• •

COMMONWIAUII Ot MASSAb mSHIS Board oj H ealth, t}M HaST , MA.

APPLICATION I:oR DISPOSAL SYSI~CqNSTRUCTlON pI:Iit!fU Application for a Permit to Construct( ) Repair(~rade( ) Abandon( ) -~e System 0 Incjjvitdt1~ ~~'ifI!iel .......,

()v.:ner 's

Map/ Parcel# Address

Lo[# Te1ephone#

Installer's arne Designe r's Name

Address Address

Type of Building ______ ...c9t:...:.,s.::r-____________________ LOl Size 31.000 +(-- sq. ft. q ,oJ

Dwelling. No. of Bedrooms ",~r1jjj~d~r .,.,

Other - Type of Building ______________________ No. of persons ___ Showers f): Cafeteria ( )

Other Fixtures ---------,-0-----'------------------------ -------Design Flow (min .1reqUired) ___ YL~..L:0,--__ gpd Calculated design now _~-"".!..I __ _

Plan: Dale 9 .0",/0, NumberofsheelS_--=="'--______ _

Title "'5eP11 ( .s'i:>~ I\.q>~\~ ?1..I-';

Design fl ow provided V" ,

Revision Date __________ _

gpd

Descdption of Soil (s) __ .o,C.~\..:.4=>::..<;-"--_1I:.L.l.._,.L. _~~=tJ"fSf="-.!k1=J\"'...tc..:...----,,.---.-____________ ~----Soil Evaluator Form No. ________ Name of Soil Evaluator 4- ftJ~~, Date of Evaluation (t/2:shcOJ

i

DESCRIPTION OF REPAIRS OR ALTERATIONS _-'==~:.......-=CL..~J,f<-"'-__ Lll''-'--''--''''-.!..-''='''l:::. ....... _______ _

.VTI'" I'i'l (t...O>::;, -The undersigned agrees to ins

further agree p!ac~.~'J~,sf}

Signed --7.~~~&~~.L--I-::"::~:.:!:.'::''':':'''----

No.

COMMONwwm or MASSACIIUSHIS FEE

BoardoJHealth, .4. kJ'r-= , MA.

nRIIrICAIJ:: or COMPlIANn Description of Work: 0 Individual Component(s) ~plele System

The undersigned hereby certify that the Sewage Disposal System; Constructed ( ) , Repaired ( ) , Upgraded ( ), Abandoned ( ) ., by: ____ ~~~~.-~--------~~--~ __ -----------------------------------------------al ____ 6~~~~J~7j~?3~~~<~L ___ ~~~A~· '~ ____________________________________ __

ed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/ as-built plans relating LO . I , da a . Approved n Flow (gpd)

~

Installer --If-\;7'?\1~~a.&I.:.qL---------7'4g,..L__z(L.~7---~L---__ ::;_;l..hr_------~~

Designer: .:...-~G~~:::::=~ .... ""----- Inspector: ~::dU~.d.:......-/-~;z:.~~:::.._=__ Date: ..,:,~~~~ _____ _

The issuance of this permit shall not be construed as a guarantee that the function as designed,

?I.. FEE ..=bZ(

COMMONWJ::ALIlI or MASSACIIUS[IIS Board oj Health, ~ 4,r,,-- , AfA.

DISPOSAl SYSlt}1 CONSTRUCTION PfRMIT Permission is hereby granted to; Construct(

&.eFt7 ~r/"J Repair( ...,..-upgrade( ) Abandon ( ) an indi\·idual sewage disposal system

rI' as described in the application for at

Disposal System Construction Permit No. cJ/.."..-.r- , dated -.Lf=:...L~ • Provided: Construction shall be completed within three years of the date of

FQrm 1255 Rev. 5196 AM. Sulidn Co. Boslon, MA Date L4 y/ol' Board of H ealth ~~:::1~~~;L~~~~~~~..;;~!!t; ...... ---

.,. ......,

,

... ~ iml..",:::2EJ:: •• ' L-I'~ ",-... ~. .n .. ;c ·,..--" . . .... ... ;:r.=

WILLIAM H. MITCHELL, JR. 680 STATION ROAD

~ rt:jJ"

06031~'

53-7233f211S BRANCH 2 AMHERST, MA 01002 4~~

C r

m,vDlllm' ~d~ ~ -1 $ OP~t:J ~~~~~4L~{J~~LLARS tn mfii/:.

~,~ Z":u --r~ o .. ./"lo. 0 2:V·l.

~~::.

20 0570 5··~~ -=-=

C"ARlAND

.""",.~I"'"''' ___ ' - ,...;;;:!'n •• ~, ........ :;;;;g;; ",.=>, _ _ ,"K-

~

r

8/24/01

9:07:33 AM

Activity Description

SPTA010 Application Entered

SPTA350 Perc Test

Activities for Case #: SPT2002-00008

Date 1 Date 2 Assigned

Date 3 To Done By Disp.

8124/01

8/23/01

Page 1 of 1

DOC

DZ DONE

Hold Level

No Hold

Hold

Updated By Updated Notes

DOC

DOC

8/24/01

8124101

FORM 11 - SOn.. EV ALVA TOR FORM Page 1 of 3

No. ____ _

Commonwealth of Massachusetts _ I Massachusetts

Soil Suitability Assessment for On-site Sewate Dis.posal

cr~o)~~ Date : ... ...... .. . Performed BY: ~~?-{/-t'"'(/;<C..#~~...,;-~ ..... . Witnessed By: ... . ..(.uj,z:; .. .. . ......... .

c..f() .s 7il'r/ ,"';.- K# .. ./ o..~,. . _ . L1 ,'// "., r-e:.,<......( ~ •

'''u. ~ C; 80 U-77J77~.J .~,. i. ~4;;"'r- T._'(...... _ 'r7CJ -731- 70 v3

~ew Construction 0 Repair ~ Office Review

Published Soil Survey Available: No DYes G-' Year Published Publication Scale

Drainage Class Soil Limitations

Surficial Geologic Report Available: No [}-yes 0 Year Published Publication Scale

Geologic Material (Map Unit)

Landform

Flood Insurance Rate Map:

Above SOO year flood boundary No DYes ~

Within SOO year flood boundary No GYes D

Within 100 year flood boundary No BYes D

Wetland Area:

National Wetland Inventory Map (map unit)

Wetlands Conservancy Program Map (map unit)

CWT'Cllt Water Resource Conditions (USGS): Month

Range :Above Normal o Normal G'BeIow Normal 0

Soil Map Unit

~~~~: --------------------------------------------

DO' APPItOVll) POD! ' Uit1ltS

_.' ;. .. ( /

FORM 11 - SOIL EVALUATOR FORM Page 2 of 3

Location Address or Lot No . {;",cfC J'c77IlT?, "-' t;i!, ... L

On-site Review

Deep Hole Number_....:G_ I ",)_ Date: J'h,r41 Time: _______ __ Weather _____ _

location (identify on site plan)

Land Use K'-c r Slope (%) .? auk /S,...e/

Surface Stones __ ""=..o4.e!-,v=.../"-____ _

Vegetation ;':?..,.- / landform

« """"

Position on landscape Isketch on the backl .

Distances from :

Open Water Body /c/(/ feet

Possible Wet Area feet

Dr ink ing Water Well ~p feet

Drainage way feet ~ Property Line y(j feet

Other

DEEP OBSERVATION HOLE LOG·

Depth from Soi l Horizon Soi l Texture Soil Co lor 5011 Other Surface /Inches ! IUSDA) (Munsell) Mortling (Structure . Stones. Boulders , Consistency, %

Gr . .... ell

,tJ rfL /0('''-~ 3/ z.

r S-L ,34"

.;22.. J3 /OY"'~ /6,,"$ f',t:

CI c.. S / 0 V" /).. ( lh ? .;z. "

-

S~ /1 [' 17

Ur J. HUU~ IAI <, <In <u '"<A _ 1.1",,",,1 (geologic) _-+'1~i.""~"'h=L'--..-_'I'_L1 .!.f,..:.'1 ___ _

W •• pi"ll from Pi! Flee: -,3,-,~=-_'_' ____ _ pePth to Groyndwlter: Sl&Oding Wlter in the Hole : ___ ,_-------

" Eali"oted Seasonal Hioh Ground Water: __ --",""'3''''O'-_______________________ _

DEP APPRovm FOaM· U I0119S

I

I

/

FORM 12 - PERCOLATION TEST

Location Address or Lot No . &. to .f'rllrr,..-~ .... d

COMMONWEALTH OF MASSACHUSETTS • Massachusetts

Percolation Tesf

Date: b /;;;3 J tJ I Time:

Observation Hole # G Depth of Perc " '-/.,) Start Pre-soak

cJ ·3'1 End Pre-soak

./'- .FCf Time at 12"

d- i S-t.; Time at 9" :J; 08 Time at 6" :3 ;L/] Time (9"-6" )

i3~ Rate Min.llnch

/.;;2...

• Minimum of 1 percolation test must be performed in both the primary area AND reserve area.

Site Passed D Site Failed D

PerlormedBy: __________________________________________________ __

~rtnessedBy: __________________________________________________ __

Df.7 APPRovm FORM· llJt7,,!

• I

7 COLD SPRING ENVIRONMENTAL CONSULTA.1'ITS, INC.

ALAN E. WEISS, M.S., L.S.P. Licensed S'le Professional Regislered SClnilarian

FORM 11 - SOIL EVALUATOR FORM Page I of 3

HydrogeoJogisl PresidcOl

350 Old Enfield Rd . ReJdlenown, MA 01007

(' 13) 323-5957 & 323-<916 (FAX)

·Subsurface Jnvesligalions -21 E Sile inVcsligalions -PoJlu[ion RCmedial ion -Pereolarion Tests and Dat e: 8k3 (O(

I Septic Designs

Commonwealth of Massachusetts

~hfK'Str , Massachusetts Soil Suitability Assessment for Oil-site Sewage Disposal

Performed By: fJ.tJ€;S5 Witnessed By: )). 2fJJ2vZ,Aj5K:;

,ew Construction 0 Repair G-" Office Review

Published Soil Survey Available: No D

Year Published \"1%'( .... Drainage Class (\'\cc\ero..-tL

Pub l ication Scale

Soil Limitations

Surficial Geologic Report Avai lable: No 0- Yes 0 Year Published

Geologic Material (Map Unit) La.'1dform

Flood Insurance Rate Map:

Publication Scolc

Above 500 year flood boundary No DYes ~

Within 500 year flood boundary No C3Yes D

Within 100 year flood boundary No llies D

Wetland Area:

Nationa l Wetland Inventory Map (map untt)

Wetlands Conservancy Program Map (map unit )

Current Water Resource Conditions (USGS): Month

Own:,", Nunc.

Ad.11clI. ~:>j

lc.kpMnc I

Range :Above Normal ONormal B13ek", Nonnal 0 Other References Reviewed:

-------------------'I:- (\;"ItlJe. bO('Iu't" ea;,..i~r

~~ nET' APPROVED FOI,c"1 . 1210"95

Dale t/20 to (

iMf/ M ,fd.e{1 C;?£J S f<:rfto.-J /?o4 D /i<V1 ~<"'-':n' <//1/'1 .

J o/.'jo2-

Soi l Map Uni! Shb

:

FORM 11 : 501L EVALUATOR FORl\1 Page 2 of 3

Locat ion Address or Lot No, (/(;{J S7f}-77dJ '2c;bb

On-site Review

Deep Hole Number TP'- I t2 Dale: Time: 2- 'cc Weather

Location (identify on site plan) __ ~ .. =-== .. = .. = .. '~".= .. ~~ __ =~~_==~~~=~== __ ~~_~_ Land Use .1hl!&c (Zes, . Slope (%}-,3",-__ Surface Stones --.:""'=4"'='LI _______ _

Vegetation.-Jl R'>:;"~ ; cff'ClclsiC;J$

Landform I ,t;! «"",;2. " .. , , .. " .. " Position on landscape (sketch on the back)

Dislances from:

Open Water Body ,00 'r feet

Possible Wet Area teo ,+ feet

Drinking Water Well ./00 '+ feet

Drainage way., , 100 'f teet

Property line 7. '5 ' feet

Other

.c ".

DEEP OBSERVATION HOLE LOG'

Depth from Soil Horizon

I Soil Texrure Soil Color

I Soil I Other

Sur:'ace (lnc!":esJ (USDA) IMunselll MonJin~ (Stru:::ure , Stones. 50uldefs. Consis;:ency. % Gravell

o _(., V A p:'L IOJe.~/Z- Ice""" ~'ql,l(>

" ,. -z.z." b w FsL fO y{!.-ok lee."k ,f'n'«1otQ... ,

2.1.-" -tu,'j , I o ra...S'/t"

;"\ 2}J , ILl u,}'r1/-.Sc S/},o;) C, ~L IC)z(./1o ],G t,

-<J ('" b i-) ~:,.j- 'l:>o~ lete r.s 1'> <0

O-ec, ., A ')-Sc ; C 'j/l- '3 Iz. Ico 'S€. C:'\'~\ol<.

(.,-'2"'1." 'is''-l FSL (O'i/1.5/~ 10 '-J(1.. <; /-r; loo"k.. 0->'<;.i1~

·2 .. :Z-I~bll (., SL- io'lu.h ~C" ~\e"D - -JC Co~'2...Sc ~!l"'»

1<;<-/& &m...s .,... o"vld~

M INIMUM Ur 1. HUL"~ W A , " V O" Y eel U'~"U'AL AiiioA

Parem Material (geologit:::J _-"O~v~'l~<..l=ee="'.L.. ____ --,:,-__ DepttnoBedrOCk:_-'-I~Z:..!'~"_~~:-------~.., 11 ') <:,"

De?Th to Groundwater: Standing Water in the Hole: _~ '''_______ Weeping from Pit Face: ~~'C'~ _____ _

"c" '\ Estimated Seasonal High Ground Water:_-,v~,-____________________ ~,;-___ _

\

DEP Al'PROVED fOR. ... t· 1:1/0,/95

"

.-------- --- -- ---------~-------

FORM 12 - PERCOLATION TEST

Location Address or Lot No . (,1f{) f5TfFr;t;N 12b

COMMONWEALTH OF MASSACHUSETTS qfl1JIEJl~ , Massachusetts

Percolation Test·

Date: "liz'S/of Time :, ~;cP ,

Observati0f) Hole # p( / Depth of Perc 'iZ v I Start Pre-soak

Z: ,)1 / End Pre-soak 2:91 I -Time at 12"

z~5'/ / , . Time at 9"

l3:0'3 / Time at 6"

3',~3 I Time (9"-6") 3S- ,I Rate Min.!lnch "",cAl

12-~ V " Minimum of 1 percolation test must be performed in both the primary area AND

reserve area.

Site Passed ~Site Failed 0

Performed By; ---!1}.;......:.M---.:....'r65_· _____________________ _

Witnessed By: p_ '2114,.cm~"

Co mments: .M_ •. _ ... " .. ......... _ ••.•• _ . ...... ,.,. "_"._ •• _" •.• •••••••. "" " __ ..•....•• " •••. • • _ •..•..•..

DEP APPROVED FORM . 11/07195

680 Station Road Final Inspection 1213/0 I

680 Station Road Final Inspection 12/03/01

•

l1..lt '!>'> '

-- - - 1

I

/

fill 1'4ofd><CO C."'1Ou~

-'\b- -- 0~1~'W(' l/!~r..S

"'ore: II 1"10 <S Je.~,M·I!<:~ 'be..ll' t.)'S ",,1"11/ • .0

&,0' O~ ~~ (",fjel-t>. -'(~'J E.,.,ShlCo '\ittf\o"'$w\...., ~

'It, ~t (!.~JI:';.1> -t Ite~,

c....,1'o1o) C~',o.ll:> IJI~; a~'T' "T~l ,,.. I>cco~~ 1'>\ II>{}. n~t.1oI\ 4\:10 .

~")Q/'ot'U.. ~'I' e._,- '\:>.'" ~", .. 't>

""~~ ~'"I'l. ~q.~ e~ ~,

S'6TEM PIPES NO MORE THAN3 FEET BELOW F1NISHGRAOE

TYPICAL NEW DBL CHAMBER 1,500 GAL S, TANK OR EQUIV, (WATERTIGHT)

PlACE STEB. OVER UD USE WATERTIGHT RISER ~ H2O LOADING -IN ::

t contractor mus confirm .02'/ft, p from sill to s, ta

itch nk

3' .:....

-.l = I +-;;;rj ,-'[(/ n 1 ""rs~~ Irm - i _10' 14' 1/ 1,;- JU4' //1.

NEW DBL. (2) CHAMBER GAS BAFFL~~ /f'Je 1,500 GAL 1\

...... CONCRE1E TANK I \ all tees sch. 40

• , / \ 80' I \ 40"

,,' , , , I .\ "

"

,

' It- + !j..SE.p~E~3!r'+l2"fO!f + + +j

I ' 126'

,I

tyPICALD. BOX (WATERTiGHT)

--- PLAcE STEEL OVER COVER

[=::~i~~=~~~~;FiRST'ZOFOUTLETPIPES 2' ,'TOBELEVEL

- 2'

MIN6"SUMP

' OUTlET ' INLET

+ + + + + 11 .. .. • Pi..ACEONSTA8tE BASECf' 8"3#4-1112"CRosHeoSTotE • USE CoNcRETE BOX WJ'Z' MtoIWJU lHICKNESS

LEACH FIELD DIAGRAM

~r

.... OU

64" 1"5'

'-'-'-

li6"

. , ,

(ms)

~---: - -- -.- - -.' J;"

T

---F------------

24'

o---~-~

~4' PERF: PVC PIPE (~3~ __

0-----------

sch 40 pvc

BREAKOuT FILL 15' to elev. of pea stone I<E-,,-'-'------~--~) ~ , 10'

32' NOTREESWIIN10'0f~ \,

CROSS SECTfON OF SEPTIC SYSTEM 'BENCHMARK =100.00 AT GAR lILAB

(Note: .... 6" OF 314-1 112" 10 Iton. under d. box and •• lank for stable baa)

--100'

ELI!\!, ' 97.25' OVER BED 2% min slope over ~Ystem USE RISER tF>11'

BAR

37' L1

Il2SLOPE

RAISE PIPING AT SILL IF NEEDED

'" 4"PVCPIPE SUB

L.-.::~~~~~r:IL ;-L1=C=:;;;'S+;:' =3 98.58'

MIN.

ELEV. BOTBED 94.85'

( EfF ELEV. = 93.35')

4.00'+ SEPARATION TO GROUNDWATER START INV. @ ' 95.50'

GROUNDWATER ELEVATION INTERPRETED =87.78' -==::;; NOTE: USE mLE V FlU. ONLY UNDER AND AROUND FJELD TO MEeT DESIGN ELEVATIONS AS NOTED ON PLAN AND AS PER 310 15.255 AS NEEDED. (e1.ar aN top and sub prior to fill p1acem.n~ (EXCAVATE TO STONE elEVATION) NOTe; REGRADING AS SHOWN

88.33' " INY.

PlACE SCH40INANDMTEES AS NOTeD TfTlEV. Gf\SBAFFLEONOU1t£T. INLET LENGTH:10" OlITlET LENGTH:14~

NOTE: REPlACE S. TANKWITH NEW PIPE TEES ON CENTER WITH SCH. «:I PVC

NOTE: REMOVE OLD S. TANK SO AS TO NOT INTERFERE WITH NEW S TANK AND L. RELO. NOTE: REGRADE AREA OF FIELD AS NOTED ' , ALTERNATIVELY, OLD S.TANK MUST BE PUMPED CRUCHED AND FILLED

'"

SITE LOCUS

SCALE: 1"=2,0813 FT. USGS 7.5 MIN. QUAD.

FEET 2«lOO

TEST PIT LOG TP·1EL. 94.45' (EFF. EL. 93.35 OVER L. FIELD)

TP·2 EL. 92.25'

0-6' A : FINE SANDY LOAM, FRIABLE·LOOSE 0.6" (10 YR 3/2)

6.-22" BW: FINE SANDY LOAM, FRIABLE·LOOSE 6.-22" (10 YR 5/6)

.' 22'126" . Cl MED TO COARSE SANDY LOAM MOD. LOOSE, 15% COBBLES . , (10 YR 6/6) .

" oXtOE'S:~ '31i'·EFF. IN TP·l & 2 . (10 YR 518) "

-.ESHWT:330"=93.35 EFF. FOR DESIGN @ (4' SEPARATION PROVIDED)

72.". 72 ....

NOTOSS3.

STANDING H20 WEEPING FROM FACE

BEDROCK

DESIGN NO"TES:

1.4 BR X 110 GAUPERSONS/DAY =440 GAUDay

72" 72".

NOTOBS."

22·126"

-Use ONE Leachfielld 24' wide x 32' LONG W/6" 01 .5 ' 01 DBL washed stone below invert. Bot Area: 24' \Wide x 32' long =768sl. Side Area: N.A. Tot. Area: 768 :slx 0.60 gal.sl. = 461 GAUday.

3. GARBAGE DISPOSAL NOT ALLOWED (to be removed) 4 .. ALL D. BOX OUTUET PIPES LEVEL FOR 2' , 5. NO PRIVATE WELLS WITHIN 100 FEET OF SAS (TOWN WELL) 6 NO WETLANDs WfiTHIN 100 FEET OF SAS (File Request lor Determination) 7. PRE & POST CONTOURS NOTED AS NECESSARY. 8. RESERVE AREA NIOT REQUIRED. (PUMP CRUSH & REPLACE OLD SEPTIC TANK

(NEW 1,500 gal.:2 chamberS. TANK MAINTAIN 0.02 PITCH FROM SILL TO S. TANK) 9. SLOPE CALCS (SEE CONTOURS). SUBGRADE INSP. REQ'D. 10.2% MIN. SLOPE OlVER SAS, CLEAR TOP AND SUB TO 24" MIN. AS NEEDED.

CLEAR TO BASE UNDER BED PRIOR TO TITLE V SAND PLACEMENT. 11. SOIL EVALUATIOIN BY A. WEISS, RS. 08/23/2001. 12. DEPTH OF PERC;. 42" BY A. Weiss 08/23/2001 13. PERC RATE = 121MINIIN , CLASS II SOIL RATING (SANDY LOAM) 14.1NSTALLilNSPEClT SCH 40 TEES (10" INLET, 14" OUTLET) ON 1,500 GAL. S. TANK 15. USE NEW, 2 CHAIMBER 1,500 GAL S. TANK WITH PROPER SCH 40 TEES IN PLACE. 16. USE APPROVED 1(11/2") DBL. WASHED STONE UNDER BED & D. BOX FOR 6". CONFIRM STONE PRIOPERLY WASHED (WITH BUCKET !H20 TEST) PRIOR TO PLACEMENT. 17. NO TREES WITH liN 10 FT. OF NEW LEACH FIELD. 18 ENGINEER TO INISPECT SUBGRADE. remove old SAS where inteneres with new SAS. 19. T.S.M. 100.00 AT <GAR SLAB, PITCH SCH. 40 PVC PIPE 0.02 TO S. TANK 20. GRADE MULCH AND SEED OVER LEACHFIELD/SAS,

SITE

DRAWN BY

OAlTE:

::"' :' "