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0075 POWDER HILL ROAD - Health
r t Powder Hill RD (Barnstable) p Y ll f S - c • f . y i a a c r a a i r to + T •a J a - J s of WEr� Town of Barnstable Barnstable Regulatory .Services Department AMmedcaC-j BARN STABLE, "6 . ,�� Public Health Division �Arfo"hA� 200 Main Street, Hyannis MA 02601 2007 m Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2367 March 29, 2011 Ms Francine D'Olimpio c/o Mr. Vincent D'Olimpio, Jr. 75 Powder Hill Road Barnstable, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located 75 Powder Hill Road,Barnstable,MA was last inspected on 1/07/2011, by Raymond Dumas, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed". under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Liquid.depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow You are ordered to repair or replace the septic system.within Sixty(60) days from the date you receive this notification. Failure..to repair/replace.the septic_system within the deadline period will result in future enforcement action. RDER OF THE BOARD OF HEALTH T omas �eafn, R.S., CHO Agent of the Board of Health - Q:\SEPTIC\Letters Septic Inspection Failures\1-I SAMPLE 60 Day Deadline.doc .,' Barnstable °fIHE r Town of Barnstable Regulatory Services Department erieaQty IIARNSfA6LE• "' D A 9 i6T • Public Health Division, m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2299 } February 17 2011 Francine D' Olimpio 75 Powder Hill Road Barnstable, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The;septic-system,located.at 75 Powder Hill Rd. Barnstable, MA-was last inspected on 1/07/201 1,by Raynond Dumas; a certified septic inspector-for the State of Massachusetts. The�inspection of the septic system showed that the,system"Failed" under the guidelines . of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Liquid depth in;,cesspool is less than 6" below invert or available volume is less than t/2 day flow';` You are ordered to repair or replace the septic system within Sixty (60)days from-the date you receive this notification:- Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH • w, - Thomas McKean;,R.S, CHO ?, Agent'of the,Board;of:Health .�,:t �f. ...rt J:\Town of Barnstabl l.doc a r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is Barnstable, Ma. 02630 1/7/201.1` required for every page. Cityrrown 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: A. General Information When filling out forms on the �. (oil computer,use 1. Inspector. only the tab key to move your_ Raymond Dumas cursor-do not Name of Inspector use the return, s_, key. ''.Dumas Landscape Const. Inc. ' T Company Name 564 Old Stage Rd.. Company Address Centerville, Ma. 02632 I I Cityrrown Aj State Zip Code 508-778-0249 = S1437 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that tW'?.,,''' �- information reported below is true,,accurate and complete as of the time of the inspection The>ltspeetion was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section;15340 of `. Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ;❑ Needs Further Evaluation by the Local Approving Authority pzz��"o �/ 1/7/2011 Inspe ors Si nature Date Y?'. 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. 1 � t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Dispo System•Page 1 of 17 f I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. Cityrrown 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: l ❑ 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: Leach pit failure 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-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owners Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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•09/08 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 M 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. Citylrown 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 laboratory, for 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: 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 %day flow t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M s 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. CityrFown 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. ❑ ® 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 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section 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 ❑ ® 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, 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Tithe 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every 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. ® ❑ 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)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owners Name information is required for Barnstable Ma. 02630 1/7/2011 every page. CityrFown State Zip Code Date of Inspection D. System Information Description: 1000 gallon septic tank, D-Box, and 1 600 gallon leach pit Number of current residents: 0 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)): N/A Detail: house vacant Leach pit Hydraulic failure Sump pump? ❑ Yes ® No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day Y(9Pd) 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts v Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable Ma. 02630 1/7/2011 every page. City/Town 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: none available 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable Ma. 02630 1/7/2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 22 yrs. complaince issued 2/25/88 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 8 ft feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: town water feet Comments(on condition of joints, venting, evidence of leakage, etc.): pipes under basement floor Septic Tank(locate on site plan): Depth below grade: 7 ft. 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: 1000 gallon Sludge depth: t5ins•09/013 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 17 J Commonwealth of Massachusetts Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): tank need to be pumped 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•09/08 Title 5 Official Inspection Form: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 M 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. CitylTown 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.): inlet tee inspected only Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: P 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. Cityrrown 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 1 inch above inlet invert 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.): some carry over 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: located 1 600gallon pit t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M s 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: precast Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Hydraulic fail water leaching from riser on pit Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 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 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 , every page. Cityrrown 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 Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at leasttwo.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 LIAI,a � k €� 7 t I } i dId 1 ~ 1 f 1 i � 1 r` t t t5ins-MOB Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments wti 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every 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: 21.3 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: no water at 144"as per down cape engineering 2/17/83 on record at B.O.H. ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: 38 ft topo water contour map 12 ft+4.7 ft adjustment for SDW252 well 38'-16.7 ft.=21.3 Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 16 of 17 1 r i Commonwealth of Massachusetts . d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 75 Powder Hill Road Property Address Frances D'Olimpio Owner Owner's Name information is required for Barnstable, Ma. 02630 1/7/2011 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 I N, ST f��jSA �� B� STABLE r_LOCATIOlti SEWAGE# &gall VILLAGE, j1,' � ��L ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �..4�;+,GAt SEPTIC TANK CAPACITY LEACHING FACILITY:(type)L:�)jO4;CUS i40S,IIOV (size) NO.OF BEDROOMS OWNER WtilJ Al- PERMIT DATE: /' 7—v �`/ COMPLIANCE DAT ✓'" ��// Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Le�aac lity�� Feet Private Water Supply Well and Leaching Facility(If any�elist on site or within 200 feet of leaching facility) Feet n Edge of Wetland and Leaching Facility(If any A s exist within 300 feet of leaching facility) Feet FURNISHED BY ll�'����� -. • `' +� 1 � ��, 1 ate, 4_ �� _ � 3�� ® . i � ..- 1 �\ �� ,,\``\ ;y \ '� i li \\� �. •: .� y___--i _._ �� No. 61 Fee 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppliYatlon for Disposal *pstrm Construrtion i3Prmit _366-651 Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./ 3— Owner's Name,Address,and Tel.No.V)',vez,, ►--DV M j U Assessor's Map/Parcel Rrrg W, 7-f R6,4) &-f /� .j Installer's Name,Address,and Tel.No. !� ,¢/`a�,6c/j Designer's Name,Address,and Tel.No-'_P,¢1rj,;9 M 4SdW Type of Building: , 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) C-f � gpd Design flow provided 7 gpd Plan Date /M/Z6& Number of sheets Revision Date Title ff Size of Septic Tank /Dw Type of S.A.S. e3 0,$' /� 7 Description of Soil Nature of Repairs or Alterations(Answer when applicable) �✓j4c " I� -1a ? I X 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 En ronmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar a h. q Signed Date /l �� Application Approved by { Date Application Disapproved by Date for the following reasons Permit No. 90 �('' �� Date Issued ♦ 1. ' - y j No. Fee / r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS tYes ` 2pplitation for bisposal *pstem Construction 3permit Application for a Permit to Construct( ) Repair( ) Upgrade( ),Abandon, ) El Complete System Individual Components Location Address or Lot No. w j i j Owner's Name,Address and Tel.No. � Assessor's Map/Parcel frf�� r ,)O.h} ' Installer's Name,Address,and Tel.No. 'ip ,QClv,� ell Designer's Name,Address,and Tel. Cd�U,4 1%74, -69, '1/Zv--/Zg5'" sue.�S'y4i►flcv. 5'-8?3- Z/ 77 Ty r of Building: Dwelling No.of Bedrooms Lot Size sq.ft. GarbagelGrinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) V0 gpd Design flow provided <,49 gpd j Plan Date /A/Zem/ Number of sheets � Revision Date Title Size of Septic Tank /d j}j- Type of S.A.S. a C 0,r 05 11042 Description of Soil 4 Nature of Repairs or Alterations(Answer when applicable) e t4_1 e4 C- )� 4 -1-0-2 SC,)( f 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 Enonmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar ea�h. q Signed o Date ( � Application Approved by c Date Application Disapproved by Date for the following reasons Permit No. U 1 1 — 61 Date Issued J— go- - - ------------ ---- -- ------------------------___---- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )by at _]5 has been constructed in acccordance with the provisions of Title 5 and the for Disposal System Construction Permit No. d0 11`61�I dated Installer Designer #bedrooms Approved design flow A gpd The issuance of thi permit shall not be construed as a guarantee that the system will Mh tion as designed Date I �..D / I 1 Inspector (/& Z") �S i ----------------------------------------------------- -------------------- ------------- -----------------------/------- ------- No. 016 11 _ 01 Fee ,yv THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION•-BARNSTABLE, MASSACHUSETTS Disposal *pstrm ConstrUttion 3permit Permission is hereby gran to Construct R air( Upgrade( ) Abandon( ) System located at T (L��'-�-- 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. i Provided:Construction must be c mpleted within three years of the date of this permit. Date I a C Approved by Town of Barnstable o��r Regulatory Services t. Thomas F.Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-8624644. Fax: 508-790-6304 Installer &Designer Certification Form Date: J /21 /20 Designer: -P AV i D "`7 Installer: ✓607 G g 0:L Address: . �� �J � f�l� Address: ( bbJUT' --- 14i_,56,4z MITT 5 �'1, was issued a on 0( ` ermit to (date) (installer) p install a septic system atif 7 5 HILL RVA LD based on a design drawn Ly �/� �/ _ (address) t ' � 14 70 4 dated (designer) ,:certify that-the septic system referenced above was installed substantially according"to die design, which may include mini- approved-changes such as lateral.relocation of the &Ikribution•box and/or septic tank. I cerW;that the septic system:referenced above was installed with ma90x:changes (ie, greater than 10' lateral relocation of the SAS qr-any vertical-elbcat18I1-of any compon�t of the.septt s-ysteui)fiat in accordance with State &Local;Regt]attons. Plan revisiorA or c ed as bi1t�y designer tb foliow. _._ Z� UAViD 9cc aegnaJnre) Q• IWASON m 1: s'1NliAR1�'�' (D er s Signature) (Affix Lgner's.Stamp Here) PLEASE RETURN TO BARNS 'ABLE-PUBLIC:-I3EALTH DIWSION.° RTy-me- TE OF- CONII']LIAN.CE WII L NO, 3 `= UED-UNTFE.`BOT 13' IS F4R1VI AS BUJL,T f ARD ARE REC:E D b:MTHE:j . S A$L7E P LIC DY ISION THANK YOU. Q:Health/Sep cffiesib erCertificationForr. r TOWN OF BARNSTABLE SEWAG LOCATION ' `.' �QC , E:# O�' ' ASSESSOR'S MAP&PARCELS INSTALLER'S NAME&PHONE NO. iris-; SEPTIC TANK CAPACITY LEACHING FACILITY:.(typeia) .., //,Jt7 (size) NO.OF BEDROOMS OWNER 1���L1( i►C '?� '(%d r'%,'st� PERMIT DATE: / Z. ' '``/ COMPLIANCE DATE f�..�0"� 7-CO Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If anywells exist on site or within 200 feet of leaching facility) LL Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility). Feet FURNISHED BY • _jl ri Town of Barnstable Po 317 Department of Regulatory Services Public Health Divisio"n NAMDate I Main Street,Hyannis MA'02601 Date Scheduled k1 Time ( Fee Pd. Soil Suitability A sessment for Sewage D' Performed By D Disposal Witnessed By: q✓�t W_ f G,, �p, �'f LOCATION& GENERAL FORMATION LACation Address-tff r �T`o,/ ®. Owner's Name d Bkr,�J' E7I� Address 7S" � � ��/ Assessor's Map/Parcel: F (' r ©s� Engineer's NamrZ)')�® B. NEW CONSTRUCTION e' " REPAIR i Telephone#5 r'TJ 3 s Land Use Slopes(go) • Surface Stones Distances from: Open Water,Body ft Possible Wet Area �ft Drinking,Water Well ft Drainage Way ft Property Line _ ----ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in}�— ---- proximity to holes) _... -_.�w.s�.-.-....wv�.y... . ---.--a-�wre.-,-.�+qL_-. r��.e ..•i-_..+"...,:.-.-sr"'*`y",-F ^"` Parent material(geologic) Depth to Bedroc Depth to Groundwater. Standing Water in-Hole: Weeping from Pit Face Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH`WATER Tau • Depth Observed standing in obs.hole: In. Depth to soil mottles: Depth to weeping from side of obs.hole: In, Groundwater Adjustment fr Index Well# Reading Date: Index Well level -_p or Ad,fact , , - .� Adj.Groundwater Level PERCOLATION TESL' bete,,,_,,,,._,— Thne__� Observation I Hole# --—� Time at 4 .,� ......... - Depth of Perc ` Time at 6" Start Pre-soak Time @ 0 r �•_�- ��� Time(9"-619) -- End Pre-soak / Rate MinJlnch Site Suitability Assessment: Site Passed SiteTailed: Additional Testing Needed(Y/N) Original: Public Health Division v Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTICUPERCFORM.DOC l DEEP-OBSERVATION HOLE LOG Depth from Soil Horizon Hole# Soil Texture .Soil Color Soil Surface(in.) - Other (USDA) (Munsell) Mottling (Structure,Stones;Boulders. ------------- lJ I DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color 4 Soil Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. on i ten % ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o ' to e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil p od Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency,%Grave Flood Insurance Rate Man: ._ Above 500 year flood boundary No Yes - Within 500 year boundary No t es Within 100 year flood boundary Noes Depth of Naturally Occurrim Pervious Material Does at least four feet of naturally occurring perv'o s aterial exist in gall areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of na rally occurring per&us material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Enviro4menthl Protection and that the above analysis was performed by me consistent with . the required training,a ertise and experience described in 310 CNM 15.017 Signatura-/-U V V Date Q:\SEFrn0PERCFORM.DOC d� Y TOWN OF BARNSTABLE T.uCATION �wtJz SEWAGE # 3'7r 7�q a.. VILLAGE ASSESSOR'S MAP & LOT A-1a o_.0S'J INSTALLER'S NAME PHONE NO. /41&0 c-f s 3G -(IZ�CJ SEPTIC TANK CAPACITY 16W LEACHING FACILITY:(type) LC iG,l_\ _XT (size) ` (� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNERoE,2 DATE PERMIT ISSUED: -f.% DATE . COMPLIANCE ISSUED: - Z S— 8"'K f VARIANCE GRANTED: Yes �w ' No *y � "`� F ��` �� ti O ? �: .S'� �. ,. S �. r � � S� e �. y No. .T� Fps.. ... _ THE COMMONWEALTH OF MASSACHUSETTS �- BOARD HEALTH �� ........ .....OF...... .... 2T .. - ... Appliration for Rinposal Marks Tonstrnrtion Prrmit Application is hereby made for a Permit to Construct (.p,<or Repair ( ) an Individual Sewage Disposal Sys em at: �Iv ...... F�....... ! --------------------- f ess _ ocat�}�A � j or o. f W !G Ow Address ... .............-------- Installer Address Type of Building Size Lot. l-----Sq. feet awellin No. of Bedrooms......--.:3--.-•----•----------------Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures -----•------------------•--------•-•------------...---••-----------------••------•--....-•-----•----•-•------------------•-.......------....--------- W Design Flow............. ..................gallons per person V7 dray. Total daily flow....._._ ...................gallons. WSeptic Tank—Liquid capacity�el .gallons Length_....___ Width: Diameter................ Depth,� _ , x Disposal Trench—No..................... Width.................... Total Length................. Total leaching area............ _-._.sq. ft. eepage S Pit No---------/-------- Diameter..../!'j_........ Depth below inlet._.;.&�,L---- Total leaching area �sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed byll ._Z74206. ate.. =Z7.--��---�-'3--_--__.. ,.-I Test Pit No. 1...155 .._---minutes per inch Depth of Test Pit-_,/ ..__. Depth to ground water__ P;q Test Pit No. 2--_��__minutes per inch Depth of Test Pit../-.. ��_ Depth to round water--__- '`'.............. H o Description of Soil............. 4 le x •--------------------------------------------•------------•--••---•---------��.....�•-�..........----•-------•------------•----......------•----------------••-------•••---------------- 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 TITL L 5 of the State Sanitary Code— Theundersigned further agrees not to g'ace the sys em in "�• �•' y' operation until a Certificate of Complian as been ssue by the-boar-of Signed .. '�" ... /--- ............_.... Application Approved By .................. . ..................... -- --------- ------ Date Application Disapproved for the f ollowing reasons:.......•...........•............_--------------------- -------------------- •------------------- ••------------- ....................•-......-•----......-•---------•--•-•------•-•�•----------..............-•-----^......•-------------------•-------•-----•---•--•----...........................................Date Permit No.. .......... �� .... Issued ..--- Date No. ......... ` F . Z THE COMMONWEALTH OF MASSACHUSETTS �� -- BOARD OF HEALTH Applira#iou for Disposal Works Tonstrur#iurt Prrutit Application is hereby made for a Permit to Construct (E/l"*or Repair ( ) an Individual Sewage Disposal System at•,,,g 1 ............ l f:..i_: :?r: �T�s;�� ✓... ;/......... J iC_,t y r / . ' / ocati Address ........ .t ' Ow er (� Address Installer Address Type of Building Size Lot_Z�,f-Z .....Sq. feet awellin No. of Bedrooms.........w,................................Expansion Attic ( ) Garbage Grinder aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --- -------------------------------•------------•-------------------•••--••-----•---••--•-•••----•-•---••-••-••••-•---•---..._••--•---..._.......-•-- W Design Flow_____________L_ ..................gallons per person per day. Total daily flow______.____...' ............._..........gallons. WSeptic Tank—Liquid capacity !'l_.gallons Length._%.�'__'_ Width_!!?a/' Diameter________________ Depth..> x Disposal Trench—No_____________________ Width.................... Total Length.................,_. Total leaching area....................sq. ft. See e Pit No.......... ........ Diameter____ �r.._.__.__ Depth below inlet....:.%�_.___. Total leaching area:_ rsq. ft. Z Other Distribution box ( ) Dosing tank 0-4Percolation Test Results Performed b Y.T�!.�'+ .... lxr:___ :: :f �! f' /�+'l�Date._.- ._! .°r__`� __.._. Test Pit No. 1...�.��-_._..minutes per inch Depth of Test Pit_._r�� ��__ Depth to ground water_.. fi Test Pit No. 2_.__`_Y__minutes per inch Depth of Test Pit__-/`i4 -�_._,Depth to ground water_`,__r": f�' /jl �'d !� si/ `,�rfvr✓-----.....•-•---_... Description of Soil -------- --- -------- •••••; f .:. r -� (xj ---------------•_`�_. .._::_/�' ,J !.icy � '�-j� - ` /��'! ...:!.fir,r,�r7/ f- f - •---- W ---------------------------------------------------------------------------- f.......�... 12..----•••. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... •• --••--•-•-•--•----------•-•-••--••-•----••................•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage D• posal System in accordance with the provisions of TIT 5 of the State Sanitary Code The undersigned furth r agrees not to place the system in operation until a Certificate of Compliance has beeiiiiss ed by,-the boajY of he4lth. Signed :'� --r... ........................ ' 7 Application Approved By_ '! /� j Date Application Disapproved for the following reasons:.............................................................................................................. .....--•-••---••-•-•--••..•------------••...-••-••--•-...--`-----------•-•-••••----------•--••---....•---•-•---•..............••-••--••••-•••-------•••-----•--•-----•-•-•--•----.._ _..---........ Date PermitNo....................................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Cwrrtifirtt#r of Tuutpliaurr THIS4,S TO CERTIFY„ That the n�'tividual Sewage Disposal System constructed (�j'or Repaired ( ) b � �c �Y�( I.�'Jn z �C � �tt 1 Install �_ _ at = y .............................................................— has been installed in accordance with the provisions of TITL,i 4f Vy4te Sanitary Cod y de'cribf�-�ln. the application for Disposal Works Construction Permit No...........� i __________________________ dated....._�.... ._.__� .......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... t THE COMMONWEALTH OF MASSACHUSETTS � -- BOARD OF HEALTH "7�c/ ..... i/Ar'.............OF........../ :/r�f'�!/ s7? �" ._....._...__...._.._......... � ... .. "7 `- NO... ._. FEE........................ Disposal� rks TIMustr u'. autit Permission is hereby granted........... `-__`_ter'' �U^� lc �l ••-------------------•----•--•-------•----------------•-----...••-----•--........_......._._..............._.. to Construct ( � epair ( a�} I div dua Sewage -isposalrSystem atNo......................... C2 = ..... ?�? _.._._..c. .... ...-...'-------•-•---- ------------------•-• ...� Street as shown on the application for Disposal corks Construction Permit-No =-______________ _ ed--------------I__.--. --------------•---- Board of Health DATEI `v --------------------------------------- FORM 1255. H BBS & WARREN. INC., PUBLISHERS A ASSESSORS MAP :- TEST HOLE LOGS NOTES: J PARCEL :_4 ij I FLOOD ZONE: (ICI� ����j�j SOIL EVALUATOR : i �lI D V�I►�`�`1 �� -- WI TNESS : I ) 1 '(b 1) The installafion shall comply with Title V and Town ofF;74 &PVgLf 13oard of REFERENCE: --(f4?1'11FIE12 -Pll* -( _ DATE : Health Regulations. PERCOLATION DATE: ,L l�U�� 1 2) The installer shall verify the location of utilities, sewer inverts and septic / (o I-- - U 0 components prior to installation and setting base elevations. 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first TH- I TH-2 two feet out of the d-box to the leaching shall be level. L'o" V&IYD 4) This plan is not to be utilized for property line determination nor any other lc, � purpose other than the proposed system installation. 6 r — 5) All septic components must meet Title V specifications. LO 6) Parking shall not be constructed over HI 0 septic components. o� The roe is bounded b property corners and property lines. LOCATION MAP - 7) property rtY y p p y p p y �b �� 8) The property owner shall review design considerations to approve of total t design flow and number of bedrooms to be considered for design. Receipt N /r '!' of payment for the plan and installation based on the plan shall be deemed G l L�F4r CIA approval of the design flow by the owner. I 9) The existing leaching or cesspools shall be pumped and filled with material bO �, per Title V abandonment procedures. Those within the proposed SAS shall _ be removed along with contaminated soil and replaced with clean sand per Title V specs. 10)System components to be 10 feet from water line. Sewer lines crossing the water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if SEPT I C SYSTEM DES I G N applicable. The proposed SAS is being installed below the water service f) line. The line is to be sleeved as aforementioned and maintained in place. S (T 11) If a garbage grinder exists it is to be removed and is the responsibility of the FLOW ESTIMATE 0 S owner to ensure such. � � q 4 BEDROOMS AT ( �� GAL/DAY/BEDROOM -'l b GAL/DAY 12}Thinstaller is to take caution inexcavation around the gas line if such SUP-4-0X'1 �',j��j 9 UI1-I1<� 13)The installer shall verify the location, quantity and elevation of the sewer PT I C TANK lines exiting the dwelling prior to the installation. I- ' GAL/DAY x 4,,DAYS - ret C..� USE O GALLON SEPTIC TANK I l,L IL ABSORPTION SYSTEM Cf �-�1' S l � � �� ` \\� ~ \�,\ °, � � ,___ � ... ._ .� 1�� ItS ��V`I►11tJ1G�1�,1 1N�/��' . ,� lri��..0 �����' � � '' r r ,''r'�'"1 1`\ ,� , u✓ 7 PT I C SYSTEM SECT I ON 9 - wpy ►C� 4.O� ,ZLj Coves ��T.S �rJ �11_��-SPfGS (.�fAwif D-BOX N CCC GAL 2��j�(o wtC(E�'( L - �t, SEPTIC TANK co II 12 . / ,� SITE AND SEWAGE PLAN +. LOCATION : IL 1 PREPARED FOR SCALE: ► `' W DAV I D B . MASON S DATE: l I IDI 1- DBC ENVIRONMEN AL DESIGNS EAST SANDWICH . MA W DATE HEALTH AGENT ( S08 ) 833- 2 177 _ _�.