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Home My WebLink About0269 OLD JAIL LANE - Health 269 Old Jail Lance Barnstable _ — A=278 ,054:,.- _ y Commonwealth of Massachusetts Title 5 Official Inspection ForM' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 269 Old Jail Lane s Property Address Thomas Blanchette Owner Owner's Name — information is required for every Barnstable MA 02630 07/11/11 page. City/Town State . Zip Code Date of Inspection 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. General Information _ on the computer, use only the tab ' Y move your key to 1. Inspector: cursor-do not Michael Kellett sethe return Name of Inspector Aardvark Environmental Inspections �V Company Name PO Box 896 Company Address East Dennis MA 02641 City/Town State Zip Code 508-385-7608 SI 3742 Telephone Number License Number LQ 1- 1 i! B. C4,itification Zzl c I certify4hat I have personally inspected the sewage disposal system at this address and that the J;� - 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 d sewag&disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5( 1`0 CMR 16.000).The system: �-- ® Passes ` ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority' rG 07/20/11 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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. ****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. t5ins-11/10 Tide 5 Official Inspection Form:Subsurface Sewag I System•Page of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owners Name information is required for every Barnstable MA 02630 07/11/11 page. Cdyfrown - State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ one or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cunt.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: " This system passes if the well water analysis, performed at a DEP certified Iaboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: h . D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: -Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 Y2 day flow t5ins-11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. J . ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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 16,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ El< the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, f 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. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ 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. ® El approximation in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 t T. I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ 'No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-11/10 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments' 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a 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): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: 20 years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.0 feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: ee 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: 1000 gal 311 Sludge depth: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 28" 311 Scum thickness Distance from top of scum to top of outlet tee or baffle . 7" Distance from bottom of scum to bottom of outlet tee or baffle 1511 How were dimensions determined? measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was sound and tight with tees in place and liquid at outlet invert. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Offrcial Inspection Forth:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ' 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert even 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 box was level and tight with no sign of carryover. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): . If SAS`not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts kiTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA ' 02630 07/11/11 page. C4 fown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): This system has five flow diffussors in an 11'x43'stone pit. There was no sign of ponding or failure in the stones. 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 q Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions F Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): A 1 { t5ins-11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 I e Commonwealth of Massachusetts Title 5 Official Inspection Forma Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's game information required for every Barnstable AAA 02630 07/11/11 page. CWrown state rip Code [Date of trion D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two peananent 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 �• V� E i6 a g? 7`1 u t5ins•11/10 Title 5 Official Inspection Form:SubsuRace Sewage Disposal System•Page 15 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 30.0 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: You must describe how you established the high ground water elevation: USGS maps show an elevation of over 30.0 feet. I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Trle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of V Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '< 269 Old Jail Lane Property Address Thomas Blanchette Owner Owner's Name information is required for every Barnstable MA 02630 07/11/11 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ` E Inspection Summary:A, B, C, D, or E checked E Inspection Summary D(System Failure Criteria Applicable to All Systems)completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file R t t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 7T11HE dNo. Fee . COMMONWEALTH OF MASSACHUSETTS Entered in computer:—r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for bisposal *pstem Construction 1ermit Application for a Permit to Construct( ) Repair( W--U-pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. U- Z Owner's7+��\Tarm Qddrsst apd Tgl.No. Assessor's Map/Parcel 01 r)g Installer's Name,Address and Tel.No. Designer's Name,Address,and Tel.No. c3C> Type of Building: Dwelling No.of Bedrooms y Lot Size oa_O�L 4 sq.ft. Garbage Grinder(46 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date yw "L.� -L* l 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) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Qged Date_—LZ1 3 Application Approved by Date Application Disapproved by Date for the following reasons Permit No Date Issued - — -- - - -L�� J%/-- J., - No. w Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:if , PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ., -application for Misposal bpstem Construttion Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 9 �-L ;1-4%, Owner's N ddressk and Tel.No. Assessor's Map/Parcel a 1>Z Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. f Type of Building: { Dwelling No.of Bedrooms Lot Size a.0 9 /�A_ sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd 1 i Plan Date y 1TzOs 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) Date last inspected: _ Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. l Date Issued v THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( 4/upgraded( ) Abandoned( )by `� c. Kay e N g" at Z R ('��, .�, ` has been cons ct in accor ce with the provisions of Title 5 and the for Disposal System Construction Permit NoW_ l/ dated Installer c VGey IAO N s� Designer e, �G/►a #bedrooms y Approved design flow ` 6 j d gP The issuance of this permit shall not be construed as a guarantee that the system will fG cti fa'as�d esigneyd. Date (u 1 r Inspector V✓ �+�_Yef --- ---- ------------------------------------- -------------------------------- - - --- �, No. l , 9 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal &pstem Construction Permit Permission is hereby granted to Construct( ) Repair( (� Upgrade( ) Abandon( ) System located at 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:Construction1must ,e c9pigleted within three years of the date of this permit. Date Approved by /�s FROM :down cape engineering inc FAX NO. :15083629880 Oct. 24 20oe 01:33PM P2 i Town. of Barnstable "'E''7°, ,0 Regulatory Services Thomas F. C;eiler, Director * RARNCTABLE: KM6. Pu.Wk Health Division sb;p• � pr Tbomus McKean,Director 200 Main Street,Hyannis,MA 0260i Office:i.ce: 508-X624644 Fax: .5U8-7t10-6304 Tpistaller& Desigger Certification Form Qom, it#Bate: SewagePrr,ni �U . . p _...... .. Assessor's Ma \I'axccl Designer: V\ ��w,Cn� ins a11��: J L pr't0( G Address: 7�, � Q r - A.ddress= �t M4 Nkof Oil _wets issued a permit to install a (elate) (i ti.gtal ter) y / r septic systei, at hissed on a design drawn by (address) dated 1. certify that the septic system. .refe�enced above was installed subtitairlially according to the desi.l n; which may include minor approved changes such as lateral ,r.•elocation of the distribution box anal/or septic tank. _ 1 certify that the septic sy ten) referenced above was installed with m<<jor changes (i.e. greater than 1 W lateral relocation of the S.A.S o►-any vertical relocation of any comptnient of the septic system) but. in accordance with State & J...oca.l. .k.egul.atio»s. T'latl tevisicm or certified as-built by designer to follow. UANIELA. 0 JAL-A (Install.ex�q Signature) � CIVIL -w.-,... No.46502 �sSIONAL EaC� . (T)esi.gner'ti Signature) (Aff..izc T)esi ltWs Stamp Here) 1?;1 FA`k. K ORN TO BARNSTABLE _;NU1;L1C 1.11: IRI0 . . CEATTFTCATt OF a COMPLiANCE WILL NOT RR jSSIJF:D UNTIL RnTO THiS 'FOkM ARID AS-BUILT CARD ARE RE(-EIVED BY Tflk',UARNTSTABLE PUBLIC HEALTH Di ISTON. THANK YOU. �l;Hmi1,th/SvP1.i(:/T)cS;ErT1er Ce'rtitication Form 3-24-04.0oo ° CERTIFICATE OF ANALYSIS Fo Page: 1 Barnstable County Health Laboratory 9ss�tCfny�t Report Prepared For: Report Dated: 9/24/2008 Thomas Blanchette Order No.: G0849405 41 R First Parish Road Scituate, MA 02066 Laboratory 1D#: 0849405-01 Description: Water-Drinking Water Sample#: Sampling Locationw269`OId�JaiLLn.Btable,MA Collected: 9/23/2008 Collected by: R.Crossen _arns~^~ Received: 9/23/2008 JRoutine +Ammonia ITEM RESULT UNITS RL MCL Method# Tested Ammonia ND mg/L 0.20 EPA 350.1 M 9/24/2008 Nitrate as Nitrogen 0.23 mg/L 0.10 10 EPA 300.0 9/23/2008 Copper ND mg/L 0.10 1.3 SM 3111 B 9/24/2008 Iron ND mg/L 0.10 0.3 SM 3111B 9/24/2008 Sodium 10 mg/L 1.0 20 SM 3111B 9/24/2008 Total Coliform. Absent P/A 0 0 SM9223 9/23/2008 Conductance 160 umohs/cm 2.0 EPA 120.1 9/23/2008 pH 8.6 pH-units 0 SM 4500 H-B 9/23/2008 Water sample meets the recommended limits for drinking water of all the above tested parameters. Approved B , (Lab ector) Co . . ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level-,, Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory 9rs�c Report Prepared For: Report Dated: 9/24/2008 Thomas Blanchette Order No.: G0849405 41 R First Parish Road Scituate, MA 02066 Laboratory ID#: 0849405-01 Description: Water-Drinking Water Sample#: Sampling Location 269 Old Jail Ln.Barnstable,MA Collected: 9/23/2008 Collected by: R.Crossen Received: 9/23/2008 EPA 524.2- Volatile Organics by GC/MS ITEM RESULT UNITS RL MCL Method# Analyst Tested Note Dichlorodifluoromethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Chloromethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Vinyl chloride ND 1.151/L 0.50 ?A EPA 5242 yn ., ,9/23/200E Bromomethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,1,1,2-Tetrachloroethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,1,1-Trichloroethane ND ug/L 0.0 200 EPA 524.2 yn 9/23/2008 1,1,2,2-Tetrachloroethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,1,2-Trichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn 9/23/2008 1,1-Dichloroethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,1-Dichloroethee ND ug/L 0.50 7.0 EPA 524.2 yn 9/23/2008 ],I-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,2,3-Trichlorobenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,2,3-Trichloropropane ND ueJL. 0.50 EPA.524.2 ;m 9/23/2008- 1,2,4-Trichlorobenzene ND ug/L 0.50 70 EPA 524.2 yn 9/23/2008 1,2,4-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,2-Dibromo-3-chloropropane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,2=Dibromoethane(EDB) _ _-_._ .- - - -- ___ ._-� ug/L -- 1,2-Dichlorobenzene ND ug/L 0.50 600 EPA 524.2 yn 9/23/2008 1,2-Dichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn 9/23/2008 1,2-Dichlor6propane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,3,5-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 1,3-Dichlorobenzene N-D ug/L o.50 E'A 524.2 yn 9/23/2008 1,3-Dichloropropane ND ug/L 0.50 EPA 524.2. yn 9/23/2008 1,4-Dichlorobenzene ND ug/L 0.50 5.0 EPA 524.2 yn 9/23/2008 2,2-Dichloropropane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 2-Chlorotoluene . ND ug/L 0.50° EPA 524.2 yr. 9/23/2008 4-Chlorotoluene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Benzene ND ug/L 0.50 5.0 EPA 524.2 yn 9/23/2008 Bromobenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Bromochloromethane ND ug/L 0.50 EPA 524.2 yn 9/23/2068 Bromodichloromethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Bromoform ND ug/L 0.50 EPA 524.2 yn 9/23/2008 ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE OF ANALYSIS Page: 2 Barnstable County Health Laboratory �S�Ct3u Report Prepared For: Report Dated: 9/24/2008 Thomas Blanchette Order No.: G0849405 4 1 R First Parish Road Scituate, MA 02066 Laboratory ID M. 0849405-01 Description: Water-Drinking Water Sample#: Sampling Location 269 Old Jail Ln.Barnstable,MA Collected: 9/23/2008 Collected by: R.Crossen Received: 9/23/2008 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS RL MCL Method# Analyst .Tested Note Carbon tetrachloride ND ug/L, 0.50 5.0 EPA 524.2 yn 9/23/2008 Chlorobenzene ND ug/L 0.50 100 EPA 524.2 yn . 9/23/2008 Chloroethare ND u-L 0. 0 EPA 524.2 yn 9i23/2008 Chloroform 1.9 ug/L, 0.50 80 EPA 524.2 yn 9/23/2008 cis-1,2-Dichloroethene ND ug/L, 0.50 70 EPA 524.2 yn 9/23/2008 cis-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Dibromochloromethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Dibromomethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Ethylbenzene ND ug/L 0.50 700 EPA 524.2 yn 9/23/2008 Hexachlorobutadiene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Isopropylbenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Methylene chloride ND ug/L 0.50 5.0 EPA 524.2 yn 9/23/2008 Methyl-tert-butyl ether NTD ag"L 0.50 EPA 524.2 yn 9/23/2008' Naphthalene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 n-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 n-Propylbenzene ND uglL 0.50 EPA 524.2 yn 9/23/2008 sec-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Styrene ND ug/L 0.50 100 EPA 524.2 yn 9/23/2008 tert-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Tetrachloroethene ND ug/L 0.50 5.0 EPA 524.2 yn 9/23/2008 Toluene ND ug/" 0.50 1000 EPA 524.2 yn 9/23/2008 Total xylenes ND ug/L 0.50 10000 EPA 524.2 yn 9/23/2008 trans-1,2-Dichloroethene ND ug/L 0.50 100 EPA 524.2 yn 9/23/2008 trans-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Trichloroethene ND ug/L 0.50 5.0. EPA 524.2 yn 9/23/2008 Trichlorofluoromethane ND ug/L 0.50 EPA 524.2 yn 9/23/2008 Water sample meets the recommended limits for drinking water of all the above tested parameters. + i Approved By (Lab ector)1 ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 7/ TOWN OF/BARNSTABLE LOCATION 0?L✓ c, / �cae SEWAGE#c2C(_ 3c;r7 VILLAGE ASSESSOR'S MAP&PARCEL n7 .27 F P S y INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 'S i (size) J J y J NO.OF BEDROOMS OWNER PERMIT DATE: fb 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 r 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 of � �., kA v &C/ 0� VULAGI ASSESSORS MAP NO: PARCEL NO.: 'ETA L E R'S NAME ADDRESS ATE LO L E R OR E-H,-Ml T-1 S-5 U E D s u 77 a � No.-A... _ FEz......../.. !.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,py�� :.71-0"✓.. ---- -----.OF........��K�1S'�r'�4 � L G- ..-------- 6�3 Appliratinn for Mgpoiial Workii Tonstrnrtinn ramit Application is hereby made for a Permit to Construct (C-1 or Repair ( ) an Individual Sewage Disposal stem at: q ..... F� � T� /G L.4 A! -.... •... L ..--•-•-- ............................. � Locat'on-Address or Lot No. . ? ! 1 ^ -Q'4G.L....E•••••••••••-•---•-- ................................... ---A•X•••• v/........_..... � .1 ................................... .. caner Address Installer Address 4— UType of Building Size Lot_.2_. .A._`........ t ►•. Dwelling—No. of Bedrooms-______.___.3 ...........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons..................._........ Showers ( ) — Cafeteria ( ) �. Other fixtures ......................................:...................................................._..._._.._._.__......._...._........._---•-_---.....__._._. W Design Flow.............x ....................gallons per person per flay. Total dalypow.._._..._._. 3._0___..______..___..gal�ons WSeptic Tank—Liquid capacityRallons Length__.__9__._.__ Width..,(/A---v._-_. Diameter................ llepth.. _sf''._-. x Disposal.Trench—No_ ____________________ Width....Y.............. Total Length.................... Total leaching area.AAK7.....sq. ft. Seepage Pit No.........../........ Diameter.......6.......... Depth below inlet___.KtJq..__.... Total leaching area..................sq. ft. Z Other Distribution box ( " Dosing tank ( ) 0-4 a Percolation Test Results Performed by..........I2QN......... �1_��___ ............:. Date..... Test Pit No. 1.....4 Z__-minutes per inch Depth of Test Pit_____ _..___ Depth to ground water__/VA.N45 __. G� Test Pit No. 2....Z._.:L_minutesper inch Depth of Test Pit----46_z...... Depth to ground water......-.A............ a -.....---•••---•......................•-•••--•-•-••-•--•-••••••-••--..........-=•--••-- O Description of Soil " ....Stl/�do/L' +�y- �1 /u�../�_� JX Ar,d......... ------------- ---- _..-------------•-••---•••••--•--••- W 12, -1 - cL6¢iv N C�.4R-Str Lcaram_._._ -PA-v i ----------- •-•- ---------- - --•-------•---------.----•-•--•---••-•-•----...••- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------•------•----------•••-•--•••-•----------•-•--•------•---•••------------••.....__---•••-•--••••-_...--------•--•-----•••••••-•••-•------•-••-••-----•••-•••-•-•-•-•••--••••.....•--•••_.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code — The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b ed b board of health. , Signed ' P Jr - ...------•-•-•- Date Application Approved B ..............................................................V PP PP Y -----• -•••••-•-•••••-•-••-•............. Date Application Disapproved for the following r sons:-------------------------------------------------- .............................................................. .._......-•-----------------------------------•--------------------------•-----------....------•------------•-----------------------------------•----------------------....---••---•----•-••.......-•--- �I Permit No-- --6.................................................. Issued Issued_...--= Date --•-----------------------••.._........••----•-•- Date No..-..>�.. .... ,.._._._ 1 r _yet FEN......... ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH G,c�..................0F........... fi i?A,' .........................................................•- Appliration for Diopoiittl Works Tonstrurtion Vrrntit Application is hereby made for a Permit to Construct ( loror Repair ( ) an Individual Sewage Disposal System at: ................ ...........�_`... ............ e -..---E................... ..........................r........4E...................................................... Location Addtes _ or Lot No ............. .. .._...---...... ........--•---•---•-...--••- ..................................................?.... Owner Address w n_ Installer Address ,.f.,. f P. FF'-S' dType of Building Size Lot.... .............Sr.feet Dwelling—No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................. . Design Flow...............: .........._.._...__gallons per person per Total dai ow..............ta.Z.!................w g g P P Yrls /r 1:: Septic Tank—Liquid capacity_.!!�=FPllons Length-------7...... Width....f °.__. Diameter................ Depth....,:,57.tf_. w . Total Length.................... Total leaching area * ..... s ft. x Disposal Trench—I�To.----•-••---•---••--- Width------r-•--------- g � g � ..---- q• Seepage Pit No____________ _______ Diameter.......0......... Depth below inlet...... `'.6_.___ Total leaching area..................sq. ft. Z Other Distribution box ( nor Dosing tank ( ) a Percolation Test Results Performed by............ �_�n!`........�.��:�D.P �'0............. Date...... .`.� •-•� � --•-----•... Test Pit No. 1------�.72-..minutes per inch Depth of Test Pit...... ``._a Depth to ground water.....A.'+ AA'..' _. Test Pit No. 2......�.-``---_minutes per inch Depth..of Test Pit...__.-Z.2..... Depth to ground water..........!,........... a . ---•--•-------------•-••-------. O Description of Soil --• �� A ..................S ........G. ____________ __________ __ ----�-•-•. ................r�... . � f : .......... .. . ------- ------ ---- - V ---------------/'2 6 )�'Q C 4 &A� Af i- J3 t'e A S o; . ��_� f A ,v w -- ....................•-•------••-..._._... ----•------- ---------•--------------••...........---........ -----••... --------...----�L•------------------•--..... UNature of Repairs or Alterations—Answer when applicable.......................:....................................................................... ••---------------------------------•---------•-------------....------------------------------------.------•-----•-----......------•---------.....------••----•------•--------••---•••---._._._....•---•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed............ =------------•---........---------------••------•-----•.....I.....7..-- ............-----_.....-•-...... �. l Date Application Approved BY t`�rr" ---�.'.'�--`---•---•---•.................... ....................... •--•------------- Date Application Disapproved for the following r ons:--•--•-•--•-••••••--••-•--••-••-••---•••--•••-•-•....-•••--•-•-••••••-•--••--•---••......••-••-......-•--•-•---- .................................. ----------••--•-••.....................••--...............................---•--•-- ..................... ..........................................D.a..t.e. .............. Permit No...... `3------------------•-_..... Issued-........--•----•---•-•------...-----•......--•-•-...... ...............•--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........� .r I.............OF.....�}�...�.................................... ... .... . . ................ (9rdif iratr of f;amphanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (f) or Repaired ( ) b �. 4 f Installer at U i .. ._...L'ir.i J l " G 10 has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Co e as described in the application for Disposal Works Construction Permit No.--h_h___-- Iq_- i.............. da.ted...... :_ J .................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE V SYSTEM WILL FUNCTION SATISFACTORY. / DATE.................... ..................... Inspector-- ----•----------••--•---•-•----....•••.......................... f•--z-I''•I-�� THE COMMONWEALTH OF MASSACHUSETTS BOARD .SQL F TH ,Z. I I OF.................. 73 NO....{r— f FEE........................ �io�rosttl o�k� �ono#rnr#ion �lerntit ,•�•. . Permission is hereby granted........ �^•---••-•-•--•••-••---•••••-•--•••-•._....-••.....•••-••••••....................................... ak: to Construct ( or Repair ( ) an Individual Sewage Dispos stem , _ ,� S at No...t '� ................CZ1. ...••--•-••.. l" a,- Street as shown on the appxJ ion iQ Disgosa�'orks Construction ermit No.-��-._Up. GDatedA_v..I....`. .................. .............................................. Board of Hearth DATE................................................................................ J Department of Env'onmenta{Wriagement/Division of Water Resources WATER WELL COMPLETION REPORT t WELL LOCATION Address iC r.,'i City/Town R/) G.S.Quadrangle Map Grid Location Owner `�, �10 An \!l 1, Address A)1( y til- An 1s to h 11} /1-11 ZVI) WELL USE CONSOLIDATED WELL Domestic Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones Method Drilled ir( --1) From To - / 2) From To Date Drilled �--g �! 3) From Tc 4) From To CASING Depth to Bedrock Length �o l Diameter ,G/�� Type 1214<LL, UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface Sand: fioe❑ medium 9/'coarse0 - Date measured Gravel: fine❑ medium❑ coarse❑Screen: GRAVEL PACK WELL Slot# 1O length 3!from to Yes ❑ .No Q� Split Screen (or 2nd screen) WATER QUALITY TESTS MADE .- S lot# length from to Chemical Q"" Biological ❑ Depth To Bedrock PUMP TEST - Drawdown 0 feet after-pumping days 4.1 hours at 1').GPM. I How measured e:�n 1�p gi--p4;A Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 m. DRILLER m Firm A6 °a Address -� tr 1 Me, j City a �tfl i Registration No. d —44 peratoir s i gnat ure Please print tirmly BOARD OF HEALTH COPY 25M-10-95•807101 G E N D SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE NOTES L MARKED WITH MAGNETIC TAPE OR SYSTEM DESIGN. (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. o m oJ5 PROVIDE IF NECESSARY 1. DATUM IS APPROX. NGVD LGIS MAP) Q_99 - _ EXISTING CONTOUR ACCESS COVERS TO WITHIN 6" OF FIN. GRADE oo `D eti INSPECTION PORT TO WITHIN 3" G DE 2. MUNICIPAL WATER IS NOT AVAILABLE X 99•1 EXIST. SPOT ELEV. GARBAGE DISPOSER IS NOT ALLOWED \ P N .1' 99 PROPOSED CONTOUR 97.5f MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM EEO3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 3 0 DESIGN FLOW: 4 BEDROOMS CAD 110 GPD =440 GPD 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS ore o 198.41 PROPOSED SPOT EL. USE A 440 GPD DESIGN FLOW 2" DOUBLE WASHED PEASTONE TO BE AASHO H-M '�0��°0p RIP TH 1 .k.. 4"SCH40 PVC 96.7' 4"OSCH40 PVC OR GEOTEXTILE FABRIC PIPES LEVEL 1ST 2' 93.0' 5. PIPE JOINTS TO BE MADE WATERTIGHT. Locus TEST HOLE SEPTIC TANK: 440 GPD (2) = 880 Ad RE-USE EXISTING SEPTIC TANK ** 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH �o 27 SLOPE OF GROUND ., :• 10" EXISTING 14 ;�` o 310 CMR 15.000 (TITLE V.) a TEE SEMC TANK"' TEE 95.3 t '. 92.5 0 0 0� UTILITY POLE LEACHING: Gas BAFFLE 0 000000000000'00 $�,$ 2-M o , 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO �Oush �o RANT SIDES:2 (41.5 + 10.25) 2 (.74) = 153 GPD 92.69' 92.52' SSoo$$ 0 90.5 BE USED PURPOSE.FOR LOT LINE STAKING OR ANY OTHER �e° cce� FIRE HYDRANT 3050 INFILTRATOR CHAMBERS Qr NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWItLGj BOTTOM 41.5 x 10.25 (.74) = 312 GPD •'•" �� 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. s TOTAL: 628 S.F. 465 GPD DEPTH OF FLOW = 4' 3/4 TO 1 1/2 DOUBLE WASHED STONE ° e 9. COMPONENTS NOT TO BE BACKFlLLED OR CONCEALED Ltln TEE SIZES: 6" CRUSHED STONE OR MECHANICAL WITHOUT INSPECTION BY BOARD OF HEALTH AND COMPACTION. (15.221 2 OVERALL DIMENSIONS TO OUTSIDE OF STONE: 41.5' X 10�25' 61 PERMISSION OBTAINED FROM BOARD OF HEALTH. *THE INSTALLER SHALL VERIFY THE USE (5) 3050 INFILTRATOR CHAMBERS INLET DEPTH = 10„ [ ]) LOCATIONS OF ALL UTILITIES AND ALL WITH 3 STONE ALL AROUND OUTLET DEPTH = 14 . �'oute 6 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING BUILDING SEWER OUTLETS AND DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM (3.6 X SLOPE) ( 1 X SLOPE) PRIOR TO COMMENCEMENT OF WORK. LOCUS MAP MA NOOTTOM TH-2 GROUNOWATER FOUND 84••5' 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE EXIST. LEACHING REMOVED 5' BENEATH AND AROUND THE PROPOSED NOT TO SCALE SCALE 1"=2000'f APPROVED DATE BOARD OF HEALTH FOUNDATION SEPTIC TANK 72 D BOX 4 FACILITY LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND ASSESSORS MAP 278 PARCEL 54 **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. (STING WELL± TEST HOLE LOGS 98.03 ENGINEER: DANIEL A. OJALA, PE, PLS, SE#1805 Cl FAR S�DF OF g 01 30 UGWIRES WITNESS: DONNA MIORANDI, IRS DATE: J U LY 21,°' 2008 (> 200) \� 98.81 198 1 ��O �� 270.00' \98�.61 _ x 93.73 PERC. RATE _ x\98.90 < 2 MIN/INCH 9 . 92.77 EDGE LAWN -• - 95. o� \ GE 93.56 92.96 CLASS I SOILS P# 12291 �97.47 BOULDERS TO OLD JAIL LANE 9 SRO EE ELEV. ELEV. 7I6.51 �95.97Q V 96.0 0„ 96.0 ti I A A OF�CROG TH x,�. 30. 96.22 94.1 ALTERNATE 93.98 SL SL 96.36 A BENCHMARK: U / 96.29 9 6 SMALL SPIKE EL 10YR 3/2 10YR 4/2 LPIT 94.19 „ 6 \F x 96.40 t\ 9�.6Ox,116,25. 94.33 B B \ �6.34 1 `9S 94.42 LS LS x 5Y 6 96.2 9s.7 9 63 „ 2. 4 92.8' F\ CA U-�� 1 / 37„ 2.5Y 6/4 38 WIRES 92.9, \LOT 54 91.13� EXIST. SEPTIC TANK" C C1 F 2.02 ACRES \ #97.32 7.83 --- , PERC MS 9J_I BENCHMARK: MS 2.5Y 2.5Y 7/6 COR BOT STEP 88.5' 97.89 ELEV. = 9 .0' 9 . I 97.9 DECK 2.5Y 7/6 C2 \� c` .11 EXISTING 4 BR MS 98• DWELLING 8.44 ygZ TOP FNDN. ELEV. = 99.1' 2.5Y 7/6 x lVt.60 99. 5 120" 86.0' 138" TR. SILT 84.5' � PORCH 8.40 NO GROUNDWATER ENCOUNTERED DECK 0 0 0 N o TITLE 5 SITE PLAN J N 170. OF 269 OLD JAIL LANE BARNSTABLE VILLAGE PREPARED FOR JEFFREY & BEA GOLDSTEIN J U LY 28, 2008 Scale: 1"= 20' 0 10 20 30 40 50 FEET EXISTING WELLt SW�, OF�ygs off 508-362-4541 s90 H OF MAstq ( fax 508-362-9880 ARNE H. ARNE cy� o OJALA H. �� downcape.com CIVIL . OJALA N d i own cope engaeefillg, ift. A NO. 30 2 0. �o �F �o �, .� civil engineers T s o� land surveyors r Sul 939 Main Street ( Rte 6A) 08- >55 DATE ARNE H. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 a FINISH c 4/� FINISH GRADE 467 CoA 3r' MIN.co 4 /9' GC) 46 �}- O -- ' 00000 ' i W4� 4 49s i. 0 0 0 0 0 ,,cAve J / 00000 WA7 LOGJS�, ,_ . ..� 00000 LfTT S v 42.70 4 N f I N 4 ft SCHEDUL E 40 PVC ° PIPE (SOLID) z � aP 43 SYSTEM PROFILE I_ylISMN6, 4�.2 NOT TO SCALE EL �.7 W ZS, 37 " LOCATION MAP E L .43.c- / 8 1 / 2 " NOTU NOT TO SCALE EL 4Z•7 4 WA SHED no sanitary savage disposal system shown hereon shall be constructed in •� aecordanee with the requirewn[a of Title V of the state eavlfQnmen[}) code and A STONE local Board of Health regulations. N 2 s Soil logo indicate soil condition, percolation rate, and water table elevation 27O•00 •Q found at [he time and location of actual testing and should be verified at the time of construction. °C � 3 / 4 " � ' Excavate all unsuitable soil in the are♦ of the leaching system to the limits COARSE �'} mpeci[i•d in Reg. 2.17 of Title V and replace with clean, coarse sand and wLl-L Ln t S ON A 5(J�jVI�l�N WASHED -Y. " gravel. 3 / 4 — 1 1 /2 " N�' �Y •TLt�h p_AN OF LAND /N BAFcNSTAS-Z- STONE COARSE Contractor shall verify and check bench mark as shown on this plan prior to <_ w(7H)N ISC' I � — D� wN A L'Y E' L'VVAkD L- le ,' I E L 3 .7 I MI W A S H E D construction of the proposed •eats•. iMAKCy 3/ /978 E L 3�.Z STONE Any verification or modifications to this design must be approved in writing by G AFL 4 : 2.OLA0ZES I ' the engineer mod [he Board of Health prior to implementation. g 7LL MAX . G . W . T. n� NEK 57EPH6lV �188/-1-T (] E L 3/•2 unlessPotherwise aspecified.lOThe ginlet Land aroutlet cpipes are nto ber fitted awith teem of proper length. Concrete strength is to be 4000 psi, 28 days, and LEACHING P I T SECTION reinforced with 6 a 6 - 10 x 10 wire mesh. 4 I ` N O T TO SCALE All Joints must be watertight, sealed with asphalt cement or equivalent. no pipe between the house and the septic tank shall be 4" extra heavy cast �^ iron, Schedule 40 PVC, asbestos cement or other material acceptable to the approving y. p pipe mot be a minimum of 0.01 (0.12 d' ^� + I"TAPER—— pp g authority. The slo • of this I M I^ inches per toot). The distribution shall have a slope of 0.005 (6"pipe p per 100 ft. length). OI. 1I•`7 O _4" If cover material over trench or field Is greater than 24", a vent shall be ,j installed at the and of perforated dimtribut ion pipe before any overflow D=box. �3"MIN. 1'-0" — I _ _V—_ _ 3eptic tank, distribution box, and lathing pit (if any) access manhole covers N N o I I are to be built up to within 12" of finished grade. ' 47 1 i �I It leaching facility and septic tank are located at least 25' from the house foundation, a foundation drain may be installed at the owner's discretion. \ COO 4'—f3'• - --- - ---'--- 5_ The distribution box and septic tank shall be placed on a minimum 6" compacted . •I gravel bus to prevent heaving o r settling..F � q'—O• If coatir.e;ioa of c:us.ruclo.: la reyuErad L, an engineer. notify this officeN 5 r LIQUID Pri tto back fillofthe ay-tam. Cos 3" LEVEL Notify the local Board of Health when the system is wady for inspection, prior 41 48.7 43.75M1N. 604 I l I to Dacktilling. T� F' 49. &S �. r +. ANY FILL MATERIAL REQUIRED AROUND THE SYSTEM, BEYOND THE MIN — �*--Q4�-i•�.�.-��•TrrT:_:��:T. ��"�'�'"• 4- WASHED STONE, SNAIL BE CLEAN COARSE WASHED SAND, WITH A PERC RATE OF LESS THAN 2 MINUTES, FREE FROM FINES, CLAY, PRECAST 1 2 50GALLON SEPTIC TANK ORGANIC,, STl1tPS AND STONES. `Fe 7 / Pf, Top E" of fill to be topsoil. 0 .P L 4TJ NOT TO SCALE Unless specified in the design analysis, this system is not designed for use of 46.7 a garbage grinder. ' I �\�J¢ ' Grade °f the first floor of the house is approximate; it may be raised but not BASIS O F SANITARY DESIGN j7 Iowa ad without the consent of the sag loser. '�,,II Plumbing in the basement shall be limited to a washing "chino if the invert of ,4 56, the outgoing Pipe is bigher than the finished basement floor, unless otherwise C NUMBER OF BEDRO)MS: 3 indicated. QSS GARBAGE GRINDER: If any lathing area coocrate retaining walls are shown on this plan, they W ESTIMATED SEILAGC PLOY: 33O G74-/�4 shall be constructed watertight, without was holes or other l f P pervious O' SIZE OF SEPTIC TANK: /Lsn GAL construction. Should the reserve area be built in the future, it say require / i 44, PERCOLATION RAT!:<Z MIN//AIC-1/ the extension of tDea• retaining walla. 45 5-5 DESIGNRATE: /7 ''`'1/N,/NLH No heavy equipment shall be run over the disposal system. i/A. Por proper performance, septic tank should be inspected annually end when the LEACHING AREA PROVIDED: SID�,5 2- $' C 2- x C� DE PrH> e13.`(D aF, total depth of scum and solids exceeds 1/3, the liquid depth of the tank should 4010 one 4010 be pumped. � �saw �o D iA. 8 TOTAL STSfF1( CA'ACITT: f3. 5'') S. Z.� ;��jS.F. 'M = 471.2S6sr4�DAY 114[ND �- - - - 611)T 7Fs. s� S.F. x �.� /o,_/s:mbar IXIST11" rff4►ogEn A-3 J 7 p C -M-)AL: 54-9. 79 6A 1>Ay -- Si et Elevation$ 4 ►re"rty lino $^ S/ Edo of(toed +� stone Well O GRAVEL WAY B.M. PAlrrr DEEP TEST HOLE INFORMATION 0 well ✓�� iA�� beep Test Hole O OLD JAIL LANE T "" �� . EL. ; _•- A=.��M � -- - rawtlnE Drain —— v 7Y—�i PIT 4 1 TT--`;;T PIS 1,ee$hln T►enah O �# L �ST TA�N B7 � � Solid Ilse O-�4,. LnAM I Sv�Olt- D`�--+�� 1_rJA^� y S;lg'�I� CKA1G SHOT 24*-�;4` ML,` M SAND 4°-8�° "'�• ��",'� ^'/ WI,"ES�SL-b 3-Y . SUBSURFACE SEWAGE DISPOSAL �C W I-Pi F]NEs FINES � MNLS IZ'7N 61 FF,'Dk- , \�r �34'=I ZOwTI rNT 'A!tiD 84`=15n° MED. �A°'vD 9 Z4-6 L NOT S T E P H E N BABBITT E: ALL ACCESS I�ANN^LE CoVEQs -ro [�Ai�� wl-ri FIND A,%b C'.-9AVEL LOT 5 L -ram w�li� Iz••�F �Irvl��n SAD,=. O D JAIL LANE EXiSTINIs IZ� 18'�" L BAN M1=b.� ISc� --(CZ" �INL SANS ZH Of MRs w Eu... DE 3ANL NO �U, BARNSTABLE, MA . KENNETH " L£NARD R. / 290-stoxt�fCISTER�V FPS. STf r JOB NO. : D.B.L.#L49 DRAWN BY -7 Mk : . DRAWING N0. SCALE . /"=So' DESIGNED BY:K.�.f. 249 DATE : F3-20- � CHECKED BY: