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Home My WebLink About0054 SCUDDER'S LANE - Health 54 Scudder's Large Barnstable F/R A = 258 021 No. �— [ / . Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: . Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Ofpplication for Wgpozal *pgtem Com6truction 3pCrmit Application for a Permit to Construct( . )Repair(�)Upgrade( )Abandon( ) Cy'Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. A essor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.N Type of Building: Dwelling No.of Bedrooms 41 Lot Size��sq.ft. Garbage Grinder( � Other 'Type of Building eweZ.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow y ( gallons. Plan Date /O //S— Number of sheets Revision Date Title r� SGGf e ,>w Size of Septic Tank Type of S.A.S. 3 _ 4D 9J 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 Certifi- cate of Compliance h e sued�b *s�ar f H 2gned Date Application Approved b Date 6`- Application Disapproved for the following reasons Permit No. Date Issued 3 1,5 A 4 --- --------------------------------------- - %.No. '�` � _•�5,...Fee � _..-- ? THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN`OF BARNSTABLES MASSACHUSETTS 2pplication for W000l 6pgtem Cootruction Permit Application for a Permit to Constrict( . )Repair(V )Upgrade )Abandon( ) ®rComplete System O Individual Components Location Address or Lot No. r �^�,�/ / Owner' 's fName,Address jannd Tel.No ses . Assor's Map/Parcel c9 a;k Installer's Rame,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: ,r Dwelling No.of Bedrooms_ Lot Size 6i sq.ft. Garbage Grinder( d Other Type of Building /7-,;i�i�N/_Y?No:-of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 5 c , gallons. Plan Date //9 Number of sheets Revision Date Title /;a 0 5 y_5r Size of Septic Tank / 5G�l" Type of S.A.S. A24ZZ__1s Description of Soil Nature of Repairs or Alterations(Answer when applicable) r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has�'beensssued by-: 's oard-of Health. S2gned _ Date Application Approved by Date >, Application Disapproved for the following reasons Permit No. 'a 00 `4- /0 1 Date Issued o L --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(�)Upgraded( ) Abandoned( )by /1/, at S/' ✓,- `_ . �/�i gc. Ale has been constructed in accordance with the prop' ions of Title 5 and the for Disposal System Construction Permit No. DwWol _dated' /:T'L I Installer )r 10(r Designer The issuance o this permit shall not be construed as a guarantee that'the system will-function as designed. Date p `' /�*^1/--._.__�___._ 7 (��( In ectai•� �. --------------------------------------- No. s�('�')`—1 l Fee .15(l) .i THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Zigpogai *pgtem Congtruction Permit Permission is hereby granted to Construct , )Repair(Kj Upgrade( )Abandon( ) System located at 5` SGG� r Pig �,o d4u IV 4Z �/11 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constfuction must be completed within three years of the d`t o this'e, Date: � 5 U �� Approved by__ TOWN OF BARNSTABLE "LOCATION J."Cd✓//dam L .SEWAGE VILLAGE & 4 ASSESSOR'S MAP & LOT `/ , INSTALLER'S NAME&PHONE N0. ,�� i� �� .rc�u✓ ;,t V,2 p::8'V C. SEPTIC TANK CAPACITY LEACHING FACII.ITY:,(type) S'OyGgCC �.,>"'l_✓� ,.` (siie) /3 33•S' •f�� }` NO.OF BEDROOMS BUILDER O OWNER PERMTTDATE: 17 3 ®S '/ COMPLIANCE DATE: fl Separation Distance Between the: i,Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet rit Private Water Supply Well and Leaching Paciliiy (If any'wells'eust 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 L'nsr��1i[ i 1 w a Z � 1 �4 f SENT BY: BORTOLOTTI CONST; 5084289399;` lv0V-3-04 11 :58; PAGE 7!7 Town. of Barnstable . THE tO" � Regulatory SeI-vices j c� Thomas F.Geiler,Director Public Health Division ' Thomas McKe=,Director 200 MWn Street,Hyaunis,MA 0260I Cfbce: 508-862-4644 Fax: 508-790.6304 Installer& Designer Certification Fors1 )0 � Date: q i Designer: 0v�/� 2 h@Cn InstaAer: F Address: Q� l / M � ,A J �. address: Y3 Oil Il ��°� _ was issued a Pe_ it to iLftall u (date) _ uis er tic at� Jews �Q�►..�2 , dr p ) based'on desigc -a� a by se system (address) dated (desl er) — — ... �� /� � i �Ier'tify that the septic system referenced above was instsl.led sjubstan�ally according to the design, which may include minor approved ;l=ges such laterid relocation of the distribution lox and/or septic tank. I certify that the septic system referenced above was installed with ryajor changes (i.e. greater than 10' lateral relocation of-the SASS or any vertical rele cation of any component of the septic system)but in accordance witu State&Local R,-gulationsL Plan revision or certified as-built by designer to follow: , ��\I(A OF M Ss9 ARNE cti� (Installer's Signature) C ALL - No. 307 2 pc�0 S T EG\� (Designer's Signature) (AfRK fain';Mere) PLEASE RETURN TO RkRNSTABLE FUIiU&MALTH DIVI$10N. C1E•RTIp7CA.TE' A OF COMTLIANCE WILL NOT BE ISSUED IJ.NTXL BOTH THIS—MR-M. AND AS- BUILT CARD AI_t R-El CEIVEM BY T T +, BX NSTABLE, FTTRI,ICy H1 'TH DIVISION. _ 'FHANK YOU. Q:Health/Sepsu"Jcsi;ner Coriificalion ronn j TOWN OF BARNSTABLE LOCATION �y ��d✓�-� L"' SEWAGE #v�GYJil al � VII,LAGE PaJ a ASSESSOR'S MAP &LOT �A INSTALLER'S NAME&PHONE NO. � hi�s�'. ��'�`i' V.2 p-TV -SEPTIC TANK CAPACITY LEACHING FACILITY: (type) f OCJ�g t CJ� ,<«� (size) I� 33•� �,�� NO.OF BEDROOMS ' BUILDER O OWNER 6Pzcgc�ir� PERMIT DATE: 3. COMPLIANCE DATE: Separation Distance Between the:" Maximum Adjusted Groundwater Table td the Bottom of Leaching Facility f f Feet Private Water Supply Well and Leaching Facility (If any wells exist Fe et on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within'300 feet of leaching facility) Furnished by "� `4C o I �sb" say` f L-1� f ` e , COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLES w1 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY:ASSESSM,, CT�O►`� SUBSURFACE SEWAGE,-DISPOSAL SYST (_ PART A _ CERTIFICATION ' RECEIVED.: Property Address: JUL 17 2002 Owner's Name: TOWN OF BARNSTABLE Owner's Address: HEALTH DEPT. Date of Inspection:, C+ ,.op a Name of Inspecto : please.print)� ,be,-� ` , f 1D� N01133dSNl 0311` A Company Name: ttr 'A P Mailing Address: -� PARCEL Telephone Number: O • 77/- LOT - CERTIFICATION:STATEMENT of I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems..Lam a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes . Conditionally Passes. eeds Further Evaluation by the Local Approving Authority Fail • . Inspector's Signature: Date: ��lJ 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. Notes and Comments X/ e WW ****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. Title 5 Inspection Form 6/15/20.00 page I P 9 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner:. . Date'of•Inspectio : r i 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: NOtt- ; Qt System Conditionally Passes: '—,—One or inoresystem components as described in the"Conditional Pass"section need to be replaced or repaired.The system;upon completion of the replacement or repair;as approved by the Board of Health;will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank(whether:metal or not).is structurally unsound,exhibits substantial infiltration or exfiltration'or.tank failure is_imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and.if a Certificate of Compliance indicating that the tank is less than 20 years old is available. . ND explain: Observation.of sewage backup or break out or high static water level in the distribution box due to'broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than'4 times.a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): :broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3.of 11 OFFICIAL INSPECTION FORM-.N.OT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM'INSPEC.TION FORM : PART'A CERTIFICATION(continued) Property Address: / Owner: Date of I nspecti n: _ C. Further Evaluation is Required by the Board.of Health: Conditions exist which require further evaluation by.the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance_with 310.CMR 15.303(1)(b)that the system is not functioning in-a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is,within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and.Public Water Supplier,if any):determines that the system is functioning in a manner that protects the public health,safety and;environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet.of a. 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 I 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 welC _ The system has a septic tank and SAS and.the SAS is less than 100 feet but 50 feet or more from.a, private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified.laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are.triggered.A copy of the analysis must be attached to this form. 3. Other: 3 r Page 4 of 11 OFFICIAL.INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 6-7.4 Owner: / ` u Date of iris pectio61 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: I Yes Ngi Backup of sewage into facility or system component due to overloaded or clogged SAS oPcesspool Disch.arbe or ponding of effluent to the surface of the ground or surface waters due to an overloaded or / clogged SAS or cesspool 1/ 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 '/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface //� water supply. J . Any portion of a cesspool or privy is within a Zone 1 of a:publicwell. Any portion of a cesspool or privy is within 50 feet of 6 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facilityand 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.] S (Yes/No.)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CIvIR 15.303,therefore:the system:fails.The system owner should contact the Board of Health to determine what will be necessary to corredthe failure. E. Large Systems: To be considered a large system the system mustserve a.facility-with a design flow of 10,000 gpd to 15,000 gPd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no — the system is within 40O 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 questibn in Section E the.system is considered a significant threat,or answered "yes"yin 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. 4 ' Page 5 of 11 OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: eifAha t Date of Inspecti QO 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? t�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? a j _ 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? _V _ Was the facility owner(and occupants if different from;owner)provided with information on the proper maintenance of subsurface sewage disposal systems The size and location of the Soil Absorption System(SAS).on the site has been determined based:on: Yes no 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(3)(b)J t 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION,FORM .PART C SYSTEM INFORMATION, Property Address: yw/�z ` r Owner: Date of Inspection. / U FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 11.0 gpd x#of bedrooms):�t� Number of current residents:2� Does residence have a garbage grinder(yes or no Is laundry on a separate sewage system(yes or nc) -(if yes separate inspection required] Laundry system inspected es or note Seasonal use: (yes or no): `/ Water meter readings, if a ilable(last 2 years usage(gpd)): _Vggo Off" Sump pump(yes or no ' Last date of occupancy: COMMERCIAUINDUSTRIAL�A& Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft;etc.): . Grease trap present(yes or no): Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system (yes or no):_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:. Al die, Was system pumped as part of the inspection,(yes or If yes, volume pumped: gallons--How was quantit) 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) _Tight tank _Attach a copyof the DEP approval Other'(describe):_ A roximate age of all components, date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no t6 - 6 Page 7 of 11 OFFICIAL.INSPECTION FORM-NOT FOR.VOLUNTARY.ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM.INFORMATION(continued) Property Address: AVO AL✓'q Owner: Date of Inspection BUILDING SEWER(locate on site plan) `'/(- Depth below grade: Materials of construction;_cast iron _40 PVC. other(explain): Distance from private water supply well or suction line: w Comments(on condition of joints,venting,evidence of leakage,etc.). SEPTIC TAN)&(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: Sludge depth: 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.): GREASE TRAZA- k ocate on sit&g an) ; #` Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping:. Comments.(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.)- 7 ry Page 8 of 11 OFFICIAL INSPECTION FORM_NOT FOR:YOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: - 7! JAid Owner: Date of Inspectio : / 2 TIGHT or HOLDING TANK-,/ -(tank must be pumped at time of inspection)(]ocate on.site plan) Depth below grade: Material of construction: concrete metal fiberglass__polyethylene other(explain): Dimensions:' Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): .Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOa , --`if present must be opened)(locate on site plan) Depth of liquid level above outlet 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.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms'in working order(yes or no): ` Comments(note condition of pump chamber,condition of pumps and appurtenances, 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM.INFORMATION(continued) Property Address: Owner: �.. Date of Inspecti / t _ SOIL ABSORPTION SYSTEM (SAS (locate on site plan,excavation not required) If SAS not located explain why: Type .............. leaching pits,number:_ leaching chambers,number: 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.): CESSPOOLS:_Z(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth'—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of.groundwater inflow(yes or no): omments ote condition o oil, signs of hydraulic failure, level ponding,condition of vegetation,etc.): ," ,. PRIVY://g=(locate on site plan) Materials �'o"ff construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM:INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: o 7 Owner Date of Inspecti : o?200 a SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. �. V�7 t c ]0 I Page I 1 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION continued Property Address: Owner Date.of Ins ectio (jam SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to.ground water �(� yfeet '; Please indicate(check).all methods used to determine the high ground water elevation* Obtained from system design plans on record-If checked,date of design plan reviewed:. 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: „ � /'mil°7 ✓t✓�� it Permit Nurtiber: Date: Completed by:. !-11GH GROUND-WA:T E•R LEVEL COMPUTATION Site Location: Lot No.. Owner: lM Add.ress: Contractor Address: Notes:. It 25 �S STE°; 1 Measure depth.to•water table. _ to neare'st.1./10-t.. ff ............. .Date l��Z month/day%year &T.EP 2 Using.Water-Level.Range Zone and Index W611)-Ma.p:locate site.an.6determine: OAPpro.priate.index well............................................... Sd� Water4evel range zone.,:._.......... STEK:3.: Using-month ly.repact:"Current Water Resources Conditions" determine current-depth to l� water. level for index well :.............. 0,5lez- 7 7. 7 month/year STEP. Using,Table.o.f•Water-level Adjustments for index well (STEP 25),.curr-ent depth to waterIevel for..index well (STEP 3):, and water-level zone (STEP 2B) determine water-level adjustment ................................... STEP: 5 stimate depth to:high water by subtracting the water-; level adjustment-(STEP 4`) TrOm measured.depth to.water level-at site.(STEP 1.) ._...........;..-. ........ ............ ........... ...... ............................... Figure. 1I1--,riieproduCibie.C0m'putddon iCim: I � ® "(� n S .� -� . �, ., s r, � f � � �� M � �� -Inv 7�m>m; It b:t f j1J ~ i M I 1 � Ei _ , } I tn Lk NNW r i r r Ik ' A lit I A :... 4 i Q or I 1 �M 5 e Q' M. 4 a: 6D CD . ; S♦ 4\ vi i aD CONA ,TV) ; i j C � I TOP FNDN. AT EL. 59.8' SYSTEM PROFILE E TEST HOLE LOGS ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) PROVIDE INSPECTION PORT WITHIN A.H. OJALA, PE .; ACCESS COVER (WATERTIGHT) TO 6" OF FINISH GRADE ENGINEER: 56.0' MINIMUM .75' OF COVER OVER PRECAST /� WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM SAM WHITE, RS 56.0 WITNESS: RUN PIPE LEVEL 2" DOUBLE WASHED PEAS ONE DATE: 9/30/03 W 57.8't* FOR FIRST 2' 3' MAX. PERC. RATE = < 2 MIN,QNCH FOCUS PROPOSED 1500 ce GALLON SEPTIC 53.75' 53.0' w 54.0 CLASS 111 SOILS, TH1 S P# 10588 TANK (H- 10 ) GAS 52.27' a '' BAFFLE 52.44' �� Cl Cl a C] 0 C7 C 0 i MIN 52.17' 0 M 0 � � ED M 0 Or4' NDCLASS SOILS ' TH2 (USE)2 % SLOPE) �6" CRUSHED STONE OR MECHANICAL C1F-I zRTE 6ACOMPACTION. (15.221 (2]) $ 2' 0 0 0 � 0 0 � 000 50.17' 4 ELEV. '� x/ DEPTH OF FLOW = 4' 3.5 1 0" 54.9' 0" 6.1' ( % SLOPE) ( % SLOPE) 3/4 TO 1 1/2 DOUBLE WASHED STONE TEE SIZES: A A INLET DEPTH = 10 /Ls - UNSUIT. ,. LS OUTLET DEPTH 14" 7" , 10YR 4/3 LOCATION MAP NTS 15., 10YR 4/3 FOUNDATION--- 80' LEACHING B / ZONING: RF-1 SEPTIC TANK 38 D BOX 12 FACILITY 45' 7.07' LS LS FOUNDATION uNsulT. FRONT: 30' -- ` SIDE: 15' „ 1OYR 5/4 10YR 5/4 REAR: 15' 30 52.4' 30" FLOODZONE: C *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL UTILITIES AND ALL ASSESSORS MAP 258 PARCEL 21 BUILDING SEWER OUTLETS AND ELEVATIONS Cl PRIOR TO INSTALLING ANY PORTION OF 43.1' C SEPTIC SYSTEM LS uNsulT. PERC LS 2.5Y 6/4 ,/' 5�s . BENCH MARK -- HIGH POINT { OF BOULDER (PAINT MARK) 96" PERCHED WATER 46.9' 96tv ' '� %/; 48.1' { LOT AREA 1S2 g�, ELEVATION = 55.5' C2 ( 55,4 Or1- �l9,736t SO. FT. 2.5Y 6/4 t M D COS 55,1 RT DRY �" E / �E NO WATER NOTES: 55.5 + 1 + 54.4 ENCOUNTERED I (: ss,s `o o Row of CEDARS + s A I SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) 1 . DATUM IS APPROXIMATE NGVD 56.2 DESIGN FLOW: -4 BEDROOMS ( 110 GPD) = 440 GPD 2. MUNICIPAL WATER IS EXISTING i Ss + 55.6 + 54.s USE A 440 GPD DESIGN FLObV 3. MINIMUM PIPE PITCH TO BE 1/8 PER FOOT. I { OP. SCREENED d� 880 4, DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- { h� + P CH + 56.7 v, + 53.6 SEPTIC TANK: 440 GPD ( 2 ) 5. PIPE JOINTS TO BE MADE WATERTIGHT. USE A 1500 GALLON SEPTIC TANK 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. { U, LEACHING: - ENVIRONMENTAL CODE TITLE V. cp EXIST. 14.5' x 10' 56.0 cn TH1 137 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT q ( h + s7.7 2(33.5 + 12.83) 2 (.74� C.O. BRICK PATIO (REMOVE) SIDES: TO BE USED FOR ANY OTHER PURPOSE. + GRES C.O. + 54� 33.5 x 12.83 (.74) - 318 {{ T 8 BOTTOM: 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. + �4,3 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT HoLLYs ^ TOTAL: 615 S.F. 455 GPD INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED ss•o +` 7 USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR FROM BOARD OF HEALTH. + EQUAL WITH 4' STONE ALL AROUND sa.3 37,2 ) 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING CESSPOOLS ( 6 7.2 INV OUT 57.8' 1 { EXIST. DWELL. + 56.6 J LEGEND TITLE 5 SITE PLAN { TF - 59.8' { ( CC CELLAR ` 58•3 5 100.d PROPOSED SPOT ELEVATION OF { ` PROP. I H2 54 S C U D D E R LANE ' / \ INV OUT 57.8' CLEANOUT / 1 �. 100x0 EXISTING SPOT ELEVATION + IN THE TOWN OF: { ,9 / PROPOSED CONTOUR � BARNSTABLE (VILLAGE) { mo BRICK ( + PATIO 100 EXISTING CONTOUR CO PREPARED FOR: KERRY BRANDIN { 06 59.1 C.O. PROPOSED CLEANOUT 137.18' s7.7 20 0 20 40 60 BOARD OF HEALTH 5' REMOVAL OF UNSUITABLE SOIL REQUIRED AROUND PERIMETER OF LEACHING FACILITY, DOWN TO SUITABLE SOIL LAYER (TO C2 LAYER APPROVED DATE MA SCALE: 1 = 20 DATE: OCTOBER 15, 2003 - SEE TEST HOLE 2). REPLACE WITH CLEAN MED. SAND. ENGINEER TO INSPECT AND CERTIFY REMOVAL off 508-362-4541 fox 508 362-9880 a I �yjH OF P4,�S S,y down Cape engineering, Inc, o�� ARNE H cy ��H OF k4 OJAL CIVIIL ARNE oSG� CIVIL_ ENGINEERS No. 307 LAND SURVEYORS °F�'F��s s cn /� FS N A L E. Y /9� 02-395 939 main st, yarmouth, mo. 02675 E qa � .E., P.L.S. DATE