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HomeMy WebLinkAbout0002 DAFFODIL LANE - Health -e. 2 DAFFODIL-LANE BARNSTABLE A_ 237 - 017:*,002 / C k I 0 � —� —ooa- ►�- Commonwealth of Massachusetts p Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Property Address , William Eddy Owner Owner's Name information is Wee#Barnstable Ma 02668 4/21/2021 required for eve + 4 every e. Citylrown State Zip Code Date of Inspection page. P 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. Inspector Information 5/-t (& lo3 on the computer, use only the tab Sean M. Jones key to move your Name of Inspector cursor-do not S.M.Jones Title V Septic Inspection use the return key. Company Name 74 Beldan Lane Company Address Centerville Ma 02632 Cityrrown State Zip Code roR, 774-2484850 smjonestitle5@gmail.com, SI4522 sean@smjonestitle5.com License Number B. Certification I certify that: I am a DEP approved s stem inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 4/21/2021 Inspector's 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 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: The property located at 2 Daffodil Lane West Barnstable is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and 7 Infiltrators. Although the system was found to be in proper working condition at the time of inspection this report does not guarantee future performance under similar or increased usage. 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) Further Evaluation is Required by the Board of Health: ❑ 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. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. 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 andJhe 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. c. Other: 4) 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 l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2 Daffodil Lane - Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: 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? 0 ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example,a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure.criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 1+311, Commonwealth of Massachusetts wM Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): pro gpd provided Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form je Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts U Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 9 P 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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 co of latest � ( Y ) copy inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other'(describe): Approximate age of all components, date installed (if known) and source of information: original system installed 10/26/2000 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2.5 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.): Joints in good condition, no leakage, vented through roof. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Pr Address Property dd ess William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 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: 1500 gallons Ilp Sludge depth: 5„ Distance from top of sludge to bottom of outlet tee or baffle 3' Scum thickness 211 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? Opened covers and took measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should.be done soon and again every 2 years for proper maintenance. Water level e was even with outlet tank was no t leaking and was structurally sound. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 cam, Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): 8. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form �- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): Distribution box was located and excavated and found in good condition with no rot. Water level was even with 4 outlet inverts. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 7 infiltrators ❑ leaching galleries number: ❑ leaching g trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching facility was video inspected from d-box and found with approx 3"standing water and no signs of past overloading. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): M t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 c� Commonwealth of Massachusetts p Title 5 official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 c� Q D 22 '� 2 A2 V 13 A3 i Z� t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ 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 describe how you established the high ground water elevation: Groundwater was established by accessing town of Barnstable groundwater contour maps. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts rn Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2 Daffodil Lane Property Address William Eddy Owner Owner's Name information is required for every West Barnstable Ma 02668 4/21/2021 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank-Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 2294 MAIN ST., BARNSTABLE A=237-017-002 III. • u r " , :i T. ' x + . �n ,. 1. - .. ♦ 0 t .t i r - 4- e TOWN OF BA/RNSTdABLE LOCATION SEWAGE # _ 3 p � o VILLAGE S A011y5 ;4a ASSESSOR'S MAP & L � INSTALLER'S NAME&PHONE NO. U11, ,41XM SEPTIC TANK CAPACITY 0 type) 1111_ �L LEACHING FACILITY: ( 17Y7A' (size) NO. OF BEDROOMS .BUILDER OR OWNER ZAA `TpF PERMITDATE: IA (OQ 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 jon 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 ( f 1 1 ' 16 l rsv tr+e Town of Barnstable /P#I S ..- rqy� Department of Regulatory Services _ + HARNSTABLE, public Health Division Date MASH g plEo .�► 200 Main Street,Hyannis MA 02601 r CX ✓►• Fee Pd. /14 Date Scheduled a' Time �M 3 J --6 Soil Suitability Assessment for Sewage Disposal Performed By: V b l'� L P�g V V__ Witnessed By: :r•' rr aiiS`. va:y." Location Address A S Owner's Name M , Address W .,d �A�N 3-1- gLA i fv1A G716 8 Engineer's Name Assessor's Map/Parcel: z S-7 In 6-L ;L. ��l NEW CONSTRUCTION REPAIR Telephone# Land Use ���t pi` Slopes(%) '15 Surface Stones Distances from: Open Water Body W O ft Possible Wet Area}ft Drinking Water Well �b 0-E' $ Drainage Way 0 1 ft Property Line o 0 It Other SKETCH:(Street name,dimensions of lot,exact locations of test holes&pore tests,locate wetlands in proximity to holes) XL X, N � t Parent material(geologie) J Depth to Bedrock 5� (� ��} Weeping from Pit Face; Depth to Groundwater: Standing Water in Hole: Estimated Seasonal High Groundwater r- �w u '�� �, { ' Y' i, 11 , , Method Used: V%6.1, A 'E c )in. Depth Observed standing in obs.hole: r '' in. Depth to soil mottles: it ---ft. De th to weeping from side of bs.hole: i9 in. Groundwater A justment -i • t3 e� .Q `- Ad factor I • Adj.Growtdwater I.eve Index Well# p W Reading Date: 1\I (1 o Index Well level �. J 13 0 0. 4 l3_ �'o� "` Observation Time at 9' i � Hole# - � ` • L l-� Time at 6" — Depth of Pere 11SW F • t ,•�'. �'. � 1��.t,� �� i�� Time(9"-6") Start Pre-soak Time End Pre-soak Rate MinAnch Site Suitability Assessment Site Passed _ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back • .. t ,?M:..,„ �....,n,xr:F:,, 1• I '.H�F q....,,;� I �h,'' k•I f '. .. F'`+` :.?...� 'a.�.f7,l: r ' '� t» ,� '�'��• :. e; � ql �'��i,�.�r'.fn, tit, ~�y� d�l�,�• x�;�is i. : d g_ •. _.. ... fie` �€ .... Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. _ Consistent %Gravel S�u�, l 0`0,5 C\i6 -ltk4G2 SA�v� �d`4� �o0 tl,l�, ,� I,!t �ld:e�: si.h.!ry!�'i ff, I 'v1.i;° il, �i 1 i .NS •u ' B u.` i 9 , , I -MI I I: .�1"tlr�:d�:�ItiaII�IN:r, Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistent %Gravel D- $ 1.oAvrv`1 �.� 1�'�IR•' �l l ti -' ' • ZZ/ 0�r �f L ��P.aD 7i •� l l�1 (o Ore IP tut-- V1KV y'�I:�g 1:r l:l�v..:'�a.rc�....I:„':I:'�F9!1'r.:::•ti:�..�,,::!wo�'!�@':I:�lry:::,:,t :-s:., yt,�:Q- k,I vr:'r,r r a I,e v:•.ii k,`'tr1 1�,...af I� "n r r�1'qn Ii�c 1 r Soil Other from Soil Horizon Soil Texture Soil Color r_lP,_�h ul_ll:.tl.-€w.��N I�!El:!Ev n�:i_:K:•aini,,l Pf��'.IrcId��:rw'id!�r66V_i"I �V!:>K Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistency,%Gravel 0 l a A Loarr t Spti3O I 13 : • , to -z,�1 $ �n�l S4uh �a yK SLt. 01,lt , : lr: .= •t : I� , a� h . A Q aI- g( Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistent %Gravel c- �AaW\ �.10 Flood Insurance Rate Map: Above 500 year flood boundary No._ Yes X Within 500 year boundary No k Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material. Does at least four feet of naturally occurring pervi,101, aterial exist in all areas observed throughout the area proposed for the soil absorption system? is the depth of naturally occurring pervious material? If not,what p Y . g Certification I certify that on P t7 te) have as es it a luator examination approved by the • Department of Environme ec 'on and a bo e an ysis was performed by me consistent with the required training, erti experienc a rib in 31 CMR 15.017. t; Signature Date l Z Ir Oo Ila- lp MAP 237 PARCEL 017-003 /45 // —40_ O -42= / /a� a` 54 DOHgt // DWC6� EL=41 0 EL�d8.4 I I \ \ 00 . Q m •. � — — J / DOH X / DOH 3 \ Ln MAP 237 EL=38.o z Z PARCEL 017-002 / / — EL=36.8 DOH#4 EL®.0 r,l — G� y< ^� JOB CIL) OAff A�--T�" SHEET NO. C` OF I NGNMOG I1NCALCULATED aY- V d *,�,�*�7 (� DATE Olv���11 `^ CHECKED BY DATE 260 Cranberry Highway,Orleans,MA 02653 508-255-6511 Fax:508-255-6700 www cecca ecod com SCALE E W- AD i i 4:� L 114 s f s Reoider From NEBS CUSTOM°"printing service 1-800-889-6327 NEBS.Inc.Groton.MA 6j47/ 1"1.1eb1.ccm Re£.NO:G 266500442 I� r , r 0ASTAL NGINEERING TRANSMITTAL OMPANY,INC. 260 Cranberry Hwy.,Orleans,MA 02653 508-255-6511 Fax:508-255-6700 www.ceecapecod.com To: Town of Barnstable Date: 12/12/06 Project No. C16424.00 Public Health Division 200 Main Street Via: ®1st Class Mail❑Pick up❑Delivery❑Fed Ex Hyannis,MA 02601 Phone: Fax: Subject: 2294 Main St. (Rte. 6A) No.of pages to follow: West Barnstable,MA ® Plans. ❑Copy of Letter ❑ Specifications ® Other We are sending the following items: Copies Date No. Description 1 11/6/06 11521 Original Soil Suitability Assessment for Sewage Disposal 1 12/11/06 Sketch Plan Showing Soil Test Locations 1 11/6/06 Deep Observation Hole (DOH)data sheet These are transmitted as checked below: ❑for approval ®for your use ❑as requested ❑for review & comment ❑ Remarks: Cc: William and Mary Beth Eddy By: John G. Schnaible,R.S. 2294 Main Street West Barnstable,MA 02668 JGS/dlb NOTE: IF ENCLOSURES ARE NOT AS NOTED,PLEASE CONTACT US AT(508) 255-6511. D:IDOCIC164001164241CorrespondencelTransBOH-121206.doc TOWN OF BARNSTABLE dF G LOCATION SEWAGE # d - VILLAGE CA/5.4/,W- ASSESSOR'S MAP & L e , o INSTALLER'S NAME&PHONE NO. f,U/.G.C/ SEPTIC TANK CAPACITY 'EQ b 4:::%L 14.V. LEACHING FACILITY: (type) -1A-17Z4.4-&1f (size) NO.OF BEDROOMS BUILDER OR O R 4- PERMTTDATE: / 0 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) t� Feet Furnished by Ra�� � r ass I- . -i \a,412- (217 i �3s _ Fee A0 o . No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 01pprication for Migonl bpgtem Construction Permit Application for a Permit to Construct(X)Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 27, f `a I. Owner's Name,Address and Tel.No. Assessor's Map/Parcel 2 ti 70 C6 fwiY/u /CA/7"'V Gv Z 3'l -PJ 1 -0®�-- n iv/S W. 62 60 Installer's Name,Address,and Tel.No. Designer's�Iame,Address and Tel.No. AL/XbS q-114440A-7H YA16 Za o M!+/n1 S 7; FAe_n fY774 /CIA 9ZS% Type of Building: Dwelling No.of Bedrooms Lot Size -7772-9 �sq.ft. Garbage Grinder(�4 Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow SS© gallons. Plan Date /a-a 8 Y 17 Number of sheets t�_ Revision Date A/,1A Title PLOTPt_AN D�S Size of Septic Tank / or Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) mate last inspected: i✓�/4 ��R�- i/�9 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 operapon-u til a Certifi- cate of Compliance has been issu 's 1 r %9Signed Application Approved by Date Application Disapproved for ollowing reasons Permit No. Date Issued No. S✓ D' ., — / y^r C-' Fee "HE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLES MASSA HUSETTS Yes 0[polication for lDigool *pztem Construction vermit Application for a Permit to Construct(X)Repair( )Upgrade( )Abandon( ) 11,•CompleterSystem El Individual Components Location Address or Lot No. 2 29 f r»p� ; `a�' Owner's Name,Address and Tek'No. i3AQN5'�LE l.�Ic-c//►M� ����6£� v� Assessor'sMap/Parcel 270 Cdrwn/ul"ICA776"V &14 Z 31 -d 17 --00-Z- NN/S W,4 d2 60/ S0V'77///71C KIX Installer's Name,Address,and Tel.No. Designer's��11ame,Address and Tel.No. 14o bH E5 4 M dl fA77Y 2-M 6 20.0 44Ain1 ST. FAcn�rY�l 1)1,4 4o2Sgo Type of Building: ,/ Dwelling No.of Bedrooms 5 Lot Size 7770,. -ti ft. ;. C Garbage Grinder(r �. Other Type of Building RE510EveE No.of Persons '¢ Showers( ) Cafeteria( ) Other Fixtures Design Flow s� gallons per day. Calculated daily flow 550 gallons. Plan Date Number of sheets Revision Date NSA Title. PLoT SjF�kvA6C IS/S��SACr GvDiP,�S x, — DpyS �"I Size of Septic Tank / DO Type of S.A.S: Description of Soil M rD • 7.) FIAJ 4F „(; 1U4b r �� r Nature of Repairs or Alterations(Answer when applicable) > /Date last inspected: i✓��+ ���C- - �. 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 'his ltl � T o0 ' Signed �\�` d ,' a Application Approved by YV= Date + (Application Disapproved for tlfe1611owing reasons "" \ 1 { Permit No. Date Issued ------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS` BARNSTABLE, MASSACHUSETTS Certif irate,of gmpliance THIS IS TO CE VRY tha the,0 -s' Sew i y"s onstructed(�O Repaired ( )-'Upgraded( ) Abandon y �" at has�b constructed in accordance with the provision of Title 5 and a for Disposal S stem Construe 'on Permit No 0® V `ted Installer Designer`~ The issiiu n e o/f/t permit shall not be construed as a guapntee that`the� s em will ut. ioftdie ' n d.� f Date f� �l c �r Inspector t� Pill; 00 ' No.--�--^-----�————j �--�--- ----Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS ;Di000f *pgtem Construction Permit Permission is hereby granted t on truct.( )Repair(/ )�grErde( )A�•nd System located at r • ' /` " l 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. j Provided:Construction must ble completed within three years of the date of this pe'Q—t\./`? /Ai°� '3 Date: /; 'I/ Approved by aw��°•i ova,°-a j • � opc•' T°'ate� - � . f MAsrca 2,eoL-4- .- 1 _ LZl''RYN :1 s I - C� ' • fWLN �'AnwN' I .. .. _ _ �wA�,Pw - ••� ava a y�y,_. _y.e• —414� -Y`0 —yl�• YW —_Y�4`— __.'—I�l°� .. � ,. / � 17— /else • �CCAND �L oo2 �Ih �� 1 y � Ye a43�o y-yl�.. yle _ 7t°.. �. tl__yle__ _._yl4• 0-O 11 ' !w•AMf ae ' J Ma.¢MAi. W,il,.:•.l Eddy . adgy MAW Sd. , Zl AAX3TA6/F wei. a off.no FLooq •'(�V � I _ �— y A tl � L I M' 1 j b. v 1 F .r y II i o f C A 6 i 4I` — i ti ar I i om4 n o � 1 y ti ti b 3 -- i os 9 z .E .pre N b �- 2" x x ; m ' n i , j Town of, Barns(able Dcpnl•lolcol of Ilcallh,Safely,and I;nviron III cnlnl Services ]Iun',' Public Ile-Mill Divisimi Dale_ SI .167 Main Shed,Ilymmis NIA 01601 1 uAnuerem� 1 IIA91 le g o'°v�• Dale Scheduled _ 'I'inte/i� I lice — ---- - • SOW )Sriit(rbiliti�..flssessriteitt.f i)i' Selvage Di,S' o*sal Vell111111CII Ily; f iQ ICAU7 /"!a4A 1VhocsSeJ Il _.,,�, � �fj r/✓_ LO(:ATION & C:I,141101AI., INIFOitMATiON , Location Address Zx Uwncr's Name I/ ;e 4 /V/e,/,_e� ,� i 2 3 -r ,% Address Assessor's Nl:gr/I'nrcel: a/, Engineer's Name N14 CONSTRUCTION IMPAIR Telephone U 1 l.mrduse Residential , Slopes(419) 0-10% SlufnceSimms none. I)islances 6(Inl: Upon woler I1ody 300 It Possible Wei Alen 150 fl Drinking Witter Well N/A 11 r Drainage 1Vny��1 II Ihnpcuy Lioc 20 ± II Other 11 S I<l;'I'd 1:(Street name,dhneuslons MAW,exact locatloos of test ImIcs&perc tests,locnle milonds In ploxiallly In 11I11e4) i IN E � f 08.44'50' E g H 08'3-1110' E _ EASEWIENTr-----533.11 — �`t�_ In WOW �° I n ——;— N 00'M'DC E AL 74.84' ; S 08'37*e ton. •44'SO'W r �1 - ' �a\ ASEMENTn$ �'N oe4i'tsat R R 43.00 T , m L-43.34 LOT 1 `G'�+••� IG . A` R�28.37' _ 'dl` t0 to 02 __.__.... k LOT 2 -- 4.08± ACRES O `�•OIL cr 4 N . I N� i i SCALE: 1 ra 100' . Pa1Cr11 uurlerinl(geologic)_ _Gla eiaj_Tl11 Deplh to Ilcdrock_ >30 feet_ Depth to(iloundwaler: Standing Willer In Ifoie: None 1Vicepigg liqul I'il tote NO FS11111aled Scnsonnl I ligh Gloundn'aler >2 5 feet --- DL'1'ERAI1NA'HON I�OR SI,ASONA1, III011 1VA'I'Ii,It '�'AIILI� Nlenmd ilsed: Regional •Groundwat-er 'Map Depth Observed standing In ohs.hole: _ in. Dcplh to soil Inollles: Ucplll to wccping from skit of obs.hole: _ _ in. GlotindmIci Adjoslmcul hulcx 1Vcll ll Ilnadinp.Dille: -- — Index Wcy lev._•1 —------ AdI a dm A... (l.o�rcywaic, :.eve, . l'1ItC'(1L/1'1'ION 't'LS'I' iidle Time I ,1 Observalioll II)le)1 _ Time:at 9" ' Depih of I'm fhne at 6" Mail I're•sook"fimc n 'fimc W-4) End PIe-sonk IIIMEn./111c11 < 5'min in in C2 at Test Hole #1 Site Sidlabllily Assessment: Site I'nsscd X Site foiled: AJJillounl'I•eslhlg Needed lI Original: Public Iiealih Divislon ' 011servnlloll Ilole Dallt To Ile Completed on Itacl( Copy: Applicnnl DE1101 Q101111 VA'1'10N HOLL L,OG1. llole I/ —� Depth lioor Soil I lorizorl S'oll Texlore Soil Color Soil Oilier Swlncc(in) (USDA) (Slrucpuc,Shnres,116111r1CIC3.'. ;# - ' ' _CnnslslsnsY.ly Sira)sJ) A loamy` ---------- --- : � i,:42„ -----B -- - - mod :.... ; 10yr 4/2 12 loamy r _ _ sand /6_ 42"=108 ,._ ..'.Ci . ._ -- sandy...;_. --. 10Y 5 Y ..--/6 10 r 6 108"=17 " ` G2 medium to ----- -- ----- fine--.sand_-2.3-Xr--RI. ---— - ------ - ....._ DE NO' OBSERVATION 110LE' LOG 11ole 1! Dcplh lium Still I lollZoo Soil TCA111C Soil Color Soil Win Sill Face fill.) IISUA( ) (C`lunscll) Ntollling (Shuclurc,Sloues,Iluuldelcs. _S.11USislSllfil.is�iIILYSI) 0-6" A loamy ---- - — ---- Land Oyr 6"742" g loamy Oyr 5/4 ---- - 42 --- — - I)ECEP 011SKMIA110N HOLE L,O(► lllilc �E —_-- Depth Dom Sall I lmizoo Soil TC011C Soil('oior Soil (llhn Sotliice(111.) (IISDA) (hillosell) Llonlin g (Slnlclulc,Sloncs,Ilanlderes. --------- - - ------- ---•------- --- — -Si1J1iIiIGIlSY..1eSiIilY41) 1)1,I!P OIISLItVATION IIOL Er LOG I/ Depth horn Soil Ilorb.on Soil"I'cxlmc Soil(blur - Soil 011ie$ Surliice(in.) (IISIDA) (Nlonscll). f,lolllin.. • g (Sbuclolc,Sloncs,Iluolderes. - —_ --•------•- _-- (�1II31115:11cY.lo.)IIflY41) ' >r i O'1wif I11Ini ul Itvs-U1S11A lit Abovc SOU year(loot holnulnr), No, 1'cs F x' ---- F. _ -Wimin 511t)year bohndnly NO Yes j ,Vl!!:10 !!!4 vcar hoot hurrntnry No Ycs Psit!!u1_LNillw fJ1LDK6tlll)I;TfdT HILMIll9ditl 1 t 1 Does a( least four feet of palurally oc6u ring pervious InlUerial exist in all al•cas obsclvc(I lhlrnlghollt the areal proposed fin the Soil absorp1io11 sySIC1117 I g_..___-_ -- I ! f not, what is Ibe depth of nwrlilly occurring pervirnls males ial? �cL'1111Litlllill 1 ccrlify Iha1 on ((In IC) I have)sassed file SUIT evalllalor CX11111111nlioll apploved by Ills 1)cpallnlcn( of Elivironnlcnlal Pro(ecfioll and (h111 the above aunllysls was perfolllled by Ille collSlSlenl with the requirc(1 Irniniog, cxpcilise nod cxperic ce described in 3I0 Chllt 15.017. ;: '. Signature - — -- I)ale l 6 O O — � - _ .. I - N F / _ E , 4 4 50 , Tf F. R OR B RG O 8_ sco eEA sE �caa/�F TH N u eEr�sE N _ . D N N ONES AND e W LSO T. J t , F UE 1_ 1 M 53 3. E NTERRY , ' . T ._ H. VARNEY E , D G E E OF 1 0 F 7 P A N 0 6 3 , , VE ' M Y - A ' E W N F' 0 '- T_ H : R 1 G , W 1 _ 1 : . 0 5 PAGE E 1 9.1 P 8 7 8 � 2 2 , L A N B 0 K , f • CEDAR P v4 . 2 E ,.. 5 _39 _ ._ — NT � s ENCROACHME � _..._ '� W .� N 08 44 5 CONNECT 0 EXISTING WAT ER MAIN a TE r W ,. w 7 5 . s t ..._. ' E ;3 .I P LE c� 7 W G o _.-, 3 P _ :_M , . . i r C•E r K _ Q 32 .__- 0 V 61.00, A .. .. D G , a �y r 'Y r .+..• .. .w..r. _ . t . W 4 5 0 .. a S 08 p . 4.6 4 Z 4 R 7 o o CEDARS 1 1 • .,. • •ice .' a . A -30.00 10 O ra . 3 o _ 8 CEDAR 4 a 1 . L 43.34 74.6 \ S W 2 , .• DRI WAY o SAWCUT PAVEMENLO T F ao REMOVE PORTION EAS ENT . : Q sly . , ao ! d' ISOLATED LAND i� ON LOT 2 F` f a SUBJECT TO FLOODING DG F P A O EDGE 0 PAVEMENT CO i EN `I a t 6 a t \ s Q c .� c9t . _ I R 28.37_ a z \. : _ CEDAR TREES 00 PLANT CE t>• d I 4 L 0 , t IN STAGGERED ROW S , / S 6 ' EDGE Of PAVEMENT TYPICAL S a , . w 3 op- , s S a R _ 8 • a ,_ t I F _ DOUBLE. K' W 4 ., ., 1 OAK 0 Q . r 6 �r ..�....�-._ LOT 1 #8 CU \ � o { E - f G •. ! ^ P G W I i h , BENCHMARK: \ kw-#N � 5 TAG BOLT OF HYDRANT 33 # WINFIELD M. NICKERSON \ • t ���.�.,.. .. / � -. : _ 02 V. — :69.05 cn AND VIOLET E. NICKERSON .• _ � \,� ry ��, 'w HOUSE _: 50,48 \ > 5 . •ti Q \"^.� • o W_ 6 : ..BOLE i 34 . , t3 I LOT w \ 4.08 -,ACRES .. ._ `• _. w -�-- � ry `t Z . . Z Z o LP LT% % ~. N o cr N 36 CID N CA , CIS .. O 0 5 1 , : I O , N F THEODORE S. HARMON - AND JUDITH A. HARMON �6 d 54 c POLE W > #35' � � •SSp • f o N _ I 10 7 HIGH, CAPACITY INFILTRATORS WITH 4 OF STONEALL AROUND . - AND 1 . Of STONE BELOW. / � .r. �0 \� al 10 IN. / 1500 GAL, THE CONTRACTOR SHALL REMOVE ALL`UNSUITABLE MATERIAL .,, /:• , BOX. •. . •. :•.. -.► �.,,,,�,�� : '� GOWN TO THE C2 LAYER 9 f AND GLACE WITH CLEAN .(DB5 H-20) ' SEPTIC TANK ( /.,.. _ H 20 GRANULAR SAND MEETING THE SPECIFICATIONS OF 310 CMR ) - 15.255 (3), (4), (5), AND (6). 50 , M • ., •O 7 Co ur ,.. i r� � N F J , •.• fl•, do 70 ROBERT D. STEWART AND j G N 08.44'50" E NOTES PRUDENCE T. STEWART N 06.37'10 E , 58 O' r 289.15 2r.os' —_� —_ EASEMENT -----533.11,395.09'---f \ 00 1. HOUSE NUMBER: 2294 $9't r FO��N TO s—oersa".w___ — —— mac-_' N osa4'so' E +,0 �• �' - 4' s�. o' �- � � ND S NE 74.6 . ,� �� W 2. ASSESSORS NUMBER: 237 17--2 �LLf S 06'374 s4" W � loo, S08.44 50 W o ( 'k s� ASEMENTcv ra ,� $� j Cq 3. ZONING DISTRICT: RF-1 .AND RF-2 R=3o.o0' s��,3 ,n o �.`� °•-' 4. FLOOD HAZARD ZONES: -C DATE DESCRIPTION Drawn hecked L=43.34 LOT' 3? .\ 0Pi 0 a00 '� Nosaa'so'E m 5. BENCHMARK: TOP OF TAGBOLT HYDRANT `#33 (EL.-69.05) Z _ R=2>3.37; �. •i i _ � R E \/ I S l p N S Q L-40,98 Z 6. TOPOGRAPHIC INFORMATION COMPILED FROM AN . 1 to 5oa202, 5" E N J ON THE GROUND INSTRUMENT SURVEY 52 7. ELEVATIONS SHOWN ARE BASED ON THE NATIONAL ��a• PLOT PLAN N LOT 2 N •p� oo OF PROPOSED SEWAGE DISPOSAL SYSTEM 4.08E ACRES GF OD NTIC• PRTIN AL DK 48• PA 34 S Og PREPARED FOR �\ O o 8. .RE ERE CE. LA B00 0, GE N/F f _ DORTHEA H. DODGE WILLIAM AND MARY BETH EDDY 6Z FOR LOT 2, MAIN STREET ��51oor E j IN 5 0� N BARNSTABLE, MA rn 2.0310 F my NOTICE _ ti ��� 0f 4, 5 10 GRAPHIC SCALE 00�'O STO Unless and until such time as the original (red) stamp of the SCALE: 1 — 20 DATE. DEC. 28, - 1999 � �s�y►�, o 4 responsible Professional Engineer, or Professional Land Surveyor o MICHAE �a w appears on this plan: h of m e S and m egra th inc. BORSELLI 4 ,� � h8.52 20 _10 0 20 60 �<< r � t � ....,1. 0 (A no person or persons, including an municipal or other C=, P P i 9 , n P civil engineers- and land surveyors CIVIL public officials, may rely upon the information contained herein; and No. 35054 • . (8) this plan remains the property of Holmes & McGrath, Inc. 200 main street R08 08 548-3564(PHONE) •� KEY MAP { nor ) falmouth, ma. 02540 ' 548-9672 FAx 4, ��sT— 1 inch = 20 ft. SCALE: 1 = 100' DRAWN: MAH CHECKED: . EDDY 9950OPP.DWG JOB NO. 99500 DWG. NO.. 74 1 29 SHEET I OF 2` D E EP OBS ERVA TION H OLE LO G "'N Gil 1 OTHER �Flnlsh SOIL SOIL 'TEXTURE , Sol "(STRUCTURES grade above ond.odjacent 'to system shall slope away at a min. of 2%. SOIL COLOR L 'ST01l BOULDERS' DEPTH ELEV. HORIZON . (USDA) (Mu s 11) T 4" diam. cost Iron or Schedule 40 PVC pipe (tight -joints). n e O: TLING CONSISTENCY,�% GRAVEL) 20'.,min. distance (building to edge of leaching system) 011 58.0 10' min. distance 0"—12 570 A LOAMY SAND 70 , YR '412 First.floor 3;-Removable covers )vithin ELEV.' 59.00 6 of finished gride (if Necessary) 42 Accesl Holes in ank to 72' 54.5 LOAMY SAIVD 70 YR 516 �VO be 20 In Diameter Dist, box 708" '0 YR 616 N 49. LOAMY SAND 42 2 /-S= VARIES INV. ELEV, 53,00 C2 S S 02 Cl 3' MED. I i­ I I I� I — I ­; 11 1 % , I ,-.: I I /I //11\l 5A AID. el 0,01 MIN, 708" 174 4,315 2.15 "Y 812 NO 2" layer of 1/8" to LJ- - - 1/2" washed stone C14 ---'--SEPTIC TANK Foundation "i 4 ft. of 3/4* to'l 1/1" washed�— ff design NK N N stone all around infiltr3tor and LEV. 50.67 by oth 1 ft. below. ers,, > -0 4' > Z 6" LAYER OF CRUSHED COM PACTE z 7'± z >: zi D S NE PRonLE 6- LAYER OF CRUSHED COMPACTED STONE Not to Scale DEEP OBSERVATION HOLE LOG',' NO.%­ THE OONTRACTOR SHALL REMOVE ALL UNSUITABLE MATERIAL 2 DOWN TO THE C2(9'±)Ill AND Ill WTH CLEAN BOTTOM OF TEST HOLE ELEV. 43.5 GRANULAR SAND MEETING THE SPECIFICATIONS Of 310 CMR 15.255 (3), (4� (5)�AND (6). SOIL TEXTURE SOIL COLOR "(STRUCTURES,� SOIL SOIL DEPTH ELEV. HORIZON (USDA) (Munsell) ' :,MOTTLING BOULDERS, CONSISTENCY" X GRAVEL) 0 570 56.5 A L OA IV Y SAND 10 YR, 412 42" 5J.5 LOAMY SAND 10 YR 514 NO, 46.5 C LOAMY SAND 70 �'R 616 , �,NO 42 126 GENERAL NOTES 1) No , change to th is system shall be made, unless SOIL TEST �dpproved in "writin ' b YL holmes and mcgrath, inc. Subject to' inspection during construction by -the DESIGN CRITERIA . Board of Health and holmes and mcgrath, inc. Date of soil , test. 12/1 /99 -Heavy cdhstrb tion ipment sh6II not t dv Test taken by: M.BORSELLI 3) c qu r el Number of bedrooms: 5 Equivalent to 110 gal.'s/day disoosal m fter construction. Gcrbage disposal unit: No over uring or a -BARRY Leaching area - capacity required: 550 gal.'s/day Results 'witnessed b y: ' E.D 4)' Disposal, system to be constructed in' accordance Side area proposed: 239 sq. ft. Percolat: on rate: <5 min./inch ''with Title 5 "of the State nvironmental Code. Bottom area proposed: 560 sq. ft. -copy of, these plans must be kept on the site Grou1nd Wcter NONE ENCOUNTERED Total area proposed: 799 sq. ft. during- the time of construction. Proposed leaching capacity: 591 gal.'s/doy 6) Acop ' of 'these plans must be furnished to the Water supply. BARNSTABLE y Precast concrete units: H-20 loading design 0 c ntractor constructing the -disposal system. .7) Before" backfilling, th'e contractor shall notify holme' s 'and mtgrath, inc., and the Board of Health Agent.-to "inspect the system as constructed. 8) If tfi�e��contr or encounters any variation between INSPECTION H OLE, the plan and the 'existing conditions shl"own on n the site, or any soil ditions ',ehcountered ,�,o, conditio ffferent than -shown o -h n -di n t e, soil log, or dnY.�,6' dverse soil,i the -contractor: shall immediately mcgrath, inc. Holmes and ,contact. holmes and .. mcgrofh,' Inc., will examine the soil condition nd ,repo le owner, any suggested revisions. a rt,�,to� th r opt 34*0 6'—3 —20" Diameter Access' Holes 14 ALL ACCESS MANHOLE COVERS FOR TYPICAL HIGH 'CAPACITY INF INLET OUTLET ILTRATOR (H SEPTIC TANK, DISTRIBUTION BOX, 10 LOADIN AND LEACHING STRUCTURE SET MORE NOT TO SCALE THAN 6 BELOW FINISHED GRADE, SHALL BE RAISED TO WITHIN 6 OF FINISHED GRADE WITH RISERS. FRAME & COVER STEEL, REINFORCED PRECAST. CONCRETE OVER "T'S" WHERE REQUIRED. PLAN VIEW TANK RISER, WHERE RE COVERS 6 6" REQUIRED :?NOTICE Unless and until such time as the o4ginal ed) .'stamp of the 7r ..L 4� responsi e ro essiona rigineer; or rofessional Land Surveyor, 6 TUFTITE SPEED LEVELERS appears' on this plan­� ALL OUTLET PIPES FROM THE , INSTALL (A) no person,o -ON ALL d`g ony munt I th' ,OUTLET PIPES , r persons, nou in Ipa ,,or �o er 3 min.. clearance, required DISTRIBUTION BOX SHALL BE 6! INLET "T" public officials, may rely upon the Information contained herein; '.and (B) this plon remains the pr drfy of Holmes�co T t E h ed I N L , min;.'inlet' to outle SET LEVEL FOR AT LEAST .2 FT. CONCRETECOVER OUTLET E 5 5" OL!TLET DATE DESCRIPTION ra �h Liquid 'level . ' 6 —0" KNOCKOUT' -6 JC S. R , E �V, a) ­—TUF—TITE -0 20 INLET T PLAN , DETAILS" , . .0 GAS BAFFLE PLO OUtLET gyt sYSTEM OF .PROPOSED SEWAGE' ,DisposA .25 "FOR T WILLIAWAND' � MAk , BETH" EDDY t6 FOR LOT ,4 , #2294,�,MAIN ST.i,'(Rt6A F- 24" 100-01t 6' —2" IN M A ., .,,BAR,N STABLE, " 'CROSS SECTION u"ROSS- SECTION PLAN SECTION END - SE AS SHOWN TDA 8,19 9 9 SCALE: ' TE" bEt.'� hollrnes,., and '. mcgroth, 'SORSE LLI TYPICAL 'I 5100 ' -GALLON SEPTIC TANK H - 20 LOADING , 6 HOLE . DISTRIBUTION BOX ' civil, engineers -and 'land surveyors 'N 2 00 ain , street TO Or cis E '' NOT TO SCALE NOT almouth,: ma. 0254 K DRAWN: :.. MJB, CHEC M, V tELEV-- ftDWC 4—l-29 'S E�T' 99500D 013­NO.� 90500 D WG., N 0.:' 2:OF�