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0188 DROMOLAND LANE - Health
188 DROMOLAND LANE, BARNSTABLE A= 335 083, e n Y .` w 1 a I v TOWN OF BARNSTABLE ;,LOCATION SEWAGE# Ace(0i _0(67 VILLAGE ASSESSOR'S MAP&PARCEL 3-3,5 SD INSTALLER'S NAME&PHONE NO.W i.AJi 06 �"�JT ! t�Q���1 477- 77 SEPTIC TANK CAPACITY 1 . 6® (:f.CDRJS LEACHING FACILITY:(type)M O q*L 6MAERS(size) ('a,�S x ✓-� c NO.OF BEDROOMS 3 OWNER L WRC--1J#-C RUX*C- PERMIT DATE: a`L^ ( 9 - Z®( COMPLIANCE DATE: 3 f l -aZO I51 Separation Distance Between the: ' Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility NIA Feet Private Water Supply Well and Leaching Facility(If any wells exist on A 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) >A Feet FURNISHED BY G1yTd1 � �(� A- A- Z 32 .5 ." oac H ,� 3 53 A - o 0 A-6 ho ` d -Z ` Z 3.5' 3. B-3- ems ' -o TOWN�lE�ITaTABL.E ;M L4C�►'ao no a V1LLA�.rFs -�A v`'�►'� 14 55£SSOR'S iv1AP S L4x_._. JMST S NAME&PH6'k NO y, e � (size) PfG / LEACgitl+iG�?J�C�TY'' (� ) r NO .mF�$P3&Ot1MS . E, +1�BRRidxTfDA' E: CCll�l' CE 1DA'J :,..... ISO pamdo ble, :.li aw.pen,kbat �MaxlmumAcfjusted Gi'aantlwrau Table W tWA.tan of4kfi n�Fat;�lity {Pr1v G�tlater up ly VJul1 d esaiiing acMY Deny eels cxis ' aa:eitss ae:;witt�an�,Qp f�et.of lensb�i�Fdcllity) l�cat `Ede;iVUetRand and X.eAcbin�l�sfty(l�iany.wetlan�ls exist witJ�lt�900: nalliry sae t rron► a3 ly �► ' or No. Fee 'v " THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 9pplitation for Mifip eal pstem ConstCUttion Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ,9 a pRQMdLANO Ld Owner's Name,Address,and Tel.No. G.1�41R� Assessor's Map/Parcel 3 35 8 3 1 &19 D Ra Installer's Name,Address,and Tel.No.502 477-9'97-7 Designer's Name,Address,and Tel.No. e�P��DC E�?�'�►Q1S .�� ��� �G �N�IeV�JN��� 04� ,Type of Building: J Dwelling No.of Bedrooms Lot Size � sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �33n gpd Design flow provided 3+ /Y gpd Plan Date a-"15 -9Lr7 t 9 Number of sheets Revision Date Title Size of Septic Tank k SOO EAtL 400E Type of S.A.S. ` Description of Soil Nature of Repairs or Alterations(Answer when applicable) USA ���/Z�� 1T_ �Cx! �Sb�TI �FiU�. �'1� ��.Z't� �`���"�y�� -���� ��8� ���E.L 1)R.� ��� �•b��t(Q� dr— / * S 0APLOU 4 Jhl L 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 Certificate of Compliance has been issued by this Board of Pealth �p igned Date "t-t" � r Application Approved by Date I CA Application Disapproved by Date for the following reasons Permit No. !�J 0 l9 Date Issued o� l r No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in co puter: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application `1 3ist oBal*pstrm Construction 3permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Jg a DROMd(�1ND Lr Owner's Name,Addresg,and Tel.No. L14Wkt3tj<L- *GL AjRC- lks Assessor's Map/Parcel 335 8 Installer's Name,Address,and Tel.No.5'Q2 4`77-9'977 Designer's Name,Address,and Tel.No. Cr4PeWtDC zs" ,, GN6"6a5 _4N(5r aL_NG Type of Building: Dwelling No.of Bedrooms Lot Size 4 -�sq.ft. Garbage Grinder( ) Other Type of Building R (ba-l-r f At . No.of Persons Showers(Y Cafeteria( ) / Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date a - ..��(q Number of sheets 6 *' Revision Date Title e Size of Septic*Tank 1 t ac b CCALL,40C Type of S.A.S. Description of Soil sRZ Ad Nature of Repairs or Alterations(Answer when applicable) I ISE Date last inspected: n 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 Certificate of Compliance has been issued by this Board of Health. igned Date -��- Application Approved by Date j Application Disapproved by Date for the following reasons r Permit No.!:�)�_/ 7 Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X) Upgraded( ) Abandoned( )by AP [�a 1t � g `5f at LA( RAOhas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NO -O o dated N ^� Installers )(T)jE � �� ) Designer #bedrooms 7:; Approved design flow gpd The issuance of this permit shallot be construed as a guarantee that the syste�''Will of 3m'oar asn Date �/ � � /► Inspector\.. - - ------------------->- ----------------------------------------------- - -------- --- ----------------------- No, 're� "' /� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pstern Construction J)ermit Permission is hereby granted to Construct( ) Repair(�[) Upgrade( ) Abandon '� ��() /�1 ( ) System located at g M �J ''`` )Cj), and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date �_ 1 Approved by �-"" Fria r. I L. LU I Y 0;D}HIVI No. 3050 P. I Town of Barnstable IN Regulatory Services d BAiiNSTAHI.P,, 1 Richard V. Scali,Interim Director 1°A`9' Public Health.Division 'r0 `Thomas McKean,Director 200 Main Street,Yiyonnis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form # 3-1 z-1 q Date; Sewage Permit# fit)Lq --OG3 Assessor's Map\Parcel Designer: TC, Erlgio e,"inj , Tn(_ Installer: C a e_wi8e lrnhcr r(seS Address: Za5y Granberr ( i#WAY . Address: 15'5 Commt.rccol SFree+ East woreJAam N(+ 42S �i �(ostn�ee )1P 02�`19 On ,;L'19 _1p(cj Coleewide- C-44zereses was issued a permit to install a (date) (installer) septic system at t Do-mo `�' �a4 C based on a design drawn by (address) -S G &51ne"io C-) I TV'C dated Feb_ j 51 116 1 (designer) \V/I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. —w I certify that the septic system referenced above was installed with major changes (i.e, greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. l certify that the system referenced above was constructed ' 1 e with.the terms of the IAA approval letters (if applicable) �P�H° As JOHN L �. • , � CNURCH►1,1,JR. (Installer' Sig to e) CI q No tea 00 r Is ( lgner's Signature) (Affix Des' er amp Here) Y'L E RETURN TO STABLE PUBLIC HEALT DI SION. CERTIFICATE,COMPLIANCE WILL NOT BE YSSUCY) UNTIL BOTH THIS FORM ANY) AS- t. BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. M THANK YOU, Q:ISepdrkDesigner Certifieacion Form Rev 8.14-13.doe a Town of Barnstable P# D ' Department of Regulatory Services f :a ` Public Health Division t Date. 3/ . � s wwarwr�q, t id1p 200 Main Street,Hyannis MA 02601 , b a' Date Scheduled " Ti G Fee Pd. b me . Soir Su716 Kati Assessment for-Sew ' e Dzsposar ' Performed.By: �"I�(�QQ� 'IQ� � EI SE . _ (� witnessed By; LO CATION&.GENERAL INI''ORMATION Location Address a�tllpp Owner's Name Z4)R6A)(9C_ LSO D7Z8``'IOC,s t�J� [fit Address I x8 DROu•CUL+ ,Vi7 e jj ' �?ZVS?it•$LL Cd{QEGzx[��EcU�I?iRL•5�S/2f3© Assessor's Map/Parcel:, 33s/©� Engineer's Namc .TC EX�C�t�uL, �cNL NEW CONSTRUCTION REPAIR X Telaphone# 5 dQS a7_3 =a 7 . I nd Use `ll G "�o l Slopes(96) O_J �, Surface Stones Distances from: Open Water Body I UQ ft Posslble Wet Area ft Drinking Water Wcll ft Dralhage Way 1 ft Property Line 1 V ft .Other ft SIMTCHL(street name,dimensions of lot,exact locations of test holes&pera tests,locate wetlands-to proximity to holes) Pe AIad� , _ I _- - • '. --�,�..cv vim.. .�. � .. .s.._ __ '.` - - -_- ._ :,,r.....r.....y....,....�..j�...•. -,,..w�-�•+."--=•-s' �,..� ....-::�—= ('.. a.__ .. "t;•�.�.:- - .�y-� �- Y _. _ ,". '."s•-,�.�.+.v 1•...+.�. tie . Parent material(geologic) �InJ G$ Depth to Bed,-Oak � Depth to Groundwater. Standing Water.ln Hole: Woe S` ping from Pit Pnoa Estimated Seasonal High Groundwater 15�11 60 RUT NAI ON FOR SEAS ONAL•I1IGD WATER T.A ELF,Mcthoa Uscd: (fib Qru0.�o.n �S �+ Depth Observed standing in obs.hole: In. Depth to loll Inottles: 1;b Doilth to weeping from side of obs.halo: '*?) lIL . Groundwater Adjurlment Index Well-# Reading Date: — Index Well Isvol Arj,fhatbr- : Adj.CJrvundwatdr•Levdl.:;• = PERCOLATION TESL' Hula if Tuna Observation Hole fF * . Tlmo at 4" Depth of Pero Tlmo at 6'.' Start Pro-soak Time Time(9"-6") ' End Pro-soak * �c Qrr- a C1 a` c, P-5 RateMihAnch 30H Site Suitability Assessment: 51to Passed site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observtitlon Hole Data To Be Completed owBack---- --- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week prior to beginning. Q:15EPTfC\PERCPORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Sail Texture Sdil Color Soil. Other Surface(In.) (USDA) (Munsell) Mottling (Stnucture,Stonei;Boulders. Consistency,%'Gravel) 16 —7e S C),, Yi ►O 1-'• 4/6 15Y 6/� - -� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sall Color Sall Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o sl en DEEP OBSERVATION HOLE LOG Hole,# Depth from Soil Horizon Soil Texture Sall Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Solt Texture Soll_Color gall Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, 0 i Flood Insurance Rate Map: Above 500 year f load boundary No— Yes., Within 500 year boundary No:/ Yes Within 100 year flood boundary No.,,— Yds Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pawl aterial exist in all areas observed thrpughout the area proposed for the soil absorption system? 1 If not,what is the depth of haturally occurring pe vlous material? Certi�on I certify that on �) (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise experlenca described in�10 CMR 15.017. Signature Datb Q:\SBp-rIMRCPORM.DOC �Y T 'own.of Barnstable Barnstable Inspectional-Services a,cac Ky t�afuaSTA L> 1 MASS, Public Health Division p,Eo"k°�s 200'Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 ,Thomas A.McKean,C140 FAX: 508-790-6304 CERTIFIED MAIL#7015 1730 0001/4989 0410 ' December 14, 2018 RUNGE, LAWRENCE G & CLAIRE 188 DROMOLAND LN CUMMAQUID, MA 02637 ORDER TO COMPLY.WITH STATE ENVIRONMENTAL CODE,TITLE 5 ,The septic system located-at 188 Dromoland Lane, Barnstable, VIA Was inspected on 12/06/2018 by Shawn McElroy, certified Title V Septic Inspector for the State of j . Massachusetts. ' The inspection of the septic system showed that the system"Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: o Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1).year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. { PER ORDER OF.THE BOARD OF HEALTH Tho cKean, R.S., CHO , Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\188 Dromoland Lane Bamstable.doc Town of Barnstable .p M17A9S. 0 � SAANSfABLE. ' Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev.5/11/16 DEADLINES TO.REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"X"marked in the ❑is the failure criteria and associated repair deadline . µ 60 DAY DEADLINEtCRITERIA ❑ Discharge or ponding of effluent to the`surface of the ground - ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ' ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis'.. indicates the well is free from pollution): TWO (2) YEAR DEADLINE CRITERIA ❑ Single.Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components,etc) ❑Leaching facility with standing liquid level at or above the invert pipe.(per Town Code §360-20 h) OTHER Repair deadline: Q:ISEPTICIDEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts - t� ,. Title 5 Official Inspectionrform ! Subsurface Sewage-Disposal System Form'-Not for-Voluntary Assessments rT11' 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name k "' information is required for every Cummaguid MA 02637 12-6-1$ .i:�,. '` t•__ page. City/Town State Zip Code Date of Inspection t..' Inspection results must be submitted onthis'form.•Inspection forms may not be altered in any way. Please see completeness checklist at the end of.the form. A. Inspector Information 6,14 l3ib , Shawn Mcelroy Name of Inspector' • ,, ,.. , 4, r.• "Upper Cape Septic Services r 5 3 Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification - I certify that:l am a DEP approved system inspector in full compliance,with,Section 15.340 of Title 5 (310 CMR 15.000);I have personally inspected the sewage disposal system afiheproperty 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,thisyinspection l have determined that the system: fl 1. ❑' Passes 2. ;❑ °Conditionally,Passes ^•`. t , t. ,tt ff,:r , r1'_+� 'T .• . ! :r' 3t r.Y,r a_ _ r, ,•,3.. `❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails 12-6-18 spector'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 `' y ° . Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth ofP'Mas'sachusetts r� Title 5 Official Inspection Form i0) Subsurface Sewage,Disposal System Form -Not for Voluntary Assessments . 9 p Y rY 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is required for every Cummaguid MA 02637 12-6-18 -' page. City/Town State Zip Code Date of Inspection C. Inspection Summary t a Inspection Summary: Complete 1, 2, 3,or 5 and all of 4 and 6. 1) System Passes, �,7A 6 ` ❑ 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: ' 2) System Conditionally Passes: o ❑ One or more.system components as described in the "ConditionalPass" 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.7/26/2016 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 r ., Commonwealth of Massachusetts Title 5 Official- Inspection foem I,I Subsurface Sewage Disposal System Form,-:Not,for Voluntary Assessments 188 Dromoland Ln Property Address }' Larry Runge f Owner Owner's Name information is required for every Cummaquid:: . ' MA. 02637 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� ` ` '• ti ❑ 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 inspectiowif(with approval of Board of Health) " t • ?i7 i e �' .':•. . .'r*tav i7 - r. "iY . �'3',} .1".r.Y ❑ broken pipe(s)jare replaced ' '¢` ' ' '` ❑ Y '❑N '❑ ND (Explain below): 1 obstruction is removed ❑-Y l ON-'., ❑ ND (Explain below): " ❑ distribution b6z is leveled'or,replaced ' `❑Y "-OW ❑` NDT(Explain below): 7tY r-'t' ❑ 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 ON a ❑ ND (Explain below): 3) Further Evaluation is Required by the Board W Health: ❑ Conditions exist which requirefurther evaluation bythe Board of Health in order to determine if "'the system is failing to protect'public health,-safety o'rthe environment: a. System will pass unless Board of Health determines,in accordance with 310 CMR 16.303(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- R :1 Commonwealth of Massachusetts _ 1� Title 5 Official Inspection dorm I� w.� rl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is required for every Cummaquid MA 02637 12-6-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) _ El 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: _ E]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. c. Other: .' 1 • - • 1 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 F] ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 k Commonwealth of Massachusetts °_ °f ,. Title 5 Official• Inspection •Fo_m-; rsF t M Subsurface Sewage Disposal:System Form-'Not for,Voluntary Assessments 188 Dromoland Ln Property Address .sF,, Larry Runge Owner Owner's Name information is „• r required for every Cummaquid.' ; a MA 02637 12-6-18`.-- page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) + 4) System Failure,Criteria Applicable:to All Systems: (cont.). Yes . t,No,r't ® 0 Static liquid level in the distribution box above outlet invert due to an overloaded 'O clogged SAS"or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is less than 12 day flow ❑ ® Required pumping more than 4 times in the last^year NOT due to clogged or obstructed pipe(s). Number of times pumped: 1t ❑,, ®T. 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: ❑ 9 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 16 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 istequal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis ;,f ,, -s t ; •,r t and chain of custody must be attached to this form j'i j • ❑ The system is a cesspool serving a facility with aFdesigh flow of 2000 gpd- 10,000 gpd. The system fails.� 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 L necessary to correct the failure. :f 5) Large Systems STo be considered a large system the system must serve a facility with a design flow•of 101000'gpd to'15 000 gpd. " -i-.,For large systems, you:must indicate either"yes" or"no".to{each of the following, in addition to the 1' questions,in:Section CA. ,t ` 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 f Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Yt �7r•T,yi ' 188 Dromoland Ln �l Property Address Larry Runge Owner Owner's Name information is CUmma Uld r required for every q MA 02637 12-6-18 page. City/Town r 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 C.4: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 flow's in the previous two week period? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® - ❑' •Was the site inspected for signs of break out? ® ''' ❑ Were all system components, excluding the SAS, located on site? ❑ n 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? i ❑ Wasthe 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)] tv i t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 � ° •, Commonwealth of Massachusetts a Title 5 Official Inspection., Form. _ i,�I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Dromoland Ln Y•i - • Property Address Larry Runge Owner Owner's Name information is . required for every Cummaquid r_ _ MA 02637' 12-6=18- page. City/Town State Zip Code Date of.lnspection D. System Information _•t r : �� `4}.R -" , 1. Residential Flow conditions: . Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x kof bedrooms): 330 Description: Number of current residents: zn 1 . V a _ Does residence have a garbage grinder?:a ' ,}, ❑ Yes ® No Does residence have a water treatment unit? -:r ::. . _�.; 1,,� -.' .-E ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection El Yes ® No information in this report.) ` "` ;' `: Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? r : , ,., ❑ Yes ® No Last date of occupancy: , Date 8 . Date p t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 t Commonwealth of Massachusetts Tile 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is Cummaquid MA 02637 12-6-18 required for every page. City/Town 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: r Date a l . Other(describe below): 3. Pumping Records: Source of information: N/A 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 6_ Commonwealth of Massachusetts : ,. Title 5 Official, lhspection 176m C�i Subsurface Sewa e.Dis osal System Form -`Not.for,Volunta Assessments 9 p Y ry - 188 Dromoland Ln Property Address Larry Runge j Owner Owner's Name " information is ,• f,., required for every Cummaquid MA 02637 12-6-18 page. City/Town _ : State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: a , ® Septic tank, distribution box,soil absorption system ❑ Single cesspool ❑, ,.. is rOV6rflow cesspool,- El Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract '_ ❑ Tight tank.Attach a;copy of the.DEP., approval.-: _;.- ❑ `_ Other(describe): Approximate"age of all components; date installed.(if.known) and source of information: 1994 Were sewage'odors detected when arriving at the site? Yes ® No 5. Building Sewer(locate,on,site plan):. .- ,• Depth below grade: feet Material"of construction: ® 40 PVC '❑ other(exlain):❑ cast iron{ � p+' Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. 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 61 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is required for every Cummaquid MA 02637 12-6-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) _ a 6. Septic Tank(locate on site plan): r 12" 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: 1500 gal Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6" " Distance from bottom of scum to bottom of outlet tee or baffle, ! I 15 - . How were dimensions determined? Tape 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 is in good condition with baffles installed and no sign of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 V . Commonwealth of Massachusetts -g .,.f.r: , .r - .. ':► Title 5 Official a n'spection-Form- ._ ,: lo"f Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments s_ 188 Dromoland Ln Property Address rt Larry Runge + : Owner Owner's Name a r information is . . required for every Cummaquid MA 02637 12=6-15' page. City/Town .. State Zip Code Date of Inspection' a D. System Information (cont.) f :Wl_ 0 . . ... 7. Grease Trap (locate on site plan): Depth below grade: feet' . Material of construction: El concrete El metal El fiberglass ; ElpolyethyleneF' El.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 related1bl outlet invert;°evidence of leakage, etc.): ' , .r .. r,.a Y r L-• t er s«,i_.¢? is } ,;.`.r,r t,!-+ _ .*r'ys. �. 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 El polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: . gallons per day t5insp.doc-rev.7/2 612 01 8 ,; e Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page11 of 18 Commonwealth of Massachusetts - r� 3 Title 5 Official Inspection Form i t Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is required for every Cumma4 uid MA 02637 12-6-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) t 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 lit Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was found with water at 1" above outlet invert and stain lines above inlet invert. :J 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 Irispectionrfdft , ? p Subsurface Sewage Disposal System Form -Not for,Voluntary,Assessments 188 Dromoland Ln Property Address Larry Runge ti 3 Owner Owner's Name , information is "_ �`. required for every Cumma qUld MA 02637 12-6-18 ' page. City/Town state Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): ;r• ;t :. Pumps in workirig order: ' f Yes ❑ No" Alarms in working order. ' '❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): •, . ...., . . , . .. � .. . . .• . ,ate... . * 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):1 If SAS not located, explain why: Type: " ^r • " ' - ® ' leaching pits n t• number: r 1-1000 gal ❑ leaching-chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts _ R. 3/ Title 5 Official Inspection Form Il M Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is required for every Cummaquid`. MA 02637 12-6-18 page. City/Town 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.): Leach pit was filled beyond capacity with water backing into d-box. 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.): f 7 ' t ` t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts z. ,, _. i, ;; N �: •, , '.� Title 5 Official Inspection, Foci <v"I, Subsurface Sewage Disposal System Form:=Not foryoluntary,Assessments .' � �• , 188 Droland Ln mo r. Property Address Larry Runge Owner Owner's Name information is q required for every Cumma uid t.` MA 02637 12-6-18 • . `# °`_r page. City/Town _• *. .,,. ' State Zip Code Date of Inspection D. System Information (cont.) • r d.; . :a F f :,rs $ •a r� •..i •YS'r !3x t. '.3s I.. .iZ 13. Privy (locate on site plan): - . Materials of Construction: ' +- f' i f'•f " �' Dimensions • . f 1. � .- 1 117 71 Depth of solids Comments_(note condition of soil, signs-of,hydraulic failure, level of ponding, condition of vegetation, etc.): ' s ` l I ` 4 . t I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts :. 5 Official Title Inspection o.. s ec� on Form,.r h. -i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is required for every Cummaguid MA 02637 12-6-18 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 r t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts ~:«z, ��a`' * ;y , k • ° '� Title 5 Official Inspection •I=o ti . Subsurface Sewa e:Dis osal System Form°-Not.for Volunta Assessments 9 p y � ry' , 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is required for every Cummaguid— 4,1 MA 02637 12-6-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont )' �- 15. Site Exam: ❑ Check Slope ❑ Surface water s. _F r �.; ❑ Check cellar ❑ Shallow wells w , Estimated depth to high ground water: ;, ,w 20 feet Please indicate all methods used to determine the high ground water elevation ❑ Obtained from,system,design plans on record :. 4, ..lf,checked,date of.design-plan reviewed:- Date ® r, Observedisite (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: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 e Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts rv� 1�,ii Title 5 Official Inspection Form bi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 188 Dromoland Ln Property Address Larry Runge Owner Owner's Name information is Cummaguid MA 02637 12-6-18 required for every _ 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 ' t • t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 6 �� ANSTABLE '�QCATION '» iw- SEWAGE 73-��� IVIL LAG E60— ;611 ASSESSOR'S MAP & LOT23s--6?3 INSTALLER'S NAME & PHONE N 1 &SEPTIC TANK CAPACITY �Q / I LEACHING FACILITY:(type) i' (size) ' NO. OF BEDROOMS ?J` PRIVATE WELL O PUBLIC WATER BUILDER R OWNER 10 ljle DATE PERMIT ISSUED: Z(2V DATE COMPLIANCE ISSUED: / VARIANCE GRANTED: Yes No t �� i Py ;6 d��, . ':+ ':" . j �3 0 NO: 3—)70 5 FEB....I 4,f..`Q........... THE COMMONWEALTH OF MASSACHUSETTS JL` xf BOARD OF -HEALTH TOWN OF BARNSTABLE Allpfiration for DioVo!3tti Modw Towitrnrtion lirruti# Application is hereby made for a Permit t . onstruct ( ) or Repair ( ) an Individual Sewage Disposal System at: �$ '�!`B �Z�� f / q Location-Address or Lot No. - ' 9 -----�.d.'-'!-E:.`f _ _ Aiwvl Sri.F-/1 Ccf b 5 : Installer Address (I Type of Building Size Lot______________..............Sq. feet U Dwelling—No, of Bedrooms------- ---------------------------------Expansion Attic ( ) Garbage Grinder ` 4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria a Other fixtures -_-_-__-_____________________ _ _ W Design Flow_____________________JJ�_._'_.________--gallons per person per day. Total daily flow_.-_..._.9-�®_._.._._.____..____._._gallons. WSeptic Tank—Liquid capacity...-____.._gallons Length---------------- Width--------:------- Diameter................ Depth................ x Disposal Trench—No. ____________________ Width-------------------- Total Length.................... Total leaching area.....................sq. ft. Seepage Pit No..................... Diameter__-________--____- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. I................mmutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ -----------------------------------------------------------------------------------------------••-•----------------------------------------- _••-------- ... 0 Description of Soil......................................................................................................................................................................... x w ..... ••--•---- ----------------------------•---•-•-----------...----------------------------------------------------------- ----• UNature of Repairs or Alterations—Answer when applicable-------------- ---�------ __-(A'r........_._.._.____________..__. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal_ System in accordance with the provisions of TITLE 5 of the State Environmental Code—Th nd rsi ne r agrees not to place the system in operation until a Certificate of Compliance been iss e _ Si ned Application Approved By ..2 2� 3 /�/)�.............----------------------...............----..................-...................... -_......-'---' /�`j�� ----�.:.r�- ----k------------ Dace Application Disapproved for the following reasons- ------------------------------ ------------------------------------------------------------------------------------------------- --_------------------------------...------------------------------------------------------------------------------..---.. ........................................ ............... . M — ace Permit No. ..:./.5----------------------------------------------- Issued �.. at THE,COMMONWEALTH OF MASSACHUSETTS a i rBOA R D OF HEALTH t l TOWN OF BARNSTABLE �r ,��r�lirtt�ilan �nr �i��n�ttl �vrk� (�a�Bt.��r�r#iun �rrnti# Application is hereby made for a Permit tp Construct ( ) or Repair ( ) an Individual Sewage Disposal Systems at: I $ D7 Bf r'i ���Gtit^� .�i+�- �it M MA-4 U 10................. ....-•--•--•-----•----•---•----•------........... .............................................. /f Location-Address or Lot No. a ' J Owner ,c� Address Installer ! Address UType of Building / "µ - f Size Lot............................Sq. feet Dwelling— No. of Bedrooms-------- ------------------------------_-Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures ----------------------------------------•-------------------------- W Design Flow........._-----------5�-_.---------gallons per person per day. Total daily flow-.-_.._..-� 0........................ WSeptic Tank—Liquid capacitv........___gallons Length---------------- Width---------------- Diameter.--------------- Depth................ ' x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box~( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •----•---••-----------------••--••---•••-•••-•---•---------•---••-------------•-•-----------•.•••........................................................... 0 Description of Soil---------------------------------------------------------•---------------------------------------------------------------------------------------•----•.........---•_.. x U •-•••-...•••••••-•••...••••-•-••-•--•••---•-----•-•--•---•---------•-------------•-•-•-•••---•----••••••••-----------•------•-•••••••---•----•-•---•••--•---------------•---------------••-------•------ W ---------------- --------- ------------------------------------------------------------------------- --------------------------------- .. ............--- U Nature of Repairs or Alterations—Answer when applicable.-.-----.-.----� ...___._ 4......._. �j`-I --------------------------------------- .--- -•••----•-----••••--•-•••..............................•--••••----------••---•-..............-----------------------------------------------••--•--•-- Agreement: The undersig d'agreeslio install the aforedescrfbed Individual Sewage Disposal System in accordance with the provisions ofJITLE 5 of the State Environmental Code The'und-rsiene �furflier agrees not to place the system in operation until£a Certificate of Compliance ha.s been iss>vedfl?;yar6t .e . Sied`/ `>,--- ------ ----------..-�� ...................... .......... ........................... Application Approved By .....................{�%�- 2c�---- `�12��9 3 ---- ....... r // Dace Application Disapproved for the following reasons: .. -- ........................ __....... .................... ....--- ----............... r ------------------------------------ I------. . .......................... ..................-- ....................... ... /--------1......... ........................................ ` Date Permit No. l .......... -- ........ Issued f' %.`2 - -------------------- 1 Dated THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Tomylianre THIS IS TO CERTIFY That the Indiv(4ual Sewage Disposal System constructed ( ')`or Repaired b U � ems.F------ ''f" '11 at .. ... �.1-......�.-.1.. :l) ..<.�n��.lc�,�--------------Z,n�-----wn�a tG v� t-= ----....----------------------------------------"-------------------------------- has been installed in accordance with the provisions of TITLE 5 of he State Environmental Code as described in the application for Disposal Works Construction Permit No. ..���..._�0�------....._----- dated .__.(Z '�/G3-------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--- Inspector P��/�- lex - ' " -------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CC�� TOWN OF BARNSTABLE N o....I.J?.... D. FEE. Dispnottl Workii Cann fr r#iIa I rantif Permission is hereby granted............................ ........ . `................................ �r ✓'"�o to Construct (U.or Repair ( ) an Individual Sewage Disposal System at No.....Elk---•--1.9-----. (+�M i�-� .,4� 1'�l�'....... _._u nnm t l ----.. ---------------- ----------••----•---... Street as shown on the appli tion for Disposal Works Construction Permit No.9---��a__�Da ed,1_.J_Z��`..... ............. ... ........... ...... d.... ••• Board of H�th DATE........... .../)/ -3.....•-........----------------------------------------------- FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS AsBuilt Pagel of 1 . r a2A§NSTABLE t _aLOCATION _I\VILLAGE C! SEWAGE /�9 ASSESSOR'S'MAP & LOT �, �� ..I INSTALLER'S NAME & PHONE N SEPTIC TANK CAPACITY i LEACHING FACILITY:(type) (size) ell / I NO. OF BEDROOMS ?j�_pRIyATE WELL O ,PUBLIC WATER BUILDER R Qa'NERji / Y ; l DATE PERMIT ISSUED: Lj I DATE COMPLIANCE ISSUED: -------------- y VARIANCE GRANTED: Yes No I = I 1 f i r http://issgl2/intranet/propdata/prebuilt,aspx?mappar=335083&seq=1 12/10/2018 r`� 1 BORTOLOTTI CONSTRUCTION, INC. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM �s l Address Prop � /9 � /�'� 0t i-W(!L-4 1f0 Date of Inspec} ,,�f` / Map arcel Owner y 0 �C'e PART A — CHECKLIST CHECK IF THE FOLLOWING HAVE BEEN DONE: NI-A PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH. (/ NONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND THE SYSTEM HAS BEEN RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE NOT BEEN INTRODUCED INTO TF}E SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE WITH N/A. ` -THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. 1- ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. v/_THE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF THE SEPTIC TANK WAS INSPECTED FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH OF LIQUID,DEPTH OF SLUDGE, DEPTH OF SCUM. � T/HE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR APPROXIMATED BY NON-INTRUSIVE METHODS. —THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSDS. PART B — SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL Nov& No of Bedrooms OC;C,rlp r E.0 —No of Current Residents oVp _Garbage Grinder -Laundry Connected to System _ pi.q _Seasonal Use • NON RESIDENTIAL: Calculated flow WATER METER READINGS,IF AVAILABLE: _ GALLONS Pumping Records and Source of Information: /V/* SYSTEM PUMPED AS PART OF INSPECTION? N A- IF YES,VOLUME PUMPED = GALS Reason for Pumping: TYPE OF SYSTEM: — �� Septic tank/distribution box/soil absorption system Single Cesspool — _Overflow Cesspool Privy Shared system (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all components. Date installed,if known. Source of information. GI SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? N� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SEPTIC TANK: Depth below grade: l f be Material of construction: c--,Concrete Metal FRP Other} Sludge Depth Distance from top of sludge to bottom of outlet tee or baffle Scum Thickness O n Distance from Top of Scum to top of outlet tee or baffle N/A Distance from bottom of Scum to bottom of outlet tee or baffle N r/4 Comments: - S (A IS P J&LJ of El'c2. WC-6 DISTRIBUTION BOX: V FS DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT Comments: PUMP CHAMBER: Pumps in working order? Comments: SOIL ABSORPTION SYSTEM (SAS): IF NOT PRESENT,EXPLAIN: TYPE: C,'�iA-Gb4 y X f� cS')4�'4itM-,0,Ch g`j !y -rl/ Aft Comments: N C tl Vz- u-S M - CESSPOOLS: Number and configuration Depth—top of liquid to inlet invert Depth of solids laver Depth of scum layer Dimension of cesspool Materials of construction Indication of groundwater inflow(cesspool must be pumped) Comments: PRIVY: t�J Materials of construction Dimensions Depth of solids Comments: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B - SYSTEM INFORMATION (Continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS. LOCATE ALL WELLS WITHIN 100' jy DEPTH TO GROUNDWATER: Za DEPTH TO GROUNDWATER METHOD OF DETERMINATION OR APPROXIMATION: ��S`� iT XV y 3 c-rtk ac.errn C-, rj,s 714 c:�;f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C — FAILURE CRITERIA (Indicate Y—yes N—no ND—not determined.Describe basis of determination.If"not determined",explain why not.) �1 Backup of Sewage into Facility? Discharge or ponding of effluent to the surface of the ground or surface waters? e� Static liquid level in the districution box above outlet invert? i Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? /J Required pumping 4 times or more in the last year? Number of times pumped Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiltration? tank failure imminent? iJ Is any portion of the SAS,cesspool or privy, below the high groundwater elevation? tJ Within 50 feet of a surface water? i ^J Within 100 feet of a surface water supply or tributary to a surface water supply? N Within a Zone I of a public well? Within 50 feet of a private water supply well? J Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools&privies only, not the SAS)? /J Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen. PART D — CERTIFICATION INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399 CERTIFICATION STATEMENT I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY RECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE IN THE PROPER FUNCTION AND MAINTENANCE OF ON-SrFE SEWAGE DISPOSAL SYSTEMS. CHECK ONE: L, I HAVE NOT FOUND ANY INFORMATION H W ICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. I HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN 310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. INSPECTOR'S SIGNATURE: DATE: ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY �x r EL. ' TOP OF FOUNDATION CONCRETE COVER '. ! T �,� CONCRETE COVERS _! /�/��•j ��/� 7�7 �/�r�� AJ .a:. . i 777rr,77--7r 3�' A 4 CAST IRON 12"MAX. 12"MAX. { OR SCHEDULE 40 •, • 4�SCHEDULE 40 P.VC.(ONLY) + � ° P.V.C. PIPE PIPE- MIN. LEACH PITCH 1/4"PER.FT. PITCH 1/4"PER.FT PIT PRECAST < LEACHING I I `—INVERT o El ,•Go _7�... INVERT INVERT ° w Q•: PIT OR SEPTIC TANK EL..Ga./q •• BOX EL SI��.. ... ; EQUIV. D.c INVERT /O✓� GAL. INVERT O' :.i; 3/4��TOIV2� o; EL./�.cZ7.. . .. . . ELF-I?. INVERT w w a' WASHED ` ELSJ;� u-o �o. ° w ° STONE - • • � /e —�-�—6 DIA. —/4-' DIA--� �'z "n ,v PPOFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM L3 e= Gt el' G� L NO SCALE i F SOIL LOG WITNESSED BY : DATE BOARD/ TIME. . ... . . . . . . T!9 • BOARD OF HEALTH / _ --. � �r)� !oT TEST HOLE I TEST HOLE 2 5 ENGINEER / t ELEV. .G3,•8v. . . ELEV. ..��•.'`�. . . // +� •,,:= L.� 07— I DESIGN DATA . ;� _ �Ila n� u /— I NUMBER OF BEDROOMS 3 . . . : . . . . � � $ , �� ';a f TOTAL ESTIMATED FLOW 33a. . GALLONS/DAY i ZS• �, J BOTTOM LEACHING AREA 3: . SQ.FT. /PIT167,l%D. ✓fs7l j r' Zb �� ;,✓�r S/"!`� SIDE LEACHING AREA . . ./53. SQ.FT./ PIT/Bel;" l .� . . . } l30 X GARBAGE DISPOSAL .!`�°^�E. . .(50% AREA INCREASE) L G1�O � fl x va TOTAL LEACHING AREA SQ.FT ' bc, pzlqN 3 CGS T,�!/�-.� 77�✓a L2. PERCOLATION RATE . . . . . . . . LAIN/INCH T�s f Ct LEACHING AREA PER PERCOLATION RATE 5.387 SQ.FT./G•��D 1 / -WATER ENCOUNTERED NUMBER OF LEACHING PITS r. / �2 77 APPROVED BOARD OF HEALTH DATE . . . . . . . ¢/.-r AGENT OR INSPECTOR ptS H OF �� O STETS N o LLtY V HA L w o. 25100 � E a c e PETITIO ` /� /� r� � •�� /^ , e �s{� /6�s� Y 1 V L Ic/l/n Lf.:rd �/���.•` ..i' L/'/I'� / Lf r L'i . �.v7 Ou/'.i lm..,i _._..--�......�..�.��.-••1 T.O.F. EL.= 67.4'± FINISH GRADE OVER D-BOX= 67.2''f , , PROP.VENT WITH CHARCOAL FILTER TO ABOVE GRADE FINISH GRADE OVER CHAMBERS 66.8 - 67.2 L NOTES PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2%MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE WITH COVER OVER INLET& 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION RISER TO WITHIN 6"OF FINISHED GRADE 4".SCHEDULE 40 PVC FINISH GRADE OUTLET TO WITHIN 6"OF F.G. INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL 66.5 # F.G. OVER TANK EL = 667�t 5" DIA OUTLET(S) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2"OF 1/8"TO 1/2"DOUBLE WASHED @ FND. EL.= . . . STONE OR GEOTEXTILE FILTER FABRIC CODE AND ANY APPLICABLE LOCAL RULES. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE PLACE RISERS ON ALL DESIGN ENGINEER. EXISTING 4" PROPOSED 4" 5.0' MAX. TOP OF SAS= 61 ,$Q' 5.4 MAX. CHAMBERS WITH 3. 4 SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE SCH. 40 PVC SEE NOTE 23 60,80' SEE NOTE 23 , INLET PIPES TO 6"OF SEWER PIPE BREAKOUT EL= 61 .30 SYSTEM UNLESS OTHERWISE NOTED. FINISHED GRADE- ;., 6" 3f' 3" DROP MAX 3„ 9„ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2 DROP MIN -�- L=23�t MIN.SLOPE @ 1% PROVIDE WATERTIGHT ELEVATION =61.30' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4 PVC IN FROM JOINTS (TYP.) �Cb- 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14" *5t�. '± SEPTIC TANK 4"PVC OUT TO 0 Q 0 0 0 0 0 _0 0 0 0 Q 0 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE • LEACHING FACILITY <D 00 0 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. SPECIFIED DROP BETWEEN C) 0 0 0 INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL ' 12" 6" o0 0 0 �� OUTLET TEE 61.20 MIN. 6� ,03' 2' o � � � � � � � � � � � � � � po 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48 VERIFY CONDITION OF 00 AND CONDITION SIZE EXISTING TEES oo 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK GAS BAFFLE 4" PVC TEE 6"CRUSHED STONE o O o o C FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 3 4.0' ( ) - I 4.0 4.0 4.0 AND DESIGN ENGINEER. 8.5' TYP OUTLET DISTRIBUTION BOX TYP') 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 65.00, TO BE INSTALLED ON A LEVEL STABLE 25.0' ( ESTABLISHED ON A NAIL SET IN A TREE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 53.80' PIPES TO BE LAID LEVEL. 58.80 12.83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,500 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON H-20 CHAMBERS 5 MIN. CHAMBER END VIEW CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES *CONTRACTOR TO VERIFY EXISTING SEPTICTANK PROFILE TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. ELEVATION PRIOR TO ANY WORK& L CDETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING ;k„ .. • T �TDATAREGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM '+ �' ` • -- PERC NO. 15900 APPROPRIATE AUTHORITY. • 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED �,* , � •�,. .:• INSPECTOR: Donald Desmarais, RS - " .: ,a • UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR .: EVALUATOR: Michael Pimentel, EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. DECK , ra . . • . . 11` .�+ C.S.E. APPROVAL DATE: Oct. 27, 1999 + ., •, { / J� . 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. BH * ° �� !1 DATE: February 6, 2019 , , • *" 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. ,., ELEV TOP= 66.80' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, / • �/ " FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ` • � ELEV WATER= <53.80 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PERC RATE_ <2 min./inch* SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. o t LOCUS � DEPTH OF PERC= 16. PROPOSED PROJECT IS LOCATED WITHIN: to #188 r... v; � EXISTING to / 04 c� - ASSESSOR'S MAP 335 LOT 83 3-BEDROOM o a TEXTURAL CLASS: 1 - / DWELLING MAP 335 z �- OWNER OF RECORD: LAWRENCE G. &CLAIRE RUNGE N, / / LOT 83 r�i a, / 44 754±S.F. ao # o ADDRESS: 188 DROMOLAND LANE FFE =68.4± :�^""'` n: �' (} o„ 66,80' � D M ' CUMMAQUI A 02637 C� ' $ fi Fill �fi x� W FEMA FLOOD ZONE X J PORGH \ • +o -: 12" Sand 65.80' COMMUNITY PANEL# 25001 CO559J A y Loam . - 1 OYr 3/1 17. DEED REFERENCE: BOOK 9683, PAGE 131 r 18. PLAN REFERENCE: PLAN BOOK 354, PAGE 65 6� - 3 ( EXISTING 1,500 \r ��� / GAS TOF= GALLON SEPTIC <c _v 0 *' B O Loam 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 10Yr 4/6 / METER 67.4± TANK TO BE UTILIZED \� 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY 4'. .� rr 1 IN THIS DESIGN FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY 72" 60.80' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. HC- \ v / ''o •` „ ~ ZONE 2 21. A 4"PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A MAP 335 REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. LOT 84 .► �. d C Med.-Coarse San / \ 2.5Y 6/6 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL Benchmark �' / BIT. DRIVEWAY \ REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. LOCUS PLAN Nail in Tree I PROPOSED H-20 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE Elevation =65.00' EXISTING DISTRIBUTION APPROVALS ARE REQUESTED FROM 310 CMR 15.221 (7): DISTRIBUTION BOX Approx. M.S.L. v BOX TO BE ABANDONED i \w SCALE: 1"= 1000' N \ 156" (1.) A 2.4'WAIVER(3.0-5.4') FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. 53.80, � \ -- _ __,6l \ (2.) A 2.0'WAIVER(3.0-5.0') FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. No Mottling, Standing or Weeping Observed ELECTRIC 9, 9 P 9 b4"TREES / N ' PROPOSED METERDESIGN DATA LEGEND 18"TREE \,: : �2d�. 2-500 GALLON CABLE Perc rate per Perc#P-5826 H-20 LEACHING I TELEPHONE (in"C"soil), dated 6-9-1986 50xO' EXISTING SPOT GRADE EXISTING LEACHING PIT / CHAMBERS \ BOX I TO BE PUMPED, FILLED D i \ NUMBER OF BEDROOMS 3 on file with the Barnstable 1 / :Tf'1 \ r Board of Health - - - 50 --- EXISTING CONTOUR WITH CLEAN COARSE 1 2) SAND, AND ABANDONED �. ELECTRIC DESIGN FLOW 110 GAUDAY/BEDROOM �6931� \\ HAND HOLE TOTAL DESIGN FLOW 330 GAUDAY r�o� PROPOSED CONTOUR LP .:� �- ,6� 6�. / 50 PROPOSED SPOT GRADE v - `L DESIGN FLOW x 200 % = 660 GAUDAY T T PERC NO. 1590 O LP l\ / USE EXISTING 1,500 GALLON SEPTIC TANK GAS EXISTING GAS LINE INSPECTOR: Donald Desmarais, RS E E EXISTING UNDERGROUND ELECTRIC ' N \ (4 EVALUATOR: Michael Pimentel, EIT, CSE MAP 335 ► I P. LOT 82 I ` ` J 4"TREE / C.S.E. APPROVAL DATE: Oct. 27, 1999 T/C EXISTING UNDERGROUND TELEPHONE/CABLE / `� INSTALL 2 - 500 GAL. H-20 CHAMBERS w/AGGREGATE 1 66x / DATE: February 6, 2019 W W EXISTING WATER LINE SIDEWALL CAPACITY TEST PIT#: 2 67- --'- , 3) PROPOSED (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY ELEV TOP= 66.80' 1 TEST PIT LOCATION PROPOSED 4" INSPECTION/ (25.0'+ 12.83') (2 ) (21) (0.74 GPD/S.F.) 112.0 GAUDAY �� PVC VENT PIPE; PORT �,�� / ELEV WATER= < 53.80' EXISTING 1,500 GALLON SEPTIC TANK to I EXACT LOCATION BOTTOM CAPACITY PERC RATE _ r2 \ PER OWNER � PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE _6a' _ \ D ,\\ oP � (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY DEPTH OF PERC= (25.0'x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY ❑ PROPOSED H-20 DISTRIBUTION BOX -67- _._. ' GP5 �\ ! QQ` TEXTURAL CLASS: 1 D� O� O PROPOSED 500 GALLON H-20 LEACHING CHAMBER 1 I \ N �100° GP5 �� TOTALS: 0 $ rn �' �' �, �\ / \ ���� TOTAL NUMBER OF CHAMBERS 2 TOTAL LEACHING AREA 472.2 SQ.FT. o„ 66.80' REV. DATE BY APP'D. DESCRIPTION TOTAL LEACHING CAPACITY 349.4 GAL./DAY Fill 12" 65.so' PROPOSED SEPTIC SYSTEM UPGRADE A PREPARED FOR: oo', 1 \ GPs RAG Sandy 1OYr311m _ GP f CAPEWIDE ENTERPRISES I \ 41 44 / c"1 do W NOTES: g LOCATED AT �p / SOYr 4/6 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 1$$ DRQMQLAND (ENE r EACH SEPTIC SYSTEM COMPONENT. 72" 60.80' BARNSTABLE, MA 02630 SWING-TIES (� /., `'� 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE SCALE: 1 INCH = 10 FT. DATE: FEBRUARY 15, 2019 PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT `6$� ,.... � 0 5 10 20 40 FEET DESCRIPTION HC-1 HC-2 ND `AN DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF tN of QX_N HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. C Med.-Coarse Sand CORNER OF STONE (1) 51.5' 37.0' OFIC WIDE`AYpUTI s 2.5Y 6/6 ,IOHN L '"� PREPARED BY: RESERVED FOR BOARD OF HEALTH USE CHURCHILL JR. -, CORNER OF STONE (2) 63.8' 47.2' 3.) ENTIRE PROPERTY IS LOCATED OUTSIDE A DEP APPROVED ZONE 2. CIVIL w JC ENGINEERING, INC. No. 41807 2854 CRANBERRY HIGHWAY CORNER OF STONE (3) 62.1' 64.2' 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY � FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS IN I EAST WAREHAM, MA 02538 o CORNER OF STONE(4) 49.4' 57.1' SITE PLAN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY 156" 53.80' 5508.273.0377 ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. SCALE: 1"= 10' NO Mottling, Standing Of Weeping Observed Drawn By: SJI Designed By:SJI Checked By:JLC JOB No.4539