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Home My WebLink About0006 BEECHWOOD ROAD - Health 6 Beeehwood Road, Centerville A= II� UPC 12534 ho- No. 2-153LOR � HASTINGS. MN PROPERTY ADDRESS: '6'BeecEwood' Road' Centervi.11e,Mass . - 02632 On the above date, I L""5ected the septic system at the above address. This system consists ' Ile following: 12, 1% 2—Block cesspools. V-1 2; 1— Precast leaching. pit. Based on my Insoectlon, I certify the following conditions: ~ SUN 1 . This is-- not a. title five septic system. 2. This is a sewage system. �'r`' 3. The sewage system is in proper working order_ at the present time.. . . - SIGNATURE: Nam@ J P Macomber Jr... i Company: J-P_Maco0er & Son-_Inc . , Address:_-B"_66--- -- -- Cen1�rvil ;e LMass__0.2.632 ' Phone:---5Q8_�75.3338------- I' THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON,. INC. Tanks-Ceupools-Leachflelds . Pump*d 4 InsUlled Town Sewer Connectlons P.O. Box 66.* ' Centerville, MA 02632-0066 77.5.3338 775-6412 .•.fir U AL Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection William F.Weld Trudy Coxe a.uet+y oOMN1Of David B.Struhs Argeo Paul Celluccla,ny„yefw LL Gommor ' e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION ProportyAddrou; 6 Beechwood Road Centerville,MassAddreaaofOwner.. 1520 Pendleton Place Date of Inspeotlow 6/6/96 (If different) Venus Florida 34292 Name of Inspootor. Joseph P. Macomber Jr. Company Name,Address and Telephone Number. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 508-775-3338 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•sits sewage disposal systems. The system: Conditionally Passes _ Needs Further Eval tiou By the Local Approving Authority _ Fails ,a InaP"tor's St gnat ,Date: The System Inspector submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design Dow 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. INSPECTION SUMMARY: Check A, B, C, or D: A) SYSTEM PASSES: D&I have not found any information which indicates that the system violuwa any of the failure criteria as defined in 310 CUR 15.303. Any fAUury criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: ID One or more system components hood to be replaced or repaired. The system, upon completion of the replacement or repair,passes . inspection. Indicate yos, no,or not determined(Y,N, or ND). Describe basis of determination in all instances. If"hot determined",explain why not) -420 The septic tank is metal,cracked, structurally unsound, shows substantial infiltration or exi ltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revlsed 11/03/95) I One Win tor St:oai I Boston, Massachusetts 02108 0 FAX(617) 556-1049 9 Telephone(617)292.5500 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oonUnued) Property Address: 6 Beechwood Road Centerville,Mass . Owner. FrancEs Taormena Date of Inspection: 6/6/9 6 Bl SYSTEM CONDITIONALLY PASSES(continued) 4�dAt�, Sewage backup or breakout or bob static water I"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 bwi is levelled or replaced 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 Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: A10_ 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 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 a surface water LV 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 APPROPRIATE) DETERMINES THAT THE SYSTEM.IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tankand soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and 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. 3) OTHER y Qtp-M ronGi ats of two hl nc+k nPGS=nnl Q andnnP =rP(,aat lcanliinn rj: Nn to S'pntion C, Parhgrq h (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 6 Beechwood Road Centerville ,Mass . Owner. Francts Taormen'a Date of Inspection: 6/6/9 6 DI SYSTEM FAILS: • AA I have determined that the system violates one or more of the following failure criteria as defined 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. dc!p Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Lls`Q Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. /JkA Jt Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1l2 day slow. &d Required pumping more than 4 times in the last year NOT due to clogged or obstructed pips(s). Number of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. . Any portion of a cesspool or privy is less than 100 feet but greater than 60 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 compounds,ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: 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: the system is within 400 feet of a surface drinking water supply AW the system is within 200 feet of a tributary to a surface drinldng water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall'bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for Atrther information.• (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST prop0rVAddr.= 6 Beechwood Road Centerville,Mass . Owner. Francts Taormena Date of Inspection: 6/6/9 6 Check if the following have been done: Pumping information was requested of the owner,occupant,and Board of Health. —LIKone 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. &gAz built plans have been obtained and examined. Note if they are not available with N/A - The facility or dwelling was inspected for signs of sewage back-up. ZThe system does not receive non-sanitary or-industrial waste flow , The site was inspected for signs of breakout. ZAll system components,Jkluding the Soil Absorption System, have been located on the site. A.V4C..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. ZThe size and location of the Soil Absorption System on the site has been determined based on existing information or ZThe roxinnated by non-intrusive methods. facility owner(and occupants;if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PropertyAddresa: 6 Beechwood Road Centerville ,Mass . 02632 Owner. Francks Taormena Date of Inspection: 6/6/9 6 FLOW CONDITIONS RESIDENTIAIr Design flo�y ns,p�v'e�/� • Number of Number of current residents:0 Garbage grinder(yes or no):—�D Laundry connected to systeJn(yes or no):,- Seasonal use(yes or no) C Water meter readings,if available: "1Q = -4;71.ewo !' Last date of occupancy:, COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow:_A&_gallons/day Grease trap present: (yes or no)" Industrial Waste Holding Tank present: (yes or no) & Non-sanitary waste discharged to the Tito 5 system: (yes or no)A.�14 Water meter readings, if available: Last date of occupancy: " OTHER: (Describe) X14A Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and&or of' rmation: System pumped as part of inspection: (yes or n _ If yes,volume pumped: ons Reason for pumping TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or noj(if yes, attac previous pection cords, if any) -- 'Other(explain 1— L O Jam. APP40XIMA AGP-X all comFNnents, date ' ed(if known) and source of information: Sewage odors detected when arriving at the site: (yea or no) �� (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C- SYSTEM INFORMATION (continued) Property Address: i Owner: Date of Inspection: i SEPTIC TANK:,4110 (locate on site plan) Depth below grade: A/V4 Material of construction.41goncrete _metal _FRP _other(explain) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle:,_A Scum thickness:_ Distance from top of scum to top of outlet tee or baffle:�� Distance from bottom of scum.to bottom of outlet tee or baffle._ All Comments: (recommendation for pumping, condition of inlet and outlet tees or baffle,. depth of liquid IPvel in relation to outlet invert, structural inte 6ty, evidence of leakage, etc.) OIL GREASE TRAP. (locate on site pian) Depth below grade:,' Material of construrtion;j*oncrete _metal _FRP —other(explain) Dimensions• Scum thickness: Distance from top vi scum to top of outlet tee or bah•le: /J;W Distance from bottom of <r„m t� bottom of outlet tee or baffle &A Comments: (recommendation for pumping, condi—n of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evtd nce of leakage, etc_i 2�� :-s-i.�yieyrli S ` :6 (revised 8/15/95) 6 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Ad(hess: 6 Beechwood Road Centerville ,Mass . 02632 Omer. Francts Taormena Date of Inspection:6/6/9 6 TIGHT OR HOLDING TANK&It. (locate on site plan) • Depth below grade:,dl} Material of oonstriction:4,1ooncrets_metal_FRP _other•(expluin) ' AA N ft Dimensions: 04 Capacity: to A zallons Design flow: ons/day Alarm level: Comments: (con do of inlet tee, condition of alarm and flout switches, etc.) DISTRIBUTION BOX:A/AV— (locate on site plan) Depth of liquid level above outlet invert: g Comments: (note ' lave and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER//'e _ (locate on site plan) Pumps in working order:(yes or no)4,W Comments: (a co n of pump chamber, condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 PrvportyAddro&4: 6 Beechwood Road Centerville ,Mass . Os;VDcr. . Francis Taormena Date of 6/6/96 SOIL ABSORPTION SYgTF-'A (low to on " PLAA if poasible; --vatiun 110L "Ll'. uu: !:U,). L' '1pPrjj11LuLAxJ by non-intrusivu nwthods) If not datzrmiaod to be pru",nt, tupliiin TYN: leaching pits, number: laachiag ch.Ambors, number: loathing galleries, number: loachiag trenches, numb-er,lengtn: loathing fields, number, dimensions overflow cesspool, nu mber:4— Comments: (note condition of iod, ia&— of f hydra dtc faLjurx. -)�jndin�, Condition of VegVtati0n,etC Medium sand & gravel to--f-ine sand;No signs of h;rdrgulic failure or i)Qndjn�; All yegetati.on-j-3--inm-a Tnal ; No rej)8jrS neerled at the CESSPOOLS: (locate on site plan) Z= Al Number and configuration: I;& Dopth-wp of liquid to iaJot Uivort: Depth of soLi(:U Layer; Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of goundwater: inflow (cesspool must be pumped as par-- 31 Comment(aou conditionf soil, signsof hydraulic failuj-r, level of pondi�, condition of vegetation, etc.) Same as atove PRIVY: AAWe-- (10caw on silo pLa-U) mater" of construction: IeW Dimonsions: Depth of solids: AM Comments: (note condition of wil, sites of hydraulic faJurv, ljvul of F-Dading, condition of vegutadon, etc-) (revised 11/03/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) PropertyAddresw 6 Beechwood Road Centerville,Mass . Owner. Frances Taormena Date of impeetion: 6/6/9 6 — 1 SKETCH OF SEWAGE DISPOSAL SYSTEM: s include ties to at least two permanent references landmarks or benchmarks locate all wells within 100, Centerville Osterville Marstons Mills Water company 42 76691 i i i • �e ss�o a�. S X 9' �a� Mtn o y>9��•�a fir- auf)�ye, O r DEPTH TO GROUNDWATER Depth to groundwater. -')Q feet method of determination or a pcx+TMiation: leachinghen i ., was in ,_ - —ifes A �fd11Y3trPrari at 12 mranc, t rPadina from sus ace of tile gluulid b, (revised 11/03/95) 8 W � r 1Sssb' 1��. THE COMMONWEALTH NWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department' s qualifications as required and is herebv authorized to use the title CERTIFIED TITLE S SYSTEM INSPECTOR as provided in 310 CMR 15 .340 and Section 13 of Chapter L IA of the General Laws. Issued by The Department of Environmental Protection. June 8, 1995 Acting Director of the -ion of Water Pollution Control TOWN OF Barnstable BOARD OF HEALTH S011SUNFACT SKWAGF: DISIUSM, SYS'1'F,M 1N91TCj'jON FORM - PART D .- CEirrIFICA'rION TYPE OR PRINT CI,EARLI'- PROPERTY INSPECTED STREET ADDREss -6 Beechwood Road Centerville -- ,Mass - ASSESSORS HAP , BLOCK AND PARCEL # OWNER' s NAME Frances Ta:,Qrmena T'ARV L) - CERVIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME J.P.Macomber & Son Inc, COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State LIP COMPANY TELEPHONE ( t;C)8 775 - 3338 FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT' I certify that I have personally inspected the sewage dispos6l system at this address and that the information reported is true , accurate , and complete as of the time of .-inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one : XXXX4X-X-X Syste6 PASSED The inspection which I have conducted has not found any information which indicates that the systein fails to adequately protect public. health or the environment as defined in 310 CHR 16 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED The inspection whicl, I have conducted has found that the system fails to Protect the public health and the environment in accordance with 'Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signatur e 6/10 Date /96 q,V Owhere ay ne cop of this certification must be provided to the OWNER, the BUYER ( PPlicable ) and the 130AIlD OF IIZAL'I'll. If the inspection FAILED , thi- owner or` 'P' erat0r shall h(-- i upgrade ' he within one year of the dtit,? of L sYstenspection , unless allowed ort requiredm otherwise as Provided in 310 CPIR 15 , 305 ,