29 Cert. of Compliance & Plan to Repair Septic System Plan to Repair
SEPTIC SYSTEM
for
Paul H. Johnson
Located at
29 Hawthorn Terrace
in Northampton, Massachusetts
Plan Number 390
Contents
Site Plan:
Site Suitability Form 11.1:
On-Site Review Form 11.2:
Groundwater Form 11.3:
Soil Analysis:
Specifications:
Design Calculations System
Plan Drawing:
Thomas S. Leue, R.S.
Homestead Inc.
1664 Cape Street
Williamsburg, MA 01096
413 628-4533
fax: 413 628-3973
Design Date: 5/30/06
Updated:
1 page
1 page
2 pages
1 page
1 page
3 pages
1 page
1 page
Separate To be signed by Owner{s2
Application for Construction Permit: 3 pages
Local Upgrade Approval Form: 5 pages
No. pT-20-390
Commonwealth of Massachusetts
Northampton, Massachusetts
FORM11 -SOIL EVALUATOR FORM
Soil Suitability Assessment for On-site Disposal
Performed By:
Witnessed By:
Thomas S. Tre..uP
Owner. Town of Northampton
Date: 5/74/06
Location Address or Lot No.
29 Hawthorn Terrace. Northampton
New or Repair Construction: Repair
Owner's Name. Address &Tel. it
paul H. Johnson
29 Hawthorn Terrace
Florence. MA 01062
413 582-0168
Office Review
Published Soil Survey Available: No ❑ Yes
Year Published: 1980 Publication Scale: 15840 Soil Map Unit: 17
Drainage Class: Poorly drained, underlain with silt.
Soil Limitations: Severe effluent limitations: poor filter.
Soil Type: Has. Hinckley loamy sand
Superficial Geologic Report Available: No ® Yes El
Year Published Publication Scale:
Geologic Material (Map Unit)
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year flood boundary No Yes
Within 100 year flood boundary No Yes
Wetland Area
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current Water Resource Condition (tU--S�GS): Month
Range: Above Normal u Normal xi Below Normal ❑
Other References Reviewed:
•
j
DEP APPROVED FORM - 12/07/95
FORM 11-SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No.: 29 Hawthorn Terrace Northampton
Number:
390
On-site Review
Deep Hole #:
Date:
Land Use
1
Soil Evaluation
9:20_AM
small trees
>150
Number:
Time
Surface
Drainageway:
Property
PT-20— 390
5/24/06
Weather:
Stones:
Landform:
Line:
Other:
clear
open field
no
Vegetation:
Slope (%):
Distance in feet from
Open
Possible
Drinking
grass and
kame terrace
1$
25
Water Body:
Wet Area:
Water Well:
>100
25
>150
Depth from
Surface
(inches)
Soil
Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
(inches)
Other
(Structures, Stones,Boulders,
Consistency,%Gravel)
0 — B
8 — 20
20 — 74
74 — 108
A
Bw
Cl
Cd
fine sandy
loam
sandy loam
fine sand
silt loam
10YR 2/2
10YR 5/8
7 .5YR 5/4
7.5YR 5/2
Mottles
7.5YR 5/8
7.5YR 5/1
no
no
36
yes
>5%
roots, organic material
weak peds, friable
asitowlia-
campect till
compact till
•MINIMUM
Comments:
Parent Material (geologic):
Depth to Bedrock:
Depth to Groundwater:
Standing Water in
Weeping from Pit
Estimated Seasonal
OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL
AREA
108 inches
96 inches
92 inches
36 inches
the Hole:
Face:
High Groundwater:
glacial outwash
Depth
YES
of Excavation:
Depth:
Depth:
YES
DEP APPROVED FORM-1207/95
Location Address or Lot No.:
Number:
FORM11-SOIL EVALUATOR FORM
Page 2 of 3
On-site Review
Deep Hole #:
Date:
Land Use:
Vegetation:
Slope (%):
Distance in feet from:
Open
Possible
Drinkin
2
Soil Evaluation
9:30AM
Number:
Time
Surface
Drainageway:
Property
PT-20— 390
5/24/06
Weather:
Stones:
Landform:
Line:
Other:
clear
open field
small trees
>150
no
grass and
kame terrace
1$
25
Water Body:
Wet Area:
Water Well:
>100
25
>150
Depth from
Surface
(inches)
Soil
Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
(inches)
Other
(Structures, Stones, Boulders,
Consistency,%Gravel)
0 — 19
19 — 22
22 — 34
34 — 74
74 — 96
fill
A
Bw
Cl
Cd
sand
fine sandy
loam
sandy loam
fine sand
silt loam
10YR 2/2
10YR 5/8
7.5YR 5/4
7.5YR 5/2
Mottles
7.5YR 5/8
7.5YR 5/1
no
no
no
46 -
yes
>5%
roots, organic material
weak peds, friable
saatisaE till
compact till
* MINIMUM
Comments:
Parent Material (geologic):
Depth to Bedrock:
Depth to Groundwater:
Standing Water in
Weeping from Pit
Estimated Seasonal
OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL
AREA
96 inches
46 inches
the Hole:
Face:
High Groundwater:
glacial outwash
Depth
NO
of Excavation:
Depth:
Depth:
'`O
DEP APPROVED FORM-17/07/95
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 1 of 5
COMMI rWE IJI-Cor ssfAcIfusTTfs
Board of Health, Northampton, MA
Application for Local Upgrade Approval
Title 5, 310 CMR 15.000
DEP Approved form required by 310 CMR 15.401(1)
To be submitted to Local Approving Authority/Board of Health: For the upgrade of a failed or
nonconforming system with a design flow of<10,000 gpd, where full compliance, as defined in
310 CMR 15.404(1), is not feasible.
To be submitted to DEP: For the upgrade of a failed or nonconforming system with a design
flow of 10,000 up to 15,000 gpd and/or of a state or federal facility, where full compliance, as
defined in 310 CMR 15.404(1),is not feasible.
NOTE: Local upgrade approval shall not be granted for an upgrade that includes the addition
of new design flow to a cesspool or privy or the addition of new design flow above the existing
approved capacity of a system constructed in accordance with either the 1978 Code or 310
CMR 15.000.
1) Facility/system owner
Name: Paul H. Johnson
Address: 29 Hawthorn Terrace,
Florence,MA 01062
Phone # 413 582-0168
Address of facility 29 Hawthorn Terrace,Northampton
2) Applicant (if different from above)
Name:
Address:
3) Type of facility
X Residential - - - - _ Commercial
School _ Institutional
_ Other (specify)
4) Type of existing system
_ privy
X conventional system
cesspool
_ Other (specify)
Type of soil absorption system (trenches, chambers, pits, etc.)
leachfield
DEP APPROVED FORM 1207/95
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 2 of 5
5) Design flow based on 310 CMR 15.203
a) Design for of existing system 660 gpd
Approved? yes
Approval Date 11/3/92
If not, why?
b) Design flow of proposed upgraded system 440 gpd
c) Design flow of facility 440 gpd
6) Proposed upgrade of existing system is
_ Voluntary
Required by order, letter, etc. (attach copy)
X Required following inspection required by 310 CMR 15.301
date inspection was submitted to the approving authority:
b) Describe the proposed upgrade to the system:
New Presby Environmental leachfield.
c) Which of the following are applicable to the proposed upgrade?
_ Reduction of setback(s) (list setbacks to be reduced with proposed setback distances)
_ Percolation rate of 30-60 minutes per inch (state actual perc rate)
_Up to 25% reduction in subsurface disposal design requirements (state required&
proposed size)
Relocation of water supply well (identify well, describe relocation)
X Reduction of required separation between bottom of SAS &high groundwater
(specify proposed reduction& perc rate)
2 ft. separation at 60 min per inch
_ Other requirements of 310 CMR 15.000 that cannot be met(specify sections of the
Code)
System upgrades that cannot be performed in accordance with 310 CMR 15.404&15.405,or
in full compliance with the requirements of 310 CMR,require a variance pursuant to 310
CMR 15.410-15.417.
DEP APPROVED FORM 1207/95
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 3 of 5
7) If the proposed upgrade involves a reduction in the required separation between the
bottom of the soil absorption system and the high groundwater elevation, an Approved
Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR
15.404 (1)(i)(1).The evaluator must be a member or agent of the local approving authority.
Distance from soil absorption system to high groundwater: 2 feet
As determined by:
Evaluator's Name: Ernie Mathieu
Evaluator's Signature:
Date of Evaluation: 5/24/06
8) Notice to Abutters
No application for upgrade approval in which the setback from property lines or a private
water supply well is reduced shall be complete until the applicant has notified all abutters
whose property or well is affected by certified mail at least ten days before the Board of
Health meeting at which the upgrade approval will be on the agenda.Such notice shall
include the date, time and place where the upgrade approval will be discussed.
If the Department is the approving authority, then such notices to abutters must be
completed prior to the date of submission of the application to the Department.
The notices to abutters shall indude a copy of the completed application form and shall
reference the standards set forth in 310 CMR 15.402 through 15.405.
List of Affected Abutters:
Abutter Name.
Address:
Date Notified:
Abutter Name:
Address:
Date Notified:
Abutter Name:
Address:
Date Notified:
Abutter Name:
Address:
Date Notified:
DEP APPROVED FORM 17/07/95
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 4 of 5
9. Explain why full compliance, as described in 310 CMR 15.404(1),is not feasible (each
section must be completed):
a) an upgraded system in full compliance with 310 CMR 15.000 is not feasible.
In order tp control cost and to minimize surface disurption,
request reduction to groundwater of 2 ft.
b) an alternative system approved pursuant to 310 CMR 15.283-15288 is not feasible:
Not needed. conventional system feasible.
c) a shared system is not feasible.
Not required. lot wiJ1 support system.
d) connection to a sewer is not feasible:
No oubLic sewer in area.
10) An application for a disposal system construction permit,including all required
attachments (e.g.plans and specifications, site evaluation forms),must accompany this
application. Is the DSCP application attached? X yes _ no
11) Certification
"I, the facility owner, certify under penalty of law that this document and all
attachments, to the best of my knowledge and belief, are true, accurate, and complete. I
am aware that there may be significant consequences for submitting false information,
including,but not limited to, penalties or fine and/or imprisonment for knowing
violations."
Paul H. Johnson
Print Name
Thomas S. Leue, Homestead Inc.
Name of Preparer
5/30/06
Date
1664 Cape Street, Williamsburg, MA 01096 (4131 628-4533
Telephone # & address of preparer
NOTE:Title 5, 310 CMR 15.403(4),requires the system owner or operator to submit to the
Department a copy of the local upgrade approval upon issuance by the Board of Health
and prior to commencement of construction.
DEP APPROVED FORM 12/07/95
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 5 of 5
Coq1q4o1TWEnLT -Coy HISS C#USTTts
Northampton, Massachusetts
LOCAL UPGRADE APPROVAL ISSUED PURSUANT TO 310 CMR 15.404 & 15.405
Facility.system owner: Name: Pa_ul_g_, Johnson. 29 Hawthorn Terrace Florence.
MA 01062
Address of Facility: 29 Hawthorn Terrace
Type of facility: Residential
design flow per 310 CMR 15.203 440 qpm
System designer: Name: Thomas Lpue Address Homestead Inc. , ] 664 Cape St . .
Williamsbiig MA 01096 Phone No. 413 628-4533
Local Upgrade Approval granted for:
reduction in setback(s) (specifv).
per rate of ao Q m>n.(nchlsoecifv rate)
reduction in SAS of up to 25%
(snecifv!reduction&size of SAS1
x reduction in separation between SAS & high groundwater
tspecifv reduction &Derc rate) 2 ft separation at 60 min per inch
relocation of a well (explain)
ist local variances(wanted (no DFP aooroval required Der 310 CMR 15 412(4)1
ist varian - granted reauirina DEP aooroval
egard of Health Approval of proposed upgrade
Name&Title
ainum City/town
THE SYSTEM OWNER OR OPERATOR SHALL PROVIDE A COPY OF THIS LOCAL UPGRADE APPROVAL
TO THE REGIONAL OFFICE OF THE DEPARTMENT OF ENVIRONMENTAL PROTECTION DIVISION OF
WATER POLLUTION CONTROL UPON ISSUANCE BY THE LOCAL APPROVING AUTHORITY& BEFORE
COMMENCEMENT OF CONSTRUCTION.
Mail to: DEP, Western Regional Office, 426 Dwight St., 5th Floor, Springfield, MA 01102
DEP APPROVED FORM 12117/95
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WORK SITE LOCATION
29 Hawthorn Terrace Northampton
DESIGN CALCULATIONS
Plan Number 390
Presby Environmental Enviro-Septic Leaching System
Construction Type: �N /`ri-Lt
Structure: Single Family House 4 bedrooms
Flow Design Criteria: 110 gallons per bedroom per day
Calc. Design Flow: 440 gallons per day
Garbage Grinder: Not Allowed 1.0 factor
Total Design Flow: 440 gallons per day
Percolation Rate: Measured Via Soil Analysis
Percolation Rate: Design Rate 60 min. per inch
L
Info Source
800 473-5298
Owner's information
310 CMR 15 201
multiply above
310 CMR 15.240
multiply above
from pert test
310 CMR 15105.
Enviro-septic ripe nequuemem
Max. Perc Rate
HI mca.
2 Bedrooms
iw..
3
4
5
6
Ea. Additional
100
150
200
250
300
50
9
13
110
165
220
275
330
55
19
120
180
240
300
360
60
30
130
195
260
325
390
65
40
140
210
280
350
420
70
50
150
225
300
375
450
75
60
160
240
320
400
480
80
Enviro-Septic Pipe Requirement: 320 feet
Pipe Length: 40 feet
Parallel Pipe Runs: 8 pipes
Percentage of System Slope: 0%
Minimum Pipe Center-to-Center Spacing Calculations:
All distances expressed in feet Perc Rate Min/Inch
(maximum)
r
% System Slope
0 - 10%
11 - 15%
16 - 20%
21 - 25%
1 -10 11 -20
judgement
divide above
from drawing
21 - 30 31 - 4041 - 50 51 - 60
1.5
1.5
1.75
2
1.5
1.75
2
2.25
1.75
2
2.25
2.5
2
2.25
2.5
2.75
Pipe Spacing: 3.75 feet
(Spacing adjusted to meet minimum field size)
Sand Bed on Sides: 2 feet Design Manual Page 40
Total Bed Width: 29.25 feet Snaring x nines+ send
2 feet Design Manual Page 40
42 feet Pioe length +sand
0.00 feet % Slope x Pioe Spacing
1228.5 square feet :Sod h Total Width
(400 sa. ft. Code minimum)
judaement
2.5 3
2.75 3.25
3 3.5
3.25 3.75
Design Manual Page 38
Sand Bed on Ends:
Total Bed Length:
Drop Between Pipes:
Total Bed Area:
Homestead Inc.
Loading: H-10
5130/06
CONSTRUCTION SPECIFICATIONS
29 Hawthorn Terrace, Northampton
Title 5 Septic System Plan Number 390
1. General
a No work on this system construction shall take place until a permit for the approved system plan has
been received from the local Board of Health. A copy of the Disposal Works Construction Permit should be
on site for inspection during the time of construction. Additional specifications may be included elsewhere
in this design.
b. Loading requirements are specified for the septic tank on the system calculations page.Loading
requirements for any other component are on the drawing. Normal loading systems are designated H-10.If
H-20 rating is specified on the drawing and/or on the page for system calculations,the tank or leaching
facility shall be custom built to meet the increased loading requirements using additional rebar, greater wall
thickness and/or other approved methods. Follow the manufacturer's rating system and installation
procedures.
c. Alternatives to these specifications should be discussed with the Engineer in advance at 800 285-4533.
2. Septic Tank
a Existing septic tank to be reused. Pump tank at the start of the work.
b. Add riser to surface over center cleanout to facilitate maintenance. Use secured cover that has four
stainless steel screw fasteners.
c. Septic tank should be inspected by the Owner or his representative for solids accumulation annually.
When the sum of the sludge and scum layer approach 1/3 the net working volume of the tank(net of 16"
total thickness), as measured at the center of the tank the tank is due for pumping. Septic tanks shall be
inspected and maintained in accordance with 310 CMR 15300 and applicable local requirements.
3. Pump System
a. Existing pump chamber,pump and alarm system to be reused.
4. Distribution Box
a The distribution box selected by the contractor shall conform with 310 CMR 15.232. Material of
construction shall be concrete or plastic lined concrete. A 6"sump is required in the d-box.
b. The distribution box shall be placed on thoroughly tamped and compacted sand or peastone a minimum
of 6"thickness, and shall be leveled utilizing a water flow test Speed levelers shall not be used on a new
installation to obtain level and equal distribution flow,but should be installed after leveling is completed in
case uneven settling occurs in the future.
c. For inlet pipe slopes of 8% or greater, or where there is a pumped flow,the distribution box shall have
an internal cast baffle or solvent welded pipe tee to reduce the velocity of the influent flow. An internal pipe
"I^"or an elbow are not acceptable.
d. The first 2 feet of pipe out of the distribution box to be set dead level. Use a fernco connector to join to
pitched pipes beyond first two feet.
5. EMLng
a Piping to the septic tank(the building sewer)shall be 4"diameter,PVC Schedule 40 or better. Slope new
Homestead Inc. Page 1
5/30/06
CONSTRUCTION SPECIFICATIONS
29 Hawthorn Terrace. Northampton
pipe installations at 1/4"per foot length.
b. All piping from the septic tank to the end of the system shall be 4"diameter, SDR-35 or better,except
as noted on the drawings Slope pipe installations 1/8"per foot length as a minimum value.
6. Leaching Facilities - 1/7.;-5998
a Leaching system for this site to be the Presbv Enviro-Septic Leaching System as approved by the MA
DEP. Installing contractors are to be trained by Presby Environmental Inc. and to hold a certificate
documenting this training before the start of the work. Information on training requirements may be obtained
from the system manufacturer at 800-473-5298. The installation requires the close following of
requirements of the MA DEP Approval document dated 11/21/05, and the "Enviro-Septic Wastewater
Treatment System Massachusetts Design and Installation Manual"dated January, 2006, which is
incorporated into the MA DEP Approval and these specifications by reference. Do not bid on this project
or initiate any construction until this manual is thoroughly understood as to system details and
requirements.
b. Notice the system sand required for this project is not the same media as that commonly known as Title
5 sand,but must meet the requirements of ASTM C-33 (concrete sand). A certificate that this media meets
this requirement is required to be delivered to the System Designer, as prepared by a certified independent
laboratory,before closeout forms may be finalized for this project.
7. Inspection
a. Two site inspections are required under the revised Title 5 code by the System Designer. First, after the
site has been prepared with clearing, excavation and system site layout,but before the installation of the
system sand. Second,the contractor shall notify the System Designer a minimum of 48 hours in advance of
the anticipated completion time for a Final Inspection. The system shall be essentially complete at the time
of the final inspection, including all components in place,risers and covers installed,electrical components
functional,etc. No installed system component shall be buried greater than 1"depth at the time of final
inspection. The System designer shall verify the system was installed as designed and authorize the final
grading. Coordinate the timing of the Final Inspection so the System Designer and the representative of the
local Board of Health may be on the site at the same time, if possible.
b. If the System Designer fords the system is not ready for inspection after being called, or if serious
deficiencies are discovered,the System Designer must be notified to return to the job site when it is
complete. There will be a charge to the installer of$50 for each return trip,payable directly to the System
Designer at the time of the reinspection.
8. Final Grading
a At conclusion of work, loam and seed all disturbed areas to perennial grass mixture.Added loam may be
required for adequate grass growth. Mulch slopes with hay,burlap or netting to minimize erosion.
b. Surface over leaching facility shall be pitched so as to shed rainwater. Also pitch surface over all tanks to
shed rainwater from any exposed covers. Do not allow surface water to puddle over any tank or component.
c. Systems built late in the year,where the grass cover does not have a chance to establish itself,requires
the contractor is to return after spring thaw and resurface final grades and add grass seed cover as required to
equalize and stabilize all disturbed areas
Homestead Inc. Page 2
5/30/06
(BOARD OF ffHee HEALTH
OF IC I'rit(litLfibtr
wrrtifiratr of tduntpliatur
TiflS JS TO ERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (t...),
by....,,kfGt►XrLt. ..:.. n
has been installed in accordance with the provisions of lb.!:":.L 5 of pT,he State Sanitary Code as descri in the
application for Disposal Works Construction Permit Noa�..tOS O. dated 057/19. 6
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM W L FUNC ION SATISFACTORY.
DATE..... °�1 2O8-� Inspector....
O11111WOFIBM
FORM 2A - DSCP
No. Fee
C034310 ' WfLT' -(OFrWISS9ICTF S'-PTYS
Board of Health, Northampton, MA
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to. Repair an individual sewage disposal system at
29 Hawthorn Terrace, Northampton as described in the application for Disposal System Construction
Permit No. dated
Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met.
Date Board of Health
DEP APPROVED FORM 596
BOARD OF HEALTH
MEMBERS
ROSEMARIE KARPARIS,R.N.,MPH
XANTHI SCRIMGEOUR,MHEd,CHES
JAY FLEITMAN,M.D.
STAFF
Ernest J.Mathieu,R.S.,M.S.,C.H.O.
Director of Public Health
Richard Meczywor,R.S.,Sanitary Inspector
Patricia Abbott,R.N.,Public Health Nurse
MEMO
TO:
OFFICE OF THE
BOARD OF HEALTH
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
212 MAIN STREET
NORTHAMPTON,MA 01060
(413)587-1213
FAX(413)587-1221
FROM: Ernest S.Mathieu,R.S.,M. C.H.O.,Director of Public Health
RE: Re-Inspection Fees for Additional Final Septic System Inspections Required after the First Initial Inspection
DATE: 02. 2006
Attached is a copy of the Board of Health fees schedule that became effective on July 1,2005 Please take notice that there is a
$25.00 Re-inspection fee for any subsequent re-inspections of the installation of the septic system after the fist initial
inspection.
Please relate this information to your Septic System Installer. Please fell free to contact me at 587-1213,if you have
any questions regarding this fee.
No).066-49
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE TH
OF
Eispnsttl arks Qtunstrurtinn j rrmit
Permission is hereby granted......... -. - -/Tires "' ,'-O
to Construct (�f) or Repair an Indi/1 Sewage Disposal System
at No a/`f-_iL�Zisa�....t Street �7/ ^/
as shown on the application for Disposal Works Construction Permit No A-.0 . Dated.._ J-bU°
�"� ` / �—(J 402- f e d of xHealth w
DATE � o Eg16T 1. MMTIRCU, RS, MI, C.H.O.
FORM 12 55 MOBES & WARREN. INC.. PUBLISHERS
FPS.... t$L&
&Xe-eifeet 67
DIRECTOR OF RFALUI
No.
FORM 1A - APPLICATION FOR DSCP
Fee t
5 c
Coq oafwnRLif94-0 F WISS910-CUSETTIS
Beard of Health Northampton MA
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to: Repair
( ) Complete System ( X ) Individual Components
Building Type: PweJ ling
Bedrooms: 4
Other - Type of Building
No. of persons
Other Fixtures
Design Flow (min. required): 440 gpd
Calculated design flow: 440 gpd
Design flow provided: 440 qpd
Description of Soil(s) sandy loam to sand soil
Soil Evaluator Form No. 390
Name of Soil Evaluator Thomas Leue
Date of Soil Evaluation 5/24/06
DESCRIPTION OF REPAIRS OR ALTERATIONS new leach field of Presby
$nvironmental system.
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 and further agrees not to place the system In operation until a Certificate of Compliance
has been Issued • the Board • Health.
Garbage grinder (noi
Showers ( ), Cafeteria ( )
Signed
Inspections
Date
DEP APPROVED FORM 596
Location 29 Hawthorn Terrace
Owner's Name
Paul H. Johnson
Map/Parcel
Address
29 Hawthorn Terrace
Florence MA 01062
413 582-0168 _
Thomas Leue, Homestead Inc.
1664 Cape St., Williamsburg MA
Lot#
Installers name
Telephone#
Designer's Name
Address
(Address
Telephone # _
Tele•hone
413 628-4533
4.`
esnnn
_
Building Type: PweJ ling
Bedrooms: 4
Other - Type of Building
No. of persons
Other Fixtures
Design Flow (min. required): 440 gpd
Calculated design flow: 440 gpd
Design flow provided: 440 qpd
Description of Soil(s) sandy loam to sand soil
Soil Evaluator Form No. 390
Name of Soil Evaluator Thomas Leue
Date of Soil Evaluation 5/24/06
DESCRIPTION OF REPAIRS OR ALTERATIONS new leach field of Presby
$nvironmental system.
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 and further agrees not to place the system In operation until a Certificate of Compliance
has been Issued • the Board • Health.
Garbage grinder (noi
Showers ( ), Cafeteria ( )
Signed
Inspections
Date
DEP APPROVED FORM 596
j
j
/
/ / IBM top ofdan=mar.
Elevation:100.00'
/ ii
/ u1r2'_1e I.
Vet 3 k dear to ground
dY R
%.----.... ~ —sotudmBac /4%
Water line,
Orig Surf.file!_97.6 awrcdmate loatim
i i 1141 Vent:1 tt.dear to ground. \
! Hide in existing mult-trunk tree
I I `\\
\
0
OIR
NH
i Kph Vent 1 ft dear to ground.
! Hide in existing multi-trunk tree
LSe black 4"da.pipe.
Driveway
Variant es Applied Far: l
_fo t separation to gamd+a[er.
En'stlng Septic Tmlq pump and reuse,add
riser to surface oar a ter deanae
Cbseout Notes for Presby Environmental Leaching System:
1. Presby Environmental leaching facility requires annual monitoring to maintain Manufacturer's
certification and is a requirement of the MA D.E.P.. Contact Presby Environmental at
800-473-5298 for further information on this requirement.
2. Recommend pumping septic tank on a 3 to 5 year schedule, depending on house occupancy.
3. A copy of this document attached in the basement/utility area will keep this information
available in future years for maintenance.
No. Qd ' 9
FORM 3A-CERTIFICAT OF COMPLIANCE
Fee .���'
COMMO24WZ1SOF ? ASS9LC7-GUSEnt
Board of Health, Northampton, MA
CERTIFICATE OF COMPLIANCE
Description of Work: ( ) Complete System (X) Individual Components
The undersigned hereby certify that the Sewage Disposal System: Repair
by:
at:
J. W. Cotton Co.
2 Hawthorn Terrace. Northampton
Homestead Inc. Project# 390
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved
design plans/as built plans relating to application No.
dated 5/30/06 Approved Design Flow 440 (gpd).
7 41
Date:
Installer
Designer:
Inspector:
Date: 8/2/06
C//14ryV Date: /04+
Local ADDrovino Authority
ERNEST J. MATHIEU. RS, MS., C.H.O.
Northampton Board of Health DIRECTOR OF HEALTH
This certification represents no warranty,expressed or Implied as to the functioning or
compliance with all applicable rules land regulations ons iin effect at plan
he time plain submittal.of the onsite subsurface
cc: Paul H.Johnson, 29 Hawthorn Terrace, Florence, MA 01062
S
DEP APPROVED FORMS/9S
FORM 3A- CERTIFICATE OF COMPLIANCE
No Fee
costa ?fwzwt(or 2149LSSWIRISE?''.rS
Board of Health, Northampton, MA
CERTIFICATE OF COMPLIANCE
Description of Work: ( ) Complete System (X ) Individual Components
The undersigned hereby certify that the Sewage Disposal System. Repair
by: J. W. Cotton Co.
at: 29 Hawthorn Terrace, Northampton
Homestead Inc. Project#: 390
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved
design plans/as built plans relating to application No.
dated 5/30/06
. Approved Design Flow 440 (gpd).
Installer
Designer:
Date:
Date: 6/2/06
Inspector: Date:
Local Approving Authority
Northampton Board of Health
This certification represents no warranty,expressed or implied as to the functioning or
longevity of the onsite subsurface disposal system. Rather, the plan and installation are in
compliance with all applicable rules and regulations in effect at the time of plan submittal.
cc: Paul H. Johnson, 29 Hawthorn Terrace, Florence, MA 01062
DEP APPROVED FORM 596
/ FORM 3A - CERTIFICATE OF COMPLIANCE
No. P,e 6— 0% Fee
Cale4011WEALTV OF MASSrACOUSETYS
Board of Health, Northampton, MA
CERTIFICATE OF COMPLIANCE
Description of Work: ( ) Complete System ( X ) Individual Components
The undersigned hereby certify that the Sewage Disposal System: Repair
by:
at: 29 Hawthorn Terrace, Northampton
has been installed in accordance with the provisions of 310 CMR 15.00 (Tide 5) and the approved
design plans/as built plans relating to application No.
dated 5/30/06 . Approved Design Flow 440 (gpd).
Installer:
Designer: Thomas S. Leue, Homestead Inc.(, i) 11$43Date: p 06
Inspector: � ca Date: d/Z%6
r 7 Lf/3�o?Y 7 j(, ate: s(Z/U4
The issuance of this permit shall not be construed as a guarantee that the system will function
as designed.
DEP APPROVED FORM 596
FORM 2A - DSCP
No. Fee
COM4.02fWEALT TOT MASS9LCTFUSEa S
Board of Health, Northampton, MA
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to: Repair an individual sewage disposal system at
29 Hawthorn Terrace, Northampton as described in the application for Disposal System Construction
Permit No. dated
Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met.
Date Board of Health
DEP APPROVED FORM 5/96
FORM 3A - CERTIFICATE OF COMPLIANCE
No. Fee
COVIA0?(Wf9ltT'G(OP W SSSC9hL P�'Ts
Board of Health, Northampton, MA
CERTIFICATE OF COMPLIANCE
Description of Work: ( ) Complete System ( X ) Individual Components
The undersigned hereby certify that the Sewage Disposal System: Repair
by:
at: 29 Hawthorn Terrace, Northampton
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved
design plans/as built plans relating to application No.
dated 5/30/06 . Approved Design Flow 440 (gpd).
Installer: Date:
Designer: Thomas S. Leue, Homestead Inc. Date:
Inspector: Date:
The Issuance of this permit shall not be construed as a guarantee that the system will function
as designed.
DEP APPROVED FORM 5/96
FORM 11-SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. 29 Hawthorn Terrace. Northampton
Homestead Inc. No. 339Q
Determination for Seasonal High Water Table
Method Used
❑ Depth observed standing in observation hole_ inches
❑ Depth weeping from side of observation hole inches
II Depth to soil mottles 46 to 36 inches
❑ Ground water adjustment inches
Index Well Number_ Reading Date _ Index well level
Adjustment Factor _ Adjusted ground water level
Depth 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? Yes
If not what is the depth of naturally occurring pervious material?
Certification
I certify that on June, 1995 I have passed the examination approved by
the Department of Environmental Protection and that the above analysis was performed by
me consistent with the required training, expertise and experience described in 310
CMR15.017.
Signature: / (-
/�., J
Date: 5/29/06
DEP APPROVED FORM - 12/07/95
Soil and Plant Nutrient Testing Lab
West Experiment Station
University of Massachusetts
Amherst,MA 01003
413 545 2311
huplIwww.umass.edu/plsoilshoiltest
Customer Name
TEXTURAL ANALYSIS RESULTS
Homestead, Inc./Thomas Leue
1664 Cape Street
Route 112 Ashfield
Williamsburg, MA 01096
Sample ID: 67233
Customer Designation: 29 Hawthorne Terrace
05/26/06
USDA SIZE FRACTIONS PERCENT OF WHOLE SAMPLE PASSING
Main Fractions Size (mm) Percent Size (mm) Sieve # i
Sand 0.05-2.0 41.2
Silt 0.002-0.05 56.4
Clay < 0.002 2.4
Total c 2.0 100.0
2.00 #10 99.8
Sand Fractions Size (mm) Percent 1.00 *18 98.9
Very Coarse 1.0-2.0 0.2
Coarse 0.5-1.0 0.7 0.25 #60 97.4
Medium 0.25-0.5 1.5
Fine 0.10-0.25 10.6 0.10 #140 86.8
Very Fine 0.05-0.10 28.2
0.05 #270 58.7
41.2
0.02 20 um 23.6
0.005 5 urn 4.1
Silt Fractions Size (mm) Percent 0.002 2 um 2.4
Coarse D.02-0.05 35.1
Medium 0.005-0.02 19.6
Fine 0.002-0.005 1.7
56.4
USDA Textural Class = silt loam
Gravel Content = 0.2% COMMENTS: