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HomeMy WebLinkAbout0011 SPYGLASS HILL ROAD - Health 11 SPYGLASS HIL RD, BARN,S.TABLE A= 355-002. 001' I �I o 'I i Commonwealth of Massachusetts Title 5 Official Ins ection For Subsurface Sewage Disposal System Form Not for VoluntaryAssess me ments `M 11 Spyglass Hill Road Property Address Katie Crum b 2 . 5 p O Z dC� Owner Owner's Name information is a required for Cummagid H is MA -, every page. City/Town b 7 j 04/04/08 State Zi Code , P Date of Inspection p n Inspection results must be submitted on this form, Inspection forms may not be altered in any .wa y. important: A. �e1�When filling out eat Information forms on the computer, use 1. Inspector: only the tab key to move your cursor-do not Michael Kellett use the return• Name of Inspector key. Aardvark Environmental Inspections Company Name P.O. Box 896 Company Address East Dennis MA 02641 ream Cityrrown 508-385-7608 ' ' State Zip Code Telephone Number SI3742 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 perfgrmed 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 El I Fails ❑ Needs Further Evaluation by the11 Local Approving Authority Inspector's Signature Date r The system inspector shall submit a copy of this inspection report to-theApproving 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. t5insp-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•page 1 of 15 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Spyglass Hill Road Property Address Katie Crump Owner information is Owner's Name . required for Cummagid H is MA 04/04/08 every page. City/Town 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: 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. Comments: B) System Conditionally Passes:, . ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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 cseptic 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: , ❑ Qbservation of-sewage backup or break out or high static water level in the distribution box due to bro ken 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 t5insp•03/08, Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments wM 6 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name a, information is Cumma Id H is MA 04/04/08' required for q g ' every page. CityTTown State Zip Code Date of Inspection B. Certification (coot.) B) System Conditionally Passes (cont.): distribution box is leveled or replaced ND Explain: " ❑ The system required pumping more than times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): El - broken-pipe(s) are replaced ❑ obstruction is removed ND Explain: C} F?rther 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: ,5 ❑ 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 21 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. t5insp-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts s Title 5 Official inspection For Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments cM 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is Cumma id H is MA 04/04/08 ` required for q 9 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ T�a 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 gran 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 0 ® 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 El E 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: Ej ® 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. t5insp•03/08 Titles Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official, Inspection For Subsurface Sewage Disposal System Form -Not for Voluntary Assessments " 11 Spyglass Hill Road r Property Address Katie Crump Owner Owner's Name infrequired Cumma id H-is ' ;,_ MA`` , 04/04/08 . required for q g ,. every page. Cityfrown State Zip Code: Date of Inspection B. Certification (COnt.) - S st m Failure Criteria Applicable to AII.S stem , Yes No+ ❑, ® Any,portion of a cesspool or privy is within a Zone 1 of a pub licwrell. . El N Any portion of a cesspool or privy is wiithin 50 feet of'a private water supply well. �. Any:portion of a`cesspoolor privy,is Tess than•100 feet buf.greater`than 50 feet from a private watersupply,w.ell 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 no must be attached to this form.] El ® The system is a cesspool serving a,facility,with a design flow of,2000gpd 10,000gpd': t T The systern fails: I have determined"that one or more of the above failure .® criteria exist as described in 310 CMR 15.303,therefore the system fails1. The" -system owner should contact the Board of Health to determine what will be _ necessary to correct the failure: E) Largq,Systems:• To be considered a large system the system must serve a facility with a design flow of 10,000 9pd to 15;00O gpd,. a F. 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 El Elthe system is within 400#eet of a surface drinking water supply ❑ the system is.within 200 feet of a tributary to a surface drinking wate`r`supply the system is'locate'd in'a nitrogen sensitive area(interim Wellhead Protection Area-7 IWPA)11 or a mapped.Zone If of a.public water supply well If you have answered "yes'to any question in Section`E the system is considereda'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 threatunder Section or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system.owner should contact the appropriate ry regional office of the Department. t5insp 03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of MaasachusettS i Title 5 Official 1nspectio�6 Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is required for Cummagid.Hgts MA 04/04/08 every page. Cityrrown State Zip Code Date of Inspection Co Checklist Check if the following have been done. You must indicate yes or no as to each of the following Yes No 0 - ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ N Were any of the systern components pumped-out in the previous'two weeks? Has the system received normal flows in the previous two week period? 71 Have large`volumes of water been introduced-to the system recently or as part of Q this inspection? Were as built plans of the system obtained and examined? (if they were not available note as N/A),> 0 Was the facility or-dwelling Inspected for signs of sewage back up? ®` ❑ Was the site inspected for signs of break out? ` r. ® G► Were all system components, excluding the SAS,located on site? ® ❑' Were the Septic-tank,man holes 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 oc'cupahts.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 atissue ® approximation-of distance is unacceptable) [310 CMR 15M2(5)] t5insp•03108 { Title 5 Official Inspection Form:`Subsurface Sewage Disposal System-Page 6 of 15 . r Commonwealth of Massachusetts " Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 11 Spyglass Hill Road Property Address Katie Crump y Owner Owner's Name t information is '- required for Cummagid Hgts MA 04/04/08. every page. Cityrrown State Zip Code- Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 41 Number of bedrooms (actual) 4 DESIGN flow based on 310 CMR.15.203(for example: 110 gpd x#of bedrooms):, 440 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes Zl No w Is laundry on a separate sewage system? [if yes separate inspection.required] 0 Yes ❑ No Laundry system inspected? ❑ Yes ® :No Seasonal use? ❑ Yes ® No Water meter readings; if available (last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy:''- current Date Commercial/Industrial Flow Conditions; Type of Establishment: Design flow(based on 310 CMR 15`203): Gallons per day(gpo) 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: Last date of occupancy/use: Date Other(describe): t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 ' Commonwealth of Massachusetts t Title 5 Official 'Inspec i® For `a u O Subsurface Sewage Dis osal S sten Form-,Not fo Volunta ry Assessments - , h a n 11 Spyglass Hill Road t e t r. Property Address Katie Crump Owner' Owner's Name information is a required for Cummagid Hgts s ' Y MA W04/08, *+ every page. Cityrrown State Zip Code Date.of Inspection.-, D. System Information (cont-) General Information". Pumping Records Source of information: Was system pumped as part of the inspection? a{ { ❑'Yes ® No If yes, volume pumped gauons How was quantity pumped determined? Reason for pumping: " Type,of System: Septic tank,distribution box, soil absoeption system El Single cesspool ❑" - ' Overflow cesspool ❑ j Privy YI El 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 inspections of the I/Asystem by system operator under-contractY` Tight tank.-Attach a copy of the DEP,approval ❑ 'Other(describe) Approximate age of all components,date installed(if known)and source of information; 01/26/96per BOH: 4 s e Were sewage odors detected when arriving at the site? ❑ Yes Z No t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 8 of 15 Commonwealth of Massachusetts . Title 5 Official Inspection Form. , Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is Cumma id H required for q gts MA • . 04/04/08 ' every page. Citylrown State Zip Code Date of Inspection D. System Information (cunt.) Building Sewer(locate on site plan): Depth below grade: 2.2 feet Material of construction: _ ❑ cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting,,evidence of leakage, etc.): Septic Tank(locate on site plan): . Depth below grade: 1.9 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 1250 gallons, , Dimensions: � , , Sludge depth: 2 Distance from'top of sludge to bottom of outlet tee or baffle 29' Scum thickness 2 Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? measured t5insp-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 r r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is Cumma id H is MA 04/04/08 required for q g every page. City/Town State Zip Code Date of Inspection D. System Information.(cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was sound and tight with tees in place and liquid at outlet invert. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain). Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete El metal El fiberglass ❑ polyethylene ❑ other{explain): t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusett6 , Title 5 Offieial Lrisectin 4 ®r Subsurface Sewage Disposal System Form,-Not for Voluntary Assessments 11 Spyglass Hill.Road Property Address Katie Crump ' Owner Owner's Name _ } information is Cumma Id H tS required for g MA • 04l04/08 every page. Cityrrown State Zip Code' Date of Inspection D. System Inforrnatioh {coat:} `` r Tight or Holding Tank(cont.) Nk Dimensions Capacity: . 'gallons . Design Flow:- on"- ., ga As per day F Alarm present: El,Yes? ❑ No.. Alarm level: Alarm to working order: ❑. Yes <No Date of last pumping. Date Comments(condition of alarm and float switches,etc.) 9 "Attach copy of current pumping contract'(required).)s copy attached ❑ Yes ❑ No <.; Distribution Box(if present must be opened)'(locate on site plan): Depth of liquid level above outlet invert even Comments (note if box is.level.and distribution,to outlets equal,.any evidence of solids carryover; any evidence of leakage into or out of box, etc.):, the box was level and tight with no si n of car over Pump Chamber`(locate on,site plan)` Pumps in working order: _ [; 'Yes. FT.No . s Alarms in working order: ❑ Yes- ❑ No t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official '-Inspection Form Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments ,M 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is Cumma ld H is required for q g MA 04/04/08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont:) 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: Type: ® leaching pits number: 2 ❑ Ieaching 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.): this system has two 6x6 precast surrounded by a foot of stone. There was about three feet of liquid in each. - t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is Cumma id H is MA` 04/04/08 ' required for q 9 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet.inverf Depth of solids layer Depth of scum layer x Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level ofponding, 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.): t5insp•03/08 Title 5 Official.Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is Cumma id H is MA 04/04/08 required for q 9 every page. City/Town State Zip Code •Date of Inspection D. Information System o mation (cost. 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. 3 - t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 15 Commonwealth of Massachusetts' Title 5 Official Inspection' f=o M Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Spyglass Hill Road Property Address Katie Crump Owner Owner's Name information is required for Cummagid Hgts MA- 04/04/08 every page. Cityrrown State yZip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to'high ground water: . 30 feet Please indicate,all methods used to determine the high groundwater elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: Checked with local excavators, installers- attach documentation ® Accessed~USGS database-explain: You must describe how you established the high ground water elevation: USGS maps show an elevation of over thirty feet. t5insp-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15'of 15 Zbo `T TROY WILLIAMS SEPTIC INSPECTIONS Certified by MA Department of Environmental Protection (508) 385-1300 19 Hummel Drive South Dennis, MA 02660 LJ COMMONWEALTH OF NIASSACHUSETTS 0 ej R _ - EXECUTIVE OFFICE OF ENVIRONMENT - FAIRS DEPARTMENT OF ENVIRONMENTAL P° 1 CT104 ONE WINTER STREET, BOSTON MA 02108 (617) 500o CQ -' 0r 1 . 1999 , to rftae TRUDY COXE �1 �TlF Secretary ARGEO PAUL CELLUCCI S DAVID B. STRUHS Governor r - Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � � �y� PART A /f n CERTIFICATION Property Address: I) Spy G1as f 14; 11 "� Name of Owner Cc�,• C v 0— Y"• J Address of Owner: /nl ,Sow G I a S 3 /� Date of Inspection: 9/3-3 1?9 t W k.,,,,N�u:� � �u. O.Z 6 � Name of Inspector:(Please Print) Troy Williams I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: Troy Williams Septic Inspections I Mailing Address: 19 Hummel Drive, So. Dennis, MA 02660 Telephone Number: (508) 385-1300 CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-sites sewage disposal systems. The system: V Passes Conditionally Passes Needs Further Evaluation By the Local,Approving Authority _ Fails kspectot s Signature:� !N�c� Y Date: 9 3 u The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable, and the approving authority. ; NOTES AND COMMENTS Although system meets the minimum requirements set forth by the Massachusetts Department of Environmental Protection,certification is not to be construed as a guarantee of future working condition of system,piping or components. This inspection represents the conditions of the system on the Date of Inspection noted above. i fr t y , revised 9/2/9`8 � r r + SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (coertirx e ) Property Address: Owner: 11 Spy Glass Hill Road, Cummaquid,MA Date of kupec6,,,: Carmel Grier September 30, 1999 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: �. � 1 have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure ,t criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: N//7 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. Indicate yes,no,or not determined(Y,N, or ND). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal, unless the owner or operator has rovided the system in P y Spector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 } x' revised 9/2/98 Page 2of11 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM y PART A CERTIFICATION (continued) Property Address: 11 Spy Glass Hill Road,Cummaquid,MA Owner: Carmel Grier Date of Inspection: September 30, 1999 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: I✓/i9 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WTTH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE ENVIRONMENT: — The system has a septic tank and soil absorption system(SAS) and the SAS is within 1.00 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 . Page 3of II h SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 11 Spy Glass Hill Road, Cummaquid,MA Property Address: Carmel Grier Owner: September 30, 1999 , Date of Inspection: D. SYSTEM FAILS: NM You must indicate either 'Yes" or "No' to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No _ _ Backup of sewage into facility or system component due to an 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. y . 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 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater'elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: ` 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: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 11 of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. 4- revised 9/2/98 Page 4ofII 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B ' CHECKLIST Property Address: 11 Spy Glass Hill Road,Cummaquid,MA ^£ owner: Carmel Grier Date of 19ection: September 30, 1999 4 r Check if the following have been done: You must indicate either "Yes" or "No' as to each of the following: Yes No No Pumping information was provided by the owner, occupant, or Board of Health. — None of the system components have been pumped-forat least two weeks and-the system has teen-receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this / inspection. V _ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. V _ The site was inspected for signs of breakout. All system components, excluding the Soil Absorption System, have been located on the site. y _ The septic tank manholes were uncovered,opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions,depth of liquid,depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the site has been determined based on: _ Existing information. For example, Plan at B.O.H. i. JC _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable! 115.302(3)(b)1 The facility owner(and occupants,if different from owner) were.provided with information on tha.propermaintenance.,of .. SubSurface Disposal Systems. r 1. revised 9/2/98 Page 5ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: owner: I I Spy Glass Hill Road,Cummaquid,MA Date of Inspection: Carmel Grier September 30, 1999 FLOW CONDITIONSf RESIDENTIAL: Design flow: /(d g•p•d./bedroom. , k Number of bedrooms(design): Number of bedrooms (actual): �f Total DESIGN flow I/p — Number of current residents: Garbage grinder(yes or no): Aid P'r6wN Laundry(separate system) (yes or no):Mo; If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use(yes or no):-�/p Water meter readings,if available(last two year's usage(gpd): 4114 Sump Pump(yes or no): NO Lest date of occupancy: Q c wr,:`& COMMERCIAL/INDUSTRIAL: NIA Type of establishment: Design flow:_- gpd ( Based on 15.203) Basis of design flow 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: OTHER:(Describe) Last date of occupancy: r GENERAL INFORMATION PUMPING RECORDS and source of information: 1196 Qc Syster{t pumped as part of inspection:(yes or no)_6 If yes,volume pumped: gallons Reason for pumping: TYPE F 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) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components,date installed Ff known) and source of information: s 4z.L�Gr GS � ��• ��. - /JS`e�waW odors detected when arriving at the site: (yes or no) /✓d " revised 9/2/98 Page 6of II f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: I 1 Spy Glass Hill Road, Cummaquid,MA Dace of Inspection: Carmel Grier BUILDING SEWER: September 30, 1999 _ (Locate on site plan) Depth below grade:-L(?2' Material of construction:—cast iron y/40 PVC_other(explain) Distance from private water supply well or suction line S /a Diameter y„ Comments:(condition of joint , venting, evidence of leakage,etc.) // . �;.c o I,sii e o i+s ov. 7U Vs - 11 � SEPTIC ANK / v' (locate on site plan) 1 Depth below grade: Material of construction:Zoncrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age Is.age confirmed by Certificate of Compliance_(Yes/No) Dimensions:_ Sludge depth: Distance from top sludge to bottom of outlet tee or baffle: Scum thickness:�/f..'.,, iro�yc✓ 4O ,roves. r Distance from top of scum to top of outlet tee or baffle: 6 Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: Comments: (recommendation for pumping,conditi n of inlet and outlet as or baffles,depth of liquid level in relation to outlet invert,structur"te rity, evidence of leakage,etc.) L c t 5 w v_.-A „� o L Al- s h c� O e v H �- w L w 4 L GREASE TRAP. (locate on site plan) 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: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert; structural integrity, evidence of leakage,etc.) i revised 9/2/98 Page 7ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued} Property Address: ) Owner: 11 Spy Glass Hill Road, Cummaquid,MA Date of Inspection: Cannel Grier September 30, 1999 TIGHT OR HOLDING TANK: A(Tank must be pumped prior to,or at time of,.inspection) (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass_Polyethylene other(explain) Dimensions: Capacity: gallons Design flow: gallons/day f. Alarm present Alarm level: Alarm in working order:Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX- ( locate on site plan) Depth of liquid level above outlet invert: GJ Comments: (no -if level end distribution is equal,evidence of solids carryover, evidence of leakage into or out of box,etc.) .� ��. w n✓ i vx .! y PUMP CHAMBER:_A/ i/ (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,etc.) ------------ revised 9/2/98 r. P-Age 8or11 a , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: 11 Spy Glass Hill Road, Cummaquid,MA Date of Inspection: Carmel Grier September 30, 1909 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible; excavation not required, location may be approximated by non-intrusive methods) If not located,explain: Type: r leaching pits, number:' X L c o,c (1 p. �' S t 2 r 5 To h L leaching chambers,number:_ i leaching galleries,number._ leaching trenches,number,length: leaching fields, number, dimensions: overflow cesspool,number:_ Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic f ilure,level of ponding, dampspil,condition of vegetation, etc.) a a— i mot c o r CA.,j l " C. 1JYc ar ro le- CESSPOOLS: (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(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRMY:��fl (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.) revised 9/2/98 v' Page 9ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) x `• Property Address: ; Owner: I 1 Spy Glass Hilt Road,Cummaquid,MA Date of Inspection: Carmel Grier September 30, 1999 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) - CjCr✓r�.L, l .- , �-V ti b s� revised 9/2 98¢. / P-Age 10 or 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(omtimi Property Address: Owner: 11 Spy Glass Hill Road,Cummaquid,NM Date of Inspection: Carmel Grier September 30, 1999 NRCS Report name Soil Type_ - Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar r Shallow wells Estimated Depth to Groundwater�04.et Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record L/Observed Site iAbutting property,observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators,installers Used USGS Data Describe how you established the High Groundwater Elevation. I(Must be completed) &A / Or y. c.i.-1 << 7 `�► /c S Yc c o r t�c V�, `o��.//�. S h ('lo WA7 �f ��JNd 0.nJ �GGc.c r1Q C/ 'S 4 A �o✓t- Of�y � G�rd�a.�. t���<✓ �( �✓w�Oh, t�j+-a/v...A ww�-�v H,c�/os •►/ 5 ��L.`► //W w )<"L✓ �Go J`j 0..'� c.�,oro Yo J.. p2,.Q t'i. �O 7 1�'µ+ V � �(�'`/�L'S T s 0L e_A was h� �J � � ,� � A revised 9/2/98 Page 11 or 11 TOWN OF BARNST�A/BLE LOCATION {" l S / ��l SEWAGE # 5 VILLAGE Cu .a v y ASSESSOR'S MAP&LOT SEE r a-I INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACTTY LEACHING FACILITY: (type) AtI(size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: ! I Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility /J 6`�",- Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) /U,-//t/ Fee* Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �tJviy Feet Furnished by `2t ' 1 Pr r� IV _ C> �� ASSESSORS MAP N0: J No..... � Prn� . ... -__..w. va Fss...Yv ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Xppliration for Bi-npuuttl Oorks Tomitrurtiun ramit Application is hereby made for a Permit to Construct ( or Repair ( an Individual wage Disposal System at: / �J. Location•i\ddress ----•••-----•--.................................................................................. or•Lot No: ...................... _._a!�-Y!' r�.- —........- � -fl i ._ .....----................................ Jl caner Address W1 A a f............. .....••-•------------•----•------ Installer Address Type of Building Size Lot.. I�_ .Y'-Sq. feet Dwelling— No. of Bedrooms--- ------------- Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ._._ W Design Flow.................... per person er day. Total daily fiow._---_.---_..-��.�----___-__•--gallons. W Septic Tank—Liquid ca acity/.Z- � �© "p q p S.___gallons Length_ ..A....__._. Width..__S____._ Diameter________________ Depth..... .... 416 x Disposal Trench—No- -------------------- Width-------------------- Total Length.................... Total leaching area.. _.........sq. ft. J Seepage Pit No...�............. Diameter.-.�.__...__...-_ Depth below inlet.._....4l.._..._ Total leaching area..�t?_�.sq. ft. Z Other Distribution box ( ) Dosingk ( )n g Percolation Test Results_ Performed by.... _.. .�.L..��._ ---- --- �%'.f��ate._..1.✓��� .___ __..-. Test Pit No. I--- minutes per inch Depth of Test Pit___ .. ........... Depth to ground water_____ ____.. 44 Test Pit No. 2....l..... _minutes per inch Depth of Test Pit__,/--, .......... Depth to ground water...../VO-4 ._._. -- • ' ------- -------- -•- - y �- -ni O Descrtptto f Soi �--,Q- /--- &.1i/n ..--1a-9 - 6. ab-.--ti=��C ----7-=r _ •✓ S��sc�i® W ........................= '`� nl��_.......-----------------....------......--------------------------------------------------•----------•------------...-•----...---- U Nature'of Repairs or Alterations—Answer when applicable._.-_._---------------------------------------------------•-.-_-.---_----_--------•----•-__---_. : : Agreement: r` The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia ce has b en issued b boar f health. Sl fled .. :. ... .....- - _:.... -------�/Dace . Application Approved By ....................... .. ........... ... . .... `3h ......e ..... -� ... _. �..... �-------------------------------- Dare .. l Application Disapproved for the following reafons: .. ..................... .... ...... .... ... ... ...... -- ......................... j ------------------------------------.................... ...........................................................................................:..............................................................................Dace...... .. Permit No. ......... .`.- ---------------- Issued ........... ...... ...... S'----oa-e . .�+ NA..._._.................. ...' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirtttilall for Di-nVa!3al lVorlai Toutilrnr#lim ranfit - �` Application is hereby made for a Permit to Construct (X� or Repair ( ) an Individua/l ewage Disposal System at: - ........ ....!r7. ..--•-••...... 2G ass .... >� 2........... Location•Address or Lot No. l > caner nf� / Address W •--••----- -�'`'- ---._ �...-. +.:�=y"`=-,A J ----••-- ------------------- Address ---•-. 11 r v Installer � S� Type of Building � Size Lot._ -_____________7_,! q. feet Dwelling—No. of Bedrooms________________-----------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria Other fixtures ------------------------------------------------------ W Design Flow....................�- ---------------gallons per person er day. Total daily flow.............. _ ..._.___-_-_--gallons. WSeptic Tank—Liquid capacity/_Z; gallons Length,JP-------- Width-----S...... Diameter_.............. Depth....S_ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.................... ft. Seepage Pit No---?................ Diameter---0............. Depth below inlet..__........... Total leaching area.. . :..sq. ft. Z Other Distribution box ( ) Dosingtank ( ) aPercolation Test ResultsL Performed by---- 't(� �.C._<1 _. ! �1. Date............................... ....... 1 Test Pit No. 1--- minutes per inch Depth of Test Pit---�` ....... Depth to ground water..... f= Test Pit No. 2....� ..minutes per inch Depth of Test Pit---l.L_!___•_-- Depth to ground water-----/!/ --_--. �+ ------------------------------•--.-------------------------•----------------................._•••••••----•••--••--_-----•••-••---•-..._............_....... D Description-of Soil•�-�.0.::J....r e�en.--- ` -• ✓ 5 _cap �= 1....................................St` /{_ ✓yi d�i_�� W ---------•-------------------- f- ------------ -��' -----------------------...-----...--------------------...--------.....----•------------------------- UNature of Repairs or Alterations—Answer when applicable.... ........................................................................................... ----------------•-------------------------------------------•--------•-----......_..................------------......---------------------------------------....--------------........................ Agreement: The unde"rsigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with- the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compiia ce hseen issued board health.b .. a^ ------ ----- 't+ S ed < ...... / ` ---.... 1e ...APPlication Approved BY -------- ....M... r' ........... . - f - ..... v Dace Application Disapproved for the following reasons: ........................... -- ...........---------------------------------------------------------------------------------- ........................................................................................................................................................-- ----------------............---------------------- ........................................ Permit No- ------------ --=_' 611. Issued ........... - ..�:::.1.�.../.... 1---.....---.......... . Dare 'f THE COMMONWEALTH OF MASSACHUSETTS t` - BOARD OF HEALTH - TOWN OF BARNSTABLE (IlE>Ctifirate of (110mytianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (,.k' ) or Repaired ( ) b ----------------------......._--------------....---------------------------------------......------------------------------- --------_----...._------------------------ ------- ....-------------..--------------..... Y l / � ` at ........ .}.......�.. ... S .. .5�..../ �! ��swile. �. Lt - -... -- has been installed in accordannce with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _9 7_.(Q...15-1-.....__..._ dated __ �_-�.41_-'..2S----- THE ISSUAN9E OF THIS CERTIFICATE'SHALL NOT BE CONSTRUED STRUED AS A GUARANT E THAT THE SYSTEM WILL FUNCT OIL S TISFACTORY. 1 C 1 DATE................... ------ ---------------------_.....------ Inspector ;/a'.L _.�i. .. TV---------.;. .. 1 .�f-V ------------------------------------- ------------ ---- ----------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH S- TOWN OF BARNSTABLE Sr FEE OlJ Ewpo.ottl Workii Tomitrudion "crini# Permissionis hereby granted---------------------------------------------------------------------------------•----------------------------------•-------------•----.----- to Construct ()d or Repair ( ) an Individual/Sewage Di posal S,y-stem r at No _ �-fi �� / /' - .S!'' f.!!=�'-�------------------------------------------------------------------------------ at No .c..� a �... - -� ,as shown on the a licati•,n for Di 'osal Works Construction Per, t N�._�� Dated __ ..!.X_f�. ' st.bet i _ 114 6' r Y Boar of He- DATE----=---•---------.. ...-•----•---•-•--•.-•---- FORM 36508 HOBHS k WARREN.INC..PUBLISHERS f TEST .MOLE LOGS t--- � LOCATION MAP (NOT TO-SCAL�� ENGI)IEER: C,4A'CaL VOCIA 6- �° 7310 wInvesS: ,/E,+x,e,r CNN��i� �/3e.H BUILDING ZONE: _ DATE. 1 I PERC. RA TE: „G 2 M1Nd1cw 1 SETBACKS: I � FRONT =SIDE 3O � REAR i ASSESSORS MAP 3SSS PARCEL CL FLOOD ZONE -.....,�� -73.0 os"` 7Z• �'G.4n/ . 'L f',' �3,c -¢G y c NOTES 1; 1. DATUM NGVD TARN FROM 'z': �_ - ✓"� , ' I t. MUNICIPAL WATER IS '4✓.411�fk- - 3. PIPE PITCH TO BE t\4"/ft UNLESS OTHERWISE NOTED. _ ! 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO-H-/e. y ,► �--� �,, ' ': � ., : 5. PIPE JOINTS TO BE YADF WATERTIGHT. f o j. r \ ` ~I \ �✓Cr u� ' . CONSTRUCTION.,� ,. � � , ,,�. _--- �/� �/� /.�r�rQ,,cCONSTRUCTION1�f,TA11S TG BE IN ACCORDANCE MASS. 1,- , , i S,4 '1 C FI�',E FOR LOT LINE STA"NG. G r 74 A. 100,' 8. SCH 40-4" PVC TO BE USED THROUGHOUT SEPTIC SYSTEM. ,S' '(NOT TO SCALE) V �' O.G 4 cry> \ ` ! :.�,� �`T \ ' } &P��C� 'e✓�E''J T'e O �S X /< 1 1VIYUY I OF CO►?R Of?R PRICIST X � '- � x r l oo -TT� 69 OD " 00 0( DEPTH OF 1a'LOW= •� Gd.7 �" TEE SIZE'S: r + INLET DEPTH = /� , ZJfINC CR USHEDOUTLETDEPTH = /� E UNDER �C-1/ I D' BOX Af FOi PIDAVON SEPTIC TANX' - - (D D' BOX IA CILII TTY FACILY -SEPTIC T ESI �r'� �►•s sc�c.._ .•�c,�Q►�c� DESIGN FLOW. -ni-( BPAMS 0 GPDIBR = � GPD SITE AND SE 1%VA GE PLAN= - -- - - - t :#y: SEPTIC TANK. : � '&D X (�S) = �'� GALrONS d ZJn Ca�0e engineering, inc. /'� USE .+ !Z IN THE TOXY OF: _ GALLON TANK LE4 CHING: I�16241,1')) �g�tk'�/S'r'-4,HL.� CIVIL ENGINEERS SIDES. ___ �'' , . _ / ' (y� _ A LAND SURVEYORS BOTTO.W.. - y 2 _._ _ (�a> = _ ?` PREPARED FOR: TOTAL: .ice/X'it+.l Z'�f #lz+iz.X2.• l,►."� R to 6a, YARMO UTH, MA USE: (L i I..-L.-' ,t 1 %Y AT. -- -- - BOA" OP BRUM e� A SCALE: ! DATE: -r ;'o /v�� JfA DATE APPROVED DArS