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Home My WebLink About0018 KEVENEY LANE - Health 18 Keveney Lane Barnstauie A = 351 028 V G Ip n a Massachusetts Department of Environmental Protection t � Bureau of Resource Protection WELL DRILLER Please specify work performed: Address at'well location: New Well Street Number: Street Name: r _._ . 1 �18 a - KEVENEY LANE Please specify well type: Building Lot#: Assessor's Map#: Irrigation Assessor's Lot#: ZIP Code: Number Of Wells: �; 02668 City/Town: Well Location BARNSTABLE In public right-of-way: GPS (j Yes rs No North: West: 41.70246_ 70.26574 Subdivision/Property/Description: Mailing Address: V click here if same as well location address`. Property Owner: Street Number: Street Name: CHESNAUSKAS 18 KEVENEYLAN771 City/Town: State: Engineering Firm: 1BARNSTABLE MASSACHUSETTS r ZIP Code: 02668 Board of health permit obtained: Ct-,Yes Q Not Required Permit Number: Date Issued: W201115 7/26/2011 r �1 Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program �. Well Completion Reports(General) Well Driller--General Well Form - - -- DRILLING METHOD Overburden Bedrock Auger --Choose Bedrock-- - WELL LOG OVERBURDEN LITHOLOGY From Drop in Extra fast or slow Loss or addition of To(ft) Code Color Comment. (ft) drill stem drill rate fluid C'a 0 15 Cobbles Brown Ye Fast r Slow Loss Q Addition C 15 35 Fine To Coarse Sand Reddish Brown [Ye r Fast C Slow Loss Addition 35 55 Fine To Coarse Sand 1 Reddish Brown Ye r Fast t Slow Loss Addition 55 (5_8 Medium Sand Reddish Brown Yes. r Fast r Slow Loss Addition j a� WELL LOG BEDROCK LITHOLOGY Visible Extra From To(ft) Cod Drop in Extra fast or slow Loss or addition'of e Comment Rust Large `(ft) drill stem drill rate fluid Staining Chips Choose Code 61 Ye Fast r Slow 00 Loss GJ Addition Ye IJ.Yes ADDITIONAL WELL INFORMATION Developed (0)Yes C No Disinfected t: Yes C No Total Well Depth 158 Depth to Bedrock F Fracture Surface Seal Type None Enhancement —C Yes r� No CASING Ej Is Casing above ground?1. From To Type Thickness. Diameter Driveshoe L 54 Polyvinyl Chloride Schedule 40 l" Ye SCREEN No Screen ,From To Type Slot Size Diameter 54 58 Stainless Steel Well Point 0.012 r4 WATER-BEARING ZONES [r DRY WELL, From To Yield(gpm) l 20 58 15 PERMANENT PUMP(IF AVAILABLE) 3 Wire Variable Speed Pump Description Submersible Horsepower I I L Massachusetts Department of Environmental Protection y Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) . Pump Intake Depth(ft) -• L4 •m Nominal Pump Capacity;(gpm).µMV�`-'-•125 ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material 2 `. Weight Water Batches.Method Of Placement (gal) t (— Choose Material Choose Material Choose One-- I 1 �� WELL TEST DATA _ Time Pumpingw. Time To Date Method * - Yield(gpm) Pumped Level (ft Recover Recovery (ft, BGS) _ - (HH:MM), BGS) _ (HH:MM) - _ y. Y 8.+16/2011 Constant Rate Pump 15 9:30 24 0:01 20 . WATER LEVEL Date Measured Static Depth BGS (ft) Flowing Rate(gpm) a 816/2011 20 15 COMMENTS WELL DRILLERS STATEMENT ------------- — This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,_and this report is complete a knowledge. Driller THOMASEDESMONDIII Registration# 764 Monitoring[M] F7 Supervising Drill Firm IDESMONDWELL DR!LLJ Rig Permit# 023 -� . Date Job Compl NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. ENVIROTECHLABORATORIES,INC. MA CERT.NO.:M-MA 063 8 Jan Sebastian Drive Unit 12 Sandwich,MA 02563 (508)888-6460 1-800-339-6460 FAX(508)888-6446 Client Name Desmond Well Drilling Location Chesnauskas, 18 Keveney Lane Address PO Box 2783' W. n le,MA Orleans MA � 02653 Sample Date 08/03/11 n„ Collected By Desmond wells 1a:oo Time iT Sample p Sample Type New well/Irrigation Date Received 08/04/11 Lab Order Number DW-112179 Well Specs 4"SCH40 PVC/60722' Location Source Date:Collected. Time Collected . Comments _' Analysis Requested Units Recommended Limits Analysis Result Method Date Analyzed Analyzed By Total Coliform /100ml 0 0 SM9222B 8/4/2011 RS -pH _ pH units 6.5-8.5 6.13 SM4500-H-B 8/4/2011 LL Specific Conductancen umhos/cm 500 156 EPA 120.1 8/4/2011 LL _--T Nitrite-N _ _ mg/L { 1.00 <0.004 EPA 300.0 8/5/2011 LL Nitrate-N mg/L 10.0 3.15 EPA 300.0 8/5/2011 LL Sodium _ mg/L __ 20.0 14.9 EPA 200.7 8/5/2011 MC Total Irona mg/L 0.3 <0.01 EPA 200.7 8/5/2011 MC Manganese+ mg/L 0.05 <0.008 EPA 200.7 8/5/2011 MC pH is below recommended limit and may have corrosive characteristics. Water meets EPA standaWrector We for drinking for parameters tested. Date 4 RonalLabor F BRL=Below Reportable Limits 'See Attached Page 1 of 1 ❑Certifteation is not available for this analyte for non potable water samples.. No. - 1- Fee----C-------------- BOARD OF HEALTH TOWN OF BARNSTABLE AP0.1at ion-lorMelt Con5truct ion Permit Application is hereby made for a permit to Construct ()), Alter ( ), or Repair ( )an individual Well at: Location-7— Address Assessors Map and Parcel Owner Address CL Installer — Driller _ Address Type of Building Dwelling--- ------------______-----_____-- Other - Type of Building—=----_—________ No. of Persons--- -.____--_--_—_—_—_._____ Type of Well ---- Purpose of Well---4xs- dd63O -----_---- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate.of Compliance has been issued by the Board of Health.'' Signed ------ date Application Approved By _ ___--__----- .2C date Application Disapproved for the following reasons: date — Permit No. — _ Issued — ------ date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by --__ --C�_ _ __� -�-f_ - --- —------- --------- Installer 1 ----------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ---=--------Dated------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE—_---__-- __ .___ -- Inspector--------------- -- No. Fee---L/)------------ BOARD OF HEALTH TOWN OFM BARNSTABLE Cc. Zipplicat ion-for Well Conoruct ion Permit Application is hereby made for a permit to Construct (�), Alter ( ), or Repair ( )an individual Well at: 1 Location — Address Assessors Map and Parcel Owner Address Installer — Driller Address l Type of Building ' Dwelling Other - Type of Building—=---_—__—____-- No. of Persons----.--_.---..-___�_—__—_.____ f Type of Well C) —_— Purpose of Well-- -� 1-i`rri____-----_— ti Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate.of Compliance has been issued by the Board of Health. �� Signed - -- ------- '►-` 6 =-i----=-- date Application Approved By date Application Disapproved for the following reasons: — date -- Permit No. —— — — -= Issued----- -— - - ---— — —-------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered { ), or Repaired ( ) by_-� -�n�o fl _ e, ��LPL/. S ' / installer at-_ _ _____ '_--��` _ C> YLt Wl./4_. 1� t7 --- — --------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. _—_—______—s__Dated--______-_-____ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--__ - — Inspector-- --=-- —— -- --_=---- BOARD OF HEALTH TOWN OF BARNSTABLE Well. Contruct ion Permit No. W o t i S Fee—yj-------- Permission is hereby granted ' ) 5;M 6/U@ L'u E c(= to Construct ( ), Alter ( ), of Repair ( ) an Individual Well at:L)F Street `` as shown on the application for a Well Construction Permit I 1 No.- -- -- Dated — - - —---------------------------_---- 7 � C �- ---_- - -- ---- ------- "r. DATE �� —_ _— Board of Health K- � Y COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION a TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSES SUBSURFACE SEWAGE DISPOSAL SYSTEM FO � C �y�'� PART A CERTIFICATION JUL 0 $:2002 Property Address: 18 Keveney Lane TOWN OF BAP NSTAE3LE Cummaquid,MA HEALTH DE PT. Owner's Name: Robert Metafora 3 r s..71 Owner's Address: 2 Ben Arthur's Way Dover,MA 02030 Date of Inspection: in 10,2002 Name of Inspector: (please print) Richard Judd,R.S. PARCEL • ®Z�3 Company Name: Richard Judd,R.S. LOT - — Mailing Address: P.O.BOX 55 South Harwich,MA 02661 Telephone Number: 508430-1764 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance'of on site sewage disposal systems.I am a DEP `-,k approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes ��0 3 OF M�Ss�y Conditionally Passes �° RICHARD �N Needs Further Evaluation by the Local Authotlity Fails " JUDD,JR. cn No. 1125 � o Inspector's Signature: ,.5. Date: June ITea`` 10 NITA0"' The system inspector shall submit a copy of this inspection report to the Approving Authority(Bo o Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments 1. Garbage disposal unit has been removed from kitchen sink 2. 1500 eallon septic tank has had risers installed on inlet and outlet ports. ****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 game or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain:' �� Page 3 of 11 0M- CIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) a Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 C. 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. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning,in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a su-rface 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) a Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for aIl inspections: Yes No _ _X_ 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 _X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ X Liquid depth in cesspool is less than 6"below invert or available volume is less than''/Z day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ _X_ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached,to this form.] NO (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. - E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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 H of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST a Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? —X — Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up'? X_ _ Was the site inspected for signs of break out? X _ Were all system components,INCLUDING the SAS,located on site? w X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the bales or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ X_ 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: Yes no X _ Existing information.For example,a plan at the Board of Health. X_ Determined in the field(if any of the failure criteria related to Part C is at issue approxirgation of distance is unacceptable) [310 C1M 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION a Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 5(per 310 CMR 15.002) #of BR(actual): 6 (System designed for 660 apd) DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550. 660 gpd provided. Number of current residents: 0 Does residence have a garbage grinder(yes or no): NO(removed as part of inspection). Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no):— Seasonal use: (yes or no): YES Water meter readings,if available(last 2 years usage(gpd)):2000=23 gpd/avg. 2001=85 gpd/avg. Sump pump(yes or no):YES Last date of occupancy: Weekend and summer use. COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):— Non-sanitary waste discharged to the Title 5 system(yes or no):— Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:June 1, 1999 per Town of Barnstable. Was system pumped as part of the inspection(yes or no):NO If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X (2)Septic tanks,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) Tight tank —Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information: Certificate of Compliance issued 5/24/99 per Town of Barnstable Health Department. Were sewage odors detected when arriving at the site(yes or no):NO Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) a Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 BUILDING SEWER(locate on site plan) Depth below grade:Waste lines exit below cellar slab floor. Materials of construction: X cast iron _40 PVC other(explain): Distance from private water supply well or suction line:>16'from town water line. Comments(on condition of joints,venting,evidence of leakage,etc.): No evidence of leakage was observed within the cellar at the time of the inspection. i SEPTIC TANK: X (locate on site plan) Depth below grade: 1000 Gal: Inlet= 15" Outlet= 10". 1500 Gal:Inlet and Outlet cover raised 6-12"of grade. Material of construction: X concrete—metal_fiberglass polyethylene other(explain) If tank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 1000 gallon(H-10)overflows to(1) 15000 gallon(H-20). 1000 gallon 1500 gallon Sludge depth: 1" 0" Distance from top of sludge to bottom of outlet baffle: 32" 32"to Tee Scum thickness:<1" 0" Distance from top of scum to top of outlet baffle: 10" T'to top of Tee Distance from bottom of scum to bottom of outlet baffle: 14" 16"to Bot.Of Tee How were dimensions determined:All measurements were taken with a calibrated measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 1000 Gallon:Liquid level observed at the exit line pipe invert. The inlet side has a concrete baffle. Exit baffle has a slight fisher but was found to be structurally intact. 1500 Gallon(11720):The liquid level was observed at the exit line pipe invert. The exit Tee contains a Zabel Effluent filter. The filter was cleaned as part of the inspection The inlet side has a PVC tee and is above the flow line. There were no observed signs of backup of leakage within or above the septic tanks at the time of the 'on. GREASE TRAP:—(locate on site plan) Depth below grade:— 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•. Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: X (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.): The cover of the DB-9(H-20)is 15"below grade The box contained one entrance line and five exit lines. The liquid level was balance across the 5 exit lines. There were no observed signs of backup or leakage within or above the D-Box at the time of the insdection. The 4 unused pipe knockouts are sealed with plastic/PVC inserts. PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ X leaching chambers,number:(5)500 Gallon Chambers(H-20)with 4.0' stone at sides and 3.75'at ends. leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovativelalternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): A steel access port cover is located in the driveway. The interior of the chamber was inspected;the inside of the Chamber was dry and did not contain a bio-mat formation along the floor. There were NO observed signs of sidewall staining ponding or hydraulic failure the time of the inspection. 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ' Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. ASSESSORS MAP: 351 PARCEL: 28 „ to - �... . , _ Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ' Property Address: 18 Keveney Lane Cummaquid,MA Owner: Robert Metafora Date of Inspection: June 10,2002 SITE EXAM Slope 2% Surface water >100' Check cellar DRY Shallow wells Auger to 1707'and dry Estimated depth to ground water>14.17 feet from surface i I Please indicate(check)all'methods used to determine the high ground water elevation: X Obtained from system design plans on record-If checked,date of design plan reviewed: 3/9/99 X 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) X Accessed USGS database-explain:AIW 247-B You must describe how you established the high ground water elevation: PLEASE SEE DIAGRAM: �n 500 GIAL, CHAM$EK �n 170" 1- 3 106" P WATER Trow4P MAY OZ C 2615 AP-jU5TMENT'= 5�,8' C(c9.lo) TOWN OF BARNSTABLE LOCATION SEWAGE # ?q—C<D? VILLAGE CL2t11k14 �AJSSE-�S�SOR'S`` rMAP & LOT �� —® INSTALLER'S NAME&PHONE NO. IbZT'i SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �.�� r -� � (size) X S0 NO.OF BEDROOMS BUII.DER OR OWNE PERMITDATE: COMPLIANCE DATE: f I ' Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 101 ® ® h -,too 414. ;j; .. CO d'Judd,R.S. Richar Registered Sanitarian 775 Freeman's Way Brewster, Massachusetts 02631 (508) 896-9316 June 2, 1999 Health Director y Town of Barnstable Health Division 367 Main Street Hyannis,MA 02601 Re: Certificate of Substantial Compliance 18 Keveney Lane , Cummaquid,MA Map 351 Pcl. 28 :<:. Dear Health Director, As per your request and in accordance with`3 id CMR'I5:021'(3)of the D.E.P. State Environmental Code, Title 5,I am addressing this correspondence to you directly regarding the above captioned project. I hereby Certify that the existing Sanitary Subsurface Sewage Disposal System has been installed in substantial Compliance with the Design Plan by Richard Judd,R.S. If I can be of any further assistance to you on this matter,please do not hesitate to contact me. Respectfully submitted, Richard Ji dd,R.S. v-e V1,710 VN OF BARN-STABLE LOCATION SEWAGE # CO? /� VII,LAGE wIIM ASSESSOR'S MAP& LOT'�V� '0 'INSTALLER'S NAME&PHONE NO. i C_an L SEPTIC TANK CAPACITY I,C"e> CA 4fP (42 � LEACHING FACILITY: (type) 60CJ4 C.L2&1&649 (size) 12..,2� X S2 NO.OF BEDROOMS ``,_�BVILDER OR OWNE PERMITDATE: 7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by .� � wU3 y . No. / i e Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:' Y PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 3pprication for Digpogai 6pgtetn Construction permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) 1complete System El Individual Components Location Address or Lot No. I k- v-p-,r,a.trb Owner's Name,Address and Tel.No. L7 �0 7 3 u*'-% ...A V,,\A U R 6''i�r� k�0-1�cc r y Assessor's Map/Parcel i 0NCAI � ' 1 O Installer's Name,,Addres ,and Tel.11o. j o v ��'u Q) Designer's Name,Address and Te.No. 77/ Y Type of Building: Dwelling No.of Bedrooms Lot Size 0010 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) -Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow , l I gallons. Plan Date Number of sheets f RevisionrDate Title Size of Septic Tank� Type of S.A.S. �S_a °, Description of Soil AA1 am% A f2 � DESIGNING ENGINEER MUST SUPERVISE INISTA TION AND GERT-IFFV-IrN WRITING Nature of Repairs or Alterations(Answer when applicable) THE SYSTEM WAS INSTALLED IN, STRICT Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued this B d pVHe Signed tfi Date Application Approved by Date vim" Application Disapproved for the following reasons Permit No. �'`X4 Date Issued i Fee X. q _-<, TH Entered in coinut i:E COMMONWEALTH OF MASSACHUSETTS _ p As PUBLIC HEALTH DIVISION'%r10WIQ OF'PBARNSTABLES MASSACHUSETTS 01,n Yicat ors for t�' o cY� p�t�e u on.5truction:. erntit Application for a Permit to Construct( )Repair( )Upg jade(= Abag'dn(i« ) Complete System Individual Components Location Address or Lot No. ) 2U (? g h Owger s Name`Address,andrTel.No. Cn 7 "-). 7 U 3 It-A ,}., c, v��o� i� �ci. 'ram E q d r y q Assessor's Map/Parcel l� ; �` C�,r,M•+•ril: ;' Installer's Name,Addres ,and Tel. ,No. 5 �,�d;. �S FDesiooer's Name.Address and Te:No rj Q�f 25 3J Type of Building: Dwelling No.of Bedrooms_� Lot Size 5.coo sq.ft. Garbage Grinder Other Type of Building No.-of Persons. Showers afeteria( ) Other Fixtures ,Y Design Flow_ 6 le gallons per day:,Calculated daily flow r_Y�(1 gallons. Plan"Date 5 9 Number of sheets f Revision. ate 10 Title Size of Septic Tank Type of-S.A.S r. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ° Date last inspected: ; Agreement: PIP . 1 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 this Board 'Heath:_ ---`r Signed V�� Date Application Approved by _ Date L?— 57— Application Disapproved for the following reasons l Permit No. Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by �d'= Y7r�r ✓`}� e�522//I5,T_. at f_16 # "e!42 e 4z X lAei ex_ ' ,W1 Luc wf� has been' constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.4 - :$9 dated 9 Installer Designer The issuance of this permit�sall Aot b c6 d as a guarantee that the sys m 1 fun io as d i� e*. IDate ._ / Inspector f Y J' ---- — �-------------------------- ---- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lizpogar *pgtem Construction Vermit Permission is hereby granted to Construct(/`)Repair( )Upgrade( )Abandon( ) C System located at Z e ` ® /� v% GI/' /�Py gt7 '9 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction/must be completed within three years of the date of this permit. j� Q Date: Approved by � '.vt,•� �`_/--� 1 �E 1n 0 K) o Lij rc) In — 1n �) 4— 66 ' DROP TOP Or I.JALL U%Is-' - (sH/`bEP C) 03 I I O 0 e 19-10 ' U. U) G!c COLT-!�GI_01 I AND I LI P C coR�IEI�S !a zx4 AL.G.uFPFJi r�rloN� \ 91_ I I_I B O N % . �caJc.Fft�iTh1ALL -(Zj FI Y V J � r Ti NCI�x IZ GONG �-KC/ Q ��Qq�� t !2)IQclx'S�Y LPL MbR. 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W+ Iu gFu1Vu.— FuwuVa.°nW 3DN301S3a SvNSndNS3H3 5�1`d 1�055`d N��J.rl l I� � wwFe.�.4,..Noq..-1-14a. ayj o} suo!lrJjallo puo suo!!!PPo m ° t ,'�I•wlrize.V 4>.1-14�'/ - R V ' N� .',._� �Il�sado 1-L>nob: ;• 1 i+ k 1 _ ... -. it e 11N, 81 ^J a WI N ( 6I d 3m m z I Z j d Yd Z A m5 W��F T kF W t � L - N J l`Sll Z 'ill J • F �d F�.. yA �p 00 0 � 0 Q d I L 0 - w 11 i wu �p opkN o w Z 0 _ �j dF �3 bj �Su° pup m Fj d- �5ryry Z P p I ° Z Cpt x 0 pT Nn Z U 11 x N ci BOTTOM OF PERC AT. S1trvE Dor1f TIME: t 1130 a 72�� PElCCkfrl7) 1 RATE: DATE: 1151119 G.W.E O_� PERFORMED BY: RICHARD JUDD WITNESSED BY: T,Duwn114 l4 • I 1 DEEP OBSERVATION HOLE #2 U /V ,P GrRovE yq DEPTH FROM SOIL SOIL SOIL COLOR SOIL .--- D.0•H•ya �scc'�L, ua 8• SURFACE In, HORIZON TEXTURE (MUNSELL) MOTTLING OTHER �. a (-7" LOAM 10 M IJ u > q �b iv1ASi1V 63 �y .7 'I rI a t a�ND 10 NONE VF- FR1A�s�-E. Ex sr. 8'x29' Q�E ,9 �.6gCH FiELl7 Fetid To ISE AiMAPONEV 51.74 -- 20 n ClSI La LOA JA I Lt. D .5YK 73IV Q' M o o BOTTOM OF PERC AT:SIEVE DONE TIME: IZtl5 � RATE:G2rn,,.1/rNcA(ciM.55UMEP DATE: 1/510VII G.W.E ® 7L,(PER(-µEn) PERFORMED BY RICHARD JUDD WITNESSED BY. J.DUNF4t 9 a3., _ y0 PItOPOSEP DATA• A 5 FOOT OYE A RDI(7 IS 9EQUIoCED a _13006AL- (WZO) W.�_ BEDROOMS X l l0 GPD/B.R. 550 GPD TO r>�Ca�Y�E�<Ef~ �'�� p ® SEPTIC T,4riK IRED FLO yo ,, 3 oRA c4tP.N �aaSE sn+`IDC'q')• `;? �, \0�P IC TANK CAPACITY. 550 GPO X 2 = I100 GPO 11000 CAL. ExlsriN(3 SEPTIC TANK LEAtrIr1C{ TO(1) ISCO (;AL, H-74 SEPTIC1TANlt s= g tooOc�AI.,CH to) / H FACILITY DESIGN: VsNrr,�g 53: SEPTIcTANK 'EA: 2. 50•oQ tl2,g )xZ X4.7 l5 FT = 5,q PROPOSED S.AS• _ y 1 AREA: C 50.00 x 12.83 x0,7$Gppjsq•FT = 7�.71 C5) CHj 8.5'xA.H'X2r o Q (o {-EACH1Tl(TCHAMf3E)t5 ti^, TOTAL = !�• '� GPD PROVIDED > 550 CPO REQUIRED �! AREA 1009: LEACH CAPACITY , N �1/q'oF Srayt AT S►PE5 3,T5 AT kNPS. ° < Ne ar r. wa�L s1 8.5 L X4,6 w x 2 P CN-20)LEACH CE•IAME:K.5 y3' PACER Sti .• ,0 ESTIMATED HIGH GROUNDWATER CALCULATION NA • M. (USGS/CCC METHOD) % s / INDEX WELL: ZONE: Of j �$,t�H FN j�, Z a ATE OF READING: DEPTH TO GROUNDWATER: \S R �p 'STRUC� ER CON GROUNDWATER A" v _ LEVEL ADJUSTMENT: Z-rimoClz W s� " I-� T11E COrJT1 ACTUAL GROUNDWATER LEVEL 0 SITE: EL=_ st�'RS ' Ppt° � FORC2) O' ESTIMATED (MAX) HIGH GROUNDWATER LEVEL: £L� SpI,T A1�I'�NC� �'� °5 ' ��7• !; 7 L\ —: EXISTIA{ � � AL NOTES: \- ��dRD�°I"� bo 3� � rNSt-hLLEi I, > �WELLEN� FOOT- of SYSTEM COMPONENTS SHALL BE INSTALLED IN _ _ 3. D )ANCE W/TITLE 5 OF THE SANITARY CODE do ANY �4i T.0,rw4 STAi3t E TA04-ETI Ij ABLE REGULATIONS. -��„ E, EL- VE GI,1(p \ ss•�0 IR TO BACKFILLING THE INSTALLATION, THE SANITARIAN S�. — Sro. E., Dkk%/E _ _ — Cvv�f-c .TH AGENT SHALL BE NOTIFIED FOR INSPECTION. _ 1. A ALTERATIONS TO THIS DESIGN MUST BE APPROVED BY — - _ \ "\ 5 r5o0 GtA.I NITARIAN & BOARD OF HEALTH, IN WRITING. rEM IS NOT DESIGNED FOR A GARBAGE GRINDER. FI PR e P. INTALLER IS TO VERIFY THE LOCATION(S) OF UTIL/TES, IOL(S) AND SEWER INVERTS PRIOR TO CONSTRUCTION. AV9,4 J IJpiKIN5 G�1RY J. NJ'"6y T A z'a`i UNSUITABLE MATERIAL WITHIN 5 FT. IN ALL DIRECTIONS \ f �605 - SD mqu I NE SOIL ABSORPTION SYSTEM SHALL BE REMOVED & ^� OLLTLT'r .ED W/CLEAN, COARSE SAND. 7 7, COwT� FILL MATERIAL UTILIZED FOR THE SOIL ABSORPTION SHALL BE CLEAN, COARSE SAND FREE FROM RIOUS MATERIAL AND SHALL HAVE A PERCOLATION RATE _s) 0 S THAN 2 MIN./!N. BEFORE & AFTER PLACEMENT, OF 0 77NG CESSPOOL(S) TO BE PUMPED AND BACKFILLED PER v \ �H s9 ABANDONMENT PROCEDURES. \ � M4C1 iAEL cy� 'NG INSTALLATION. THE CONTRACTOR IS RESPONSIBLE TO j S. m E A SAFE EXCAVATION AREA. �13,00 LADUE o —I )UND COVER OVER SEPTIC SYSTEM COMPONENTS SHALL Na 37560 y 'CEED 36". sut� - w GRAVITY SEWER PIPE SHALL BE 4" DIA. SCH 40 PVC �bo OTHERWISE NOTED. THE MINIMUM SLOPE OF 4" DIA.. PVC SHALL NOT BE LESS THAT 0.01 FT/FT. 7 1�� P8 4 :REVER SEPTIC LINES CROSS WATER SERVICE LINES OR VFTER SERVICE LINES COME�WI HIN 10' OF THE OUTE6A 1 5ED S.A.S. - PIPES SHALL BE CLAS*5150 PRESSURE r��I-��/A - r SHOULD BE PRESSURE TESTED TO ASSURE WATER Y .-SS. COORDINATE WITH LOCAL WATER DEPARTMENT. ` i DEEP OBSERVATION HOLE LOGS GnvG goo Fn r LOCUS DEEP OBSERVATION HOLE #1 ti/K ELLIoT UANlI �}.< �EDWITH �a8twt E. DEPTH FROM SOIL SOIL SOIL COLOR SOIL , TOP OF D.O.H. 1 *Oft SURFACE In. HORIZON TEXTURE (MUNSELL) MOTTLING OTHER ,0 -- " —' N,4wX L.Aw,14 AKEA ALft MA5SIVE. ? 3 -- `7-7 t 10YK`)2. No C \IF_Kv EkJ ®�,,�Nu bb Q 1 b Q o �c.oGu> a �. 21re bA I ap ZZa dd ' BOTTOM OF PERC AT. 511"VE PoNf: TIME. 11130 RATE: DATE: 115149 G.W.E O 7Z" PegowD) A PERFORMED BY. RICHARD JUDD WITNESSED BY. -:DuNnte 4 49• z DEEP OBSERVATION HOLE ,02 A/ EvE >J 0frL00t> ZUNE G 'l qq . ! DEPTH FROM sac Sal SOIL COLOR soli �q' FS 8 SURFACE h. HORIZON TEXTURE (MUNSELL) MOTTLING OTHER D, H•k �'E'(„ uB'�6 TOP Of D.O.H. 2 1-7" A 17 LnAPY l0 `4 11 SANDY 4 1y1A►S31V 5 u`� �3 s �� b -ff,7 10 ON Very Fv.%At,►.E Ex,sr. 8'x29' Y v6 D.o,N.2 LCACH FIELD 11.74 -" 2 " CI SILT L.ki. Xvf 7 5 YR I V IF- Q To ne AUA1004EG A`�- yN J� 5 qq 10 ,AH j BOTTOM OF PERC A T.S IBYE BONE TIME: I W.15 �� RATE:42mj,4 INc+t(c2)ASSWED, DATE: 1/510M G.W.E O 7ZII(PEKcHED) sl PERFORMED BY. RICHARD JUDD WITNESSED BY,• J.DUNNL 1 ��y� 0-2o0)pq q 0 a° DESIGN DATA: A 5 FOOT OYEKPI(T IS R4ulKr_D " ,C--Iso�A�(H zo) 5°A° w N' TO nim C2 ��1c R FL• (r.o0) SEPTIC TANK o'e ' 1, REQUIRED FLOW. S BEDROOMS X 110 GPD/B.R. - 550 GPD oRA c6LA4 60OSF- SANp(r 1) � `' 2. SEPTIC TANK CAPACITY.• 550 GPD X 2 = 1100 GPD �s. peP USE (1) 000 GAL. ExIsrlNc SEPTIC TANK LEAaINq To(t) 1500 (TAL, N-20 SEPTIC TANK Sz 9 • EooOtfAL,CH Io) 3. LEACH FACILITY DESIGN: VEuTW/; ,3,' SEPTIC TANK � SIDE AREA: 2 (50•o0tla.gt)XZ X0,7q(CPp/5Q,FT = 5'� PRoPOSEDS.A,S• BOTTOM AREA: 50,00 x 12.63 x0.74r Cz?pl5Q•FT = 7 L_ o TOTAL LEACHIN(TCHAM56(t5 (n(aD GPD PROVIDED > -5 5Ca GPD REQUIRED . RESERVE AREA = 1009: LEACH CAPACITY - USE. 5) 8.5'LK4,8'wKVkH-20)LEACH C1, MUE'R5 VJ/A'OFSnNU AT StIzEcj 3,15' AT ENDS, s."° C gJ6D hcNERET. WALL.- o9 y P 5ti.5I pR\ o ESTIMATED RICH GROUNDWATER CALCULATION NA •15,M•- ; s^ �` Aep� ' (USGS/CCC METHOD) EL. Sfp.b-( \a 5a.�o ��.,3 -• eo INDEX WELL: ZONE: 014 DATE OF READING.--DEPTH TO GROUNDWATER: \3jbaE GA Z- r� A UCTI ON NOTES ; GROUNDWATER LEVEL ADJUSTMENT: ttIHBE� WALL ONTRr1GTOfZ MUST"CONTA�T T}IE- $AIJITAKIAN ACTIJAL..GROUNDWATER-,LEVEL SITE. EL= Sr�tias pgr,o v ; ESTIMATED (MAX) HIGH GROUNDWATER LF_VEL: tL-- SPLiTgq%LFFNGt? 59 os_ -- ___ —� . __^_�_/ _ -...\`ct . �XISTlA1( r} N5GTION M£rRLGOVJ<1C IGENERAL NOTES: g a-1=DRoo� bb S� t-LEP IN PRIVEriI,lY�D U) To w1T14114 df,�(0) 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN �_f DWELIIN/� Foor OF (TKA-D'E. ACCORDANCE WITITLE OF THE SANITARY CODE & ANY _ o �s T.01FTN1 3, 1>15rKIBUT1OIJ gc}t, UST t�E F'L-r.(EPP Ok A LE.VEL- APPLICABLE REGULATIONS. Elt-,61,1(p 57AI5 E r;/ASF, OFST IE-OK CoFIGP.ETi. 2. PRIOR TO BACKFILLING THE INSTALLATION, THE SANITARIAN _ _ & HEALTH AGENT SHALL BE NOTIFIED FOR INSPECTION. - - �. J. VENT L«ATIoN I� To gE p�E�I.tiIN� �.( per , A C k4. OAI- FtL� R IS RE vttZ p. ' J. ANY ALTERATIONS TO THIS DESIGN MUST $E APPROVED BY -- —— � � i � 4 THE SANITARIAN & BOARD OF HEALTH, IN WRITING. 5, �50o Gr�iL•LH-;to) SEFrjcI . rA�K,15 TZ7 rFAuE 1,a ciF 4. SYSTEM IS NOT DESIGNED FOR A GARBAGE GRINDER. rKE INLET ANV ovrj_ETc:ovEK,S Win+-IN (o" 5. THE INTALLER IS TO VERIFY THE LOCATION(S) OF UTILITES, PReP. 5q � OF mmI'54 4g A a, CESSPOOL(S) AND SEWER INVERTS PRIOR TO CONSTFIUCTION. \ Oro,, � ,vlF 6. ALL UNSUITABLE MATERIAL WITHIN 5 FT. IN ALL DIRECTIONS \' AvnN J I,prKINs G�4RY .1. ` +V,gNGY �" O A � �-�'"1Uv£7 EFFWENr FILTH (S FROM THE SOIL ABSORPTION SYSTEM SHALL BE REMOVED & \�,v f 8605- 50 Kf:qU IKEv W •tl+C 1500 6jAI._ SEF>TR-_TArrIK, REPLACED W/CLEAN, COARSE SAND. OUTEF-*r TIME, 7. ALL FILL MATERIAL UTILIZED FOR THE SOIL ABSORPTION 0 7, COIJTKACTOP-'5 SYSTEM SHALL BE CLEAN, COARSE SAND FREE FROM o / STATE T 1tA"!" T}Ik I J0U 6rAl. C1'I"ii1-pAt4K DELETERIOUS MATERIAL AND SHALL HAVE A PERCOLATION RATE w O H-Af:a. AN EF'Ft_- -r FI LTE.FR, OF LESS THAN 2 MIN./IN, BEFORE & AFTER PLACEMENT, 4 8. EXISTING CESSPOOL(S) TO BE PUMPED AND BACKFILLED PER q' HOF -jHOF TITLE 5 ABANDONMENT PROCEDURES. 9. DURING INSTALLATION, THE CONTRACTOR IS RESPONSIBLE TO - AMCHAEL ctiG o�� PROVIDE A SAFE EXCAVATION AREA. L13 S. m �� RICHARD J. 10. GROUND COVER OVER SEPTIC SYSTEM COMPONENTS SHALL LADUE " JUDD y NOT EXCEED 36", No 37560 y ,JR. No. 1125 11. ALL GRAVITY SEWER PIPE SHALL BE 4" DIA. SCH 40 PVC •PF �p UNLESS OTHERWISE NOTED. THE MINIMUM SLOPE OF 4" DIA, �y,�pSu c/sTEa SCH 40 PVC SHALL NOT BE LESS THAT 0.01 FT/FT. SgNITARt�'N 12. WHEREVER SEPTIC LINES CROSS WATER SERVICE LINES OR WHEN WATER SERVICE LINES COME,.WITHIN„10' OF THE RO�rEcp,4 f ...` j`� PROPOSED S.A.S. - PIPES SHALL BE-CLASS`150 PRESSURE I l I(�u 2 PIPE & SHOULD BE PRESSURE TESTED TO ASSURE WATER H��lY 1. TIGHTNESS. COORDINATE WITH LOCAL WATER DEPARTMENT. RIChO/ d Mudd, R,S. T.O. FDN. NOTE - RAISE ALL COVERS TO ACCESS PORT 775 Freeman Is WO WITHIN 6" OF FINISHED GRADE ' y� EL. (Oi 1 FI I`E;HED GRADE Brewster, MA 0263 WASTE LIME Exrr5 2.00 9" MIN. 9" MIN, ADD 9" MIN. 2" LAYER OF 1/8" TO 1/2" WASHED STONE (508) 896-9.316 36" MAX - 36" MAX IA&z-T"rcE 36" MAX. 9" 111N. Al _f ;t�r1i,TUt3E. TITLE: 18 KEVENEY LANE_ $E!bW FI�lC�, FL_OOk / 36" MAX. 44,G5 POW$L-F WASHEI> ley OUTLET PIPE TO CUMMAQUID) MA, BE LEVEL FOR 2 FT. MIN. , ------too----- EXISTING CONTOURS 51• 507' ).4U 50,15 `"45 c� o 0 0 0 o PROPOSED CONTOURS , OWNER: MaFOKA 9.9•45 ca e Ln o 0 o EFFECTIVE DEPTH, w-- WA7EROEK� G_ GAS 9S q2 I Ip 5�o,�C 15 UNDERGROUND UTILITIES RE VISIONS: IOC AL. CAS BAFFLE 1 AL. GAS BAFFLE - 3/4" TO 1/2" � QVI�Ei�UNL • OVER DIG 93t EXIST SEPTIC TANK M_z0 SEPTIC TANK I 1 51 WASHED STONE 51 +I'-87 TEST HOLE STONE LENGTH = s�2,5) STONE F� DESIGNING ENGINEER MUST SUPERVISE MAP: PARCEL: TO BE INSTALLED ON A LEVEL STABLE rIq G8 INSTALLATION AND CERTIFY IN WRITING BASE 6" CRUSHED STONE REQUIRED l - ' THE SYSTEM WAS INSTALLED IN STRICT DATE: SCALE: PROPOSED SEPTIC SYSTEM — PROFILE rL,2-7.2-1 D.0,N. 2_ ACCORDANCE TO PLAN. DWG NO.: q9-0(0 NOT TO SCALE _ ____� _._- _