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Home My WebLink About2760 MAIN ST./RTE 6A(BARN.) - Health • to ,�!^* 1 v 2760SMainYStreet, Rt6Fi -`064 . . Y�. =% W76 0 Grrct e,,c. TOWN OF BARNSTABLE T.00ATION ',.Pp — �r I?I I—r47Y 2 SEWAGE # S*? -� VILLAGE ASSESSOR'S MAP & LOTo2S G INSTALLER'S NAME & PHONE NO. D` / "(CS SEPTIC TANK CAPACITY l-�0® LEACHING FACILITY:(type)Ix (size) a0 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER � T�( DATE PERMIT ISSUED: — 87 DATE .,COZIPLIANCE ISSUED: VARIANCE GRANTED: Yes No ,� � � inv `� �'1 v* ..r""'_, `TOWN OF BARNSTABLE ./ 0 LO('AT10N .• �� ® ��i1/ SEWAGE# VILLAGE Z— 9--I ' Ce ASSESSOR'S MAP & LOT,2 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILTTY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 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 �_ \• :�4 �� ^r .' d �; -]. �=, Ficis q. 6VI THE B ARD COMMONWEALTH F FHEALTH s p Appliratiun for Disposal Works Tons#.rartiun Permit �14plication is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal ystem at: ................_____».»� f........... ......... _►T ....(1 ... ).. - ` , -» 1 ...................................... ».............._»»».5s.!.St< tSi'1.�....L1.dress....4..!. ..-. ... .. •- ...._....or Lot-No_....._......._......»..»....»........ a O n.er --•- Address- ...... - .............. ... .-- .......... .......:....... Installer Address �Z - Type of Building Size Lot............... ........Sq. feet U.. Dwelling—No. of Bedrooms....... .... _____Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers a YP g ----•--•-----•-•--....__.... p ( ) — Cafeteria ( ) 04 Other fixtures . Design Flow.,•---....L10._...---.... gallons per pew-pgr day. Total dailflow................. ......gallons. c Septic Tank—Liquid capacity . gallons LengthAQl>.... Width:r'J;_+7... Diameter________________ Depth..CA..... W Disposal Trench--No.......... ......... Width.................... Total Length Total leaching area....................sq. ft. 3 Seepage Pit No....:�/...... Diameter.._.._f v.._.. Depth below inlet......(a......... Total leaching are _sq. ft. Z Other Distribution box ( Dosing tank Percolation Test Results Performed b Osl. . ...tPF...f. � ... �r. � Date. �� 7�l. .. �G.i. Y �.. ... Test Pit No. 1... ____minutes per inch Depth of Test Pit... 00._. Depth to ground water.] - LL, Test Pit No. 2---' _minutes per inch Depth of Test Pit... 11;5Q_...... Depth to ground water_.. . pd ..............r;-•-•-.............._..-•••-•......----•- ..........................------.....---- ...... ............. 2 ?dl'.z �t1�3. G ( ?..`.`..... � � O Description of Soil _ �..... — _ F p �1 "..� ......----•• ....................................................... J_- `` 7 5 G� ..... #?�-- 6....�.1�� UNature of airs or Alterations—Answer when applica le..._.____.•......................:................:...:........................................ ..._....--•--._.._....-•..................••-•--•-•----------•-•-•--•--..._........-•--••-------•----.._..........--•-------...._..-------........-------............................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL; 5 of the State Sanitary Code— The undersigned further agrees qet,,to place the system in operation until a Certificate of Compliance has been i th oar of health. d.. Gr.................... ........ .........................._.... Application Approved By........................................ ................................-_----------------------- ............ .. Date Application Disapproved for the following reasons:.............:......................................................:.....................................»»_ .........-•---•• -��.»^��c� _.... »....--r•----------•Issued............. - . ----»..�.��... .�1.�. :�. .....»....» Dale Permit No.--••--•- ' D� ti ... No....................._ _ � �,. r , FEs...........ti��._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H(�E,{A1L'TH`rt ? r_ ' OF.............. 1C..-M`y-I -Jac-1 t-/1........ G ,gyp iratiutt for Dispusttl Works Tons#rudion Permit Application is hereby made for a Permit to Construct ,),or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. Kr :n....--•--...........tom. ---- ----•---------------•--..•.....--••---•--- --. ....................»»»...._.»..... Owner t Address a ............................ ..... ::... =' _ ........»... ?' ....... ............ Q Installer Address Type of Building Size Lot_...7ZZI.�3Sq. feet ......... ..... Dwelling—No. of Bedrooms................. ...Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building __. No. of persons............................ Showers G4 YP g ----------------•-•-•---- P ( ) — Cafeteria ( ) a' Other fixtures ..........................•---••---•� a k y ; ...-----------------------•--------------•........•------�•--•-...........-....... ._.... WW Design Flow.......... M_ __________ ______gallons per,perton>per h r day. Total daily Q flow.__........._________ ...........gallons. WSeptic Tank—Liquid'ca.pacity�_�0��gallons Length l� _... Widt -._._. Diameter:............... Depth. _'dc................ x Disposal Trench—No..................... Width....................Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..... ':�...... Diameter__._..!! _____ Depth below inlet..... -v............. Total leaching area_4a4..sq. ft. z Other Distribution box (;K), Dosing tank Percolation Test Results Performed by--4:V124ez......:.....:...................r..--_--_---_-:_- Date._.._:...p....-•--•-•--_-----_� Test Pit No. 1...G ....minutes per inch Depth of Test Pit....6..r0_._ __ Depth to ground water-- �:!�!:�. r. rr _ Lt, Test Pit No. 2...!4 -__minutes per inch Depth of Test Pit-_A :�?:...... Depth to ground waterA re/A 1�! a ............ ...... ......... ..... -...:.............- .............. _ . . O Description of Soil`��:c ) ( 1— ...'7 * 11.da�Eil, t ...��►�`� " /c�:2" "-,qAe:SAS n E&( s AC ' =" r ...................- -. . - U Nature of Repairs or Alterations—Answer when applicaLle.............................................................................................. -•.................................•-------•-------------------•----------------...---...------•---------•--•-•----------------•--•---•-----........................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i�ssu d by the,fioard�of health. �� Signed:—`-�-':1 _.�Y_ "' J• ! ---- ... ,ice �� . Application Approved By.............................�.'_f.��:��...—�...._ ''_..�.-•--- -. . ........:'. 3 Date r• Application Disapproved for the following reasons:-----_--••.................'________________•__.�._..........____________._............_-_..-..........»»» . r .. •• r ; r^ ............_ Date Permit No...................................................v G� y sued........... ` l Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . OF..... . .- ...................................................................... - (Irr#if ird a of Tomplinnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (\..)foRepaired ( ) by..............................•-•...................•----....--------.................•...............................................................-........._......................»..»...._ installer has been installedin accordance with the provisions/of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.` .. .�....._�.....D dated__... I.1.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. N DATE..... . ......................... -. _.. :, ..- l '�.». � --- . Inspector---------------------- ... . ........_._........_................... _ au...-.1.......•.YF_._.. n w.p..r_ .n n T n_w+.•ry••ry n w........n.u ar waM.u. .•i.._.,.•w.Y�... n.+r.- _ e ti-.. -.a - .•� Y Y n G •f.i..-.- -.--�..e-�}.-w...---n.u...F. THE COMMONWEALTH OF MASSACHUSETTS —_,-_.._..:.._...---BOARD OF HEALTH �5 OF..... =,i,•1' ....a.................................................. -5- No:- - O Fzz.... .~.-:..... Disposal Iforks Tono#rudiun Frrmu Permissionis hereby granted.......-----------•---._-_.........................................................................................._...........-....... ...... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo....... ...... ........ C; ?.... :. lac---_--------•• � l�t>1. _(.?k�.......................................................................... �} street 75 as shown on the application for Disposal Works Construction Permit No _7_T r 2 Dated............��=3.f_.......................... » . DATE.............................................................................» } °Ft1HE ram, Town of Barnstable Barnstable Regulatory Services Department HAIMSTAIIU- 1 1 r y MA9S p• 0 P39. ,� ubl lc Health Division m pTfdk'P�A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 9156 September 24, 2018 HOEFT, EDWARD J & MARILYN E HOEFT P 0 BOX 163 BARNSTABLE, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 2760 Main Street/Route 6A, Barnstable, MA was inspected on 08/22/2018 by Joseph M. Martins, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • The distribution box needs to be replaced and.flow equalized to both leaching pits. The septic tank outlet tee needs to be replaced with a new PVC tee and gas baffle. , You are ordered to repair or replace the septic system within two (2)years 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 T BOARD OF HEALTH Dc ean, .S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Conditionally Passes Letters\2760 Main Street Route 6A Barnstable.doc ti Town of Barnstable + w + SARNSrABLE, w 0,19. ,�� Regulatory Services Department rfD MAY h 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 60 DAY DEADLINE CRITERIA ❑ 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 Xo ny"conditionally passed systems" (broken cover, relocation of a pipe,relocation f 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:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc f Commonwealth of Massachusetts llh! Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments mi 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is. required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown - State,' Zip Code Date of Inspection r,g � I Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information /3362 o on the computer, use only the tab Joseph M Martins key to move your Name of Inspector cursor-do not Accu Specheck use the return Company Name key. d Drive Company Address ess South Dennis MA 02660 Cityrrown State Zip Code 508-385-5891 SI 147 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ® Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 8/27/2018 Ins ctor'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 office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note:This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform. in the future under the same or different conditions of use.. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address L Marilyn and Edward J Hoeft PO Box 163. Owner Owners Name information is required for every Barnstable MA' 02630 8/22/2018 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑ 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 cr ria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ® One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ® Y ❑ N ❑ ND(Explain below): DISTRIBUTION BOX NEEDS TO BE REPLACED AND FLOW EQUALIZED TO BOTH PITS. ' SEPTIC TANK OUTLET TEE NEEDS TO BE REPLACED W A NEW PVC TEE AND GAS BAFFLE. THIS PER CONVERSATION W DON DESMARAIS HEALTH AGENT, TOWN OF BARNSTABLE. INSPECTOR RECOMMENDS PUMPING FULL LEACH PIT. l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner - Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown 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 Bo rd of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static wa r level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or repl d ❑ Y ❑ N ❑ ND(Explain below): ❑ The syst/ction ping more than 4 times a year due to broken or obstructed pipe(s). The system on if(with approval of the Board of Health): ❑ re replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ moved ❑ Y ❑ N ❑ ND(Explain below): A 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, . safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 3 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown State a Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated etland or a salt marsh b. System will fail unless the Board of Health and Public ter Supplier, if an Y ( pP � Y) determines that the system is functioning in a manner th protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption s tem (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a su ace water supply. ❑ The system has a septic tank and SAS and th AS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS an he SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SA nd 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 passVabsent alysis, performed at a DEP certified laboratory, for fecal coliform bacteria inde presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppmher failure criteria are triggered. A copy of the analysis must be attached to this f c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed)pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.) ❑ ® The system is a cesspool serving a facility with`a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system m serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is withi 00 feet of a surface drinking water supply ❑ ❑ the system ' within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the sy m is located in a nitrogen sensitive area(Interim Wellhead Protection Ar —IWPA)or a mapped Zone 11 of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. CityrFown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs ofYnthe t? .. ® El all system components,1� SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): NA Number of bedrooms (actual). 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 Description: 1000 GALLON SEPTIC TANK, DISTRIBUTION BOX AND 2 LEACH PITS W 2-3-OF STONE. ONE LEACH PIT HAS LIQUID LEVEL TO TOP OF LEACHING. OTHER PIT HAS 0-1" IN IT. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? . Z Yes ❑ No Seasonaluse? ❑ Yes 0 No Water meter readings, if available last 2 ears usage d 209 9 ( Y 9 (gP ))� Detail: 2016: 94,000 G 2017: 59,000 G Sump pump? ❑ Yes ® No Last date of occupancy: 2017-2018. Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): alions 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 presen . ❑ Yes ❑ .No Non-sanitary waste discharged the Title 5 system? El Yes ❑ No Water meter readings, if av ilable: Last date of occupanc se: Date Other(describe b w): 3. Pumping Records: Source of information: PUMPED IN 2007 PER ROBINSON Was system pumped as part of the inspection? ❑ Yes Z No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 r c� Commonwealth of Massachusetts Title 5 Official Inspection Form k V�w,-'0 — Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft .PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspooR ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 31 YEARS. INSTALLED IN 1987 PER AS BUILT AT BHD. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑cast iron ' ®40 PVC ❑ other(explain): 10 Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage,etc.): .; OK NO LEAKS t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is Barnstable MA' 02630 , required for every 8/22/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1 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: APP 8.5X6X5 1000G Sludge depth: - 6 INCHES Distance from top of sludge to bottom of outlet tee or baffle 28 INCHES Scum thickness 0 INCHES Distance from top of scum to top of outlet tee or baffle6 INCHES Distance from bottom of scum to bottom of outlet tee or baffle 14 INCHES How were dimensions determined? CORETAKER Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): HAS PVC INLET TEE. HAS CRACKED AND CORRODED OUTLET TEE IN POOR CONDITION- IT NEEDS TO BE REPLACED. NO EVIDENCE OF LEAKAGE. LIQUID LEVEL OF 48"AT OUTLET INVERT. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form - is Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum t/evidence or baffle i Distance from bottom of scuutlet tee or baffle Date of last pumping: Date Comments (on pumping recinlet and�outlet tee or baffle condition, structural integrity, liquid levels as related to ouce of leakage, etc.): Lvz 8. Tight or Holding Tank(tank must be pumped at time of inspec' n) locate on site plan): ( P ) Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fi rglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA 1 Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes No Alarm level: Zitches, in working order: ❑ Yes ❑ No Date of last pumping: Comments (condition of alarm and I I *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 AT ONE INVERT i Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): DBOX IS DETERIORATED AND NEEDS TO BE REPLACED. ALL FLOW GOING TO ONE PIT ONLY t5insp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ es ❑ No* Alarms in working order: Yes ❑ No* Comments(note condition of pump chamber, condition of pumps d appurtenances, etc.): *If pumps or alarms are not in working ord , system is a conditional pass. 11. Soil Absorption System(SAS)(locat on site plan, excavation not required): If SAS not located,.explain why.- Type: ® leaching pits number: 2 W'-2.5 STONE ❑ 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.7126=18 Mile 5 Ofidat Inspection Form:Subsurface.Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630, 8/22/2018 page. Cityrrown State Zip Code Date of,Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): ONE PIT IS COMPETEY FULL OF EFFLUENT,THE OTHER IS EMPTY. THE EMPTY PIT,HAS A MODERATE STAIN LINE OF 32"ABOVE PIT BOTTOM. STONE IS CLEAN. ABOVE STAIN LINE PIT IS CLEAN AND SIDES ARE GREY. i 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site pla 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 so", signs of hydraulic failure, level of ponding, condition of vegetation,' etc.): ' u s _ t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form!Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form A11. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/20 ` page. Citylrown State Zip Code Datepffinspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: .s Dimensions Depth of solids Comments (note condition of soil, signs of h aulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of.Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owners Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityrrown 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 W/ KEA P.. ` A B O _D ISTI�NCES O A = 3Y.5' gns ti7r AN.53' 124 o4S=q0 ' 135=411.5' Ot NT.S t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �- Flii Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA. Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page.. Cityrrown State . Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 33' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: GOOGLE MAPS, CAPE COD COMMISSION GROUNDWATER CONTOUR, FRIMPTER You must describe how you established the high ground water elevation: SAS IS 54'ASL. CCC GROUNDWATER CONTOUR IS 16'ASL. MAX RISE IS <5'. GRADE-TO SAS BOTTOM IS 12'. SEPARATION MATH: 54-(16+5+12)=21'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts 5 1 f U Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2760 Main St Rte 6A Barnstable MA Property Address Marilyn and Edward J Hoeft PO Box 163 Owner Owner's Name information is required for every Barnstable MA' 02630 8/22/2018 page. Cityfrown 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 TOP OF FOUNDATION TOP OF GRADE=0 -->s-Top of S.A.S._ Bottom of SAS. /e2 . - Separation= �, Amt of Stone= A,Si Adjusted C omdwater= 3 3 Observed Groundwater= $ t5msp.doc•rev.71AW18 Trtle S,q ficiel Inspection Fow.Subsurface sewage Disposal System•Page 18 of 18 No. ®( 0 Fee /✓ o� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS � n&q apphtation for i0isposai 6pStrm Construction Vermlt P Application for a Permit to Construct( ) Repair ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. A76 0 M -A 5 fe/~ Owner's Name,Addres and Tel.No. L Assessor's Map/Parcel ;� � o P l 4&3 A 5 1 er's Name,Address,and Tel.No. ��" - J Designer's Name,Addres ,and Tel.No. 444ofj t?III✓9KA D N�uy A_) Type of Building: b a Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �y Design Flow(min.required) lu i gpd Design flow provided A)A— gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Al tions(Answer when applicable) V� r 1, Date last inspected: Agreement: ey 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 Cod of to place the system in operation until a Certificate of Compliance has been issued by this Board of He Si ed Date / Application Approved by / Date Application Disapproved by Date 'OF t000, for the following reasons ��fff111 Permit No, (�� - j� Date Issued 'II h O No. /01r 3q4 Fee t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ' PUBLIC HEALTH DIVISION - TOWN OF-BARNSTABLE, MASSACHUSETTS 01pplitatlott for Misposal 6pste tt Construction Permit Application for a Permit to.Construct( ) Repair / ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No ,�.76 0 Aq t A S�e 114gf Owner's Name,Address and Tel.No. 1 Assessor's Map/Parcel Q Q V P-1� ?v Installer's Name,Address,and Tel.No. �f �6 Designer's Name,Addres ,and Tel.No. tl�1% 1 Type of Building: 02 6 b o 41 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) gpd Design flow provided A!A-- gpd y Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) (_t / �. Date last inspected: Agreement: r f 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 Cod n of to place.the system in operation until a Certificate of Compliance has been issued by this Board of Health. Me Signed Date ' Application Approved by Date o/ Application Disapproved by Date for the following reasons e Permit No.1h1.3V-'k Date Issued j 1661 . ► -.. ,, ----------------------------------------THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance l vts THIS IS TO CERTIFY,that the On-site.S.,ecw�ge D,ii osal system Constructed( ) Repaired) Upgraded( ) Abandoned( )by- �� 41,q i /t l s LsEf��. at 2-7&0 14/mil ".-/—W le Go¢ has been constructed in accordance with the provisions of Title 5 and the for(Disposal System Construction Permit No. dated (( 201 Installer - � y,.S�D/F �<<�n,1 ./L Designer �zvit—c�— #bedrooms Approved design—flow, / `y J' �1 gpd The issuance of this permit shall not be/con s �eJd s a guarantee that the system will function as i signed. Date ) {/ ;a / 1� �' Ins ector.,, �� k _ 1------------------- - - ` -------------------- - - -- ;- • ---- -f-------------------- No. .� FeeU� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ` MispoBal opstem Construction Permit t� Permission is hereby granted to Construct(° )1 4�Repair(�) Upgrade( ) Abandon( ) System located at o7 6 () 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:Con trucf on must be completed within three years of the date of this permit. _ Date Approved by I_0 Ln •. • Y ,, p .. I�rD Certified Mail Fee r u. �N � $ Extra turn R oe&Fees(check boll,add fee as appropriate) �`� ❑Return Receipt(hardcopy) $ - N _ O ❑Return Receipt(electronic) $ ¢ Z�tark p ❑Certified Mail Restrlcted,Delivery $ are p ❑Adult Signature Required $ 9y ❑Adult Signature Restricted Delivery$ r r3 post ---- �j r' $ ''n $Tote HOEFT, EDWARD J & MARILYN E HOEFT � se P 0 BOX 163 srie, -BARNSTABLE, MA 02630 Certified Mail service provides the following benefits: •A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate •Electronic verification of delivery or attempted return receipt for no additional fee,present this_ delivery. USPS®-postmarked Certified Mail receipt to the, ■A record of delivery(including the recipients retail associate. 1_I signature)that is retained by the Postal Service- Restricted delivery service,which provides -13 for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminders. Adult signature service,which requires the •You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Ciass Mail®,First-Class Package Service®, available at retail). t or Priority Mail®service. Adult signature restricted delivery service,which •Certified Mail service is not available for requires the signee to be at least 21 years of age international mail. , and provides delivery to the addressee specified, ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). !-1 of Certified Mail service does not change the •To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a'- certain Priority Mail items. USPS postmark.If you would like a postmark on > •For an additional fee,and with a proper this Certified Mail receipt,please present your 1 endorsement on the mailpiece,you may request Certified Mail item at a Post Office-for F, the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion r of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.C. electronic version.For a hardcopy return receipt, 't complete PS Form 3811,Domestfc Return Receipt;attach PS Form 3811 to your mailpiece; IMPORiARr.Save thts receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530-02-000.9047 • • • • • ■ Complete items 1,2,and 3. A. Signatu ■ Print your name and address on the reverse X ❑Agent so that we can return the card to you. ❑Addressee lle Attach this card to the back of the mailpiece, B. Receive by( 'nted Name) C. Dat of D iv or on the front if space permits. fl livery address different from itemi 1? PY4 S,enter delivery address below: p No HOEFT, EDWARD J & MARILYN E HOEFT P 0 BOX 163 i RNSTABLE, MA 02630 4 II I IIII9I III IDI I II II I III I III II II II I I IDI I III 3:Service Type ❑Priority Mail Express® Adult Signature ❑.Registered MaiITm ❑ dult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9402 3759 8032 3749 06 certified Mail® Delivery Certified Mail Restricted Delivery yyetum Receipt for ❑Collect on Delivery Merchanaise 2. Delivery Restricted Delivery ❑Signature Confirmation*r" fail p Signature Confirmation 7'p1t5°s173'0 �0001 !49879156 : ,i ail Restricted Delivery Restricted Delivery � (over$500) �Ps Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt k USPS TRCPIN�O'# Rostaga'&Fees.Maid USPS Permit No.G-10 I 9590 9402 3759 8032 3749 06 N United States P's ender:Please print your name,address,and ZIP+4®'iri this box• Postal Service N � r Down of Barnstable Health Division Os 200 Main Street Hyannis,MA 02601 i I I k AsBuilt Page 1 of 1 TOWN OF BARNJ'rADL& LOCA171ON 1 7� D / i5'iit/ SEWAGE 7 Q0 O vII.L.AGE 2 ,911- P1v^T"ce ASSESSOR'S MAP&LOT OG INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILrrY:(type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 306 feet of leaching facility) Feet Furnished by i y` + I . http://issgl2/intranet/propdata/prebuilt.aspx?mappar=258064&seq=1 11/9/2018 I - SECTION - SEWAGE --- - --- _ ... .. 4 -- -SEPTIC TANK - �Z - "D"BOX - �j - LEACH TOP n 4.'7 (MSL)x 4�EMC7VG ANY U1aSUITAC'Slrc MA'(�TZIAL 118 1 '�, I Z,,1 T.4�• 2"OFTO Ih" FOi✓ A, DsSTANL� GR' 10 F�• Ae1�JNo Er.LT2_E WASHED STONE l�At-H T'�IT"S f1.1+0 R�J�•Pr�. Y�IT�-1 CLCs�.wl � t / �� 4IN- OUT. ` 1'-�r70 IN- OUTS INSzaa SEPTIC Q r+ TANK Z�i�C 3 ELEV: ELEV. ELEV. ELEV. I ELEV. ELEV. ' 4-1•moo ELEV° - �•O_ D T - E ex �9 WASHED STONE EL Try oe T6c r 401 e 4 ►p Tit N TEST HOLE LOG z� �# ��`� z f: �K` ° T,fi� y H.CU91.9 ..f/' 3 By TEO re-,,WO yS. I �� `� `- —' TH r '�.Z �- DESIGN BEDROOM HOUSE Rj / '70 I{U Gw.w-L'^��7E+ I lam) �1.�71�.1 ! � D �.� ,'_1� ,A,^` I SB.Io' CAPAGrr%e 0 _ ELEV.S�.Z7 / Gq �? 1 4-Z DISPOSER DISPOSER r f NO ` PERC RATE MIN/IN. _ 4�` ` ` F��.I•/ (V Q FLOW RATE �WL> (GAL./DAY) N y SEPTIC TANK 4 -O (I.S)= �Q 4 r J REQ'D SEPTIC.TANK SIZE60 4n� U SL- 150a GAS•-L.0 N S�r'�T1 G..TAI-►K_ � `.� - �` LEACH FACILITY C6�F SIDE WALL �D 1=311.0(Z.S ) - ��z .�� G/D. r t / . rl0 BOTTOM ZX i� C 57.111.v ) _ _�S�_ � G/D. ^h iirE TOTAL yr��ryL(y = q q 6' cl. USE: 'T wv C� LEACHING ITS --r,� or c3,• I C, 't f3 M_ roe _ IV Q WATER ENCOUNTERED l • �` Y ' NOTES: (UNLESS OTHERWISE NOTED) 1. DATUM(MSL)+TAKEN FROM QUADRANGLE MAP 2.MUNICIPAL WATER----------------{_�------_---------------AVAILABLE 3.PIPE PITCH:1/4"PER FOOT 4.DESIGN LOADING FOR ALL PRE-CAST UNITS: AASHO- �- IQ -44 _ (,,�1 _r �►� 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. CF�t{4 ,{��. DISTANCE AS CERTIFIED 6.PIPE JOINTS SHALL BE MADE WATER TIGHT rx. PLAN 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. /1A(VE H. G SITE I-L/1N STATE ENVIRONMENTAL CODE TITLE 5 OJALA a� LOCUS: OF A� E� ENGIIV EF _ o��`pt �yC REF• M�Qc2.`t' 4. c2^N1&E. �,► b��. 'Iq1 Z ]�_ � ARNE . P . H E1��l�lA�J7 -� , t� I Q�Oi�/! ca a en iaeeriab ;� � PREPARED FOR: C,CF CIVIL ENGINEERS L73' LAND SURVEYORS 3�SNoi�S TAc_C YAt�41.115 MASS. BOARD OF HEALTH C fS R . ( �fp CONTOURS (EXISTING) J ` �Oy{ Sv� %A=3�� {g �Z n r (PROPOSED)-O-O-O-O- APPROVED DATE Pip P�STA C5LEMA � ■ Yarmouth&Orleans,MA t l�M�.= SCALE DATE `9 111 - REV �1-►-