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HomeMy WebLinkAbout0016 WILD ROSE LANE - Health 16 Wild Rose Lane Barnstable A = 336 084 i i i 1 i r TOWN OF BARNSTABLE ..00ATION I to WJ� '0 t Q SEWAGE# Z 0 t 0'- O .g X VILLAGE CA Ins MaQ"J ASSESSOR'S MAP&PARCEL 3 3(o -E!y INSTALLER'S NAME&PHONE NO. A/ CIZS' Idd 9 SEPTIC TANK CAPACITY 1 15-y0 0°1 , a,,Q",i*Vn LEACHING FACILITY:(type) 0 Are- 3(0/to W z o.(size) //a 3 )e 3S' NO.OF BEDROOMS y 11 OWNER PERMIT DATE: q-/S - 2010 COMPLIANCE DATE: y- 2 7 Z O l D Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)/ Feet ���FURNISHED BY_Cvi,cLe S k t • 3 f 9.3 1 i jZ z a•fo '�!` C�n 63 V a 3 c� 3S • � • CIO D 47 ID(o y 9 , 04/28/2010 13:04 5084775313 ENGINEERING WORKS PAGE b1 Town of Barnstable Regulatory Services Thomas F.Geller,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyaneis,MA OW1 091ce: 508-862-4644 Fax: "S-79""4 Date: Sewage Permit#Z W-01S I Assessor's Map/Parcel �F q Installer&Ikagner Certiou Form Designer: v�9 ��Et rm� crY�v, frk C . Installer: ara-kvacede Address: TL- W. G-e a�-{^-c 1 c�1 cz.\ Address: e o - yo,c '7 6 3 On S' ZO(O Cc, J4 &+�crp�%St) was issued a permit to install a (date) (installer) septic system at (Co !N; Id 12osc `�w%a c/•d based on a design drawn by (address) IFC4 eef) M C-&t-CA f dated 3 l 1 1 1 v (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with ma'or changes (i.e. grater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the sods were found satisfactory, OF PETER T. (III ler's S gna ) McEN?E ti CIVIL 9NN0.35109 �4 (Designer's Signature) (Affix De 1 CEZ PLEASE STAB E N. OF C2LTLIAN4qE WILL NOT L q;b�oe i t3fleaelon faun dm ` 8 lop 7 F COMMONWEALTH OF ACH S rya, EXECUTIVE OFFICE OF E g- MENTAI:AFFa RS John Graci DEPARTMENT OF ENVIRONME A�RQ 'CT�ION DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617 500�� P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 16 WILDROSE LANE BARNSTABLE 62�Q VgiA L �--� Name of Owner NEIL RUDZINSKI Address of Owner: BOX 607 CUMMAQUID AM.02637 ` Date of Inspection: 2/9199 Name of Inspector:(Please Print)JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: John Graci Title V Septic Inspection Mailing Address: P.O.Box 2119 TeaTicket,Ma.02638 Telephone Number: (608)6644813 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-site sewage disposal systems.The system: X Passes The inpection is based on criteria defined in Title V _ Conditionally Passes code 310 CMR 15.303.My findings are of how the system is Needs Further Evaluation By the Local Approving Authority performing at the time of the Inspection.My inspection does _ Fails not imply any warranty or guarantee of the longgevity of the septic system and any of its components useful life. Inspector's Signature: Date:2/10/99 The System Inspector shalliubmit 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 SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. revised 9/2198 Page 1 of 11 y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:219/99 INSPECTION SUMMARY: Check A, B, C, of D: A. SYSTEM PASSES: _ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection 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. Indicate yes,no,or not determined(Y.N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. ND The septic tank is metal,unless the owner or operator has provided the system inspector 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. NO 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 ND 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 r revised 9/2/98 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:2/9/99 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and 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 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 100 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 nta_(approximation not valid). 3) OTHER Wa revised 9/2198 Page 3 of 11 ", N SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) . Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:219/99 ` D. SYSTEM FAILS: 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 X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped n&. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X 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 ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure. 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 X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9098 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:2/9/99 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health. X None of the system components have been pumped for at least two weeks and-the system has been 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. X As built plans have been obtained and examined.Note if they are not available with N/A, X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout, X All system components,excluding the Soil Absorption System,have been located on the site. X 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: X Existing information,For example,Plan at B4O,H, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [1 5.302(3)(b)) X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:2/9/99 FLOW CONDITIONS RESIDENTIAL: Design flow:M g.p.d./bedroom Number of bedrooms(design): 5 Number of bedrooms(actual):2 Total DESIGN flow: U1 Number of current residents:) Garbage grinder(yes or no):MQ Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no):JLQ Seasonal use(yes or no):JLQ Water meter readings,if available(last two year's usage(gpd): nLa Sump Pump(yes or no): MQ Last date of occupancy: nLa COM M ERC IALIINDUSTRIAL Type of establishment: n& Design flow' n&gpd(Based on 15.203) Basis of design flow: nLa Grease trap present:(yes or no):.SLQ Industrial Waste Holding Tank present:(yes or no): KQ Non-sanitary waste discharged to the Title 5 system:(yes or no):NQ Water meter readings.if available:nLa Last date of occupancy: nta OTHER: (Describe) nLa Last date of occupancy: Wa GENERAL INFORMATION PUMPING RECORDS and source of information: SYSTEM WAS LAST PUMPED 4 YEARS AGO System pumped as part of inspection:(yes or no):NO If yes,volume pumped nLa_ gallons Reason for pumping: n& TYPE OF SYSTEM XSeptic 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: nLa APPROXIMATE AGE of all components,date installed(if known)and source of information: SYSTEM WAS INSTALLED 10 YEARS AGO. Sewage odors detected when arriving at the site:(yes or no): MQ revised 9/2198 Page 6 of 11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:2/9199 BUILDING SEWER: (Locate on site plan) Depth below grade: 4 Material of construction:_ cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: TOWN Diameter: n& Comments: (condition of joints,venting,evidence of leakage,etc.) nLa . SEPTIC TANK: X (locate on site plan) Depth below grade: 4' Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) nLa If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): MQ nla Dimensions: L 10'6"H 5'7"W 5'9" Sludge depth: Z_ Distance from top of sludge to bottom of outlet tee or baffle: M Scum thickness:1_ 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: 1Z How dimensions were determined: MEASURED 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.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND RECOMMEND PUMPING SYSTEM EVERY TWO YEARS GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) n/a Dimensions: n/a Scum thickness: nLa Distance from top of scum to top of outlet tee or baffle:, ila Distance from bottom of scum to bottom of outlet tee or baffle n& Date of last pumping: n/a 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.) nLa revised 912/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:2/9/99 TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: nLa Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) II& Dimensions: n& Capacity: n(a gallons Design flow: n& gallons/day Alarm present: NQ Alarm level:ji&- Alarm in working order:Yes_No_: NQ Date of previous pumping: n& Comments: (condition of inlet tee,condition of alarm and float switches,etc.) nLa DISTRIBUTION BOX: _ (locate on site plan) Depth of liquid level above outlet invert:n1a Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) nLa PUMP CHAMBER: NQ (locate on site plan) Pumps in working order:(Yes or No): NQ Alarms in working order(Yes or No): NQ Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) nla revised 9/2/98 Page 8 of 11 I ~ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:2/9/99 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: nLa Type: F leaching pits,number: 1000 GALLON LEACH PIT leaching chambers,number: 11La leaching galleries,number: -nLa leaching trenches,number,length: n& leaching fields,number,dimensions: n/a overflow cesspool,number: 19A Alternative system: n& Name of Technology: -n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.PIT WAS 1/2 FULL AT THE TIME OF THE INSPECTION CESSPOOLS: _ (locate on site plan) Number and configuration: nLa Depth-top of liquid to inlet invert: nLa Depth of solids layer: nLa Depth of scum layer. nLa Dimensions of cesspool: nfa Materials of construction: n& Indication of groundwater: n& inflow(cesspool must be pumped as part of inspection)n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)` nLa PRIVY: _ (locate on site plan) Materials of construction:n/A Dimensions:nLa Depth of solids: n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) t revised 9/2/98 Page 9 of 11 3�2 9�5z SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:2/9199 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) n/a n A AA 3V a 6A 4q revised,9/2/98 Page 10 of 11 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 WILDROSE LANE BARNSTABLE Owner: NEIL RUDZINSKI Date of Inspection:219/99 NRCS Report name: nLa Soil Type: nLd Typical depth to groundwater: nLa USGS Date website visited: n& Observation Wells checked: NO Groundwater depth:Shallow _ Moderate Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 16 Feet Please indicate all the methods used to determine High Groundwater Elevation: XObtained from Design Plans on record _ Observed Site(Abutting 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.(Must be completed) GROUNDWATER WAS OBTAINED FROM ENGINEERED PLANS 192"NO WATER ENCOUNTERED. revised 9/2/98 Page 11 of 11 TOWN OF BARNSTABLE 0 LOr.T'ION G VC,-, SEWAGE # ?�ILIE4GE i`1 Cif R�' c,�19�- ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. � ' SEPTIC TANK CAPACITY 5O� LEACHING FACIL= (type) Q F�)4- (size) /060 NO.OF BEDROOMS BUILDER OR OWNER el,I U�ZA PERMITDATE: C 1 I CiCi Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching.Facility Feet Private Water Supply.Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished byITfGB _F3 q4 y No. ZU I O I Fee d0 C THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS„ es ftpliLation for Disposal 6pstrm Construction Permit Application for a Permit to Construct( ) Repair(� ""Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1(0 LZ,1 d t2os t ellla,4 9,,j Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3 3co $ Y C 3 vy s o V rJ7� ui Installer's Name,Address,and Tel.No.[➢ep";eke Cn4c�p„_,S Designer's Name,Address,and Tel.No.Er?5*1-ein;, were, t1 2L -`1,2 Po 3�sc 7,,3 IZw- c.ogKid ( �.r+T-c...��t �yl/a �77-S3/3 fo.esrvatE Type of Building: �� Dwelling No.of Bedrooms �" of Size)5 2, cog± sq.ft. Garbage Grinder( ) Other Type of Building Fars'*1 y No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 30+ I I'D gpd Design flow provided y q3- S gpd Plan Date 3 Number of sheets 3 Revision Date Title l to (-z 1 d 2.oie Size of Septic Tank 15 o u 4 0 L 4-10 Type of S.A.S. 3 j< 3 S Description of Soil vl / J.�►-► 0- t z 541& Cam, f 3(, /i c�'S,Ircaag, C-2 12c�1 — (-74 - 4_J Nature of Repairs or Alterations(Answer when applicable) 6&4 r j o a c/A ,Seth Z 7yyy4 T-a` n—rho iz� 5tZAA,-_,, I, .,� -gj Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si ne Date q- 1 'ZQIO Application Approved by k_ Date - Application Disapproved by Date for the following reasons Permit No.aI U — O Date Issued o j d !'N / No. 2 U 1 () �� j/ -::V.. i< Fee�'' �d 0 THE COMMONWEALTH OF MASSACHUSETTS Enteredincomputer: , / PUBLIC HEALTWDIVISION - TOWN'OF BARNSTABLE, MASSACHUSETTS0,. t. Rpplitation for Disposal 6pstem (Construction Permit "~ Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 16 L z',l d 12o s 4 C �S � Owner's Name,Address,and Tel.No. 12z Assessor's Map/Parcel 3-3 y Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. „g , Vic<�Gs (li7 8.,e 7b3 /L w. crossc)d LI2 CT-cs.t\1r ,iyt/1 y77-53/s' i - Type of Building: 3 � ' q��fi ,�. Dwelling No.of Bedrooms t of Size 5 2� (­5± sq.ft. Garbage Grinder( ) Other Type of Building S, t y No.of Persons Showers( ) Cafeteria( ) Other Fixtures J Design Flow(min_.required) gpd esign flow provided 4 c/3. S gpd Plan Date 3- ( - of Number of sheets 3 Revision Date I Title l to c Z,\cf lose Size of Septic Tank 1 S o c� 4 0 L 14- /o Type of S.A.S. 5 ivn z I el �c� N. 3 g 3 arc 3�L)In" j Description,of Soil' S L 3c _ r z c S,' Nature of Repairs or Alterations(Answer when applicable) 6e' r:vo T-o Date last inspected: S,00 q 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 Certificate of Compliance has been issued by this Board of Health. '1 Signe Date Application Approved by r k_ V pvsDate Application Disapproved by Date —� for the following reasons Permit No. �2 y U 1;C Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate �f Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by �A p2x-J,c�e t�t�-e-r f J;--e (1.� at kto (.J,\.� (-05< t_.v ,! L has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �ul d,b 7 dated y'/5'--2o1 o Installer (..c pw; k 6� t��i II ll� Designer EE,(teat 4, (,J.O�(.. #bedrooms ?a�' b Ll +P4 Approved des : U gpd The issuance of this peFt it shall not be construed as a guarantee that the system wiluri ion as desig ed. Date 0 Inspector /L✓ �f r No. 0 d ' V�0 F Fee 100 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS Disposal 6pstem (Construction 31ermlt Permission is hereby granted to Construct( ) Repair(V,) Upgrade( ) Abandon( ) System located at (o C.J,\A LZS l_v✓+^�.I�r w i and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with i Title 5 and the following local provisions or special conditions. Provided:Construction us t be completed within three years of the date of this perm' . Q Date i /l Approved by ��) /` CITY/TOWNg✓�� APPI..ICA t Ap i SS:, 16 i v. I C f2w s r— C DIN h ;OW.; gPd REYICWE1P BY: LL',x --ee. r� DATEt ry 3 N/A Legal boundaries denoted 310 CMR 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided 310 CMR 15.2204(t)] Plan proper scale? (1"=40' for plot plans, 1"= 20' or fewer for components) 310 CMR 15,220(4)] Easements shown 13.10 CMR 15.220 4 b System located totally on lot served [310 CMR 15.405(1)(a) for ✓ upgrades]- if not, a variance is re ired 310 CMR 15.412(4)] F Location of impervious surfaces (driveways, parking areas etc.) 310 CMR 15.220(4)(d)] Location all buildings existing and proposed 31.0 CMR ✓, 15.220(4)(c)] Location and dimensions of system components and reserve areas. ✓, 310 CMR 15.220(4)(e)] System Calculations 310 CMR 15.220 4 dail flow septic tank as aci (required andprovided) soil abso 4n s stem r. uired and rovided whether system desi ed for garbage der North arrow 310 CMR 15.220 4 Existing and ro osed contours 310 CMR 15.220 4 ✓ Location and 164 of deep observation holes (existing grade el. on each test) [310 GMR 15.220(4)(4)] Names of soil evaluator and BOH representative [310 CMR 15.220 4 h and i Location and dale of percolation tests (performed at,proper elevation?) '310 CMR 15,220 4 i Percolation test results match load' rate? 31.0 CUR 15.242 Certification statement by Soil Evaluator P10 CMR 15.220 4 Observed and Adjusted groundwater (method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR V 15,22 4 n Address 9 N/A Location of every water supply, public and private, [310 C!VM within 400 feet of the proposed system location in the case of surface water su lies.and gray eked lac water su 1 vintlun 250 feet of the ro osed s stem loegbon in the case ✓' within 150 feet of the proposed system location in the case .. of vate wator wells Location of all s ace waters and wetlands located up to 100 ft. 31'0 C1 R 15;:211 aid any;catch basins ' 310 Clk1 15 22 4 i ater lines and Oder subsurface:utilities.located [3 0 Clvl 15 220 4 water line cross see 316 CiVfR 15.211 1`` 1 Profile ors hem showin invert elevations of illoy.stem: e ii ones43ad -:btton of the 3AS. 31Cl+v :5t 2� :4 . St`am :off deli "err. 310 CMR 15.220 1' and 3-10 CIVi1 15.220 2! Stamp of Registered Land Surveyor (required if constiuction a v t as.vuttk»i,5 #t; Of lot Test Holes a4equate (two in each of the prum.' and reserve unless4knehes as permuted in 31.0 EAR 15.102(2}or:as '► a ,rovod fo" an u:: ade under LUA at 310 C1vIR`I5;4'OS` 1 ,k Tp�t hole adequate-to demonstrate four feet of suitable material? 040 CNM 15.1 3,;4, Test Holes a�eAd confirm adequate groundwater separation?, '10C MY5.103. 3; SA 75':of s. stems: 31A 0. .1.5., 2Q Materials specificafions.noted?jvarious sections:of 310 CMR h5 000 System eompcinentS:not>.3&! deep (unless Local Upgrade A royal ar..,L>UA re: nested. 310 CMR 15;4 5 1 Addireiis shed 2 of 9 N/A (OIL 10. Size OK? 310 CMR 15.223 1 Inlet tee located ten inches below flow line 310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase fft depth [310 CMR 15.227(6)]. Outlet tee with gag baffle or approved filter 310 CMR 15.227 4 Note regarding ii*aation on stable compacted-base [310 CMR ,f 15.228 1 Separation between inlet and outlet tees(no less than liquid depth) 310 CMR 15.227(2)] ` Inlet/Outlet elevations at least 12" above high groundwater (except as described 31 O CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k. Minimum cover (Tanks buried more.than 9" must have risers on all openings and on the d-box) [310 CMR 15,2228(1) and 310 CMR 15.232 3 Three access cnyers (inlet and outlet must be 20" or greater) - middle access at least 8" 7/07 310 CMR 15.228 2 Access to within'6 " of grade - one port for 9ystems<0009pd, two:for Mystems Q00.gp d 310 CMR 15.22$.2 3 s N All at-grade covers secured to unauthonzed' ccess? [31O C/ 15.228 2 > l0 ft frombuil ' foundation 310 CMR 15.21,1 1 Buoyancy calculation Required/Done 310 Ch"- -15.221: 8 H,�20 Where a ro riate? 310 CMR 15.226 3 Setbacks from re ources i10 CMR 15.211 �Required when gther than single-family dwelling or flow>1000 gpd 310 CMR 15.223 1 First compartment 200% daily flow; Second compartment 100% daily flow 310 CMR.15..224 2. .and 3 "U 1.pipe-through or over bade, outlet of each compartment with as bale or approved filter 310 CMR 15.224(4)] r i of 9 ._ _ .... N/A OK NO Located-at least ten feet.froth any wate7777 Disposal piping it least 18" below watesewer cros's see 310 CMR 15.21? 310 CM Thrust blocks s -in force mains? 31U CR�iR 15.221 6 c Slope'ofsewer line not less than 0.01 (1/811/ft) 0.02 preferable 3{10 CMR 15.122(6)1 Proper piton all runs? (.005 within gravity4stributed trenches L and beds) [310 CMR 15.251 9 and 310 CMR 15.252 2 c Siphon rolilem/. each ield below pump chamber- E ' ed? ' than � not smaller . Size and.ori�ta�n of discharge.holes.specrFied.. 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR -� Materials specified (31.0 CMR 15.251(5) specifies various pipe / typ6g,W6wed) Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232 2 a Splash plate or baffle tee required on inlet/provided?(when pressure sewer to d-box or,steep pitch of gravity sewer) [310 ,✓ CMR 15.323(3)(a)] Riser°i dee er than : 3.,10;CMR 15132 Inside m tvmutri a sion 12" 3.10 CMR 15.23.2 2 minimum sump 310 CMR 15.232 3 e Watertight cover if<2000gpd); waterproof manhole if>2000gpd J 3.10 CMR 15.232 3 d Capa�tty( erncy sotage above working=designi�t ? Pro er setbacks. 310 CMR 15.211 same as septic taxes Watertight,20.innjinjurn access manhole at least 20" MUST BE To.GRADE 3;1.0 CMR 15.23.1. 5 Service components accessible (not too deep with piping, disconnects accessible Alantn floats alarm on circuit separate from s ecfied? Exceeds to wo units must have two pumps operating in lead-lag m 643101 51111; 6 and 8 Stable Ca nd Base f310 CMR.15.221(2)1 . r - Sheet 4"of 9 Addfeas needed?Provided?.:310 Q :I5,221 8 77 r - � r raj. .c � J 1 ry" h It : P t,A 9 i - S:o£9. G N/A OK NO Calculations-correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.24 1 Required s aration to oundwater? 310 CMR 15.212 ate s cified as double washed 310 CMR 15.247(2)] System Venting wg»ed/pro�vided? (system under driveway or >36" d` 310 CMR 15.2�41 Inspection ports specified and within 3"final grade? [310 CMR 15.240 13 Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CNM 15.211(1)[4] and +� Guidance Doc ent Chambers and Gal. in trench configuration supplied with inlet every 20 ft. 310 CMR 15.253 6 Each structure vNith one inspection manhole(if>2000 gpd must be �J tograde) 310 CMR 15.253(2)] Aggregate 1' minimum- 4' maximum: 310 CMR 15.253 1 2' sidewall credit maximum 310 CMR 15.253 1 a In bed confi ration, inlet every 40 sq. ft. 310 CNIR 15.253 6 Width 2'minimum 3' maximum 310 CMR 15.251 1 b 100 feet -maximum len h 310 CNfR 15.251 1 a' Minimum separation 2x effecrive depth or width whichever greater 3x if reserve between trenches . 310 CMR 251 1 d Situated along cpntours 310 CMR 15.251 2 Breakout OK? 10 CMR 15.211 1 4 and Guidance Document rununum 2 distribution lines .310 CMR.1.5 252 2 a f 1vlaxittiun arm between lines 6' 310 CM'Rl 5.252 2 .d Maanmun separation between lines and outside of bed 4' [310 CM1 .R :15.252 Aggregate depth below discharge pipes 6" minimtkm, 12" mxu»pfin 310 CMR 15 252 2 S'` anon betty 10' mum• 310 CIvIR 15.252 2 Bottom area a in cal lations.only 310 CNM.15.252 2 i Ad�l•ess . - shy d,of 9 f Pressure Dosed System ? Provided pump and piping calculations as reqaired 310 CMR 15.220(4)(r)] Pressure dosing required on aU systems >2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and UA Remedial Use ovals If used in graveHM system -make sure jet is directed as not to t/ scour soil interfarce. Guidance Document Inspections once per year(systems<2000 gpd)or quarterly >2000 dgood to note on plan 310 CMR 15,254(2)(d)] Cvnstraction in f iil - Did the plan specify that the fill shall meet the specification specificationof 31 U-CMR 15.25 5 3 ? ImpeMou&bxTjpr and/or wall ? Guidance Document Impervious hwier installation must be superrised by designer ./ 310 CMR 15.25 5 2 Retaining wall must be designed by Registered Professional Ea ' eer 310 gM 15.255(2)(a)] , Side slope not exceed 3:1 ? 310 CMR 15.25 5 2 ,/ Breakout re4uirements met?[310 CMR 15.252(2)and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended i 10 CMR 15.255 2 e Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil 'interface Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Canditions? Is there a rote on the plan regarding the requirement for perpetual na Wppanceagreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has. submitted a co of a tna en&nce ascent? MMOMMINME7 Are the variances listed on the plan ? [310 CMR 15.220 4 1tLS Si necessary on plan if a component is within five feet of P19kerty fine 310 CMR 15.412 4 r ,,. Fa: pax "goo 4w p [der QJ () of WS INS f r ON M Alto TAX&* INS AWAY On l i l . rI e i i ft e ', - c. y � cf .Address _ J. N/A QK N4. Is the system in a Designated Nitrogen Sensitive Area (Zone H for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and cI/ 310 CMR 15.21¢ - also refer to Policy regarding upgrades of such vasting systems] Is the system proposed on the same lot as served by private well ? 310 CNM.15:21 2 Are the nitro8en loads proposed in compliance? [310 CMR 115.2160)]. Pumping to septic tank ? 310 CIMR 15.229 Shared System ?1-CMR 15.290 I Address Sheen 9.of 9. Towle of Barnstable P# 11. 7 Department of Regulatory Services WANernsts, : Public Health Division Hate >, 200 Main Street,Hyannis MA 02601 Date Scheduled i D f UU ' Time f Fee Pd. Soil Suitability Assessment for Sewage Disposal { Performed By: Witnessed By:_ 6 v i? LOCATION& GENERAL INFORMATION Location Address I( GJ��/`( �C fe Owner's Name �C I Assessor's Map/Parcel: Address 33 r Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes(%) Z' Surface Stones / J4 Distances from: Open Water Body -7 ft Possible Wet Area too —ft Drinking Water Well ?`5-11 ft Drainage Way J 15-_L� 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) i� - - - Parent material(geologic) w''c Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: In, Groundwater AdJustmetit ft. Index Well# Reading Date: Index Well level AdJ,factor Adj.Groundwater Level , a PERCOLATION TESL' bate 'rime, 'Observation 1 // Hole# Z 86 c�n ./2 Td �o o G�e� v Time at h" Depth of Perc �� M !at`-t .' 41me at 6" Start Pre-soak Time End Pre-soak Rate Min./Inch y Site Suitability Assessment: Site Passed_ L Site Failed: Additiondl Testing Needed(Y/N) Original: Pubic Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week prior to beginning: Q:\S EPTICIPER CFO RM.DOC DEEP.OBSERVATION HOLE LOG Hole# t 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency,% ravel d—jyy �O�Y s�— �tv CLA CL G Hole# DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell). Mottling (Structure,Stones,Boulders. Consistency.% ravel 5L 1o �nYlz �`f' f� ZJ4-I'7� C z L0404y Sttt�tll DEEP OBSERVATION HOLE LOG Hole#. 3 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%orav 126—17 Gz Lag 5c.�:m( n �Z �nQ� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. 'A. c Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No < Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perviou material exist in all areas observed throughout the area proposed for the soil absorption system? S If not,what is the depth of naturally occurring pery ous material? Certification / I certify that on (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 train' ,expertise and experience described in 310 CMR 15.017. y. l Signature AA Date Z / Q:\S•EPTICWERCFORM.DOC f w TerraFilter,LLC. P.O.Box 227 10 Main St. Sturbridge,MA 01566 W Tex � )347-7263 woRker ' � Fax:(508508)347-9857 i January 18,2010 r Peter McEntee Engineering Works, Inc. 12 W.Crossfield Road Forestdale,MA 02644 RE: Particle Size Analysis (Alternative to Perc Test) 16 Wild Rose, Cummaquid, MA Dear Peter: v F_ Below are the results of the particle size analysis from the sample submitted for the above referenced property. The analysis was performed utilizing the hydrometer method of Gee & Bauder (1986) in Methods of Soil Analysis, Part 1. Physical and Mineralogical Methods,2nd Edition. Sand Silt Clay (2.00 to.05mm) (.05'to.002mm) (<.002mm) Portion Passing 78.7% 15.7% 5.6% #10 Sieve USDA Soil Textural Classification: Loamy Sand MA Section 16.243 Soil Classification: Class I 4 Based upon the DEP's Title 5 Alternative to Percolation Testing Policy for System Upgrades,the following effluent loading rates apply: Un-compacted Soil 0.66gpd/sf Should you need additional information, .or require further testing services, please do not hesitate to contact our office. Sincerely, Mario Farrell,Soil Scientist o©no4oQQo Gig UNDvo(Roam TOP OF'FOUNDATION: CONCRETE COVER e 1 ° CONCRETE COVERS `67 e e 4 CAST 'IRON 2°MAX. . .` 12`'MAX. 'ns„ %'m'7A1s OR SCHEDULE 4: ` !4 SCHEDULE 40 PV.C.(ONLY) —� PM-C. PIPE . .PIPE MIN. i LEACH... PITCH I/4"PER. PLTCH I/4�'PER,FT.. PIT PRECAST LEACHINIG `—INVERT a . �.0 40� INVERT EL.... ¢ ... INVERT PIT OR SEPTIC. TANK 3 DI S.T. 3 zZ Lu EQUIV. INVERT BOX. 3 88 Soo:,. .:.GAL.. . INVERT 6 .c��oF' 0 'i� 3 1"T0. 1.Il '. 3 3 INVERT w w /4. 383n . , . u.p WASHED .• w .r' -STONE. iDI A'. PROFILE OF GROUNDWATER TABLE . SEWAGE DISPOSAL SYSTEM 'I rA-4. iN NO SCALE ' R.e a Aria .44.5 a&yo.Va P- CZ 9 J45 S01 L LOG WITNESSED .BY::-- DATE':fir !z�/�BG TIME/o:oa LE1TiVETz BOARD OF HEALTH TEST HOLE I TEST. HOLE 2 ENGINEER_ ELEV, 4 3c. . . E.LEV: .. .. . . . . . . DESIGN DATA SuB:Soic-/ NUMBER OF BEDROOMS 3� G, TOTAL .ESTIMATED FLOW 330 . GALLONS/DAY BOTTOM LEACHING. AREA .SQ.FT /.PIT,,P.D � . SIDE;.LEACH-ING . AREA.. ZZL, .Z >SQ,FT./:PITIA-6 "pD. /yam . -GARBAGE DISPOSAL Yam`.. (60% AREA. INCREASE) ' R � 9 TOTAL LEACHING AREA 33 3 SQ.FT Ie W/TL-- 'Ssl,/a ' ERGOLATIO-N R-ATE-- ..L&z--5,...77�G P. - LEACHING.AREA PER. PERCOLATION ~RATE 47f.�. SO.FT ,A/P WATER ENCOUNTERED NUMBER OF :LEACHING . PITS APPROVED... . . . . BOARD OF HEALTH ' . , 5/per: . . . . . . .. . .' . DATE AGENT .OR INSPECTOR C!` s .so z .. N� yGf V HAl y1 IN/LD . .PoS� LJ�' ELLEY v ' . U �. Q Not 26100 �o. IST>;.p� S4Hrt.A4,�P� PETITIONER:. /Q�Rt LAKO�' ENVIROTECH LABORATORIES 4..1O Rte. 110• Sa:-:dv,ich. MA 02,563• i6.7I 888-6400 Mr Runzinski Lot Wild Rose Lane i CLIENT. LOCATION: 2 _ I �- at.es a ee arnstable,MA f ADDRESS: ow , N�_II17-T� — — I COLLECTED BY: outs—Ttap�is SAMPLE DATE: 10/27/87 TIME: 12:00 PM DATE RECEIVED: 10 27 87 SAMPLE ID: ET175 =_ JOB ;: New Well WELL DEPTH: 50 ft RESULTS OF ANALYSIS: = Parameter Unity Recommended limit Result -- Conform bacteria;'100 ml (MF Method) 0 0 E- pH PH units 6.0-8.5 5.81 Conductance umhos./cm 500 : 281 - Sodium mg,,'L 20.0 27.2 Nitrate-N mg/L 10.0 .76 �- Iron mg/L 0.3 .32 _ Manganese mg/L 0.05 Hardness mg/L as CaCO 3 500 - = i Sulfate mg/L 250 _ Potassium mg/L 20.0 Alkalinity mg%L 200 Chloride mg/L 250 FE COMMENT:Iron and Sodium levels ,are not health .hazards. = YES NO a Yl1 WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED c: ,,,l : DATE .:3333::3:ii:31..».33:it«3333i:«::3:31U.33.:.«»13::liliti3:313U1:3333i:U ' "'w Massachusetts Water Resources Commission/Division of Water Resources WK WATER WELL COMPLETION REPORT Address ��.9 WEI�y/TI��'St City/Town �'� 07 S G.S.Quadrangle Map Grid Location Owner Address 73 64"le-5 /'/6" f . OM WELL USE CONSOLIDATED,WELL , Domestic[(� Public❑ Industrial❑ Type of Water-bearing Rock Other Water-bearing Zones METHOD DRILLED 1) From" To "'` Rotary(hype) Cable❑ 2) From To f F!/GE'/Z 3) Froni c.T _ Other �— 4) From To CASING Depth to Bedrock Length_Diameter_ Type PAC ' UNCONSOLIDATED WELT. STATIC WATER LEVEL water-bearing Materials Feet below land surface Sand fine❑ medium❑ coarse ell Date measured dL Gravel: 'fine❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL SIot;R/-? length_ from to 'd Yes ❑ No Split Screen(or 2nd screen) WATER QUALITY TESTS MADE Slog---;e h from to Chemical ❑ Biological Depth To Bedrock PUMP TEST Drawdown 6 " feet after pumping daysLhours at""��GPM. fee How measured -44 v Recovery f t after hours.. LOG of FORMATIONS°° COMMENTS:(On well or water) - Materials From .-.To _ 0 0/ —!oL-ILL AD-f <' DRILLER ILL Firm � _ C a I Address P. 2 O -S I City 1 Registration Nb. 4�4�P.at.rs ease print fir ly 1owaffii.164a43 TOWN OF BARNSTABLE LOCA.:TION IU jLp f csE LA-4: SEWAGE # P�L 41 yoZ VILLAGE CU Q ASSESSOR'S MAP 6i LOT =336 INSTALLER'S NAME & PHONE NO. f ,.e, SEPTIC TANK CAPACITY !SO O r S T" LEACHING FACILITY:(type) Lr,,4e4 Qir (sue) /Ben NO. OF BEDROOMS— PRIVATE WELL OR PUBLIC WATER�w g BUILDER OR OWNER W C E( Q y 0 E° ►nJ S m i DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: /Z 7 zpp VARIANCE GRANTED: .Yes No r i 1 �ykn al Y 4 V) 4,Yw�� p�'t - -\ ti P t�, Yr ASSESSORS MAP NO: e/ PARCEL N0: -- _.. .-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � N� 1P(�1�Q� �o ------ .------.. ...... 6—'6 -_.........._ olo Appliration for Uiipniia1 Work.5 Tanstrurtion Fermi# Application is hereby made for a Permit to Construct (L.-T or Repair ( ) an Individual Sewage Disposal System at: W/CA IFosc-7- 40h LoT '*Z -�--------------------------------------------------•--------•-------........-----•--•--------...... _........._..--•-----...-•------..__....-----•---•----•---•-••----•- ... Location-Address or Lot No. NAG . !! �7r•�s.(G�' ST�wc� Mf3ss Address Owner ......................................... W Installer Address UType of Building Size Lot._-?e7Z_____._Sq. feet Dwelling—'No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (t�j a`4 Other—Type of Building _...___.... No. of ersons____________________________ Showers YP g P ( ) — Cafeteria ( ) Other fixtures :.. W Design Flow............. _.,___.___._________._gallons per person per day. Total dail flow...___.._._-. -3©__.._._____,_,_,_,_gallons. WSeptic Tank—Liquid capacitylSap.gallons Length.4!A '.... Width.-o.. ...._ Diameter................ Depth.._�'r__� .` . x Disposal Trench—No. ................... Width.................... Total Length__......... _..... Total leaching area_______•-_--_,______sq. ft. Seepage Pit No------- ._.--__-- Diameter----__/Z_._.---- Depth below inlet....... _.......... Total leaching area__6.78,__/.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1 4 Percolation Test Results Performed by._,_`�_._� !�?? .:___..�� _______ __ Date.��_r_�_.:__K; /�8� f Test Pit No. 1---- Z....minutes per inch Depth of Test Pit.... ....... Depth to ground water______ ___________ _ �Tq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -•----•-••------•--------•-•----•-•-------------------•••-----------....--------•-•---------••-----.._.......-----•----•--•------....._•------..._.._...._... O Description of Soil---- Woopfh`>;'..�SvB_.SarGr / ........................................................................... UW -----•-----•----------------•----•--•----------•----•--------------------•-------------------------------•-------------------•-------------- --•------•-•---••----••---•----- ......................... 'Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ •---------------------------•--------•-----•---•--•--------•-------•-----•-••--_----------------•-•••------------•--••------------•---------•----•--••-----•--•--•--------•--•-•--------_. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with o the provisions of'T"LE ;of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sued by he bard of health. p Signed----- ............. d -'•+e.7 - ,� � Date Application Approved By_____________ -----------------•---------••-•-•--- ---------------------------------------- Date Application Disapproved for the following reasons:............................................................................................................. ----------------------------••---------•----•---------------....-•-------...--------------...------•...----..........`..----------------------....------------------------------------ IL Date Permit No......_�f__-7.n... _ _x�..---------------- Issued._..._....---------------- ---___--- Date Finc THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......gyp,►A..A/.....--....OF......4�. 74A/ ?9 6eG . ppliratiou for 1 spatial Works Tomtrurtion Vanfit Application is hereby made for a Permit to Construct (c,4 or Repair ( ) an Individual Sewage Disposal System at: 14 ------•.............................. .-••----••--------•••--•---•----•---•--•--•-•------•-- ----•----••-•-----.......................•. ��----••-----.-?..... '�.....------. Location-Address or Lot No. A147G . ....................................................... .. Owner Address s aU-•- --� —'Y'S L' . �� ........... . Z�_Z ®C6 AA)............... -- ss .Sz O � Instal?er Address Type of Building Size Lot. �.__.7z........Sq. feet Dwelling—No. of Bedrooms...........................................................................Expansion Attic ( ) Garbage Grinder (�) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ....................................................................................................................................................... Design Flow.............�..........__._.....•..gallons per person per day. Total daily flow.._..........3-5v....................gallons. W .:t G ,, R; Septic Tank—Llquld capacltyls�4.gallons Length 8.�....•._ Width................ Diameter.._..._..._.•._. Depth_-�_.�. _. Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......./----------- Diameter--___`Z_......__ Depth below inlet.................... Total leaching area_6.78-./_...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by._ h��L�----------' "ZGL �G' /7. a ----•••• Date. ..................r ,.a Test Pit No. 1....�``...� ._..minutes per inch Depth of Test Pit.... ........ Depth to ground water.__.................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------------------....................................................:.................................................................................. D Description of Soil Q !3.:Sof _F/CLA /. /� .. EGG/ ?v_•1�✓✓/ i% :.... l t/4----------------•---•--•--•---------------......----•-----------.....-------- W -----------------------------------------------------------------------•••----•-•--•---•--•-••--••----••---•••••••-•••-••-••--•---••-•••--••-•-----••-•--•--•-•--....••--...-----••---•--•--•-•---_.._. VNature of Repairs or Alterations—Answer when applicable____________________________________________________________________________________•_--------. --------------------------------•--------------------------•-------------------•----...........------------------------------...------------•--•-------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T1T E ;of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued bye b and of kealth. Signed.----�.-- 9 y Date Application Approved By--••-...... '-^ r--- -------------------------------•---- Date Application Disapproved for the following reasons:.................................................-............................................................ _ ---------------------------•-----------•-•---•-----•-----------------•-----•----•------------------•-•---I•-••••-•---------•---------••-•••-••--••-•••••-•••-•-••••••••---------••--••-•---••--•...._.._. Date PermitNo...... ----------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH lW��._......OF...... ��!/_4'T.�eG6 ............................. Trrtif iratr of Toutphaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (&,�) or Repaired ( } by------------- ...... k---- ..........................-------------------------------•----------....------------..--...------------------....---------- Installer JP at................. .... -------------•--••-------•-----------------------------------------------•---••--------------- has been installed in accordance with the provisions of ii i'I E j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..___. ._�.-__._�l!.�..._... dated---.._----._----------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT rHE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... ............................... Inspector.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y 0F..........F-'.A2�o+.�.TF� 3GE .................. IVYo.� ......�!_. FEE-..... . Disposal lVorks %onotrttr#ion rruti Permission is hereby granted.......ra ...$cam_..... ..............................•........... to Construct ( or Repair ( ) an ItWividual �e,pwage Disposal System T t�3e 4�•, c�ti rc. �� i at iV o -" Street as shown on the application for Disposal Works Construction Per it No 7�1i. .. t Dated.......................................... .................... ..,.--. ------------..............---- DATE................1-11--- ------------------------------- Board of Health • --�•"---�.7 FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS 34 �o z 0 0 NG Noe, \ \ �'� 2° RL o IR �tf• F '' ��\ \, GOB V� CEI�TI FI ED PLOT PLAN LOCATION . .. , ST�YBLGs Gc��f/9A min 48...Fe../..... .. ... .�.. . ... ..� . . ..� Ft'" y� SCALE ./�........ .... DATEi..�!� / 87 h oonD'f7o PLAN REFERENCE . 25�-71 !(g.• 47 Z PAP - � ��/ �q 5 . .!�: . .?�. : . . . . . .. .. . . . .. . . . . . . . . . . . .. . I XI-1 O F c . /' E ARD I.CERTI FY THAT THE .11 o E. SHOWN ON THIS PLAN IS LOCATED ON THE GROUND • KELLEY AS SHOWN HEREON AND THAT IT CONFORMS TO THE No. 26100 �o SETBACK REQUIREMENTS OF THE TOWN OF �f��STER��� BA7?ays7iJ"1�L WHEN CONSTRUCTED. L LANDS DATE .Ttcv� �yiP,7 Pie iv.) /r�/i�13rG f. N�� �2�oe�.vs�/ — P�77 TioNETL REGISTERED LAND SURVEYO TOP OF FOUNDATION s CONCRETE COVER �;; CONCRETE COVERS • 6.67 e o 4"CAST IRONN MAX. X. �mr�n�r 12"MAX. "'�'�'' • OR SCHEDULE 4 4°SCHEDULE 40 PV.C.(ONLY) l e ' P.V.C. PIPE PIPE- MIN. LEACH t �' PITCH 1/4"PER. PITCH 1/4"PER.FT PIT PRECAST ' S °• ° � '' • LEACHING o' INVERT ` e EL...... .. .. SEPTIC TANK INVERT DIST. INVERT zL o w �? V: PIEQ�IV. �.a INVERT /Soo fL.. 9-. . . . BOX EL..%..... >_ ; GAL. INVERT 6• ~'a rj• �:•' 1. e; EL. 3.9..88._ 3 3 INVERT 0 .�. 3/4 T011/2 EL.. 4f w w p WASHED . � w STONE 0 0 • EZ.3Z.3o •.: • , -- 6 DIA. ° ',• �-- /Z DIA e.0 .e, — - - - PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM 1-7z'l- u�.sv.r�ate �IAI-M fic)t /N ,W.--mil NO SCALE '9&� -,3,p4D /a' L3&'yo"D 7D SE �QE7fOl/ED fiT/D kV17 / CG6 r}�v SOIL LOG WITNESSED BY : DATE TIME�Or�4 9'!. it/�„rc,/ LEi-'AICZ • . BOARD OF HEALTH TEST HOLE 1 TEST HOLE 2 G�In/,q?ZD E• �(!eZGE� ENGINEER ELEV. .44 30. . . ELEV. .. .. . . . . . . DESIGN DATA : W000Co/k,�� 3 5"8;SbyC NUMBER OF BEDROOMS C, TOTAL ESTIMATED FLOW , 33a , , • GALLONS/DAY BOTTOM LEACHING AREA SQ.FT. /PITIC,R D, SIDE LEACHING AREA . . . zz6•. ?. . . SQ.FT./ PIT/,5zSC,i?D. R.3Z.3o GARBAGE DISPOSAL . .yam`. . .(50% AREA INCREASE) TOTAL LEACHING AREA 3.39 .3 . . SQ.FT 'spa PERCOLATION RATE MIN/INCH 678 / LEACHING AREA PER PERCOLATION RATE .. . . c.. SQ.FT/G;PA, Nd .WATER ENCOUNTERED NUMBER OF LEACHING PITS APPROVED . . . . . . . . . . . BOARD OF HEALTH ' r DATE. . . . . .. . . . . AGENT OR INSPECTOR - — - - �P`�H 0 E • . . . . . . .L. r O� (l A NA I v;'7- E. 5 V/GD ELLEY O y` No 26100 ,o ISTEP� '�(' BAD/ C-C L, f CI TER aHrrAa� S PETITIONER ^/l--7G 4,D657.AI-5e L LA APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION LoT 'Z `t/iG/_� /ZvSC� C/��.C' �GG� /lxr l�iGc /�� ) NO. �� C VILLAGE DATE APPLICANT FEE `I S_ ADDRESS 1//a-i�_,tiu v��Dvn7- TELEPHONE NO. (Non-refundable) ENGINEER L�?�r�% � C_ /�� C_ / TELEPHONE NO. 362- 2 z 66 DATE SCHEDULED (Applicant' s signature) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . o . o . . . . . . . . . . . . . L ASSESSOR'S MAP OT'NO: SOIL LOG SUB-DIVISION NAME LET DATE P&c- i Z / X..C l` TIME EXPANSION AREA: YES ENO ' P�.Bl�. zgi {6,9_ — s ENGINEER TOWN WATER ,,,-PRIVATE WELL BOARD OF HEALTH �• D l//,r oG SUvs EXCAVATOR SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percolation tests, , locate wetlands in proximity to test holes ) NOTES : 0 0 i .5 z S4),FT s � i 171 s-� zoG. O PERCOLATION RATE: TEST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 1 1 2 w0001 o�/77 2 3 /y 3 4 SAGS 0 Z_ 4 5 r 5 6 6 7 / �114 7 8 8 9 ✓� 9 10 10 11 :17- 11 12 7L 12 13 14 An ED CL C.9A✓ 14 15 u,,A//7 �' °y'� 15 l.9 16 /yo 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER .ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY EY P . E , AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT SHEET....... OF... . ... SHEETS SOIL LOG " CLIENT * 4 AriN. . .-T� L S . . . . . . DATE ��✓.�. !�f �`i'7.1 . . . TIME . . . . . . . . . . . . . . . . ADDRESS BOARD OF HEALTH 7—cj 9. .c. (. . . . . . . . . ENGINEER ��=.i<<�,...:� . . . . . .:.. . . EXCAVATOR LOCUS . . 4Tz . .�:��P. .is.� .�-�!►�. . LX BEDROOMS .. .. .. . .. . : EXPANSION ATTIC... . . .. �Rr,s�� �:c . . . . . . . . . . . . . . . . . . . . TOWN WATER .Yt=s... PRIVATE WELL .. . . .. . . . ASSESSORS MAP ................PARCEL.......... GARBAGE DISPOSAL . . . . . . . . SKETCH : NOTES : Pc'zc tzx)Tc-- 7-w4 N C;;tsl ZrnJn���CH {P Lt i�Z Sz cTz n' TEST H®LE ... ---...... PERC. RATE TEST HOLE .. ...... PERC. RATE ELEV. ........ .. .. . .... .. DROP MIN. SEC. ELEV. .... ... .. .. ... -... DROP MIN. SEC. III_ 211 111 _ 2II bL/CSC Cti 11 11 CLq-7 3 4 3 11- 4 I_ 4 11 c / \ -i 1,D .^Jl /1 11_ 511 \� f w 11_ 511 `t �� 5' n 1> [ \— 13 z 11 611_ 7 11 ��,`,. C.l.y _ 7 11 7 - 8 8 9 8II_ 911 911_ 1011 %.�j n 0911_ 1011 1011- 1 1 II 1011- 1111 Z cr 1 111- 1211 11 11 12 <<•4 N.b.....: WATER ENCOUNTERED ��'�.... WATER ENCOUNTERED � J UG r „ Holl 1-^ 0 { a 04._ o 4 C - se n �d r.rt f r. o� <: 2 CL v N N 88 32'30” E 1 201.99' A �l Route i LOCUS Y \ - , t. 99,07 v CB/DH/FND , 3 I a • a Y ., v I• . N • ' LOCUS MAPNOT TO SCALE ' . cam„` Y ni GENERAL NOTES: - Scr. t ` Porch _ r Deck' r Y TH m 1. -ALL CHANGES TO THIS PLAN MUST BE APPROVED B E LOCAL EX t, BOARD OF HEALTH AND THE DESIGN ENGINEER. ISTING HOUSE (#16) p ° 2, ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 1 0 �. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE A s z h h z� u�d. LOCAL .RULES AND REGULATIONS ♦ 92 75 - r � KFILLED PRIOR p9' ELL 3 TOE INSPECTION SEWAGE DI ANDS APPROVAAL LI BY THE BOARD OF SHALL' NOT BE CHEALTH AND THE - x , DESIGN ENGINEER. 4.-ANY. CONDITIONS ENCOUNTERED `DURING CONSTRUCTION DIFFERING FROM THOSE- SHOWN HEREON SHALL BE REPORTED TO.THE. DESIGN• " Lot 2 p ENGINEER BEFORE CONSTRUCTION CONTINUES., - 52,069t S.F.: v S..ALL ELEVATIONS BASED ON ASSUMED DATUM. 1.20t AC. I t. 7C _ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF rTHE MOP. 3`�V HEALTH FORCTOR OR OWNER TO PROPER INSPECTIONS NOTIFY DURING CONOCAL STRUCTIION. OF ' BARN _ Parcel 84 _ . : 206.03' " W 2$ 7. WATER- SUPPLY PROVIDED- BY PRIVATE WELL:. $`1Q'1 8. THERE ARE NO WELLS WITHIN-150' OF;THE' PROPOSED $:A.S. z, 9. ALL .AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS. = TM AGREED 0 OWNER A 0 R OR*OR A ED UPON BY AND C NT ACT AS OTHERWISE r DIRECTED BY THE APPROVING AUTHORITIES.' a s� 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY ALL UTILITIES- TO BEGINNING MgSs9 THE LOCATION-OF A UNDERGROUND U CITIES; PRIOR C /DH/FND CONSTRUCTION: 99.20 WH R RE UI D CONTRAC OR S ALL EMOVE A' UNSU LE SOILS o� PETER T. G� 11. E E Q RE T H R LL ITAB G 1�1.54 _� MCENTEE IN THE AREA-BENEATH AND FOR 5' ON ALL' SIDES 'OF THE S.A.S. AND �\\ Stone Drive - 75,10.10� C "' REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). CIVIL > 5 No. 35109 12 AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS' SHALL BE + Y O� • RF6/STE��`O � INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. MLD ROSE _ _ _SEE SHEET 2_ _ SS ENA 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND LANE 2O SCALE S T CONSIDERED A OPERTY LIN SURVEY.ryt _ I NOT 0 BE `PR E S Y t ` " � _ PROPOSED SEPTIC SYSTEM UPGRADE PLAN } 16 WILD ROSE, CUMMAQUID, MA ' OWNER OF RECORD Prepared for: Capewide Enterprises, P.O. Box 763, Centerville, MA 02632 NOLAND, PEGGY SCHIFFER Engineering by: SCALE DRAWN JOB. No. 16 :WILD-ROSE Engineering Works, Inc. 1"=40' P.T.M. 230-09 i P.O. BOX; 510 . g g CUMMAQUID, MA 02637 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. r. (508) 477-5313 3/1/10 PT.M. 1 Of 3 LEGEND Approximate location �i EXISTING CONTOUR Right-of-Way —— 98 —— Pl. Bk. 110 Pg. 61 x 100.98 EXISTING SPOT GRADE O _ i �z E UNDERGROUND WIRES x 98,97 G EXISTING GAS SERVICE CL 1 99,63 Wx99.74 I'1 Screened W EXISTING WATER SERVICE Porch N JV Deck W PROPOSED WATER SERVICE TEST PIT m Y 9 4- Go r*oge EXIS77NG BENCHMARK ''. HOUSE (#16) TOF=100.66 l` S(one y (Assumed) ,10 X 98.84 Dr/ve : : .....> 99.44 Exisr. SEWER � INV.=96.50f 99,70 92,75 99,40 'P4 ^ Benchmark Set 99,35 ��, �9.09 Island 9,81 x 9 .78 -96 Right cor. a ran ;-'V/ PICK T 8 EL.=99.82 rssumed) � 9 .52 9y8 90 99, 9.35 x 9,42\`� \�`� E X 99,15 LOT 99,49 x 2F EE E y 98, S' PTIC/C❑NC❑ �\ ?� TP-3: ao 98,23 3 �98-�6 G x 0 - TP-2 98, 8,25 UT BARN O .. 97,68 O h FUTURE EXPANSION 98 fig• 1 BEDROOM (MAX.) 206 03 -CH W O o. I 95.04 , 4'28 57 r .. 196' 70� I X 5 C�1FT-CHERRY 19 �` iTP-1 A VENT �Li� 97 62 Lot 2 �9, ,Pf P � � `� Lx_ 5,95 EXISTING SEPTIC TANK 52,069f S.F. 9,25 -'�'-�'E0��5'�k ^% I —'96 TO BE PUMPED, RUPTURED, FILLED �^ I WITH AN AN O SAND D ABANDONED 1.2of AC. � ,64 � ,�� P � A--k-:�. ,17 Ma 336 ' Parcel 84 ,y EXISTING LEACH PlT(APPROx.) TO BE REMOVED STRIPOUT (12 f)� . . (SEE, ALSO, NOTE 11)��� � ;... '. I -w ... .. (SEE NOTE 11—SHEET 1) ' SAP , CB/DH/FND 7,7`14: of M - 9.q; . :.`.: a: ti PROPOSED SEPTIC SYSTEM UPGRADE PLAN G � �j : .•:.: . . .. P ., .::;:. �.. ETER T. 16 WILD ROSE, CUMMAQUID, MA pnve . :::. W 10 10 M CIVIL CENTEE p� SERv�cE, o. 35109 Prepared for: Capewide Enterprises, P.O. Box 763, Centerville, MA 02632 00 JC:�9.9,82 �,;.WpTER RFC S E Engineering by: SCALE DRAWN JOB. NO. WILD ROSE ° ss Engineering Works, Inc. 1„=20' P.T.M. 230-09 LANE 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. \ `U (508) 477-5313 3/1/10 P.T.M. 2 Of 3 9' , I NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL.95.5 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT INSTALL INSPECTION PORT"OVER END UNIT OUTLET AND SET TO 6" OF FINISH GRADE T.O.F. COVER SET TO 6" OF GRADE BARN EXISTING F.G. EL.=98.3f F.G. EL: 98,5(MAX.) F.G. EL: 98.3f (SL-A-B fMAINTAIN 2% GRADE (MIN.) OVER S.A.S. V i rn INSPECTION ® S=1%8(MIN.) ® S=1%'(MIN.) ® S=18((MIN.) PORT M 47.5' 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC[Li I � 10 14 14" 6- 10.38" TO 6• 5 P S �� INV.=95.67 48" LIQ. INVERT eGAS BAFFLE 1 INV.=95.32 PROPOSED INV.=95.15 - 4 ROWS OF 7f UNITS AT 5.0'/UNIT. = 35' INV.=95.42 D-BOX INV.=95.07 w 35 SOIL ABSORPTION SYSTEM (PROFILE) 0 GALLON 2-COMPARTMENT SEPTIC TANK COMPARTMENT NO. 1 - 1000 GALLON STORAGE ESTABLISH VEGETATIVE COVER S.A.S.LAYOUT COMPARTMENT NO. 2 - 500 GALLON STORAGE BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS, 6-a' POLYSEAL OUTLETS TIE IN TO EXISTING SEWERS AT 21" t-4" POLYSEAL INLETS HOUSE, INV. EL.=96.50 VERIFY 2" 2 BREAKOUT=TOP � • • • ��NOTES: TOP ELEV.=95.53 INV. ELEV.=95.07 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE C4 O O INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=94.20— ' U, 2) SEPTIC TANK AND D-BOX SHALL BE SET LEVEL AND 2.83' o ' TRUE TO GRADE ON 'A MECHANICALLY COMPACTED SIX 5 'MIN. ABOVE BOTTOM OF T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=11.3' INCH CRUSHED STONE BASE, AS SPECIFIED .IN - - 310 CMR 15.221(2). EXISTING SUIT AB iV Top View p—BOX Section 3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO G.W., EL=84.3 = MATERIAL 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE c USE 4 ROWS OF 7-ADS Arc 36HC UNITS WITH NO AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. SEPTIC SYSTEM PROFILE SEPARATION BETWEEN EACH ROW & NO STONE 63.25" N.T.S. TYPICAL SECTION SOIL LOG 78" DESIGN CRITERIA i 34.5 DATE: 12/12/86 DATE: DECEMBER 10, 2009 (REF#12,793) NUMBER OF BEDROOMS: 3 BEDROOMS (EXIST.) + 1 BEDROOM (FUTURE) WTNE: E KELLYANCYLEITNER ; SOIL EVALUATOR:SS: DATE McENTN R.S.EE #1542) SOIL TEXTURAL CLASS: CLASS I (LOAMY SAND—SIEVE ANALYSIS) HEALTH AGENT [ HEALTH 'AGENT DESIGN PERCOLATION RATE: 8 MIN/IN ELEV. TP—1 DEPTH ELEV. TPy-2 DEPTH ELEV. TP-3 DEPTH TOP soW DAILY FLOW: 440 G.P.D. 0" 98.8 A 1 �` 98.8 A 0 END CAP END CAP " SANDY LOAM SANDY. LOAM FRONT VIEW SIDE VIEW DESIGN FLOW: 440 G.P.D. 10YR 4/2 10YR 4/2 0 GARBAGE GRINDER: NO 97 8 B 12" 97•8 B 12" END CAP AR/TOP VIEW . .W. . SANDY LOAM SANDY LOAM NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT" SIDE VIEW LEACHING AREA REQUIRED: (440) = 666.7 S.F. 16YR 5/4 10YR 5/4 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY .66 WOODLOAM 95.8 C1 36" 95.8 C1 36" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. _ PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY-2 COMPARTMENT SU& C SOIL LAY SILT 4640 TRUEMAN BLVD LOAM SILT LOAM OHIO 43026 HILLIARD, PROPOSED D-BOX: 1 INLET, 4 OUTLET (MINIMUM), H-10 RATED SY1s/3 sY s/3 Are 36HC DETAIL * 144" 88.3 C2 � 126" 88.3 C2 126" ADVANCED DRAINAGE SYStEMS,INC. LOAMY SAND LOAMY SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 4 ROWS OF 7-ADS Arc 36HC UNITS WITH NO MED. CLEAN 10YR 5/6 1OYR 5/6 16 WILD ROSE, CUMMAQUID, MA SEPARATION BETWEEN EACH ROW & NO STONE WHITE SAND SAMPLE TAKEN SIEVE ANALYSIS Prepared for: Capewide Enterprises, P.O. Box 763, Centerville, MA 02632 BOTTOM AREA: GENERAL USE APPROVAL FOR 4.80 SF LF OF UNIT 192" ' 84.3 174" 84.3 174" ( � ) � Engineering by: SCALE DRAWN JOB. NO. (Arc 36HC Units) 28 UNITS x 5.0 LF x 4.80 SF/LF = 672.0 SF PERC RATE <2- MIN/IN. NO GROUNDWATER ENCOUNTERED Engineering Works, Inc. NTS . P.T.M. 230-09 IN CLEAN SAND SEIVE ANALYSIS: CLASS 1, LOAMY SAND g 9 0.66 GPD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.66 672.0 S.F.) = 443.5 G.P.D. NO GROUNDWATER ENCOUNTERED t /SF _ r ( PERC RATE 8 MIN/IN. ("C2" HORIZON) (508) 477-5313 3/1/10 P.T.M. 3 of 3