 RESERVED FOR BOARD OF HEALTH USE SCALE: 1 INCH = 20 FT. DATE: MAY 16, 2005 0 10 20 40 80 FEET LEACHING CORNER(3) 33.9' 46.6' (5) 0 JnHN L. cw PREPARED BY: LEACHING CORNER(4) 54.8' 64.4' t a CHURCHILL w JR- JC ENGINEERING, INC. cml LEACHINGCORNER(5) 56.0' 68.9' (4) " .�' " 2854 CRANBERRY HIGHWAY LEACHING CORNER(6) 35.8' 52-T EAT 5 SITE PLAN 508.273.0377 SCALE: 1" =20' ,f/ Drawn By: MLP Designed By:MLP Tchecked By: JLC JOB No.854