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HomeMy WebLinkAbout0079 STONEY POINT ROAD - Health 79 STONEY POINT RD. ' BARNSTABLE A = 336 091 Fl, I 11� a fi n o e Commonwealth of Massachusetts 3310 oqt . Title 5 Official Inspection Form ; Subsurface Sewage Disposal System Form-Not for Voluntary Assessmentsco ' 79 Stoney Point Rd Map 336 Parcel 91 "'•' Property Address George& Eleanor McMahon r- Owner Owner's Name information is Barnstable �` required for every ✓ MA 02631 01/26/2019 00 page. City/Town State Zip Code Date of Inspection r�°I Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out fortes A. Inspector Information - on the computer, use only the tab Mathieu Rebello key to move your Name of Inspector cursor-do not Rebello Septic Inspections use the return Company Name key. 30 Norse Rd Company Address South Dennis MA 02660 Cityfrown State Zip Code ,ow 774-722-0271 SI-14140 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 16.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 01/26/19 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer„if applicable, and the approving authority. Please note: 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.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George & Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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): t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts uh Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George &Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George& Eleanor McMahon Owner Owner's Name information is Barnstable MA 02631 01/26/2019 required for every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cost.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes . No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ElDischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts 1 Title 5 Official Inspection Form M1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George&Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary (cost.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than,50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) 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 CA. Yes No the system is within 400 feet of a surface drinking water supply ❑ ❑ PP Y � Y ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George&Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(if they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 ' Property Address George&Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 Description: 1500 gallon septic tank, distribution box, 3 flow diffusors Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage 152 gpd 9 ( Y 9 (gpd)): Detail: 2018-60,000 gallons 2017-51,000 gallons Sump pump? ❑ Yes ® No Last date of occupancy: current Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c Commonwealth of Massachusetts iM Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 1 79 Stoney Point Rd Map 336 Parcel 91 Property Address George & Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Cityfrown State Zip Code Date of Inspection D. System Information (coat.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: 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 below): 4 3. Pumping Records: Source of information: pumped 6 months ago per owner Was system pumped as part of the inspection? ❑ Yes ® No ' If yes, volume pumped: gallons How;was quantity,pumped determined? Reason for pumping: t5insp.doc-rev.M62018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �.UIP. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George&Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: installed 01/2000 per BOH Were sewage odors detected when arriving at the site? Y g g ❑ es ® No 5. Building Sewer(locate on site plan): ' Depth below grade: 1 feet Material of construction: ❑ cast iron ®40 PVC ❑other(explain): >10'+ Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): joints tight,proper venting, no evidence of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address r George& Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 611. feet Material of construction: ® concrete ❑ metal .❑fiberglass ❑ polyethylene ❑other(explain) H-10 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500g tank Sludge depth: 0-111 Distance from top of sludge to bottom of outlet tee or baffle 30" Scum thickness . 0° Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? tape measure and stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): recommened pumping at least once every 3 years.Tee's in place working properly. No evidence of leaking from tank. Liquid levels are at proper operating levels at 48"at outlet invert. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Farm.Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George& Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: N/A 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.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: i Ca act p y gallons Design Flow: gallons per day - t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 79 Stoney Point Rd Map 336 Parcel 91 Property Address George& Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): �I "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. 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.): box is level-1 inlet, 3 outlets. No evidence of soild carryover or high stains. D69 Box is strucurally sound, has speed levelers. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George& Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): N/A *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 3-12x35x2 ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts UTitle 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George& Eleanor McMahon Owner Owner's Name information is Barnstable MA 02631 01/26/2019 required for every page. Cityrrown State Zip Code Date of inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): soil and stone dry and clean. Sidewalls inspected with.no signs of hyrdaulic failure or unusual vegetation. 0"of ponding found at bottom of SAS 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George& Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: N/A Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 f OP cc * V U k 3 TOWN OF BA.RNSTABLE fv O L '�C ATION 's I_11k1,V l-7' ,/ SEWAGE #;?eeff VILLAG Z;YCZ—� ASSESSOR'S MAP & 1,017904"d?/ SDB INSTALLER'S NAME&PHONE NO. - ' SEPTIC TANK CAPACITY /ZX3S—x z LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: ��' `'` � �f�COMPLIANCE DATE:. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 'Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within-210 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist , within 300 feet of le g�facilily�) Feet Furnished bynI i� /��,T Al- "D- a -D.i 23 D r 31 Fron4 `1 prise�►�,y , #. . ` a4 _ Commonwealth of Massachusetts � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 19c;0 1� Property Address George&Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page, City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 it i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 f Commonwealth of Massachusetts : r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 79 Stoney Point Rd Map 336 Parcel 91 Property Address George& Eleanor McMahon Owner Owner's Name information is Barnstable MA 02631 01/26/2019 required for every - page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 8. feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 08/28/1998 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: file ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: per design test hole 06/30/1998 groundwater encountered at 8.5' EL=96.0.Bottom SAS EL=91.5 Well AIW247 .3 adjust Seperation Math(96+.3=96.3-91.5= 5.1 to bottom SAS to adjusted water. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,Pr 79 Stoney Point Rd Map 336 Parcel 91 Property Address George&Eleanor McMahon Owner Owner's Name information is required for every Barnstable MA 02631 01/26/2019 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 18 of 18 ` - - TOWN OF BARNSTABLE _ -�/ LOCATION Zf SEWAGE # �� S i .� VILLAGE ASSESSOR'S MAP & LOT9.'9�v" f INSTALLER'S NAME&PHONE NO. �g3 SEPTIC TANK CAPACITYf/%/ S LEACHING FACILITY. (type) /2X3S'-.r p (size)- NO. OF BEDROOMS BUILDER OR OWNER �i]fr�� /o, at/OyC /TC�fjjybi(� PERMrrDATE: COMPLIANCE DATE: 0 7.1 Separation 15�stance Between the'.. Maximum Adjusted Groundwater:Tab16to the Bottom of Leaching Facility' Feet Private Water Supply Well and.LeachingFacility ty (If any wells eztst on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist . within 300 feet of IeAdiiog facility) Feet Furnished by - - t1-3 z L2 3- J 5 E 2 . �C V 3 TOWN OF BARNSTABLE 10/�a/05 I.°�I"A'flON Z� SEWAGE #.OW 5e VILLAGE i4iP/�I� C�+ ASSESSOR'S MAP & LOT ' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS f BUILDER OR OWNERL/�r?,SE /.ri� it PERMITDATE: COMPLIANCE DATE:. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist I on site or within 2I0 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of,leachi g facility)� � • Feet Furnished by Iry 33 1-4F-F 31 r- 6 '4 L <3�. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(ppYfcation for W5po.5al *pgtem Construction Permit Application for a Permit to nstruct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot N . I Owner's Name,Address and Tel.No. L0T*3 1%�>j pari.ir f.i). ¢ 01'MtA-i 0A- Assessor'sMap/Prarrcel Cur►�t>1 A3,\J1t6 C�� r (00 'ssNar ,,Address and Tel.No 150 Designer's Name,Address and Tel.No.;;er �"\ Z4j6-A16tq-ULT Z-S- -i f D(a ) �10 29S Po w qo .4enri 4 Type of Building: -t, Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( M Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow � gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank n Type of S.A.S. Description of Soil K. 1' d14>✓1L�1� �L' l Nature of Repairs or Alterations(Answer when applicable) Date last inspected: r 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 J)tNWat. Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued z '"' ��� r /� r r Fee �rpr THE C lmmt6b'WEALTH OF MASSACHUSETTS Entered in computer: �s 'PUBLIC HEALTH DIVISION - TOWN bF BARNSTABLES MASSACHUSETTS P, 01pprication for Mi5pogar *pMem-Construction Permit Application.for a Permit to Cons ct( )Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot N . Owner's Name,Address and Tel.No. OT Assessor's Ma � l el G'vrwM aV 11_� e's N Address and Tel ANo. Designer's Name,Address and Tel.No. --Ir'� ^� �f`�'i � G "Tl3-/�►�J+4 -R��J�IV 1r(�IJt.T �2-S• :. r_ N VA 6 Zb 1 sD ra ) -90- zT @ f� Po eou 4o t;_4enrf ►�►�- 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 44440 gallons per day. Calculated daily,flow. gallons. Plan Date jNumber of sheets 1 Revision Date7.7 F Title �� #` N Size of Septic TankType of S.A.S. Description of Soil 1Z0 ff-CL_ `.,TD 0-T7-r+CHf►l . Nature of Repairs or Alterations(Answer when applicable) E � Dare last inspected: r � Agreement: I The undersigned agrees to ensure the construction and maintenance of tl!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 ftof Ta r ,. ..,..,._ Signed Date Application Approved by Date Application Disapproved for the following reasons --Pe t No.— --------- w.;.. rmi ��'�'`� Date Issued————— '- — _THE COMMONWEALTH OF MASSACHUSETTS B#RNSTABLE, MASSACHUSETTS :e Certificate_of Compliance i 3 THIS IS T,O ZY that e On- ' e k a e !orl System Constructed(�)Repaired( )Upgraded( ) r ) Abandoned(' )by (U r , at, '_/ r has been constructed in accordance with the rov' ,i9nrso�Titl 5 vloifepsa ste CPnstruction Permit '" � � datedInstallerp F'"V"1 N( Designer The issu ce of this peritm shall not be construed as a guarantee that the s ill function as dys�g-ned. Date "� `. �1 <3Z Inspector Y No.Zeloo `�'� Fee THE COMIIA¢ONWEALTH OF MASSACHUSETTS E PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mi5po5af *pgtem Conotruction Permit _ Permission is hereby granted to Construct Repair( ad;,, )Abandon ) System located at 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:Cons cti must be completed within three years of the date of this permit. fro Date: Approve ..y' �., q-) n � pF IHE Tp� DATE: A FEE: * EIMMSrABLE. + �$ 6119. 't Town of Barnstable REC. BY 4F \� a� 166F® Board of Health 78 367 Main Street, Hyannis MA 02601 6 1998 rayv, Office. p508-790-626�5gFBgqNSrq Susan G.Rask,R.S. FAX: 508.790-6304(TpOEPZ B� Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. 8 L VARIANCE REQUEST FORM LOCATION Property Address: L o+ S+c)o e\, PUt y)+ Rk CA rt(y- Assessor's Map and Parcel Number: Cal— Size of Lot: Wetlands Within 300 Ft. Yes Subdivision Name: J No Business Name: APPLICANT CONTACT PERSON Name: P.1eGtnRy -k qE ",e e (y'tct mr, Name: g��@ far Nli. Mt-i.k-mA. Address: amMain �+ Y(ad`M)i , &Address: [n. �1ij SC) •yq.,I-ry)oq� Phone: Phone: �oF 3qg 666q [� S-6F 11( 79C� FAX: 5()0, i-3 S n q j FAX: I S ,1 j q F?! VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) See r'L�41 %fn.e —, tJT �s2t31-I y 17e�.1'I/Y�ci' fJ�Rt,:F_ 1 Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans) Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variances only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ �y *THE To�o TOWN OF BARNSTABLE m OFFICE OF BARISTAEL BOARD OF HEALTH HAS& o MpY 367 MAIN STREET HYANNIS, MASS.02601 March 2, 1998 Eleanor McMahon 232 Main Street South Yarmouth, MA 02664 RE: Lot 3 Stoney Point Road, Cummaquid Dear Ms. McMahon:! Your disposal works construction permit #95-652 is extended six (6) months.. This extension will allow you to install an onsite sewage disposal system at Lot 3 Stoney Point Road, Cummaquid, Massachusetts with the following conditions: (1) Soil evaluation must be conducted in the area of the proposed relocated SAS system. (2) The engineered septic system plan shall be revised to show all wetlands located within 300 feet of the proposed onsite sewage disposal system. The engineer will attempt to move the leaching facility to the required 100 feet setback, if possible. (2) The extension is granted until September 30, 1998. Therefor, the septic system shall be installed before September 30, 1998. The existing permit was scheduled to expire on March 24, 1998. This extension is granted because the applicant stated she was recently informed by the Conservation Department that an area on this property was designated as wetland. It will be several weeks or months before the applicant will be able to resolve this issue with the Conservation Commission. Sincerely yours, Susan G. Rash-R.S. Chairperson Board of Health Town of Barnstable mcmahon PART XII: VARIANCE REQUEST PROCEDURE // ADOPTED 11/1/83, REVISED OWN OF WNSTABLEVE 1/1/94 e OFFICE OF ',E •�ai�rur, BOARD OF HEALTH A " , ""I& 367 MAIN STREET HYANNIS,MASS.02601 VARIANCR REOLMBT PtOCBbtME The Board of Health, of the Town of Barne3ibl o►f MchaptereA111 / of the accordance GeneralMiLaws and of under the authority granted by section ublic meeting of the Massachusetts, adopted the following rules and regulations after a p Board of Health on December 9, 1993. (1) All requests for variances from the Board of Health or State Regulations will be submitted fifteen (15) calendar days prior to the scheduled Board meeting. The variance hearing may be held at a later date if the Board has scheduled eight (9) 1 hearings prior to submission of the request. (2) The variance request shall be made on a form prescribed by the Board of health► (3) Plans clearly showing the details of the request must be attached. plane for oneite ssional or sewage disposal systems or s all new Pared and construction tendsd by shallrof be a submitted a least Registered sanitarian f fifteen (15) days prior to the scheduled Board Meeting. (4) Any applicant who submits revisions to plans, grauire under ed ng ehall abeaph I a ed by ithe than two (2) days prior to the scheduled Bo Health Department to postpone the variance hearing to a later date. (5) No request for variances from 310 ClIR ► t /of sanitery State seaegeirnorentAl from code, Minimum Requirements for the subsurfaceDisposal any other Board of Health Regulation listed under section VIIII oneite Sewage Disposal Regulations, shall be heard for a new sewage disposal system, nor for an enlargement to an existngsystem haswhich notifiedincreases all abutters by certifiede mail ddiattohis nal flows except after the applicant own expense at least ten (l0) days before the Board of Health meeting at which the variance request will be on the agenda. ed (6) A non-refundable filing fee of $65.00 is required• No sewage disposal illbey temrequir unless for filing a variance request upgrading existing oneite g the upgrading involves approval of a building permit. This regulation is to take effect on the date of publication of this notice. Brian R. Grady, R.B., irman usan G. R e , R.8 i eeph C. snow, M.D. OARD O! HEALTH TOWN O! BARNSTABLE 310 CMR 10.99 Form 9 DEQE File No. ;s' OF tHE T� (To be provided by DEQE) Commonwealth s City-Town of Massachusetts $" NASL 9 Applicant a Op 1639. Enforcement Order Massachusetts Wetlands Protection Act, G.L. c. 131 , §40 TOWN OF BARNSTABLE ORDINANCES, ARTICLE XXVII From Barnstable Conservation Commission Issuing Authority To George and Elenor McMahon Jr. , 232 Old Main Street, South Yarmouth, MA 02664 Date of Issuance geb IL, 1998 Property lotrparcel number, address map 336 parcel 091, dev. lot #3 Stoney Pt. Rd. , Cummiquid Extent and type of activity: Filling of a wetland for driveway access Clearing in a buffer zone for driveway access. The Barnstable Conservation Commission has determined that the activity described above is in violation of the Wetlands Protection Act. G.L. c. 131 , §40. and the Regulations promulgated pur- suant thereto 310 CMR 10.00. because: XX Said activity has beeniis being conducted without a valid Order of Conditions. Said activity has beeniis being conducted in violation of an Order of Conditions issued to , dated File number , Condition number(s) El Other(specify) The Barnstable Conservation Commission hereby orders the following: � The property owner, his agents, permittees and all others shall immediately cease and desist from further activity affecting the wetland portion of this property. YL-X Wetland alterations resulting from said activity shall be corrected and the site returned to its original con- dition. 9-1 Effective 11/10/89 C1 Completed application forms and plans as required by the Act and Regulations shall be filed with the -- Barnstable Conservation Commission on or before (date), and no further work shall be performed until a public hearing has been held and an Order of Conditions has been issued to regulate said work. Application forms are available at: the Commission Office, 367 Main Street, Hyannis. The property owner shall take every reasonable step to prevent further violations of the act. )I Other(specify) Property owner shall remove all fill (sand) rocks and debris placed in the wetland, by Feb 16, 1998. Property owner shall submit a landscape sketch plan showing replacementcrfany trees or shrubs that were removed for driveway access by Feb 16, 1998. Plantings shall take place by May 15, 1998. Any future clearing, mowing, or building within 100' of wetland (Conservation jurisdiction) shall require a Notice of Intent filing. Failure to comply with this Order may constitute grounds for legal action. Town of Barnstable Ordinance, Article ggvII provides: Any person who violates any provision of this ordinance, regulations thereunder, or permits issued thereunder, shall be punished by a. fine. of.not more than three hundred dollars ($300.00) . Each day or..portion thereof�.during. which a violation continues shall constitute. a separate. offense, and' each, provision of the ordinance, regulations or permit violated shall_'constitute a separate offense. Questions regarding this Enforcement Order should be directed to: Darcy Ross 790-6245 Issued by Barnstable Conservation Commission Signature(s) Notary Public (Signature of delivery person or certified mail number) Note: This Enforcement Order is not appealable to DEP. Any appeal must be directed to the Superior Court. This Enforcement Order will be discussed at the Town of Barnstable Conservation Commission Hearing held on rob _iggg after 6:30pm. You are welcome to attend. 9-2 e NAME Of OFF-RiD .ER YA/R �� TOWN 0�--�' ADDRESSr�OF F DER c t ¢ BARNSTABLE CITY,STATE,ZIP 0 Q a p3� 1 MVIMB REGISTRATION NUMBER OFFENSE NAN\1l'ABI.E. 'E.(]/�/ ' LU d - LU i634' TIME AND DATE OF TIO TION pF VIOLATION W NOTICE OF �� n P M)ON Z Z 19 {0 .# 5b'1 , ✓ VIOLATION SIGNATU ING PERSON EN ING DEPT. / BADGE NOLU �N OFT EREBY ACKNOWL GE RECEIPT OF CITATION X a ORDINANCE ; Unable to abtam Sic at f'offender. Z THE;NONCRIMINAL FINE FOR THIS OFFENSE IS t/QO dO W Date mailed w OR YOU HAVE THE FOLLOWIN ALTERNATIVES WITH REGARD TO:DISPOSITION OF TWS.MATTER EITHER OPITON(1)OR OPTION(2)WILL OPERATE AS A FINAL a DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w REGULATION p)You may elect to pay the above fine;either by appearing in person between 8.36A.M.and 4:01)P.M,Monday,through Friday,legal holidays excepted, w before:The Barnstable Town Clerk,367 Main Street,Hyannis,MA 02601,or by mailing a check,money order.or postal note to.Barnstable Clerk, a P.O.Box 2430 Hyannis,MA 02601,WITHIN TWENTY-ONE(2ou desire to contest this matter in a noncriminalpp1)DAYS Oroc edinOgF'yyTHE DATE OF THIS NOTICE; FIRSTIf BARNSTABLEDIVISION,COUR COMPOUND,MAIN STREETeBARNSTABLEou MAO2630, tt21DmakiNocrminalHearings auest to nd encosea copy of this citaSTRICT COURT tion for a hearing. (3)If you fail to pay the.above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay.any fine determined at the hearing to be due,criminal complaint may be issued against you: ❑.I HEREBY ELECT the firstoption above;confess to the offense charged,and enclose payment in the amount of S Signature 232 Main St So. Yarmouth, Ma. 02664 . BARNSTAB!E CC`: '.": Feb. 12, 1998 The Town of Barnstable Conservation Division 367 Main St. Hyannis, Ma. 02601 Dear Ms. Ross, ' I'm writing in response to your letter of Feb 2, 1998 informing us of the wetland violations on our lot on Stoney Point Rd. in Cummaquid. The day after receiving your phone message we stopped by the office to talk to you . about our situation. At the time there was no one available to talk to, so later in the day I called back and had a conversation with Rob Gatewood. This letter is mainly to reiterate what was discussed during the course of our conversation. It is very important to us that you understand that we wouldn't and didn't knowingly violate the wetland zoning laws. As I discussed with Rob, there are several reasons why we thought we had no reason to be concerned about the area in question. First of all, you may or may not remember a few years ago when Mr. John Libbey, who sold us our property, raised quite a ruckus in the neighborhood when he cleared, apparently too indiscriminately, a portion of the unbuildable lot adjacent to ours and an area on our lot as well. As it turned out, he violated wetland zoning laws and as a result had to go through a long, expensive process with many of the town departments. Needless to say, this made us aware of the consequences of violating the laws, certainly not something we would choose to have to experience.! During that time, when my husband and I were at our lot one weekend poking around, making plans, doing a little clearing, we ran into a gentleman who was on the conservation board. We had a long and interesting conversation with him about many of the challenges facing him as a member of the board- of trying to achieve the balance of practicing sound conservation methods while. having as minimal as possible impact upon the rights and needs of private property owners. During the course of that conversation, we indicated to him where we planned to build our house and his response was that we were all set over in our area. This was a casual conversation, and I don't hold him accountable because his reason for being there wasn't to address our personal issues, but this conversation was one incident of many that led us to believe there were no "official" wetlands on our property. The next reason is the nature of the area in question itself. There is of course an area, the one you are concerned about, at the front of our property that is low lying and often contains varying degrees of water. It has a pipe that leads from it and goes under the road to provide drainage of the area. This led us to believe that somewhere along the line, someone decided that it was better that water wasn't in this area, and made an effort to provide a way for it to escape. Because no one is there to tend it, it frequently gets clogged and needs to be cleared, which we felt a little bad about since we don't live there yet and aren't able to maintain it properly. We do make an effort, from time to time, when we stop by for other reasons, to clear the drain a bit to allow the water to drain as it was designed to do. This is another reason why I guess we didn't percieve this as wetland, since it seemed that it's purpose as a low lying area was to recieve runoff from the surrounding area and then drain it away. Both these reasons contributed to our perception that we weren't subject to the process of approval. It truly never occurred to us. On the plus side, and the rest of this letter pertains to the nature of our inadvertent violation, is that what we have done has had little impact on the area in question. As I explained to Rob that day, who was gracious enough to listen to my concerns, for as long as we have known of this lot, both before and after purchasing it, the area that we are using to access our lot has been used as a little parking area. At least during our 3 year history with the property, the area has been relatively flat, and free enough of vegetation to park cars there. We did remove the remains of the stone wall, and place them near the edge of the low lying area, clear away some sumac further in to gain access to the rest of the lot, and level out the area somewhat further in, again to gain access to the lot, and that is the extent of what was neccessary to achieve what you see there today. It didn't make any sense to disturb the low lying area mi any way, and beyond that is a stand of trees that are quite unique, and enjoyed by local wildlife. On the practical side, we are on a very tight budget, and this was by and away the simplest and least invasive entry to the property. I don't bring this up to defend our actions- we realize that if that area is wetlands, then we are in violation of the bylaws by altering terrain within 100' of a wetland. We just want to allay your concerns that we had to fill in any of the wetland itself to do what you see there. Although we haven't kept track of time, this area has been as you saw it early in Feb for close to two years, and that is why your letter came as such a shock to us. We have a septic permit that is due to expire on March 24, 1998, and were in the process of having the various departments sign off on our project the day we stopped in to talk to you about the letter. We've been through the Old Kings Highway process - in short we are finally ready to roll on this project and are anxious to get this issue squared away by pulling together the notice of intent as quickly as we can. After talking to Rob that day, I put in a request for an extension of our septic permit, that would allow us an extra year, and take considerable pressure off us. That meeting is Feb 25, and we won't know until then if we have the extension or not. I also need to respond to your request that a sketch of replanted vegetation be sent to your office by Feb 17. In no way is it my intent to appear uncooperative, however, as I explained above, there truly was very little vegetation in the area in question to begin with, and I can say with a fair amount of confidence that by May 15, which is the date you request that the replanting take place by, nature will have done our job for us. In any case, we will be at the meeting Feb 18 so we can introduce ourselves in person, and will certainly be in further touch as we go through the process of the notice of intent. Thank you. Sincerely, y Feb 7, 1998 We have a septic permit that is scheduled to expire on March 24, 1998. We were about to have the septic system installed in the near future. On Feb 5 we had a message on our answering machine from the conservation department regarding an area on our property that they have designated as wetland. We were totally taken by surprise by this designation as it had never been brought to our attention in the three years that we've owned the property in spite of the town having many occasions to take note of our situation. I bring this up as explanation as to why this issue is unresolved at this late stage. It was only brought to our attention yesterday for the first time. Although this "wetland" area doesn't affect our septic design, as it's 100 feet away, it does have a great impact on access to our lot, and therein lies the problem. We are anxious to get this resolved, but the conservation process is likely to take us beyond the expiration date for our septic permit. That is what brings us to the neccesity of asking for an extension of our permit. We request an exension on our permit due to these unexpected mitigating circumstances. Thankyou . t„AM IssasSo>PARCEAp TEST HOLE LOGS P* NOTES: A HORIZON t169 L VERTICAL DATUM: ASSVNdD FROM WAD(NCVD+/-) _ CURRENT ZONING:RF i leWn SAND 6ao rNCINZER:THOMAS MCLELLAN.P.E. 2.MUNICAPAL WATER I_AVAILABLE. o BUILDING SETBACKS: - /s WITNESS EDWARD BARRY _ S.SCHEDULE 40-!PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. B MORISON DATE: 6-20-96 F:_w S: 1S R:,_ - �, JaIaD A ALL PRECAST UNITS.TO CONFORM WITH AASHTO A-f0 d A-20 y - LOCT76 _ IOYR 5/6 4" PERCOLATION RATE: c 2 MIN/fN LOADING SPECIFICATIONS. C FLOOD ZONE: C a HORIZON S.PIPE PITCH- 1/4, PER FOOT,(UNLESS NOTED OTHERWISE). YMEDI M SAND N TX-2 �A TA-3 Ha a FIRST 21 or PIPE OUT of D-BOX TO BE SET LEVEL./` 'z' A RONSON y1w A HORIZON SLEV T.THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOYODATE THE SANDY LOAN LOAMY SAND b n! SfLrr CLAY LOAM jr- tOYR 4/E toTA J/E SOZ USE Or A GARBAGE DISPOSAL. ppUs6 c3 NOR/ZON B HORIZON B NDRIZON 8.ALL CONSTRUCTION DETAILS ARE TO HE IN CONFORMANCE WITH THE ter MEDIUM SAND 4aT asoAtN Q�AM 46J of SAND STATE OF MASS.ENVIRONMENTAL CODE(TITLE FIVE)AND LOCAL LOCATION YAP HEALTH REGULATIONS. LOT 2(43,560 SF) I NO CBOUND►dtt ZNCOVMTt/tts Cr HORIZON Cl HORIZON $1LTY C'tJY tour MED-FINS SAND 8.CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR BENCHMARK Ar PE NAIL 26Y 6 E �a 7 SAND S NDY TO CONSTRUCTION. ZLEYAfION-6" cz HORIZON LOAD!SAMDY MEDIUM SAND tOT etD 1O•gED SLY. ER OVER ALL SdPTlC SYSTEM COMPONENTS NOT TO 6! SAY 6/6 NJ tDT ca xORrzox a6x C2 HOAIzm tf.D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. 60 t DLi CLAY LOAM i E/Lff CLAY LOAM D 6t Z28.TT USCS CiaWNDWATEA ADNSTMZNT: WELL'Aft-24T, ZONA-A AWUSTMZNT:a0 1 I ! ; SEPTIC SYSTEM DESIGN FLOW ESTIMATE: a. E ar -4-BEDROOMS AT HO GAL/DAY/BEDROOM-K CAL/DAY i I It SEPTIC TANK: r I I 40 CAL/DAY E 2 DAYS-AQQ CAL i I USE ISOO GALLON SEPTIC TANK LEACHING AREA: Ont w .6 I PROPOSED D - �TH� ',/ USE 6 FLOWDIFFUSORS WITH!OF STONE AROUND / `� PAOPA4ZD i IDES AMe._a AT ENDS f5!z 12 z T DEEP) 4 BEDROOM t4 0MEE ` o' f,L SIDE AREA• (54+iZ)2 S f-132 (SO)- 79 GAL/DAY BOTTOM AREA 6f m iP.646 SF (60)-389 GAL/DAY ET 24' rx roraL CAPACITY-_YA&cIt/DAr PROPOSED DWELLING TOWN Or BARNSTABLE DESIGN CALCULATIONS: e.� �4' rM-4 `''\� ► �� BOTTOM AREA(6S D 13')-715 SF(76)-536 CAL/DIY SEPTIC SYSTEM SECTION rPEASTDNE . vERs WITHIN tr Or rn rlNlsxZD v-A-E s/!-f 1/2' _ `ONl/NJPICrl COVtR e ` - ___, ' TOP OF FOUNDATION To Dt►IrHIN s•of CAADE) WASHED STONE T t� ' f7-8 `ID tit , - J 1500 CAL ELEV. D-BOX A ELEV. 488E •w A71 U SEPTIC TANK s885 (6'OF ELdV. S� �4, ELEV. Z-- a (6'Or STONE UNDER OR ELEV. STONE �—64' at MECHANICALLY COMPACTED) UNDER) 4BJ USE 6 rLOIDIPFUSORS WITH O OF STONE 6O' CAS BAFFLE AROUND SIDES ANDS AT ENDS TEE SIZES: Ar CVTLEr YEN ELEV. (64's/P a.f DEEP)(H-20) INLET.6'UP.13'DOWN I OUTLET:r UP,14•DOWN AD✓USrED GROUNDWATER ELEV,42J SITE AND SEWAGE PLAN APPROVED BY: DATE., KEY: G EXISTING coxroUR: ——-- LOCATION.• PROPOSED CONTOUR '''' LOT 2 STONEY POINT ROM &Am OP rAr AND EXISTING SPOT ELEVATION: 25b PROPOSED SPOT ELEVATION:25 CUMXAQIIID,MA TEST HOLE: UTILITY POL�4 PREPARED FOR rENca LINE: ® REEF REALTY HYDRANT.b DENT - a LIJN dNGfNZERlNC SCALE: f DArI: 8 2O 86 RETAINING WALL•azma AREST M LE .LL E4 SCHOOL sr"sr P.O.DOE 468 96-f1b(DZOFPf) TREE:p ►EST DZNNIS,MASSACHUSETTS OEMREFERENCE: PLAN 800K 3D PAGE 70 DM/ PHONE t FAZ:(606)SOO-'YfO THOMAS MOLELLAN,P.E. ✓OHN Z.DEMAREST✓R_P.LS. �3 r Fria. I b.n.... THE COMMONWEALTH.OF MASSACHUSETTS_ BOARD OF, HEALTH TOWN OF BARNSTABLE Appliratiall for. �11 i!ip1 ial H111flui (911inli#rurtion .plermi# Application is hereby trade for a Permit to (_onstruct '(v ) .or Repair ( ) an Individual Sewage Disposal System at: l Z.4ln ---�slnt-----R-��. . Ci„ttcntCl'� 1. ..r..l.,.fJ !....:.. �- o.. Tr nn-.\ddress �,1 Or Lot C✓,I1J.�t� .A...: J• ---• I�IC-►�-CA C .......... ..:. i;L;z--�1�-gin ......... (? r `:�M ski l ..4a..... Owner ( t ddress • — M W - Y ....J.:.t t''-� a ............... -..... ----.. P...v.._.P�4 1 ...�......t, ................... • tnstallef Address d Type of Building '�j Size Lot............................Sq. feet U Dwelling— No. of Be( roonts......-.�1.. ..l..Xpansion, Attic (--) Garbage Grinder (-) QL4 Other—Type of Building ...:... . .... . ........ No. of persons.-.......................... Showers. ( ) Cafeteria ( ) 04 Other fixtures ......... .--- ---- ................. d W Design Flow--... ..---:- .......gallons per pers n per day. Total daily flow.. .........gallons. WSeptic Tank--1_1yuid Capacity_..-- .gallons Length ..... -: Width .... DiatnetE ..... Depth................ x Disposal Trench No. ...... ..... Width .... total Length..................... Total leu :ing area sq. ft. Seepage Pit Na........ ..... .. Diameter Dearth below inlet.. .............. Total 1:.�.'t,ng area..................sq. ft. z Other Distrihution box ( ) Dosing tank ( ) Percolation 'Pest Results Performed by........ ........ ......... ...: --- ..................... Date..... .... :..:: Test Pit No. I................ininutes per inch Depth of Test Pit.:..... .......:.. Depth to ground water....... ..:...'..::. Test Pit No. 2................nunutes per itich Depth of Test Pit....... .......... Depth to ground water........................ f� .---- _------------- ..-•--•-......----- ••-•• •-•--•.............. .....................:---' O Description of Soil ...._.... • ........... :..... ... . ....... :. ......... U .. ............................. ..... .. . ... ................................. :. ......... W .................... .....' . .................................................... ----- . . -•-... .... ......._.... VNature of Repairs or Alterations -Answer when applicable.... l ...: PGC. ....{J�Ct6lS -•-:--••••• ...............--•••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syszern in accordance .with the provisions of TITI.E 5 of the State Environmental Code—The undersigned furtht..,agrees not to place die systern in operation until a Certificate of Compliance has.been issued by the board of heal.zh. Signed ...... ...... �« Application Approved By . ` -• -11....... ..... .a .. ...... a... ...�f S Application Disapproved for the fallowing rea.ron,r: ..... ..: ...... ....... ...... }ka ..... . .. .. ......... . . tom« Permit No.J. K..... — C Issued ......... , y.. ..-"......:... �s - ^ ` S J...-ry K THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH TOWN OF BARNSTABLE w Cn1?x#ifictt#e of C�omlittncE TI-IIS IS 7'0 CERTII That the Individual Sewage Disposal.System constructed.l;t. ) or Repaired V. ( ) ' . .... by _.:. ,... In tal�cr at ..L.ot.-3.. . ) .�ne�.. Pc),n1': c,u v 4ry _ u.e.vl . ............. has been installed in accordance with the provisions of TITIkE 5 f-The State Environso<entaI Code as described in the application for Disposal Works Construction Permit No. — I Fled s. .. G y. . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT;BE CONSTRUED AS A I-PUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATEInspector ............................ .................................................... -- — --— - ——-'—- #. ', ------------------.--- — -'--- ---------- -- .THE COMMONWEALTH OF MASSACHUSETTS (S. BOARD OF HEALTH x TOWN OF BARNSTABLE 3 (D 5 v` FEE.....lcs ca........ t �J .. i nl tt ilnrk� Tnxii#rnt#inn Permit {. Permissionis hereby granted..................................................-------•--........................................:......................................... to Construct ( ) or Repair ( ) an Individual-Sewage a Disposal System at No...J,..A . 3.- �. .Uri�� .. oi1n.�-------- t.t --. n .. .............. ............................. .. ........ � {' hAJ(aca•C:Y�Lf!0 Street �...�........ as shown on the application for IIisposal Works Construction Permit .......................................... f ......................................................................................................... Board of ft_•sl1h DATE................................................................................ snnm 9e50it 14OR99&WARREN.INC..PUBLISHERS ~ TLST 1101A, I.OG DATE:CY!eu'`� 'Z5,191.;, P-gl7 Co'L TEST BY: r-- KE-L-LE-Y WITNESS: 1%• G 1 F oR J "? e-bc l PERC RATE: <2 I oo 1�1 4�a r i� A �A h �*21 ML1r SAW p I4g, t 96 LrA- �' Q 0 1 51 o jzo 51,o ke lkN r�ar'1 U 5p pLf, tL:71 e r %7-L- 132 4i,5 � 138 I/ -----���5•]=ram `D�� 30 i - - I &c) DESIGN DATA � — - DAILY FLOW:C4)WZF6 x110 p5' — SEPTIC TANK GpO x USE:I ':AW- PVE ITS T T / 1 LEACHING FACILITY: USE:(4)4,'4 58 CAPACITY: SS SIDEWALL: X�.2�x Z�Jz4G0,to 5� BOTTOM: 8x 1•0 *0.0C> TOTAL: Cv20.Co 4p i r - PIPE TO BE _AID 2"LAY,:],OF 3I8"PEASTONE I` LEVEL FOR 2' OU.OF OVER 3/4"-1 II2" WASHED DISTRIBUTION BOX STONE ALL AROUND TOP OF FOUND. \ 10" 14" ALL POPE TO BE 4"DIA.SCH 40 PVC 49 " RAISE ALL APPLICABLE MANHOLE -'��>✓ IMIo�COVERS TO TO WITHIN 6" OF FINISH j a 1 j A?ZcAO,Q T-r' j GRADE 1 r � , THIS SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL W w SEWAGE SYSTEM PROFILE SCALE: 1"=10' J,�p`tiN OF dlgsf� BOAMAN ctiG� GENERAL NOTES o VVIL 1. CONTRACTOR TO BE RESPONSIBLE FOR THE u No.32686C�O w LOCATION OF ALL UTILITIES,ABOVE AND SITE—SEWAGE PLAN �� FGISTFti �� UNDER GROUND,PRIOR TO ANY CONSTRUCTION FOR FSS/G L`-N� OR EXCAVATION. 3_ 7_cls- 2. INSTALLATION OF SEPTIC SYSTEM TO BE IN COMPLIANCE WITH 310 CMR 15.00:TITLE V. PREPARED FOR - -- . .- )�F'4., 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY G Hrl �\pt?�t"Q1 .r" +,� LINE DETERMINATION. SCALE: I�- �}pl DATE: MA>ZCA ' JV WELLER&ASSOCIATES ``fir yea P.0.BOX 119 YARMOUTHPORT,MA.02675 (508)362-8131 APPROVED BY kr. Ediward ia. Kelley Ounp. Dear Mr. Kelley: You are ,r anted a variance on belhalf ur cli, Ckarles W. i ties, to Install septic leaching flov,,, cliffusors 81 fe tom a w ands, in lieu of the required ICDO feet, oil Lot 23), Stoney Poi oad, liar -ble, (Curnmaquid), vrith the follow-ingy condttiorls: (1) The system must be ins-, ecl in ax: ....ance witb. -the submitted plan and must Tn.aet all of th a is o' Itle 5, of the State Environmental 2) The cesigning 11Z. g stere(", .8,anitari i must iv present on site to supervise construction. Pri to the issuaric of a Certificate of Compliance the de- signing 'RIegistere "anitarian rrw certify in tiwrtting to the Board that his desion has been str y a('herea Q Yo "UGr comply wit i "'Irder of Conditions frorn the Co.uservation C MiWon. This va once expires, Ap 1 1, 1986. VC! -ru ours, R Bert L. Childs, Chairman B BOARD OF HEALTH TOWIN OIF BARNSICABIL cc.: 1"..`.opservatlon LOCATION PIN" /rl D NO. VILLAGE 6�a l Al rN,ka t i� DATE /O APPLICANT V� LF �. �i C FEE /S. UD ADDRESS �jTyN /- 2- /K/�ll dr/J TELEPHONE NO2K 3/ (Non-refundable) •ENGINEER Z�,JiV,1,C pc:-Fz c/ _TEL✓F DATE SCHEDULED_ -- 03 p� C (Ap is s signat)rre) ................................................................................. SOIL LOG 1•SUB-DIVISION NAME n�... �/= �i?�c�- Ci D/3 V DATE Dl� Z� /�jo�/ TIME EXPANSION AREA: YES f/NO !{� ENGINEER i. I.TOWN WATER✓PRIVATE WELL 72•A- G//<fo2D BOARD OF HEALTH zC Liz EXCAVATOR SKETCH: (Street name,etc.,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES: Alv& 4 "7 Err r 30 LDS 7 /i9xi J`>Lvo 8Ati9xs-4— �, , m rH z /S / . 7"a'57 A'lo["3 43 �'� ,472e-/vb T AcC.ErP7*8G6- ZOT 3 PERCOLATION RATE: C 2 / /,V//,Vcy TEST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 2 z Ozz li0<►'I fL� 2 G+�•rl ¢ Sv8-So>L L 3 3 is 4 I , 4 � 5 ------------ �! J, 8 Wi n-1 8 9�.r 10 /Zt�" 10 11 Gi..irs S•A�� ;. 12 12 13 j3C u wer�rn. .;' 13 _ 14 _ 14 i 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD BLEACHING PITS LEACHING TRENCHES ✓ UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PE C T T APPLICATION ORIGINAL: C011PLFTFD IN ENTIRETY RY P. E. AND RETURNED TO BOARD OF HEALTH COPY: RF.TAI::ED BY APPLICANT LOCUS z z y (SCRIBNER'S ERROR ROU 0 N E 6 P I SUBD1 vl ON -------- DENOTES THl 212 S COURSE AS 215.54, LOCATION MAP ,54' ) o I � �f J �,,, w C,✓r Qb oQ 01 98' n' AO I 7 ✓ n 1 ro ( rllte LQT S, 50,419 SQ. ET. ! 1 1 {{i f 7] SID * 1CA-) j U F S t , PROPOSED SITE PLAN IN CUMMAQUID, BARNSTABLE, MASSACHUSETTS AS PREPARED FOR i GEORGE & ELEANOR AICHAHON SCALE 1" = 20' 'ANUARY 20, 1998 � c-- �. a 0 10 20 40 60 80 , r/�'/9 -; SWEETSER ENGINEERING , t r } 235 GREAT WESTERN ROAD f P.O. BOX 713 SOUTH DENNIS, MASS. 02660 7 - (508) 398-3922 ' 48.82' 65.82 f FAX (508) 398-3063 40 — o o t _ SOIL TES TOP OF F%MAT" 20 FT. MINIMUM FROM CELLAR DATE OF SOIL TEST (c. ,I I,- 7 10 FT. MINIMUM 10 FT. 104" FROM OR GMIIIL SPACE SOIL Im DONE it TE CLLAN SAND VIM= e SCHEDULE 40 "'vc PIPE LOAM AND SEED OBSERVATION HOLE 1 ELEV-w OBSERVATION HOLE 2 ELEV-w M" PITCH I/go Pa FT. r L.0 (LR OF PERCOLATION RATE — MK/VCH AT __ INCHES PERCOLATION RATE — MIK/ViCh AT INCH" 1/6' X, 1/2* -bp-lw_kw mTURr —COLOR - MO TT.- 07mut ]g7lml _HORIZ TOMRC— CUM MO 07NER lo 4TOK tw)�akwt 4' CAST IRON PIPE NllTp 0-1 i07 y m0l; 4z- (OR Egft) M*,4MUW f�f Niol- WO&VI ru)Lc i- PITCH 1/4 PER FT. Of I- r-of, I CU. FT 3 CONCRETE s I LT, Ft. -LOW LINE ANOW L ion— Li-uo4 o vijj!!y at -TMIN. ca 0 0 I= 1 S6b ELEV, ELEV. ELEW. Iq 0 DISTRIBUTION 41 (TO K PLACED ON Fft-USE) TO BE WATER BOX TESTED 0ut )I�T por- vwrf TRENCH FORMA If MGM THAN ONE OUTLET 1500 GALLON WATER FA=N700 AT ELEV. WATER ENCOUNTERED AT UV. f-99 (TO 09 PLACED ON Fft MU) SOIL ABSORPTION ONE FEET SEPTIC TANK a z i v/1"..0 i i:) I c-S� 3/4' TO 1 1/2 SYSTEM (SAS) WOEX - 'v y WASHUI ST" ANUST _EGEND: DESIGN CALCULATIONS cvju BOTTOM OF TEST "Ov•4xv. - E)USTIOG SPOT CLEVA71ON OOsO NUMBER OF BEDROOMS SEWAGE DISPOSAL SYSTEM PROFILE USGS ADJUS70 TER TAPL, alV. - Damo CONTOUR ----00---- GARBAGE DISPOSAL UNIT NOT TO 5GAIX ­4" FINAL SPOT ELEVATION TOTAL ESTIMATED FLOW OBSERVED WATER TAW (r/ my. - FINAL CONTOUR— ( 110 /8&/_IDAY X . BR.) GAL/DAY SOIL TEST LOCATION REQUIRED SEPTIC TANK CAPA07Y CAI U71UTY POLE -0- ACTUAL SZE OF SEPTIC TANK )/5 TOWN WATER ONOW SOIL CLASSIFICATION CATCH BASIN lit DESIGN PERCOLATION RATE GAS LINEa EFIFLUENT LOADW RATE Y/V , LSADW AREA LEACHING CAPACITY (AREA X RATE) GAL./DAY RESERVE L4AQ"Q CAPACITY GAL./DAY c NOTES: . WOPKMANSW AND MA RM TO D.E.P.tem c_wu)v-i m 1 ALL TIT 7= OND.LE 5 AND THE TOVM OF RULES AND �3 QPN�'�4YLO YA hA ST2)NVS, REGULATIONS FOR THE SUBSURFACE DWOM Of SEWAQ& 2. ALL COVERS TO SANITARY UNITS 9j" K 8R000HT TO Cjo " Ll:s VAT" go OF FINISHED OWE 42 c- SA LIT- t,()Iq p- *3 3. ALL COMPOWM OF THE SAIATARY SYSTU Su#4LL 8E CAJOAMU 4" WITHISTANONG M-10 LOA" UNU:33 rNEY ARE Uk= (01 V40 10 r? if DAIVES OR #~ 0j"& 4-me 4""4 S1 It 14" Zio V IV'** 10 f*l at Auto cm **A%" mKo" *** *aoftmw ."'% 4& V No 0" TO 0" VVA 4h dW 400 04 KAM A- N 0 0 0: 'AS &"-Y 'ADE AS TO 001*LIA01 nCEDED OP ZOMM NE"A1400 *#W 4P_ftj4W I w f V41 1^0 ft" To (AWNIUK" woft ON SITE rs 7. CONTRACTOR 13 TO VEIVY GRADES AND ExsAloa AS W_j�, As STE ODWT04 PRIOR TO 0 , CCWMDKM VM ON = I I & PARCEL .5 IN FLOOD ZONE O. LOT 1; 5MWN ON A53LUM MAP AS PARCEL (0#41'6�. (cow�4r*j Vt�6AAAvwAt3, -Tnc )kIL4r, T)101 'TO'tt CH&A*C kOLL 3e QEl4+TT_10 -it" pre_qk6co _slclyl�M.4 ))j)nAM4 5() L b0T'�, i-6)vo we-ILC IE!- fi-s &- 1,1 Am QNk-e_ol 0, vs r*vvrN I i�k:Evlcvs Tt,�4�,4 Ohl ZNS-T)4( tje-�e, 7Z) use F te 7 APPROVED: BOARD OF. HEALTH v 0 DATE AGENT 61, PROPOSED SEPTIC DESIGN i rf N L T�lu L F(A 4i; 1,46 1,?r OT-v5 oviv 6& A� PROZCT LOGATIOW VL MT'0vO ENVIRONMENTAL CONSULTANTS 26 COMPASS LANE. DENNIS, MA 02638 (508) 385-2425 ANY DATE. lit 7, _71 ry I F i 0CATIrN MAP OF Town of Barnstable P# Department of Health,Safety,and Environmental Services Its Public Health Division Date 367 Main Street,I lyannis MA 02601 i eAxnerASM B t6 ` riine Fete Pd. zo O revrnut� Date Scheduled C; _�D _ �QL>� Soil Suitability Assessment for Sewage Disposal. � Witnessed By: Aigeg RlPerformedBy: ! � 43.04- . l~U A ON � GON RA; I a TxA r. Location Address Owner's Name Mcmg hpy/7 {Ut � s� U1 _'r Address Assessor's Map/Parcel: Engineers Name TCiiYI�fGt IJ�IgghllGLf�( �`�. NEW CONSTRUCTIONREPAIR Telephone It Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot;exact locations of test holes&perc tests,locate wetlands in proximity to holes) S �S aly� N s °� ,e �i&/7- Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in I tole: Weeping from Pit Face_ Sk �' Estimated Seasonal High Groundwater �41T.� .i '✓ i.f'¢,L'J}*;yXA � ......::.:...U sed.::.,:r...:::......,....::...... ... ..... ....... ... ... :..:.. ..; ... ... .:.. ..... ....., ....... ., ....... ..........::. Method : Depth Observed standing in obs.hole: oO\0-11. in. Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# -Reading Date: Index Well level„_.___ Adj.factor Adj.Groundwater Level P +l�R.COI(��17C ON rf�+'S� Ju+e: T�tt _.....::::;:.:.........................................:.............:......... ........................................ ...................._..........................................:::;..... _. Observation �� Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time® ime(9"-6") _ End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant A+ ;: >;>>«::;. E> FSE1ATIq�t HT�I;LOG Tool # . 511 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulderes. % L014ry' ►c�Y� 312- Boon �'=6Z'` z1 o�4m 2.S~ / l2uG So r►+S off' yl 5ui IP'FSuE� 2- lOZ e2 SICT L04M I p e 6 3 cuA2Ss �u r, ►" 1� :: DEEP OB8ERVMiUN SOLE LOG Hale# Depth from Soil Horizon Soil texture Soil Color Soil Other 51 Surface(in.) (IISDA) (Munsell) Mottling (Structure,Stones,Boulderes. e. ° 1 D_Yl 56-�jr)Y L104M 200T�> -<J'�rdDly t_,014M Y6011A)b )noses, 1-et�rxc CZ slta-�o ► A .� v>✓ev cv�►tcr 102 —136 G MGi�l.s wI 16 SlL'r CL6Y �o Cc�nP7?T BEJE ' — \ ' I�V L Depth from Soii Horizon Soil Texture Soii Color Soii Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ® iGravel) tt �-Z I 13 +bY tir✓i 00" sra�►� ^mi►�c 24 - 1 C 51 LT C.0 i4rV1 , '� 2ockS, touvT r 16- fsy 3 meb,sm�1-J-) C ItTq��'y ,(5 �?EEP OBSERVATION (IEE LAG Hole «.: Depth from Soii Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. o Flood Insurance Rate Man: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No_ Yes Deiith of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? ik3 Certification 'y I certify that on OV 3 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required Ming,1pentse and experience described in 310 CMR 15.017. Signature `� Date } f'h BENNETT & O'REILLY, INC, 84 Underpass Road P 0 Box 1667 Brewster, MV 02631. , Sheet 1 of 2 PROJECT McMahon / stony Point Road �Sq�,�PLE-i�UF18ER_ #1 DATE December 7 , 1999 PROJECT McMahon / Stony Point Road SIEVE ANALYSIS SA14PLED BY Tanya Daineault DATA AND C014PUTATION SHEET WEIGHT OF SAtiPLE 204 . 5 gin TESTED BY David J . Walsh, E. I .T. . JOB NUMBER Sieve 0 enin s Weight Gumulative roject Milli- Sieve Retained Percent Percent Manual Inches meters Mesh in Grams Retained Finer Specifications 2 .0 10 21 . 1 10 .3 89 . 7 1 . 0 8 11 . 3 ( 32 ._4 ) 5. 5 ( 15 . 8 ) 84 .2 0 . 5 35 21 .4 ( 53 .8 ) 10 .4 ( 26 .2..) .73 .8 0.25 60 39 . 7 ( 93 . 5 ) 19 .4 ( 45 .6 ) 54 .4 0. 15 100 68 .4 ( 161 .9 ) 33 .4 ( 79 .0 ) 21 .0 0.075 200 14 . 2 ( 176 . 1 ) 6.9 ( 85 .9 ) 14 . 1 PAN 25 .8 ( 201 .9 ) 12 .6 ( 98 .5 ) - Passed Mesh Sieve TOTAL REMARKS: 1 .2W weight loss OK U.S. STANDARD SIEVE"NUMBER Ml MWIi�i ioi iiiiiiCi ii=iiiiliiismlmiiilllmlmiii llmmmiiiiilmmmiiiillmom I NONE ' Illi�■� 111 ���� loom- ■ �1111��� =11112.10 lmmmiiiillmmmiiiillmm llillmmm=lllllLlom .. . 11111111111 No iis■ iiilin�m— � �� i mmmiiiiilmm kv _� ii�i�iiEiinii 111111 ommil I Inum ME 1111 olmmillimmism liiiinmmmii looml mmmiiiiim mmiiiilommm liiiiisimiiilllmi I�111��■ S 1l1���■�1t111 ■ IINUNN Ilion 1 11I mmmm illllmwm llilloom lillonoLm I ism 110011 1 lommiiiilommm liiiinomm llilmmwmllli N liiiinsmiii ■ 1� BENNETT & O'REILLY, INC. 64 Underpass Road P 0 Box 1667 Brewster, MA ' 02631. , "Sheet i of 2 PROJECT McMahon / Stony Point Road 2 � DATE December 7 , 1999 . PROJECT McMahon/Stony Point. Road SIEVE ANALYSIS SA14PLED SY Tanya Da ineaul t DATA AND COMPUTATION SHEET IJEIGHT OF SAMPLE 226 .4 TESTED BY David J . Walsh, E. T .T. JOB NUMBER Sieve 0 enin s iWeight Cumulative Project Milli- Sieve Retained Percent Percent Manual Inches meters Mesh in Grams Retained Finer Specifications 'r 2 .0 10 35_ 6 15 . 7 84 . 3 1.0 18 17 . 5 ( 53 . 1 ) 7 .7 ( 23 . 4 ) 76 .6 s 0 .5 35 34 .2 ( 87 .3 ) 15 . 1 ( 38 . 5 ) 61 . 5 0.25 60 48 . 5( 135 .8.) 21 .4 ( 59 .9 ) 40 . 1 0. 15 100 47 , T( 183 . 1 ) 20 .8 ( 80 . 7 ) 19 . 3 0.075 200 38 . 5( 221 .6 ) 17 .0 ( 97 . 7 ) 2 .3 PAN 4 . 1( 225 .7 ) 1 . 8 ( 99 . 5 ) - Passed Mesh Sieve TOTAL. RF3r pM: 0.3.0 weight loss less than 2% OK films MMI Is MEMO I mom Is If INN 011111 MEN Is MMI IN HE 0 Ills NUNN 1110 IN 11,111 INN ME MEN No11 U.S. SlANOATF71D SIEVE-pjjjpf_8-Ea 'iiME 111111110111 ism III' Is