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0120 SCUDDER'S LANE - Health
120 Scudder's Lane Barnstable A=259011 rj i �(rr r`I� I,X3 r i J' � „7 .:.# .tA � a >rr y� +° �y"`i� r'E>eyi•'� 7. ,. r "< �.'t t..q r z” � r 7 �_�'r4 '�` �_� s�' � � „ � '§F�`' ���� � '��s.�>r cif x �}' .:•�.. '' ,S�' +��'�� �� 'a�.�''�. .,,4c"',5 x u �� � ,r fie:� L•' T � - 1 , p G,r �,�'ik p f�� �'_. + �.y,�e - .�, �'`' ���t ?a'xa``� s�a �a �a� ' #��„ .a• iC ` r r`'te'ew {`l t { 'fit t� �' f ��¢ T ' rti` # �• Y P�. �. � s •� ' ' 42>_ � u4 sr'a4 n a ���*��r• Sy�, .t,"'$ a• > `f � �' !1!._.�. �- :_ y:-� y�' ., a -rrr cat 1"��r{j• _ ' Tts ell. „s a, � ?� , �* � ¢. Y` ' �::fl �'�� r ' wb,+' z, ' €. t dt,Z, i f a t +.t:•t 1 rar,.. ,� � a4a' tr ;°sue - *'� < �us"'€ r f'3 '1+. q g°",'€`�ht ,ra` t€'' �.r�..,+ s ,'. Y e'- €' - ..'1 i �1r .�"ii,• { T +''^r +r �. A*i.`�,n<e.....". rt�.nr..,f✓�7's> w :_� '� �i. 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Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. z - Important,When A. General Information filling out forms (11 OF1VfgS4ii�i�� on the computer, sq' use only the • tab . 1 Inspector _ I �I �o key to move your =: JRMEScyccn�- cursor-do not James D Sears "' =o: �= ' use the return _C) SEARS � key. Name of Inspector CapewideEnterprises,LLC try T1F� •Ca�2� Company Name N S9"- \\0�� 153 Commercial Street Company Address Mashpee x• MA 02649 CityRown State _ Zip Code , - 5081i77-8877 , ' ': S1623 .: Telephone Number - License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes []„Conditionally.Passes ❑, fails �- ❑ Needs Further Evaluation by the Local Approving Authority spectoes Signature .: Date . A 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. Wthe system is a shared system or has a design.ftow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate,regionaloffice of the DEP.The original should be sent to the system owner z 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 iri the future under the same or different conditions of use: 151ns•3113 ' Title 5 Oftidel hs on o u uftoe Die seli/,W1151 ,g._.1 of 17 . P� �Se Po Jan 16 1510:37p 1. `- p.2 Commonwealth of Massachusetts Title 5 Ofro ci al- Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ` 120 Scudder's Lane Property Address Dan Curtin Owner Owner's-Name information is , + - .r Barnstable Village, MA 02630 h '.1'15-16 required for every 9 page, cityrrown Stale Zip Code Date of inspection B. Certification (cost.) .. , Inspection Summary: Check,A,B,C,D or /always.carnplete all of Section D A) System Passes: V ® 1 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. 14 Comments: The system is a 2000 Gal.Tank D Bok and six chambers. r , - X . 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): A, F a a t5irm•3113 ~ Title 5 afidal kmpedlan Forth.Subsurface Sewage D'oposel System•Page 2 of 17 a X" Jan 16 1510:37p p.3 Commonwealth of Massachusetts - Title 5 Official inspection Form . a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 120 Scudder's Lane Property Address - Dan Curtin Owner Owner's Name information is Bamstable Villa a MA `02630 -1-15-15_ required for every 9 page. CityfTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass With Board of Health approval if pumpslalarms are repaired., $ B) System Conditionally,Passes (cont-): ;: rt ❑ 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 replace ❑ YY ❑ N' ❑ ND(Explain below):' P ( P ) ❑ 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): 4 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,, safet y and the environment:. r ❑ 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 , 151ns-3113 - Title 5 ORcial Msped im Form:Subsurface Sewage Disposal System-Page 3 of 17' 1 Jan 16 1510:38p p•4 Commonwealth of Massachusetts; Title 5 OICosl Inspection Form- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Y .? 120 Scudder's Lane _ Property Address f Dan Curtin ` Owner _ information Is Barnstable Village = MA ...„ 0 ;• required for every 2630 page, Ctty/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: y r - ❑ 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 aseptic 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 DVEP certified laboratory,for fecal coliform bac teria indicates absent and presence he r o f t p 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: i1 D) System Failure Criteria Applicable to All Systems:' F You must indicate,`Yes or No to each of the followingall,Inspections _ n .. n for Yes Na ,+. k 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 ._ f due to an overloaded:or clogged SAS or cesspool ' Static liquid level'in the distribution box above'outlet invert due to an ov or clogged SAS or cesspool Liquid depth in is less,than 6" below invert or available volume is less t ® than Y2 day flow �yiaG (Sins•3r13 Tifle 5 Otfidd Form.SubsurfaceSewage Ofeposet System•Page 4 or 17 - rt Jan 16 1510:38p p,5 Commonwealth of Massachusetts ' Title 5 Official Inspection *i`ormn Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 120 Scudder's Lane { Property Address Dan Curtin _ Owner Owners Name information is Barnstable Village required for every 9 r , MA' 02630' 1=15-15 page. City/Town State Zip Code ;,Date of inspection ' B. Certification (cost.) Yes No ® Required'pumping more than 4 times in'the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ti ❑ ® Any portion of the SAS, cesspool or privy is below high,ground water elevation. Any portion of cesspool or ;❑ ® . p 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 s and chain of custody must be attached to this form.] , The system is a cesspool serving a facility with a designrflowof 2000gpd- 10,000gpd.' ,. :. `E] I _,The system fails.I have determined that one or more of the above failure -'- t 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. Ef 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. L ry Yes Noo Y • Q ❑ the system is within 400 feet'of a surface,drinlcing water supply % r ❑ IT _- the system is within 200 feet of a tributary to a surface drinking water supply r , the system is located in a nitrogen sensitive area (interim Wellhead Protection Area-IWPA)or a mapped Zone I) 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. t5ina•3M 3•' Title 5 Official Ins pection Form:Subsu face Sewage Disposal System•Page 5 of 17 is :- „ - ' - ;. . - Y •. Jan 16 15 10:38p p 6 Commonwealth of Massachusetts Title 5 Official Ins pecto®n Form ..- -- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments'' :{ 120 Scudder's Lane f,a z Property Address Dan Curtin Owner Owner's Name Information is arnstable Village MA" 02630" ' 1-15-15 required for every B 9 , page. City/Town State Zip Code gate of Inspection C. Checklist - , Check if the following have been done. You must indicate"yes"ar`no"as to each of the following: Yes No y 3 ❑ ® Pumping information was provided by the owner, occupant, or Board of Health El ® " Were any of the system components'pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period7.a Have large volumes of water been introduced to the system recently or as part of ® this inspection? ® z E] Were as built plans of the system obtained and examined? (If they were not available note as NIA) ;. ® ❑ :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 v 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: F ® ❑ 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 Condltlor r ` Number of.bedroorns(design) , Number of bedrooms(actual). , 550 DESIGN flow based on 310 CMR'15.203(for example: 1`10 gpd x#of bedrooms):, ;. , ulna•3113 � '' We 5 official Inspection Foam Subsurface Sewage Disposal System•Page 6 of 17 Jan 16 1510:39p p,7 Commonwealth of Massachusetts. Title 5 Official Onspecition Forte x: Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •. -- .f 120 Scudder's Lane Property Address Dan Curtin Owner Owner's Name information is y required for every 3amstable Vill@ge MA 02630 1-15-15 page. City/Town Stale Zip Code Date of Inspection D. System Information Description: _ The system is a 2060 Gal Tank D Box and six chambers Number of current residents: Does residence have a garbage grinder? z C� fYes No _ Is laundry on a separate sewage system? (Ind la - und• 9 Y ( _ laundry system ins action P information Yes No anon in this report) ,. :❑ Laundry system inspected? -El ; -Yes ® No Seasonal use? Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)j: 2013-74,000Gals 2014-184,000GaPs'. Detail: Sump pump? 0 Yes Z�•No . Last date of occupancy ,_. �' f NA - Date CommerciaUlndustrial Flow,Conditions: , Type of Establishment: �- - Design flow(based on 310 CMR 15.203): ' , - Gallons per day(gpd) Basis,of design flow(seats/personslsq.ft,.etc.): Grease trap present? i ' ❑ Yes ❑.; N4 Industrial waste holding tank present? El yes ❑ No Non-sanity waste di i f ry scharged to the Title 5 s stem? Y Yes ' No' Water meter readings, if available: Bins•3rt3 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systdm•Page 7 of.t7 x_ Jan 16 1510:39p p.8 Commonwealth of 1Vlas saSck u se tts. Title 5 Official ,Inspection Form Subsurface Sewage Disposal System Foam -Not for Voluntary Assessments 120 Scuddees Lane' Property Address Dan Curtin a Owner e Owner's Name - - information is ' required for every Barnstable Village _ Mk •02630 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) w p , Last date of occupancy/use: y Date Other(describe below): t` General Information Pumping Records: Source of information: " „ NA, . Was system pumped as part of the inspection? `'' r ❑ „Yes ® -No If yes,volume pumped: gallorts How was quantity pumped determined? Reason for pumping: a Type of System:' ® Septic tank, distribution+box soil absorption system ❑ Single cesspool , ... r G' ❑ Overflow cesspool ❑ Privy . „ �� z .t Y • ❑ 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.AttacKa copy of the DEP approval Elr Other(describe): 15ins•311 3 », Title 5 Official Inspection Forth Subswace SewageDisposal System•Page a or 17 • Jan 16 15 10:39p _ p g Commonwealth of Massachusetts, Title 5 Official Inspection Form Subsurface Sewage Disposal System form-Not for Voluntary Assessments 120 Scudder's Lane Property Address Dan Curtin Owner Owner's Name n informationfor is requiredredfor every Barnstable Village • MA 02630 - 11-15-15 page. Cityrrown State Zlp Code Date of Irepectlon D. System Information (cunt.) Approximate age of all components, date installed(if known)and source of information: 2005 Permit #2005-516. Were sewage odors detected when arriving at the,site? ❑ Yes ® No Building Sewer(locate on site plan): - r 16" Depth below grade: - feat 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.): Pipeing is 4" PVC SCH 40.` t Septic Tank(locate on site plan):, Depth below grade: feet Material of construction: ®concrete metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal,.fist age: ,d .years Is age confirmed by,a Certificate of Compliance?(attach a copy of certificate) ❑ Yes' ❑ No 2000 Gal.Precast H-10 Dimensions: Sludge depth: - t5ins•3/13 Idle S OMdal Irrspecfian Form:Subsurface Sewage Disposal SystSM•Pape 9 of 17 Jan 16 15 10:40p p.10 3 Commonwealth of Massachusetts Title 5 Official Onspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' F _ } - 120 Scudder's Lane •� .:, k Property Address r Dan Curtin v a Owner Owners Name information is Barnstable Village + required for every 9 MA 0200 - 1-15-15 ' page. City/rows state :v Zip Code Date of Inspection D. System Information (cont.) u Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 29 r. 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. k = How were dimensions determined? - Asbuilt Tape Plan• Sludge Judge -' ° • Comments (on pumping recommendations, inlet and outlet tee or baffle condition,,structural integrity, Aquid levels as related to outlet invert,evidence of leakage, etc.): - Tank'at working level.Tank and covers at 6"below grade.,In and outlet tee's. No sign of leak age or over loading. j Grease Trap(locate on site plan) Depth below grade: Material of construction: .r `_ *.,,. fir•.•}. r ��`� ``• ;� F'' - . - ❑concrete F ❑ metal .❑fiberglass, ❑ polyethylene +y ❑ other(explain).- Dimensions: „I Scum thickness" _ g r Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle N Date of last pumping: - Date- s t5ins?3113 - Title S Official Ins i �. •° • • per3ion Form:Sub>wAace.Sewepe Disposal system•P ' • ~ - age 10 of 17.• : - r Jan 16 1510:40p • p.11 Commonwealth of Massachusetts Title 5 Official efispection Form, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 120 Scudder s,Lane Property Address, , Dan Curtin `- Owner Owner's Name information is required for every Barnstable Village ,; ti MA '_ 02630 1-15-15 page. City/Town State Zip Code ,Date of Inspection.. D. System Information (cont.) ' f 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): *I Depth below grade: .: Material of construction:'- w ❑concrete ❑ metal ❑fiberglass D polyethylene other•(explain}: Dimensions: Capacity: 4 gallons " Design Flow: x z' gallons per day Alarm present: Yes 0 No Alarm level: . Alarm in working order: >"[]'Yes 0 No Date of last pumping: t ~ Date S �.• Y Comments(condition of alarm and float switches etc:) Attach copy of current pumping contract{required). Is_copy attached? ❑ Yes "- :� 'No. , p a ` ,151ns•W13 Title 5 ofooial lnspec0on For=Subsurface Sewage Disposal System';Page 11 of 17 Jan 161510:40p p.12 Commonwealth of Massachusetts , _ , Ville 5 Official Inspection Foam } Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 120 Scudder's Lane Property Address Dan Curtin Owner Owner's Name ieq rotation is ry. Barnstable Village required for eve til1A 02630 '' 1-15-15 .'' • page. City/Town State Tip 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 0 ' Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,,any , evidence of leakage into or out of box, etc.): _;, •_ ' ' D Box is 20"x24'4-Below grade w/cover at 4'., Box is H2O, Box is clean and solid w/three lines . out • Pump Chamber(locate on site plan):: ' Pumps in working order. ' Yes C] Nc` f. Alarms in wonting order. Q' Yes ❑,No' Comments(note condition of pump chamber;condition of pumps and appurtenances, etc.).- If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required). a' ` If SAS not located,explain wtiy: e ' ° . t5ins•3M 3 Titles Offid d Inspection From:Subsurface Sewage Oispossl System•Page 12 or 17i'1 Jan 16 1510:41 p p.13 P Commonwealth of Massachusetts Title 5 Officinal Ins' ecti®n 0=®ran Subsurface Sewage Disposal System Form-Not for Voluntary ryAssass. a.�� ,i s,• 120 Scudder's Lane Property Address Dan u C rtin Owner Owner's - information is Barnstable Village "required for every _ MA, 02630 `N; 1-15-15 page. City/Town Stale Zip Code Date of Inspection D. System Information,(cont.) a Type. ❑ leaching pits number ® leaching chambers number: ❑ leaching galleries _ number: leaching trenches nu mber, length: _ ❑ leaching fields number, dimensions. ; ❑ overflow cesspool number ❑ innovative/altemative system Type/name of technology, Comments(note condition of soil, signs of hydraulic failure, level of pondng, damp soil, condition of „. vegetation, etc.): Leaching is six 500 Gal. Dry well chambers wk'stone. Chambers are`36"below grade ` w/cover at 8". Chambers are clean and drywall%clean • 1 Cesspools(cesspool must be pumped as part of inspection)(locate on site plan); F a _ x Number and configuration Depth-top of liquid to inlet invert Depth of solids layer. 'F ' Depth.of scum layer _ Dimensions of cesspool Materials of construction„' " r V Indication of groundwater inflow ❑ Yes ❑ No '15ins•311 a - • Title 5 Official ImpeaDn Fomc Sub L feca Sewage Dleposel system•Page-13 of 17 Jan 16 15 10:41 p - p.14 Commonwealth of Massachusetts .r~. Official Inspectioxn �'��-m Title 5 Offi Subsurface Sewage Disposal System Form Not for Voluntary Assessments^ " 120 Scudder's Lane - Property Address r Dan Curtin Owner Owner's Name Information is Barnstable Village ' required for every 9e MA d2630 1-15-15 pales- Citylrown State . ZIP Code Date of Inspection D. System Information (cont.)' . Comments(note condition of soil, signs ofhydraulic failure,level of ponding, condition of vegetation; etc.): . A r Privy (locate on site plan): "1 Materials of construction: Dimensions' -' Depth of solids s Comments(note condition of soil, signs of hydraulic failure, level of ponding;condition of vegetation, etc.): 21 r Y it X. � + (Sins•W13 T11W 5 Official Inspection Form:Subsufaca Sewage olsposal System Page 14 of 17 Jan lb 1 b 1 U:41 p p.15 Commonwealth of Massachusetts Title 5 OffIcIal 8nspection For Subsurface Sewa®e Disposal System Form-Not for Voluntary Assessments 120 Scuddees Lane Property Address Dan Curtin Owner Owner's Name information is Barnstable Village required for every NIA 02630 7=15-15 page. Cltymawn State Zip Code Date of Inspection D. System Information (cost.) , Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately ., .. ' cj Al ,W$ A :P l Ba_ ►�, $ k c.q cs-.3�6 • _ ... ,, e,.. a 3, _. _ ,. - 0. . . Jan 16 1510:42p p.16 fi •_i. 24. _ Commonwealth of Massachusetts- Title 5 Official lfispection Foy ; " q Subsurface Sewage Disposal System Form -Not for Voluntary.Assessments, 120 Scudder's Lane Property Address = Dan Curtin ; 4 Owner ame information is required for every Barnstable Village MA 02630 1-15-15 r page. City/Town State Zip Code Date`of Inspection`` D. System Information (cont.) , ' Site Exam: ❑ Check Slope kM f w r ❑ Surface water. ❑ Check cellar r _ ; ❑ Shallow wells 4 r , r 12'+` Estimated depth to high ground water: feet r ` 4 i Please indicate all methods used to determine the high ground water elevation:,; ` ® Obtained from system`design,plans on record 5-3-90 'If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole with!nA50 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 - .p T.H. on design plan 5-3-90 no G_W.,at 12'.-Bottom of chambers at0' below grade. Bottom of ' chambers at 6'above T.H.Deeth' ; p f - ` Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ind-3113 Y y - TWO 5 Official Inspection Fam:SubwKsce Sewage Disposal System•Page 16 or 17 Jan 16 15 10:42p p.17 Commonwealth of Massachusetts Ville 5 Official Inspection Form _ A ?' Subsurface Sewage Disposal System`Form-Not for Voluntary Assessments'. 120 Scudder's Lane Property Address ; - r ,. Dan Curtin Owner information is Owner's Name required for every Barnstable Village MA,, 02630 1-15-15 page. City/Town slate Zip Code. Date of Inspedlon 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 Ze • + " • - sk , . f { �� is �;_[• �� ee _ r i - t5ins-3113 Me.5 Otfidel kopecilon Form:Subsurface Sewage Disposal System•Pape t 7 of i , Town of Barnstable I"ETO�ti� Regulatory Services Thomas F. Geiler, Director awxxstnaM - Mom. Public Health Division. 0 9. 10 - p'Fo►r+A'�°i Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 Installer & Desi2ner.Certification Form Date: le ,4 o4l Sewage Permit# c C —516 Assessor's Map\Parcel a 5V— r Designer: ,S'TG-T3'on/ /Z. /-�.9GL �.S Installer: I ,,rvc� o� '; Itr Address: . Z8 2aM8Z.4—z ,00l,�-D Address: 8Z �©VNIO S1-. On AUG. C Zoo6 s� n,c�rle„e c,��� "�r- was issued a permit to install a (date) (installer) septic system at l an -sr_.,04v1-Lfv. — FuC"r-based on a design drawn by (address) /z. /-44C -dated AgA/ls&m 3 31 o4. (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the, distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. l/ I certify that the septic system referenced above'was installed with major changes'(i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance'with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) w s inspected and the soils were found satisfactory. oP�S�of,9�gssgy 4 o � (�ncr's Signature) No.527 s srFREDSPN��P� EYAl�P�� ffix Desig (Designe 's Signature) (Aner s Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Designer Certification Fonn Rev 03-09-06.doc r i TOWN OF BARNSTABLE LOCATION ho O 5C,,Aj2Cr- L&yG SEWAGE#o?GbS-cS/G `JILLAGE tl' A2iyS7AAIC ASSESSOR'S MAP&PARCEL dS�-0 INSTALLERS NAME&PHONE NO. 2-3,bkc-et,11; Ze - ya8-Ssa q Ip SEPTIC TANK CAPACITY O40 GPI, LEACHING FACILITY:(type) ,S'. 6--yl Clry 2J�6)(size) /a /O NO. OF BEDROOMS OWNER PERMIT DATE: 8- /- 06 COMPLIANCE DATE: /d(, Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY .a, i l �- �r ✓ No. 1y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISIO114 -TOWN OF BARNSTABLE, MASSACHUSETTS • ZIppYicatiou for Zigogar *pg;tem Consgtruction i3ermit Application for a Permit to Construct C)Repair( )Upgrade( )Abandon( ) Complete System O Individual Components Location Address or Lot No. /Z 0 V,�c' �- Owner's Name,Address and Tel.No. Assessors Map/Parcel Z �� l� Z, dGfi�G✓ T�Y1 �'y ���^Z�f "53 Installer's N e,Address,and,Teell..�No. C2 Designer's Name,Address and Tel.No. 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 j gallons per day. Calculated daily flow Z S gallons. Plan Date Oc-? ! Y 24XVc Number of sheets _Revision Date Title ' Zf"-1 Z J G v�LT'ry �2 ]ll Size of Septic Tank GAG 2Wy Type of S.A.S. Description of Soil' y� ���� f�d So/C r 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 has been issu d by this Bo d of H Signe Date Application Approved by Date Application Disapproved for the following r a s K� Permit No. f Date Issued .� + ti.,ayi_r• s �P -.`y.�`y f 14i! �'i . _ _.r'. 3 ! _•*•t. „,�/y^sI j � .� — .. f� ,i «'�r.�i`";...,� — — -� _. .r,+ I�= `` r Entered in computer: THE COM'M`C WEALTH OF MA SSACHUSETTS" Yes • s PUBLIC HEALTH.Dtti'ISIO. kTOWN OF BARNSTABLE., MASSACHUSETTS ,R t rtcatton for Mtq oga l 6 demo ;�o�ngtructtor� - p P ermtt Application for a Pemut to ConstrucOC)Repair`( Upgrade( )Abandon( ) ;K,Complete.System ❑Individual Components Location Address or Lot No. Owner's Name,Address'and Tel.No. 5kpi / Assessor's Map/Parcel Z $ �. / {. / Z c X Y7l�IG/�'L 7c•t !2 /—z�f �� Installer's N e,Adkd ess,and T 1 No. G Designer's Name,Address"and e. o. Type of Building: " Dwelling\ No. of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures f `• Design Flow �5 y gallons per day. Calculated daily flow 6 S gallons. -� Plan Date 0 -7 l Y 26V'� Number of sheets Revision Date Title - Size of Septic Tank 4,-s2'G �t�() Type of S.A.S. Q— `/ `Co�.�t S as tic r C.46r� .,Description of Soil� � Nature.of Repairs or Alterations(Answer whena'applicable) ` k . Date lastinspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo d of He It ! Q Signe w, - ` ,-� Date G '!_ i Application Approved by ,/ Date �C Application Disapproved for the following reaVn ✓'� Permit No. DateiIssued ` —————— -----------�_..._-------�---------- f THE COMMONWEALTH OF MASSACHUSETTS • BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(I/Repaired( )Upgraded( ) Abandoned( )by S-hac`c.\,,"c at O 5C p oc,- LAItC 1�r32oI s/�Wr 4 _has been constructed in accordance with the rovisions of 1 Title 5 and the for Disposal System Construction Permit No. dated Installer-�c O r, iC: Designer The issuance o s e t/shall not be construed as a guarantee that the system`�il+ nction desi d. Date �b Inspector No.. -------Feed THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi.5pozat*pztem Cow5tructton Permit Permission is hereby granted to Construct(Repair( )Upgrade( )Abandon( ) System located at Q0 -Sc"0 ac nn c. '— -SAr- t t f A(c and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this elm t. Date: /) Approved by U r.JZDye-f- t(— D 0,7 f � 25'-6" . 11-10" T-T' ' -8'A° .9'-11° - W-6" N io F . � S_L_.;- THIS WALL- - 7 1/1&"PLYWO BOTH w b e - SIDES-8d 4 12" o < FF - BATH -IYING q -v DECK 1 S.L. sari'=6r c (4)14DU 2 EA.SIDE 6'.6" 6'-6" V-0" - THIS WALL - 1/Ib"PLYWOOD .DECK - - - 25'-6° 2./,�. -FLOOR PLAN SCALE 1/411 _ 11-011' l ® TOWN OF BARNSTABLE LACATIONI;�4fGZ:19 :mil c6e:—1 tic Za✓ SEWAGE # 7e � VILLAGE ASSESSOR'S MAP 6i LOT - INSTALLER'S NAME & PHONE SEPTIC TANK CAPACITY LEACHING FACILITY:(type),,,)- f zv :fJfae� (size) �'6 X G NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUMbOORmOR OWNER .3 0 A✓ 4f c1A 7'1"4✓ J� DATE PERMIT ISSUED: 'c2 3 DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No r - A f. V.� l • " .: .-k 4� ' / � 4 ,�S s a� �; � ;" �.� �dC m3 r �I � y ra® ur �F+c -rd � � r �y: ;�dv� 3 -- . .� � .� j,. ��� f� +� No.._.�.... ._. r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..""".-%d'Al N...........OF..... ....................... Appliratiun for Disposal Works Tunitrn.rtiun Vrrmit Application is hereby made for a Permit to Construct (&,I or Repair ( ) an Individual Sewage Disposal System at: .S'c.vDDL� d Location--Address or Lot No. �M&I �.....G'v/2?l�✓ �T2 ---•-------•----•----•---••---•-•----•-•- ..........--...................................................................................... Owner Address W Instal ier Address d Type of Building Size Lot.....f......................Sq. feet Dwelling—No. of Bedrooms.....................'......_.._...._.....Expansion Attic ( ) Garbage Grinder ( } per, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ....................... . . W Design Flow................IS' ......................gallons per person per day. Total daily flow.............. .....................gallons. R; Septic Tank—Liquid capacity.l�!,ete..gallons Length..A.6_'F..... Width..'0�'6.'... Diameter................ Depth................ ��� Disposal Trench—No....... ._......_--- Width.._fE`........ Total Length.._../6...._.... Total leaching area---32o-------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by...... !? ?�^ .....4:.._! ........... Date:_M�... / l�'v r•---•.---•------- a Test Pit No. 1__4r__4.._.minutes per inch Depth of Test Pit.... Depth to.ground"water...................... Test Pit No. 2_.4%.6.._minutes per inch Depth of Test Pit... ....... Depth to ground water_--= .......___. •-•-•-•---•-•--•-----•----•-•-------•---••••-••-•---•-----•...............•----- . .................................................. i 0 Description of Soil------���=�' �......... ,0" rL"e Saic. 4-g'`�7 �G ........................................ 1.4 ------------------------------------------------•-•--------------------------------------------------------•-----------==---------------------------------------------------------------------------•-•- 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 i I i Imo, j of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has begn issued by the boaKd of health. C� at Application A roved e Date Application Disapproved for the following reasons: .......................•--••-•--•.............---------•-----------•---•--- ;. ..---•-•-•----------------------------------------------------------------------------------------------•-••••••-•........•------•-------•-•-----••-•---------......---_ ---------------------- Date Permit No.... . / _..._ Issued---•- ----------- IP10-........ Date No................-.....-- FEs.........-.._............ _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7T l.v.v ..........................................OF...... Appliration for Disposal Works Tonstrurtiun "amit Application is hereby made for a Permit to Construct (r/7- or Repair ( ) an Individual Sewage Disposal System at: d 'S L�� 8C"i'-s7AL3GG' .._...... __.- ............. ......................... :.._....... ...-•------.......------------.....---------------- ........-•• ..................... Location'-Address or Lot No. �' Cv�z?i�✓ �/2............................ ..........--.................................. -r............................................... W owner Address a ................... ............•.. Installer Address 6-��C q Q Type of Building Size Lot.....:...............--_._S . feet Dwelling—No. of Bedrooms...................Z'....................Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No. of persons............................ Showers YP g --------•-•----------------- P ( ) — Cafeteria ( ) Q Other fixtures .......................... W Design Flow....................................... per person per day. Total daily flow............. 'Z�'................__..gallons. WSeptic Tank—Liquid capacity_/?,'?�o.gallons Length...0_6..... Width...'r��G Diameter---------------- Depth...s. x Disposal Trench—No.......Z........... Width..... 6.......... Total Length...... 6_. ..... Total leaching area...._14 a......sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by...... !�??'�.... __..!��-ZG -•-•------ Date.._ ..: ,-7 r Test Pit No. 1---:�.A...minutes per inch Depth of Test Pit_... ' Depth to ground water.......-' '........... 44 Test Pit No. 2---�.Jb..minutes per inch Depth of Test Pit.... Depth to ground water..... ------ 0+ --------------••----•••-----•--•--•--•----------.....•----.......---......_.....-----......----------•-------•-•-•----•---•--•- D Description of Soil...--- "4`.............. -svl -.Solt. 48 —14-or" "&-V- ---------•--. ---•------------------------•---...----------- V -----!./��i... SUNG ............... W ------•-------------------------------------------------------•---------------------------.......------------•-----------------------------•-------._...--------------...---------....------------..... 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 TITLL 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 h� 57 40 Signed!/Lc- C_% `'... -= ......................"_...' to Application Approved By-----------• ------_..._ Date Application Disapproved for the following reasons:-•-----------------------------•----......--------------------------------•-•----...------------------••---•--- -------------------------------------------------....---•-•......--.....-•------•--------•--•------...-----•-•-------•-•--------....-------•------------..........------•....-------------------------- Date Permit No..... _...... f.- ---- Issued. - -. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD ,pOF HEALTH �lnl N.......O. ........L� -tiS� �GEF............................... Tatifiratr of Tuntphaurr THIS IS CE • IFS That the /_ ividua) ` age Disposal System constructed (L4 or Repaired by...................r.. ... ..: ......................... .:_. -----------------------------------------------------------------•-----...---.....------ p� Installer at__........ f.• s ! 's.rJl�,N.� ..�✓ - 0� .. ...- -�...................................................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary C... e as Oescribed in the application for Disposal Works Construction Permit No.... ...� , '. __. dated..... ......... ' ........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f'y -••--• �,�f� d!`�^..1..........O F............./�? . S� ... �. .............................. 6Gr No. --•---••----. FEE. ..................... Disposal n � onstrnrtilan rrntit Permission is hereby ranted ....�. �.......d _..1���l1 -..... .......................................................g to Constru�t�(Wor or epai ) Individual Sewage Disposal Sy atNo. - 1 �! R ►,.A..... ..................................... Street as shown on the application for Disposfal Works Construction PeLgak No._�!W 01 �_......1 .. . ated_...._ �_ . and of Health DATE.--=�I�=---------=�----•---=---•- ........................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r 5'-C' 3'-0' t - ____ ___ _ .Y 6 31i6' 'L� 1 3 1 IG. 2.6'+a-6' 2'-6'v 4'{' 2'-6'+q'-6' 2=e'•q'-6' 3'-6 2'V 5'-6' 5.,c. ;._o, LA NDRY .-s ar ro E'.Ic o.• . 0 LU - m PON'DE KITCHEN BATH ROOM c BED ROOM D "' _________ _______ HALL kp ANTRYN o b 3 112'D.5TL. - 3,-�, o c - '._______ CLO.� COL.-UP/DN a _ __FLUSH STEEL BE MS_____ _ z'-6 Ile SECOND FLOCR UP Cu - U FOYER HALL 4 3 1/2•D.5TL. - 8'-6°C.O_ COL.-UP/DN - a � N b - ___________ _______________________________ _________ _______ __.; . q,� -- ............_________ ___________. 'LIVING o ♦ - . 0 4X6 P05T� 4X6 P05T� - 9'.9' r-a�•r z6 '.Iv uz• DINING DEN/STUDY = - I 3-0 S _ C - "9? § a'-C 3/16' 2'-61lE' :'-61/E' 2'-6 I/9' 2=61 a-03/le 2=e IIL' Z'61/B' • - PORCH N PO RCH ORCH o I E•-v 9z-a zs-a' aP-0 FIRST FLOOR PLAN I/4°= V-D' CURTIN RE5IDENCE 120 5CUDDER5 LANE,5ARN5TADLENA. 5CALE A5 NOTED APPROVED DRAWN BY D.O. DATE o_Il.zoos REVISED 1lL5CIN DE51GN:5,5 1IT15 _ HOWARD WOOLLARD-BUILDER 28 5 ARN5TABIE ID.,HYANNIS.MA.o2rol SDe-7']5,30C ol5onde�wn net ' NUMBER xr FIR5T FLOOR PLAN DRAWING A-2 A - • �z•-b A • 115;16' 2'-6,1/B' I 2i I!E' 2'-6 I/C' 2'i I!E' 3�/z• 21.4 i' �'£' 4'-6' 2'-6'.4'6" 2'-6'.a'6' IIO�' '6',4'-c' POOP OVERHANG .I- D.ATH BAI I MASTER BATH W.I.C. ^' - ^ ------------------ --- _ BED ROOM#I4 - 6 SOLID WD.PO51 u N _ ` UN. 3'-In3:e' I'.p - n 3•. Z4'-I I OLD. < -----�--- --------{ - D I p3•0 I HALL c 4o z O _ < zi' O I y b LA O N MITER BED ROOM BALCONY p b BED ROOM 13 ELEV. I - - u N 14-Ip ie•-D ' BED ROOM#2 i w a n I I - I I a .9� 2:e'•a'.e 2'i' a'i' 2'.6'.9:6' YL'.a'i' 2'-6'.a' 2-f'. -6' 2'C.a'i' I I b I!2' I. .�l2 115.16' i�l/E' I 2'. IW 5-31!2 2=6' 3 I" PORCH ROOF I" SCREEN PORCH ROOF 1116' I'.3 1,16' I•:3 I/i'e' I'-3 I/16' I I. I 90.-0. 20'-p 5'-b SECOND FLOOR PLAN CURTIN RESIDENCE 120 5CUDEER5 LANE, 13ARN5TABLE.MA. 5CALE A5 NOTED I APPROVED DRAWN BY D.O. DATE OCT. 1 1,2005 REVISED OL50N DE51GN A55001TE5 HOWARD WOOLLARD-BUILDER. 25 BARN5TABlE RD,NVANN15•MA.02rOI 50e-775-4300 DISD�Mesw� , DRAWING NUMBER eruD SECOND FLOOR PLAN A-3 EL..27 TOP OF FJUNDATION \ — CONCRETE COVERS � ••� as„oow7„r 4"C4ST IRON 9 - "v 7, OR SCHEDULE 40 4"SCHEDULE 40 P_V.C. (ONLY) LEACHING TRENCH ( )RED. • 9. M I N . — .�\ P.V:C. PIP M1N, PIPE- MIN. D 1/e~- 1/2' WASHED STONE 36 MAX. � PITCH 1/4 PER.FT PITCH 1/4 PER J`T ` 2 zf/3 i•. iNVERL GAS BAFFLE-vj��44. 4 Ez.z EL...,, , . . SEPTIC TANK INVERT E INVERT ;c�,�' t�;t�;'o /b.ca;'�;� 24" — \ ,:. INVERT EL J/ ,o, �� 7 /Soo GAL.. INVERT GIST INVERT EZ _ EL. 90x EL- Pfecast 500 Gal.Leach 3/4"-11/2 6"CRUSHED STOIC Chamber WASHED STONE ovE-� C •i;i, r' � �o 'O NnwE EA/ColiaTE"�D ` 1 G � � \ `� �PG � 0� PROR LE Or C`EA�,:µ \ e 9���` ►�► \ _ !,:•.!I. GROUND WATER TA3LE \\ SOIL LOG SEWAGE DISPOSAL SYSTEM TYPICAL CROSS SECTION °iJa`� i NO SCALE LEACHING TRENCH .� � \ Q, 4w� � DATc .M�. :3 /9gp TIME . //,.po /aH, __ � \ ` •, TEST ROLE 1 TEST HOLE 2 Ce i'•r. ELEV. . :31, 0 .. . . ELEV. .?¢:4a. . . . DESIGN DATA : �- , _ , + 1" I INN NUMBER OF 9E�RCCA!$ - 9 N. W,SHFD 36 MAX eqn, SV aSo/L 1oAN .� - -, � `< cC,o Sid So,� -. o . . . - - 2" 2 \, ' \ \ eL.,\ / y TOTAL ESTIMATE) FLOW GALLONS/DAY = �_ 8 4' i-- g . Q d. / ��� CGgy BOTTOM LEACHING AREA . .�` �. �?. . 50.FT./�nENCH r p•,� .p ,� 4„ — `e„ _ 24 \ /�Fxc, ,• ie SlOE LEACHING AREA . . l:'�. ' `.- SQ.FT-/TRENCH 0' �; j� ) /'� Jv� � \ 7z 90 o w. GARBAGE DISPOSAL . . . . . . . . .(50 /o AREA INCREASE) s4wz) �✓ w/rw SANb TOTAL LEACHING AREA . 8� ''. . S0.•i. ( �� P�'L�' So••fE wig/ s _•�-_C s I �vET�9 \ \ �// 10a'1i o�°'�'� �o�•. \ \ �2 , •''_\� Fi e5 PERCOLATION RATE !�/w. . . . PER. INCH ��.. iz'/o" �'' 1 \ \ ,SvnE � i • G'N�s LEACHING AREA PER PERCOLATION RATE GRCUND V . e!2,/y,40 1EG. i2 APPROVED BOAPD OF HEALTH 32 \ �//� � •ii,, ^ \ �tiE��� � ��' \ J N0..WATER ENCOUNTERED DATE \ � / \ r rPh� ; I o° 5 y p WITNESSED BY : AGENT OR INSPEZ Toy � � ���'� BOARD OF HEALTH ( ENGINEER / o .) �, }I / •f tr 0 L ' `�` / / PE—iITIONER / r ��2.A/-ST/-I�jL� /�/oTC — ,q•v,/ uNSu/Tipi,�LE /`'/A:'�7Z//aL / 77-/L LC/aCN • �r; -- � --- __�. _� I /, \\ / ,��j• /� l C _ �:IJG ' I l2L=N .28' j av /4�5 Al wp4 PONp 6P� " ' 1 ��� daPt L o 1 I �I K1 IInQ n ^ ' Ile FISsEsso,Z-S /`1AP Z.S� \•� / 4.� � � ► I � Q�•P/�j �o'. cR� 7D t• \. / �, 4 v t I � I f'LFI N �i�12�/S T�9tSL� /`yflSs. �1. of A� / ��• `7 ` `� ate A HN ,.T. Cv�27i�/ .T2 R H el T x t• f _ i 627 �. / 1 J r� ST j� �1�/SCD a�7: ism Zoo S � AEDSPQ. s �A, el ILIA. 0246,-37 721 EY No. 26100 g EX�, Tin/G ��� o \� A4> TE- EGEV/.7 rl ni S /jib SE1� a/.1 4 �`CrSTER 3 2 ' - - z z L 2d.?4 �FCo.t. �erv.J p� TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS i r �-mr mmnmr \ \ CAST IRON 12"MAX. � 12"MAX OR SCHEDULE 40 4"SCHEDULE 40 PVC (ONLY) .� �- P.V.C. PIPE ' PIPE - MIN. ,., ,, PITCH I/4"PER.FT PITCH 1/4"PER.FT PRECAST •` C" o' �—INVERT . �<<•�, .". . . .�.1 INVERT INVERT : war F., k, t. T,, ° SEPTIC TANK EL. 'B 7� BOT• EL.�b,d% >_ \ o INVERT coo GAL . INVERT /a"'-a ;•: ,� N4.4v ' INVERT � ' wW :.. 3/4 TO II& .,t EL... EL ,7 S� o WAS o W STONE E \ \ PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE ""7` /9.'(' TIME . �/ oo �i> �L LAn�UE72s BOARD OF HEALTH TEST HOLE I TEST HOLE 2 -�L7Gvia,eo uy. ENGINEER ELEV. ELEV. 24,9c 134 CGAH i LOAM �. o V 1 � X V. DESIGN DATA . ? / \ 71 'jLR►-y NUMBER OF BEDROOMS � GAL LO N /D�AiYTOTAL ESTIMATED FLOW -22 BOTTOM LEACHING SQ.FT. /PI7AREA a � a Yv/ SIDE LEACHING AREA �'¢'O SQ F'T / PIT /ov'so A�fe- C• a. ` x , \ `�,,��.•� HrVES GARBAGE DISPOSAL .`_�E . (50 % AREA INCREASE) TOTAL LEACHING AREA ?Zo. SQ.FT iJ _ PERCOLATION RATE MIN/INCH 144 � � LEACHING AREA PER PERCOLATION RATE G SQ.FT T.fi.,% WATER ENCOUNTERED I NUMBER OF LEACHING PITS Ttrva FGc�a!- /Fv�eg �\?�\► ' t t 1 APPROVED . . . . . BOARD OF HEALTN Ii✓i7? jam` STD/✓Ex 0�4/ /�tG ' 1 .� � I � I I DATE j AGENT ;:R iNSPE(;TJR J Zle oe i N } v O `r / (� t I of w lit• / V} �;;;Sr�f � tN Nf Of o`er EDWARU o� KELLEY It""LL \ / No. 26100 , /1/0 7� � �zE 1//4.71G.�^/_S �L�r�"Z> O,N �-''E�'JtiJ �t.�l �E'✓� 0 �<'sf�ofC/STf�oS `7` *(�� / MAL lkN , t � I 'MNRAMta'�' .