392 Septic Inspection 2003 •
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Page A of I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SIBSIIRFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address
Owner:
Date of Inspection
39?
TIGHT or ROI.DIN(; TANK: (tank must he pumped nt time of inspectlon)(locate on site plan)
Depth helm v grade _
Material of construction concrete metal fiberglass polyethylene _ other/explain)
Dimensions
inns
< apncicv enllor
Design Hots urlonc din
A lan i pr ceo t'CS m .)
� r
Alarm level. Alarm in scorking ordea (ves or no)
Dale of last pumping:
Comments(condition of alai and float ssylmhes.etc.T
DISTRIBUTION BOX: if present must he opened)(locate on site plan)
Depth of-liquid level shave outlet invert Q'
Comments (note if box is level and distribution to outlets equal- ans.evidence of Solids cart over- y evidence of
leaknee into or out of In etc I: - an
/ ie..) 4, f�jf-� frz./ "y
eec'/4' e---c-a-f-cr¢,
PI TPIP CHAMBER: on site plae/LiA
Pumps in corking order(ve% or no). _ __
Alarms in svorking order(yes or no).
Comments (note condition of pump chamber. condition of pumps and appurtenances. etc.).
R
Page 9 of I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
�
Property Address: 32a Cd./.ZSf/t/Cii�.{ -t2J2.Q
_
—Tao;
Owner: /4) G/9-si f/Ff�L164-y
%/%/O3
SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required)
Date of Inspection:
If SAS not located explain why: 4,5-
Type
leaching pits,number:
_leaching chambers,number:
leaching galleries, number
leaching trenches,number,length:
y leaching fields,number,dimensions: c_ze p�Cj.y7
overflow cesspool,number:
innovative/alternative system Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation,
etc.):
.fi//
CESSPOOLS:_(cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum laver:
Dimensions of cesspool.
Materials of construction:
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.):
' A/W
PRIVY:
(locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegeta
39z C/J,CsrAf- Ltd ,p_D
/‘:/_)5 "479
ji t , -5,A//Y c)/1 y
7/ 9103
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i N
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tiL
0151 °a
a, vaiss .o'
if a !y It-
," II N.,i;M av
0N1 e
6b 4 ur slS ,rYi raves
yf
S7,-vim 6, mstr7 , m
(?)-l... . .c c7 =77
t/r' 0-2yny ✓1--✓L) - 24C
clung Capacity = 90
SIGN CAPACITY
TEES:
Inlet and outlet b
Access cover to b
be plugged at end
All top soil, sub-s
and for a horizon
be filled wit' cle
elevation 1
breakout distance r
Septic Tanksh
All work to be
0.60 GPllist- - )4U
Gib/02Y
of existing 1000 gallon septic tank to be replaced with 4" PVC tees.
tailed over new outlet of tank and raised to grade. Existing outlet pipe to
tamps, roots, and all other unsuitable material to be excavated from under
stance of 5' beyond the perimeter of the leach system. Excavated area to
ular sand fill, free of organic matter and other deleterious be need erial, up to
b field to be installed on new fill. Excavated material ma,"
`
ments
inspected and pumped every
two years.
,.;
accordance with the Massachusetts Environmental Coat, Title 5.
SEPTIC SYSTEM RE
HARRY R . I ASHWI
392 CHESTERFIELD R
NORTHaMPTO?C , M
DRAty
J:. '. "r;_' A. GRACIA, PE
99 G.E-NDtLE STREET EASTriAA' TO.",1✓1
FINISH GRADE TO SLOPE MIN. 27.
DIST. BOX
DIST. BOX
C
0p
G
0e ^
C
0e
C
4"-PVC (PERFORATED) 0 5 • 0.57
VP 8?r, = 6° UNDER PIPE
ELEVATION VIEW
45,
WASHED STONE
4' PVC (PERFORATED) 0 5 • 0.57
PLAN VIEW
LEACH FIELD DETAIL
NOT TO 5CALE(
SEPTIC Sl STEM D IGN CALCULATIONS:
3 Bedrooms @ I i 0 G Birm = 330 Gals/Vag x I50°° -7495 Gals/Da■
BREAKOUT DISTANCE
15' MINIMUM
INV. 0 END
OF FIELD
103.50
TONE
A
9.5
3
Q I
PERCOLATI?t` TEST:
DATE- 10- i °5
BY JAM;• ;A. GRACIA, PE
RATE- 5 INCH 0 42"
WITNESS. P. M' PLAIN
TEST P
104.0±
•
7
ti
l Og Uo F 9;. -
100' R
EXISTING'
3 BEDROOM
DWELLING
HO. #392
$ -:1f I 171hrc
tl
itS
:1
107
J
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106
105
104 _
103
102 -.
J ,. 101 . _
100
D NA''_ ''N POLE 136/25
DWI • ELEV_ a 100-00 ASSUMED W
XN VIEW
ALE:
C S'i'ERFIELD RO