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Home My WebLink About0272 CRAIGVILLE BEACH ROAD - Health Hawthorne Terrace Condos 272 Craigville Beach Road Hyannis o C � ==mod c 1 7. Q •� a C r E 1 a 1 4 i' Malkus, Karen From: Emily Michele Olmsted <emilymichele.olmsted@barnstablecounty.org> Sent: Tuesday, November 13, 2018 2:26 PM To: Malkus, Karen Subject: RE: BEA's Title 5 Septic Inspection for Hawthorn Terrace Condos, 272 Craigville Beach Road Hi Karen, Sorry to be just getting to this now. I see your other e-mail too, I think I'll dissect these one of a time. I have an idea as to why it may not have been included in the September inspection but in both of these cases the operator is going to better be able to give an answer: I think the Title 5 system inspection you sent(which we don't normally get, we just get the routine inspections of specifically an I/A system) indicates there's an issue with the pump chamber and so it would not have appeared in the inspection for the FASTthat is reported to us. Pump ClItarnlber(locate on site plan): Pumps;in working order Yes No` Alarms in working order. Yes ? No` Comments (noto.eondition of pump chamber,condition of pumps and appurtenances, etc,)„ Pump i#1 in pump chamber is not functioning property and is in need of replacement, pump#2 I'undoning appropriately, pressure bell system is functional. Normal water level observed in pump chamber at tune of inspection.Audible and visual alarm are fundoning properly. We don't currently track inspections of the Pump Chamber and so I am guessing that that was why it was not filed with US. I will say this too: we don't have a permit summary sheet on file for this. If you happen to have one that you wouldn't mind sending, I'd appreciate a copy. If you looked at the permit and are satisfied with the set up (4 inspections, no samples)then that is okay too' Thoughts? Thanks, / Emily Michele From: Malkus, Karen <Karen.Malkus@town.barnstable.ma.us> Sent: Friday, November 09, 2018 3:56 PM To: Emily Michele Olmsted <emilymichele.olmsted@barnstablecounty.org> Subject: FW: BEA's Title 5 Septic Inspection,for Hawthorn Terrace Condos, 272 Craigville Beach Road Hi Emily Michele, 1 FYI—Here is a 8-31-18 report that says the system alarm is not functioning. Sharon has contacted Bennett to see if they are repairing it- not sure why this was not on the 9/4/08 inspection report sent to you?? Thanks Karen From: Lezli Rowell [ma ilto:I rowel l@ ben nett-ea.com] Sent: Wednesday, November 07, 2018 8:39 AM To: Malkus, Karen; McKean, Thomas Cc: Samantha Farrenkopf; Joe Smith Subject: BEA's Title 5 Septic Inspection for Hawthorn Terrace Condos, 272 Craigville Beach Road Good morning, I have attached electronic copy of BEA's Title 5 Septic Inspection filed with the Barnstable Health Department dated 8/31/18 along with scan to show the payment of$25 filing fee as cashed with receipt of the report. It is now our understanding that the mailed hard copy cannot be located; does the attached PDF suffice to remedy your record, or do you require another hard copy to be mailed in? Please advise what best assists in this matter. Should you have any questions, I have copied BEA's Wastewater team. Thank you, Lezli Rowell Administrative Assistant BENNETT ENVIRONMENTAL ASSOCIATES, INC. 1573 Main Street/ P.O. Box 1743 Brewster, MA 02631 508-896-1706 508-896-5109 fax http://bennett-ea.com Please visit us on Facebook Bennett Environmental Associates, Inc. Z �`�e � � � �� y � ENNETT ENVIRONMENTAL ASSOCIATES, INC. 0 LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 1/27/17 BEA09-10167 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Hawthorne Terrace Condominiums 272 Craigville Beach Road SHIPPING METHOD: West Hyannisport,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR COPIES DATE DESCRIPTION 1 DEP Approved Inspection and 0&M Form for Title 5 I/A Treatment and Disposal Systems(March, June,September and December 2016) 1 Bio-Microbics Field Inspection&Service Report(March.June,September and December 2016) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: 0 REMARKS: Please find enclosed the DEP Inspection and O&M Forms and Bio-Microbics Field Inspection&Service Reports for operation and maintenance conducted during this reporting period for the above referenced property. While there is no access for annual inspection of the pressure distribution field lateral lines,pumps,floats and the pressure distribution panel were inspected and found to be functioning properly. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Diane Ferrigno,Treasurer Jim Bell-BioMicrobics[via email] FROM: Samantha Farrenkopf,Wastewater Program Manager If enclosures are not as noted,kindly notify us at once R0=1HCORPORATED FIELD INSPECTION & SERVICE REPORT FASTO wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDE,R Installation Address Name v-j�- - Owner Name Street 1511 Mail Address Mail Address city . :S 04A Statev* Zi ,0'zJa-j-',, Ci 1�r�:�ti( Sta04 Zip C"l.V3� -ZACk Phone Fax Phone Fax e-mail a-mail �.' - 5`��0 INSTALLATION INFORMATION Model No. Serial No. Date of Installation .Date of last pumpout M(, xy-\L' <-601kA MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Eiechical Panel(s)"�`s '� 1 �w `>•-� Visual Alarm 0 eratin Audio Alarm Operating �� ,�� " \ r u F�.�,•.a\. if resent Blower(s) Air inlet Filter Clean \u!U4%.r r-A. v y� Blower Hood Vents Clear ��,.� � - s Excessive Noise +f Excessive Vibration t �. Treatment Units Unusual Odor �� 3� �,� �` '� f vs` �` Ci- Plan out Re uu-ed: Sy Primary Settling Zone Aerobic Treatment Zone / �� - ��.s ��-- o" EFFLUENT(options) LIMIT RESULT Estimated Daily Flow •t'�� U+. \ F-S Azi H Standard Units 6-9 S.jodor L� Color ClearTem erature Odor SlightlMusty � "- to Z not se OWNER SIGNATURE----- TECH LAN IGNA ;� 'SERVICE DATE C � art^\ " , y J� � 1 _ �--� ��..r - �:� � �,��,..L�.,:. ��--� u��tea.�-,� c3.�-rr�c��• e � 1 e INC0RP08ATE0 FIELD INSPECTION & SERVICE REPORT FAST@ wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address Name 7Nt�- Owner Name Street lE!� . Mail Address 1j to,-\1�o Mail Address city k�-> State�� Zi c`LW-1,-, Ci' f"..4 0"u, StateN'1J zip Phone Fax Phone Fax e-mail I e-mail INSTALLATION INFORMATION Model No. Serial No.A- LDate of Installation Date of last um out c. W\ 4�\,\% MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating �' �b�� c5 °` �'"� -�' o�'`i' c;•�-` if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear _ Excessive Noise Excessive Vibration Treatment Unit(s) Unusual Odor 4 Pum out Re eked• S4Z4vr°-•wt Primary Settling Zone Aerobic Treatment Zone vz, - O EFFLUENT(options) LIMIT . RESULT \�� $S �'�- Z, Estimated Daily Flow H Standard Units 6-9 S.U. vo Color Clear �✓ vY 3.`S Temperature- Odor Slightly Musty odor S\A 7v not se tic OWNER SIGNATURE TECHN SI TU WSERVICE DATE - z� LA , N � � IN" T;MOO M vrc-s anaroa ATE n FIELD INSPECTION & SERVICE REPORT FAST, wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address r�7,� �'st�. �� SIP ed,,1 r"" Name Owner Name f,u larrle— 0,( Street U r�\, Mail Address Mail Address , U iTA' Ci �� Yt t�lr�� 5 ar StateWtzi 62,& rZ Ci ��6�`r StateK, ZipgUQ1\ Phone Fax Phone Fax e-mail e-mail 41; INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout vy\t/ a MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panels ) � Visual Alarm 0 eratin Audio Alarm Operating J, �, '�L.,��,. ,�r+� �L.•-*--v+ �s� if resent Blower(s) Air InletFilter Clean Blower Hood Vents Clear Excessive Noise r/" Excessive Vibration vW\ve Treatment Unit(s) Unusual Odor , Pam out Required: w� R Primary Settling Zone Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT Estimated Daily Flow �*>`""}'� G .� `�We, H Standard Units 6-9 S.U. .� Color Clear z z Temperature t, Odor Slightlyv` Musty odor not septic) OWNER SIGNATURE TEC SIGNATUIW K, SE VICE DATE IHC0RP00ATE0 FIELD INSPECTION & SERVICE AMPORT FAST@ wastewater treatment syOpams INSTALLATION ALLA.TION AUTHORIZED SE . E A O-- .DER Installation Address2?2 crc l U'>tfC',/ `✓/ Name �. f Owner Name ctc�/�f'/III/9[ "ter=.r Street Mail Address Mail Address city State Zip city ,zip1 r' Phone Fax Phone Fax e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installs Y IN Mg I UM out MAINTENAN , �:�_' EQUIPMENT YES NO AND CO � . sT. EIectrical Panels ,fit S 'fZi i:n Visual Alam Operating Z`F,, r �,r E�°L Audio Alarm Operating r „ if resent Blowers a Air Inlet Filter Clean 1/ Blower Hood Vents Clear Excessive Noise ✓' Excessive Vibration Treatment Unit(s) Unusual Odor Pum out Required: A n Primary Settling Zone r;J •yam -`7 Aerobic Treatment Zone _ EFFLUENT(options) LIMIT RESULT Estimated Daily Flow H Standard Units 6-9 S.U. r` Color Clear -''�s i (f�� i'f�� f��Jc t i? Y Tem erature 3 - t J. Odor Slightly Musty odor not septic) OWNER SIGNATURE TEgHM $ ATURE SERVICE DATE , �. �! ♦4 .+ l �f Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:when Hawthorne Terrace Condominiums c/o Diane Ferrigno, Treasurer filling out forms Owner on the computer, use only the tab 2.72 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: r� P.O. Box 134 Street Address/PO Box: Belmont MA 02478 City State Zip (508) 790-7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/2/16 12/7/15 Inspection Date Previous Inspection Date Recommend pumping of primary portion of ST [Pumping Recommended ® Yes El No Sludge Depth(to be checked yearly) t5aiom.doc•rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 1/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ® some pH 7.0 SU DO 6.0 mg/L Turbidity 17.2 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. Cleanouts for pressure dosing SAS not to final grade. Pressure Dosing System: control panel capacitor and motor starter are showing signs of corrosion, evaluation by an electrical contractor and replacement if needed is recommended. Pumping of primary portion of septic tank also recommended. t5aiom.doc•rev.04-11-13 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5Ll . ®Eli Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems Ho Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology.O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 311h of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title. 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Diane Ferrigno, Treasurer filling out forms Owner on the computer, _use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: r� P.O. Box 134 Street Address/PO Box: Belmont MA 02478 City State Zip (508) 790-7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/8/16 3/2/16 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 ®EIS Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: M no ❑ some pH 7.0 SU DO 5.0 mg/L Turbidity 13.8 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. t5aiom.doc•rev.04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 ®EP Approved Inspection and O&M Form for Title 5 p/A Treatment and Disposal Systems Ho Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. C a1711:-7 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 Massachusetts Department of Environmental Protection LlBureau of Resource Protection - Title 5 ®EP Approved Inspection and O&M Form for `title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Diane Ferri no, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: P.O. Box 134 Street Address/PO Box: Belmont MA 02478 City State Zip (508)790-7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/26/16 6/8/16 Inspection Date Previous Inspection Date Primary ST: pumping needed Secondary ST: 6" pumping Recommended ® Yes ❑ No sludge, V scum } t5aiom.doc•rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems p Y E. Field Testing Field inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ® Other(specify): Cloudy Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 3.0 mg/L Turbidity 36.0 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information p 9 Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: All mechanical components of the system are operating correctly. Pumping of the primary septic tank is recommended. Effluent quality passed field testing parameters. t5aiom.doc•rev.04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 ®EP Approved Inspection and O&M Form for Title 5 I/ Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMi R 2.00. Operator Signature / ® Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 4 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 ®EP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Diane Ferrigno, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: t� P.O. Box 134 Street Address/PO Box: Belmont MA 02478 city State Zip (508) 790-7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896-1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/07/16 9/26/16 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ®'Yes ❑ No t5aiom.doc•rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 ®EP Approved Inspection and ®&M Fora for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection:. Color: ❑ gray ❑ brown ® clear ❑turbid ® Other(specify): Cloudy Odor: M musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 6.5 SU DO 3.0 mg/L Turbidity 26.4 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. t5aiom.doc•rev.04-11-13 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 ®EP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems Ho Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. i Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use—by January 315{of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31 th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 BENNETT ENVIRONMENTAL ASSOCIATES, C®OCIATEma' INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O. Box 1743 (508)`$y96-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER:�w CA Massachusetts Department of Environmental Protection 'X.' Attention:Title 5 Program 12/11/15 BEA09-10167 I Winter Street-6th Floor Boston,MA 02108 REGARDING: Hawthorne Terrace Condominiums 272 Craigville Beach Road SHIPPING METHOD: West Hyannisport,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail 0 Green Card/RR ❑X COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(March, June,September and December 2015) 1 Bio-Microbics Field Inspection&Service Report(March.June,September and December 2015) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: 0 REMARKS: Please find enclosed the DEP Inspection and O&M Forms and Bio-Microbics Field Inspection&Service Reports for operation and maintenance conducted during this reporting period for the above referenced property. While there is no access for annual inspection of the pressure distribution field lateral lines,pumps,floats and the pressure distribution panel were inspected and found to be functioning properly. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Diane Ferrigno,Treasurer Jim Bell-BioMicrobics [via email] FROM: David Bennett WWTO#6243/Samantha Farrenkopf WWTO#13265/Joseph Smith WWTO#12529/Greg BrehmWWTO#16149 If enclosures are not as noted,kindly notify us at once LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Diane Ferrigno, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return City Zip key. Mailing address of owner, if different: P.O. Box 134 Street Address/PO Box: Belmont MA 02478 City State Zip (508) 760-7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/17/15 12/9/14 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: M musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO y 3.0 mg/L Turbidity 13.3 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. Check Pump Chamber Run Times as Follows: P#1: 67.56hr P#2: 263.08hr. t5aiom.doc•rev.04-11-13 Page 2 of 3 L i-It Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use— by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aiorn.doc•rev.04-11-13 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Diane Ferrigno, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return City Zip key. Mailing address of owner, if different: , P.O. Box 134 Street Address/PO Box: Belmont MA 02478 City State Zip (508) 760 -7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896 - 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/8/15 3/17/15 Inspection Date Previous Inspection Date e Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.04-11-13 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 4.0 mg/L Turbidity 2.16 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is mechanically operating correctly. Effluent quality passed field testing parameters. Check Pump Chamber Run Times as Follows: P#1: 67.56hr P#2: 267.29hr. Cleanouts for pressure dosing SAS not to final grade. t5aiom.doc•rev.04-11-13 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CrMR 2.00. gnu Operator Signature `�i� Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Diane Ferrigno, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: P.O. Box 134 Street Address/PO Box: Belmont MA 02478 City State Zip (508) 760-7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/14/15 6/8/15 Inspection Date Previous Inspection Date Pump Primary portion of ST, Pump Both Sections of FAST unit Pumping Recommended ® Yes ❑ No t5aiom.doc•rev.04-11-13 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ® some pH 7.0 SU DO 5.0 mg/L Turbidity 8.79 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is mechanically operating correctly. Effluent quality passed field testing parameters. Check Pump Chamber Run Times as Follows: P#1: 67.56hr P#2: 274.74hr. Cleanouts for pressure dosing SAS not to final grade. Pumping recommended of primary portion of Septic tank, and both sections of FAST unit due to solids accumulation. t5aiom.doc•rev.04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature V Date' System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use-by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Diane Ferrigno, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return City Zip key. Mailing address of owner, if different: r� P.O. Box 134 Street Address/PO Box: Belmont MA 02478 City State Zip (508) 790-7698 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/7/15 9/14/15 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.04-11-13 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 ®EP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.5 SU DO 6.0 mg/L Turbidity 5.65 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. Pump Chamber Run Times P#1: 67.56hr P#2: 278.97hr. Cleanouts for pressure dosing SAS not to final grade. MicroFast: Replacement of inlet air filter for blower. Pressure Dosing System: control panel capacitor and motor starter are showing signs of corrosion, evaluation by an electrical contractor and replacement if needed is recommended. t5aiom.doc•rev.04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. 'S CRC V t Operator Signature i Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use— by January 31 st of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 301h of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 51h Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 INC0RP0RATE0 FIELD INSPECTION & SERVICE REPORT FAST @ wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address , ( Name Owner Name vim, e Street S Mail Address Mail Address city W �- u"tv�3 �f�bStateM� zip� �. Ci l��fW` t" State M� zip Phone Fax Phone Fax e-mail e-mail �Ja`�l INSTALLATION INFORMATION Model No. Serial No. Date of lnstal.ation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating (if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear v- ExcessiveNoise !/ �2;��J.arc J� S G �eJ•�'.� CSC Excessive Vibration S t,. S Treatment Uuit(s) (o3,0 R•r^�5 Unusual Odor Pum out Required: 0" \v \� �1 §C`^'� vSr, •� Primary Settling Zone ✓ Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT 'T" oaf Estimated Dai!y Flow H Standard Units 6-9 S.U. JJ Color Clear G�'"r Tv(_ l"� Temperature Odor Slightly S\1_3 3 `d Musty odor ` not septic) OWNER SIGNATURE TECHN GNA>YRE SERVICE DATE WCEIMMCURPORAYEn FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems � INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address Name 'T.)f1. 1'- Owner Name ^ Street \c,-J"3 Mail Address g p `-\;04, kx,%' Mail Address q v .%-I. \-I Ci c p\StateK� Zi a1.b-t--- Ci JT) State'"N�-Zi � 5c`6 -�6C�b - k-113� Phone (�\ 1,,1 e� ,Fax Phone F „axC��—'� _ e-mail 5�� e-mail � �, `� �� INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panels Visual Alarm Operating Audio Alarm Operating ;..r if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents ClearExcessive Noise C� Excessive Vibration Treatment Unit(s) Unusual Odor O� Pum out Re uired: Primary Settling Zone Aerobic Treatment zone EFFLUENT(options) LIMIT RESULT Estimated Daily Flow H Standard Units 6-9 S.U. Color Clear Tem eratm•e Odor Slightly rev Musty odor not septic) OWNER SIGNATURE TEC TAN 81-GNA ERVICE DATE IRCORPORAFEO FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address Name TjT� �- W—<-= Owner Name Street Mail Address Mail Address P.o t3 oy— %-I\h:-> City�J vv-\ State P\.I\. Zip 10 Ci �,( Statelj,�� Zip 0 %'-3 i Phone Fax Phone Fax e-mail e-mail Sb%- INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last purnpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s)5�.. fit.%,•cr/� Visual Alarm Operatin y' Audio Alarm Operating J- c��v�r4--ems c„��. �j=�► � �o•� n c,�,-,, if present Blower(s)1 �•J �/ J c.M�U� Air Inlet Filter Clean Blower Hood Vents Clear U� Ud ".11,11 5o�+ Excessive Noise ./ Excessive Vibration Treatment Unit(s) Unusual Odor ✓ V r-, pa S�c.�1t;..S Pum out Required: Primary Settling Zone V5, Aerobic Treatment Zone V EFFLUENT(options) LEWIT RESULT Estimated Daily Flow H Standard Units 6-9 S.U. 0 Color ClearTemperature Odor Slightly Musty odor not septic) OWNER SIGNATURE TEC IA isERVICE DATE ' i 1 f x I :9 lR CO R P pit A7 E p FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address 4t&l2 dL- Name CL f-N �W4� _, Owner Name Street l,5'15 Maii Addressc,Y, 46 Mail Address 19 --:j�45 City i State .,.Zip c9t&' Z_. City 361 -0-4<` StatetjOA- Zip U' Z(a�j 11. Phone Fax Phone Fax e-mail e-mail 50 INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last purnpout c— O MAINTENANCE PERFORMED EQUIPMENT Y S NO AND COMMENTS Electrical Panels ! (L/o Visual Alarm Operating / ,m,, a V Audio Alann Operating i£presents Blower(s) Air Inlet Filter Clean2 4 C eWtQ Blower Hood Vents Clear V Excessive Noise Excessive Vibration Treatment Units n ( h, Unusual Odor -fS( Pi m oat Re aired: Prirnary Setaing Zone Aerobic Treatment Zone EFFLUENT o tions LIMIT RESULT Estimated Daily Flow H Standard Units 6-9 S.U. Color Clear O - Temperature Odor Slightly Musty odor { not sq2tio OWNER SIGNATURE TECHrO N SIGNATURE SERVICE DATE Lc~ BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/18/13 BEA09-10167 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Hawthorne Terrace Condominiums 272 Craigville Beach Road SHIPPING METHOD: West Hyannisport,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑X Green Card/RR COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(December 2012;March,June,September 2013) 1 Bio-Microbics Field Inspection&Service Report(December 2012;March,June,September 2013) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: REMARKS: Please find enclosed the DEP Inspection and O&M Forms and Bio-Microbics Field Inspection&Service Reports for operation and maintenance conducted during this reporting period for the above referenced property. While there is no access for annual inspection of the pressure distribution field lateral lines,pumps,floats and the pressure distribution panel were inspected and found to be functioning properly. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc-.Barnstable Board of Health j Ms.Gertrude Wilcox,Treasurer David C.Bennett,Principal[Internal] Jim Bell-BioMicrobics[via email] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO 413265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: rab P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/6/12 9/13/12 Inspection Date Previous Inspection Date 6" sludge, 0"scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 Page 1 of 3 i Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 4.0 mg/L Turbidity 4.23 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CM`R 2.00. \ 1 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 315t of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: 19ji P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508)778-2581 ext. Telephone Number . B. Authorized Service Provider Bennett Environmental Associates, Inc: O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/5/13 12/6/12 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown M clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: M no ❑ some pH 6.0 SU DO 5.0 mg/L Turbidity 7.08 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: The septic tank and both FAST tank compartments were pumped on 3/1/13. Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is operating correcity and effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/10/13 3/5/13 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ® some pH 7.0 SU DO 5.0 mg/L Turbidity 11.34 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is operating correclty and effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. c—&—k-o Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t5 Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: E General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes E No D. Operating Information 9/9/13 6/10/13 Inspection Date Previous Inspection Date 5" Sludge; 6" Scum Pumping Recommended ❑ Yes E No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ® some pH 7.0 SU DO 5.0 mg/L Turbidity 4.26 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Check audible/visual alarm function of FAST systems and Pump Chamber and note proper function. Check Blower/Pump Chamber and note proper function. Notes and Comments: Effluent quality passed field testing parameters. Check sludge levels as follows: S.T.P. 6"scum,5" cludge/1"scum, 4"sludge. FAST 0"scum, 9"sludge/0"scum, 14"sludge. Check Pump Chamber Run Times as Follows: Pump Chamber-p#1: 67.56hr p#2: 233.35hr. t5aiom.doc•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts-certified operator in accordance with 257 CMR 2.00. Q a- qV A\ Operator Signature Date T—' System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t �I I II 4 t5aionn.doc•rev.11-07-05 Page 3 of 3 INCORPORATED FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION\ AUTHORIZED SERVICE PROVIDER Installation Address Z.. 2 Owner Name Street Mail Address f �t6 Mail Address �1 p ty iN\A Zip O��p"S 1 CityC.D'�•�rr.� �, State iv\(a Zi 02��12 Ci �J�,�e,L.S State n 6 Phone Fax Phone Fax e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout M -6v 9S MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating ✓ Ceti.`-•st, ,r� �,�� o r �5�,, ` . .v� Audio Alarm Operating if resent �v�;��--�v.s�� •.,rw. �o-c,,-i«....� C�t�e� Blower(s) Air Inlet Filter Clean ✓ "C' f a z< - cl-. Iccuq Blower Hood Vents Clear Excessive Noise Excessive Vibration v Treatment Units y /V Unusual Odor ✓ S 1 Pum out Required: Primary Settling Zone 5 Aerobic Treatment Zone 510 0° - EFFLUENT(options) LIMIT RESULT e�,a uF,\; es ;v Estimated Daily Flow --j\; H(Standard Units) 6-9 S.U. 0 Color Clear �� Temperature 33 S C� Odor Slightly Musty odorU (not septic) QS OWNER SIGNATURE TECH-N-WIAN,$IGNAZURE SERVICE DATE ►z IZ D "3 1 ��e,7Svfe ��:,r le,�.t�,:� — ti.�o e�.u��vs � � ,�„��• ,�vd�1o�Ivd4�°�\ �.1,�'�\ v�.c,�,1�n-,� 1 INCORPORATED FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATIO\,N AUTHORIZED SERVICE PROVIDER Installation Address ?,�Z C,�(v� v� -��^ 6ti'�- Name -5?.k J.�c Owner Name Street \S 7 1M^a CZ Mail Address ,p �� l�cbY, Mail Address e�,p,13 cd, V-7\�3 City01 State 7a Zip a2'-`I7, city, / �c✓ StateM3, Zip VV0\ Phone' Fax Phone Fax e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last purnpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating vrjA Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear ✓ Excessive Noise Excessive Vibration %J, Treatment Unit(s) Unusual Odor Pum out Required: 1 v \S ►� p� b vz- Primary Settling Zone Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT ��,, W�. c <\, �s�c,� Estimated Daily Flow H(Standard Units) 6-9 S.U. (- O Color Clear e`,x, Temperature 10 ,(Z 'L Odor Slightly 5\1S�^��^r Musty odor �v5,,1 00 � not septic) OWNER SIGNATURE TEC CIAN SIGNATURE ERVICE DATE �(e��vfz Y�il Le.,t�� i� [. ��3 c•�v�� .��.�0\4 v;S.,'�� < ,c.I.,— -��°''v� ► it � e IRC0RP0RAT60 FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address .��p��,� `�w�(v.�� Namel)t- OwnerName Street 1<S"23 Mail Address p `�v� �� Mail Address City �.�.Y.�S af\% State K\, Zip O L�*I2. City 1��1�a�� StateM�' Zip (,IV-3 \ 72� "1 - 1.�;'_6\ \-t oQ Phone Fax Phone Fax e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating tag �`J1v� a r if resent Blower(s) Aix Inlet Filter Clean 'S Blower Hood Vents Clear ✓ Excessive Noise Excessive Vibration v" Treatment Unit s Unusual Odor Pum out Required: 2 O k v- K Primary Settling Zone >� Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT f Estimated Daily Flow H(Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly S\�� \n� Musty odor Ylf\ (not septic) OWNER SIGNATURE TEC ICIAN SIGNATURE SERVICE DATE FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation rddress Name f, Owner Name Street > T3 Mail Address ` �r l;�C,r{ Mail Address CityLD.;� �w�:� aft, Statel`�• Zip Ci4r1,ce-0-5\,,( Statej"\� Zip G� E Phone 1�.� " 2'�Fax` �� ,"-�,v�ne Fax_ e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pum out MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel (s) Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear ✓ Excessive Noise ro Excessive Vibration ✓ uk�� ( bS Gcs A�c Treatment Unit (s)�.� Unusual Odor ✓ Pum out Required: Y{aS Primary Settling Zone SUQ-V-\ 5 Aerobic Treatment Zone` EFFLUENT(options) LIMIT RESULT Estimated Daily Flow H(Standard Units) 6-9 S.U. Color Clear \-JIN Temperature Odor Slightly S,V, Musty odor 70 (not septic) OWNER SIGNATURE TECH1vV IAN SIGNATURE SERVICE DATE rill 13 �� •v�. SOS v,�-�.��,,:�� ,.f,�,� r BENNETT ENVIRONMENTAL ASSOCIATES, INC. .v LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/20/11 BEA09-10167 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Hawthorne Terrace Condominiums 272 Craigville Beach Road SHIPPING METHOD: West Hyannisport,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑X Green Card/RR COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(Dec 2010; Mar,June,Sept 2011) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: REMARKS: Please find enclosed the DEP Inspection and O&M Form,and laboratory test results of wastewater samples collected during this reporting period for the above referenced property. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Gertrude Wilcox,Treasurer David C.Bennett,Principal [Internal] Jim Bell-BioMicrobics FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox,Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road. key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc.. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information FAST FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/7/10 9/8/10 Inspection Date Previous Inspection Date 8"Sludge, and 5" Scum Layer Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc-rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.54 SU DO 6.94 mg/L Turbidity 11.8 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System functioning correctly. Pressure dosing system for leaching field is functioning properly. Notes and Comments: System passed field testing parameters t5aiom.doc•rev.11-07-05 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification Ll certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist,.and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. CQC_�.Q� -1 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox,Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip 01-1 Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. 0&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information FAST FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/15/11 12/7/10 Inspection Date Previous Inspection Date 6" Sludge, and 2"Scum Layer Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 6.74 SU DO 12.94 mg/L Turbidity 7.47 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System functioning correctly. Pressure dosing system for leaching field is functioning properly. Notes and Comments: System passed field testing parameters. Left a leave behind notice for Ms.Wilcox to get in touch with me in regards to having Visual/Audible alarm boxed replaced with a new one. t5aiom.doc•rev.11-07-05 Page 2 of 3 r • Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 r Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Lll� Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: tab P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information FAST FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/7/11 3/15/11 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 3 I LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: M no ❑ some pH 7.5 SU DO 8.14 mg/L Turbidity 3.52 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System functioning correctly. Pressure dosing system for leaching field is functioning properly. Notes and Comments: System passed field testing parameters.Touched base with Ms.Wilcox about APS form letter for Audible and Visual alarm replacement, and she does not prefer to have it replaced currently. t5aiom.doc•rev.11-07-05 Page 2 of 3 I LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. r1A it Operator Signature Date System owner must submit this report, technology 0&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: i Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doe•rev.11-07-05 Page 3 of 3 i Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return Ll key. City Zip Mailing address of owner, if different: r� P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information FAST FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/8/11 6/7/11 Inspection Date Previous Inspection Date NA Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc-rev.11-07-05 Page 1 of 3 f Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 8.53 mg/L Turbidity 2.57 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System functioning correctly. Pressure dosing system for leaching field is functioning properly. Notes and Comments: System passed field testing parameters. t5aiom.doc•rev.11-07-05 Page 2 of 3 i LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. g� 9 Operator Signature Date T— System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 Copy - �t T Town of Barnstable do Regulatory Services B" ASSa M Public Health Division ASS. iDr i63qvtA�0 Thomas McKean,Director fp MA 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 December 23, 2019 Mr. Dan Pulit Mortgage Lending Officer Cape Cod Five Cents Savings Bbank 85 Route 6A, Sandwich, MA 02563 Dear Mr. Pulit, The innovative-alternative septic system at 272 Craigville Beach Road , Hawthorne Terrace Condominiums, Hyannis Massachusetts was recently repaired. Robert B. Our, Inc, a licensed contractor, installed new pumps, floats and a new panel. This work occurred after the 9/7/2108 Health Division order letter to repair the system. Please accept this letter as notification that this innovative-alternative system is now in compliance. Sincerely, as A. McKean, , Director of Public Health f � ��E�,�tlt{TY CONiS7 ;U Ar ate::, October 19, 2018 Hawthorne Terrace Condominiums Attn: Diane Ferrigno P.O. Box 134 Belmont, MA 02478 Dear Diane, Please accept this letter as notification that the Robert B Our Co., Inc. has installed the new pumps, floats, and new panel in conjunction with the owner's electrician. The system is operational. Should you have any questions or need anything else please do not hesitate to let me know. We appreciate your business. Best Re ards, igail Our i 24 Great Western Road,P.O.Box 1539,Harwich,MA 02645 Tel:508-432-0530 Fax:508-432-7057 Web:robertbour.com r McKean, Thomas From: Crocker, Sharon Sent: Monday, December 23, 2019 3:42 PM To: - McKean,Thomas Subject: FW: Hawthorne Terrace Condos- 272 Craigville Beach Road, Hyannis 02601 Attachments: Invoices and letter from ROur.pdf Here you are. From: Pulit, Dan [mailto:dpulit@capecodfive.com] Sent: Monday, December 23, 2019 1:41 PM To: Crocker, Sharon .Cc: karen@propertycapecod.com; Catherine Jones; Pulit, Dan; neila neary Subject: Hawthorne Terrace Condos- 272 Craigville Beach Road, Hyannis 02601 Hello Sharon, Nice to chat with you today. Please feel free to forward this email to Karen in your dept for when she returns from vacation. `Hello Karen, Cape Cod Five is handling the financing for a buyer of one of the units within Hawthorne Terrace in Hyannis (Hyannisport). Attached is a letter from Robert B. Our Inc,that the repairs have been made. This letter came from the management at Hawthorne Terrace. Since we normally would see a Cert of compliance (COC) issued by the town in this situation,we would also accept the following if you can't produce a COC: -A signed letter from the BOH, on town letter head,that the system has been repaired since the 9/7/2018 BOH letter from Thomas McKean, and the system is in compliance. I know your our of the office this week on vacation, but when you return could you please assist with this? Please feel free to call me with any questions. Dan Pulit Mortgage Lending Officer Cape Cod Five Cents Savings Bank The#1 Lender on Cape Cod 85 Route 6A,Sandwich Ma 02563 Office 508 247 2323/Cell/text 774 487 0859 eFax 508 2471334 NMLS 10#423218 Visit My Website CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! i r ; Tripp,Vanessa From: McKean, Thomas Sent: Sunday, January 31, 2021 4:40 PM To: Tripp,Vanessa ' Subject: Re: Updated Title V/ Hawthorne Terrace Attachments: Hawthorne Terrace Title V 2018.pdf Follow Up Flag: Follow up Flag Status: Flagged Correction Units 1 through 20 On Jan 31, 2021, at 4:39 PM, McKean, Thomas <Thomas.McKeanQtown.barnstable.ma.us>wrote: Attached is an inspection record for Hawthorne Terrace which shows an inspection date in 2018 for units 1 through 30. Begin forwarded message: From: Hawthorne Terrace <272hawthorne(cr�,gmail.com> Date: January 31, 2021 at 11:07:24 AM EST k To: "McKean, Thomas" <Thomas.McKeangtown.barnstable.ma.us> Subject: Updated Title V Good morning Mr. McKean, I am the manager or Hawthorne Terrace Condo Association on Craigville Beach Road. I am writing to you because I've been notified by a realtor, who is in the middle of selling a unit, that your records there are not updated with a Title V Pass. We completed a large septic project that was required back in 2018 and Bennett Environmental thought they sent the over to you thereafter. I am attaching the documentation you would need to update your files. If you have any questions or concerns, please do not hesitate to contact me. Otherwise, I would greatly appreciate your updating our records. Thank you for your time. 1 I Diane Ferrigno Diane Ferrigno Manager and Treasurer Hawthorne Terrace Condo Association CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! 2 Commbnw�ealthaof�assach:usett i Tilt 5 Off c7 f f n"", Siutisutface,S.eW' ager0isposai sy %th F Not far.Wuntary Assess.merats li 272 Cm Vllle`5each R-oadl H.Yarltt s:l�A, 801 jt rs,inspectlon cavern ali con<loaurnts 9 thro�igW20] Property,AddFess, Hawtharne'Cerrakce Condpminit�rn Trost Otiirner.a tame . _ . . .. .,: :. information is reg 'for, West Hyann�s�art MA ©2672., yired, Qvery page;;, G(tylTvwrii State Ztp Cgde. ,t)ate of:lnspecddoo inspec#it�n Ite ulits must b+e submttfed,on this form inspection'forms:mayrnot,be Olt>~red in.any x way phase $ee cope®nieC schle+ckll#tt the end,of i +�fiorfn.. Importartt'1Nhen A Genera,lriforrnaton, �IHOAot.#orms on;the camputee; use only th®,tab 1': Irtspcctt)r key"o move.your 'qm do not„ Jose" h`8mith' _ u return: .. - IAy. 1enr;:etti=rrctr�na^�efalt�cie#es_ ` ` BrewserMA St - 1.'r3iep1t6r►e fil�itttser :Lteense''Nufi7t7er. .;-.__n _w ., ; . !4Or'h'y that I have;personally,i,`nspecfed tha{e�wa a rltspm, iafttem af.tl ls.,address;artd that tli Worm, reported b 9. 1I , is fine ccUrate and�cornpie#e as of iris tlme:af,the,it speefiran Ttie`inspection wv performed basedjo'n my f-ih' ng and Operrence�in the pl$oper,fur�cfian anti snalnter anc+?.of or, site Sewege'tl spot a!syst rrtsf i a�n s t} P s rO�l@t aS Bt@trt; r�Sp@ tit i '� tit o'S' h `�l�y 4o T fie 5 01 CIIA� 1,5.00 ),Tt'le t ys#er#iz �3 Pas$es CI 'Ganditinnally Passes [ t s ❑_`Aleeds7urtherEVa 'attars bythe Locaist�p :roving;AiithoritY r >` "i19318 TiNrsyslern inspector shall submit a copy of tbis3 iilspec lonj r partto the ppraumg At fhor ty{Board of Hea9fh rarbEP,)wlthtn 30 days�cificc�l»ple�r�g thls inspectlan 1f they;systemIS,'si;shar�t�ksystem;or ttas a design fl'ovu of 10 OO:i3 gpd or greater,the nspectAr An.,.Al�e system owners.(ati sub St.t reportAb Me appropnate,,reg�anal{.offite ofithe'OEi 1 heorJginat shouid s Beni rtrs e system ovum a`nd copies sentito;the buyer,<if appiicat le, a,d};this approvtngia„uthorty.. YNRE, Thi report only ctil scr bes.conditions at the;time o °tn pectio�any!a dr er=the conditi'or of use at that`tlme This#:inspection does notaddressahow the,system will pefform;;in t' future under the same.6i,,diffiv(6 it conditlons of use. t5tne?•.t13x Title"5 iJSf7ai 3tnsp4ct Ftk z Stigsu4 '.Bd xi4t ow tr"tong°p"o 9 or 17 �_ s;. 4, r i K.;: October 19, 2018 `. Hawthorne Terrace Condominiums Attn: Diane Ferrigno P.O. Box 134 Belmont, MA 0247.8 Dear Diane, Please accept this letter as notification that the Robert B Our Co., Inc. has installed the new pumps, floats, and new panel in conjunction with the owner's electrician. The system is operational. Should you have any questions or need anything else please do not hesitate to let me know. I I We appreciate your business. Best Re ards, r igail Our 24 Great Western Road,P.O.Lox 1539,Harwich,MA 02645 'lei:508-432-0530 Fax:508-432-7057 Wed:robertbour.com ■ Complete items 1,2,and 3. - ❑Agent ■ Print your name and address on the reverse X s so that we can return thb card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B R iu;d by(Printed Name) CD ate of Deliveily or on the front if space permits. 1..An - - `l so�deli ery ad-W— ifferent from item 1? [:]Yes { r • If YES,ent4 ii�e' dress below: ❑No M IS;ADLSBERRY, JANET ETALI `AND.ELIAS, ELAINE M � 11 RICHARDSON CIR 1 SAUUS, MA 01906 �` 1 �, 7 II I�IIIII IIII I'I I II II I IIII�I II r �rtlrfvieicde M T,aYdPZ�e ❑Priony M ail Expre s s� AW, u gntu ❑Registered MailTm ul IIII II( Ihaurre dl ❑Registered Mail Restrict ed 'iv:'9402 3759 8032 3748 21 rtlfedMail� etuReceipt for ❑Coll Merchanaise-r- i ,I R 3 n r„u—* Delivery Restricted Delivery El Signature ContirmationTM 4 # 0 Signature Confirmation 7 015 ,.17 3 0. 0001° 4 9 9 0' 6 6 61• '11il Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt l USPS TRACNNG# FlrstaClass Mail Rostage'&Fees.Paid A .PemS'No.G-10 9590 9402 3759 8032 3748 21 United States •Sender:Please print your name,address,and ZIP*40`in this bft• Postal Service own cf B-.cnstable 'fin :lei.i:h Division _00 klain Street 1 y:apnis, MA 02601 E � E t V g ate""CA o/7 ' --Town of Barnstable w/41,Ao Barnstable �t r Regulatory Services DepartVifj�e, j e`caC j R"A -SeAet.r. I 039. A,aS� Public 'Health Division e°MA 200 Main Street, Hyannis MA 02601 z:-- 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 6661 September 7, 2018 SAULSBERRY, JANET ET AL AND ELIAS, ELAINE M 11 RICHARDSON CIR SAUGUS, MA 01906 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 272 Craigville Beach Road, Hyannis, MA was inspected on 08/27/2018 by Joseph Smith, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system Conditionally Passes under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • The pump chamber pump/alarm is not operational and need to be repaired. You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH v Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mai ling\Conditionally Passes Letters\272 Craigville Beach Road Hyannis.doc Town of Barnstable + DARNSfABLE, b � Regulatory Services Department ArfD�,fa Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS '(Town Code §360-44 and-Title V: 310 CMR 15.000) An"x'marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑.Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool kAny"conditionally passed systems" (broken cover, relocation of a pipe, relocation o -driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc o L Commnwealth of Massachusetts 0-33 -®0-A W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through120] Property Address ~w Hawthorne Terrace Condominium Trust Owner Owner's Name -++ information is required for every West Hyannisport MA 02672 8-27-18 ,. page. City/Town State Zip Code Date of Inspection 6, 31 P; - Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information / filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Joseph Smith use the return Name of Inspector key. Bennett Environmental Associates �y Company Name P.O. Box 1743 Company Address Brewster MA 02631 City/Town State Zip Code 508 896 1706 SI#4994 Telephone Number License Number B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.060). The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further luation by t Local A oving Authority pector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface�Sewage Disposal System Form - Not for Voluntary Assessments M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hyannisport MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 13 System Conditional) Passes: Y Y ® 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. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ® Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 public health, safety or 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 public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West HY p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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, safety and 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 SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *' This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Note: System conditionally passes, one of the pumps in the final dosingpump chamber is faulty and is in need of replacement. All other appurtenances to the final dosing pump chamber functioning appropriately. D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 '/day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 272 Craigville Beach Road --Hyannis".MA 02601 (This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West HY P annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of 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 1 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 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking 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 If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 272 Craigville Beach Road --Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 40 Number of bedrooms (actual): 40 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 4,400 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 , Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road- Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Septic system that serves a condominium complex is comprised of: 9,000 gallon septic tank; 6,000 gallon I/A FAST tank(Bio-Microbics FAST System); 6,500 pump chamber; and two 30'x 100' pressure dosed leaching fields (design capacity 4,400 gpd required). Number of current residents: 60-70 est. Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): See details. Detail: 2016: 538 units = 53,800 cubic feet=402,424 gallons/yr; average flow= 1,102 gpd 2017: 486 units =48,600 cubic feet= 363,528 gallons/yr; average flow= 996 gpd Sump pump? ❑ Yes ® No Last date of occupancy: Currently occupied Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts , W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. CityTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Hawthorne Terrace Assoc. Pumped 2016 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ® Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts, W Title 5 Official Inspection Form _ - Subsurface Sewage Disposal System Forkn - Not for Voluntary Assessments 9c°�M 272 Craigville Beach Road --Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for every y West H annis ort MA 02672 8-27-18 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2004 BOH Certification Letter Engineer Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5'feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 50' +/-town water line feet Comments (on condition of joints, venting, evidence of leakage, etc.): Properly vented to roof. No evidence of leakage of piping or joints. Septic Tank(locate on site plan): Depth below grade: 2.0'feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 9,000 gallon septic tank with schedule 40 pvc inlet and outlet tees in good condition with no structural concerns. Covers to final grade elevation with steel ring If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 9,000 gallons Sludge depth: 4" outlet, 6" inlet t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 61" Scum thickness 0" outlet, 12" inlet Distance from top of scum to top of outlet tee or baffle 8"outlet, 2" inlet Distance from bottom of scum to bottom of outlet tee or baffle 48" How were dimensions determined? Sludge judge, tape, probe Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping of excessive scum layer in septic tank recommended at time of inspection. Both schedule 40 pvc inlet and outlet tees in working order and are functioning as intended. Liquid level as related to the outlet invert is at a normal operating height. No evidence of leakage encountered while conducting the inspection on the septic tank. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 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 Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Pressure Distribution, No D-box Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pressure Distribution, No D-box Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump#1 in pump chamber is not functioning properly and is in need of replacement. Pump#2 functioning appropriately, pressure bell system is functional. Normal water level observed in pump chamber at time of inspection. Audible and visual alarm are functioning properly. * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. Soil conditions explained in next section for SAS t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Fowm -Not for Voluntary Assessments 272 Craigville Beach Road- Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: (2) 30'x100' ❑ 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.): (2) 30' x 100' pressure dosed leaching fields: no surface ponding present, soil clean and dry, normal vegetation (grass) over top of both leaching fields. Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. No evidence of hydraulic failure present at time of inspection. (Design capacity of leaching field =4,400 gpd). 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 layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 i Commonwealth of Massachusetts, W Title 5 Official Inspection Form Subsurface Sewage Disposal System Fcrm - Not for Voluntary Assessments ^M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-27-18 required for every Y p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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 vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts' Title .5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Folrm - Not for Voluntary Assessments 272 Craigville Beach Road--Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 6'+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Design Plan By JC Engineering Plan Date: 1-13-2004 ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Established estimated depth to high groundwater by referencing septic as-built plan by JC Engineering Inc. of East Wareham, MA(plan date of January 13, 2004), wherein the bottom of the pressure dosed leaching field is noted at elevation 28.0'. The soil test data noted on the same plans (conducted by Samuel Philos Jensen and inspected by Samuel White), indicates that no groundwater was encountered at elevation 21.54', which puts estimated groundwater at an elevation of 6.0'+from the bottom elevation of the leaching field. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title .5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for every y West H annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 _.�r�OI Ft3; t. {{c; i=��_.�.�•rs....s +�.�w�''s �S�'_r"_'f ��_1 to-:�T�M1•�'�a:�,;l; 41 . ��'�P.'i.•�•' ;'�S•r is R,.t'br:1=E�X�1i,'.�+�i-,i�'i.�,�'S 1 . _'zri:�i-s?- .'`'.}`i�(.;�°�4:^_ .`/'��=G—. L.•/A-' {.ti f/�. r f^�^-aG f, �� F��:� ';� La••'9'2LT+1- ^n.v`•,��. fY•-%2 r,•fJ�'r� :� ` - - •e ' , — - t�i?':..�.2�_•��93• �;f,r�"i'�.ia�•�.F.��F�ra's� ,riT'-�''F Li;e S•�'rJY_�^_G�'[isoosa S-mB i'Cac.'_Iffiig L-,s toatjE .� —•.� .^ ,a<:1l'—,.".S:.S. �• C.`^_'i��'. y LW.rLC-a.'iiti j�j_ L e '� -Sf - i i•a•�r.%ie:"r.r•::�r 9P•�'•pF��_�`'_£[=y�3;.f,.�'S Siz=::%j:kd i _ r , . • op ro !�RCY. - .ter,----rv��.,n+u---v�ti w� a��__.• _v�� ~ya _!{ � iu, ft Y��^fs•L' ' ,_ i.r i 1•f. .Lfa.l'- i•f:• ' •^ _ ^`..,,, ^— ` ^SLY { _ � r.�„%:..•.f� -f' , J' ljj•`uet,v._�v+^f t . •--`—'�_ ._ �-..w__. __�_ate,l��r�+,..t /�'n n .-r• t r_ra-rrreorrnr•nt 7-.rilCGfilCl4filCT [-111M--'I1-I IgWNHA:WOJ4 )T.:AT ?Tl?-;DGI-)IHW BENNETTENVIRONMENTALAsSOCUTES, NC. LICENSED SITE PROFESSIONALS d ENVIRONMENTAL SCIENTISTS ® GEOLOGISTS t ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster,MA 02631 ® 508-896-1706 6 Fax 508-896-5109 Q www.benneft-ea.com I I BEA10-10167 I February 21, 2018 I Ms. Diane Ferrigno Hawthorne Terrace Condominiums P.O. Box 134 Belmont,MA 02478 RE: OPERATION AND MAINTENANCE CONTRACT Innovative/Alternative Septic System 272 Craigville Beach Road-Hyannis, MA Dear Ms. Ferrigno, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for the continuation of professional services relative to the operation and maintenance of the Innovative/Alternative Wastewater Treatment System located at the above referenced property. The collection and field analysis of samples collected from the effluent of the septic treatment system is a required condition of the system,as set forth by the MA Department of Environmental Protection(MA DEP)to qualify treatment capacity on a quarterly basis. As such, work proposed by BEA includes the inspection and field testing of wastewater samples,as well as the preparation of the required forms for distribution to the appropriate town and state offices. Additionally,at the time of such inspection,blowers,filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced to you quarterly. Should any repair or treatment system component replacement be required,you will be notified to authorize the additional work and expenses. Such work will be billed at time and expense portal to portal. Should field-testing parameters indicate the need to collect samples for laboratory analysis,such sampling will be conducted and will be noted on a BEA form that is left at your facility following the inspection. The following budget represents estimated annual costs through one year of service to include four inspection events. These annual costs are valid for two years subsequent to the date of the next inspection. Please note that this contract runs with the property. As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore,you are required to notify any buyer for the transfer of this contract. ' 1 EMERGENCY SPILL RESPONSE t WASTE SITE CLEANUP 6 SITE ASSESSMENT k PERMITTING ® SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE FEBRUARY 21,2018 HAWTHORNE TERRACE/BEA10-1 0 167 PAGE 2 OF 2 UA W WTO&M QUARTERLY.INSPECTION/MAINTENANCE/FIELD TESTING Inspect I/A system and take field measurements of dissolved oxygen,pH and turbidity. At the time of monitoring events the conditions of the system will be inspected and documented with regards to the blower units, sludge level and associated piping. REPORTING/FILING Review inspection and field-testing results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms on a quarterly basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. TOTAL ANNUAL EXPENSE: $932.00* TOTAL COST PER EVENT: $233.00 *Note:UA systems located in Barnstable County are required to report inspection and sampling results on the MA Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. We are proceeding with this work as outlined. Immediate notification in writing is required if you do not wish to proceed. Otherwise, please sign'the authorization below indicating acknowledgement and acceptance of our Terms&Conditions and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES,INC. Samantha Farrenkopf,W WTO Wastewater Program Manager cc: Kara Risk,Business Manager encl. Abbreviated Terms&Conditions(2011)/Fee Schedule(2016) AUTHORIZATION: DATE: l j 4 f • p 1 IRCORP0RATE0 FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address w4 ' Nameyrd t. ,' ✓ Owner Name- ;-> Street 04r,;., 50 Mail Address 1., g 4x; Mail Address 3 city }• t .. State Oki`Zi c`� r;c,� Citys jtv_.<:. t��;t. Stated +_zip i5 ':. Phone fC s ,;,- %`�`` Fax Phone �`:}�%!�.-c�r,�- Fax e-mail . e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panels ,,t; = „� .rzl;;a .§, �.,;>.�l Visual Alarm Operating Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blo Hood Vents Clear v e Noise e Vibration ' it(s) =; r �- ' • r dor , s LnZ Zone ; , tom, ,., tment Zoe 1 o fio LIMIT RESULT stimated Dail Flow t� r H Standard Units 6-9 S.U. u Color Clear Temperature Odor Slightly Musty odor not s tic OWNER SIGNATURE TEC LN . SIGNATURE SERVICE DATE I_ AsSOCIATES, INC. 1573 ML6n St..RO. Box. 174 ' rt Jr`'9 13re ster. 11 A 0'?63 1 508-896-1706•,.Nrw*v* -&..nett-ea.corn Date&time of visit: (� �-�; .�/V =%. A site visit was conducted today for: O&M ETYES ❑ NO Testing [TYES ❑ NO Repair ❑YES 17 NO Alarm Call ❑YES E1 NO Your system is operating correctly 8/YES ❑ NO Tank(s) in need of pumping ❑YES ONO Further maintenance required ❑YES L�'NO Repairs needed ❑YES Q NO Please contact our office ❑YES 0 NO Contract renewal required ❑YES ❑'NO Field testing 12 Pass ❑ Fail Sample pulled MES ❑ NO Laboratory sampling conducted ❑YES E�NO .L55 r_ yif'yI�41 }, ll ati r ;t"s�FIV6VE"ET EW-30NIVIENTAt_ :.. ASSOCIATES,INC. •ASSESSMENT c t •RE-MEDIATION `R rRESOWROE MANAGEMENT _ MM � n 3 iY I•_tt�. sez s6,az Y CB/FND. /FND. ` •kE " MAP 267 \` (4o W`�Y uBRC L� LI PARCEL 166 / \ ) •Q. GUARINO � -'-"' /3, 76350, m \ N89'30'5B"E Z EX INV:30.16'•. _ lA6 �'L �v `\ CB/FND. m `� /\, \ X ✓ Y--XX X\\ MAP 267 (� 'L`EXISTING X--X• 3 PARCEL 179 �// \ /`77 i EXING CHAMBERS TO BE rr/////� \ )�� (`-max DAWSON PUMPED AND FILLED WITH J / CLEAN E�SnNg SAND(TYP.) CONDOMINIUM u1 `� PROPOSED SEWER MANHOLE FIELD VERIFY ANY COMPLEX I e,. 9'INV.OUT-29-W ELECTRICAL FLAG Fr. tSq,Fr. SLEEVE SEWER PIPE AT WATER MAIN CROSSING da - ROPOSE04'SCH.4D PVC 1 ( 1 I?.` tUERHER SIDE(TYP,) LOPE AT 1%MIN.(iYP-) I [ :� ' EX.INJ.=3020'(rF) 1 Y . D(ISTING SEPTIC TANKS,TO BE PUMPED AND FILLED MFH a O O CLEAN SAND AND BOTTOM TO U BE PUNCTURED R-P.) a 10.0' PRO =3 POSED W SOR35 EX.INV 0.00' ' PIPE SLOPE AT.75% + PROPOSID9.000 . GALLON SEPTICTANK 7STING LEACHING PITS TO SE IMPED AND F P-LID W TH £AN SAND(TYP.) a MAP 267 MAP 267 PARCEL184 PARCEL 00i HUGHES KARPOVSKY ' OIL (POSED AIR SUPPLY GALLON IT TO RUN UP SIDE OF f O PROPOPROPOSED6000 DING TO TOP OF ROOF a a SEPTICTANKWIiH MICROFAST INSERT u / / 10'D41 m LLi VENTING PIPE UPi 3'D1A MM, BLOWER PIPING -B/FND. DESIGN DA /w LT �,. b OP 3 LP a2 (HC2) I(DIST.) 'I NUMBER OF BEDROOMS(ASSESSOi! Y LP PROPOSED 6,SDOGALLON NUMBER OF BEDROOMS(DESIGN) X {+ N CEMENT BLOWER LP +� pO q 6 (PC 5) PUMP CHAMBER DESIGN FLOW I la GALIDI NENCLOS ENCLPAD OSED FOR 31— :ENCLOSIDFOR TOTAL DESIGN FLOW 4400 I RISE PROOFING 19'3 DESIGN FLOW X 200% = BB00 _ 30.0' • USE PROPOSED 9,000 R 6,000 C X X i // MAP 267 I^�•- L 'L•.',.L. EXISTING MAN HOLE FOR / A=PARCEL 73 :• ' SPRINKLER SYSTEM JJJCCC ARE1.5+/-ACRES ' INSTALL 2-100'x 30'LEA T•'` 10.0 SIDEWALL CAPACITY B.M.Cal h Basin LEACHING CATCH fl 3 F un El— 30-00' BASINS TTYp.) li(- I�M� t NO SIDEWALL AREA CREDIT TAKEN R ::� MSL 1 BOTTOM CAPACITY 1{ PROPOSED(2)30'z IW (LENGTH x WIDTH)x(.74 GAUSO.FT, PAVED �I tHI•; ..�•.�• LEACHING FIELDS (2)(1000 x 30.0)"z(.74 GALISO.FT.)'. PARKING _•!' 3Z2' I AREA J `� DOSING&STORAGE RE jyp[p. •'7 DESIGN FLOW: 4,400 GPD. / ,(1•j•'.' )'•:'� a r DOSING REQUIRED: 4 CYCLES I 4.400 GPDl4 MAP 267 DISTANCE REQUIRED BETWEEN PL ' C• - •-,• PARCEL72 ON AND PUMP OFF FLOATS: MOCHEN ` �•�-•1•-•''t 1100 GAUCYC E- 723 GAUFT= MAP 267 ,yo` ��R.�•• � '^ (USE 1'43"TO PROVIDE FOR BACK F PARCEL85 I 39.8, 31:82• '� - STORAGE REQUIRED ABOVE WORN HEYWOOD I "•:'i•'•' AA STORAGE PROVIDED ABOVE WORK TOTALS: —30 ,�,. I y TOTALLEACHING AREA 6,000 . 1 � i 100.0' ge PROPOSED4'WYETO TOTAL LEACHING CAPACITY_4' DISTRIBUTE FLOW EQUALLY ZA \ L�•-.�• ,^' .{ 'y GAS LINES TO BE FIELD VERIFIED AND REL=T® i AS NECESSARY \ NOTE 18.1' 1,CONTRACTOR TO VERIFY ALL DESCRIPTION HCl UTILITIES BEFORE 4 \ \ X CONSTRUCTION BEGINS SEPTIC COVER IN(1) 2.POSSIBLE FILL LINE AT 50'ON t,V SEPTIC COVER OUT(2) DEWgLK 58.3' EASTERNSIDEOFTP ERIFY CRAIGVJ _ B%FND. AT TIME OF INSTALL AND REMOTE _ OBSERVATION COVER(3) I__IE BEACH ROAD SI _ DIST.) AS NECESSARY(SEE NOTE 14) (40'WIDTH-PUBLIC) —��_ 3.PROPERTY LOCATEDINA PUMP CoVER(4) DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVED ZONE PUMP COVEP,(5) SITE PLAN SCALE:1•=20' GENERAL NOTES '1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. ' 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. • ) T /6 4. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS 10r - •. est Lo {{)._t THAN'ELEVATION=29ATFOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS.UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM SA.S.AND THE TOP OF THE LINER IS NOT LESS THAN THE .r.- ` -•� t1'CJ+ �.1,v 1 � BREAKOUT ELEVATION. T 5. SLOPE ALL MISSOLID NO DESE AT IGNED FOR w^'-� ,a•`• rr--�� .x�.-. o• " ¢. 6. THIS SYSTEM IS NOT DESIGNED FORAGARBAGE DISPOSAL 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO - _ h �•�� D. BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION.SYSTEM IS NOTTO BE BACK FILLED WITHOUT FIRST OBTAINING 1 j APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER.`.• _ 1,..` +. r B. ELEVATIONS BASED ON N.G.V.D.DATUM OF 30.0V MSL OBTAINED FROM CATCH BASIN RIM AS SHOWN ON PLAN. 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION T HROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE '2 �t t.,,'! 1i •'-• pT1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES.REPORTANY -1' • .a DISCREPANCIES TO THE DESIGN ENGINEER. _ TE tD ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRE @ .j ! ` •. STRUCTURES SHALL BE MADE WATERTIGHT. • r r • - 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR - . -��6 k '� •�, 82 ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH ICOA DETERMINATION FROM APPROPRIATE AUTHORITY. •-- yy_ fd;8 4 O 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED UNDER PAVEMENT,DRIVES OR TRAVELED WAYS IN WHICH CASE 'T. 5 w JY e 4 0 i '*•'' THEY SHALL WITHSTAND H-20 LOADING. 9 l a '-••, (`/_f_NJ } 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT,DUST AND FINES. U 1 s 14. WHERE REQUIRED,CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF LEACHING FACILITY.REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,PINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 'Ch � •. 1 ,.e _ - Q' •' SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK 16. PROPOSED PROJECT IS LOCATED WITHIN: ASSESSORS MAP 267 PARCEL 73(A-T) y �;`•'_ .� - 17. OWNER OF RECORD: HAWTHORNE TERRACE CONDOMINIUMS O _ _ f ADDRESS: 272 CRPJGVILLE BEACH ROAD HYANNIS,MA 02601 18. FEMAFLODDZONE C LOCUS PLAN - 79 AS SHOWN ON COMMUNITY PANEL R 2500050008D . PLAN E REFERENC 1,PLAN ENTITLED"HAWTHORNE TERRACE SITE PLAN,WEST SCALE:1'=1000- HYANNISPORT,BARNSTABLE,MASS,FOR JAMES J.TAYLOR-.DATED SEPTEMBER 1978,SCALED AT 20 FEET TO AN INCH.BOOK 327 PAGE 77. 2.PLAN ENTITLED"HAWTHORNIE TERRACE SHOWING SANITARY/SEWER CONNECTIONS AS BUILT',DATED OCTOBER 1B.1978.SCALED AT 20 FEET TO AN INCH, 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE.THIS PLAN IS TO BE USED ONLY FOR SEPTIC SYSTEM UPGRADE JC ENGINEERING WILL NOT ASSUME ANY DATA LIABILITY FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE 3SESSORS) 40 .SIGN) 40 -GAL/DAY/BEDROOM TEST PIT DATA TEST PIT DATA LEGEND 400 GAUDAY = 8800 GAUDAY --50-- EXISTING CONTOUR .000 GALLONTANKS F-50-1 PROPOSED SPOT GRADES Z� PROPOSED CONTOUR INSPECTOR: Samuel White INSPECTOR: Samuel White )'LEACHING FIELDS -E/T/C EXISTING ELECTRICAL UTILITIES SOIL EVALUATOR:Samuel PhBos Jensen SOIL EVALUATOR:Samuel Philos Jensen f DATE: APAI D4.2003 DATE: APnT 04.2003 GAY- EXISTING GAS LINE (TAKEN TEST PIT#: 1 TEST PIT lk. 2 -v EXISTING WATER LINE ,L/SQ.FT.)= GAUDAY ELEV TOP= 32.04' ELEVTOP= 31.87 TEST PIT LOCATION 4.440.0 GAUDAY ELEVWATER= >126'B.G.S. ELEV WATER= O O O PROPOSED 9,000 GALLON SEPTIC TANK PERC RATE= <2 MIWIN PERC RATE= MIWIN 3E REQUIREMENTS PROPOSED 6.000 GALLON SEPTIC TANK 10 GPD DEPTH OF PERC= 38'-56' DEPTH OF PERC= ' O W/MICROFAST UNIT 'CUES 1 DAY TEXTURAL CLASS: 1 TEXTURAL CLASS: 1 PROPOSED 6,500 GALLON PUMP CHAMBER 10 GPD/4=1,100.0 GALICYCLE /EEN PUMP 4"SOLID SCHEDULE 40 PVC PIPE - 2'SOLID SCHEDULE 40 PVC PIPE AL/FT=1.52 FT/CYCLE ----.-- 2"PERFORATED SCHEDULE 40 PVC PIPE BACK FLOW) 8"SDR 35 PIPE E WORKING LEVEL'4,400 GAL E WORKING LEVEL-4,579 GAL 0 32.04' 0 31.82' (96.87') ACTUAL ELEVATION'AS-BUILT' Sandy Loam Sandy Loam A 10 YR 3/2 A 10 YR 312 5-10%Gravel 6,000 SOFT. 12' 31.04' 12' 30.82' Loamy Sand' Sandy Loam ( 4,440 GALJDAY g 5-10 YR III B 10YR4/6 10%Gravel REV. I DATE BY APP'D. DESCRIPTION 34' 2921' 38, T RE5 2856tVEDwRePMooF"FALTHusE - "AS-BUILT"SEPTIC SYSTEM _ 38' M-C Sand M-C Sand PREPARED FOR: Pere 25Y614 2.5Y614 HAWTHORNE TERRACE CONDOMINIUMS 56' 10.20%Gravel 10-20%Gravel C C - LOCATED AT 272 CRAIGVILLE BEACH ROAD HYANNIS,MA 02601 HC 1 HC 2 - HC 3 69.F 27.1' ---- No Groundwater Terminated due to SCALE: 1 INCH=20 FT. DATE:JANUARY 13,2004 as line 58.3' 37.8' ---- 126" Ohserved 21.54' 80" 9 25.16' a 1e m ed eo 49.6' 60.9 ---- IoPa5-S U I LT' PREPARED BY: 26.6' 29.9 JC ENGINEERING,INC. 2854 CRANBERRY HIGHWAY --- 25.3' 15.T PLAN EAST WAREHAM,MA 02538 508.273.0377 Drawn BY SR Desleneb Br JLC Checked By.JLC JOB SHEE N0.971 T 1 r • • ALTERNATE TOP SLAB. { REINFORCED TO MEET H-_O LOADING ADJUST TO REQUIRED•: 20'(vifN.ACCESS COVER.(TYPICAL FOR 3y PROVIDE LESARON LK-'100 MANHOLE COVERS INSTALL 7/q GRADE W/MIN.20R TO FINISIi GRADE FOR ALL COMPONENTS ACCESS TO INSPECT 10'VENTIIJG PIPE SCREEN(SI MAX 4 BRICK COURSES PUMP OUTS MUST ` OR EQUIVALENT BE PROVIDED(6-MIN. 1NOTE 6) DIMENSION WITH DIA)(SEE NOTE 12) 24'OIA 1 °RAh1E IN FULL BED OF MORTAR 'REINFORCED OBSERVATION aNHOLE FRAME&COVER 7 CONCRETE COLLARS. FINISH C-RApE OVER ON EL=3'I-2l'-32.46' _ PORT DIE DROP FRONT / c`T � •L -„^�-- -�-_-• 3TDI/ 'PE M14H.STEP4STAINLESS \ BTTUMASRC COATING FOR 2'-0"+/_ - � �� (7,6cr SANITARY MANHOLE -� L TOP OF TANK SEE"IN PRECAST REINFORCED DRAWING I BLOV CONCRETE M.H.CONE _ FLUSHOF RUBE PIPIN 2•,O•+P SECTION 4'.0"DIAMET"ER - CONCUDHSF 4.5X I GASKET MIN.0.121N.STEEL PROPOSED WITHINI-12"PER VERTICAL FOOT, 8"SDR35PLACED ACCORDING EDTREATMENT PLAEDACg• 2"DROP MtN. 8'SDR 35 ZONE L=69.00' 3"DROP MAX g•DESIGNATION M799 t3z.oD 28.3T'-0"DIAMETER HEIGHTOF RISER° (28.9$) 8d" INV.OUT=3T Qj E 2•QL SECTIONS VARY t LIQUID 2$.29 E FROM 1'T04' 29.65 2$•90' LEVEL 2$.65 _ �� - 28$.) NFLUENTOUTSIDE OF � WASTE ;, FAST INSE5"MIPIPE+2' FROM BIO-MICRCLEARANCE - SETTLING iE PRECASTROVIDE'V' 6'CRUSHED STONE ZONE 4219 GALLONSEESOPENINGS OVER MECHANICALLY MIN.LIQUIDOTE4COMPACTED BASE BEER BOOT NLESS CEMENT CONCRETE CAPACITYEL BAND CL \ pS•q• (15971L.)NITARY PIPE TION .\-1] LENGTH iT-0" WIDTH 10'-0' pEpTH 10'-B" NOTE 10 LENGTH 1T-0• WIDTH 10'-0• DEPTH r-S BEDDING9,000 GALLON SEPTIC TANK(LOW PROFILE) 6,000 GALLON SEPTIC TANK WITH FAST INSERT OPENINGS T IN RISERN3AR AROUNDGS FOR PIPES IAMETER AND OVER.I'COVER" PROPOSED 9,000 GALLON SEP1 PRECAST CONCRETE PROPOSED 6,000 GALLON SEPT[ MANHOLE(H20) PROPOSED 6,500 GALLON PUMP 1 NOTTO SCALE NOTTO SCALE v LIFTING HOLE" 3"PIPE CAP' WAIR LINE PIPING(TO 3/4'TO 1-112"DOUBLE WASHED STONE TO CROWN 6'MIN CIA PUMP (SEE NOTE 5) BLOWER BY BIO-MICROBICS)OUT PORT(SEE O 2"OF 1/8'TO I/2"DOUBLE WASHED STONE- NOTE 4) o FINISH GRADE OVER LEACHING FIELD= 30.2-31.8' 4" SLOPE @ 2%MIN.OVER SYSTEM IENT WASTE 24"DIA A SETTLING TANK MANHOLOOSSERVATIO N is,3'DIA4WAYTE PORT - ` CONTINUOUS PITCH BACK 6'OBSERVATION e'DIA I TO PUMP CHAMBER PORT(OPTIONAL) FAST a 4"SCH.40 FORCE MAIN 4219 GALLON 10"DIA VENTING PIPE TREATED +1- LZ'SOLID PVC 2•PERFORATED LATERAL SET MIN.LIQUID 7. EFFLUENT '^v LEVEL INV.ELEV.=28.50' BO- CAPACT Y ( ) '-- I. v vi 45•ELBOW /Z8$� (21293L.) X2TEE O O &7 11 4°MANIFOLD S-0.5% TREATMENT - FAST MODULES BACK TO FORCE MAIN FIELD PROF ZONE BI0.MICROBICS 3"PIPE CAP 5' 6"DIA MIN PUMP OUT NOT TO SCALE - - PORT 7TS.S(195.6t1.3an) 79-i5-(200.731.3an) (SEE CONCRETE THRUST 156" NOTE 4) 114'PERFORATION A BLOCK an) AT70 75 'CLOCK(TYP.) (396 10' _ LENGTH 17-0" WIDTH 10'-0' DEPTH T-9' I TC 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) - t EL,27.76 �rme n3a y ODory ° NOT TO SCALE o A O o O Z 2' APPURTENANCES TO FAST(EG.SEPTIC TANK,PUMP OUTS,ETC.)MUST CONFORM TO ALL COUNTY,STATE,PROVINCE,AND LOCAL CODES. m 0 m p SDO T m O �R-WAY 3'DIA.PVC TEE IS PROVIDED 6Y THE FACTORY AS WELL AS 3'PVC PIPE EXTENDING HORIZONTALLY FROM THE TEE IN BOTH DIRECTIONS AND DEL=27.60 D OFF OUTSIDE OF THE MODULE LINER.THE AIRLINE MUST COME W FROM THE TOP AND ATTACH TO THE PVC TEE -1 3/4"T. AARY AND SECONDARY TANKS MAY BE ONE DUAL COMPARTMENT TANK WITH A BAFFLE NOTE MINIMUM COMPARTMENT DIMENSIONS REMAIN THE "Lo' 2'LA I ERAL(TYP.) n WASF n O CROV 1/4"PERFORATIONAT - A O m TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT,MORE THAN ONE IS RECOMMENDED. 5 O'CLOCK(TYP.) > R HOLES FOR LIFTING DERBARSBETWEEN THE FAST TLESE ARE SUPPLIED.CONITRACTORSUPPUED SPREADER BARS ARE TO BE USED IN LIFTING THE UNIT.PLACE PLAN VIEW m Z p NOT TO SCALE 1 BLOWER MUST BE WITHIN 100 FEET(30.5M)OF FAST UNIT WITH LESS THAN 4 ELBOWS. ANCHOR- FOR DISTANCES GREATER THAN 100 FEET-CONSULT FACTORY.BLOWER BASE DUST BOLTS.SE ACCESS TO INSPECT INSTALL 1/4'MESH BE ABOVE NORMAL FLOOD LEVEL NOTE 2 PUMP OUTS MUST 10'DIA VENTING PIPE SCREEN(SEE BE PROVIDED(6-MIN. NOTE 8) BLOWER WITH HOOD 2. BIO-MICROSICS REQUIRES THAT PIPING FROM BLOWER TO TANK BE GALVANIZED OR DIE)(SEE NOTE 12) 24'DIA (BY BIO-MICROBICS) CPVC.PIPING INSIDE TANK TO FAST AIRLIFT MUST BE CPVC OR NON-CORROSIVE OBSERVATION SEE NOTE 1 MATERIAL DO NOT RUN GALVANIZED PIPE LENGTH INTO TREATMENT TANK. PORT 3. BLOWER CONTROL SYSTEM BY BIO-MICROBICS,INC. rz _ 4. (11)ORIGINAL FEET ARE ON THE BASE OF THE FAST TREATMENT MODULE _ - :-_ _ EACH LEG EXTENSION IS TO BE ATTACHED TO THEIR CORRESPONDING n 1 BRACING 3' IA FOOT WITH THE PROVIDED HARDWARE SEE LEG EXTENSION DRAWING_ TOP OF TANK SEE (7.Bcm)MW ELECTRICAL CONDUIT S. ANCHOR ALL LEG EXTENSIONS T07HE BASE OF THE TANK EXCEPT THE CENTER LEG ^ PLAN FLUSH WITH BLOWER (TO BLOWER EXTENSION.PLACE BOLTS AT OPPOSITE CORNERS OF THE FOOT EXTENSION BASE IF PIPING(SE BOTTOM OF HSF S X GABKET� CONTROL SYSTEM) ELONGATING THE LEG EXTENSIONS PAST 23'(58A-)IN HEIGHT,THE CENTER LEG I CONCRETE LID SEE NOTE 3. EXTENSION MUST ALSO BE BOLTED DOWN.ANCHOR BOLTS ARE NOT PROVIDED. I TREATMENT WITHIN 1-12' 6. TO ELONGATE THE FOOT PAST THE PROVIDED 12'(30.5cm)EXTENSION,CUT THE 3.9'DLL. ZONE (9.8cm)LEG EXTENSION INTO TWO SEPARATE PIECES.NEXT,CUTA 4'SCH 40 PVC PIPETO THE DESIRED LENGTH AND SUP THE PIPE OVER THE TOP CUT SECTION AND THE BOTTOM CUT SECTION OF THE LEG EXTENSION.ATTACH PIPE WITH STAINLESS STEEL SCREWS NON-CORROS EQUAL ELONGATION MUST BE DONE ON EACH LEG WHEN THE PROVIDED 12•IS FOUND CLAMP EVERY INSUFFICIENT. Lo T. IF LEGS ARE EXTENDED PAST 48',USE OF SCH 80 OR STRONGER PIPE IS RECOMMENDED. -INFLUENT - m 8. RUN VENT t0'OIE TO DESIRED LOCATION AND COVER WITH 114"MESH SCREEN.VENT RISE WASTE \ MUST NOT CAUSE EXCESSIVE BACK PRESSURE. FROM `FAST INSERT-(BY 8 DIA(10.2an) 9. PLEASE SEE DRAWING HSF 4.5X SETTLING .ban BIO-MICROBICS) FAST TREATED EFFLUENT ()10. COPYRIGHT C 2001,BIOTAICROBICS,INC. ZONE 11. SETTLING TANKS EQUALING 12 X TO 1 X DAILY FLOW MUST BE USED PRIOR TO FAST. LEG EXTENSION SEE 1 SEC- 12 FAST TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT-MORE NON-CORRO: GALLON NOTES Pa NOTE 4 SEE NOTES 6&7 THAN ONE IS REQUIRED. CLAMP EVER LIQUID 13. FAST COVERS OVER THE AIRLIFT AND ONE PUMPOUT MUST BE TO GRADE AND FASTAIRL %CITY - SEALED WITH GASKETS.COVER OVER PUMP CHAMBER MUST BE TO GRADE- 'IL) 14. 10"VENT AND AIR SUPPLY PIPES MUST BE PITCHED TOWARDS THE TANK FOR DRAINAGE_ NOTE to 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) 16. FIRSTOBEFIRMLYSECURE AIR SUPPLY E OTEGANKTOED. 17. VETTOBEFION AND EIGHT ARE CRHE ITICAL TO PREVENT MOVEMENT IN ANY DIRECTION. NOT TO SCALE � 17. VENT LOCATION AND HEIGHT ARE CRITICAL ALL 1/4'MESH EEN(SEE E 8) BLOWER WITH HOOD - PROVIDE LEBARON LK-100 INSTALL 1-1/4•PVC TO BUILDING.JOINTS TO BE MADE (BY BIO-MICROBICS) MANHOLE COVERS TO FINISH GRADE OVER TANKS EL, WATERTIGHT.WIRE PUMP AND FLOATS TO DUPLEX-PAC-2' HOISTING CABLE 7 x 19 SEE NOTE i 31.75' FINISH GRADE FOR ALL LEVEL CONTROLLER W!SUBMERSIBLE PRESSURE BELL COMPONENTS STAINLESS STEEL NEMA4 JUNCTION BOX CORROSION RESISTANT 8 DIA.I1,760 LB.STRENGTH �D. -� ?T UOUID-TIGHTCABLE CONNECTORS SUPPORTED 4"BALL VALVE w/UNIONS CONNECTORS SUPPORTED BY 1-1/4"PVC CONDUIT, SCH.40 PVC (7.6cm)MIN ELECTRICAL I JOINTS TO BE MADE WATERTIGHT BLOWER CONDUIT(TO PIPING(SE BLOWER (2)BARNES 45E-LPOMP 275 GPM 2S TDH 230 VS]NGLE CONTROL PHASE 4.S HP,6.5" P. DIA MODEL m4SE4524L SYSTEM)SEE _IL NOTE 3. 4"SCH.40 TO 4'SCH.40 TO E 4-MANIFOLD I _L3- I MANIFOLD PROPOSED 8"SDR 35 - I 'SCH.40 TEE SLOPE .754.,N,L - T nuPu ou I w/CLEAN-OUT CAP L=49.0' L.uo oNAAC oNl � !o ' 28.62' nano ON �116.0' I I 5• R INSERT(BY (28.14') 28.22' LAD ONnAOON to 27.22' IIII1_1111111 -MICROBICS) (27.1. 6° EXTENSION INLET TEE `° 4'SCH.40 PVC DISCHARGE PIPE VOTES 6&7 - " " TWO(2)-1/4'WEEP HOLE IN DISCHARGE PIPE 6'CRUSHED STONE 4'BALL CHECK VALVE SCH.40 PVC 100 OVER MECHANICALLY off 14 7,9. COMPACTED BASE P.S.I.FLOWMATIC OR EQUAL LENGTH 17'-0" WIDTH 7'-0" DEPTH 11'-2' LENGTH 1T-0" WIDTH T-0• DEPTH 11'-2' =RT(LOW PROFILE) 6,500 GALLON PUMP CHAMBER IEPTIC TANK 6,500 GALLON PUMP CHAMBER :PTIC TANK& NOTE:ALL TANKS SHALL BE CAPABLE OF NOT TO SCALE WITHSTANDING AASHTO H-20 LOADING TANKS MP CHAMBER SHALL BE INSTALLED ON A LEVEL STABLE BASE.DIMENSIONS ARE TAKEN FROM ACME 'TANK SHALL BE WATERTIGHT PRECAST CO.,INC.SPECIFICATIONS AND WATERPROOFED CROWN OF PIPE 1/4"PERFORATION TO BE PLACED _ BLOWER W/HOOD(BY IN THE END CAP HORIZONTALLY BIO-MICROBICS) NEAR THE CROWN OF THE PIPE AT 31.8' THE END OF EACH LATERAL - - (29.13') A TOP OFSAS.=28A.83'-,, � I 1 _ CONCRETE BASE BOTTOM OFTRENCH TO BE LEVEL EL_ 28,0' I Z �!! II I�I,ii��l. (28.3') ELECTRICAL CONDUIT 12"I L(TO BLOWER CONTROL r 5'MIN- � .AIR PIPING SYSTEM) ROFILE GROUND WATER ELEV,<21.54' SCALE BLOWER HOUSING DIMENSIONS NOT TO SCALE FINISH GRADE OVER LEACHING FIELD= 30.2'-31.8' XV 12" SLOPE @ 2k MIN.OVER SYSTEMTOP OF SAS.= 28.83'� 2'PVCPERFORATED PIPE 2"OF1/8"TO 12"DOUBLE WASHEDSTONE3/4"TO 1-12"DOUBLEWASHED STONE TOCROWN OF PIPE 3' 6' 6' 3, 30, 5'MIN. - GROUND WATER ELEv,<z1s4' BLOWER HOUSING BASE FIELD END VIEW A-A ) DIMENSIONS(SECTION A-A) NOT TO SCALE NOT TO SCALE NCHOR iTS SEE BOLT LEG ORIGINAL DTE 2. ORIGINAL EXTENSION FOOT FOOT FOOT. SEE C SCHEDULE 1.SECURE ORIGINAL I.I-FOOT TO LEG FOOT.SEE q0 PVC PIPE EXTENSION BY PLACING TWO SCREWS IN NOTE 1. EACH SIDE OF THE LEG EXTENSION.EIGHT SEE %-- NOTE 4. !_CUT SECTION SCREWS PER FOOT ARE INCLUDED AND 8" 3.875' SEE NOTE 3. SHOULD BE USED ON EACH LEG n TYP EXTENSIONS. _ 1 I 2 ANCHOR ALL LEG EXTENSIONS TO BASE p �EVy 1 ANCHOR MODIFIED LEG OF THE TANK EXCEPT THE CENTER LEG L BOLTS EXTENSION WITH 4' EXTENSION.PLACE BOLTS AT OPPOSITE- REV. DATE BY APP'D. DESCRIPTION PROVIDED 12' SEE .PVC PIPE NOTE 2 CUT SECTION CORNERS OF THE LEG EXTENSION BABE IF LEG EXTENSION ELONGATING THE LEG EXTENSIONS PAST "AS-BUILT SEPTIC SYSTEM LEG EXTENSION (HSF 4.5X)SEE NOTE3. 23'IN HEIGHT,THE CENTER LEG EXTENSION PREPARED FOR MUST ALSO BE BOLTED DOWN.ANCHOR :ORROSIVE 924" ) FAST AIR LIFT (H30.4' BOLTS ARE NOT PROVIDED. HAWTHORNE TERRACE CONDOMINIUMS P EVERY 2 (H30.Scm 3.TO ELONGATE FOOT PAST THE - - LOCATED AT - GASKET NON-CORROSVE - GASKET PROVIDED 12'.CUT THE 3.9"DIA.LEG CLAMP EVERY 2 FT EXTENSION IN THE CENTER INTO TWO 272 CRAIGVILLE BEACH ROAD RISER - SEPARATE PIECES.THEN CUTA SCH 40 HYANNIS,MA 02601 3"AIR RISER 3"AIR PVC PIPE TO THE DESIRED LENGTH AND SUPPLY SUPPLY SLIP THE PIPE OVER THE TOP AND BOTTOM LINE LINE CUT SECTIONS OF THE LEG EXTENSIONS. - SCALE: N.T.S. DATE:JANUARY 13,2004 -CORROSIVE GASKET GASKET 4.ATTACH PIPES WITH STAINLESS STEEL PREPARED BY'.NP EVERY2 FT - SCREWS.IF LEGS ARE EXTENDED PAST 48' NON-CORROSIVE FAST USE OF SCH 80 PIPE IS RECOMMENDED. 3T AIR LIFT CLAMP EVERY2FT AIRLIFT 11AS-BUILT' JC ENGINEERING,INC. S.THE AIR SUPPLY INTO THE FAST UNIT 2854 CRANBERRY HIGHWAY AIR SUPPLY OPTIONS SEE NOTE MUST BE SECURED SO AS TO PREVENT PLAN EASTWAREHAM,MA02538 MICROFAST64.5 X DETAILS DAMAGE FROM PIPE VIBRATION, 508.273.0377 NOT TO SCALE Draw„BY-S32 Designed SY JLC Cherk<d BY JLO JOS No.371 SHEE 2 Town of Barnstable 9� 9 LF� Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS -(Town Code §360-44 and-Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadli*-~e 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool kAny "conditionally passed systems" (broken cover, relocation of a pipe, relocation driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc .' �-�� a �1� m��a�� a�� r� Shanonhascontacted8ennetttoyee�theyanerepaihn8h-nruncUon� ' ��u?? otuu��s not on the 9/4/o8 inspection report Thanks Karen From: LeziRowell ---'-- ------ ----------___-_------------ ------- Sent: Wednesday, November 07, 2018 8:39 AM To: Malkus, Karen; McKean, Thomas Cc: Samantha Farrenkopf, Joe Smith Subject: BEA's Title 5 ptic Inspection for .."w"^«v Terrace Condos, 273Cnai9vUle Beach Road Good morning, � I have attached electronic' copy ofBEA's Title 5 Septic,Inspection filed with the Barnstable Health Department dated. ng -.^hscano show the payment of$25 filing fee as cashed with receipt of the report. It is now our understanding that the mailed hard copy cannot be located; does the attached PDF suffice mur---'-' ~' ~" v"v /equ/neanotherhardcopytobemailed in? - Please advise what best assists in this matter. Should you have any questions, I have copied BEA's Wastewater team. Thank you'� Lez / Rovve / Administrative Assistant BENNETT ENVIRONMENTAL ASSO[IATES |NC l573K�ain Street/P.O. Box 1743 ` ' Brewster, K4AO2631 508'886'1705 508-896'5109fax Please visit usonFacebook Bennett En iironmental Associates, Inc. Z U � � Malkus, Karen From: Emily Michele Olmsted <emilymichele.olmsted@barnstablecounty.org> Sent: Tuesday, November 13, 2018 2:26 PM To: Malkus, Karen Subject: RE: BEA's Title 5 Septic Inspection for Hawthorn Terrace Condos, 272 Craigville Beach Road Hi Karen, Sorry to be just getting to this now. I see your other e-mail too, I think I'll dissect these one at a time. I have an idea as to why it may not have been included in the September inspection but in both of these cases the operator is going to better be able to give an answer: I think the Title 5 system inspection you sent(which we don't normally get, we just get the routine inspections of specifically an I/A system) indicates there's an issue with the pump chamber and so it would not have appeared in the inspection for the FAST that is reported to us. Pump Chamber(locate on site plan): Pumps in working order. ® Yes © NO` Alarms in working order Yes ❑ No" Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump#1 in pump chamber is not functioning properly and is in need of replacement, Pump#2 functioning appropriately, pressure bell system is functional. Normal water level observed in pump chamber at time of inspection. Audible and visual alarm are functioning properly. We don't currently track inspections of the Pump Chamber and so I am guessing that that was why it was not filed with us. I will say this too:we don't have a permit summary sheet on file for this. If you happen to have one that you wouldn't mind sending, I'd appreciate a copy. If you looked at the permit and are satisfied with the set up (4 inspections, no samples)then that is okay too. Thoughts? Thanks, Emily Michele From: Malkus, Karen <Karen Malkus(@town.barnstable.ma.us> Sent: Friday, November 09, 2018 3:56 PM To: Emily Michele Olmsted <emilymichele olmsted barnstablecounty.org> Subject: FW: BEA's Title 5 Septic Inspection for Hawthorn Terrace Condos, 272 Craigville Beach Road Hi Emily Michele, 1 FYI—Here is a 8-31-18 report that says the system alarm is not functioning. Sharon has contacted Bennett to see if they are repairing it- not sure why this was not on the 9/4/08 inspection report sent to you?? Thanks Karen From: Lezli Rowell [mailto:lrowell@bennett-ea com] Sent: Wednesday, November 07, 2018 8:39 AM To: Malkus, Karen; McKean, Thomas Cc: Samantha Farrenkopf; Joe Smith Subject: BEA's Title 5 Septic Inspection for Hawthorn Terrace Condos, 272 Craigville Beach Road Good morning, I have attached electronic copy of BEA's Title 5 Septic Inspection filed with the Barnstable Health Department dated 8/31/18 along with scan to show the payment of$25 filing fee as cashed with receipt of the report. It is now our understanding that the mailed hard copy cannot be located; does the attached PDF suffice to remedy your record, or do you require another hard copy to be mailed in? Please advise what best assists in this matter. Should you have any questions, I have copied BEA's Wastewater team. Thank you, Lezli Rowell Administrative Assistant BENNETT ENVIRONMENTAL ASSOCIATES, INC. 1573 Main Street/P.O. Box 1743 Brewster, MA 02631 508-896-1706 508-896-5109 fax http://bennett-ea.com Please visit us on Facebook Bennett Environmental Associates Inc. 2 PermitInspections Page 1 of 2 Barnstable-- Co Septic Management Program Karen Malkus-City of Barnstable 3:45 pm Main I Permits Reports Compliance Contractors. Technologies Help Horne > Inspections s View Inspection Cancel- ' Inspection Details Field 'testing Insection p i Address: 272 Craigville Beach Road Color: Clear i. ..__.._...-----------..-........_.___ -- " - Component: FAST Odor: Musty Print Inspection Date: 2018-09-04 Effluent Solids: No View Permit Time: 12:55:00 pH: :7.0 SU Contractor: Bennett Dissolved Oxygen: 5.000 mg/L View History Operator Name: Greg Brehm Turbidity: 4.87 NTU License#: 16149 Settleable Solids: 0.000 Site Conditions Operating information Seasonal Residence: No Sludge Depth: 12.00 in _ _ Air Temperature: '86.0°F Scum Layer Thickness: 0.25 in Weather Conditions: Sunny; Pumping Recommended: No Soil Absorption System Observations Signs of Breakout: No Depth of Ponding: in Tonding Above Invert: No Maintenance Issues Any Apparent Violations of the None Reported Approval? Any Cleaning or Lubrication of Parts None Reported Performed? Any Control Adjustments Made? None Reported FAST Blower and alarms operational. Pumps, Switches, Alarms Tested? System is operating mechanically correctly,except for discharge pump#1. Any Equipment Failures? Discharge pump#1 is bad and is turned off at switch. Any Parts Replaced? None Reported Any Recommended Corrective None Reported Actions? Inspection Completion Inspection Completed? Yes Incomplete Inspection Reason inaccessible_alarm_panel https://septic.bamstablecbuntyhealth.org/reg/permit inspections/view/37045 11/9/2018 PermitInspections Page 2 of 2 Actions to be Taken to Resolve None Reported 'Incompletion Comments Technology Specific Checklist Date of Last Pumpout Not Reported. l Equipment Yes No Comments 0;i Visual Alarm Operating Audio Alarm Operating Air Inlet filter Clean O O i Blower Hood Vents Clear i f Excessive Noise Excessive Vibration O Unusual Odor O Pumpout Required O j lJ+r Depth Comments 1,Primary settling Zone 12" Aerobic Treatment Zone g^ Effluent Result "Estimated Daily Flow i Temperature https:Hseptic.bamstablecountyhealth.org/reg/permit_inspections/view/37045 11/9/2019 rermitlnspections Page 2 of Actions to be Taken to Resolve Incompletion None Reported Gonstr9> tat Technology Specific Checklist Date of Last Pumpout .Not Reported. Equipment Yes No Continents Visual Alarm Operating O Audio Alarrn Operating Air Inlet filter Clean (�� C9 , Blower Hood Vents Clear Excessive Noise n Excessive Vibration Unusual Odor r:, Pumpout Required Depth Comments Primary Settling Zone 12 Aerobic Treatment Zone s„ _ .. Effluent Result Estimated Daily Flow Temperature https://septic.bamstablecountyhealth.org/rea/permit inspections/view/1704'S , , Barnstable � Town of Barnstable Wi��,rAV. Regulatory Services De artiMn�b rn " `CeC� Re g p 1e � ► 9A,ktNS'rAHLE. y MASS. i679. Public Health Division _ �;..Yj;v ArfOMA'�� VehAlo 200 Main Street, Hyannis MA 02601I { 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 6661 September 7, 2018 SAULSBERRY, JANET ET AL AND ELIAS, ELAINE M 11 RICHARDSON CIR SAUGUS, MA 01906 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 272 Craigville Beach Road, Hyannis, MA was inspected on 08/27/2018 by Joseph Smith, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • The pump chamber pump/alarm is not operational and need to be repaired. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mai ling\Conditionally Passes Letters\272 Craigville Beach Road Hyannis.doc BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICE,NSED SITE P;ROPESMONAf,S,EN`IRONM:GNTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street, P,O,Box 1.743 (508)896-1706 Brewster,MA 02631 fax (508)896-5109 LETTER OF TRANSMITTAL -TO: DATE;� JOB NUMBER: `fhotnas Mclean,'Director Barnstable Healfh Divisio?i JBEA12-10167A 200 Main Street Hyannis,MA 02601 REGARDING; TITLE 5 OFFICIAL INSPECTION FORM: Hawthorne Terrace Condominium Trust(Units 1-20) — 272 Crai pv i l le Beach Road S1 P1NG M THOD; West Hyannisport ----- [Assesoes Map/Parcel IDs; 26707300,A-Tj Regular M$il Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Expres's Mail ❑ Other C,rofied Mail ❑ Green Card/RR �f, w ..CC)rlp DATE DESCRIPTION ---- — - — - g 8/27/18 Title 3 Official Inspection.Form,with enclosures 5 8/31/18 Septic Inspection filing fee,Checic No. 1731,$25.00 r4 For review and comment: For approval: (] As requested: For your use: F1 ItEMARIQ M�.Mcl4+ean, I'ieas find enclosed the Title 5 Inspectio:n for the Hawthorne Terrace Condominiums.This inspection has found the system to "Conditionally Pass"as noted. If you leave any questions or need additional information,feel free to contact our office, Thank you, eV. Diane Ferr 8no,Hawthorne Terrace Condominium Trust.(advance copy via email) +1RCYM Joseph R, Smith,RS,SI/:Lezli Rowell,Administrative Assistant If enclosures are not its noted,kindly notify us at once Commonwealth of Massachusetts �3 -0-33 -oo.A W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hyannisport MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection I Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information r� y filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Joseph Smith use the return Name of Inspector key. �� Bennett Environmental Associates �-11 Company Name P.O. Box 1743 Company Address Brewster MA 02631 City/Town State Zip Code 508 896 1706 SI #4994 Telephone Number License Number B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further luation by t Local A oving Authority pector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. l5ins•3l13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 I A Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West HY P annis ort MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for every y West H annis ort MA 02672 8-27-18 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) ® Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 public health, safety or 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 public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. CityfFown State Zip Code Date of Inspection B. Certification (cont.) 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, safety and 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 SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Note: System conditionally passes, one of the pumps in the final dosingpump chamber is faulty and is in need of replacement. All other appurtenances to the final dosing pump chamber functioning appropriately. D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 %day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hyannisport MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of 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 1 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 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No } ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking 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 If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 40 Number of bedrooms (actual): 40 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 4,400 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments w °4 272 Craigville Beach Road- Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-27-18 required for every Y p page. City/Town State Zip Code Date of Inspection D. System Information Description: Septic system that serves a condominium complex is comprised of: 9,000 gallon septic tank; 6,000 gallon I/A FAST tank(Bio-Microbics FAST System); 6,500 pump chamber; and two 30' x 100' pressure dosed leaching fields (design capacity 4,400 gpd required). Number of current residents: 60-70 est. Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d See details. 9 ( Y 9 (gpd)): Detail: 2016: 538 units = 53,800 cubic feet= 402,424 gallons/yr; average flow= 1,102 gpd 2017: 486 units =48,600 cubic feet = 363,528 gallons/yr; average flow= 996 gpd Sump pump? ❑ Yes ® No Last date of occupancy: Currently occupied Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 a, Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Hawthorne Terrace Assoc. Pumped 2016 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ® Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for every y West H annis ort MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2004 BOH Certification Letter Engineer Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 p g feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: fee +/-town water line feet Comments (on condition of joints, venting, evidence of leakage, etc.): Properly vented to roof. No evidence of leakage of piping or joints. Septic Tank(locate on site plan): 2.0 Depth below grade:p g feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 9,000 gallon septic tank with schedule 40 pvc inlet and outlet tees in good condition with no structural concerns. Covers to final grade elevation with steel ring If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 9,000 gallons Sludge depth: 4" outlet, 6" inlet t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-27-18 required for every y p page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 61" Scum thickness 0"outlet, 12" inlet Distance from top of scum to top of outlet tee or baffle 8" outlet, 2" inlet Distance from bottom of scum to bottom of outlet tee or baffle 48" How were dimensions determined? Sludge judge, tape, probe Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping of excessive scum layer in septic tank recommended at time of inspection. Both schedule 40 pvc inlet and outlet tees in working order and are functioning as intended. Liquid level as related to the outlet invert is at a normal operating height. No evidence of leakage encountered while conducting the inspection on the septic tank. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 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 Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-27-18 required for every y p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hyannisport MA 02672 8-27-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Pressure Distribution, No D-box Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pressure Distribution, No D-box Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump#1 in pump chamber is not functioning properly and is in need of replacement. Pump#2 functioning appropriately, pressure bell system is functional. Normal water level observed in pump chamber at time of inspection. Audible and visual alarm are functioning properly. * If pumps or alarms ate not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. Soil conditions explained in next section for SAS t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 272 Craigville Beach Road- Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: (2) 30'x100' ❑ 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.): (2)30' x 100' pressure dosed leaching fields: no surface ponding present, soil clean and dry, normal vegetation (grass) over top of both leaching fields. Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. No evidence of hydraulic failure present at time of inspection. (Design capacity of leaching field = 4,400 gpd). 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 layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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 vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 272 Craigville Beach Road- Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-27-18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 61+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Design Plan By JC Engineering Plan Date: 1-13-2004 ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Established estimated depth to high groundwater by referencing septic as-built plan by JC Engineering Inc. of East Wareham, MA(plan date of January 13, 2004), wherein the bottom of the pressure dosed leaching field is noted at elevation 28.0'. The soil test data noted on the same plans (conducted by Samuel Philos Jensen and inspected by Samuel White), indicates that no groundwater was encountered at elevation 21.54', which puts estimated groundwater at an elevation of 6.0'+from the bottom elevation of the leaching field. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 _ Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �^M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-27-18 required for every Y p page. CityTTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ' T�.�j i�t.J'1� FL�0��.•1 R�"i._Y L L�� d��f-7� , _ � £s6 ' �� . r a ate. ''-'_ 'r,a syS-'f T--ff PART C wee 41 _'-trE��,'''::C_<.'ti:"_ ,�-:Pam.. L..�f, y_J•1� ._�,?<aGtl, J�{� E�' ';� I i •� -',WU "S:'S :?CY.e I s—,El,S...%?Ti 5?=1 Ili ib ;,fit:a"a•r.%.i�,•'C rhac w r r�,v'r t i ---..P.��..,,y..,.. -- 1 �,� G., f'J'•'-�f:�.1, •J v% 1-hy Y '_ •p ter: - z _ ':`� ' �_- ••�• . . -1 ri �i .� n .-r• 1 r_raTrrectrr�r-•n l 4. CGrG I QPCT !-!I'-IM�I-I l gNJ>IHP:UIOJ-I J T.:RT PTOP.-?GI-.IHI,J BENNETTENV.1�RONMENTALAssocIATES, INC. LICENSED SITE PROFESSIONALS � ENVIRONMENTAL SCIENTISTS C�' GEOLOGISTS 6 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 C 508-896-1706 6 Fax 508-896-5109 (, www.bennett-ea.com BEA10-10167 February 21, 2018 Ms. Diane Ferrigno Hawthorne Terrace Condominiums P.O. Box 134 Belmont, MA 02478 RE: OPERATION AND MAINTENANCE CONTRACT Innovative/Alternative Septic System 272 Craigville Beach Road -Hyannis, MA Dear Ms. Ferrigno, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for the continuation of professional services relative to the operation and maintenance of the Innovative/Alternative Wastewater Treatment System located at the above referenced property. The collection and field analysis of samples collected from the effluent of the septic treatment system is a required condition of the system,as set forth by the MA Department of Environmental Protection(MA DEP) to qualify treatment capacity on a quarterly basis. As such, work proposed by BEA includes the inspection and field testing of wastewater samples,as well as the preparation of the required forms for distribution to the appropriate town and state offices. Additionally,at the time of such inspection,blowers,filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced to you quarterly. Should any repair or treatment system component replacement be required,you will be notified to authorize the additional work and expenses. Such work will be billed at time and expense portal to portal. Should field-testing parameters indicate the need to collect samples for laboratory analysis,such sampling will be conducted and will be noted on a BEA form that is left at your facility following the inspection. The following budget represents estimated annual costs through one year of service to include four inspection events. These annual costs are valid for two years subsequent to the date of the next inspection. Please note that this contract runs with the property. As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore,you are required to notify any buyer for the transfer of this contract. ' 1 EMERGENCY SPILL RESPONSE V WASTE SITE CLEANUP C, SITE ASSESSMENT b PERMITTING 6 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE i FEBRUARY 21,2018 1(AW l'NORNF TFRRACE/BFA10-10167 PAGE{2 OF 2 VA W WTO&M QUARTERLY INSPECTION/MAINTENANCEIFIELD TESTING Inspect I/A system and take field measurements of dissolved oxygen,p1l and turbidity. At the time of monitoring events the conditions of the system will be inspected and documented with regards to the blower units, sludge level and associated piping. REPORTING/FILING Review inspection and field-testing results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DPP transmittal forms on a quarterly basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. TOTAL ANNUAL EXPENSE: $932.00* TOTAL COST PER EVENT: $233.00 *Note:I/A systems located in Barnstable County are required to report inspection and sampling results on the MA Septic onl ine database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. We are proceeding with this work as outlined. Immediate notification in writing is required if you do not wish to proceed. Otherwise, please sign the authorization below indicating acknowledgement and acceptance of our Terms&Conditions and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, BENNETT ENVIR_ONMENI'AL ASSOCIATES, INC. (" l Samantha Farrenkopf, WWTO Wastewater Program Manager cc: Kara Risk, Business Manager encl. Abbreviated Terms &Conditions (2011)/Fee Schedule (2016) AUTHORIZATION: !'/� Lw( 10 , DATE: AsS UAnTES, INC. r ors A. ��,�� =k,i tl1 ✓ ' 508-896-1706 vvw .be.nnett-eaxonn Date&time of visit: A site visit was conducted today for: O&M 194YES ❑ NO Testing M`YES ❑ NO Repair ❑YES CT NO Alarm Call ❑YES EJJ NO Your system is operating correctly L7 YES ❑ NO Tank(s) in need of pumping ❑YES ES NO Further maintenance required ❑YES C'NO Repairs needed ❑YES Q NO Please contact our office ❑YES 0 NO Contract renewal required ❑YES ❑'NO Field testing 11 Pass ❑ Fail i Sample pulled ©`YES ❑ NO Laboratory sampling conducted ❑YES IJ'NO J , W;.u_xK t a^� ( f' 3 '3EhtdWETT ENVIROMMENTAL '�ASSOCIAI"FS,INC- •ASSESSMENT }3i -•REMEDIATION RESOURCE MANAGEMENT F�O ^I✓ S s S82'56'1aK` 5.2'10 w 7 CBIFND. FND. MAP 267 �BR�tE PARCEL186 "\ N89 '30S8'E e 1 A6' Z EX.INV.-30.laz X�-��h� �/ CBIFND. ',♦' o m X\ MAP 267 �...�I. \• �C^ P-�.I_ 7 ��"/•� �j N PARCEL 179 + \ EXISTING CHAIdEERS TO BE \ ,'' ( 7 DAWSON +. PUkPED AND FILLED WfiH EXISTING CLF1075ANQ(TYP.) CpNppMIfVIUM �y PROPOSED SEWER MANHOLE IF co � '? B'INV.OUT-29-W FIELD VERIFY ANY =27,194± + ELECTRICAL FLAG / SQ.FT. ' SLEEVE SEWER PIPE AT WATER MAIN CROSSING tU ETDHER SME MP-) :O 4'POSEOSCH.�4Tw0 PVC OPEAT I%MIN.(TYP.) r` r f EX.IUV.30"(H-) :%ISTOIG SEPTIC T.4NKS TO BE O B 'LIMPED AND FILLED WITH 0 XFA4 SMD AND BOTTOM TO _ E PUNCTURED ITYP.1 fi 70.0' - PPOPOSED 6'SOR 3"5 .3 t EX.INN0.00' © WE SLOr AT.75•; 1 PROPOSED 9,000 GALLON SEPTIC TANK.. STING LEACHING PITS TO BE fa If APED AND FILLED WITH aysv:D(7YP.) - , MAP 267 , MAP 267 i PIS, PARCEL 001 PARCEL 184 HUGHES KARPOVSKY t i 'OS®AIR SUPPLY I O PROPOSED 6000 GALLON 'TO RUN UP SIDE OF SEPTIC TANG WITH _ NNG TO TOP OF ROOF r _ gj• MICROFAST INSERT 10,DIA. W LP VENTING PIPE _ s a� 3'DIA MIN. / BIFND C�+e BLOWER PIPING DESI/ 1 7' GIVIDA W . OP 3 LP •?3.ry( C 2) tDIST.) NUMBER OF BE ROOMS(ASSESSol LP O LP PC4 6,(PCs) �\ PROPOSED 6,500 GALLON NUMBER OF BEDROOMS(DESIGN)_ )POSEDBLOWER _ PUMP CHAMBER DESIGN FLOW 110 . GALIW TOTAL DESIGN FLOW 4400 CEMENT PAD TO �--." L7— 3.10. ®05 FOR c EN PROOFING 79•3 DESIGN FLOW X 200% = 8800 3 1 _5-1,, 30.0• USE PROPOSED 9,OD066,000 G MAP 267 �� 1 •1• •' (, Ern-'TING M1U,U HO!E FOR PARCEL73 r SPRINKLER SYSTEM AREA=1.5+(-ACRES ' 1 �I I INSTALL 2-100'x 30'LEA I A. 10.0' SIDEWALLCAPACfTY B.M.Catch Basin J LEACFI1WE C9,TCIi Aj NO SIDEWALL AREA CREDIT TAKEN RunElev.=30.00' yy�� BASLNsmr.) I j BOTTOMCAPACIIY MSL (q T-, �.i •�. ,� . PROPOSED(2)3PYt0U (LENGTH X WIDTH)x(.74 GAUSO.FT ll �,� PAVED LEACHING F.y p;. 1 LEACHING FIELDS (2)(100.0'x 30.01 x(.74 GAL150.FT.)= PARKING 1J' 37.2'AREA yr" •Y •�, '�. 1 DOSING&STORAGE RE DESIGN FLOW: 4.400 GPO DOSING REQUIRED: 4 CYCLES I +. 4,400 GPON MAP 267 DISTANCE REQUIRED BETWEEN PL PARCEL 72 ON AND PUMP OFF FLOATS: MAP 267 I qo 1 f MOCHEN 1100 GAUCYCLE r 723 GAUFT= PARCEL 85 I 398 I3 2-�,�'.:•', (USE AG TOQUIREDE FOR BACK F F STORAGE REQUIRED ABOVE WORK HEYWOOD It- 99 STORAGE PROVIDED ABOVE WORK Jd� TOTALS: ` 26�• i t N 000 TOTAL LEACHING AREA 6' f — 100.0' F 7 PROPOSED4'WYETO TOTAL LEACHING CAPACITY 41 DISTRIBUTE FLOW EQUALLY . i - _ ,{ — GAS LINES TO BE FIELD ?s ue^'�•:J,' r VERIFIED AND RELOCATED :. �� T�.�,� .�it�• '�`'— ( AS NECESSARY NOTE < <s� CYO\ y'�•�•yy�'--.y.Yy�, \ \ 18.1' 1•CONTRACTOR TO VERIFY ALL DESCRIPTION HC1 \, l/..1.lµ \, "1"1'WY�•�•Yl'lW yy.yYl'1 —37\ x UTILITIES BEFORE SEPTIC COVER IN 69.6 \ CONSTRUCTION BEGINS 2.POSSIBLE FILL LINE AT 5('ON SEPTIC COVER OUT C1) 58.3' EASTERN SIDE OF TP 1,VERIFY B/FND. AT TIME OF IN STALL AND REMOVE (+•RA)G�/)LLEB __—_ _ _ SIDEWALK DIST.) AS NECESSARY(SEE NOTE 14] OBSERVATION COVER(3) 49.6' EACH ROAD — — 3.PROPERTY LOCATED IN A —�• PUMP COVER(4) (40'WIDTH-PU8LIC) DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVED ZONE2 PUMP COVER(5) -SITE PLAN _.�- .._.._ SCALE:1'=20' GENERAL NOTES 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH TITLE 5OF THE STATE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 3. 4"SCHEDULE 40 PVC PIPE WITH WATERTIGHT JOINTS SHALL BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. _ Y9 4. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS l . e9L to j THAN'ELEVATION=29AT FOR A DISTANCE OF 15'AROUND THE PERIMETER •• • .5ch © T'C7 - OF THE SAS.UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST sQ (� •- FIVE FEET FROM SAS.AND THE TOP OF THE LINER IS NOT LESS THAN THE �r.� - d •,�• ,_1�, BREAKOUT ELEVATION. -p \ S. SLOPE ALL SOLID PIPE AT I.0%MINIMUM. 6. THIS SYSTEM IS NOT DESIGNED FORA GARBAGE DISPOSAL "lV ' • i ! 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK FILLING WHEN SYSTEM IS NEARLY FILLED WITHOUT READY FOR • • _ INSPECTION.SYSTEM IS NOT TO 8E BACK FILLED WR'HOUT FIRST OBTAINING • • APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. 8. ELEVATIONS BASED ON N.G.V.D.DATUM OF 30.00'MSL OBTAINED FROM '1, ••J• CATCH BASIN RIM AS SHOWN ON PLAN. e !!• • 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION ! .:.II:.•• a THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE (t•. �N�.7 \ .L •�1r•.eT• •` ••�1 V o AT1-888ZIG•SAFE AND ANY OTHER APPLICABLE AGENCIES.REPORTANY \ _ - 1.1 • DISCREPANCIES TO THE DESIGN ENGINEER. • • ` • f0• 10• ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE q • 1!T . 13 p STRUCTURES SHALL BE MADE WATERTIGHT. r; ••S: 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ( • ,�1• .� ZONING REGULATIONS. OWNERIAPPLICANT IS TO OBTAIN SUCH / DETERMINATION FROM APPROPRIATE AUTHORITY. •8.• •{A; ]7 •��O 12 ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS _•. f• `a p• LOCATED UNDER PAVEMENT,DRIVES OR TRAVELED WAYS IN WHICH CASE • A�• `�+(U( THEY SHALL WITHSTAND H-20 LOADING• "� (• A r� i_ •' �lf 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT,DUST AND 1-0'a B 0 ' _ FINES. w 7 14, WHERE REQUIRED,CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND �9�tl1`S-tt p a - UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF +.= LEACHING FACILITY.REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN p p 0 p L j 5" • COARSE SANG FREE FROM CLAY,FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). V W •t• '� (11 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN y 1/00 SITE CONDITIONS FROM THOSE SHOWN PRIOR 70 CONTINUATION OF WORK ��•• J+� •` •- �' li 16. PROPOSED PROJECT IS LOCATED WITHIN: - •`� '" ,/�j ASSESSORS MAP 267 PARCEL 73(AT) 17. OWNEROFRECORD: HAWTHORNE TERRACE CONDOMINIUMS.-u ADDRESS: 272 CRAIGVILLE BEACH ROAD It HYANNIS,MA 02601 18. FEMA FLOOD ZONE C LOCUS PLAN AS SHOWN ON COMMUNITY PANELS 25000500080 19. PLAN REFERENCE: I. PLAN ENTITLED'HAWTHORNE TERRACE SITE PLAN,WEST SCALE-1-1000' HYANNISPORT,BARNSTABLE,MASS,FOR JAMES J.TAYLOR',DATED SEPTEMBER 1978,SCALED AT 20 FEET TO AN INCH.BOOK 327 PAGE T7. 2.PLAN ENTITLED'HAWTHORNE TERRACE SHOWING SANITARY/SEWER CONNECTIONS AS BUILT•,DATED OCTOBER 18.1978.SCALED AT 20 FEET TO AN INCH. 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE.THIS PLAN IS TO BE USED ONLY FOR SEPTIC SYSTEM UPGRADE JC ENGINEERING WILL NOT ASSUME ANY LIABILITY FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE DATA ESSORS) 40 IGN) 40 GAL/DAY/BEDROOM TEST PIT DATA TEST PIT DATA LEGEND 10 GAL/DAY 8800 GAUDAY --50-- EXISTING CONTOUR DO GALLON TANKS 50 _ PROPOSED SPOT GRADES PROPOSED CONTOUR INSPECTOR Samuel While INSPECTOR: Samuel White LEACHING FIELDS -E/i7C EXISTING ELECTRICAL UTILITIES SOIL EVALUATOR:Samual Philos Jensen SOIL EVALUATOR:Samuel Philos Jensen DATE: Apdi D4,2003 DATE: April 04,2003 -OAS- EXISTING GAS LINE TAKEN TESTPITM TEST PIT#^ 2 -v EXISTING WATER LINE SQ.FT.j= GAL/DAY ELEV TOP= 32.04' ELEV TOP= 31.87 TEST PIT LOCATION i.FT.j= 4,440.0 GAUDAY ELEVWATER= >126"134G.S. ELEV WATER= O O O PROPOSED 9,000 GALLON SEPTIC TANK PERC RATE= <2 MWAN PERC RATE= MIWIN . " REQUIREMENTS PROPOSED 6,000 GALLON SEPTIC TANK GPO DEPTH OF PERC= 38'-56- DEPTH OF PERC= O W/MICROFAST UNIT :LES/DAY TEXTURAL CLASS: 1 TEXTURAL CLASS: 1 PROPOSED 6,500 GALLON PUMP CHAMBER GPD/4=1,100.0 GAUCYCLE 4"SOLID SCHEDULE 40 PVC PIPE EN PUMP 2"SOLID SCHEDULE 40 PVC PIPE -IFT=1.52 FT/CYCLE _�---- 2'PERFORATED SCHEDULE 40 PVC PIPE 4CK FLOW) 8•SDR 35 PIPE NORKING LEVEL'4,400 GAL NORKING LEVEL:4,579 GAL p 3204' 0 31.82' (96.87') ACTUAL ELEVATION"AS-BUILT' Sandy Loam Sandy Loam A 10 YR 32 A 10 YR 3/2 5.10%Grovel 6,000 SQ.FT. 12" 31.04- 12' 30.8Z Loamy Sand Sandy Laam 4440 GALJDAY B 10 YR 516 B 10 YR 416 REV. DATE BY APP-D. DESCRIPTION 5-10%Gravel 34' 2921' 39' 285T "AS-BUILT"SEPTIC SYSTEM 31r M-C Sand M-C Sand PREPARED FOR Per° 2-5Y614 25Y614 HAWTHORNE TERRACE CONDOMINIUMS 56, 10-20%Gravel 10-20%Gravel C C LOCATED AT 272 CRAIGVILLE BEACH ROAD HYANNIS,MA 02601 IC 1 HC 2 HC 3 1,5' 27.1 --- No Groundwater Terminated due to SCALE: 1 INCH=20 FT. DATE JANUARY 13.2004 Observed gas line o fa za �o eo 1.3' 37.8' ---- 126' - 21.54' 80" 25.16' I.V 60.6 ---- 11AS-BUILT' JC ENGINEERING,INC.PREPARED BY: zfi.fi 29.9' 2854 CRANBERRY HIGHWAY .-_ 25.3' 15.3' PLAN EAST WAREHAM,MA 02538 _508.273.0377 J�C Checked By.JLC�JOBET I SHEET 1 r ALTERNATE TOP SLAB. REINFORCED TO MEET �H-ZO LOADING v 1J ADJUST TO REQUIRED 20'MIN.ACCESS COVER.(7 MANHOLE C 3) PROVIDE LEBARONLTC-100 MANHOLE COVERS GRADE W/MIN.20R TO FINISH GRADE FOR ALL COMPONENTS ACCESS TO INSPECT 10-VENTING PIPE INSTALL 114 MAX 4 BRICK COURSES PUMP OUTS MUST SCREEN(SI OR EQUIVALENT BE PROVIDED(6'MIN. 24•DIANOTE 6j DIMENSION WITH CIA)(SEE NOTE 12) OBSERVATION MiE IN FULL BED OF MORTAR REINFORCED PORT 4HOLE FRAME&COVER CONCRETE COLLARS. FINISH GRADE OVER TANKS EL,31:2l'-32.46' IA.DROP FRONT _. .- _- BAIMASTICCOATWGFOR T-0"+/- � (7.6c 'E M.H.STEPS a= c=_ _-_ •'--�- _ 3"DO SANITARY MANHOLE y -�70P OF TANK SCIN i BLOV PRECAST REINFORCED FLUSH WITH DRAWING O CONCRETE M.H.CONE I_o BOTTOM OF RUBE PIPIN rco 2.-0-+AI SECTION 4'-0'DIAMETER CONCRETE LID HSF 4.5X GASKET MIN.0.121N.STEEL 'z,afiw8 PROPOSED I WITHIN I-1l2' UW PER VERTICAL FOOT, VSDR 35 PROPOSED wo TOAASHTO ACCORDINGLACED acre ToI 3' 2'DROP MIN. 8'SOR 35 TREATMENT DESIGNATION M199 L=69.00s% 3'DROP MAX- g•i au� to ~==32.0.sa 4'-0"DIAMETER HEIGHTOF RISER. (28.98') 8'-4" INV.OUT=37' 28.37-� �E _ 1"CLEAR 2'CLEAR SECTIONS VARY t LIQUID 28.29 E FROM i'TQ4' 29.65' 28.90' LEVEL 28.65' ��) .28 S1, NFLUENT OUTSIDE OF t ) WASTE FAST INSE S"MIN PIPE+2 - FROM BIO-MICRO CLEARANCE SETTLING i PRECAST 6"CRUSHED STONE ZONE E LEG NOTESS ROVIDE'V" MIN.GALLON t SEE = SEE- SEE NOTES OPENINGS OVER MECHANICALLY MIN.LIQUID NOTE 5 Tn OTE 4 3ER BOOT AND STAINLESS CEMENT CONCRETE COMPACTED BASE CAPACITY 1 BAND CLAMP FOR CLASS"A" _ (15971L.)SEE LENGTH IT-(Y WIDTH 10'-0 DEPTH 10'-6' TARY PIPE CONNECTION NOTE 10 LENGTH 1�'•0� WIDTH 10'-0' DEPTH T-<- PENINGS TO BE CNEBEDDING 9,000 GALLON SEPTIC TANK(LOW PROFILE) 6,000 GALLON SEPTIC TANK WITH FAST INSERT ST IN RISER SECTION IR AROUND OPENINGS FOR PIPES METER AND OVER,I'COVER PROPOSED 9,000 GALLON SEP7 PRECAST CONCRETE PROPOSED 6,000 GALLON SEPTI MANHOLE(H20) PROPOSED 6,500 GALLON PUMP NOT TO SCALE NOT TO SCALE LIFTING HOLE" 3'AIR LINE PIPING(TO. 3/4"TO 1-112"DOUBLE WASHED STONE TO CROWN I (SEE NOTE 5) 3"PIPE CAP BLOWER BY BIO-MICRO F MIN CIA PUMP - I 2"OF 1/8'TO 1/2"DOUBLE WASHED STONE- OUT PORT(SEE O VOTE 4) t 4" E r FINISH GRADE OVER LEACHING Fl[LD= 30-2'-31.8' Ni WASTE 24'DIA I SLOPE Q 2%MIN.OVER SYSTEM SETTLING TANK MANHOLE/OBSERVATION f 18' 3'DIA4-WAY TE PORT - E Iv t I CONTINUOUS PITCH BACK TO PUMP CHAMBER _ 6'OBSERVATION B'DIA 1 - PORT(OPTIONAL) FAST 4"SCH.40 FORCE MAIN L2'SOLID PVC Z'PERFORATED LATERAL.SET 4,219 GALLON = 10'DIA VENTING PIPE TREATED BO' MIN-LIQUID 7° I EFFLUENT 1p v 5°ELBOW LEVEL INV.ELEV-=28,50' CAPACITY (TYP) �""� I 4 X 2 TEE (25.8') (21293L.) O O 4'MANIFOLD S=0 5% TREATMENT FAST MODULE BY ...I 6'DIAMIN t BACK TO FORCE MAIN FIELD PROF ZONE BIO-MICR 3'PIPE CAP 5 PUMP -. OUT NOT TO SCALE - - PORT 77'Y5"(795.6±1.3cm) 79'i5'(200.731.3cm) (SEE CONCRETE THRUST NOTE 4) _ 1/4-PERFORATION A 156' AT 7 O'CLOCK(TYP.) F BLOCK (39fian) I 10' 75 LENGTH 1T-D" WIDTH 10'•0- DEPTH T-9" S ) _ TC ••6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) t EL=27.75�mmON 3>>orn . NOT TO SCALE o z A O o C)Z 2"� m��m� DO M TO ALL COUNTY STATE PROVINCE 'PURTENANCES TO FAST(EG-SEPTIC TANK,PUMP OUTS,ETC.)MUST CONFORM , ,AND LOCAL CODES. O O ST, 0 WAY 3'DIA PVC TEE IS PROVIDED 81'THE FACTORY AS WELL AS 3'PVC PIPE EXTENDING HORIZONTALLY FROM THE TEE IN BOTH DIRECTIONS AND D OFF OUTSIDE OF THE MODULE LINER THE AIRLINE MUST COME IN FROM THE TOP AND ATTACH TO THE PVC TEE. -,- EL=27.60_ O 3/4'T RY AND SECONDARY TANKS MAYBE ONE DUAL COMPARTMENT TANK WITH ABAFFLE.NOTE:MINIMUM COMPARTMENT DIMENSIONS REMAIN THE 100.0' 2"LAI ERAL(fYP.) -� WASh O CROV 1!4'PERFORATION AT A C ANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT,MORE THAN ONE IS RECOMMENDED. 5 O'CLOCK HOLES FOR LIFTING THE FAST LINER ARE SUPPLIED.CONTRACTOR-SUPPLIED SPREADER BARS ARE TO BE USED IN LIFTING THE UNIT.PLACE A Z 12 BARS BETWEEN LIFTING HOLES. PLANVIEW , NOT TO SCALE 1• BLOWER MUST BE WITHIN 100 FEET(30.5M)OF FAST UNIT WITH LESS THAN 4 ELBOWS. ANCHOR- FOR DISTANCES GREATER THAN 100 FEET-CONSULT FACTORY-BLOWER BASE MUST BOLTS BE PUMP O TO MUST 10'DIA VENTING PIPE INSTALL V4'MESH BE ABOVE NORMAL FLOOD LEVEL NOTE 2. PUMP OUTS MUST SCREEN(SEE BLOWER WITH H000 2- SIO-MICROSICS REQUIRES THAT PIPING FROM BLOWER TO TANK BE GALVANIZED OR BE PROVIDED(6'MIN. NOTE 8) DIA)(SEE NOTE 12) 24'DIA (BY BIO-MICROBICS) CPVC.PIPING INSIDE TANK TO FAST AIRLIFT MUST BE CPVC OR NON-CORROSIVE OBSERVATION SEE NOTE 1 MATERIAL DO NOT RUN GALVANIZED PIPE LENGTH INTO TREATMENT TANK. PORT3. BLOWER CONTROL SYSTEM SY BIO-MICROBICS,INC. 4. (11)ORIGINAL FEET ARE ON THE BASE OF THE FAST TREATMENT MODULE 3'6IA -, EACH LEG EXTENSION IS TO BE ATTACHED TO THEIR CORRESPONDING ry 1 I FOOT WITH THE PROVIDED HARDWARE SEE LEG EXTENSION DRAWING. ^ BRACING SLOW)MIN TOP OF TANK SEE ELECTRICAL CONDUIT 5. ANCHOR ALL LEG EXTENSIONS TO THE BASE OF THE TANK EXCEPT THE CENTER LEG PLAID FLUSH WITH DRAWING RUBE SLOWER (TO BLOWER EXTENSION.PLACE BOLTS AT OPPOSITE CORNERS OF THE FOOT EXTENSION BASE IF PIPING(SE BOTTOM OF HSF 4.SX GASKET CONTROL SYSTEM) ELONGATING THE LEG EXTENSIONS PAST.ANCHOR IN HEIGHT,THE CENTER LEG CONCRETE LID SEE NOTE 3- EXTENSION MUST ALSO BE BOLTED DOWN.ANCHOR BOLTS ARE NOT PROVIDED, I :EATMEM WITHIN I-1W 6. TO ELONGATE THE FOOT PAST THE PROVIDED 12-(30.5cm)EXTENSION,CUT THE 3.9'D61. )NE (9.8cm)LEG EXTENSION INTO TWO SEPARATE PIECES.NEXT,CUT A 4"SCH 40 PVC PIPE TO '(E THE DESIRED LENGTH AND BLIP THE PIPE OVER THE TOP CUT SECTION AND THE 60TT I I(I,Vr CUT SECTION OF THE LEG EXTENSION.ATTACH PIPE WITH STAINLESS STEEL SCREWS NON-CORROS EQUAL ELONGATION MUST BE DONE ON EACH LEG WHEN THE PROVIDED 1T IS FOUND CLAMP EVERY INSUFFICIENT. Lp7. IF LEGS ARE EXTENDED PAST 48',USE OF SCH 80 OR STRONGER PIPE IS RECOMMENDED. 4FLUEM - 0 8. RUN VENT 10"DIA TO DESIRED LOCATION AND COVER WITH 114"MESH SCREEN.VEM RISE VASTE m a v 8'DI0.(102an) MUST NOT CAUSE EXCESSIVE BACK PRESSURE. FAST INSERT_(BY 9. PLEASE SEE DRAWING HSF 4.5X ROM S ST DW(1EATED.2-) SETTLING - 6-1�" BIO-MICROBICS) EFFLUENT 10- COPYRIGHT(C)2001,SIO-MICROBICS,INC. :ONE - - z 11. SETTLING TANKS EQUALING 12 X TO 1 X DAILY FLOW MUST BE USED PRIOR TO FAST. NON-CORRO: LEG EXTENSION FAST TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT.MORE CLAMP EVER NOTE 5 4LLON �+ NOTE 4 SEE NOTES 6 8 7 12. THAN ONE IS REQUIRED. 3UID 2i13. FAST COVERS OVER THE AIRLIFT AND ONE PUMPOUT MUST BE TO GRADE AND FAST AIR fTY SEALED WITH GASKETS.COVER OVER PUMP CHAMBER MUST BE TO GRADE _) 14. 10"VENT AND AIR SUPPLY PIPES MUST BE PITCHED TOWARDS THE TANK FOR DRAINAGc 3TE 10 11 FIRST 50'OF AIR SUPPLY PIPE TO BE GALVANIZED. 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) 16. UNIT TO BE FIRMLY SECURED TO THE TANK TO PREVENT MOVEMENT IN ANY DIRECTION+ NOT TO SCALE - 17. VENT LOCATION AND HEIGHT ARE CRITICAL I ,LL 1/4'MESH EN(SEE BLOWER WITH HOOD INSTALL 1-1/4-PVC TO BUILDING.JOINTS TO BE MADE E) PROVIDE LEBAftON LK-100 FINISH GRADE OVER TANKS EL, WATERTIGHT,WIRE PUMP AND FLOATS TO DUPLEX'PAC-2" SE NOTE MANHOLE COVERS TO HOISTING CABLE 7 x 19 ., SEE NOTE 1 31.75' LEVEL CONTROLLER W/SUBMERSIBLE PRESSURE BELL FINISH GRADE FOR ALL STAINLESS STEEL EN COMPONENTS NEMA<JUNCTION BOX CORROSION RESISTANT& DL4 11,760 LB.STRENGTH LIOUID-TIGHT CABLE CONNECTORS SUPPORTED 4"BALL VALVE w/UNIONS CONNECTORS SUPPORTED BY 1-1/4'PVC CONDUIT, S (7.6Gm)MIN ELECTRICAL I JOINTS TO BE MADE WATERTIGHT CH.40 PVC BLOWER CONDUIT(TO PIPING(SE BLOWER (2)BARNES 4SE-L PUMP 275 GPM @ 25'TDH 230 V SINGLE CONTROL PHASE 4.5 HP,6.5'IMP.DIA.MODEL 04SE4524L SYSTEM)SEE _—IL NOTE 3. 4'SCH.40 TO I 4'SCH.40 TO E 4'MANIFOLD 3' MANIFOLD PROPOSED _ m a'SDR 35 I 'SCH.40 TEE �LGPE .isz T a�u oxI WCLEAN-OUT CAP L=49.0' GrinAc aN 1p 11R 28.62' H(BY (28.14) 2822, lS) (27.25') (27.17') 6" (TENSION INLET TEE fO 4'SCH.40 PVC DISCHARGE PIPE )TES 6 8 7 'O TWO(2)-1/4'WEEP HOLE IN DISCHARGE PIPE 6'CRUSHED STONE 4"BALL CHECK VALVE SCH.40 PVC 100 OVER MECHANICALLY COMPACTEDBASE P.S.I.FLOWMATIC OR EQUAL 7,9. LENGTH IT-W WIDTH 7'-0" DEPTH 11'-2' RT(LOW PROFILE) 6,500 GALLON PUMP CHAMBER LENGTH 17'-0' WIDTH T-0' DEPTH 11'-2' :PTIC TANK 6,500 GALLON PUMP CHAMBER ?TIC TANK& NOTE:ALL TANKS SHALL BECAPABLE NOT TO SCALE WITHSTANDING AASH70 H-20 LOADING TANKS 4P CHAMBER SHALL BE INSTALLED ON A LEVEL STABLE BASE.DIMENSIONS ARE TAKEN FROM ACME 'TANK SHALL BE WATERTIGHT PRECAST CO.,INC.SPECIFICATIONS AND WATERPROOFED ROWN OF PIPE 1/4'PERFORATION TO BE PLACED _ SLOWER W/HOOD(BY IN THE END CAP HORIZONTALLY SIO-MICROBICS) NEAR THE CROWN OF THE PIPE A7 1.8_ THE END OF EACH LATERAL - (29.13') A A TOP OF SAS.=28.81 CONCRETE BASE I T�II�I II BOTTOM OFTRENCHTOBE LEVELEL= 28,0' z Il i . .1 1 1 1 Ir (28.3') 12' ELECTRICAL s ELECTRICAL CONDUIT S MIN. 3'MIN.AIR PIPING S(TO CONTROL OFILE GROUND WATERELEV.<21.54' BLOWER HOUSING DIMENSIONS ALE NOT TO SCALE FINISH GRADE OVER LEACHING FIELD= 30.2'-31.8' 17' 12' SLOPE @ 2%MIN.OVER SYSTEM TOP OF SA.S.= 28.83' I - (29.13')� 2'PVC PERFORATED PIPE 2'OF DOUBLE WASHED � '- STONE I ) EC rvE EP1N 314'TO 1-12'DOUBLE WASHED STONE TO CROWN OF PIPE 3'. B !.1107-5'MIN. 21.5 < 4' BLOWER HOUSING BASE FIELD END VIEW A-A GROUND WATER ELEV= _DIMENSIONS(SECTION A-A) NOT TO SCALE -~ NOT TO SCALE TsS OLTLEG ORIGINAL TS SEE ORIGINAL EXTENSION FOOT E2 FI'OT TO ORIGWAC 4 FOOT.SEE SCHEDULE 1.SECURE ORIGINALTX7'FOOT TO LEG 40 PVC PIPE EXTENSION BY PLACING TWO SCREWS IN NOTE 1.SEE EACH SIDE OF THE LEG EXTENSION.EIGHT Q+-- NOTE 4. SCUT SECTION SCREWS PER FOOT ARE INCLUDED AND SEE NOTE 3. SHOULD BE USED ON EACH LEG J ,ryP L.` 3.875' II��fF EXTENSIONS. PLAN VIEW 11 ANCHOR `MODIFIED LEG Z ANCHOR ALL LEG EXTENSIONS TO BASE BOLTS EXTENSION WITH 4- OF THE TANK EXCEPT THE CENTER LEG SEE PVC PIPE EXTENSION.PLACE BOLTS AT OPPOSITE REV. DATE_ BY APP'D. DESCRIPTION _ PROVIDED 12' NOTE Z CUT SECTION CORNERS OF THE LEG EXTENSION BASE IF LEG EXTENSION ELONGATING THE LEG EXTENSIONS PAST IIAS-BUILT SEPTIC SYSTEM LEG EXTENSION (HSF 4.5X)SEE NOTE 3. MUST ALSO BE BOLTED DOWN.OWN.A23"IN HEIGHT,THE CENTER LEG NCHOR ON PREPARED FOR BOLTS ARE NOT PROVIDED. HAWTHORNE TERRACE CONDOMINIUMS _VERY (0305—) FAST AIR LIFT (030?5—) 3.TO ELONGATE FOOT PAST THE LOCATED AT GASKET NON-CORROSIVE GASKET PROVIDED 12',CUT THE 3.9'DIA.LEG CLAMP EVERY 2 FT EXTENSION IN THE CENTER INTO TWO Z72 CRAIGVILLE BEACH ROAD RISER SEPARATE ETOTHPIECES.D THEN DESIRED T A SCH 40LENGTH HYANNIS,MA 02601 3'1AIR RISER WAIR PVC PIPE TOE OVER THE AN OTT SUPPLY SUPPLY SLIP THE PIPE OVER THE 70P AND BOTTOM _ LINE LINE CUT SECTIONS OF THE LEG EXTENSIONS. SCALE: N.T.S. DATE:JANUARY 13,2004 ORROSIVE GASKET GASKET 4•ATTACH PIPES WITH STAINLESS STEEL EVERY 2 FT SCREWS.IF LEGS ARE EXTENDED PAST 48- PREPARED.BY: NON-CORROSIVE FAST USE OF SCH W PIPE IS RECOMMENDED. 'AIR LIFT CLAMPEVERY2FT AIRLIFT "AS-BUILT" JCENGINEERING,INC. 5.THE AIR SUPPLY INTO THE FAST UNIT 2854 CRANBERRY HIGHWAY AIR SUPPLY OPTIONS SEENOTES MUST BE SECURED SO AS TO PREVENT PLAN EAST WAREHAM,MA 02538 DAMAGE FROM PIPE VIBRATION. 508.273.0377 NOT TO SCALE f�11CROFA l4 X DETAILS D n By.61Z Desgnea9yJLC CheGed9YJLG O6No.F1__.. _ — SXEEf2 r PermitInspections Page 1 of 2 Barnstabpe County Septic Management Pirogiram Karen Malkus-City of Barnstable 3:45 pm Main i Permits Reports I Compliance I Contractors Technologies I Help{ k Home> Inspections >View Inspection FQ Cancel Inspection Details Field Testing Inspection Address: 272 Craigville Beach Road Color: Clear i Component: i FAST Odor: Must Print Inspection 1 y Date: 12018-09-04 Effluent Solids: No View Permit Time: 112:55:00 pH: 7.0 SU-� Contractor: Bennett Dissolved Oxygen: 5.000 mg/L View History Operator Name: !Greg Brehm Turbidity: 4.87 NTU License#: 116149 Settleable Solids: 0.000 Site Conditions Operating Information Seasonal Residence: No Sludge Depth: 12.00 in Air Temperature: 86.0°F Scum Layer Thickness: 0.25 in Weather Conditions: Sunny; -- Pumping Recommended: No Soil Absorption System Observations Signs of Breakout: No Depth of Ponding: in Ponding Above Invert: No Maintenance Issues Any Apparent Violations of the None Reported Approval? Any Cleaning or Lubrication of Parts None Reported Performed? Any Control Adjustments Made? None Reported FAST Blower and alarms operational. Pumps, Switches,Alarms Tested? System is operating mechanically correctly, except for discharge pump#1. Any Equipment Failures? Discharge pump#1 is bad and is turned off at switch. Any Parts Replaced? None Reported Any Recommended Corrective None Reported Actions? Inspection Completion Inspection Completed? Yes Incomplete Inspection Reason inaccessible_alarm_panel https://septic.bamstablecountyheaIth.org/reg/permit_inspections/view/37045 •1 1/9/2018 PermitInspections Page 2 of 2 Actions to be Taken to Resolve None Reported Incompletion Comments Technology Specific Checklist Date of Last Pumpout Not Reported. Equipment Yes, No Comments Visual Alarm Operating ( O Audio Alarm Operating f O Air Inlet filter Clean O Blower Hood Vents Clear O IT/ Excessive Noise Excessive Vibration 0l=1 / Unusual Odor O Pumpout Required O Depth Comments Primary settling Zone 12" Aerobic Treatment Zone Effluent Result Estimated Daily Flow Temperature https:Hseptic.bamstablecountyhealth.org/reg/permit inspections/view/37045 11/9/2018 BENNET 1C ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-17Q6 Brewster,MA 02631 fax(508)896-51Q14; LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: o Thomas McKean,Director 9/10/15 BEA12-10167A Barnstable Health Division 200 Main Street Hyannis,MA 02601 REGARDING: TITLE 5 OFFICIAL INSPECTION FORM SHIPPING METHOD: Regular Mail 0 Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑ Green Card/RR ❑ COPIES DATE DESCRIPTION 1 8/31/15 Title 5 Official Inspection Form Hawthorne Terrace Condominiums-272 Craigville Beach Road,Hyannis 1 9/10/15 Septic Inspection filing fee,Check No.7381,$25.00 For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑ REMARKS: Mr.McKean, Please find enclosed the Title 5 Inspection for the Hawthorne Terrace Condominiums.This inspection has found the system to"Pass". Pumping of excessive scum layer in septic tank recommended at time of inspection. If you have any questions or need additional information,feel free to contact our office.Thank you. cc: Diane Ferrigno,Hawthorne Terrace Condominium Trust FROM: JRS/Ir If enclosures are not as noted,kindly notify us at once ft CERTIFIED MAI LoR . rq Domestic .G O i Cr Certi'led Mail Fee 3J11AI� Extra Services&Fees(check box,add/ee as appropri �s� 0 Return Receipt(hardoopy) $ N r-qO ❑Retum Receipt(electronic) $ • r Posfmar 0 O ❑Certified Mall Restricted Delivery $ — t -Here [L C3 []Adult Signature Required $ Q- ❑Adult Signature Restricted Delivery$ N J' O Postage �y M ` e3 aTotal Postage all SAULSBERRY, JANET ETAL Ln $ ent To AND ELIAS, ELAINE M r- 11 RICHARDSON CIR O $iieefandslpEl SAUGUS, MA 01906 Ciry Stafe,ZIPa PS Form 38002015r r rrr•r. Certified Mail service pWvides the following benefits: ■A receipt(this portion of the Certified Mail label). ^e for an electronic return receipt,see a retail ■A unique identifier for your associate for assistance.To receive a duplicate ■Electronic verification o:. W empted return receipt for no additional fee,present this delivery. ) ti USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the red.pient's retail associate. signature)that is retained by the Postal Service' Restricted delivery service,which Iro ides for a specified period. delivery to the addressee specified by game,or to the addressee's authorized agent. 1, Important Reminders: Adult signature service,which requiVs th� -L o You may purchase Certified Mail service with signee to be at least 21 years of age(not .r First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. r= Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. 1• and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent, with Certified Mail service.However,the purchase (not available at retail). E, of Certified Mail service does not change the o To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on-T1 ®For an additional fee,and with a proper this Certified Mail receipt,please present your 'T endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion, of delivery(including the recipient's signature). of this label,affix R to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.Lj electronic version:For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt attach PS Form 3811 to your mailpiece; IMPORTMT.Save this receipt for yoiw records. Ps Form.3800,April 2015(Reverse)PSN 7530-02-000-9047 Commonwealth of Massachusetts Vol W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t'T 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 M Property Address Hwy Hawthorne Terrace Condominium Trust Owner Owner's Name information is t Hes annis ort MA 02672 8-31-15 required for every W y p -L+ page. City/Town State Zip Code Date of Inspection r q nu Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms /on the computer, use only the tab 1. Inspector: key to move your cursor-do not Joseph Smith use the return Name of Inspector key. Bennett Environmental Associates r�S Company Name P.O. Box 1743 Company Address Brewster MA 02631 City/Town State Zip Code 508 896 1706 SI#4994 Telephone Number License Number B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ NAFurthvaluation by the Local Approving Authority Cl At k� pector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts a� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-31-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in working condition and is functioning as intended. None of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 existed at the time of 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. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c�M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers ail condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-31-15 required for every y p page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N FIND (Explain below): 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 public health, safety or 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 public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments c°M 272 Craigville Beach Road -Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-31-15 page. CityFrown State Zip Code Date of Inspection B. Certification (cont.) 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, safety and 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 SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: '*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 '/day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 ti Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �7M40 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-31-15 page. CityFrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of 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 1 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 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. El ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of.a tributary to a surface drinking 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 If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts - w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-31-15 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 40 Number of bedrooms (actual): 40 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 4,400 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 272 Craigville Beach Road -Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for every y West H annis ort MA 02672 8-31-15 page. City/Town State Zip Code Date of Inspection D. System Information Description: Septic system that serves a condominium complex is comprised of a 9,000 gallon septic tank, a 6,000 gallon FAST tank(Bio-Microbics FAST System, I/A), a 6,500 pump chamber, and two 30'x 100' pressure dosed leaching fields(design capacity 4,400 gpd required). . Number of current residents: 60-70 est. Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): See details. Detail: 2013: 755 units = 75,500 cubic feet= 564,779 gallons/yr; average flow= 1,547 gpd 2014: 672 units= 64,200 cubic feet=480,249 gallons/yr; average flow= 1,316 gpd Sump pump? ❑ Yes ® No Last date of occupancy: Currentlyoccupied Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is ort MA 02672 8-31-15 West H annis required for every y P page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped every year, per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ® Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-31-15 required for every y p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2004 BOH Certification Letter Engineer Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 50' +/-town water line feet Comments (on condition of joints, venting, evidence of leakage, etc.): Properly vented to roof. No evidence of leakage of piping or joints. Septic Tank(locate on site plan): Depth below grade: 2.0 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 9,000 gallon septic tank with schedule 40 pvc inlet and outlet tees in good condition with no structural concerns. Covers to final grade elevation with steel ring If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 9,000 gallons Sludge depth: 8"outlet, 12" inlet t5ins•3/13 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-31-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 57" Scum thickness 0" outlet, 12" inlet Distance from top of scum to top of outlet tee or baffle 8"outlet, 2" inlet Distance from bottom of scum to bottom of outlet tee or baffle 48" How were dimensions determined? Sludge judge, tape, probe Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping of excessive scum layer in septic tank recommended at time of inspection. Both schedule 40 pvc inlet and outlet tees in working order and are functioning as intended. Liquid level as related to the outlet invert is at a normal operating height. No evidence of leakage encountered while conducting the inspection on the septic tank. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 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 Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for every y West H annis ort MA 02672 8-31-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day ._- Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 (This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-31-15 page. CityFrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Pressure Distribution, No D-box Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any, evidence of leakage into or out of box, etc.): Pressure Distribution, No D-box Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber functioning properly. Both pumps are functioning, and audible alarm and visual alarm are functioning properly. * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. Soil conditions explained in next section for SAS t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-31-15 required for every y p page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® .leaching fields number, dimensions: (2) 30'x100' ❑ 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.): (2) 30' x 100' pressure dosed leaching fields, no surface ponding present, soil was clean and dry, normal vegetation (grass) over top of both leaching fields. Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. No evidence of hydraulic failure present at time of inspection. (Design capacity of leaching field 4,400 gpd). 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 layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West Hy p annis ort MA 02672 8-31-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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 vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road -Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is West H annis ort MA 02672 8-31-15 required for every y p page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° M 272 Craigville Beach Road - Hyannis, MA 02601 [This inspection covers all condo units 1 through 20] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for every y West H annis ort MA 02672 8-31-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 6'+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Design Plan By JC Engineering Plan Date: 1-13-2004 ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Established estimated depth to high groundwater by referencing septic as-built plan by JC Engineering Inc. of East Wareham, MA with a plan date of January 13, 2004, wherein it is noted that the bottom of the pressure dosed leaching field is at elevation 28.0'. Also the soil test data which was conducted by Samuel Philos Jensen and inspected by Samuel White, notes within the same plan that no groundwater was encountered at elevation 21.54', which puts estimated groundwater at an elevation of 6.0'+from the bottom elevation of the leaching field. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road -Hyannis, MA 02601 [This inspection covers all condo units 1 through 20 ] Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for every West HY P annis ort MA 02672 8-31-15 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Ao '�:s'F -'%�%i3_'J�f Z.: •_'48,.�v.�ir-t'�i_44 y�•�i°�;.� '} J�%. E S�r-_ice`_•) r^r�-moo a Do ka -jai._.• b'•�.��@'s J f. �:�_3 1._.pu'h'�'?�.a�.3,*'s: ' _Yt:}."€ice+�?T.r..'(:�vy; rr''•`-:P\ C....�:%. '`'{,r'_�'/� ;/,.?ciG tt, 4",r:" S;. 1 .��. . 41 _ .�r_c Q��. e,^.��^,i Zip$��vdY_i?C�f•-a 3!S�`SL:r: a. 1 Farr:s..$�O$:Su - _`�l/,-4: L�•Cc:ELa.�.:: '�.T3v[:YIt%r3_i�.Ma�.';t' •�:;• n _*'S:S. :?cate--.,. :i44'..%itti.`--.?_':+�f(,i EvCL:.fiA`a`',A•.r%ft.''C rt �•' ��L'3;%E+S d'.>.B t(9. , i r" J • a`< ! •� i t I _ _ j ? • ol f r, ALWei' u~ •I 1 , ' r P � i iS, �i;' � I SrT'd 60TS9688OS:O1 1?02906Z80ST Hi-IdBH 1SNHU8:WOJJ LT:OT 2TO2-20-MW D,'.,DD,,iEim,Ni,,E 11 u ENVff O , �F E a ffi, AssocmaEm, INC@ LICENSED SITE PROFESSIONALS 6 ENVIRONMENTAL SCIENTISTS b GEOLOGISTS 0 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 508-896-1706 d Fax 508-896-5109 b www.bennett-ea.com BEAl O-10167 January 14, 2014 Ms. Gertrude Wilcox Hawthorne Terrace Condominiums P.O. Box 488 Hyannisport,MA 02672 RE: OPERATION AND AL41NTENANCE CONTRACT Innovative/Alternative Septic System 272 Craigville Beach Road-Hyannis, MA Dear Ms. Wilcox, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for the continuation of professional services relative to the operation and maintenance of the Innovative/Alternative Wastewater Treatment System located at the above referenced property. The collection and field analysis of samples collected from the effluent of the septic treatment system is a required condition of the system,as set forth by the MA Department of Environmental Protection(MA DEP)to qualify treatment capacity on a quarterly basis. As such, work proposed by BEA includes the inspection and field testing of wastewater samples,as well as the preparation of the required forms for distribution to the appropriate town and state offices. Additionally,at the time of such inspection,blowers,filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced to you quarterly. Should any repair or treatment system component replacement be required,you will be notified to authorize the additional work and expenses. Should field-testing parameters indicate the need to collect samples for laboratory analysis,such sampling will be conducted and will be noted on a BEA form that is left at your facility following the inspection. The following budget represents estimated annual costs through one year of service to include four inspection events. These annual costs are valid for two years subsequent to the date of the next inspection. Please note that this contract runs with the property. As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore,you are required to notify any buyer for the transfer of this contract. 1 EMERGENCY SPILL RESPONSE & WASTE SITE CLEANUP SITE ASSESSMENT 6 PERMITTING SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE A WASTEWATER TREATMENT,OPERATION&MAINTENANCE JANUARY 14,2014 HAWTHORNE TERRACE/BEA10-10167 PAGE 2 OF 2 UA WwPO&M QUARTERLY INSPECTIONALUNTENANCE Inspect IUA system and take field measurements of dissolved oxygen,pH and turbidity. At the time of monitoring events the conditions of the system will be inspected and documented with regards to the blower units, sludge level and associated piping. REPORTING/FILING Review inspection and field-testing results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms on a quarterly basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Services $905.00 TOTAL ANNUAL EXPENSE: $905.00* TOTAL COST PER EVENT: $225.86 *Note:I/A systems located in Barnstable County are required to report inspection and sampling results on the MA Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. We are proceeding with this work as outlined. Immediate notification in writing is required if you do not wish to proceed. Otherwise, please sign the authorization below indicating acknowledgement and acceptance of our Terms&Conditions and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES,INC. Samantha Farrenkopf,ES, WW 0, WSO Wastewater Program Coordinator cc: Kara Risk,Business Manager encl. Abbreviated Terms& Conditions (2011)/Fee Schedule (2014) AUTHORIZATION: DATE: D �a I N C O R P O R A F E ll FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address Name '16 vt �'' ►�� Owner Name Street \C,-k'3 r*,(\-Q,,-, Mail Address 0 p `104, k `'W, Mail Address 6 !a Ci 'Q c r\StateK� Zi d't b-V-- Ci 114S StateVJ\�,Zi p0 2Jo� k-1 1c) P one �� --�,� ,Fax Phone F _ e-mail 51;3c'\ 1 e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) 'k Visual Alarm Operating . hv �� VSS'��\ ►\ �3 �„ �,A Audio Alarm Operating ;, if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise W, Excessive Vibration Treatment Unit(s) Unusual Odor O� Pum out Required: oxo— Primary Settling Zone Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT Estimated Daily Flow H Standard Units 6-9 S.U. Color Clear t, -/ -�,a►( Temperature Odor Slightly Musty odor not septic) OWNER SIGNATURE TEC UN SlIGNAT ERVICEDATE ASS®CIATES9 INC. 'J'`' 1573 Main St.,P.O.Box 1743 �J'' Brewster,MA 02631 508-896-1706 www.berulett-ea.com Date&time of visit: Cole , tk) -�o A site visit was conducted today for: 0&M YES ❑ NO Testing ❑YES 1gNO Repair ❑YES NO Alarm Call ❑YES �5(1\10 Your system is operating correctly AYES ❑ NO Tank(s) in need of pumping ❑YES CANO Further maintenance required ❑YES JNO NO Repairs needed O YESNO Please contact our office ❑YES Contract renewal required ❑YES bkNO Field testing XPass ❑ Fail Sample pulled ❑YES ` I NO Laboratory sampling conducted ❑YES (®,NO a i F � 'BENNEff.::ENVIRQNMENTALi.�rp�`.: w„y-z a ;„': ASSESSMENT -__ -- ,Y V-11,00, BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 12/18/14 BEA09-10167 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Hawthorne Terrace Condominiums 272 Craigville Beach Road SHIPPING METHOD: West Hyannisport,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR 0 COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(June, September and December 2014) 1 Bio-Microbics Field Inspection&Service Report(June,September and December 2014) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑x REMARKS: Please find enclosed the DEP Inspection and O&M Forms and Bio-Microbics Field Inspection&Service Reports for operation and maintenance conducted during this reporting period for the above referenced property. iWhile there is no acces for annual inspection of the pressure distribution field lateral lines,pumps,floats and the pressure distribution panel were inspected and found to be functioning properly. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms. Gertrude Wilcox,Treasurer Jim Bell-BioMicrobics[via email] FROM: David Bennett WWTO#6243/Samantha Farrenkopf WWTO#13265/Joseph Smith WWTO#12529/Greg 8rehmWWTO#16149 If enclosures are not as noted,kindly notify us at once LAMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems ; : : A. Installation r � Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer ' filling out forms on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address xI r,a cursor-do not Hyannis 02601 use the return City Zip key. Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (617) 590-0266 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896 - 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/5/14 3/10/14 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.04-11-13, Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.5 SU DO 6.0 mg/L Turbidity 4.30 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd I Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. Check Pump Chamber Run Times as Follows: P#1: 67.56hr P#2: 247.26hr. t5aiom.doc^rev.04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use— by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 5t Floor Boston, MA 02108 t5aiom.doc•rev.04-11-13 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return City Zip key. Mailing address of owner, if different: P.O. Box 488 �I Street Address/PO Bois: W. Hyannisport MA 02672 City State Zip (617) 590-0266 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896 - 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/10/14 6/5/14 Inspection Date Previous Inspection Date 4"sludge, 6" scum Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some 7.0 SU 5.0 mg/L 2.08 NTU pH 6 to 9 DO 2 or greater Turbidity 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of,2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. t5aiom.doc^rev.04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Fora for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use—by January 31"of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 5t Floor Boston, MA 02108 t5aiom.doc^rev.04-11-13 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and.Disposal Systems A. Installation Important:when Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return City Zip key. Mailing address of owner, if different: r� P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (617) 590 -0266 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/9/14 9/10/14 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc^rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 4.0 mg/L Turbidity 4.87 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be.collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. Check Pump Chamber Run Times as Follows: P#1: 67.56hr P#2: 258.80hr. t5aiom.doc•rev.04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 51/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. t \2_ Operator Signature Date System owner must submit this report, technology O&M checklist, and an required. sampling results Y P 9Y Y q P 9 to the local board of health as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5t Floor Boston, MA 02108 t5aiom.doc^rev.04-11-13 Page 3 of 3 _ I N C 0 N P 0 8 A T E 0 FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address ryr>��-C J�-z � 1`-�' Name �' Y Owner Name Street Mail Address j? C, +" Mail Address city W cwvr. + State Pam- Zi rJkV-1C- CityV - � StateP*- Zip O t,P\ Phone Fax Phone Fax e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND`COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating ,/ U if resent Blower(s) Air Inlet Filter CIean `� Ca, r.tK Blower Hood Vents Clear ✓ Excessive Noise Excessive Vibration Treatment Unit(s)5 4. Unusual Odor Pum out Required: 5 v ` S �` - 0— M111APolk1 -- Primary Settling Zone Aerobic Treatment Zone EFFLUENT(options) LIMIT • RESULT ��- Estimated Daily Flow II Standard Units 6-9 S.U. S� Color Clear Temperature Odor Slightly Musty odor ��,� not septic) OWNER SIGNATURE TE C,104CIAN SI ATURE j jSERVICE DATE it INCORPORATED FIELD INSPECI`ION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address 21,11.:C cp, '. `\s .�s � -�- Name .mac, Owner Name td °, C Street Mail Address ti,3, �� i� Mail Address City\,A State zip 0-1k-j Z. Cit StateK\ Zi Q(e.(,,3\ Phone Fax Phone Fax e-mail I e-mail s- "S WVc� INSTALLATION INFORMATION Model No. j� Serial No. Date of Installation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panels) lk Visual Alarm Operating v Audio Alarm Operating if resent Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear v Excessive Noise Excessive Vibration Treatment Unit(s) Unusual Odor V Sw S\�J Z h: Pnm out Required: Primary Settling Zone • Aerobic Treatment Zone f u EFFLUENT o tions LIMIT RESULT Estimated Daily Flow 1'4 ia �\S H(Standard Units) 6-9 S.U. p Color Clear Temperature Odor Slightly Musty odor n- (not septic) rn� OWNER SIGNATURE TEC, IAN SIGNATURE SERVICE DATE W4MMINCORPOOnTro FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address Name Owner Name Street 1�7 73 Mail Address Q�� ,�c�l L4446 Mail Address City W <\StateN% Zip Qi�TL State, \�a zip 0U31 Phone Fax Phone Fax e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of lastallation T Date of last um out MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panels Visual Alarm Operating Audio Alarm Operating if resent Blower(s) � �� Air Inlet Filter Clean f Blower Hood Vents Clear c,-, Excessive Noise ✓ #\ VI5 fC, Excessive Vibration Treatment Unit(s) Unusual Odor Pum out Required: i'h Primary Settling Zone J Aerobic Treatment Zone ✓ EFFLUENT o tions LIMIT RESULT ��S ►�` �� - Estimated Daily Flow H(Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly �� Musty odor D= LA (not se tic rn`�0 OWNER SIGNATURE TECffiYJe1AN SIGN URE SERVICE DATE PA vi, � BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL 7 TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 4/28/14 BEA09-10167 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Hawthorne Terrace Condominiums 272 Craigville Beach Road SHIPPING METHOD: West Hyannisport,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail X Green Card/RR ❑ COPIES DATE DESCRIPTION —� 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment ari3'Disposal Systems( ecember 2013;March 2014) r 1 Bio-Microbics Field Inspection&Service Report(December 2013;Mar 2014) — For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: n REMARKS: Please find enclosed the DEP Inspection and O&M Forms and Bio-Microbics Field Inspection&Service Reports for operation and maintenance conducted during this reporting period for the above referenced property. While there is no access for annual inspection of the pressure distribution field lateral lines,pumps,floats and the pressure distribution panel were inspected and found to be functioning properly. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. CC!'Barnstable Board of Health Ms. Gertrude Wilcox,Treasurer David C.Bennett,Principal[Internal] GJim Bell-BioMicrobics[via email] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896 - 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/10/13 9/9/13 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: M no ❑ some pH 7.0 SU DO 5.0 mg/L Turbidity 3.43 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Check audible/visual alarm function of the FAST systems and Pump Chamber and note proper function. Check Blower/Pump Chamber and note proper function. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. Check Pump Chamber Run Times as Follows: Pump Chamber- p#1: 67.56hr p#2: 238.37hr. t5aiom.doc•rev. 11-07-05 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. t,� C U " ! , Operator Signature ; Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use— by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 311h of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Hawthorne Terrace Condominiums c/o Gertrude Wilcox, Treasurer filling out forms Owner on the computer, use only the tab 272 Craigville Beach Road key to move your Facility Street Address cursor-do not Hyannis 02601 use the return key. City Zip Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 City State Zip (508) 778 -2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information Bio-Microbics FAST DEP ID Manufacturer ID Model Number 12/31/03 12/31/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/10/14 12/10/13 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.5 SU DO 5.5 mg/L Turbidity 11.3 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Check audible/visual alarm function of FAST system and Pump Chamber and note proper function. Check Blower/Pump Chamber and note proper function. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. Check Pump Chamber Run Times as Follows: Pump Chamber- p#1: 67.56hr p#2: 242.62hr. t5aiom.doc•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. i.. ". . P & uk\1 � \�k Operator Signature 1 Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address Name r&ti Owner Name G-e.t v 2r� ��C-i Street Vb 13 Mail Address �� t� vv '� Mail Address ?,Q \30i, \lk3 City c hi c r StatcK , Zip C�`v�'� City iq c.u�l, r State t 4� Zip G-V-3 Phone Fax Phone Fax _ e-mail e-mail cDr3 -ebq, ' koc\ INSTALLATION INFORMATION J Model No. Serial No. Date of Installation Date of last pumpout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alann Operating fu ', >�v- Audio Alarm Operating �.v�'•�o V$�v' e•\s�tw �,s�:,a if resent Blower(s)a �i.w �✓. ;3 �. r�.�� tv t,l e t Air Inlet Filter Clean ✓ Blower Hood Vents Clear ✓ (e .�e, ,;• :� `. `c �U' Excessive Noise V Excessive Vibration ✓ ' i tiI Treatment Units Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT Estimated Daily Flow H Standard Units 6-9 S.U, Color Clear Tem erature Odor _ Slightly 5`v. Musty odor '��` ,Q) not septic) OWNER SIGNATURE TEC CIANN RE I SERVICE DATE IN COtIPOBATEU FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address. ti Name Owner Name Street \ Mail Address e,p .r\sc4k C\qq Mail Address City(,)• r„hh�s o r� . State S0- Zip D Z&�l Z State M�, Zip 024 3\ 5��-1-1`d -2<-e41 �`� \'1a�,- Phone Fax Phone Fax e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation= Date of last purapout MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating N111 �� , t• ', v is.r, Nw s Audio Alarm Operating V, r �;�s�,, �. Z,>>.� o.�<t .��Z c�r \1•\, if resent) Blower s uv,i/ 3 a• �/a�a.. wdr,f t� Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration — 5 Treatment Unit(s)Q 1\2 Unusual Odor Pum out Required: v's' - Primary Settling Zone ✓ Aerobic Treatment Zone ✓ EFFLUENT(options) LIMIT RESULT \, Estimated Daily Flow i H(Standard Units) 6-9 S.U. Color . Clear Temperature Odor Slightly Musty odor. �p (not septic) OWNER SIGNATURE TEC C N SJONATURE I SERVICE DATE Commonwealth of Massachusetts W Title 5 Official Inspection Form YAK- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Crai ville Beach Road - Hyannis, MA 02601 [Unit 1 , Unit 2 , Unit 3 , Unit 4 , Property Address Unit 5 , Unit 6 , Unit- , Unit 8 , IM—litUnit , Unit 11 Hawthorne Terrace Condominium Trust Unit 12 , Unit 13 , Unit 14 , Unit 15 , Unit 16 , Owner Owner's Name Uhit 17 , Unit 18 , Unit 19 , Unit information is required for West HY P annis ort MA 02672 8/15/12 ` every page. Cityrrown State Zip Code Date of Inspection (,�h;-�s-��-2d Inspection results must be submitted on this form. Inspection forms may not be alter - in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information �- �9 12-- forms on the computer,use 1. Inspector: only the tab key to move your Joseph Smith cursor-do not Name of Inspector use the return key. Bennett Environmental Associates Company Name � P.O. Box 1743 Company Address Brewster MA IwoIwoCity/Town State Zip Zip Code 508 896 1706 SI #4994 Telephone Number License Number B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑2Need.s.. her Evaluation by the Local Approving Authority 8-22-2012 isgature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts 4 - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for y West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in working condition and is functioning as intended. None of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 existed at the time of 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. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 public health, safety or 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 public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh l5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts _ Title 5 Official InspectionForm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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, safety and 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 SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 '/day flow l5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M y< 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West HY P annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of 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 1 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 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking 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 If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M ' 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. CitylTown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 40 Number of bedrooms (actual): 40 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 4,400 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is r equired for y p West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Septic system that serves a condominium complex is comprised of a 9,000 gallon septic tank, a 6,000 gallon FAST tank(Bio-Microbics FAST System, I/A), a 6,500 pump chamber, and two 30'x 100' pressure dosed leaching fields (design capacity 4,400 gpd required). . 60-70 est. Number of current residents: Does residence have a garbage grinder? ❑. Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings,.if available (last 2 years usage (gpd)): See details Detail: 2010: 473 units =47,300 cubic feet=353,851 gallons/yr; average flow= 969.5 gpd 2011: 470 units= 47000 cubic feet= 351,607 gallons/yr; average flow= 963 gpd Sump pump? ❑ Yes ® No Last date of occupancy: Currently occupied Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped every year per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ® Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 272 Craigville Beach Road -Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West HY P annis ort MA 02672 8/15/12 every page. CityFrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2004 BOH Certification Letter Engineer Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5' feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. fee +/-town water line feet Comments (on condition of joints, venting, evidence of leakage, etc.): Properly vented to roof. No evidence of leakage in piping or joints. Septic Tank(locate on site plan): Depth below grade: 2.0 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 9,000 gallon septic tank with schedule 40 pvc inlet and outlet tees in good condition with no structural concerns. Covers to final grade elevation with steel ring. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 9,000 gallon Sludge depth: 5"outlet, 4" inlet t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 _ I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 60" Scum thickness 1"outlet, 7" inlet Distance from top of scum to top of outlet tee or baffle 8"outlet, 3" inlet Distance from bottom of scum to bottom of outlet tee or baffle 35" How were dimensions determined? Sludge judge, tape, probe Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not recommended at time of inspection with no significant sludge or scum accumulation. Both schedule 40 pvc inlet and outlet tees in working order and are functioning as intended. Liquid level as related to the outlet invert is at a normal operating height. No evidence of leakage encountered while conducting the inspection on the septic tank. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 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 Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West HY p annis ort MA 02672 8/15/12 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West HY p annis ort MA 02672 8/15/12 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Pressure Distribution, No D-box Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pressure distribution, no D-box. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber functioning properly. Both pumps are functioning, and audible alarm and visual alarm are functioning properly. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. Soil conditions explained in next section for SAS. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: (2) 30'x100' ❑ 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.): (2) 30' x 100' pressure dosed leaching fields, no surface ponding present, soil was clean and dry, normal vegetation (grass)over top of both leaching fields. Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. No evidence of hydraulic failure present at time of inspection. (Design capacity of leaching field 4,400 gpd). 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 layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West HY p annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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 vegetation, etc.): t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy P annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name required for is West H annis required for ' Y port MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date 004 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Established estimated depth to high groundwater by referencing septic as-built plan by JC Engineering Inc. of East Wareham, MA with a plan date of January 13, 2004, wherein it is noted that the bottom of the pressure dosed leaching field is at elevation 28.0'. Also the soil test data which was conducted by Samuel Philos Jensen and inspected by Samuel White, notes within the same plan that no groundwater was encountered at elevation 21.54', which puts estimated groundwater at an elevation of 6.0'+from the bottom elevation of the leaching field. Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 272 Crai ville Beach Road - Hyannis, MA 02601 9 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for west HY P annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 -`E_%.L3�`J ! :_xA'•:'i. �� rJ�a.= si.�L�. 6_1 �y.•,Sy.F � ,w--^ �y rat"•'' t: _ y"• �.�€•:t.%_ors:�.��+'`_�ti�3.,s:w��i +`a'�;fi,'vv -,_c Fe�:=�.^ ^_i ul4'. wlx_C 5�=j !Sj L:L ?r, ^.S ICs$:Ju1Sc:+xF 'S�i7}rai it%r^s3^?. a-4u•_d::cl' Jtr IC6 fl, si S Me i I;• r MI — � �.. - - - -.r`-'-� � ��i �f✓4 s_�'^wi •y ram. ,..a-r„3 r ,;��,�.:sit .,;�`��•�,� �__ 1t av 1r'4 ,I,•�.' i i r, _ F ' ��•J,�� rah' .�f'= %��~ �.- - B/T'd 60IS96880S:o1 002906180ST Hild9H 1SNdue:wojd LZ:Oi ZIOZ-ZO-AUW BENNETTENVIRONMENTALAsSOCIATES, INC. LICENSED SITE PROFESSIONALS & ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS 0 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 508-896-1706 0 Fax 508-896-5109 www.bennett-ea.com I BEA10-10167 January 31, 2012 Ms. Gertrude Wilcox COPY Hawthorne Terrace Condominiums , P.O. Box 488 Hyannisport, MA 02672 RE: OPERATION AND MAINTENANCE CONTRACT Innovative/Alternative Septic System 272 Craigville Beach Road-Hyannis, MA Dear Ms.Wilcox, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for professional services relative to the operation.and and maintenance of the Innovative/Alternative Wastewater Treatment System located at the above referenced property. The collection and field analysis of samples collected from the effluent of the septic treatment system is a required condition of the system, as set forth by the MA Department of Environmental Protections (MA DEP)to qualify treatment capacity on a quarterly basis. As such, work proposed by BEA includes the inspection and field testing of wastewater samples,as well as the preparation of the required forms for distribution to the appropriate town and state offices. Additionally,at the time of such inspection,blowers,filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced to you annually. Should any repair or treatment system component replacement be required,or additional sampling beyond the annual requirements be necessary,you will be notified to authorize the additional work and expenses. Should field-testing parameters indicate the need to collect samples for laboratory analysis,such sampling will be conducted and will be noted on a BEA form that is left at your residence following the inspection. The following budget represents estimated annual costs through one year of service to include four inspection events. These annual costs are valid for two years subsequent to the date of the first inspection. Please note that this contract runs with the property. As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore, you are required to notify any buyer of the transfer of this contract. 1 EMERGENCY SPILL RESPONSE 6 WASTE SITE CLEANUP & SITE ASSESSMENT 0, PERMITTING 8 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 0 WASTEWATER TREATMENT,OPERATION&MAINTENANCE JANUARY 31,2012 HAWTHORNE TERRACFJBEAIO-10167 PAGE 2OF2 I/A WWTO&M QUARTERLY INSPECTION/MAINTENANCE Inspect I/A system and take field measurements of dissolved oxygen,pH and turbidity. At the time of monitoring events the conditions of the system will be inspected and documented with regards to the blower units, sludge level and associated piping. REPORTING/FILING Review inspection and field-testing results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms on a quarterly basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Services=$1,000.00 TOTAL ANNUAL EXPENSE: $1,000.00* TOTAL COST PER EVENT: $250.00 *Note:I/A systems located in Barnstable County are required to report inspection and sampling results on the MA Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. We are proceeding with this work as outlined. Immediate notification in writing is required if you do not wish to proceed. Otherwise, please sign the authorization below indicating acknowledgement and acceptance of our Terms&Conditions and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES, INC. Samantha Farrenkopf, ES, WWTO _, WSO Wastewater Program Coordinator cc: Kara Risk, Business Manager encl. Terms &Conditions(2011)/Fee Schedule (2010) AUTHORIZATION:. DATE: / , R INCORPORATED FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER 66, Installation Address C,c�;. v:tV. b tC.cL. _ Name Owner Name Gam!�,d 43 c;ID4, Street �5 3 ,S Mail Address ? , W6 Mail Address -? I-JA—j City rreir��,;s. c��, State Zip City` &C.;,�\.,r State MA Zip CJW-3� Phone Fax Phone Fax �50<6 e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pum out 2 . `3 - ZW3 MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if resent L� Blower(s) Air Inlet Filter Clean v, , ��,r G �u�,'� ,•�, Blower Hood Vents Clear Excessive Noise V" Excessive Vibration Treatment Unit(s) Unusual Odor Pum out Required: V v_\,.. Primary Settling Zone Q c� ��.�•S �,�. �, Z i i Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT Estimated Daily Flow H(Standard Units) 6-9 S.U. �. - Color Clear U,3�, Temperature I I`'3c� Odor Slightly "IN Musty odor W�Js�a� �(� — �1 3 (not septic) OWNER SIGNATURE TECH916AN SIGNAT SERVICE DATE pry sU�� r� yaa l� _ BENNETT EWMONWNTAL ASSOCIATES INC. 1573 Main St.,P.O.Box 1743, Brewster,MA 02631 � 508-896-1706•www.bennett-ea.com J Date&time of visit: q 1L 'UU A site visit was conducted today for: &O M =Testin;' Repair Alarm Call Your system is operating correctly ❑YES ANO Tank(s) in need of pumping ❑YES QZkNO Further maintenance required ❑YES XNO Repairs needed (5w +��`�' ') , XYES ❑ NO Please contact our office ❑YES '\�(N0 Contract renewal required ❑YES bfNO Field testing: Pass / Fail Sample pulled: YES / NO Laboratory sampling conducted ❑YES ANO �ye�si,�cr:.� c��..t cam•\\�v Qr��. AW, 7�)cr-6 — -e6,6V — kSIv, -o-( 3c�vht5 BE-,............... ........................... 1 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments �M 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for Y p West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information forms on the I computer,use 1. Inspector: L only the tab key �y to move your , cursor-do not Joseph Smith Name of Inspector use the return key. Bennett Environmental Associates Company Name -a P.O. Box 1743 Company Address kl Brewster MA 02631 -` Cityrrown State Zip Code:, 508 896 1706 SI#4994 Telephone Number License Number B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 8-22-2012 is Sighature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Offcial Inspecti n o Subsurface Sewage Disposal System•Page 1 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is p required for y West H annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in working condition and is functioning as intended. None of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 existed at the time of 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. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. . The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 public health, safety or 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 public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 CraigviIle,Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for Y p West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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, safety and 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 SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® 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 Y2 day flow t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for Y p West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of 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 1 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 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] E. ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking 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 If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts F Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 40 Number of bedrooms (actual): 40 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 4,400 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is r equired for Y p West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Septic system that serves a condominium complex is comprised of a 9,000 gallon septic tank, a 6,000 gallon FAST tank(Bio-Microbics FAST System, I/A), a 6,500 pump chamber, and two 30'x 100' pressure dosed leaching fields(design capacity 4,400 gpd required). . Number of current residents: 60-70 est. Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d See details 9 ( Y 9 (gpd)): Detail: 2010: 473 units=47,300 cubic feet= 353,851 gallons/yr; average flow= 969.5 gpd 2011: 470 units=47000 cubic feet= 351',607 gallons/yr; average flow= 963 gpd Sump pump? ❑ Yes ® No Last date of occupancy: Currently occupied Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts v r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West HY P annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped every year per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy t ❑ Shared system (Yes or no) (if yes, attach previous inspection records, if any) ® Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts w W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for y p West H annis ort MA 02672 8/15/12 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2004 BOH Certification Letter Engineer Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. 50' +/-town water line feet Comments (on condition of joints, venting, evidence of leakage, etc.): Properly vented to roof. No evidence of leakage in piping or joints. Septic Tank(locate on site plan): Depth below grade: 2.0 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 9,000 gallon septic tank with schedule 40 pvc inlet and outlet tees in good condition with no structural concerns. Covers to final grade elevation with steel ring. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 9,000 gallon Sludge depth: 5"outlet, 4" inlet t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 60" Scum thickness 1"outlet, 7" inlet Distance from top of scum to top of outlet tee or baffle 8"outlet, 3" inlet Distance from bottom of scum to bottom of outlet tee or baffle 35" How were dimensions determined? Sludge judge, tape, probe Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not recommended at time of inspection with no significant sludge or scum accumulation. Both schedule 40 pvc inlet and outlet tees in working order and are functioning as intended. Liquid level as related to the outlet invert is at a normal operating height. No evidence of leakage encountered while conducting the inspection on the septic tank. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 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 Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts N W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West HY p annis ort MA 02672 8/15/12 every page. CityFrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts v v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road -Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Pressure Distribution, No D-box Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pressure distribution, no D-box. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber functioning properly. Both pumps are functioning, and audible alarm and visual alarm are functioning properly. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. Soil conditions explained in next section for SAS. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 272 Craigville Beach Road -Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for y p West H annis ort MA 02672 8/15/12 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: leaching fields (2) 30'x100' ® number, dimensions: 9 ❑ 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.): (2) 30' x 100' pressure dosed leaching fields, no surface ponding present, soil was clean and dry, normal vegetation (grass)over top of both leaching fields. Inspection ports are sub-surface and could not be located with as-built, metal detector or probe. No evidence of hydraulic failure present at time of inspection. (Design capacity of leaching field 4,400 gpd). 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 layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts F W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for y p West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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 vegetation, etc.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for Y p West H annis ort MA 02672 8/15/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts v W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5.1 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for West Hy p annis ort MA 02672 8/15/12 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 61+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 1-13-2004 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Established estimated depth to high groundwater by referencing septic as-built plan by JC Engineering Inc. of East Wareham, MA with a plan date of January 13, 2004, wherein it is noted that the bottom of the pressure dosed leaching field is at elevation 28.0'. Also the soil test data which was conducted by Samuel Philos Jensen and inspected by Samuel White, notes within the same plan that no groundwater was encountered at elevation 21.54', which puts estimated groundwater at an elevation of 6.0'+from the bottom elevation of the leaching field. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 272 Craigville Beach Road - Hyannis, MA 02601 Property Address Hawthorne Terrace Condominium Trust Owner Owner's Name information is required for Y p West H annis ort MA 02672 8/15/12 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 MAY-02-2012 10:17 From:BARNST HEALTH 15087906304 To:50Be965109 P.1/8 o— A� r 4w 7 47 7: C r7 I 'A .4 szx lj,-L&!& i Erz&9 mr bdF 44. sc Z�Mal,& 3 T Ire?Is F-Ij! p 7 4 eL> toa aiv CIISAS-TV530-, SWIE 3-31YAMI:J1.s 71- Iva sit ENNETT NVIONlEN"T'AE sOCIATS, INC. LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS 0 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 508-896-1706 0, Fax 508-896-5109 0 www.bennett-ea.com BEA10-10167 January 31, 2012 Ms. Gertrude Wilcox 77. rz Hawthorne Terrace Condominiums P.O. Box 488 Hyannisport,MA 02672 RE: OPERATION AND MAINTENANCE CONTRACT Innovative/Alternative Septic System 272 Craigville Beach Road-Hyannis, MA Dear Ms. Wilcox, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for professional services relative to the operation and maintenance of the Innovative/Alternative Wastewater Treatment System located at the above referenced properly. The collection and field analysis of samples collected from the effluent of the septic treatment system is a required condition of the,system,as set forth by the MA Department of Environmental Protections (MA DEP)to qualify treatment capacity on a quarterly basis. As such, work proposed by BEA includes the inspection and field testing of wastewater samples,as well as the preparation of the required forms for distribution to the appropriate town and state offices. Additionally,at the time of such inspection,blowers,filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced to you annually. Should any repair or treatment system component replacement be required, or additional sampling beyond the annual requirements be necessary,you will be notified to authorize the additional work and expenses. Should field-testing parameters indicate the need to collect samples for laboratory analysis,such sampling will be conducted and will be noted on a BEA form that is left at your residence following the inspection. The following budget represents estimated annual costs through one year of service to include four inspection events. These annual costs are valid for two years subsequent to the date of the first inspection. Please note that this contract runs with the property. As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore, you are required to notify any buyer of the transfer of this contract. 1 EMERGENCY SPILL RESPONSE 0 WASTE SITE CLEANUP 0 SITE ASSESSMENT & PERMITTING 6 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE & WASTEWATER TREATMENT,OPERATION&MAINTENANCE JANUARY 31,2012 HAWTHORNE TERRACEBEA10-10167 PAGE 2 OF 2 I/A W WTO&M QUARTERLY INSPECTION/MAINTENANCE Inspect I/A system and take field measurements of dissolved oxygen,pH and turbidity. At the time of monitoring events the conditions of the system will be inspected and documented with regards to the blower units, sludge level and _ associated piping. REPORTING/FILING Review inspection and field-testing results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms on a quarterly basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Services=$1,000.00 TOTAL ANNUAL EXPENSE: $1,000.00Y TOTAL COST PER EVENT: $250.00. *Note:FA systems located in Barnstable County are required to report inspection and sampling results on the MA Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. We are proceeding with this work as outlined. Immediate notification in writing is required if you do not wish to proceed. Otherwise, please sign the authorization below indicating acknowledgement and acceptance of our Terms&Conditions and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES, INC. Samantha Farrenkopf, ES, WWTO, SO Wastewater Program Coordinator cc: Kara Risk, Business Manager encl. Terms & Conditions(2011)/Fee Schedule(2010) AUTHORIZATION: �2ui�C/cam � ,�� , DATE: 2.C,r, /� '201Z- t INCORPORATED FIELD INSPECTION & SERVICE REPORT FAST® wastewater treatment systems INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address Namec Owner Name Gz�'�, �,3; c: �. Street \5 ,, Mail Address ? , Mail Address'T}p ti 93 c II A3 City m State Zip Q-Ck Jlt City�ex,.&N r State Jq\js Zip © �� Phone Fax Phone Fax J0c6 e-mail e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation =Date of last pumpout '3 ZW3 MAINTENANCE PERFORMED EQUIPMENT YES NO AND COMMENTS Electrical Panel(s) Visual Alarm Operating V c. Gov A,��U�. ,x"\ GJ, Audio Alarm Operating ��' x r..e\ 'r '� •�u�y,��vw\v� �,�� if resent Blower(s) Air Inlet Filter Clean ✓ 1 �e ,A F,nv �uti yv� �n Blower Hood Vents Clear Excessive Noise V" Excessive Vibration Treatment Unit(s) Unusual Odor Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT(options) LIMIT RESULT „ Estimated Daily Flow H(Standard Units) 6-9 S.U. "fire� — Color Cleare \v t Temperature Odor Slightly Musty odor Do (not septic) OWNER SIGNATURE TECH9elAN SIGNAT SERVICE DATE b.fq it, (�f<.SSvse, �,C,�S=`� 6�G�,.�"�i �� \ \v�c.�:n,,.. �✓�' � � C��;�,,;�j�4✓ �y$��\ `Nr��'�atv�l� BENN-ETT EW MON1VI NTAL ASSOCIATES Nc. 1573 Main St.,P.O.Box 1743, Brewster,MA 02631 `--' 508-896-1706 •www.bennett-ea.com Date&time of visit:-( 0 A site visit was conducted today for: C&M) Testin ) Repair Alarm Call Your system is operating correctly ❑YES �kNO Tank(s) in need of pumping ❑YES UNO Further maintenance required ❑YES VGY,,NO Repairs needed (5— ') RYES ❑ NO Please contact our office ❑YES '�fNO Contract renewal required ❑YES tdNO Field testing: Pass / Fail Sample pulled: YES / NO Laboratory sampling conducted ❑YES Q®,NO Iy - . 1 l ........... ' BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1106 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Thomas McKean,Director 8/28/2012 BEA12-10167A Barnstable Health Division 200 Main Street Hyannis,MA 02601 REGARDING: TITLE 5 INSPECTION SHIPPING METHOD: Regular.Mail ❑X Pick Up Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑ Green.Card/RR ❑ COPIES DATE DESCRIPTION 1 8/22/12 Title 5 Official Inspection Form Hawthorne Terrace Condominiums-272 Craigville Beach Road;Hyannis 1 8/23/12 Septic Inspection filing fee(check no.4767,V5.00) For review and comment: ❑ For approval: ❑_ As requested: ❑ For your use: ❑ REMARKS: Mr.McKean, Please find enclosed the Title 5 Inspection for the Hawthorne Terrace Condominiums.This inspection has found the system to"Pass". However,the inspection ports for the soil absorption system nor cleanouts for the pressure dosing lines were found.It is recommended that cleanouts be located and built to grade as would benefit operation,maintenance and monitoring of the facility as required. If you have any questions or need additional information,feel free to contact our office.Thank you. cc: Gertrude Wilcox,Hawthorne Terrace Condominium Trust(inspection form only) FROM: JRS - If enclosures are not as noted,kindly notify us at once BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARIANS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/23/10 BEA09-10167 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Hawthorne Terrace Condominiums �7 272 Craigville Beach West Hyannisport, SHIPPING METHOD: S E P 2 g REC'D Regular Mail ❑ Federal Express ❑ V gy v Certified Mail ❑X UPS El Priority Mail ❑ Pick Up ❑ Express Mail ❑ Hand Deliver ❑ COPIES DATE DESCRIPTION 3 DEP Approved Inspection and O&M Form for Title 5 UA Treatment and Disposal Systems(Mar,June, Sept 2010) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: 0 REMARKS: Please fmd enclosed the DEP Inspection and O&MTorm,and laboratory test results of wastewater samples collected during this reporting period for the above referenced property. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Gertrude Wilcox,Treasurer David C.Bennett,Principal[Internal] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important: Hawthorne Terrace Condominiums: C/O: Gertrude Wilcox, Treasurer When filling out Owner forms on the computer, use 272 Craigville Beach Road only the tab key Facility Street Address to move your Hyannis 02601 cursor-do not use the return City Zip key. Mailing address of owner, if different: VQ P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 7B°'D City State Zip (508) 778-2581 ext. 129 Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. 0&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information FAST FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/8/10 6/10/10 Inspection Date Previous Inspection Date 6"Sludge, and 4"Scum Layer Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc-rev. 11-07-05 Page 1 of 1 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ❑ clear ®turbid ® Other(specify): Cloudy Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ® some pH 7.11 SU DO 3.03 mg/L Turbidity 37.3 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: FAST System blower is not functioning, have sent out an APS form to Gertrude Wilcox in order to have a new blower installed for the system. Pressure dosing system for leaching field is functioning properly. Notes and Comments: Audible and visual alarm for fast blower is not functioning; however, audible and visual alarm for the control panel for the pressure dosed leaching field is functional. Blower is undergoing approval to be replaced. t5aiom.doc-rev.11-07-05 Page 2 of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 UA Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. �&z Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6 Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 ' I Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important: Hawthorne Terrace Condominiums: C/O: Gertrude Wilcox, Treasurer When filling out Owner forms on the computer,use 272 Craigville Beach Road only the tab key Facility Street Address to move your Hyannis 02601 cursor-do not use the return City Zip key. Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: W. Hyannisport MA 02672 'B"0f city State Zip (508)778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information FAST FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/10/10 3/17/10 Inspection Date Previous Inspection Date 9"Sludge, and 4"Scum Layer Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev. 11-07-05 Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Clear Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.71 SU DO 5.95 mg/L Turbidity 4.71 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System Functional, passed field tests. Notes and Comments: Audible and visual alarm for fast blower is not functioning; however, audible and visual alarm for the control panel for the pressure dosed leaching field is functional. Accessed blower enclosure and blower was inspected . Pumping of portions of the system reccomended (primary and secondary portions of the fast tank) i i t5aiom.doc-rev.11-07-05 Page 2 of 2 l i LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00.i q 12�10 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31"of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important: Hawthorne Terrace Condominiums: C/O: Gertrude Wilcox, Treasurer When filling out Owner forms on the computer,use 272 Craigville Beach Road only the tab key Facility Street Address to move your Hyannis 02601 cursor-do not use the return City Zip key. Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: ` W. Hyannisport MA 02672 City State Zip (508)778-2581 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, Inc. 0&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information FAST FAST DEP ID Manufacturer ID Model Number 12/31/2003 12/31/2003 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/17/10 Inspection Date Previous Inspection Date 14" Sludge, and 9"Scum Layer Pumping Recommended ® Yes ❑ No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 Page 1 of 1 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ® gray ❑ brown ❑ clear ❑ turbid ® Other(specify): Cloudy Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 6.52 SU DO 4.88 mg/L Turbidity 33.7 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System Functional, passed field tests. Notes and Comments: Audible&visual alarm for fast blower not functioning; however, audible&visual alarm for control panel for pressure dosed leaching field functional.Access to blower was restricted due to locked gate to enclosure in which the blower is housed in (we will need access to enclosure). Pumping of portions of system recommended (primary portion of the fast tank, and primary portion of the septic tank). t5aiom.doc•rev.11-07-05 Page 2 of 2 o Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. 9'.- , - -alzilic-) Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: i Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 I i I I I I t5aiom.doc•rev. 11-07-05 Page 3 of 3 `��a��eutater �i�eatinerl�cfervices% �izo. 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 January 5, 2010 a' Hawthorne Terrace Condominiums P.O. Box 488 :Vest Ilyannisport, MA 02672 Re: Serial Number: 8.048 Location: C272 Craigville Beach Road, Hyannis, MA � Dear Hawthorne Terrace Condominiums: We understand you do not wish to continue your maintenance contract with our company. Please be advised the Massachusetts Department of Environmental Protection requires a maintenance contract be in place for the life of the alternative septic system. Also, we are required to`inform both`the'state and local agency of your decision. If you have any questions or need additional information please call our office at (508) 880-0233. ® Q Sincerely, U) Donna L. Callahan 0 .. o0 v Copy to: Massachusetts DEP Ua_rnstableBoard'of Health- 200 Main Street —J f i Hyannis, MA' -02601 r BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARIANS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Brian Baumgaertel,Program Coordinator 1/5/10 BEA10-10167 Barnstable County Department of Health and Environment 3195 Main Street/P.O.Box 427 Barnstable,MA 02630 REGARDING: Innovative/Alternative Septic System Maintenance Contracts SHIPPING METHOD: Regular Mail ❑X Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑ Green Card/RR ❑ COPIES DATE DESCRIPTION 1 11/6/09 272 Craigville Beach Road-Hyannis,MA �? O C=' _ e 0 T 70 go •• Go � r 0- For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑ REMARKS: Please find enclosed authorized operation and maintenance agreements for the above referenced property. Thank you. cc:Barnstable Board of Health FROM: Samantha Farrenkopf,Wastewater Program Coordinator If enclosures are not as noted,kindly notify us at once RECEIVED JAN 0 4 -010 - BENNETT- ENVIRONMENTAL-AsSOCIAT-Es-4NCO' -- LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS ® GEOLOGISTS A SANITARIANS 1573 Main Street-P.O.Box 1743, Brewster, MA 02631 6 508-896-1706 6 Fax 508-896-5109 www.bennett-ea.com PROPOSAL HA7YANP�hteq% ORN I TERRACE CONDQ 40 November 6,2009 WT, MA 02672 . ram Hawthorne Terrace Condominiums _HyarIA-A3b01 �• rz�,1 s j�� f� t / d 17 2- R : OPERATION f IND inYl Al1i�T L1�A�.:CE ::.�.J11"i•i�: '�v..i . Innovative/Alternative Septic SyStem 272 Craigville Beach Road-Hyannis,MA EFILE COPY Dear Mr. Cotto, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for professional services relative to the operation and maintenance of the FAST system located at the above'referenced property. The inspection and field testing of samples collected.f om the effluent of the septic treatment system is a required condition of the approved Innovative Wastewater Treatment System, as set forth by the Massachusetts Department of Environmental Protection(MA DEP). As such,work proposed by BEA BEA includes the inspection and field testing of wastewater samples for laboratory analysis and the preparation of the required forms for distribution to the appropriate town and state offices as well as you. Additionally, at the time of inspection,blowers, filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced quarterly. Should any repair or treatment system components replacement be required, or additional sampling beyond the annual requirements necessary,you will be notified to authorize the additional work and expenses. The following budget represents estimated annual costs through one year of service to include four inspection events. These annual costs are valid for two years subsequent to the date of your initial inspection/maintenance event. QUARTERLY INSPECTION/MAINTENANCE Xyg p ty.H and turbidi At the time of monitoring events Inspect I/A system and take field measurements of dissolved o en, the conditions of the system will be inspected and documented with regards to the blower units, sludge level and associated piping. 1 EMERGENCY SPILL RESPONSE Q WASTE SITE CLEANUP Q SITE ASSESSMENT ENVIRONMENTAL PERMITTING LAND USE PLANNING WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6'WASTEWATER TREATMENT,OPERATION&MAINTENANCE NOVEMBER 6,2009 HAWTHORNE TERRACE/PROPOSAL PAGE 2 OF 2 UA WWTO&M REPORTING/FILING Submit inspection results on the County database on a quarterly basis. Prepare DEP transmittal forms on a quarterly basis. Submit DEP transmittal forms to MA DEP, local Board of Health, and associated vendors/contractors, as appropriate,on an annual basis. Professional Fees Inspection[WWTO(S)2hrs x 4 quarters] $ 560.00 Professional Fees Reporting[WWTO(P) 1.5hrs x 4 quarters] $ 480.00 TOTAL ANNUAL EXPENSE: $1,040.00* TOTAL COST PER EVENT: $260.00 *Note:UA systems located in Barnstable County are.required to report inspection and sampling results on the MA Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this tui ie,BCDHE has found it necessary to institute annual user fees for filing on this required database.- This fee is$25 for the year 2009 and$50 per year thereafter. This fee will be included on your invoice on an annual basis. Therefore,if you are in agreement and wish to proceed with the work as outlined,please sign the authorization below to indicating acknowledgement and acceptance of our Terms&Conditions and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES, INC. Kara Risk, RS Business Manager cc: Samantha Farrenkopf, Wastewater Program Coordinator encl. Terms &Conditions(2009)/Fee Schedule(2008) r AUTHORIZATION: ,DATE: Oaw / 2 0/6 r �j-- s COIL mm—\MKE_LTH OF ALzSSACHUSE•T'TS � ( EkECUTi`E OFFICE OF \�lr O �T IL DEPARTMENT OF E1,4`VIRON'LIENTAL �R(�TFC T IOC �s X TITTE S OFFICIAL INSPECTION FORM—SOT FOR VOL U'��T_RY ASSESS!•TENTS SUBSURFACE SE",AGE DISPOSAL SXSTEINT FOR_1I PA.P.T A CERTIFICATION ;;?iG/'a r yr / i Property Address: �l� �e�� G Owner's Name: / r,c,i (O�,cro 3:. Owner's Address: O a.9 z 34,5(051 0.16�'o? Date of Inspection: p g _lame of Inspector: ltease print)��Yl� Company- ame:&i!/!i/p —TCGh! iLlailing Address: d3C /d $� Telephone Number: 7 s'- 9 2 6a/ CERTIFICATION STATEMENT 1.certify that 1 have personally inspected the sewage disposal system at this address and that the i-iforrrianon renoned below is true; accurate and complete as of the time of the inspection.The inspection vvas performed:based on my 4' tr experience n r^ ti maintenance se-wage c training and expe�_enc_ in the i,rope .anc._on and ma ntena�_ce of on site sez.a�� disposal sysre:m. I am a DEP F approved system inspector pursuant to Sec . n 1.5.340 of Title 5(310 C-NIR 15.000). The system: ':asses Conditionally Passes Needs Further Evaluation by the Local Approving Aumoriry- i. - r zils 9 f s Inspector's Sibnaturee C/x �. ! Date: The system inspector shall submit a copy of-his inspection report to the Approving Authorty Board of idea>th or DEP)within 30 days of completing this inspection.if fhe system is a shared system or has a &'s-- flowof-10,00,0 gpd or greater;the inspector and the system owner shall submit the report to the appropriate regional of=lce o_Jh, DEP. The original should be sent to the system owner and copies sent to the buyer, if applicahle. and the a -o authority. Notes and Comments �t. This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 1' Title " . o Inspection Form 6/15/2000 page 1 Page 2 of 1-1 OFFICIALL INSPECTION FOR-M.--NOT FOR VOLUT'N-TA-Ry --8-SSESS!\JENTS SUBSURFACE SEWAGE DISPOS--iL, SY-ST"FM INSPECTION FOP—Al PART A (7EIRTIFICATION(continued) Property Address: 1-fe,:;c-4 1�Property Owner: Aw-Aa. f Date of Inspection: 72/ Inspection Summary. Check A,.,BC,D or E zALN'VAYS complete all of Section D A Svste asses: I have not found any information which indicates that any of the failure criteria described in 0 C\,[R- 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicatec"', below=. Comments: B. Svstem Conditionally Passes: A/ One or more system components as described Ln the"Conditional Pass' section need to be replaced or i repaired. The system- upon completion ofthe replacement or repair, as approved by the Board of Health, -� pass. Answer yes,no or not determined(Y,"N-,ND)in the for the fbllovvrina statements. If"not determnnedt'o'k-se 'explain. Ihe septic tank is metal and over.20 year old*or the septic tank(whether naetal or nor) is stracnirally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.System:will pass lnspect�on:-fthe existing tank is replaced-adth a comply'M0, septic tank asapproved by the Board of-Health. *A metal septic tank--Ali]l pass inspection if it is structurally sound,not leaking and iffa Cemlficate of C'OnIVIa-1ce indicatinc,that the tank is less than 20 years old is avai-lable. N-D explain: Observation of sewag backup or break out orhigh static water level in the d:s--ibu-,lior.box du: to b-o;-n-- or obstructed pipe(s) or due to a broken. settled or une,,-,-rt distribution box. System will pass i nspecil or, f w, kj3provai of Board of Health): broken pipe(s)are replaced o'bsruction is removed distribujon box is leveled or replaced N"D explain: The system required pumping more than 4 times a year due to broken or obs—nic-Led pass inspection if ap-.,.)rova-,' of the Board of Health): broken pire(s' are i-c-placed obstruction-is removed N-D explain: Page 31 of 11 OFFICIAL INSPECTION FORN'I- NOT FOR VOLUNTARY ASSESSA- 11 N TS SUBSURFACE SEYVAGE HISPOS41, SY_TE?+k1INSPECTION FOP—AT P<-iRT A CERTIFICATION(con L'iued) i Property Address: tP- //�c 1 di We /3/Jeei e, k2d F h a hhif /yJ/f O�6®/ Owner: ;wf4 � s Bate of Inspection: p9 t C. .Further Evaluation is Required by the Board of Health: /v Conditions exist;which require farther evaluation by the Board of Health in order to cer if the- s,%s crt is failing to protect public health; saf ty or the environrlert. 1. System will pass unless Board of Health determines in accordance with 310 CIIR 15.303(1)(b)that the system is not functioning in a manner which-will protect public health.safety and the environment: _ Cesspool or is within.50 feet of a surface-,vater -- %essnool or privy is vithin 50 feet of a bordering Vegetated wetland or a salt m- arsl7 2. System will fail unless the Board of Health (and Public eater Supplier, if any)determines that the system is funetionin2 in a manner that protects the public health.safety and environment: The system has a sen 7c tank and soil absorption syster=(SAS)and the SAS is v-:i:hin 100 rzet of a surface water supply or`:butary to a surface water suppiv. T:1e syster'i has a s--pt-lank and SAS and the SAS is within a Zone 1 •t a nublic wat_r sun'o lv. . ... _ The system has a septic tank and SAS and the SAS is within 50 fee:of"a private w ater suppl_. .t°ell. The system has a septic tarik and SAS and the SAS is less than 100 fees_bit 0 f et o-mot. from a private v.rater supply weli" . Method used to detem7�r-c d.ista;ace "'This system passes ifthe well Nvzter analysis;perionned at a DEP certified laboratory; bacteria and volatile organic compounds indicat;:s that the well is Tee Torn polio=ion fror,1 that Tacilitv and the presence of ammonia nitrogen and mtraie rltrog?n is equal to or less than J rprn, provided Char_10 Otl er failure criteria are triggered. A cope of the analysis must be attached to tin' s foriM. t �F �i 3. Other: jj Y I. Page 4 of 11 1 OFFICLA-L I_SPEC'I1O!S.T FORA;; -NNOT FOR VO e_'_'T_A_RY ASS ESSNIEN T S iEi l� SUBSURFACE SEWAGE DISPOSAI, SYSTENT 1- SPEC'TION F®R:kT i PART A CERTIFICATION(continued) � �� C Ile Property Address: �� v� h,f 0a G 0/ Owner:liq w ,Of#r- 01 v Date of Inspection: 0 D. System Failure Criteria applicable to all systems: You most indicate"yes"or-no''.to each of the foliov ie-nor all inspections: Yes _:o ✓ Dacnap of sewage into facilit•:1 or system component due to ov erloa eed or—clogged SAS or Cesspool Discharge or pondinq of effluer t to ffie sinface of the around or siur-ac_ % aters dLa to an ovei'Oade� O' — dogged SAS or cesspool P " Static liquid level in the distribution box above outlet inv-ert due to art overloao'ec or, clogged j A S oi" �espooI y- i,t c- �L quid depth in cesspool is less than S"velo;x �.ert or available volume is less t-_an ;'_. day: i ov, �/Required pumping more than 4 times in the last year NOT due to clogged or obs-tructed n_ me(s). N=_bzr f times pumped it �_.y portion of the SAS,cesspool or privy is belo<<r high ground.rater ele;a_tion. portion of cesspool orpri.y is :,ith n 100 feet of a syface water supply or tributary to a s i`ace rater sup piv. Any rortionyof a cesspool or nri; is,_..-:hin a Zone I of a public,=:-211. portion of a cesspool or Jriz% is within 50 feet of a private water supply jell. portion of a cesspool or pn ry is less than 1.00 feet but greater than K feet frorn a private water supply well with no acceptable water quality analysis. [This system passes if the well rater analysis. performed at a yDEP certified laboratory,for coliform bacteria and volatile or;anic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate r_itroben is equal to or less than 5 pp rj,provided that no other failure criteria are triggered.A copy-of the analysis must be attached to this form.] / V V (Yesl o) T.he system fails.I have determined that one or more of the above failure criteria exist as t described in 310 CN R 15.303.therefore the system fails.The system ovner should contact the Board of 4 Health to deterriune;A-hat twill be necessary-to correct the failure. E. Large Systems: To be considered a large syste.m the s i7stern must serve a facility with a design ilo- of 10.000 gpd to 155.000 gpd You must indicate either"ves"or"no"to each of the followi a: ' (The following cr teria apply to large systems in addition to :he criteria above) yes no the system is within 400 feet of a surface drinking-water supply- the systems,;-ithin 200 feet of a tributary to a surface drnkinC.;-ate_si;..0;- — — he sysrem is located in a nir_oaer_sensitive area (';_tenor V1'eilriead rro:ecr_on Zone II of a public w-ate.:supply�.�-P11 If you have answered "yes"to any question in Section E the system is co—, a;tort l.artt Le.a.. or a-i;i;,. "yes"in Section D above the large system has failed. The ov-ner or operator of any large c;,cseni cpn.c; `-,,• significant threat under Section E or failed under Section D shall, g s up-rade the sl-ste:n 15.304. The system oxvner should contact the appropriate regional of-L ce of e D�pa,irnej,- I• 9 , i Page of 11 i OF�'ICIAI., INSPECT1ON FOl2NI—-NOT FOR V011Uli'T-AJRY ASSESSAT£N T'; f SUBSUPF-ACE SEYVAGE DISPOSAL SYSTEM I\'_SPFCTTO FOP-Ay PART R CHECKLIST // Property Address: � �� lG� v�/� �GG h jQ�/ �ahn�f, /�f OoZ6p/ Owner: ��Gw�o�c P✓�a�G ., 0 7.'/ Date of Inspection: 9 Check if the following have been done. You must indicate'yes"or"no"as to each of the follo•..Lg: 1 Y"es o Pumpimz information was provided by the o-.cner; occupant; or Board of Health F l/<�A7re any of the system coIIlponeIIts pumped out in the previous two wee s 1 Has the system received normal flows in the p o w revious t,cv ��period? _ . Have larRe volumes of water been introduced to the system recently oI'as pan of t1is ins-r ecrio n Were as built plans of the system obtained and examined?(if then were not available note as Was the facility or d;,,elling _nsp:cted for signs of sewage baclk up v N as the site Inspecteci for suns of break out? Were all system components;excluding the SAS, located on site ? f '1 Were the septic tan-:mansoles tul cove red. opened,and the ir_rerior of tie tan-: insp_cted for the ca-di:ion of the baffles or tees; material of construction; dimensions, depth of liquid,depth of sludge a-d depth-of scum ' I r r'.` r/ Was the facility owner(and occupants if d .-re t from owner)provided tb ir�fo-rration on the r: per maintenance of subsurface sewage disposa systems'? tf The size and location of the Soil Absorption System(SAS)on the site has been de-e--r-n-dned bas--d on: Yes no Existing infoi-,nation. For example, a plan at the Board of)<ea.th. Deteir.-ned in the field(if any of the failue criteria related to Part C is at issue a :roximatio-of d stanc_ is unacceptable) 1 10 CM-R 15302( )(b) K , li,Ij j Pace6of II OFFICIAL INSPECTION )i+ORIM—NOT FOR VOLUT TARP __kSSESSAIE'e TS SUBSURFACE SENVAGE DISPOSAL SYSTF-M INSPEC—TIO FOIZ�I F RS T C /� // SYSTEM T FOR IATIO�v Property address: /� l�/�lei v17le a1c G01- , Owner: lTga/Thcrew 0 7^ius Bate of Inspection: FLOW CONDITIONS RESIDENTIAL Nu.- ber ofbedrooms(design):4�O NUmber of bedrooms(actual): �O DESIGN 1ov:based on, 10 C_N/Tc 15.20= (for examp�: 110 pd x_of bedrooms):LZ Lf L/0 1 \'umbor of current residents: Does residence have a carnage erin-'er;yes or no):/t/O Is laundry on.a separate sewage system ryes or no 0 .•es separate ins echo..requ_reci] Laundry system inspected(yes or no): Xa Seasonal use: (yes or nc):If--4 Water meter readings; if available (last 2 years usage(v~'d0: Sump pump (yes or no): Last date of occupancy: C'u f/'f"7 C0.NT7VIERCI_ 1./'NTDU,S T RI.4L Type of establishment: Design flow(based or.310 CNIR 15.203): cpd Basis of design low(seats./perso s!sgft;etc.)' Grease trams Preserit(yes or no):— Industrial waste holding tank-present(yes or no):_ Non-sanitary waste discharged to the Title S system(yes or no):_ Water meter readings, i f available: Last date of occu-_narcyiuse: OTHER(describe): GE�� 41INFOR;oizTION Pumping Records Source of information: IX as system pumped as part of tic inspection(yes or no):A If yes,volume p-?mped: gallons--How was quantity pumped de e:mined' Reason for pumping: TY"�' OFSYSTEM _Septic tarik; distribution bo;i. soil absor-otion systen7 _Single cesspool Overflow cesspool _—Pri.v _ aced system(yes or no) (i::es; attach previous ins_Deci on-,cords, i`aPV" IT technology. Attach a copy of he Curren ope-a on and rri n-marls_, con. a_- + obtained from system owner) r —Tight tan'_- _Attach a copy of the DEP approval —Other(describe): Approximate age of all cornponents. date ins lied Of Icio«._; nd s ay e of uiio area: _ O Were sew-age odor; detected when arriving at the site(}%e,- or.-Iol. Pace "i of 1 l O>„FICIAL E SFECTIOIa� FORINI-SOT FOR VOLU-NT_ Y ASSESSMENTS SUBS RI FACE SEWAG—F DISPOSAL SYSTEINZ IN SPE CTION FORM PART A li'7 C, SY ST'E! UNTORMAT'ION(continued) Property Address: 02 �oC G/ v/Ae, ` �[- �/� aoni Da60/ j Otis ner: // �✓T"i o/ on p 717;�N r Bate ofInspection: L1` 09 l £ETILDIN'G SEWER(Ioocate on site plan) Depth below grade: J // Materials of construction._Cast irOP_ ?V 4'C of ner(explain): Distance from private water supply well or suction line: _ Comments(on condition of joints; ventinc, evidence ofl'�akage, etc.): i SEPTIC TASK: _��Cocate on site plan) Depth below grade: / 6 Material ofconst_uction: -/c —metal metal tiberglass_pol��ethylene 1 _ other(explain) If tank is metal list acre:_ Is ace conflr_r_ed by a Cer-ificate ofConxnliance(yes or no : —(a ach a cep, of certificate) Q Dimensions: ! 000 k v, 65700 �''�,�i4 ST (A N/7L ^� !a I Sludge depth: I'. Distance from top of sludge to bottorn of outlet tee or baffle: S� Scum thiclmess: 0—%'/ !/ Distance from top of scum to top of outlet tee or baffle: Dis ante from bottom of scam to botto of outlet tee or ba-M)- Ho�'«�ere dimensions determine o/e �v�� Comments (on pumping recOIPmendatlors,inlet ari ouilet tee or baffle coIlcMion;st,aCtilra!P.Iten l ,, JiOUi !ev,-1z as re tcd to outlet invert. evidence of lea'-age etc):� / V -1 CC 4 y �H C.h / !GGy H! �h ✓tV A/'Ce G �� _ 'eGr�✓'G GREASE TRAP:& (locate on site plan) Depth below grade:— t ; Material of construction:_concrete_metal_fibe-class polyethylene otheT (explain): Dimensions: Scum thiciciess: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bo-.iem of outlet tee or bar.---.- Date of last pumpin?: Comments(on pumping recornir_endar,'ors, inlet and outlet tee or baffe cons on s uc_,,-?; as related to outlet invert, evidence of leakage, etc.): t 4 1.E' III i Page 8 of 11 P 1 , if 11 OFFICIAL INNSPECT' ION FORM--NOT FOR N7OLUN'T ARY ASSESSMENTS SUBSURFACE SEWAGE DISPO ;, S:�I. S�STE�IIN�,, FC'TION FORM 1 P AH.1. L. SYSTEM INFORMATION ;continued} Property Address: 1� 912 66, /0- 'JG'G r✓C, Q� H Ni 0/.1GO/ Owner: ��ic✓ Gam.nt r' ✓iolce GonNo f-�4s� Date of Inspection:_ p TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan') Depth below grade: Material of cons r_action: concrete metal f ce glass po"�7cthvlene ot7er(explainl: Dimensions: .5 Capacity: ?allons Design glow: gallons%day ' Alarm present(yes or no): Alarm level: Alarm in yr r (ye_s o- a orxtz_order _no): Date of last pumping: t Comments(condition of alarni and float switches,e.^.): DISTRIBUTION BOX: /I/ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments (note,i box is level and disc iburon to outlet_equal; am, eLider_ce o: solid:: carrvover. anv evidence of leakage into or out of box, etc.): �r PL1TP CHAie'IB-c-I'.: �ocat,.on site plan) Pumps in workina, order(yes or no): v ! f Alarms in working order(yes or no): Comments (n e condition.of pu 7p chamber, condition of pumps and' appy��ena cgs. etc.): - �^i/J5 �n G a:./Grr�rS /�r_c E4sG! C o-ti �,��v Ji�� a F 1 �+ s ;• Page 9 of 11 I: OFFICIAL 1- SPECTIO--N-' FOR.-11--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL ,SY,STE-I ItiSPECTIiOIN FORN'I PART` C /SYSTEM INFOR -TATIO\(con-inued) Property Address: Q2 /� C�� e ��c 4 a vti / O��O O � wner: a `�i�s Date of Inspection: !jI ii I SOIL ABSORPTION SYSTEM (SAS), _(locate on site plan,excavation not required) s If SAS not located expia_n why: i. j Tape leaching pits; number.: _ leaching chambers, number: leaching galleries, number._ aclZing trenc lies. number, length: (/ leachi g fields, umbc--1 di nens.ons: 02 o>C/00 overflow cesspool; number: innovative/alternative system Tv 'name of techmolcg}~ Colrurnents (note condition of soil signso^f hydraullcc�failure. level of pondina, damp soil_. condition of 5 .e_etatie^. 01/ h it CESSPOOLS: A (cesspool Kau St be pu_r_ped as part, of i-:spectio:_)(locate.on Site plan, is Numbe_and cor_fi`,uration: Depth— top of hquid to inlet invert: Depth o solids layer: Depth of scum.laver; Dimensions of cessnvo-: Mi aterials of consiracdoi:: _ indication of groundwater in ov:(yes or no): Co=ents (note condition of soil, signs cfhydraulic failure.; level ofponding, condition of:-e_etation. etc,is t PRIvY:koocare on site plan) �l -Materials of const-.action: ' I! Dimensions: a Depth of solids: t Comments (note condition of soil; signs of hydraulic failure, level of ending,~condition o-VeEeaa-_-,n.- - , 's t, r li .�Z J NFORMI-NOTIFORV W-AR-Y SYS- s zK-2 T C H 0 F- s E v k G E. sip f? 4- 1 r-A ----------------4 pg.! Paae 11 of 11 ,I OFFICIAL INSPECTION FORM—NOT FOR V'OLU:N°T ARY ASSESSMENTS SUBSURFACE SEV AGE DISPOS-kL SYSTEM INSPECTI07N FOR I F F.- IlkR_t C. SYSTEM INF01R—NIATION(cunt Trued) Property Address: � �`- /G '�V/ vtir O«ner:Date of of Inspeetion: SITE EXANT Slope Surface water Check cellar Shallow wells Estimated depth to grou-nd:eater feet. t Please indicate(check) all me _^.ods used to detenni-ne the h-�-,h ground Ovate eleva^on: t Obtained from system design plans on record-1f che-l:ed, date of design plan reviewed: O rued site(abutting proper-v/observation hole� i '_ir_ 150 feet of SAS) ( .,Decked wit local Board ofHea!&,expiain: (G 7 t ,.7 C ueCk nits R)cal excavators. costa ler5 (a ac h d^CLI TleIltat1 Il) Accessed L.-SGS database-t-xp'_a n: -- I You must describ hovti you estaEisbed the high Grou1n nwater ete ration: ✓ 4 C- c. rc�, —L� �!2Y i� 4 t f 1• E � Y• r 6 JC ENGINEERING, Inc. Civil & Environmental Engineering n�7 2854 Cranberry Highway East Wareham, 1 Massachusetts 02538 Ph. 508-273-0377—Fax 508-273-0367 February 2, 2004 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 i f RE: 272 Craigv1lle Beach Road, SEPTIC AS-BUILT j To Whom It May Concern: We have conducted various inspections at the above referenced property and have prepared a Septic "As-Built"plan based on the inspections. Based on our inspections the system ,,as constructed in accordance with the design plans and the "As-built"plans reflect the actual constructed locations and elevations. Additionally, the pumps, alarm, controller and pressurized field was inspected and it was found that they where working properly and that adeauate pressure is being distributed throughout the field. ` Any further information required, please contact our office. Sincerely, 7 �. � v r John L. Churchill, Jr., P.E. President Copy: Mir. Dennis Cotto L r r COMMONWEALTH OF MASSACH(TSETTS ExEcIJTrVE OFFICE OF ENVIRONMENTAL AFFAIRS Y t d DEPARTMENT OF ENVIRONMENTAL PROTECTION e� OqM SY0„ // -e ��/Gr C Co�►c" O TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEMS FORM PART A CERTIFICATION Property Address: aL / GlGo 1 v./161, /12 ti C Owner's Name: �7qc,� ore�� T��oote <onc�o �ias� Owner's Address: o O _ Date of Inspection: O Name of Inspector: lease print) R e^ r- e Company Name: ✓v/0 — —g-G 4z -- Mailing Address: ® O of " Telephone Number:6,L0 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the 14o tionreported below is true,accurate and complete as of the time of the inspection_The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15340 of Title 5(310 CIMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature Date: ota) The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of health or DEP)within 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 DEP.Theoriginal should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 J i Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARYY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION FORM PART A /� CERTIFICATION(continued) Property Address: 02 / r�,<v��e &c,c 4 Rd 14 Odb0/ Owner: 7?'e s Date of Inspection: MW,0 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A.�ysPasses: e not found any information which indicates that any of the failure criteria described is 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B, / _{ System Conditionally Passes: ,/1/ 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. Answer yes,no or not determined(Y;N,ND)in the for the following statements.If`riot determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is rent System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 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 ND explain: Page 3�of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSP"N-TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAR71 A /� CERTIFICATION(continued) Property Address: � /C2 GSAP lG ei Rd re ya, aaZ 6 6�1 Owner: -A o ✓�S Date of Inspection:_ O C. Further Evaluation is Required by the Board of Health: h/ Conditions exist which require fii ther evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of health determines in accordance with 310 CAM 15303(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or pri .is within 50 feet of a 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,safety and 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 SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form_ 3. Other: r Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECT-10N]POI PART A CERTIFICATION(continued) Property Address: / 2 lG i 41e dew c Ad Owner: AAtV1 v P/ Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No/ _ " ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or —ieiogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ uid depth in cesspool is less than 6"below invert or available vohme is less than'h day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number �f times pumped y portion of the SAS,cesspool or privy is below high ground water elevation_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. r/ portion of a cesspool or privy is within a Zone 1 of a public well. _ ✓ ' portion of a cesspool or privy is within 50 feet of a private water supply well.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.[This system passes if the well water analysis, performed at a DEP certified laboratory,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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] �O(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. 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) es no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—rWPA)or a snapped Zone II of a public water sulrply well If you have answered"yes"to any question in Section E the system is considered a significant drreat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL, INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPEC-nON FORM PART B CHECKLIST Property Address: c2 /n 6 d G i P i Ye- 4.,c A dqc-J Gp�vrn . Oo16 0/ Owner: Date of Inspection: Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes o /Pumping information was provided by the owner,occupant,or Board of Health _ Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? � Have large volumes of water been introduced to the system recently or as part of this inspection? a/ Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components,excluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of thebaffles or tees,.material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Z_ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Existing information.For Example,a plan at the Board of Health_ _�_ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CM R 15.302(3)(b)] r Page b of 11 OFFICIAL., INSPECTION FORM-NOT FOR VOLUNTARY ASSESSME TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C; SYSTEM INFORMATION Property Address: (�?U &.y XC'j /� a•') of _ 0.2 6 0/ Owner• //��✓f�0 ®' �'�S Date of Inspection: 9 � 0 FL, W CONDITIONS RESIDENTIAL, Number of bedrooms(design): 4/0 Number of bedrooms(actual): DESIGN flow based on 310 CINM 15.203(for example: 110 gpd x##of bedrooms): l7 Number of current residents: e + Does residence have a garbage grinder(yes or no): Is la-ondry on a separate sewage system(yes or no):/�� [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no):&t2 Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): /f�V Last date of occupancy: � COtNMERCIAI J11NTDUSTRL A-L Type of establishment: Design flow(based on 310 C1d1R 15.203). gpd Basis of design flow(seats/persons/sgfl,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL.INFORMATION Pumping Records J Source of information: a 0 ��°e Was system pumped as part of the inspection(yes no : If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TY/E OF SYSTEM Septic tank, distribution box,soil absorption system _Single cesspool _Overflow cesspool Privy hared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of a 1 components,date 'installed(if known)and sour of orrr�tio�; 900 o/ CPr� Ze - b ki n�Pr Were sewage odors detected when arriving at the site(yes or no):*0 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT'S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ry SYSTEM INFORMATION(continued) Property Address: (P- / d, Crf a-�2-�t�lle— &,,-1, 9d Qn0+-f 7", 0�2L®1 Owner: /V� w 01�+i /erg c Date of Inspection: 9a/o BUIELDING SEWER(locate on site plan) Depth below grade:�� Materials of construction: r/cast iron _<O PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_" (locate on site plan) Depth below grade: e� Material of construction:_concrete_metal_fiberglass polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 7000 AK Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle. 60 Scum thickness:Ze S Distance from top of scum to top of outlet tee or baffle:3S Distance from bottom of scum to bottol}of outlet tee or bale: How were dimensions determined: re le— 941 et ce- Comments(on pumping recommendations,inlet and oudet tee or baffle condition,structural integrity,liquid levels as rel ed t outlet invert,evidence of leakage,etc.): _ ®7�� An, 1", o ��.��, - /�!P -¢eel r� �a.. J®, `o� ww t� I'1m a 4-he, 41~' GREASE TRAP: /! (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass polyethylene_other (explain): Dimensions: 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: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8,of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISP®SAL SYSTEM INSPECTION FORM FART C SYSTEM INFORTMATI®N(continued) ]Property Address: C2 9d, Cia, V�& �eu uA ad �/-1 Oa6O/ Owner: //7e.w ef;K� a f�or►lo Date of Inspection: 9 o?d o TIGHT or HOLDING TANK: tank must be pumped at tim of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(expiain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:kif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: '— "'-C Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): L/ PUMP CRAM]BER: (locate on site plan Pumps in working order(yes or no): Alarms in working order(yes or no):._d� Cownents(note condition of puQmpa chamber,condition of pumps and appuVmmces,etch: I Cr®®CA Taal_ G T—____�__ T+ i•. �•........ Q Page 9'of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: C� 7'�' cra vill gG4a, //!! "U _ Dc��O/ Owner: f�.,z,i-A, Te✓� Co,• Date of Inspection: �e�a�o SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not repaired) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: � eaching trenches,number,length: leaching fields,number,dimensions: 02 3® Ix V0 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.): 04 ® p ra e,• �G r �- 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 layer: 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.): 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 vegetation,etc.): Pagge 10 of 11 OFFICLAL INSPECT ION F)ORI—NOT FOR V®I_.$1J'$' Y SESS ,NTs SUBSURFACE SEWAGE DISPOSAL SYSIEIM DiSPEC9no FORM PART C SYSTEM LN-FORIMMO (cam Property Address-Own /�G w�e�: �� Date of Inspection: 9 da 1®2 SKEICH OF SEWAGE IDISPOSAL.SYSTEM Provide a sketch of the sewage disposal system icludmg ties to at least two pemamat refizeme, €9' benchmarks_ Locate all wells within 100 feet.Lomk where public waka seemly S tlw Wig_ .T-. Cleo` ALL ifte4�.L Cres ava ! � s�fv-Ftc, T��Iy 9(,V0 4-11.., `��¢ �✓ 4 s ld /6 < � t 4 B 9 77 a i } .i t!, (�o ,7O )L /o 0 I �r Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C n SYSTEM INFORMATION(continued) Property Address: /� 61Q :i� Owner: G t✓4 8.� 7-z!/'/`-G Co-rJe 7,i-,yL Date of Inspection: old SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water/a 6 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must de scribe owou established the ' h gro nd water a vation: JC ENGINEERING, Inc® Civil & Environmental Engineering 2854 Cranberry Highway East Wareham,Massachusetts 02538 Ph. 508-273-0377—Fax 508-273-0367 February 2, 2004 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: 272 Craigville Beach Road, SEPTIC AS-BUILT To Whom It May Concern: We have conducted various inspections at the above referenced property and have prepared a Septic "As-Built"plan based on the inspections. Based on our inspections the system was constructed in accordance with the design plans and the"As-built"plans reflect the actual constructed locations and elevations. Additionally,the pumps, alarm, controller and pressurized field was inspected and it was found that they where working properly and that adequate pressure is being distributed throughout the field. Any further information required,please contact our office. Sincerely, John L. Churchill, Jr., P.E. President Copy: Mr. Dennis Cotto 'THE Town of Barnstable �Op tp� y�P ti� Regulatory Services saxxsrnaLe, ; Thomas F. Geiler,Director 9$ 039. ••� Public Health Division ATEo N►ar" Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. 44 Commercial Street TOWS; Of B; ► OLLAA 027677005 rr APR _7 TMA8�880-0233 Fax: (508) 880-7232 April 4, 2005 . _. __.DIVISION Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST® Treatment System Serial Number: 8048 Attached please find the Field Inspection& Service Report for services performed on 03/28/2005 at the property of Hawthorne Terrace Condominiums located at 272 Craigville Beach Road -Hyannis,'MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Hawthorne Terrace Condominiums Massachusetts DEP Massachusetts Department of Environmental Protection Bureau of Resource Protectlonf Tit 5rn Y ,W aR , rpt,,y 't 4 }DEP Approvedlnspection and O&M Form for Title 5 I%A ir � + za`:s? � x Ra � xnrnirz� x cw4 may, v: Treatment" D sposal Systems " . ,.z 4863 A. Installation ; Important: Hawthorne Terrace Condominiums When filling out Owner forms on the computer,use 272 Craigville Beach Road only the tab key Facility Street Address to move your Hyannis 02601 cursor-do not use the return City Zip key. Mailing address of owner, if different: P.O. Box 488 Street Address/PO Box: West Hyannisport MA 02672 City State Zip (508-790-4109 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information 8048 Bio-Microbics, Inc. MicroFAST FAST 4.5 DEP ID Manufacturer's Name&ID Model Name&Number 12/31/2003 Installation Date Start of Operation Approval Type: X General _Provisional _Piloting _Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 03/28/2005 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc•4/4/05 Page 1 of 2 f Massachusetts Department of Environmental Protection Bureau of Resource #e V; - DEP A }:� " "r. �� k :,,�f pproved Inspection and 0&M Form-for Title 5 I/A � �o ; •:r:•.• ' Al :.'s� S a �. . t,. r s i''' h. .,.Treatment and Disposal Systems } :.��x, ${tA��,� -4863 M E. Sampling Information Samples Taken:_Influent _Effluent Parameters sampled:_pH_BOD_TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: Also tested: , , , . Pump counts -#1 - 16.61; pump#2- 16.13. F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Michael Dillen 03/28/2005 Operator Signature Date System owner must submit this report, technology 0&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting & Provisional Use- General Use—by September 31't of each year for the within 30 days of inspection 301h of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc•4/4/05 Page 2 of 2 h INCORPORATED 8450 Cole Parkway w Shawnee, KS 66227 a;Phone 913-422-0707 m Fax: 912-422-0808 4863 . e-mail: onsite 0biomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT - For Bio-Microbics Single Home FASTO System INSTALLATION AUTHORIZED SERVICE PROVIDER .3 272 Craigville Beach Road Installation Address Hyannis,MA 02601 Name Wastewater Treatment Services,Inc. Owner Name Hawthorne Terrace Condominiums Street Mail Address: Mail Address 44 Commercial Street P.O.Box 488 Raynham, MA 02767 . West Hyannisport,MA 02672 City State Zip 508-880-0233 508-880-7232 Phone 508-7904109 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out FAST 4.5 8048 12/31/2003 -E UIPMENT YES IN.O MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow Condominiums H Standard Units Color N/A Temperature Odor None Comments: Pump counts-#1 -16.61;pump#2-16.13. TECHNICIAN SERVICE DATE Michael Dillen 03/28/2005 r � c Ot+rrlaMs N+ AIeT►tland EJarcel9(Herrin Run Place) System Location 19S C„Rouie I (Hering,tun) HcmeAddt 1g -O,,Route,m4 g Town Bsin t blo Clty State 73k Marstorm MNts,;MA 026d9 DEP File No, Phone System Type 0MNI RSF Biiling Address J PO.PO.i Box 1404 Contract Terms Life of'Ownershlp Ci ^Suite, i'- .'M rston Mills,MA 02649 Contract Start: 11/01/04 NOTE pMNI EnvirsihrnenteJSystems shall riot be responsible for any misuse or Improper operation bynoh omnipersonnel or the system owner,atJt!any opeCaHan NQ,,,in!accordance with the OMNI RSF System Owner's and Operator's Manual., TeE' and Agreement for Standard and Preventative,Maintenance lnnavative/Alternative Technology O Vttati>istrdres��au pT dulFat+atiN r tarrdard anst-Preventative Maintenance for the OMNC-Recirculaft Sand Filter. Ilsted.at tFielabove addiress fot fhe+coritracf period'specified above under"Contrast terms". This agreement may-be, terminated or e�ctetlitBdb thes stem owner b rovidin OMNi Y Y A g Env ym 1).tth 30 da sironmental Sstes, nc(QMN ., r notice 6f infeM OMNIwdl-provide the system owner with thirty(30)days written notice.of its changes to the,currerif pricing i;chf3dule, :rtf to system oWnelr wjh clot be obli.gated.to renew contract in the event of arty pricing changes OMNh will be;ob!lgated to provi�te aii,prepaid services in the event of any pricing changes:' a reementwill ir�lr��le qual This agre.,ement consists of all Standard,and Preventative.Maintenance listed in the Owners and Operators Martial this- This rteriy,inspections as required by the Department of.Enulronmental Protection(QEP):-it lithe respdnsibity��of the+sy, +sm-owner to supp'Iy•any local or state septic system approvals andlorconditions to OMNI This agreentertt.inctiudearOutine maintenance Inspections and does not include costs occasioned by neglect,misuse and accident-or consurneblies;.This agreement does not include travel costs for.the Islands and eny locations outside a 20. mite radius of Ea61Fa1n1o. uth, This agreement DOES NOT COVER ANY TESTING/SAMPLING KEQUIREMENTS:F: In;cansiderafion ofthe.setvices contalried in this agreement the-system owner agrees to pay OIUINi`Envtronmentai' Systems,Inc the sucispecified ln.the payment options section for the above maintenance agreement one prepayment. . bask,.Frayment is 04o flfte_on(1Sir days from Invoice Date prior to execution of,services and will be subject.to any 'applicable late chorges;•Monthly,poyees are excluded from prepayment requirements.? Thisag��ant is ttotosaiig�ndble by.eithex party and Is non-refundable for any prepaid services This.agreement wtllnote. so$IVe nail itle.flrst payment as outlined below has been received by OMNI Environmental Systems,Inc" i Ifthe termsarad•cs E#tions contained herein,including the terms and conditions set-forth on th4 enclosed docuir ent�ation' fitledTE'R ANlDtbN6J'f1ONS,a're'acceptable,kindlysign and return one(1)copy of this contragf along with the frrst,`� . prepaid:payment,.-RioprtaeraJoo!d�ind'agreedthat the foregoing,-including ONDIT _IC�NSsetforthwilf constitute the foil between ther parties to this agreement r of OMNI The undersigned agreesao the following payment schedule'., r-", _ at any.'. date- the sole option The contract xpi rtyt(30}days.from the date hereof,but may be accepted 1. Select m tlpg by,I lowatkin a ro JO box. See Terms and.Conditions for details on ` e ts•o t a. a erat-Ci"` imst ,. P, M th $10 qs' r 1&5 Se i�.nn al 5, i r The above.Costs, Project$cope'of Work,'terms and conditions are satisfactory and'are hereby accepted,:f 1 is. ,. hereby authorized t praVidt3 the services as specified, Author nt.f�iame=(pwr�e� •System piune �S,g1�W, 10a' Aiteri7rAVF Septic:Technology Manufactul intn,? „ Contract for Sampling (Testing) Services D: rr : Owners Name Normand Barcelou Project Name ROUTE149_195C BARNSTABLE Home Address P.O.Box 1404 System Location 195-C Route 149(Herring Run) City,State Zip Marstons Mills,MA 02648 Contract Start 1/12008 Contact Name Normand Barcelou Contract Terms 2 Years v Phone 508-428-3575 Sy stem Type OMNI RSF Notes NOTE:OMNI Environmental Systems shall not be responsible for any misuse or improper operation by non-omni personnel or the system owner,and any operation NOT in accordance with the OMNI RSF System Owner's and Operator's Manual. Terms and Agreement for Sampling Services Innovative/Alternative Technology OMNI is hereby authorized to render sampling(testing)services for the Innovative/Altemative Technology listed at the above address for the contract period specified above under"Contract Terms". This agreement may be terminated or extended by the system owner by providing OMNI Environmental Systems, Inc(OMNI)with 30 days written notice of intent. OMNI will provide the system owner with thirty (30) days written notice of its changes to the current pricing schedule. The system owner will not be obligated to renew contract in the event of any pricing changes. OMNI will be obligated to provide all prepaid services in the event of any pricing changes. This Contract DOES NOT INCLUDE any Standard and Preventative Maintenance,costs occasioned by neglect;misuse and accident or consumables, and any travel costs for the Islands or locations not within a 20 mile radius of East Falmouth. This Contract DOES NOT COVER ANY OPERATION AND MAINTENANCE SERVICES. This Contract includes quarterly samples tested for Total Suspended Solids(rSS),Nitrate Nitrogen(NO3-N),Total Kjeldahl Nitrogen(rKN),Nitrite Nitrogen(NO2-N),Biochemical Oxygen Demand(BOD),and pH by a Commonwealth of Massachusetts certified laboratory. In consideration of the services contained in this agreement the system owner agrees to pay OMNI Environmental Systems, Inc. the sum specified in the payment options section for the above referenced sampling contract on a prepayment basis.Payment is due fifteen(15)days from Invoice Date prior to execution of services and will be subject to any applicable late charges. Monthly payees are excluded from prepayment requirements and must contact OMNI for account setup. This agreement is not assignable by either party and is non-refundable for any prepaid services.This agreement will not become effective until the first payment(outlined below)has been received by OMNI. If the terms and conditions contained herein,including the terms and conditions set forth on the enclosed documentation titled TERMS AND CONDITIONS,are acceptable,kindly sign and return one(1)copy of this contract along with the first payment. It is understood and agreed that the foregoing, including the TERMS AND CONDITIONS set forth will constitute the full and complete agreement between the parties to this agreement. The contract offer expires thirty(30)days from the date hereof,but may be accepted at any later date at the sole option of OMNI. The undersigned agrees to the following payment schedule: Select payment option below by marking appropriate box. See Terms and Conditions for details on eff ments o ors. Payment Options: 1 $39 Monthl (save$32) $135 Quarter) ❑ $260 Semi-Annual $500 YearlylE The above costs,terms and conditions are satisfactory and are hereby accepted. OMNI is hereby authorized to provide the services as specified. Author' e N FldrsoWnel Date r ?_Z [SIGN AND RETURN THIS COPY] Print Name(Owner) System Owner Signature to Alternative Septic Technology rt3nuldr;turing • Testing • Maintenance 4 ISMUADWATER {. ANALYTICAL loolrgajhie Ch Omsk f,c.rd,'ID: FIR'C fvtairiit: AquboiCt. Rrole.Ct., QMi'li Envl dhMeAW SYA6nts,Inc. Rfttii-.�Vd: i2 Y:74447e15 C)ierre OMNl Enrrtonmeplal 5y;tetTts Lab tDr 122419.-03. Sampled:, 12-17-08 11-00 Cmtsiner.-.:500 raL Plask Preservation'.. Cool ;�tealyte RourC Clntts 1i1 bFT!4�1! plus Nltrrte(as NrtE[i n) 32o5 inI 13 t.r.as 2o�z6 rlaa97 1._._....... ....._-.._.._._. ---- :$:1it pr4d 12 1 y 0$i 3 i10. ca,raincr 51t CnC`Platis rPS .efi4rl CboC Analyte Result'• Units i�C 1JIF vof"rice 3!(If 4:,! WNW: i 1 Nitrogen,Tntaf.Kjeldahl(TKNj t.5 mg/C 0.5 I 10 mL 13:2't-01s 5100 TKN-25�t11N 'A;;,'� 'rr 1 jR ` I. Lai 1:0; 12 419-,1R Sampled 12 17 08 13 Q0 Paxatgrr 11 Plasttc T PreseNaltAh:dal: hnalyte ttesult- T Urjts ii Ufotume A. ;' n BrOchetni(al Oxygen Oetnand BRL mg/l 3 200A t2a7Aa22:ao t+OR9 o 1Y 3142104 •3. xC Solids Total Suspended. BR1. _ rnA/I. 7 , sop mt iitaolsL9)9 7sti+tS.66Aw W254an ..__......._...._........_........ _._.. _._ PH 6.0 pH NA I 50m1 12170422.15 P,{1691•W $M4500Fd.p ,2 KG t Methtid Referehi:e: Mettfrjtr*v fdrt tleRtieal'Apalysiy pl.'Wpter'a.nd Wastes,lJS EP 1.EWA<60Afd-7r1U U10'(R�vige'i :ty(i}J'Aj1if M�pfoEtS toY"tltd Qeteamination 6f Inorganic Substances in.Environmental Samples,U.S EPA.;F.PA/600/R-9;I/1.00(:1993),and 5iandard' Methods:for'the Exarnination of Water arrii:Wastewater.APWA,Twentieth Edit(on(19991;,and teaMathods.:Cur.Evatuating r-: Solid WSste,:US';EPA,SW*846,Third Edlifon,Update W(1990). Report Notations: -ARL. Inditates epnCentration;i1 any tsbelow reportin limit(or:arralyte: Reporting IrnkIs the Ip .aonbrrriration"ihet n e 1 �i4l ry qulitilrllsd under rout ne labortGyry oper tifigtOndit 0ris. Reporting li itsr4re:4djiSs"(ar Ofiplt+�S dfr dillt[oil: . i; RL Report ng.,Urnit. [)F Dil.utrwt Factor. 1 tnstrumenl:ID: LachatAQ0 Autoartalyzer 2. Inifiru er)(ICY. AefumetP.R50 3 (hbiN nerWIQ: YSj 5:1- is 4 InslromentID: MettlerA7.200 8alanee r 4 l i I r i GrriundwamrAnilytical, Inc., P-0, Box 1200, 228 Main Street;BLIzz Fds Bay;:MIA,Q?$32 Rage-7 Gf 1 ......:................................................ 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 January 7, 2005 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST® Treatment System Serial Number: 8048 Attached please find the Field Inspection& Service Report(as required) for services 'performed on 12/23/2004 at the property of Hawthorne Terrace Condominiums located., at 272 Craigville Beach.Road -Hyannis, MA7 Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Hawthorne Terrace Condominiums Massachusetts DEP Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 2835 A. Installation Important: Hawthorne Terrace Condominiums When filling out Owner forms on the computer,use 272 Craigville Beach Road only the tab key Facility Street Address to move your Hyannis 02601 cursor-do not use the return city Zip key. Mailing address of owner, if different: _Q P.O. Box 488 Street Address/PO Box: West Hyannisport MA 02672 City State Zip (508-790-4109 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Joan Peterson 9166 Certified Operator Name Certification Number C. Facility/System Information 8048 Bio-Microbics, Inc. MicroFAST FAST 4.5 DEP ID Manufacturer's Name&ID Model Name&Number 12/31/2003 Installation Date Start of Operation Approval Type: X General _Provisional _Piloting _Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 12/23/2004 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc-1/7/05 Page 1 of 2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 2835 E. Sampling Information Samples Taken:_Influent _Effluent Parameters sampled:_pH_BOD_TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection & during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: Also tested: , , , . F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Joan Peterson 12/23/2004 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting & Provisional Use- General Use—by September 31 sc of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc•1mo5 Page 2 of 2 f f. 1 i I NCORPORATED 8450 Cole Parkway m Shawnee, KS 66227 m Phone 913-422-0707 m Fax: 912-422-0808 2835 e-mail: onsite(ftiomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 272 Craigville Beach Road Installation Address Hyannis,MA 02601 Name Wastewater Treatment Services,Inc. Owner Name Hawthorne Terrace Condominiums Street Mail Address: Mail Address 44 Commercial Street P.O. Box 488 Raynham, MA 02767 West Hyannisport,MA 02672 City State Zip 508-880-0233 508-880-7232 Phone 508-790-4109 Fax e-mail Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out FAST 4.5 8048 12/31/2003 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow Condominiums H Standard Units Color N/A Temperature Odor None Comments: TECHNICIAN SERVICE DATE Joan Peterson 12/23/2004 t as r � ' 44 Commercial Street JVY- Raynham, MA E 1 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 October 6, 2004 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST® Treatment System Serial Number: 8048 Attached please find the Field Inspection& Service Report(as required) for services performed on 09/23/2004 at the property of Hawthorne Terrace Condominiums located at 272 Craigville Beach Road -Hyannis, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Hawthorne Terrace Condominiums Massachusetts DEP LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 2835 A. Installation Important: Hawthorne Terrace Condominiums When filling out Owner forms on the computer,use 272 Craigville Beach Road only the tab key Facility Street Address to move your Hyannis 02601 cursor-do not use the return City Zip key. Mailing address of owner, if different: Dennis Cotto, President Street Address/PO Box: Hyannis MA 02601 City State Zip (508-790-4109 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Joan Peterson 9166 Certified Operator Name Certification Number C. Facility/System Information 8048 Bio-Microbics, Inc. FAST 4.5 DEP ID Manufacturer's Name&ID Model Name&Number 12/31/2003 Installation Date Start of Operation Approval Type: X General _Provisional _Piloting _Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 09/23/2004 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc-10/6/04 Page 1 of 2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 2835 E. Sampling Information Samples Taken:—Influent _Effluent Parameters sampled:_pH_BOD—TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate,and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Joan Peterson 09/23/2004 Operator Signature Date System owner must submit this report,technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting & Provisional Use- General Use—by September 31"of each year for the within 30 days of inspection 30`h of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc-10/6/04 Page 2 of 2 MWIMCORPORATED 8450 Cole Parkway m Shawnee, KS 66227 m Phone 913-422-0707 m Fax: 912-422-0808 2835 e-mail: onsite _biomicrobics.com w www.biomicrobics.com @ 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION. AUTHORIZED SERVICEP.ROVIDER 272 Craigville Beach Road Installation Address Hyannis,MA 02601 Name Wastewater Treatment Services,Inc. Owner Name Hawthorne Terrace Condominiums Street Mail Address: Mail Address 44 Commercial Street Dennis Cotto,President Raynham, MA 02767 Hyannis,MA 02601 City State Zip 508-880-0233 508-880-7232 Phone 508-7904109 Fax e-mail Phone Fax e-mail INSTALI.`ATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out FAST 4.5 8048 12/31/2003 E UIPMENT -§Fp + ., s YES ;ff.N0 m MAINTENANCE:'PERFORMED AND COlvilvfENT.S,d Electrical Panel(s) Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow Condominiums H Standard Units Color N/A Temperature Odor +--gone— Comments: TECHNICIAN SERVICE DATE Joan Peterson 09/23/2004 4 -i /'VQ6%EC(JCLf,P/`'✓/'P.CII/17,e/lli JP/YlLCe6', �2G. P �'� 44 Commercial Street v��` Raynham, MA 02767 _ OCi21'Q4 �� 0 O Q H METER I G X Barnstable Board of Health 200 Main Street Hyannis, MA 02601 L��.�'.v:i 'a^i. 'v,rye. ti y: lIIFi 1311iii lliFtl}}}}Ffl�il}fl�lflil-liffSf lil!-IF7}�1Fiiil Flil !t ! (fill 21 11) 11 1 11 11111 fii! its i rii ti F F ifiiS i • P fS ,ftk" SIMPLE SEAL OLD COLONY ENVELOPE I P i i I RE(;EIVED 44 Commercial Street Raynham, MA 02767 JUL 13 2004 f Tel: 508 880-0233 (TOWN OF BN RNS DEFT BLE Fax: (508) 880-7232 HE July 8, 2004 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention:-, Health Agent:—,- Reference: Single Home FAST® Treatment System Serial Number: 8048 Attached please find the Field Inspection& Service Report(as required) for services performed on 06/28/2004 at the property of Hawthorne Terrace Condominiums located at 272 Craigville Beach Road -Hyannis, MA. Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Hawthorne Terrace Condominiums Massachusetts DEP Massachusetts Department of Environmental Protection aureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 2835 A. Installation Important: Hawthorne Terrace Condominiums When filling out Owner forms on the computer,use 272 Craigville Beach Road only the tab key Facility Street Address to move your cursor-do not Hyannis 02601 use the return city Zip key. Mailing address of owner, if different: Dennis Cotto, President Street Address/PO Box: Hyannis MA 02601 City State . Zip (508-790-4109 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip (508)—880-0223 ext. Telephone Number Joan Peterson 9166 Certified Operator Name Certification Number C. Facility/System Information 8048 Bio-Microbics, Inc. FAST 4.5 DEP ID Manufacturer's Name&ID Model Name&Number 12/31/2003 _ Installation Date Start of Operation Approval Type:X General _Provisional _Piloting _ Remedial Seasonal Residence—used less than 6 mo./year:_Yes X No D. Operating Information 06/28/2004 Inspection Date Previous Inspection Date 'Sludge Depth(to be checked yearly) _ Pumping Recommended Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc•7/8/04 Page 1 of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 2835 E. Sampling Information Samples Taken:_Influent _Effluent Parameters sampled:_pH_BOD_TSS_TN—Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: F. Certifica tion I certify: I have inspected pected the sewage treatment and disposal system at the address 9 p d ess above have Y completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Joan Peterson 06/28/2004 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting & Provisional Use- General Use—by September 315t of each year for the within 30 days of inspection 30`h of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 61h Floor Boston. MA 02108 DEPMicroFASTnew.doc•7i8/04 Page 2 of 2 l � Q I NCORPORATED 8450 Cole Parkway w Shawnee, KS 66227 Phone 913-422-0707 m Fax: 912-422-0808 2835 e-mail: onsite(Wbiomicrobics.com w www.biomicrobics.com M 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER 272 Craigville Beach Road Installation Address Hyannis,MA 02601 Name Wastewater Treatment Services,Inc. Owner Name Hawthorne Terrace Condominiums Street Mail Address: Mail Address 44 Commercial Street Dennis Cotto,President Raynham, MA 02767 Hyannis,MA 02601 City State Zip 508-880-0233 508-880-7232 Phone 508-790-4109 Fax e-mail I Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out FAST 4.5 8048 12/31/2003 EQUIPMENT YES NO MAINTENANCE PERF0RN ED AND COMMENTS. ," Electrical Panel(s) Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow Condominiums H Standard Units Color N/A Temperature Odor None Comments: TECHNICIAN SERVICE DATE Joan Peterson 06/28/2004 44 Commercial Street Raynham, MA 02767 2QQ4 Tel: (508) 880-0233 fax: (508) 880-7232 OF BARNSTAgLE 4 March 5, 2004 rOWNEALTH DEFT Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: 'Health Agent Reference: Single Home FAST® Treatment System Serial Number: 8048 Attached please find the Field Inspection& Service Report(as required) for services performed on 03/04/2004 at the property of Hawthorne Terrace Condominiums located at 272 Craigville Beach Road -Hyannis, MA. I' Please call if you have any questions or require additional information. Sincerely, Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Hawthorne Terrace Condominiums Massachusetts DEP I d Massachusetts Department of Environmental Protection , Bureau of Resource Prot®coon . .� � �� <�; DEP A .rovetl°Ins action rantl 0&MForm for Title pp. p o_ .; Treatment an`d Di sposal Systems y 2835`� s A. Installation Important: Hawthorne Terrace Condominiums When filling out Owner forms on the computer,use 272 Craigville Beach Road only the tab key Facility Street Address to move your Hyannis 02601 cursor-do not use the return city Zip key. Mailing address of owner, if different: 1/ Dennis Cotto, President Street Address/PO Box: Hyannis MA 02601 ' City State Zip (508-790-4109 ext. Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 . City State Zip (508)—880-0223 ext. Telephone Number Michael Dillen 11173 Certified Operator Name Certification Number C. Facility/System Information 8048 Bio-Microbics, Inc. FAST 4.5 DEP ID Manufacturer's Name&ID Model Name&Number 12/31/2003 Installation Date Start of Operation Approval Type:tX.General _Provisional _Piloting _Remedial Seasonal Residence—used less than 6 mo./year:_Yes X;No D. Operating Information 03/04/2004 Inspection Date Previous Inspection Date 11 Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No Color: N/A Odor: None Effluent Description DEPMicroFASTnew.doc•3/5/04 Pagel of 2 Massachusetts Department of Environmental Protection f »` .Vh �a Bureau ofResQurce Protection -Title 5� aai r.�,�r, '� h, p`?""`�Y ..,.,. .. �at�, y ��.'�: •.."� i4 t '� i � A` DEP Approved Inspection and 0&M Form for:Title�5 r . Treatment and Disposal Systems . °Y R ,.2835 r E. Sampling Information Samples Taken:_Influent _Effluent Parameters sampled:_pH_BOD_TSS_TN_Other(list below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter,,,Splash Recycle, Notes and Comments: F. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate,and complete as of the time of the inspection. 'I"am`a Massachusetts certified operator in accordance with 257 CMR 2.00. Michael Dillen 03/04/2004 Operator Signature. 9 Date System owner must submit this report, technology 0&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting & Provisional Use- General Use—by September 31 st of each year for the within 30 days of inspection 30th of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston. MA 02108 DEPMicroFASTnew.doc•3/5/04 Page 2 of 2 t � Yi*c�', 8450 Cole Parkway Shawnee, KS 66227 Phone 913-422-0707 Fax: 912-422-0808' 2835 s> ' e-mail: onsite(cDbiomicrobics.com www.biomicrobics.com 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System INSTALLATION AUTHORIZED SERVICE PROVIDER - 272 Craigville Beach Road Installation Address Hyannis,MA 02601 Name Wastewater Treatment Services,Inc. Owner Name Hawthorne Terrace Condominiums Street Mail Address: Mail Address 44 Commercial Street Dennis Cotto,President Raynham, MA 02767 Hyannis,MA 02601 City State Zip 508-880-0233 508-880-7232 Phone 508-7904109 Fax e-mail I Phone Fax e-mail INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out FAST 4.5 8048 12/31/2003 3. EQUIPMENT- YES''. ;„`_NO MAINTENANCE.PERFORMED"AND COMMENTS Electrical Panel (s)_ R,+ Visual Alarm Operating X Audio Alarm Operating X if resent Blower(s) Air Inlet Filter Clean X Blower Hood Vents Clear X Excessive Noise X Excessive Vibration X Treatment unit(s) Unusual Odor Pum out Required: X Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT Estimated Daily Flow Condominiums H Standard Units Color N/A Temperature Odor None Comments: - TECHNICIANI SERVICE DATE Michael Dillen 03/04/2004 JC ENGINEERING, Inc. Civil & Environmental Engineering 4 0 2854 Cranberry Highway East Wareham, Massachusetts 02538 Ph. 508-273-0377—Fax 508-273-0367 February 2, 2004 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: 272 Craigville Beach Road, SEPTIC AS-BUILT To Whom It May Concern: We have conducted various inspections at the above referenced property and have prepared a Septic "As-Built"plan based on the inspections. Based on our inspections the system was constructed in accordance with the design plans and the"As-built"plans reflect the actual constructed locations and elevations. Additionally, the pumps, alarm, controller and pressurized field was inspected and it was found that they where working properly and that adequate pressure is being distributed throughout the field. Any further information required, please contact our office. Sincerely, John L. Churchill, Jr., P.E. President Copy: Mr. Dennis Cotto w JAR SALES A SERVICE, INC. January 12, 2004 Hawthorne Terrace Condominiums Dennis Cotto, President 272 Craigville Beach Road Hyannis, MA 02601 Dear Hawthorne Terrace Condominiums: We at J&R Sales and Service, Inc. would like to thank you for ordering the FAST Wastewater Treatment System, Enclosed for your records is a copy of the fully executed Inspection & Effluent Testing Agreement as well as a copy of the Product Registration Report. Should you have any questions or require additional information please do not hesitate to call. Sincerely, JameS.R. Dunlap President Enclosures V 44 Commercial st. a Raynham,MA 02767 9 'iela;508.82.19500 HAWTHORNE TERRACE CONDO Fax 608,800.7232 P.O. SOX 488 W. HYANNISPORT, MA 0:672 Sip 16 03 12: 50p 508 880-7232 p . 2 `lPa��.tewa&r Treatin elz t_.1ef'urr.ew,, ,/rro. 44 Commercial Street Plcasc comptcle all sterns marked' Raynham, AAA ncluding three signatures. Mail 02767 signed uriginal curivact Ur Wastewalcr Treatment Scrvices,Inc. 44(arnmerc al Straet Tel: t508 880-0233 ftharn.M 1 027(7 Fax: (508) 880-7232 INSPECTION AND EFFLUENT TESTING AGREEMENT Agreement entered into by and between Wastewater Treatment Services,Inc. (herein called WTS) and the FAST"'System OWNER(herein called OWNER) for the inspection by WTS of certain equipment of OWNER which is described below. Upon acceptance of this agreement:at WTS's office, WTS will render the following services only: k,:q+uipment will be inspected_a.t..leas:t4.tithes per year that this Agreement remains in effect, with the first inspections beg:nnmg Zyn, ,. These inspections will include.: 1) 'testing of the sludge depth in the septic tank. 2) Take amperage and voltage readings, change oil, grease blower, check belts,check air pressure, air scour uni±, check airlift, check recycle line, and clean replace intake filter of air blower. 3) Inspection of the alarm system. 4) Inspect over-all condition of Modular FAST*System. S) Notify OWNER of any problems encountered. 6) Invoicing; on a quarterly basis for testing only to be paid within 30 days from date of invoice. Annual maintenance cost to be paid in full upon acceptance of this agreement. 7) Must receive a signed purchase order from OWNER prior to any work being performed other than that cover by this Inspection Agreement, Service other than routine maintenance will be billed at an hourly rate plus travel and material. w , WTS shall notify the local board y nt health and Department of lrnv lrotatnctstal Ptotcetiatt in writing within 24 hours of a qv-stern failure or alarm event including corrective rveasures that have been taken. OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional Iabor time will be billed to the OWNER at standard labor rates of$74.00 per hour. Errergencv service between regular inspections will be provided at standard labor rates during normal buslness.l•iours;,at time and one-half after 5:00 pm artd on Sacurduys; and at double 1imc.on Sundays and holidays. Emergency s,ecvicg charges will include a minimum four(4)hours of labor, plus standard WTS charges for parts,plus mileage and travel charges. The annual rate includes routine maintenance, but does not include repairs required for damages caused by abuse, accident, theft, acts of third persons, forces of nature, or alterations made to the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes, labor disputes, non-cooperation by OWNER, or other factors beyond the control of WTS. OWNER understands and agrees that WTS is not responsible for special, incidental or consequentialdamages, including loss of time. injury to person or property, or equipment failure. OWNER agrees that WTS may enter ONVIlER's property and have acceptable access to all areas deemed by WTS to be necessary or appropriate for WTS to perforrn its duties hereunder. HAWTHORNE TERRACE CONDO P.O. SOX 488 W. HYANNISPORT, MA 02672 Sep 16 03 12: Sop S08 880-7232 p. 3 This is a two-year contract which will be billed annually. All failure co pay invoices promptly ur to otherwise comply with thisy ontractrmay res It in non-refundable. O'on of's service, cancellation of contract and/or nullification, of warranties, at the election of WTS. This agreement is not assignable without the consent of WTS and will remain in force until This by either party through written notice, MANUFACTURER MOD- EL NO, SE L NO. (3io-11�Iicrobics Modular FAST 4.5 LOC� ATIUIY &N—WUA1, RA TE d 1f Hyannis, MA $1,200.00 EQUIPMENT OWNER ' S Jc'��''/ /��1�" Wastewater Treatment Services I_n_e. 'Signed by OWNER: Ha vthome.Terrace CotfdPininiums-Dennis Cotto SigneQr Address:272 Craigville Beach Road44 Cacial Street Raynham, MA 02767 Tele: (508) 823-9566 *City: State: Zip: Fax: (508) 880-7232 Hyannis MA 02601 "Telephone 508-790--4109 — Effective Date of Agreement—a J1 0-3 Daytime Telephone. OWNER understands that: 1 oand is f the non-refundable; and 2 Current law requires O nt is for one year only of this hvo=year agreement ANNUAL RATE payment WNER to maintain a service agreement for the life AST®Systern. I' READ AND UNDERSTAND THE FOREGOING. *Signed by OWNNER: '' �_ Effluent Testing Effluent sample taken 0 times per year and delivered to a qualified testing lab for evaluation. Results sent to State and local Agencies as well as the OWNER. OWNER is responsible for providing acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed. PERMIT: *(PLEASE CHECK-ONE) - - (-?� )GENERAL PROVISIONAL *SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTHH((Y) or(N) if YES MEDLkL )pleease attach co of permit copy ( ) pH, BODS, TSS ( ) TKN, Ammonia, Nitrate, Nitrite O Other- *Cost for testing: No Testing Operator assigned: William Everett Telephone: (508) 400-3 *Engineer: John Churchill HAWTHORNE TERRACE CONDO P.O. 13OX 488 W. HYANNISPORT, MA 02672 HAWTHORNE TERRACE CONDO Q P.O. BOX 488 461 W. HYANNISPORT, MA 02672 M 1 I C 0 R F OR A T 1 0 8450 Cole Parkway u.Shawnee, KS 6.6227 ■ Phone 913-422-0707 rm Fax: 912-422-0808 e-mail: onsite(ZDbi6rtiicrobic&com n www:biomicrobics;com a 800-753-FAST(3278) PRODUCT REGISTRATION REPORT Product Registration Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty. Date of Start-U J) '43 Date Shi ed to End User 12/21/03 Serial# 8048 OWNER NAME Hawthorne Terrace Condominiums ADDRESS 272 Crai ville Beach Road CITY/STATEIZIP Hyannis,MA 02601 PHONE/FAX ;BIO-MICROBICS DISTRIBUTOR NAME Wastewater Treatment Services,Inc. ADDRESS 44 Commercial Street CITY/STATEIZIP Ra MA 02767 _ PHONE/FAX 508-880-0233 FAX: 508-880-7232 :INSTALLER NAME Robert Our&Co. ADDRESS 24 Great Western Avenue CITY/STATE/ZIP N. Harwich,MA 02645 PHONE/FAX, 508432=0530 a CONSULTING ENGINEER if a " liCable NAME John Churchill ADDRESS 2854 Cranbegj Highway CITY/STATEIZIP E. Wareham,ILIA 02538 PHONE/FAX 508-273-0377 Good Bad NA Good Bad NA ELECTRICAL PANEL(S) TREATMENT UNIT(S) Visual Alarm Operating ❑ ❑ Air vent clear ❑ Audio Alarm Operating. ❑ [� Septic tank level ❑ BLOWER(S) Septic tank meets min. size �V Wired for correct voltage ®' ❑ Septic tank filled to ❑ operating level Inlet/outlet piped correctly ❑ Air Lift Operation ❑ Filter element installed Recirculation tube in place ®/ ❑ Blower hood secure Fasteners tight �/ ❑ Bower works correctly. WATER-TIGHT JOINTS Blower located within 100' of (lam ❑ ❑ Treatment unit to septic tank ❑ treatment unit Air line clear ❑ Entrance tube to insert cover �.• ❑ ❑ Air inlet screen clear ❑ Insert to insert cover L�/ ❑ Blower hood vents clear Discharge line connection ❑ Factory Authorized Personnel: Title. Firm. Wastewater Treatment Servic s Inc. Date:-14T1 7 Sep 16 03 12: 50p 508 880-7232 p. 2 44 Commercial Street Please complete all items marked Raynham, MA including three signanrres. Mail 02767 signed original cutilraLt to: Waste Water rreatrnent Services,Inc. 44 Commercial Strccl Tel: (508) 880-0233 Raynharn,Mn 02767 Fax: (508) 880-7232 INSPECTION AND EFFLUENT TESTING AGREEMENT Agreement entered into by and between Wastewater Treatment Services,Inc. (herein called WTS) and the FAST'System OWNER(herein called OWNER) for the inspection by WTS of certain equipment of OWNER which is described below. Upon acceptance of this agreement:at WTS's office, WTS will render the following services only: Equipment will be inspected at least 4 times per year that this Agreement remains in effect, with the first inspections beginning Za-3i-6.3 . These inspections will include: 1) Testing of the sludge depth in the septic tank. 2) Take amperage and voltage readings,change oil, grease blower, check belts,check air pressure, air scour unit, check airlift, check recycle line, and clean/replace intake filter of air blower. 3) Inspection of the alarm system. 4) Inspect over-all condition of Modular FASTO System. 5) Notify OWNER of any problems encountered. 6) Invpi,cing=on-a-quarterly_bas-is for testing'only-to=be paid;wi thin 730:days-from-date-cif-in voice? Annual maintenance cost to be paid in full upon acceptance of this agreement. 7) Must receive a signed purchase order from OWNER prior to any work being performed other than that cover by this Inspection Agreement. Service other than routine maintenance will be billed at an hourly rate plus travel and material. WTS shall notifythe local board of heat and Department of Environmental Protection in writing within health tg P 24 hours of a system failure or alarm event including corrective measures that have been taken. OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional labor time will be billed to the OWNER at standard labor rates of$74.00 per hour. Emergency service between regular inspections will be provided at standard labor rates during normal business hours, at time and one-half after 5:00 PM and on Saturdays, and at double time on Sundays and holidays. Emergency service charges will include a minimum four(4) hours of labor, plus standard WTS charges for parts,plus mileage and travel charges. The annual rate includes routine maintenance, but does not include repairs required for damages caused by abuse, accident,theft, acts of third persons, forces of nature, or alterations made to the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes, labor disputes, non-cooperation by OWNER, or other factors beyond the control of WTS. OWNER understands and agrees that WTS is not responsible for special, incidental or consequential damages, including loss of time, injury to person or property, or equipment failure. OWNER agrees that WTS may enter OWNER's property and have acceptable access to all areas deemed by WTS to be necessary or appropriate for WTS to perform its duties hereunder. Sep 16 03 12: 50p 500 880-7232 p. 3 This_is,a-two=year'doniract:which will be billed annually. All payments are non-refundable. OWNER's failure to pay invoices promptly or to otherwise comply with this contract may result in suspension of service, cancellation of contract and/or nullification of warranties, at the election of WTS. This agreement is not assignable without the consent of WTS and will remain in force until canceled by either parry through written notice. MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE Bio-Microbics Modular FAST 4.5 41 Hyannis, MA $1,200.00 EQUIPMENT OWNER4 Al5 Wastewater Treatment Services Inc. 'Signed by OWNER:, ' Hawthorne Terrace CoYdominiums-Dennis Cotto Signed *Address: 272 Craigville Beach Road 44 Co ercial Street Raynham, MA 02767 Tele: (508) 823-9566 *City: State: Zip: Fax: (508) 880-7232 Hyannis MA 02601 g *Telephone 508-790-4109 Effective Date of Agreement-Yd Daytime Telephone OWNER understands that(1) ANNUAL RATE payment is for one year only of this two-year agreement and is non-refundable; and(2) Current law requires OWNER to maintain a scrvice agreement for the life of the FAST®System. I READ AND UNDERSTAND'THE FOREGOING: *Signed by OWNER:, Effluent Testing Effluent sample taken 0 times per year and delivered to a qualified testing lab for evaluation. Results sent to State and local Agencies as well as the OWNER. OWNER is responsible for providing acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed. PERMIT: *(PLEASE CHECK ONE) ( X )GENERAL ( ' )REMEDIAL; O PROVISIONAL *SPECLAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y) or(N) if YES, please attach copy of permi t ( ) pH, BODS, TSS ( ) TKN, Ammonia,Nitrate,Nitrite ( ) Other: UDC ost for testing, No Testing Operator assigned: William Everett Telephone: (508)400-3868400-3868 *Engineer: John Churchill A Ain INSP 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 January 12, 2004 JAIL 1 3 2004 [TOWN OF BArZtl:;TABLE HEALTH DEFT. Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Board of Health Agent Reference: Home FAST Treatment Serial Number: 8048 Attached please find a copy of the Product Registration Report for the FAST Treatment System for work performed on 12/31/2003 at the Hawthorne Terrace Condominiums located at 272 Craigville Beach Road, Hyannis, MA. Also, attached is a copy of the fully executed Inspection &.Effluent Testing Agreement's If you have any questions or require additional information please do not hesitate to call. Sincerely, Donna L. Callahan Enclosures COM111 I INCORPORATED 8450 Cole Parkway ■ Shawnee, KS 66227 ■ Phone 913-422-0707 ■ Fax: 912-422-0808 e-mail: onsite(a-_biomicrobics.com ■www.biomicrobics.com ■800-753-FAST(3278) PRODUCT REGISTRATION REPORT Product Registration Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty.. Date of Start-Up J) '3 Date Shipped to End User 12/21/03 Serial# 8048 OWNER NAME Hawthorne Terrace Condominiums ADDRESS 272 Crai ville Beach Road CITY/STATE/ZIP Hyannis,MA 02601 PHONE/FAX BIO-MICROBICS DISTRIBUTOR NAME Wastewater Treatment Services,Inc. ADDRESS 44 Commercial Street CITY/STATE/ZIP Raynharn, MA 02767 PHONE/FAX 508-880-0233 FAX: 508-880-7232 � .,-INSTALLER' '.' "r NAME Robert Our&Co. ADDRESS 24 Great Western Avenue CITY/STATE/ZIP N.Harwich,MA 02645 w. PHONE/FAX 508-432-0530 CONSULTINGENGINEER if a licable NAME John Churchill ADDRESS 2854 Cranberry Highway CITY/STATE/ZIP E. Wareham,MA 02538 PHONE/FAX 508-273-0377 Good Bad NA Good Bad NA ELECTRICAL PANEL(S) TREATMENT UNITS) Visual Alarm Operating (� Q Q Air vent clear Q Audio Alarm Operating or Q Q Septic tank level Q BLOWER(S) Septic tank meets min. size Q Wired for correct voltage 17' Q Septic tank filled to Q operating level Inlet/outlet piped correctly 6a' Q Air Lift Operation �' Q Filter element installed Q Recirculation tube in place Q/ Q Blower hood secure Q Fasteners tight Q/ Q Blower works correctly ( Q WATER-TIGHT JOINTS Blower located within 100' of ( Q Q Treatment unit to septic tank [ Q treatment unit Air line clear Q Entrance tube to insert cover Air inlet screen clear [ Q Insert to insert cover �/ Q Blower hood vents clear [ — Q Discharge line connection [� Q Factory Authorized Personnel: Title: Firm: Wastewater Treatment Services, Inc. Date: J t, Massachusetts Fire Incident Report Hyannis Fire Department Date of Time Of Arrival Time In FDID Incident No. Exposure #. Incident Day of week Call Time Service 0 192 2 1 A231208 1 � 11 /17 Monday 2� 1 1 :0 4 11 : 13 11 :40 Address Zip Census Tract 2 7 2 Craigville Beach Road lWest Hyport 5 0 Type of Situation Found Type of Action T en Mutual Aid 40 Hazardous Cond., Not 4 0 3 Investigation Only0 Classified Fixed Property Use Ignition Factor "7 Through 20 Units." 4 2 3 00 No Fire Found Occupant Name Occupant Telephone Ha:vthorne Terrace Condo. Trust Owner Name Owner Address Owner Telephone Same I Same Method Of Alarm Shift No Of Alarms # of Personnel Responded LHaardous1 Telephone 1� © ® erialsEngines Tankers Aerial Other Vehicles esent 001- 000 000 001 Yes _- .Fire Service _. - _- .. _ -- _- . _ Other_.Injuries In'uriest.y 0'0 0 '_" "Fatalities' 0.0 0 Injuries 0 0 0 Fatalities' O O O P° Rescues 0 0 0 - _ 0 .-Mobile Property Use -� Is Car Insurance Company Mobile Property Make Year Model Color License Number .VIN 0 0 0 Complex Area Of Origin Estimated Loss Equipment Involved In Ignition Form Of Heat Of Ignition 0 0 If Equipment Was Involved In Ignition Material Ignited Year Make Model Equipment Serial Number 0 Method of Extinguishment Level Of Fire Origin Number Of Stories 0 0 '-Construction Type Detector Performance Sprinkler Performance Extent Of '-Fla-me _- _ _- _ Smoke Material'Generating Moot Smoke Type Of Material Generating Most Smoke Avenue Of Smoke Travel Weather Conditions Commanding Officer C.I.e.ax.................................................................. F Lt Knowlton Report By JU Knowlton HYANNIS FIRE DEPARTMENT - INCIDENT REPORT Y. COMMENT PAGE .Incident No. A231208 Address 272 CRAIGVILLE BEACH ROAD Date of Report 1 1 /1 7/2003 ommanding Officer Lt Knowlton Report By JU Knowlton We received a call from the Robert B. Our Company (508-432-0530) reporting that one of their crews dug up an abandoned underground oil tank at 272 Craigville Beach Road. They reported that the tank was leaking. I responded on 822 with FF P. Cabral and FF Hanson driving. Arrived on location and met with the crew on site and found, what we believed to be, a 500 gallon, steel, fuel oil tank resting on one end in an area where this company was performing sewer system replacement. The area is located south of the parking area for the property and is within 100 feet of Craigville Beach Road. The members of the crew positioned the tank as so to minimize the leak and plugged two holes on the tank and the leak had stopped when we arrived. There was a strong odor of fuel oil in the area and the tank was over 50% full. 806 arrived on location. I requested a representative from the Town of Barnstable Health Department at 1116 hours and David Stanton arrived at 1130 hours. The site Project Manager, Bill McMann, from Robert B. Our Company had already called Enviro-Safe Corporation (508-888-5478) from Sandwich to perform the cleanup operations. Their ETA was 30 - 45 minutes. Mr. Stanton will remain on scene until Enviro-Safe arrives and he assures that they will perform the proper cleanup procedures and permitting process. 822 secured the scene at 1140 hours and arrived back in quarters at 1147 hours. Richard A. Knowlton, Lieutenant Health Complaints 20-Nov-03 Time: 11:30:00 AM Date: 11/17/2003 Complaint Number: 17167 Referred To: DAVID STANTON Taken By: DENISE WITTER Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE Article X Detail: Business Name: Hawthorne Terrace Condos Number: 272 Street: Craigville beach Road Village: HYANNIS Assessors Map_Parcel: 267-073 Complaint Description: Robert Our was digging for a new septic system, when they found an old old tank. The oil tank is leaking. Actions Taken/Results: DS WENT TO SAID LOCATION. THE TANK WAS TILTED UPRIGHT TO REDUCE LEAKING, WITH STICKS IN HOLE TO STOP THE LEAK. ENVIROSAFE CAME AND PUMPED OUT THE REMAINING 168 GALLONS LEFT IN THE TANK. IT WAS PROBABLY A 500 GALLON TANK. DS CONTACTED DEP (MIKE MORAN (508) 946- 2855) AND WAS GIVEN RELEASE TRACKING NUMBER 4-18130. TODD EVERSON OF BENNETT O'REILLY ARRIVED FOR THE LSP. ROBERT OUR BEGAN REMOVING SOME OF THE CONTAMINATED SOIL LATERALLY. SAMPLES WERE TAKEN, AND THE CONTAMINATED SOIL WAS PILED AND COVERED WITH POLY. AWAITING 2 WEEK LAB ANALYSIS. 0. Investigation Date: 11/17/2003 Investigation Time: 11:35:00 AM 1 I PART VII: NUISANCE CONTROL REGULATIONS SECTION 2.00 NUISANCE CONTROL REGULATION NO. 2(SOURCES OF FILTH) ADOPTED 8/19/86, EFFECTIVE DATE 9/25/86 4GFTME fps * 1ARNSfABLE.p 9 MA&W.039. 0 $ArFD MA'S A�� Town of Barnstable Board of Health NUISANCE CONTROL REGULATION NO.2 (SOURCES OF FILTH) In accordance with the provisions of Chapter 111, sections 31 and 122, of the General Laws of Massachusetts and for the protection of public health, the Town of Barnstable Board of Health adopts the following regulation after a public meeting of the Board of Health on August 19, 1986: Every owner, or agent, of premises in which there are private sewers, individual sewage disposal systems, or other means of sewage disposal, shall keep the sewers and disposal sewage systems in proper operational condition and have such works cleaned or repaired at such time as ordered by the Board of Health. Sewage disposal works shall be maintained in a manner that will not create objectionable conditions or causes the works to become a source of pollution to the waters of the Commonwealth. No sanitary sewage shall be allowed to discharge or spill onto the surface of the ground or to. flow into any gutter, street, roadway, or public place, nor shall such material discharge onto any private property. Any person in violation of this regulation may be fined twenty-five (25.00) dollars. Any person who fails to comply 'with an order issued pursuant to this regulation, shall be fined twenty-five (25.00) dollars. Each separate day's failure to comply with an order shall constitute a separate violation. This regulation is to take effect on the date of publication of this notice. Robert L. Childs, Chairman Ann Jane Eshbaugh Grover C. M.Farrish,M.D. 68 f 'Sr, 5 � 0 L. Old le-i f7hMnurn�TejrMCe // r/ OhG�Uf i��eNKi1nq Oi T�✓tK, �27..2 �v,Ile r�w�tor,�e TQf/'hce �c,�cs. 11/1742003 _ IAP790 32 14, k. q?.z c rv��.11P He Zpr,ct a,Kof �I/ 7�a'Io 3 cw . Inn,) r� ►.� 1 e�� <,,k 72 (J..7"h 4mw��-n.e Tefrr,ce (vi,rXuS },c;w tGrJIP T�(1hCt Lo,c�as. /I//71a043 J *t ti f}N 71TfrNcc (d�Kof I1'►7laUo COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE 20 RIVERSIDE DRIVE, LAKEVILLE, MA 02347 508-946-2700 MITT ROMNEY ELLEN ROY HERZFELDER Governor Secretary KERRY HEALEY ROBERT W.GOLLEDGE,Jr. Lieutenant Governor Commissioner URGENT LEGAL MATTER: PROMPT ACTION NECESSARY CERTIFIED MAIL December 23,2003 Dennis Colto,President RE: BARNSTABLE-BWSC Hawthorne Terrace Condominium Assoc.,Apt#5 Hawthorne Terrace Condominium Assoc. 272 Craigville Beach Road 272 Craigville Beach Road Hyannis,MA 02601 RTN#4-18130 NOTICE OF RESPONSIBILITY M.G.L. c. 21E,310 CMR 40.0000 ATTENTION: Mr.Dennis Colto,President On November 17, 2003 at 12:10 PM the Department of Environmental Protection (the "Department")received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property, which requires one or more response actions. An estimated seventy-five (75)gallons of#2 heating oil leaked from an abandoned underground storage tank(UST)to the surrounding soil. At the time of the release, approximately one hundred and fifty(150) gallons of product remained in the abandoned tank. The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan (the "MCP"), 310 CMR 40.0000, require the performance of response actions to prevent harm to health, safety, public welfare and the environment which may result from this release and/or threat of release and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. The Department has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. The Department also has reason to believe that you (as used in this letter, "you" refers to Hawthorne Terrace Condominium Association) are a Potentially Responsible Party (a "PRP") with liability under M.G.L. c.21E §5, for response action costs. This liability is "strict", meaning that it is not based on fault, but solely on your status as owner, operator, generator, transporter, disposer or other person specified in M.G.L. c.21E §5. This liability is also "joint and several", meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. This information is available in alternate format.Call Aprel McCabe,ADA Coordinator at 1-617-556-1171.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep Z�� Printed on Recycled Paper . ..�1 2 The Department encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials.By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by the Department in taking such actions. You may also avoid the imposition of,the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L. c.21E is attached to this notice. You should be aware that you may have claims against third parties for damages, including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. The Department encourages you to take any action necessary to protect any such claims you may have against third parties. At the time of oral notification to the Department,the following response actions were approved as an Immediate Response Action(IRA): • Removal of all oil within the abandoned Underground Storage Tank(UST). • Removal of the abandoned UST. • Excavation and disposal of up to eighty(80)cubic yards of contaminated soil. • All Remediation Waste must be properly stored/handled and disposed of within 120 days from the date of generation per 310 CMR 40.0030. ACTIONS REQUIRED Additional submittals are necessary with regard to this notification including,but not limited to,the filing of a written IRA Plan, IRA Completion Statement and/or an RAO statement. The MCP requires that a fee of$1,200.00 be submitted to the Department when an RAO statement is filed greater than 120 days from the date of initial notification. Specific approval is required from the Department for the implementation of all IRAs, and Release Abatement Measures (RAMS) pursuant to 310 CMR 40.0420 and 310 CMR 40.0443, respectively. Assessment activities, the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement. In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form (BWSC-103, attached) be submitted to the Department within sixty(60) calendar days of November 17,2003. You must employ or engage a Licensed Site Professional (LSP) to manage, supervise or actually perform the necessary response actions at this site. The Department has Dave Bennett, of Bennett and O'Reilly,Inc. listed as the License Site Professional of record. Unless otherwise provided by the Department, potentially responsible parties ("PRP's") have one year from the initial date of notification to the Department of a release or threat of a release,pursuant to 310 CMR 40.0300, or from the date the Department issues a Notice of Responsibility,whichever occurs earlier, to file with the Department one of the following submittals: (1) a completed Tier Classification Submittal; (2) a Response Action Outcome Statement or, if applicable, (3) a Downgradient Property Status. The i �v 3 deadline for either of the first two submittals for this disposal site is November 17,2004. If required by the MCP,a completed Tier I Permit Application must also accompany a Tier Classification Submittal. This site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c.21E and the MCP. If you have any questions relative to this Notice, please contact Michael Moran at the letterhead address or at(508)946-2855.All future communications regarding this release must reference the following Release Tracking Number: 4-18130. Very truly yours, Ibis ffnaf document copy is belng prodded to you eledtoniea4 by the Department of Eavimameatai Protection.A signed copy of tiffs dommeat is on fife at the DEP office Riled on the fetfethead. Richard F.Packard,Chief Emergency Response/Release Notification Section P/MRT/re CERTIFIED MAIL#7002 2030 0006 4994 9847 UThomas��ro�ran me1Bi�ClNot,��s1NQIZ�1,4�13� rai" olt4n Hawthori�-Z'er�r„CQnla'03�1�117d�e` Attachments: Release Notification Form;BWSC-103 and Instructions Summary of Liability under M.G.L.c.21E Department's guide to hiring a Licensed Site Professional. ec: Board of Health,health@town.barnstable.ma.us Board of Selectmen,council@town.barnstable.ma.us Fire Dept.,wajones@barnstablefire.org cc: Mr.Dave Bennett,LSP Bennett and O'Reilly,Inc. 84 Underpass Road Brewster,MA 02631-1667 1++ -I 1 1 No.`"'V✓ Fee 10 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: J Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS C 2pplication for Zigool by.5tem Con6truction Permit Application for a Permit to Construct( , )Repair( )Upgrade( V)Abandon( ) O Complete System El Individual Components Location Address or Lot No. �iOK'� T " �' Owner's Name,Address and Tel.No. Assessor's Map/Parcel �' S,, rflA O 3�01 t C CAW 1CG�'t'1 T-2i�V C� br Cj ' �-&j 1 —1 3 Installer' Name,Address, d Tel. o. Designer's Name,Address and Tel.No. o l�e�✓1- C c 4 t� c, �G f�,7-,et t�e�V ► y i t-\e Cvzirc_� � —'1 ti� t-Ea v wt c aM 1- o 4-,5 wQ-v U{- ,-, *A o a 5 v Type of Building: 'l, Dwelling No.of Bedrooms 4-0 Lot Size A7,W.0 sq.ft. Garbage Grinder( ) Other Type of Building Y-A0 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date—Tu-1L-1 -:�L-- Number,of sheets 01-- R6visiog Date Title �QC-1D+_C_ 1�3 v -v Size of Septic Tan1CS CCO S V—C(c� 000 �' Type of S.A. — >0, �U t —tCT Description of Soil " r G � 19 M t n/t Nature of Repairs or Alterations(Answe when applicable) I.TCANT MUST OBTAIN A SE Date last inspected: "' 4 t CONNECTION PERMIT FROM THE Agreement: �IGR ERMG DIVISION F2IORTO VOL)STRUCTION. 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�nd not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. CX, Signed Date I Application Approved by • .S FOR 7: Me 2 a N Date d Application Disapproved for the following reasons Permit No. Date Issued Z p3 11/ZS�3 of Barnstable tory Services F.Geiler,Director , a ealth Division McKean,Director et Hyannis MA 02601 1 , ``,Fax: 508490-6304 ,.I t December 31;2003. / �. � l� t'!4 A Jr. n `.,—.,♦ '' R.q, ' Y xS�,y.✓ `u— q VM x r �y' � ft ydE�•"" d' y �� w No. `/�,/`Y � Fee ,. THE COMMONWEALTH OF MASSACHUSETTS Entered in compute .._ Yes `•.i PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS. �r Zfpplicafion for Mi.9;po al 6p$tem Con!aruction Permit hcatton for a Petmrt to Construct( , )Repair( )Upgrade( )Abandon( ) O Complete System El Individual Components App ' etw fhcvne �e vvacc ��✓i ur w Location Address or Lot No. Owner's Name,Address and Tel.No. J a [ Cv.E,jv�ik 5ecu( vd , f �^ Assessor's Map/Parcel e ct',-A 0 4a 1_I C�C G�w �"fG✓n-r—T—e-N V SSGC ' 3 Installer's,N e,Address,and Tel o. Designer's Nme,Address and Tel.No. G i-S . (j J-- !a { c c E ne e r E✓ , r� tit 1-la Y �c�, rY1 A G 4 5 Eu s� �v,,-� G I-�a n-, , �Yl� o;� 5 3 Type of Building: Dwelling No.of Bedrooms Lot Size � G sq.ft. Garbage Grinder( ) Other Type of Building -tor 6 o No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow, gallons per day. Calculated daily flow gallons. Plan Date f LA-A L_, u-3 Number sheets 0-- Revision Date Y Title v� F Size of Septic Tan1_S9 C100 'S l6L-CO '� Type of S.A.S. � - �0L w Description of Soil '� � r G ! G�r1� � �r,LNG. i .4•.1� Lam— �. M i t rn Nature of Repairs or Alterations(Answer whea'applicable) F— SJ � YY12-mot� 9 f ^ era•„ "+, . . t 1 t t V[_y [,'(4 Date last inspected: " 41 05 t ,µ 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 nd not to place the system in operation until a Certifi- cate of Compliance has been issued by,this-Board of Health. Signed Date b 1 U Application Approved by �t ��•.. _ -,°' C f M, 0 t?/U Date Application Disapproved for the following reasons' Permit No. 2 OD 3- '73 Date Issued t --------------------------------------- m u c' If c c cc WC THE COMMONWEALTH OF MASSACHUSETTS 1"10 N i T-t,k,I NG. fit ! N BARNSTABLE, MASSACHUSETTS I LA ► - Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )b at - 2 ,( a a.tr has been constructed i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2C'6 3-5 78 dated [ 117 c I ' Installer Designer I The issuance(of this permit shall not be construed as a guarantee that the sys m wQ 1 functi -as designed. Date I I1�,�t� Inspector�� 'j CrJ r SU L v . No.20U s `760 ------------�'—-----------Fee �> THE COMMONWEAL '�.1ra $SACHUSETTS �C 9Ft��P�` U�,71;'�IJ 111�1�^Ar+r17 _,1i2 w[a3 ETA QI :a w�A C." A f%Ll1 IC=' R r , Mi�pogaf *p5tem Con0truction permit Permission is hereby granted to�Construct( ff)Repair( )Upgrade )Abandon( ) System located at 2 '7? -J rt. and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construc on m st be completed within three years of the date of this pec Date: I I Z`If U 3 Approved b - PP Y IMMEDIATE RESPONSE ACTION COMPLETION STATEMENT CLASS A-1 RESPONSE ACTION OUTCOME SUPPORTING DOCUMENTATION MA DEP RTN 4-18130 Hawthorne Terrace Condominium Association. ' #2 Fuel Oil Release 272 Craigville Beach Road Hyannis, MA 02601 ' Project#B003-3909 DECEMBER 22,2003 1O'REILLY Inc. ENNE� Tn , Engineering, Environmental & Surveying Services 1573 Main Street PO Box 1667 Sanitary 21E/Site Remediation Property Line Site Development Hydrogeologic Survey Subdivision r Brewster, MA 02631 ' Waste Water Treatment Water Quality Monitoring Land Court 508-896-6630 Water Supply Licensed Site Professional Trial Court Witness 508-896-4687 Fax BENNETT A O'REILLY, Inc. Engineering, Environmental & Surveying Services 1573 Main Street Sanitary 21E/Site Remediation Property Line PO Box 1667 Site Development Hydrogeologic Survey Subdivision Brewster, 02631 Waste Water Treatment Water Quality Monitoring Land Court S08-896-6630 Water Supply Licensed Site Professional Trial Court Witness 508-896-4687 Fax 1 B003-3909 IDecember 22, 2003 Richard F. Packard, Section Chief ' Massachusetts Department of Environmental Protection(MA DEP) Southeastern Regional Office(SERO) Bureau of Waste Site Cleanup, Emergency Response Section(BWSC/ERS) 20 Riverside Drive Lakeville,MA 02347 RE: IMMEDIATE RESPONSE ACTION COMPLETION STATEMENT CLASS A-1 RESPONSE ACTION OUTCOME HAWTHORNE TERRACE CONDOMINIUM ASSOCIATION #2 FUEL OIL- RELEASE-RTN#4-18130 - 272 CRAIGVILLE BEACH ROAD,HYANNIS,MA., 02601 Dear Mr. Packard, BENNETT & O'REILLY, INC., has prepared the following Immediate Response Action Completion Statement with a Class A-1 Response Action Outcome and Supporting Documentation as representing remedial response actions and environmental assessment activities conducted at the above referenced location,as consistent with the provisions of the 310 CMR 40.0427 and 40.1035 respectively. Remedial response actions were conducted to mitigate environmental and human health hazards associated with the release discovery of an unknown volume of#2 fuel oil from a 500 gallon Underground Storage Tank(UST). A 2-hr release notification condition was triggered based on a sudden release of more than-10 gallons of#2 Fuel Oil when the previously unknown vessel was inadvertently ruptured.during the course of septic system upgrade. The release was reported to the Hyannis Fire Department by the excavation contractor who subsequently made"notification to the MA DEP (SERO),Michael Moran. This report provides technical rationale and justification in support of a Class A-1;Response Action Outcome(RAO)Statement in accordance with the Massachusetts Contingency Plan(MCP) 310 CMR,Section 40.1036(l). The excavation of some 88.79 tons of contaminated soils to a depth of 13' (+/-) below ground surface (bgs), has effectively eliminated the source of #2 fuel oil contamination in soils and mitigated environmental impact. Laboratory results of petroleum concentrations in soil samples collected at the extent of excavation report concentrations Below 1 1 DECEMBER 22,2003 HAWTHORNE TERRACE CONDOMINIUM ASSOCIATION:B003-3909 PAGE 2 OF 6 IRAC/CLASS A-I RAO:RTN#4-18130 Detection Limits as consistent with concentrations expected of background and demonstrate a condition of"No Significant Risk"for human exposures and environmental hazards in accordance with 310 CMR 40.0970. As such,a permanent solution has been achieved in support of regulatory ' closure within the initial 60 day statutory deadline. This work has proceeded under my supervision in a manner consistent with the MCP Response Action Performance Standards, pursuant to 310 CMR 40.0191 and QA/QC policies of BENNETT&O'REILLY,INC. The facts and statements herein are,to the best of my knowledge, a true and accurate representation of the site activities,remedial response actions and environmental conditions associated with the project. ENVIRONMENTAL CONDITIONS [Refer to Appendix A] The Site, as shown on Hyannis Assessors Map 267 Parcel 73, is an approximately 1.5 acre parcel of land developed as a condominium complex[Refer to Figure 1]. The area and surrounding ' land consists of residential properties and a golf course. Access to the subject property is unrestricted with low frequency and intensity of use with respect to the area of impacted soil. The property is essentially flat with elevations ranging from approximately 35 -28'NGVD. Review of USGS topographic maps and regional groundwater contours indicate a southeasterly flow direction toward Hyannis Harbor [Refer to Figure 2]. Municipal water service is available to the surrounding area and there are no known potable wells within 500'of the subject Site. The depth to groundwater on the subject property was measured as being>20'below ground surface (bgs). The MA DEP,BWSC overlay for the GIS mapping program shows the subject Site as within the EPA Designated Sole Source Aquifer of Cape Cod [Refer to Figure 3]. Additionally the Site is within the DEP Approved Wellhead Protection Area(Zone 2). As such,the RCS-1 and Reporting concentrations as well as the S-land S-2/GW-1 and GW-3 Method 1 Risk Characterization iStandards are applicable to on-Site soil conditions.. BACKGROUND [Refer to Appendix B] Under round Storage Tank was ruptured upon On November 17, 2003 , a 500 gallong g p p discovery of the vessel by the excavation contractor during the installation of a leach field at the above referenced property. As a result of the rupture an unknown amount of#2 fuel oil was released from the vessel. The Hyannis Fire and Health departments were subsequently alerted to the presence of the release and reported to the property to assess Site conditions. Upon inspection of Site ' conditions the release was reported to the MA DEP by the Hyannis Health Department at which time the RTN#4-18130 was issued to the Site. BENNETT&O'REILLY,INC.,was contacted to make an emergency response to the Site on the date of release. Based on observations made by BENNETT & O'REILLY, INC.,personnel upon arrival,the MA DEP was contacted in order to obtain verbal approval for the removal of up to 50 yards of contaminated soils as authorization of an Immediate Response Action(IRA). I DECEMBER 22,2003 HAWTHORNE TERRACE CONDOMINIUM ASSOCIATION:B003-3909 PAGE 3 OF 6 IRAC/CLASS A-I RAO:RTN#4-18130 ' PRELIMINARY RESPONSE [Refer to Appendix B] On November 17, 2003,BENNETT& O'REILLY, INC.,personnel reported to the Site as ' part of an emergency response to the release. EnviroSafe Corp., was also on site to pump out the remaining#2 fuel oil and water from the tank. Approximately 156 gallons of#2 fuel oil and water was pumped from the tank prior to removal by EnviroSafe Corp. After securing a Tank Removal ' Permit from the Hyannis Fire Department,the tank was removed from the grave and transported off Site by EnviroSafe Corp., for scrap metal recycling. Upon inspection of the UST, once removed from the tank grave and cleaned, many quarter to dime size holes were noted along the bottom as ' being related to the corrosion of the vessel over time. Following the removal of the tank approximately 15 yards of impacted soils were excavated from the sidewalls and base of the former.tank grave. Soil samples were collected from the sidewalls and base of the UST grave. The samples were placed in a sealed 300 milliliter glass jar with an ' aluminum septum and agitated to develop organic vapors. The soil samples were then screened with a photoionization detector(PID) meter(HNU PI 101, 10.2 electron volt lamp)by"jar headspace" analysis, as consistent with MA DEP "Interim...Soils Policy" WSC-97-400. Based on field screening results it was apparent that the southern side wall(SW)and bottom of hole(BOH)within the excavation would require further soil removal. Soil samples were collected from the apparently clean northern, eastern and western sidewalls for confirmatory analysis. Additionally a Stockpile soil sample was collected and analyzed for Total Petroleum Hydrocarbons for disposal characterization for recycling at Aggregate Industries,West Dennis facility. Upon completion of the days' operations the excavation and stockpile of impacted soil were covered by polyethylene sheeting to prevent against the exacerbation of environmental conditions due to rainfall pending receipt of analysis and additional authorization. IMMEDIATE RESPONSE ACTIONS [Refer to Appendix B and Appendix C] On November 19, 2003, after approvals were granted by the Condominium Association to continue with excavation activities, Mike Moran of the MA DEP was once again contacted and approval for the removal of 80 yards total of impacted soil was.granted. As such, excavation activities were conducted.expanding the southern end of the excavation to an area approximately 12'W x 12'L x 13'D at which time field screening of Total Organic Volatile concentrations (<10 ppmv)indicated that the vertical and lateral extent of contamination had been reached..Endpoint soil samples were collected at the completion of excavation activities in an effort,to provide more definitive data for the purposes of estimating the extent of impact to surrounding soil.Based on TOV readings reported for the end point soil samples, the samples biased to have the highest TOV concentrations, SW-N 4-10' were submitted to Groundwater Analytical for analysis of EPH with target (17) PAH's and VPH with BTEX compounds. Similarly, the remaining samples were submitted for either EPH with target(17)PAHs or TPH concentrations as based on their respective TOV concentration as a cost saving measure. The balance of laboratory analytical for the endpoint soil samples,received on November 24 and 25, 2003, reported concentrations of all EPH with target (17) PAH's and VPH with BTEX ' DECEMBER 22,2003 HAWTHORNE TERRACE CONDOMINIUM ASSOCIATION:B003-3909 PAGE 4 OF 6 IRAC/CLASS A-1 RAO:RTN#4-18130 ' compounds and TPH concentrations as well below the applicable Method I S-I and S-2/GW-I and GW-3 Risk Characterization Standards. Based on the results of the compilation of endpoint soil samples,a condition of"No Significant Risk",has been established in conjunction to the discovery 1 of the#2 fuel oil release and the verbally reported 2 hour condition. A summary of analytical results reporting the endpoint soil samples is represented in Table I and Table II below. t s SUMMARY OF EPH and TPH.ANALYSIS FOR � � � �, {< � vMETHOD 1 RISK CHARACTERIZATION ;SOIL .; � + ' .NR''F �s t d'"S 3`' �'t^`a i" �-'`^"�.Wt,'.y "s'•'-,:�-` T�' x„-s ' �r Loeahoo/ I 4EPH .Ztargets_ x r An ' t.aI ' S1zSod Standard ,,ii S•2 Soil Standards *S 3 Sorl Standards t "`+' rr .'{r �a Ex os-@Fm6rnt m m � � g( FPS$PPS ) �x �p� and,Date MA1DEPMethod y„ 310 CMR 310 CMR40 0975(6)(b) 310 CMR 40 0975(6)(c)1: ,rs. 5 £r �t��4.srurk � r ''40 0975(6)(a) �GW3 'k tGW)/GW,3t �� 3"Y` 1.+'7 4.•i .�,� shl.tn 4`� k ' ?x iu y '� :.,•-" g r°s a `4.k+u ,. ...� ,�-"4r`P'9? w t +T` 3 1 - 'i� `2r' ,n°Ek'Tsrlsy�I 1: is r`��it, � -�.7'x' ' , r�'(,�� ,�F GW�YI/GW�3� x � f , '� ��' $��?��a+. vs.�-y ..�'�._�'-�`".�'3" . � _.�xf°� -_r;�-M w��i _'_s�.."�4�Ey '�."�-=�*.k�.d-...�: SW-N:4-10' C9 to C18 BRL<31 1,000/1,000 ?" 50012b500� ?'� 5,000/5,000 o ' (11/19/03) C19 to C36 BRL<31 2,500/2,500 a{5 000%5 OO9M 5,000/5,000 CI 1 to C22 BRL<31 200/800 �200l2 000 'y- ` 200/5,000 a `s Naphthalene <0.51 4/100 s4/1�000 4/1,000 2-Methylnapthalene<0.51 4/500 4/1 000 �g 4l1,000 `t"'541,111 Phenanthrene<0.51 700/100 N-7,00/100�.g 700/100 1 Acenapthene BRL<0.51 20/1,000 � 20/4,000 Acenaphthylene<0.51 100/100 } {* 100%1�000�k 100/1,000 Flourene <0.51 400/1,000 ..... 0'00� gr 4 400/4,000 SW-S:4-10'(ton9) TPH BRL(<60) 200/800 �200/ 000 � 200/5000 NCR;. IMP SW-W:4-10'(7on9) TPH BRL(<61) 200/800M200/2000 200/5000 SW-E:4-10'(2)(10/19) TPH BRL(<61) 200/800 200/2000 � r 200/5000 SW-Nx2:0-4'(10m) TPH BRL(<62) � 200%80 200/2000 200/5000 OE 200/2000 200/5000 SW-Ex2:0-4'(t0m) TPH BRL(<60) s 200/800 ` ; SW-Wx2:0 4'pon7) TPH BRL(<61) 200/80k� 200/2000 200/5000 � 'ra �7 SW-S0:04(ion9) TPH BRL(<62) }200/800;1 200/20,00 200/5000 SW-N:10-13'(ton9) TPH BRL(<61) 200/800 � 200/2000k 200/5000 krt SW-S:10-13'(ton9) TPH BRL(<60) 200/800 y 200/2000 � ) 200/5000. 1 s SW-W:10-13'pon9> TPH, BRL(<62) 200/800 '�§ (2200/20A0n�' 200/5000 'sTaHs s.r..�� a+Fax'fi:Fi'�1 Fse." u„ SW-E:10-13'(ion9) TPH BRL(<62) 200/800200/2 00� 200/5000 BOH@ 13"(tong) TPH BRL(<62) 200/800 N 200/2000 200/5000 EPH'=Extractable Petroleum Hydrocarbon,TPH=Total Petroleum Hydrocarbon BRL=Below Reporting Limits BoWindicates values above applicable Method 1-Risk Characterization Standards Shaded areas represent applicable Method 1-Risk Characterization Standards 1 i DECEMBER 22,2003 HAWTHORNE TERRACE CONDOMINIUM ASSOCIATION:B003-3909 PAGE 5 OF 6 IRAC/CLASS A-I RAO:RTN#4-18130 TABLE II:METHOD 1 RISK CHARACTERIZATION STANDARDS (RTN 4-18055) VOLATILE PETROLEUM HYDROCARBONS/TARGET ANALYTES-SOIL Locations/ VPH RESULTS S-1 Soil Standards S�2 Sod1Sfandard" � S-3 Soil Standard ' Exposure Points (mg/kg-ppm) (ppm) K� (ppm) (ppm) EPA 8015 310 CMR M310cCMR 40 975(6)(b) 310 CMR 40.975(6)0 = r (MADEP modified) 40.975(6)(a) WW1/GW 3 'i$ GW 1/GW-3 GW-1/GW-3ar SW-N:4-10'(nn9iO3) � � Og CS-C8 BRL<1.0 100 " 500 500 C9 12 C BRL<1.0 1,000 ��500 5,000 - ' C9-CIO BRL<1.0 100 100/500 t }y 100/500 MTBE BRL<0.10 0.3/100 wr0 3/200 0.3/200 Benzene BRL<0.10 10/40 10/200 Toluene BRL<0.10 90/500 90/2,500 Ethyl benzene BRL<0.10 80/500 80/500 80/500 v t YI, Total Xylenes BRL<0.10 500/500 800/I 000 � 800/2,500 Naphthalene BRL<0.10 4/1004/I000 4/1,000 P �. Wit_,. VPH=Volatile Petroleum Hydrocarbons BRL=Below Reporting Limits Bold=indicates values above applicable Method 1-Risk Characterization Standards Shaded areas represent applicable Method I-Risk Characterization Standards RISK CHARACTERIZATION [Refer to Appendix D] ' Soil As previously represented,the S-1/GW-1 and GW-3 soil categories are considered in review of Method 1 - Risk Characterization standards in accordance with the provisions of 310 CMR ' 40.0975. Laboratory analysis,received November 24,25, 2003,reported all TPH, fractional EPH and VPH concentrations in all discrete SW and BOH areas within the excavation as significantly below the Method 1 -Risk Characterization standards for the appropriate S-1/GW-1 and GW-3 soil categories as evaluating direct dermal contact,inhalation and ingestion exposures. Additionally,all reported concentrations of petroleum constituent were reported at levels Below Detections Limits (BRL) as consistent with concentrations expected of background. As such, laboratory analysis of soil samples at the extent of excavation represent a condition of"No Significant Risk"to ingestion, inhalation or direct contact exposures,and potentially leaching to groundwater or any environmental 1 receptor. GROUNDWATER ' The vertical limit of impact was defined as within 13'of grade surface with all side wall(SW) and bottom of hole (BOH) reported as (BRL). Groundwater is estimated to be >20' below grade ' surface. As such, there is no apparent threat of groundwater impact and no laboratory testing of groundwater was deemed necessary and none was conducted. i DECEMBER 22,2003 HAWTHORNE TERRACE CONDOMINIUM ASSOCIATION:B003-3909 PAGE 6 OF 6 IRAC/CLASS A-I RAO:RTN#4-18130 CONCLUSIONS 1 As a result of Immediate Response Actions conducted in the period of November 17' and 19`t', concentrations of petroleum constituents within soils have been reduced to concentrations ' reported as Below Reporting Limits (BRL) of laboratory instrumentation as consistent with concentration expected of background conditions. Based on laboratory analysis of endpoint soil samples, it is the opinion of BENNETT & O'REILLY, INC., that a condition of "No Significant ' Risk"exists as associated with release of greater than 10 gallons of#2 fuel oil from an abandoned 500 gallon UST and that no further action is required at the subject property. As such,a permanent solution for a Class A-1, Response Action Outcome (RAO) without an Activities and Use Limitation(AUL) is applicable for the closure of this project, in accordance with the provisions of 310 CMR 40.1036(1). The findings of this investigation,as represented herein,set forth the rationale and technical justifications for the LSP opinions offered,as established by the certifications made on the attached ' Transmittal Forms. The LSP opinions are based on the available data and regulations in effect at the time of this reporting. Should you have any questions regarding the project or require additional information,please contact me at your earliest convenience. ' Sincerely, T 8 ILLY,INC. ' Bennett, SP Scott Krai anzel, Project Manager Director f Env' nmental Services Environmental Scientist ' encl: -Immediate Response Action Completion/Response Action Outcome Statement- Supporting Documentation.",prepared by BENNETT &O'REILLY,INC.,Dated December 22,2003 -Release Notification Form(original), BWSC-103 i -Response Action Outcome Statement Transmittal Form(original), BWSC-104 -Immediate Response Action Transmittal Form (original), BWSC-105 cc: Hawthorne Terrace Condominium Association, c/o Dennis Cotto, President Hyannis Fire Department,Attn: Chief Brunelle ' Barnstable Town Manager,Attn: John C. Klimm Barnstable Health Department,Attn: Edward Barry Murphy Risk Services, Attn. Betsy Staber 1 ' IMMEDIATE RESPONSE ACTION COMPLETION STATEMENT CLASS A-1 RESPONSE ACTION OUTCOME ' SUPPORTING DOCUMENTATION MA DEP RTN 4-18130 Hawthorne Terrace Condominium Association. #2 Fuel Oil Release ' 272 Craigville Beach Road Hyannis, MA 02601 Project#B003-3909 DECEMBER 22,2003 Prepared By: BENNETT & O'REILLY, INC. 1573 Main Street ' P.O. Box 1667 Brewster, MA 02631 David C. Bennett, LSP On Behalf Of: Hawthorne Terrace Condominium Association ' c/o Mr. Dennis Cotto, President 272 Craigville Beach Road Hyannis, MA., 026301 ' Prepared For: Richard Packard, Section Chief Bureau of Waste Site Cleanup -Emergency Response Section MA Department of Environmental Protection (MA DEP) Southeast Regional Office (SERO) 20 Riverside Drive -Lakeville, MA 02347 APPENDIX A: Reference Plans I -Site Plan entitled"IMMEDIATE RESPONSE ACTION COMPLETION....RTN#4-18130,Prepared by BENNETT&O'REILLY,INC.,Dated December 29,2003. -Figure 1: Site Locus Plan(USGS Topographic Quad.,Hyannis,MA. 1998),Excerpt. 1 -Figure 2: Water Table Contour Map Excerpt,Hyannis,Cape Cod Planning&Econo.Devlp. Com. -Figure 3:MA DEP BWSC GIS Map,Hyannis(1997),Excerpt. APPENDIX B: Field Reports -Field Response Log ' -Hyannis Fire Department Incident Report -Uniform Hazardous Waste Manifest,MA M775734 -Tank Pull Permit ' APPENDIX C: Environmental Records -Release Notification Transmittal Form,BWSC-103 -Response Action Outcome Statement Transmittal Form,BWSC-104 I -Immediate Response Action CompletionTransmittal Form,BWSC-105 -Bill of Lading Transmittal Form,BWSC-012 A,B,C/Soil Recycling Submittal/Receipt(Aggregate Industries) APPENDIX D: Laboratory Analysis ' APPENDIX E:Quality Assurance/Quality Control Plan t 1 1 � APPENDIX A 1 1 1 1 1 i 1 1 1 i 1 1 r ' 272 CRAIGVILLE BEACH ROAD,HYANNIS,MA.,02601 41°38'S1",70°19'S8" 41038'51",70018'08" zr; SW 'u8•' �,'u^, +'N, y�' Y « r N. �� ,. gym' S ' ,;,� y + ��` « to� �� ',w` 4 r� f� �;,, + + � +��• , 4 ." , ;� « .1,=;* !.�'i ��.d 8�' '�� ,r x!.LS i' I • • «+ ` .p ar-4. ,' ,i r6 '� Y:`r4• ns f 3`Prt. LL a" r a • w 1 11 qvV "` • r� sr+. + r m '.+7 as 4 �� 4 � ;;�','' ; �� : « • « � «+ mod. 1h �`' :.: wo • � _�' ; � ".,ate._ _ °G'- — 't ��4 R' ,•_. �r � �sc� �• a ssGYn:\_ h�7a^r � .n �'� � L 6' 41037'55",70019'58"NAD83 41°3755", 018'08" MN TN r - r -- 1 12 1 1 MILE 0 16° 1000 0 1000 2000 3000 4000FEET Printed from TOPO! m1998 Wildflower Productions(www.topo.com) rFIGURE 1: The Site,as shown on Hyannis Assessors Map 267 Parcel 73, is an approximately 1.5 acre parcel of land developed as a condominium complex. The area and surrounding land consists of residential properties and a golf course. Access to the subject property is unrestricted with low frequency and intensity of use with respect to the area of impacted soil. The property is essentially flat with Elevations ranging from approximately 35 - 28'NGVD. r i 1 1 1 1 "{ 1 i;. ,Y c ,r. .Y� '3' M• r`L�Ev�-� .x�� '' r .0 t1 Y'" 1 �f�..�;wU ,2��L Lv/'`�^• ti 1✓' . a t` CAS, A " ? ab iy. a dr 1 �} Y<4t h �J(r y 1 r ,r s.� tt � 4-•"�i, -i- 34 ,n 5 M • sm i l r 1 `30r1t �c 9pst f sl IMAM" .;�'� ,• v Lip �,. ` �V� �r,� Y (.,ter y1 / � j'.� `�. { N ,. 7' v �f��.r'� �,,,•�6 _,C� /r+�. �- � 5�111� �1' }��44��7ti�� , r. '"/ `! '1' 6i 01Z6 24 3 ,�Mtr �r IN a N >© ' . °, to ,y �' r•9r,JI f L YJ218 90 a'i c•i.m - i{M ° p r w Ft tee ' r xx s �1 r g r< sT f �a x.�•:; �^�}t r t ;{ r,,�� r• ors O„CE 226} ° Q. t$W 37vifPA �,,<.5��-� �� ,,, :�s y4+�1� C�'8{8 �I �a�.�,. QO,,>��i a �[ 1��1� f t � xfl^�,. ,,�,• r�W� ' z. - ''.c^ LOCUS �sr�r<wt.sA> ��_ � �.__j..,. � >:r.•. -� .<,.t��r 1.r ydA wt Y' ., r:. _ ,e r Y f I L. S Pi AIV HYANNI.S H,IRBPR CENTERVILLE HARBOR FIGURE 2: Review of USGS topographic maps and regional groundwater contours indicate a ' southeasterly flow direction toward Hyannis Harbor. Municipal water service is available to the surrounding area and there are no known potable wells within 500' of the subject Site. The depth to groundwater on the subject property was measured as being>15' below ground surface (bgs). 1 ��►=i? � y, 1►�Qi=�,�1111i11��1��1 i11 Ij11�l11�j*� ► . " 1 ��11k;�11�1�1i,11�:"-�y��i� i��1,y1��1�,��1� ►6+�1 1I 11 r► ►►a !1 i11 !1 1; i 1' 1 rt' , �t ' ;.,e$M � i 61". 11 �� , � �11,111�i�1"a � �,a k, 1+1�n ��1; '� 1,�� lit1�►1�,t�!\� 't �� ti= ,�a<� _ ..xl� '�A �, � � ��`Z,11��►��t\el�1a`�� 1'kllt�saN�1�� t ►�a�e�o��'+ �, �'��1 a�l,1�\1111►�►= c 1.,;R w +�� ! � ,��.�� j1.��!�1,��,u� �F�.LL,,�\1111�1i11111�i.►► i` �► ck11�111l�1 !!+!`\111��`� h'!! ►' '� _ k � � �r.��.�,�nyt �9• � r� �k�� 1► �1►i1=► ��l�yi111��` i1�1`��111,1!�1111 FG �„ >` 1[: h :,1 \ r;3r'� * rr 1� �,/ � -�. • .�� "�!► �!r111US ji,.� `�'� 111'��`'►�' �p�� @��1�®�� af��►1� . E � e�:,r•� � � *..�, �. , �•� i 111i1 r ii� !s 1R Pa AIR '71 Cam. .• - 1 ■■■■ � '- s I r' ! tik' 1'IIt�Oiir p � �;.is i•°t3 1 1 � APPENDIX B 1 1 1 1 1 1 1 1 1 i 1 1 i Hawthorne-BO03-3909 FIELD RESPONSE LOG ' Hawthorne Terrace Condominium Association B003-3909 Responsible Party: Hawthorne Terrace Condominium Association Denis Cotto, President 272 Craigville Beach Road ' Hyannis, MA 02601 Property Location: 272 Craigville Beach Road I ' Hyannis, MA 02601 Background Conditions: • During installation of the Condo Association leach field,a 500 gallon home heating oil UST was discovered by the Septic installer(Robert Our Co.). The tank was punctured by Robert Our Co.during its discovery as the existence of the tank was unknown. An unknown amount of#2 Fuel Oil was released at this time due to the puncture. Hyannis Fire and Health department reported to the scene to assess the release. Hyannis Health Department reported the release to the MA DEP and RTN#4-18130 was assigned to the release. Hyannis Fire Department reported the front of the Condominium property had originally been developed as a Tavern which had been demolished. EnviroSafe Corporation was contacted to pull a tank removal permit, pump the remaining Fuel oil from the tank and remove it from the property. BENNETT&O'REILLY,INC.,was given verbal authorization from Robert Our Co.,to make an emergency response to the Site and contact the MA DEP to obtain approval for the removal of up to 50 yards of contaminated soils as the necessary equipment was on Site. Environmental Conditions: iThe Subject Site, at 272 Craigville Beach Road,as shown on Hyannis Assessor's Map 267 Parcel 73,is developed as a condominium complex. Based on the MA DEP,BWSC overlay for the GIS mapping of the area,the subject Site is within the Cape Cod Sole Source Aquifer and borders an area designated to be a DEP approved wellhead protection area (Zone 2). Depth to water at the Site is estimated to be>15'below grade surface (bgs). Groundwater flow direction is estimated to be in a southerly direction towards West Hyannis Port. i Hawthorne-BO03-3909 Remedial Response: Date Time 11/17/03 12:55 pm BENNETT & O'REILLY, INC. personnel (Scott Kraihanzel) receives call from Heather ' Atwood (ESC) indicating a release of#2 Fuel Oil from a 500 gallon steel tank that was discovered by Robert Our Co., in the process of installing a leaching field at 272 Craigville Beach Road. 1:10 pm ' Bill McMahn of Robert Our Construction Co.,was informed of BENNETT&O'REILLY, INC., availability to make an emergency response to the site and the requirement of LSP oversight as per the MCP 310 CMR 40.0000. Mr.McMahn gave the verbal approval for one Environmental Scientist to report to the Site to assess the release and make recommendation for remediation if necessary. 1:47 pm BENNETT&O'REILLY, INC.,personnel Todd Everson(ES) en-route to Site. 2:05 pm BENNETT&O'REILLY,INC.,personnel Todd Everson(ES)arrives on Site and meets up with Envirosafe Crew. Witness Tank being removed from excavation. Two quarter sized holes are noted at the bottom of the tank along with many- other varying size holes: Envirosafe personnel removed 1.56 gallons from.the tank before removal, Collect soil samples from sidewalls and base of excavation for screening 1 LOCATION DEPTH PID SW-N 0-3 56 SW-E 0-3 32 SW-S 0-3' 84 SW-W 0-3 5.6 BOH@3' 8' 80 2:45 pm Hawthorne-BO03-3909 Extend excavation laterally 2' in each direction and 1'deeper. LOCATION DEPTH PID SW-Nxl 0-4 34 SW-Exl 0-4 12.4 SW-Sxl 0-4 28 S W-Wx l 0-4 20 2:50 pm David Bennett Spoke with Mike Moran to acquire approval for up to 50 yards of soil removal. 3:00 pm I , Extend excavation an additional 3' laterally and resample. LOCATION DEPTH PID SW-Nx2 0-4 2.8 SW-Ex2 0-4 0.6 SW-Sx2 0-4 68 SW-Wx2 0-4 0.6 Secure Site with Poly liner covering the contaminated stockpile+excavation. In speaking -with Condo Assoc.President(Denis Cotto),inform him of incident plan for source removal reporting requirements,remedial liability, etc. 4:00 pm Attempt to contact Mike Moran @ DEP. Speak with Melody Thomos and forward info reporting Site;Contact excavation dimensions hot areas.(South sidewall,BOH). Speak with Denis Cotto and inform him of call to DEP and current situation. Will have Dave Bennett contact him tomorrow R.B. Our crew depart site. 4:15 pm BENNETT& O'REILLY,INC.,personnel depart site. 11/19/03 7:30 am Hawthorne-BO03-3909 ' BENNETT&O'REILLY,INC.,personnel(Scott Kraihanzel,ES)arrive on site to meet with condo assoc., Rusty Wilcox (Treasurer) and Denis Cotto (President). Discuss project probable project time line and direction of project. 9:00 am Excavation activities begin. Soils from the previously screened and clean sidewalls pulled back in an effort to not remove clean soil. rLOCATION DEPTH PID SW-Sx3 0-4 0.6 SW-N 4-10 0.8 Dexil32ppm SW-E 4-10 0.2 SW-W 4-10 0.6 SW-S 4-10 0.4 10:30 am Excavation has been enlarged to I FL x I VW x 10'D and SW Samples taken ' Base of excavation still emitting strong petroleum odor. An additional 30 yards of soil removal approval granted by Mike Moran,MA DEP. Soil: Brown Sand,Fine Med and Coarse,trace silt, no strat, some fines, loose,moist LOCATION DEPTH PID BOH 13 0.2 SW-N 10-13 0.2 SW-E 10-13 BDL SW-W 10-13 BDL SW-S 10-13 0.2 , Excavation Final Dimensions 121 x 15'W x 13'D 12:00 pm BENNETT& O'REILLY, INC.,personnel packing up and leaving Site. 'I Hawthorne-BO03-3909 Submitted by: BENNETT& O'REILLY, INC. Todd A Everson Environmental Scientist I Scott E. Kraihanzel Environmental Scientist I This Field Res onse Log is a compilation o reld observations, interviews with individuals familiar with the P g P .ff project and a review of public record. As such, it is intended to be an accurate and complete record of pertinent information. However, based on the reliance on thirdparty and hearsay information included, no guarantee or warranties of the accuracy and completeness of that information is expressed or implied. 1 1 1 REP DEC 2 3 2003 Health Complaints 19-Dec-03 Time: 11:30:00 AM Date: 11/17/2003 Complaint Number: 17167 Referred To: DAVID STANTON Taken By: DENISE WITTER Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE Article X Detail: Business Name: Hawthorne Terrace Condos Number: 272 Street: Craigville beach Road Village: HYANNIS Assessors Map_Parcel: 267-073 Complaint Description: Robert Our was digging for a new septic ' system,when they found an old old tank. The oil tank is leaking. Actions Taken/Results: DS WENT TO SAID LOCATION. THE TANK WAS TILTED UPRIGHT TO REDUCE LEAKING, WITH STICKS IN HOLE TO STOP THE LEAK. ENVIROSAFE CAME AND PUMPED OUT THE REMAINING 168 GALLONS LEFT IN THE TANK. IT WAS_ PROBABLY A 500 GALLON TANK. DS CONTACTED DEP (MIKE MORAN (508)946- 2855) AND WAS GIVEN RELEASE TRACKING NUMBER 4-18130. TODD EVERSON OF BENNETT O'REILLY ARRIVED FOR THE LSP. ROBERT OUR BEGAN REMOVING SOME OF THE CONTAMINATED SOIL LATERALLY. SAMPLES WERE TAKEN, AND THE CONTAMINATED SOIL WAS PILED . AND COVERED WITH POLY. AWAITING 2 WEEK LAB ANALYSIS. PHOTOS ON FILE (DIGITAL/POLAROIDS) Investigation Date: 11/17/2003 Investigation Time: 11:35:00 AM 1 Al r A , IA t � I I fv d _ s t .Y ? k ` }`F 9FP ,1 4 B N P _ggm ma;m"m oil two mom WIMS W A 7— maw 'T, rr ep" tipW 1A, ...... 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F,I" G's,� ,,t".y'. �r r e��• d$x�.'" �'•+" � .,SL rt l . `4 • Gu• !'st� ,�fi �J�° -A;; ix, �` ,�+ �' t�; ,,. �YA ".:r��,,,.Rc fi. �a• �' ,,z �.�rx#a�y,/, w �as.�S..' .r�vr _ k�;e ' 't �x + ♦ r c=. �l�`".,v:.� t�';':..e=� _��YY f yr'�' wrw>.t.>�•^va '�".,. � � �'a'"..:a-�, 'rpr_ a pr 6., di�7 x,�„_., ' - .:4[ � 1,Y•,7 „t.. t ��.y,.�.,:_ .^ � - � .nb"a s"�1r�:�ii`;'- .a....�.,v. i Massak...iusetts Fire Incider, _) Report Hyannis Fire Department Date of Time Of Arrival Time In FDID Incident No. Exposure #. Incident Day of week Call Time Service 01 822 1 A231208 0� 1 1 /1 7 003 Monday 20 11 :04 11 :1 3 11 :40 Address Zip Census Tract 272 Crai ville Beach Road West Hyport 5 0 Type of Situation Found Typ—eoKAction jqen, Mutual Aid ' 40 Hazardous Cond., Not 40 3 Investi•ation Only Io� Classified Fixed Prorperty Use Ignition Factor "7 Throu h 20 Units." F 00 No Fire Found 00 1 Occupant Name Occupant Telephone Hawtio.rne Terrace Condo. Trust) Owner Name Owner Address Owner Telephone Same Same Method Of Alarm Shift No Of Alarms # of Personnel Responded 1 Telephone 1� © 1� ® Hazardous Materials Engines Tankers Aerial Other Vehicles Present 001 000 000 001 Yes Fire Service Other Injuries Injuries 0 0 0 Fatalities 0 0 0 Injuries 0 0 0 Fatalities 0 0 0 Rescues 0 0 0 Mobile Property Use Is Car Stolen Insurance Company _ 0 0 Mobile Property Make Year Model Color License Number VIN 0 0 0 Complex Area Of Origin Estimated Loss Equipment Involved.In. Ignition Form Of Heat Of Ignition 0 . . If Equipment Was Involved In Ignition ' Material Ignited Year Make Model Equiprnent'Serial Number 0 Method of EAn uishment Level Of Fire Origin nn Number Of Stories 0 L— r Construction Type Detector Performance Sprinkler Performance ' Extent Of Damage Flame 0 Smoke 0 Material Generating Most Smoke Type Of Material Generating Most Smoke 0 Avenue Of Smoke Travel Weather Conditions Commanding Officer ' C.lia�r...................:............................................. Lt Knowlton Report By JU. Kniowlton HYANNIS. F II E DEPARTMENT - INCIDE. T REPORT COMMENT PAGE Incident No. A231208 Address 272 CRAIGVILLE BEACH ROAD Date .of Report 11 /17/2003 Commanding Officer U Knowlton Report By JU Knowlton ' We received a call from the Robert B. Our Company (508-432-0530) reporting that one of their crews dug up an abandoned underground oil tank at 272 Craigville Beach Road. They reported that the tank was leaking. I responded on 822 with FF P. Cabral and FF Hanson driving. Arrived on location and met with the crew on ' site and found, what we believed to be, a 500 gallon, steel, fuel oil tank resting on one end in an area where this company was performing sewer system replacement. The area is located south of the parking area for the property and is within 100 feet of Craigville Beach Road. The members of the crew positioned the tank as so to minimize the leak and plugged two holes on the tank and the leak had stopped when we arrived. There was a strong odor of fuel oil in the area and the tank was over 50% full. 806 arrived on location. I requested a representative from the Town of Barnstable Health Department at 1116 hours and David Stanton arrived at 1130 hours. The site Project Manager, Bill McMann, from Robert B. Our Company had already called Enviro-Safe Corporation (508-888-5478) from Sandwich to perform the cleanup operations. Their ETA was 30 - 45 minutes. Mr. Stanton will remain on scene until Enviro-Safe arrives and he assures that they will perform the proper cleanup procedures and permitting process. -- 822 secured the scene at 1140 hours and arrived back in quarters at 1147 hours. Richard A. Knowlton, Lieutenant 1 - 1 - 1 "fr - - r <. •«" i SI' ., kf -_4rr'iJ 4 �r t t rz -s � .}�-` x.. tom,,F -mac F z, 4 a �.. ,y, \,. t,.,� r..z•�."rsd MIN � � � w ��,s��a`j� � ♦��Yr-'� �3' �"��"t>,,,c�T.-..v ...,�.'�` --fir _ t r a .sM�' .�•�r,--�GL'�#T�- ��` "k�"`- �i i ;y- �4 ��f, '■} 1Z y;T s43 P T UlC S� t w RECEfPT OF DISPOSAL OF CJNDERGROUND STE STORAT INp¢ �f- 7 N `c. - r t A� -fi• t , Use' 57�.�2Earti,FP 291 a F,�� ,. r ,�,.„ �..,.cam:,z xa- { r`"r-t �- :a� $ •U�S IP..�, _ Ogg 4 a id-1 *:'ir #'! .�c>_'ate E ,..�'�".a7.. i --tee-r- '`" 4F:.. .. .w F [ NAME ANb ADDRESS OF gPPROVED'TANKYARD{ - r " gn•.,4 i> > "i � � f r.. � OWNS �j t'P �r9MINE � r Fd� I�' 7 S. s sue£r ,� "x a`,.. 1C€" rim r M iia Ya APPROVED TANK YARD NO ; / Tank Yard Ledger 502 CMR 3 03(4)Number t• F R 4+,€` '.d`+; X- i t certl:,under enal ofaaw 1�aue �fsofjalfy,.ezam(ned,f�e underg0. round steel storageaank de(jyered fo`thls approved tanK yartl by f`Frm ca�porahon or r s r F part ersmp w j z and accepted`same Incnf rmance wath Massachusetts Fire Prventlon Regufatlon 5Q2 00 Si nsfo ppro g,Un grounr Sleet Storage Tank=dlsmantiing yards A valld:.permrt was(slued by LOCAL Head of Fire Department FDlDtIj 3 fo transpo this tank to tfis and ; n - t � NEra e:arftl o 'at 4tle of_approved tank yard owner' ners=auth pzed re 1 ro k : 9 U -i # .n trA, fir,• r ._ ' t r= N b -ursuantfo 502GMR 3 00 t � ;� Thrssigned recelp of dlsposaf must be returned to Foie local dead of't6efire department FDID# P � - f y EACF�.TANK MUST HAVE A REGElPT OF DISPOSAL �, � rt � L.._� .,�..,r______ emu., `f -� __ r ,.___"�.�s" i ,.� „,....�. n� dam•�Sc _is-,-{"''_�'_Sj a v .—��i.. 4 l l[-fa { M � y 5- -rf's �A� +^v f• S�{c^£ I t E 144 � r t, D FROM' `' .� �e .` _r c TAN REM TANK DATE1'64 r w C + } t I eGBllanS a ` «t ^' r (PIO and tr t) ::'t �` z.. �•v #j4 b f �, x` Kk Previaus Contents s LeQgth t. .rG ,r ..,x sy., - a (City Vol Dlametfer x s s as z n r as 3 `} k ✓ i :. Date Received r ? s a r. �t I- s t F s_: i x, : Z ..-;,� a Y� -,:"' f3 `�`.s '"'. �- ,r� F'�s``� v, x �: s Fire Depar[ment PerQut,#_ �s '� �N t, �.�.4a, { f `sg k;y,�2•t�� 4:s x z .,t s rf 8v i Gle r3 a `'nc. r..,y.c ,*a^ jj �} - "� v `a+" s T +e.. a $'-"tt ; _Sertai#( ) f z 4 s -a x s r ti t y t 3 S "'f z rj ` ` t.-"k, z skt r� 1, 3 {Tank I,D #(Farm FF 290) _ 46 AN" - tx 'r '�� 31 ` y (FP290, orxFP290R} to ;UST COMP ance,r Ocaner/O e-ator;to mail revised copy of Nottficatton Form r t 1 a P h/ Officetof the State F>lre Marshal, P O Box 1025;State Road,Stow,, MA iCOMMONWEALTH OF MASSACHUSETTS FOR III-STATE WASTE DEPARTMENT OF ENVIRONMENTAL PROTECTION OIL ONLY DIVISION OF HAZARDOUS .MATERIALS OR One Winter Street IN-STATE VS®G HW/WO Roston, Massachusetts 02108 Please print or type.(Form designed for use on elite(12-pitch)typewriter.) UNIFORM HAZARDOUS 1.Generator US EPA ID No. Manifest 2.Page 1 Information in the shaded areas WASTE MANIFEST I I9041 ocu nt of is not required by Federal law. 3.Gen r' am a Mailin Address 3 REALTY TRUST 272 CRAIGVILLE BEA, . HYAN NIS MR 02I91 4,denera bpfi ne - -41439 zl Transporter 1 Company Name 8. US EPA ID Number In E NVIRNI-SAF=E CORPORRTIIN 3 7.Transp Name 8. US EPA ID Number ? . W 9.Designated Facility Name and Site'Address 16. US EPA ID Number ® 01-SON15 GREENHOUSES o 5% SOUTH ST. EAST RAM9733378 V 12.Containers 13. 14. W 11.US DOT Description(including Proper Shipping Name,Hazard Class,and/D Number) Total Unit No. Type Quantity WtNol a. G b. PETROLEW OIL, 3, NA1270, P8 III n E z e C 0 A c T M 0 0. d. ... Z y W 15.Special Handling Instructions and Additional information m Eaerg Contact: ENVIRO1 SAFE ` -M-5478 ERF# A) B) 0 D) 16i,GENERATOR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed,marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national government regulations.. 63 If I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that 1 have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health and the environ- ment;OR;if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that 1 can afford. Date Prin d/Typed Name S' lure Month Day Year JC ' IIZ.G. T. 17. vans 9-er 1 Acknowledgement of Receipt of Materials Date R Q AN Pdoted/Typed Name. r store Month Day Year ® A •1 S.Transporter 2 Acknowledgement of Receipt of Materials Dat e E Printed/Typed Name Signature Month Day Year. R 19.Discrepancy indication Space F , LC 20.Facility Owner or Operator:Certification of receipt of hazardous materials covered by 6s manifest e ' pt s noted in Item 19. B Data T Y /Type ame Sign ore Mont Day ear ' Form 4proved OMB No.2050.0039 EPA Form 8700-22(Rev. 9-94) Previous editions are obsolete. COPY>3 : TRANSPORTER RETAINS RT90,18 0 E C 8 Make application to local Fire Department. Fire Department retains original application and issues duplicate as Perm . ckk APPLICATION. and PERMIT for storage tank removal'and transportation.to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: Tank Owner Name(please print) Haw Thorne Terrace Realty Trust - Sr nature ita 9 ( pp ying or parmi Address 272 Crai villa Beach. Road Hyannis, MA 02601 sr�eer city Slate Zp Removal . • • • Enviro—Safe Corporation Company Name .. Co.or Individual Print Address 14B Jan Sebastian Dr Sandwic Pnnr Prinf, Address Print Signature(if applying for permit) Signature if a plying for permit) n IFCI`Certified Other n IFCI'Certified r1 LSP# ' OtherTank Information _ Tank Location 272 Craigvil nad' Steef Address ni ity Tank Capacity(gallons) ;3g8 UST Substance Last Stored r6llm,_Qyl� Tank Dimensions(diameter x length) Remarks: Disposal Hrm transporting 'Waste_ Enviro-.Safe Corp. 329 State Lic.# Hazardous waste manifQst# [n4M7 7 5 7 3 4 . E.P.A.# . M.AD9'8 5 2.6 9 3 2 3 . . Approved tank disposal yard . Turner .IriC. Tank yard# 002 Type of inert gas Tank yard address 235 Commercial Street Lynn, MA City or Town -_ / ��/1�/1✓ls FDID# Q? ��° —Permrt# Date of issue 3 t 1 Ulu e of expiration Dig safe approval number: ,a �3t (al "I +�� Dig Safe Toll Fre Tel. umber-800-322-4844 Signature/Title of Officer granting permit After removal(s)("Consumptive Use"fuel oil tanks exempted)send Form FP-290R signed by Loc ire Dept.to UST Regulatory Compliance Unit, Department of Fire Services, P.O.Box 1025,State Road,Stow,MA 01775. `International Fire Code Institute �� FP-292(revised 4/97) 1 1 1 1 APPENDIX C 1 1 f 1 1 1 1 1 1 1 1 1 L71Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC103. RELEASE NOTIFICATION & NOTIFICATION Release Tracking Number RETRACTION FORM 4❑ - 18130 ' Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) A. RELEASE OR THREAT OF RELEASE LOCATION: ' 1. Release Name/Location Aid: Hawthorne Terrace Condominium Association/Assessors Map 267, P 73 2. Street Address: 272 Craigville Beach Road ' 3. city/Town: Hyannis 4. ZIP Code: B. THIS FORM IS BEING USED TO: (check one) ❑✓ 1.Submit a Release Notification ' ❑ 2. Submit a Retraction of a Previously Reported Notification of a release or threat of release including supporting documentation required pursuant to 310 CMR 40.0335 (Section C is not required) (All sections of this transmittal form must be filled out unless otherwise noted above) C. INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR): t1. Date and time of Oral Notification, if applicable: 11/17/2003 Time: 10:30 ✓❑ AM ❑ PM mm/dd/yyyy h h:m m ' 2. Date and time you obtained knowledge of the Release or TOR: 11/17/2003 Time: 10:00 0 AM ❑ PM mm/dd/yyyy h h:m m ' 3. Date and time release or TOR occurred,if known: 11/17/2003 Time: 10:00 AM ❑ PM mm/dd/yyyy h h:m m Check all Notification Thresholds that apply to the Release or Threat of Release: (for more information see 310 CMR 40.0310-40.0315) ' 4. 2 HOUR REPORTING CONDITIONS 5. 72 HOUR REPORTING CONDITIONS 6. 120 DAY REPORTING CONDITIONS Q✓ a. Sudden Release a. Subsurface Non-Aqueous a. Release of Hazardous ❑ Phase Liquid(NAPL)Equal to. ❑ Material(s)to Soil or ❑ b. Threat of Sudden Release or Greater than 1/2 Inch Groundwater Exceeding ❑ c. Oil Sheen on Surface Water b. Underground Storage Tank Reportable Concentration(s) (UST)Release b. Release of Oil to Soil ❑ d. Poses Imminent Hazard Exceeding Reportable ❑ e. Could Pose Imminent ❑ c. Threat of UST Release Concentration(s)and Affecting More than 2 Cubic Yards Hazard ❑ d. Release to Groundwater to f. Release Detected in near Water Supply c. Release of Oil❑ e ❑Private Well Groundwater Exceeding ❑ e. Release to Groundwater Reportable Concentration(s) ' ❑ g. Release to Storm Drain near School or Residence d. Subsurface Non-Aqueous ❑ h. Sanitary Sewer Release ❑ f. Substantial Release Migration ❑ Phase Liquid(NAPL)Equal to (Imminent Hazard Only) or Greater than 1/8 Inch and Less than 1/2 Inch Revised:06/27/2003 Page 1 of 3 I Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC103 ' RELEASE NOTIFICATION & NOTIFICATION Release Tracking Number RETRACTION FORM - 18130 Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) C. INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR):(cunt) 7. List below the Oils(0)or Hazardous Materials(HM)that exceed their Reportable Concentration(RC)or Reportable Quantity (RQ)by the greatest amount. O or HM Released CAS Number, O or HM Amount or Units RCs Exceeded,if if known Concentration Applicable(RCS-1,RCS-2, RCGW-1,RCGW-2) ' #2 Fuel Oil Q 50-100 GAL RCS-1 8. Check here if a list of additional Oil and Hazardous Materials subject to reporting is attached. D. PERSON REQUIRED TO NOTIFY: 1. Check all that apply: El a.change in contact name b.change of address c. change in the person notifying 2. Name of organization: Hawthorn Terrace Condominium Association 1 3. Contact First Name: Dennis 4. Last Name: COtto ' 5. Street: 272 Craigville Beack Road 6.Title: President 7. City/Town: Hyannis 8. State: MA 9. ZIP Code: 02601-0000 10. Telephone: (508.) 790-4109 11.Ext.: 12. FAX: ❑ 13. Check here if attaching names and addresses of owners of properties affected by the Release or Threat of Release, ' other than an owner who is submitting this Release Notification(required). E. RELATIONSHIP OF PERSON TO RELEASE OR THREAT OF RELEASE: ' 0 1. RP or PRP Q a. Owner ❑ b. Operator c. Generator d. Transporter e. Other RP or PRP Specify: ' 2. Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21 E,s.2) . ❑ 3. Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21 E,s.50)) ' 4. Any Other Person Otherwise Required to Notify Specify Relationship: ' Revised:06/27/2003 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC103 ' RELEASE NOTIFICATION & NOTIFICATION Release Tracking Number RETRACTION FORM - 18130 ' Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371 (Subpart C) F. CERTIFICATION OF PERSON REQUIRED TO NOTIFY: ' 1. I,Dennis Cotto, President ,attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii) ' that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal. I/the person or entity on whos ehalf this submittal is made am/is aware that there are significant penalties,including,but not limited to, possible fine an imprisonment,for illfully submitting false,inaccurate,or incomplete information. 2. By. 3. Title: President Signature /� p 4. For: i�ll� J//�P /// �'�( nd� L S5()C/2Y01I 5. Date: ' (Name of person or entity recorded in Section D) mm/dd/ YYYY '. 6. Check here if the address of the person providing certification is different from address recorded in Section D. 7. Street: 8. City/Town`: 9. State: 10. ZIP Code: ' 11. Telephone: 12.Ext.: 13. FAX: YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY 1 RETURN THE DOCUMENT AS INCOMPLETE. IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. ' Date Stamp(DEP USE ONLY:) 1 ' Revised:06/27/2003 Page 3 of 3 ' Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC104 Release Tracking Number RESPONSE ACTION OUTCOME (RAO) STATEMENT ® _ 18130 ' Pursuant to 310 CMR 40.0580(Subpart E)&40.1056(Subpart J) ' A. SITE LOCATION: 1. Site Name/Location Aid: Hawthorne Terrace Condominium Association 2. Street Address: 272 Craigville Beach Road Hyannis 02601-0000 3. CitylTown: 4. ZIP Code: 0 5. Check here if a Tier Classification Submittal has been provided to DEP for this disposal site. El a. Tier 1A b. Tier 1 B c. Tier I ❑ d. Tier 2 6. If a Tier I Permit has been issued,provide Permit Number: B. THIS FORM IS BEING USED TO: (check all that apply) ' 1. List Submittal Date of RAO Statement(if previously submitted): ;MM/DD/YYYY: © 2. Submit a Response Action Outcome(RAO)Statement ' 0 a. Check here if this RAO Statement covers additional Release Tracking Numbers(RTNs). RTNs that have been previously linked to a Primary Tier Classified RTN do not need to be listed here. b. Provide additional Release Tracking Numbers)that are ❑ _ � ❑ _ i ' covered by this RAO Statement. 3. Submit a'Revised Response Action Outcome Statement a. Check here if this Revised RAO Statement covers additional Release Tracking Numbers(RTNs), not listed on the RAO Statement or previously submitted Revised RAO Statements. RTNs that have been previously linked to a Primary Tier Classified RTN do not need to be listed here. ' b. Provide additional Release Tracking Number(s)that are ❑ _ _ covered by this RAO Statement. 4. Submit a Response Action Outcome Partial(RAO-P)Statement 1 Check above box, if any Response Actions remain to be taken to address conditions associated with this disposal site having the Primary RTN listed in the header section of this transmittal form. This RAO Statement will record only an RAO-Partial Statement for that RTN. A final RAO Statement will need to be submitted that references all RAO-Partial ' Statements and,if applicable,covers any remaining conditions not covered by the RAO-Partial Statements. ❑ 5. Submit an optional Phase I Completion Statement supporting an RAO Statement Ei 6. Submit a Periodic Review Opinion evaluating the status of a Temporary Solution for a Class C RAO Statement (Section E is optional) ❑ 7. Submit a Retraction of a previously submitted Response Action Outcome Statement(Sections D&E are not required) ' (All sections of this transmittal form must be filled out unless otherwise noted above) Revised:09/18/2002 Page 1 of 7 B W SC 1040902001 I IIIII I I III I I IIIIII IIII(III(IIII IIIII I I I I I I I I I I(IIII I I I I I II I I I IIIII III I I IIII IIII Massachusetts Department of Environmental Protection BWSC104 ' Bureau of Waste Site Cleanup RESPONSE ACTION OUTCOME (RAO) STATEMENT Release Tracking Number ' Pursuant to 310 CMR 40.0580(Subpart E)&40.1056(Subpart J) 4 - 18130 C. DESCRIPTION OF RESPONSE ACTIONS: (check all that apply,for volumes list cumulative amounts) ❑ 1. Assessment and/or Monitoring Only 2. Temporary Covers or Caps ❑ 3. Deployment of Absorbent or Containment Materials ❑ 4. Temporary Water Supplies ' ❑ 5. Structure Venting System ❑ 6. Temporary Evacuation or Relocation of Residents ❑ 7. Product or NAPL Recovery ❑ 8. Fencing and Sign Posting ❑ 9. Groundwater Treatment Systems ❑ 10. Soil Vapor Extraction ❑ 11. Bioremediation ❑ 12. Air Sparging 0 13. Removal of Contaminated Soils ❑✓ a. Re-use,Recycling or Treatment ❑ i.On Site Estimated volume in cubic yards ' ❑✓ ii.Off Site Estimated volume in cubic yards 60 ' iia. Facility Name: Aggregate Industries Town: West Dennis state: MA iib. Facility Name: Town: State: ' iii. Describe: ❑ b. Landfill ' ❑ i.Cover Estimated volume in cubic yards Facility Name: Town: State: ' ❑ ii. Disposal Estimated volume in cubic yards Facility Name: Town: State: ❑ 14. Removal of Drums,Tanks or Containers: a. Describe Quantity arid Amount: ' b. FacilityName: Town: State: c. Facility Name: Town: State: Revised:09/18/2002 Page 2 of 7 BWSC1040902002 111111111 E11111 III 1111111111 II II!II 11111111111111111111111111111111 L Massachusetts Department of Environmental Protection Bureau BWSC104. of Waste Site Cleanup RESPONSE ACTION OUTCOME (RAO) STATEMENT Release Tracking Number Pursuant to 310 CMR 40.0580(Subpart E)&40.1056(Subpart J) ® 18130 C. DESCRIPTION OF RESPONSE ACTIONS(cont.): (check all that apply,for volumes list cumulative amounts) 15. Removal of Other Contaminated Media: a.Specify Type and Volume: b.Facility Name: Town: State: c. Facility Name: Town: State: ' 16. Other Response Actions: Describe: 17. Use of Innovative Technologies: 1 Describe: ' D. RESPONSE ACTION OUTCOME CLASS: Specify the Class of Response Action Outcome that applies to the disposal site,or site of the Threat of Release. Select ONLYone Class. 1. Class A-1 RAO: Specify one of the following: ® a. Contamination has been reduced to background levels. ❑ b. A Threat of Release has been eliminated. El' 2. Class A-2 RAO: You MUST provide justification that reducing contamination to or approaching background levels is infeasible. 3. Class A-3 RAO: You MUST provide an implemented Activity and Use Limitation(AUL)and justification that reducing contamination to or approaching background levels is infeasible. 4. Class A-4 RAO: You MUST provide an implemented AUL, justification that reducing contamination to or approaching ' background levels is infeasible,and justification that reducing contamination to less than Upper Concentration Limits(UCLs) 15 feet below ground surface or below an engineered barrier is infeasible. If the permanent solution relies upon an engineered barrier, you must also provide a Phase III report justifying the selection of the engineered barrier. Revised:09/18/2002 Page 3 of 7 B W S C 1040902003 I IIIII I I III I I(IIIII IIII IIII IIII I II II I I I( I I I I IIII IIIII IIIII IIIII IIIII IIII IIII 1 " I Massachusetts Department of Environmental Protection ' Bureau of Waste Site Cleanup BWSC104 Release Tracking Number RESPONSE ACTION OUTCOME (RAO) STATEMENT ® _ 18130 Pursuant to 310 CMR 40.0580(Subpart E)&40.1056(Subpart J) D. RESPONSE ACTION OUTCOME CLASS(cunt.): ❑ 5. Class B-1 RAO: Specify one of the following: ❑ a. Contamination is consistent with background levels ❑ b. Contamination is NOT consistent with background ' ❑ 6. Class B-2 RAO: You MUST provide an implemented AUL. levels. ❑ 7. Class B-3 RAO: You MUST provide an implemented AUL and justification that reducing contamination to less than ' Upper Concentration Limits(UCLs) 15 feet below ground surface is infeasable. ❑ 8. Class C RAO: Specify one: ❑ a. Monitoring ❑ b. Passive Operation and Maintenance ❑ c. Active Operation and Maintenance(defined at 310 CMR 40.0006) ' E. RESPONSE ACTION OUTCOME INFORMATION: 1. Specify the Risk Characterization Method(s)used to achieve the RAO described above: ❑✓ a. Method 1 ❑ b.Method 2 ❑ c.Method 3 ' ❑ d. Method Not Applicable-Contamination reduced to or consistent with background,or Threat of Release abated 2. Specify all Soil and Groundwater Categories used in the Risk Characterization. More than one Soil Category and more than one Groundwater Category may apply at a Site. Be sure to check off all APPLICABLE categories. a.Soil Category(ies)Applicable: ❑✓ i. S-1/GW-1 ❑ iv.S-2/GW-1 ❑ vii.S-3/GW-1 ❑ ii. S-1/GW-2 ❑ v.S-2/GW-2 ❑ viii.S-3/GW-2 ❑✓ iii. S-1/GW-3 ❑ vi. S-2/GW-3 ❑ ix. S-3/GW-3 b. Groundwater Category(ies)Impacted: ❑✓ .i. GW-1 ❑ ii. GW-2 ❑✓ iii.GW-3 3. Specify remediation ❑✓ a. Check here if soil remediation was conducted. ❑ b.Check here if groundwater remediation was conducted. 4.Estimate the number of acres this RAO Statement applies to: 0.01 Revised:09/18/2002 Page 4 of 7 BWSC1040902004 IIIII III IIIIIIIIIII II IIII IIIII IIIII IIIII IIIII IIIII 11111111111111EI IIIIIIII 1 Massachusetts Department of Environmental Protection ' Bureau of Waste Site Cleanup BWSC104 RESPONSE ACTION OUTCOME (RAO) STATEMENT Release Tracking Number Pursuant to 310 CMR 40.0580(Subpart E)&40.1056(Subpart J) F. LSP SIGNATURE AND STAMP: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form, including any and all documents accompanying this submittal. In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3),and 309 CMR4.03(2),and (iii)the provisions of 309 CMR 4.03(3),to the best of my knowledge,information and belief, > if Section B indicates that either an RAO Statement,Phase I Completion Statement and/or Periodic Review Opinion is being provided,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed and implemented in ' accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,and(iii)complies(y)with the identified provisions of all orders,permits,and approvals identified in this submittal. I am aware that significant penalties may result,including,but not limited to, possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. David C. Bennett 1. First Name: 2. Last Name: 3. Telephone: (508) 9 4 Ext.: 102 5 FAX: 5088964687 ' rl4;q 6. Signature: M� 7. Date: 4303 9.LSP Stamp: 8.-LSP#: 4 �H OF tkwA 10, DAVID BENINETT � No,4303 F -SITE P G. PERSON MAKING SUBMITTAL: 1. Check all that apply: c. change in the person pp y ❑ a.change in contact name. ❑ b.change of address 0 undertaking response actions 2. Name of organization: Hawthorne Terrace Condominium Association ' Dennis Cotto 3. Contact First Name: 4. Last Name: 5. Street: 272 Craigville Beach Road 6.Title: President Hyannis MA 02601-0000 7. City/Town: 8. State: 9. ZIP Code: (508) 790-4109 10. Telephone: 11.Ext.: 12. FAX: Revised:09/18/2002 Page 5 of 7 BWSC1040902005 IIIIIII III II IIIIII IIII III IIIII III I I I III III IIIII I III IIIII IIIII II I Massachusetts Department of Environmental Protection ' Bureau of Waste Site Cleanup BWSC104 Release Tracking Number RESPONSE ACTION OUTCOME (RAO) STATEMENT — 18130 ' Pursuant to 310 CMR 40.0580(Subpart E)&40.1056(Subpart J) 6-7L ' H. RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON MAKING SUBMITTAL: © 1. RP or PRP © a. Owner ❑ b. Operator ❑ c. Generator ❑ d. Transporter ❑ e. Other RP or PRP Specify: ❑ 2. Fiduciary,Secured:Lender or Municipality with Exempt Status(as defined by M.G.L.c.21 E,s.2) ❑ 3. Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21 E,s.50)) ❑ 4. Any Other Person Making Submittal Specify Relationship: I.REQUIRED ATTACHMENT AND SUBMITTALS: 1. Check here if the Response Action(s)on which this opinion is based, if any,are(were)subject to any order(s),permit(s) ❑ and/or approval(s)issued by DEP or EPA. If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. ❑ 2. Check here to certify that the Chief Municipal Officer and the Local Board of Health have been notified of the submittal of an RAO Statement that relies on the public way/rail right-of-way exemption from the requirements of an AUL. © 3. Check here to certify that the Chief Municipal Officer and the Local Board of Health,have been notified of the submittal of a RAO Statement with instructions on how to obtain a full copy of the report. 4. Check here to certify that documentation is attached specifying the location of the Site,or the location and boundaries of ❑ the Disposal Site subject to this RAO Statement. If submitting an RAO Statement for a PORTION of a Disposal Site, you must document the location and boundaries for both the portion subject to this submittal and,to the extent defined,the entire Disposal Site. 5. Check here if required to submit one or more AULs. You must submit an AUL Transmittal Form(BWSC113)and a ❑ copy of each implemented AUL related to this RAO Statement. Specify the type of AUL(s)below: (required for Class A-3,A-4,B-2,B-3 RAO Statements) ❑ a. Notice of Activity and Use Limitation b. Number of Notices submitted: ❑ c. Grant of Environmental Restriction d. Number of Grants.submitted: 1 0 6. If an RAO Compliance Fee is required for any of the RTNs fisted on this transmittal form,check here to certify that an RAO Compliance Fee was submitted to DEP,P.O. Box 4062,Boston, MA 02211. ' 7. Check here if any non-updatable information provided on this form is incorrect,e.g.Site Address/Location Aid. Send ❑ corrections to the DEP Regional Office. ' © 8. Check here to certify that the LSP Opinion containing the material facts,d ata,and other information is attached. ' Revised:09/18/2002 Page 6 of 7 BWSC1040902006 I IIIIII)III IIIIIIII IIII IIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII III)IIII k' Massachusetts Department of Environmental Protection ' Bureau of Waste Site Cleanup BWSC104 RESPONSE ACTION OUTCOME (RAO) STATEMENT Release Tracking Number ' Pursuant to 310 CMR 40.0580(Subpart E)&40.1056(Subpart J) ® - 18130 J. CERTIFICATION OF PERSON MAKING SUBMITTAL: 1.I, Dennis Cotto ,attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this ' transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii) that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal. I/the person or entity on whose behalf this submittal is made am/is aware that there are significant penalties,including,but not limited to, possible fines mprisonment,for 'Ifully submitting false,inaccurate,or incomplete information. 2. By: President 3. Title: Signature 4. For: Hawthorne Terrace Condominium Association Z2/,9///)- :3 (Name of person or entity recorded in Section G) (mm/dd/yyyy) 5. Check here if the address of the person providing certification is different from address recorded in Section G. 6, Street: 7. City/Town: 8. State: 9. ZIP Code: ' 10. Telephone: 11.Ext.: 12. FAX: YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE. IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY:) t t Revised:09/18/2002 Page 7 of 7 B W S C 1040902007 I IIIII I I III I I IIIIII I III IIII IIIII IIIII IIIII I I IIII IIII IIIII IIII IIIII IIIII IIII III I Massachusetts Department of Environmental Protection ' Bureau of Waste Site Cleanup BWSC105 IMMEDIATE RESPONSE ACTION (IRA) TRANSMITTAL Release Tracking Number FORM Pursuant to 310 CMR 40.0424-40.0427(Subpart D)L71 ' A RELEASE OR THREAT OF RELEASE LOCATION: 1. Release Name/Location Aid: Hawthorne Terrace Condominium Association ' 2. Street Address: 272 Craigville Beach Road Hyannis 02601-0000 3. City(fown: 4. ZIP Code: ❑ 5. Check here if a Tier Classification Submittal has been provided to DEP for this Disposal Site. ❑ a. Tier 1A ❑ b. Tier 1 B ❑ c. Tier 1 C ❑ d. Tier 2 I ' ❑ 6. Check here if this location is Adequately Regulated, pursuant to 310 CMR 40.0110-0114. Specify Program(check one): ❑ a. CERCLA ❑ b. HSWA Corrective Action ❑ c. Solid Waste Management ❑ d, RCRA State Program(21C Facilities) B.THIS FORM IS BEING USED TO: (check all that apply) 1. List Submittal Date of Initial IRA Written Plan(if previously submitted): (MM/DD/YYYY) ❑ 2. Submit an Initial IRA Plan. ❑ 3. Submit a Modified IRA Plan of a previously submitted written IRA Plan. ❑ 4. Submit an Imminent Hazard Evaluation(check one) ❑ a. An Imminent Hazard exists in connection with this Release or Threat of Release. ❑ b. An Imminent Hazard does not exist in connection with this Release or Threat of Release. ' ❑ c. It is unknown whether an Imminent Hazard exists in connection with this Release or Threat of Release,and further assessment activities will be undertaken. ❑ d. It is unknown whether an Imminent Hazard exists in connection with this Release or Threat of Release. However, response actions will address those conditions that could pose an Imminent Haza rd. 5. Submit a request to Terminate an Active Remedial System or Response Action(s)Taken to Address an Imminent Hazard. ❑ 6. Submit an IRA Status Report. 7. Submit an IRA Completion Statement. a. Check here if future response actions addressing this Release or Threat of Release notification condition will be Eiconducted as part of the Response Actions planned or ongoing at a Site that has already been Tier Classified under a , different Release Tracking Number(RTN). When linking RTNs,rescoring via the NRS is required if there is a reasonable likelihood that the addition of the new RTN(s)would change the classification of the site. b. State Release Tracking Number of Tier Classified Site(Primary RTN): ❑ - These additional response actions must occur according to the deadlines applicable to the Primary RTN.Use the Primary RTN when making all future submittals for the site unless specifically relating to this Immediate Response Action. ' ❑ 8. Submit a Revised IRA Completion Statement. (All sections of this transmittal form must be filled out unless otherwise noted above) Revised: 09/11/2002 Page 1 of 6 BWSC1050902001 III II III IIIIIIII IIII IIII IIIII IIIII I III IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII I II Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC105 IMMEDIATE RESPONSE ACTION (IRA) TRANSMITTAL Release Tracking Number® _ 18130 FORM Pursuant to 310 CMR 40.0424-40.0427(Subpart D) ' C. RELEASE OR THREAT OF RELEASE CONDITIONS THAT WARRANT IRA: 1. Identify Media Impacted and Receptors Affected: (check all that apply) ❑ a. Air ❑ b. Basement ❑ c. Critical Exposure Pathway ❑ d. Groundwater ❑ e. Residence ' ❑ f. Paved Surface ❑ g.Private Well ❑ h. Public Water Supply ❑ i. School ❑ j. Sediments Q k. Soil ❑ I. Storm Drain ❑ m. Surface Water ❑ n. unknown ❑ o. Wetland ❑ p. Zone 2 ❑ q. Others Specify: 2. Identify Oils and Hazardous Materials Released: (check all that apply) ' ❑✓ a. Oils ❑ b. Chlorinated Solvents ❑ c.Heavy Metals ❑ d. Others Specify: D. DESCRIPTION OF RESPONSE ACTIONS: (check all that apply.for volumes list cumulative amounts) ❑ 1. Assessment and/or Monitoring Only 0 2. Temporary Covers or Caps ❑ 3. Deployment of Absorbent or Containment Materials ❑ 4. Temporary Water Supplies ❑ 5. Structure Venting System ❑ 6. Temporary Evacuation or Relocation of Residents ❑ 7. Product or NAPL Recovery ❑ 8. Fencing and Sign Posting ❑ 9. Groundwater Treatment Systems ❑ 10. Soil Vapor Extraction ❑ 11. Bioremediation ❑ 12. Air Sparging ® 13. Excavation of Contaminated Soils 1 Q a. Re-use,Recycling or Treatment ❑ i.On Site Estimated volume in cubic yards © ii.Off Site Estimated volume in cubic yards 60 iia.Facility Name: Aggregate Industries Town: State:West Dennis MA iib. Facility Name: Town: State: iii. Describe: ❑ b. Store ❑ I.On Site Estimated volume in cubic yards ii.Off Site Estimated volume in cubic yards iia.Facility Name: Town: State: iib.Facility Name: Town: State: Revised: 09/11/2002 Page 2 of 6 BWSC1050902002 I IIIIIII III IIIIIIII IIII IIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC105 IMMEDIATE RESPONSE ACTION (IRA) TRANSMITTAL Release Tracking Number . FORM Pursuant to 310 CMR 40.0424-40.0427(Subpart D) - 18130 D. DESCRIPTION OF RESPONSE ACTIONS(cont.l: (check all that apply,for volumes list cumulative amounts) c. Landfill i.Cover Estimated volume in cubic yards Facility Name: Town: State: ii. Disposal Estimated volume in cubic yards Facility Name: Town: State: 14. Removal of Drums,Tanks or Containers: ' a. Describe Quantity and Amount: b. Facility Name: Town: State: ' c. Facility Name: Town: State: 15. Removal of Other Contaminated Media: ' a.Specify Type and Volume: ' b.Facility Name: Town: State: c. Facility Name: Town: State: 16. Other Response Actions: Describe: ❑ 17. Use of Innovative Technologies: Describe: Revised: 09/11/2002 Page 3 of 6 BWSC1050902003 I IIIIIII III IIIIIIII IIII IIII(IIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII Massachusetts Department of Environmental Protection ' Bureau of Waste Site Cleanup -BWSC105 Release Tracking Number IMMEDIATE RESPONSE ACTION (IRA) TRANSMITTAL ® _ 18130 FORM Pursuant to 310 CMR 40.0424-40.0427(Subpart D) E. LSP SIGNATURE AND STAMP: I"attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form, including any and all documents accompanying this submittal. In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1), (ii)the applicable provisions of 309 CMR 4.02(2)and(3),and 309 CMR4.03(2),and (iii)the provisions of 309 CMR 4.03(3),to the best of my knowledge,information and belief, > if Section B of this form indicates that an Immediate Response Action Plan is being submitted,the response action(s)that is (are)the subject of this submittal(i)has(have)been developed in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000 and(iii)complies(y)with the identified provisions of all orders, permits,and approvals identified in this submittal; > if Section B of this form indicates that an Imminent Hazard Evaluation is being submitted,this Imminent Hazard Evaluation was developed in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,and the assessment activity(ies) undertaken to support this Imminent Hazard Evaluation complies(y)with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000; > if Section B of this form indicates that an Immediate Response Status Report is being submitted,the response action(s)that is (are)the subject of this submittal(i)is(are)being implemented in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000 and(iii)complies(y)with the identified provisions of all orders, permits,and approvals identified in this submittal; > if Section B of this form indicates that an Immediate Response Action Completion Statement or a request to Terminate an I ' Active Remedial System or Response Action(s) Taken to Address an Imminent Hazard is being submitted,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed and implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000 and(iii)complies(y) with the identified provisions of all orders,permits,and approvals identified in this submittal. I am aware that significant penalties may result, including,but not limited to, possible fines and imprisonment, if I submit information which I know to be false,inaccurate or materially incomplete. David C. Bennett 1. First Name: 2. Last Name: (50 ) -66 0 102 (508) 896-4687 3. Telephone: 4. Ext.: 5. FAX; 6. Signature: - 7. Date: HOF4303 gf�', 9.LSP Stamp: DAVID a� C. BENNETT c r No.4303 CFO STEa S17E PR ✓ Revised: 09/11/2002 Page 4 of 6 BW9C1050902004 1111111111111 IR 1111111111 E l 1111111111111 11 11111 1E1 111111 I Massachusetts Department of Environmental Protection BWSC105 Bureau of Waste Site Cleanup Release Tracking Number IMMEDIATE RESPONSE ACTION (IRA)TRANSMITTAL _ 18130 FORM Pursuant to 310 CMR 40.0424-40.0427(Subpart D)K-'qA 1 F. PERSON UNDERTANG IRA:El ❑ 1. Check all that apply: a.change in contact name. b.change of address c. change in the person undertaking response actions ' 2. Name of Organization: Hawthorne Terrace Condominium Association 3. Contact First Name: Dennis 4.Last Name: COtto 5. Street: 272 Craigville Beach Road 6.Title: President Hyannis MA 02601-0000 7. City/Town: y 8. State: 9. ZIP Code: 10. Telephone: (508) 790-4109 11.Ext.:. 12. FAX: G. RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON UNDERTAKING IRA: Q 1. RP or PRP 0 a. Owner ❑ b. Operator ❑ c. Generator ❑ d. Transporter ❑ e. Other RP or PRP Specify: ' ❑ 2. Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21 E,s.2) ❑ 3. Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21 E,s.50)) ❑ 4. Any Other Person Undertaking IRA Specify Relationship: I H.REQUIRED ATTACHMENT AND SUBMITTALS: 1.Check here if any Remediation Waste,generated as a result of this IRA,will be stored,treated,managed,recycled or ❑ reused at the site following submission of the IRA Completion Statement. If this box is checked,you must submit one of the following plans,along with the appropriate transmittal form. ❑ A Release Abatement Measure(RAM)Plan(BWSC106) ❑ Phase IV Remedy Implementation Plan(BWSC108) 2. Check here if the Response Action(s)on which this opinion is based, if any,are(were)subject to any order(s),permit(s) ❑ and/or approval(s)issued by DEP or EPA. If the box is checked,you MUST attach a statement identifying the applicable ' provisions thereof. ❑ 3. Check here to certify that the Chief Municipal Officer and the Local Board of Heath have been notified of the implementation of an Immediate Response Action taken to control,prevent,abate or eliminate an Imminent Hazard. ❑✓ 4. Check here to certify that the Chief Municipal Officer and the Local Board of Heath have been notified of the submittal of a Completion Statement for an Immediate Response Action taken to control,prevent,abate or eliminate an Imminent Hazard. ❑ 5. Check here if any non-updatable information provided on this form is incorrect,e.g.Site Address/Location Aid. Send corrections to the DEP Regional Office. © 6. Check here to certify that the LSP Opinion containing the material facts,data,and other information is attached. Revised: 09/11/2002 Page 5of6 BWSC 1050902005 I IIIII I I III I IIIIIII IIII III I IIIII IIIII I I III IIIII IIIII IIIII IIIII IIIII IIIII I III IIII ■ Ill' Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC105 Release Tracking Number IMMEDIATE RESPONSE ACTION (IRA) TRANSMITTAL ® _ 18130 FORM Pursuant to 310 CMR 40.0424-40.0427(Subpart D) ' I. CERTIFICATION OF PERSON UNDERTAKING IRA: Dennis Cotto, President 1. I, ,attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this ' transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii) that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal. I/the person or entity on whose alf this submittal is made am/is aware that there are significant penalties,including,but not limited to, possible fines.Ano/im prison ment [ ill ul y submitting false,inaccurate,or incomplete information. ' 2. By: Od President 3. Title: Signature 4. For: Hawthorne Terrace Condominium Association (Name of person or entity recorded in Section F) (mm/dd/yyyy) 5. Check here if the address of the person providing certification is different from address recorded in Section F. ' 6. Street: 7. City/Town: 8. State: 9. ZIP Code: 10. Telephone: 11.Ext.: 12. FAX: YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE. IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. 1 Date Stamp(DEP USE ONLY:) 1 Revised: 09/11/2002 Page 6 of 6 BWSC1050902006 IIIII III IIIIIIII III II IIII IIIII III IIIII IIIII IIIII IIII IIIII IIIII III ■ AGGREGATE INDUSTRIES ENVIRONMENTAL SERVICES 1101 TURNPIKE STREET, STOUGHTON, MA 02072 PHONE (781) 341-5500 FAX (781) 341-2440 ' SOIL RECYCLING SUBMITTAL (Revised 4/1/00) ' Site Information: ' Name: Hawthorne Terrace Condo Assoc. Contact: DePrds Cotto, President Street: 272 Craigville Road Phone#: 508-709-4109 Hymds State/Zip:: i`_R 02601 Cary/Town. p Generator Information: Name:,, Hawthorne Terrace Condo Assoc.. Contact: Dennis Cott(), President Street: 272 Craigv-ll e Road Phone#: 508-709-4109 Ciry/Town: Hyannis State/Zip: MA 02601 Consultant Information: Name: BIl= & 01R=I Y, INC_, Contact: Scott Kra hanzel. Project Manager Street: P 0 Box 1667 Phoneg: 508--896-6630 City/Town: Brewster State/Zip: MA 02631 1 - ' Estimated Soil Quantity 75 Tons 50 Cubic Yards Soil Contaminants (gasoline, diesel fuel, motor oil, etc.) #2 Fuel Oil Analyses Performed (check all that apply) X TPH, VOCs, Flash, pH, Reactivity (S, CN), ---,- PCBs As, Cd, Cr, Hg, Pb, TCLP (metals); if required based on total levels All the above tests were performed Other Laboratory.Analytical Data Attached X Screening Data Attached x Instrument Used and Constituents Found TOV (benzene equiv) HNU PI 101, 10.2 ev lamp pprnv . Description/Source of Release X UST, Other, Describe Date of Release 11/17/03 1 Soil Description Physical Description (sand, gravel, silt, etc.) ' Brown fine to coarse sand, some gravel, trace silt. Classification Method Burmeister 1954 Check if the following materials are present: ' clay, construction debris, vegetative matter, ash, coal, other deleterious materials (list) Soil Characterization Methodology Sampling Method Grab X Composite Biased samples (e.g. headspace screened, visually contaminated) Constitutes of Concern Site History (check if exza sheets attached) Curren[ Use Condoninium property I � ' Past Use Restaurant & Bar I_ the generator, having used due diligence, determined that there is no reason to suspect or believe that the petroleum contaminated soil has bean impacted by.any releases of oil or ' hazardous materials other than that of the known source or I have identified the additional oil and hazardous materials that are suspected or known to be present in the soil, in addition to those associated with the known release., including any anthropogenic contaminants. a search of information and records I, the generator, realize that due diligence shall consist of reasonably available to the generator of the contaminated soil and sufficient to make the determination. Such records and information may include, but are not limited to, those of tie generator, location of generation (i.e. facility if not the venerator), the Department's Bureau of Waste Site Cleanup and the municipality (i.e.Board of Health, Fire Department) within which rthe site is located. All samples for VOC analysis were collected according to DEP policy WSC 1-415. 5��. cure of Generator Date Dennis Cotto, President Generator - Printed Name A site diagram is required indicating any major structures or roads, excavation areas and ' stockpile locations. All sampling locations must be noted. Check if diagram attached. 1 SITE DIAGRAM cl—y' - ; I � k � E ,cn i V ' Dr up-wd-y ROIrA v 1 Name of Individual preparing diagram: BENVEI'r & O'REILLY, INC. r BTES/900 4/1/00 , 3 1 December 8, 2003 AGGREGATE ROBERT OUR ROBERT B. OUR CO., INC. INDUSTRIES 24 GREAT WESTERN AVE HARWICH, MA 02645 ' Re: Soil, Hawthorne Terrace 272 Craigville Beach Rd. Hyannis, MA ' Release Tracking#: 4-18130 Recyclable soil from the above address was received at our facility on December 5, 2003. Attached is the shipper's log of soil receipts totaling 88.79 tons along with the Bill of Lading and other receipt documentation. We will issue a"Certificate of Recycling"upon request after processing. Thank you for recycling soil at our So. Dennis facility. Yours truly, William R. Reinhardt Aw _ Manager, Soil Division i AGGREGATE INDUSTRIES Northeast Region 1101 Turnpike Street Stoughton, Massachusetts 02072 Telephone 781-344-1100 Facsimile 781-341-5523 DEC. 1.2003 4:42PM BENNETT & OREILLY iNU„ore r.D ' Massachusetts Department of Environmental Protection BWSC-012A Bureau of Waste Site Cleanup ' Release Tracking Number' R BILL OF LADING (pursuant to 310 CMR40.0030) 4❑ _ 18130 A. LOCATION OF SITE OR DISPOSAL SITE WHERE REMEDIATION WASTE WAS GENERATED: Release Name(optional): T3anrthcxne Terraca CendMi Street: _272 t raiaville Aeaeh Read location Aid: West of 9traiahtnrax ' Cltyfrowrl: ffiMmnig(Rarnct:abla) ZIP Code: Date/Period of Generation: 11/14/20Q3 to: _11121 aan1 Additional Release Tracking Numbers Associated with this Bill of Lading: 'Note: IFOts BrtaFLadd►g A t'ha result of a Lftnbef Remavat Action(LRN taken prior to NaWeObn, a Rota aso rimewhg Numbers not noadod. 8. PERSON CONDUCTING RESPONSE ACTION ASSOCIATED VM BILL OF LADW03 ' Name of organization; Name of contract; r)effiia Cette Title: Pregiftt Street: 777.Cr iayilla d Anarkmant 45 oitY/Tovrm: J3vanni_c State: MA ZIP Code: ommm Telephone.* InSt.790.4109 Ext.- C. RELATIONSHIP TO RELEASE OF PERSON CONDUCTING RESPONSE ACTION ASSOCIATEDWITH BILL OF LADING: ® RP or PRP Specify: ® Owner Operator 7 Generator ❑ Transporter Other RP or PRP: Fiduciary,Secured Lender or Munlclpallty with Exempt Status(as defined by M.G.L.e.21 E,a.2) U Agency or Public Utility on a Right of Way(as defined by M.G,L,o,21 E,s.SG)) ' Other Person: If an owner and/or operator Is not conducting the response actlon associated vfah the Bill of Lading,provide on an attachment the name, contact person address and telephone number,including any area code and extension for each If known, D. TRANSPORTER OR COMMON CARRIER INFORMATION: Transporter/Common Carrier Name: 1 Contact Person: Bill mcM&han Title: Street: _flreat West=Read City/Town: Nnrth_Harwich State: MA ZIP Code; Tel ho e• Ext.: E. RECLMNG FACILITY/TEMPORARYSTORAGE LOCATION: Operator/Factllty Name: 1 Contact Person: B,�111Rai0hRrxh Title: SnitsManap=r ' Street: 230 0=4t WPatmM Read City/Town: nth Dcnniv State: MA ZIP Code: Telephone: '81.341-45nn Ext.: ' Type of Facillty: ® Asphalt Batch/Cold Mix Landfill/Disposal Incinerator Temporary Storage (check one) ® ,asphalt Batch/Hot Mix Landfill/Daily Cover Other: Thermal Processing LandfilliStructural Fill EPA IdentiRcatlon#: ' Division of Hazardous Waste/Clacs A Permit#: 3-n1-0�l Division of Solid Waste Management Permit#: Actual/Anticipated Period'of Temporary Storage(specify dates If applicable): to: Reason for Temporary Storage: OT DEC. 2.2003 1:38PM BENNETT & OREILLY NO.J4r r.G MassachusettsDepartment of Environmental Protection BWSC-012A p Bureau of Waste Site Cleanup ' Release Tracking Number" BILL OF LADING (pursuant to 310 CMR 40.00301 18130 E. RECEIVING FACILITYITEMPORARY STORAGE LOCATION(continued) i Temporary Storage Address: Street: ' City/Town: State: ZIP Code: F. DESCRIPTION OF REMEDIATION WASTE: (check all that apply) Contaminated Media(check all that apply): O Sail C) Groundwater O Surface Water O Other. Contaminated Debris(check all that apply). O Vegetation or Organic Debris 0 Demolition/Construction Waste O Inorganic Absorbent Materials 0 Other: Non-hazardous Uncontalnerized Waste(check all that apply): 0 Non-aqueous Phase Liquid Q Other: Non-hazardous Containerized Waste(check all that apply): O Tank Battoma/Sludges Q Containers O Drums O Engineered Impoundments O Other. Type of Contamination(check all that apply): [� Gasoline Diesel Fual ® #2 011 94 Oil E] 0 Oil Waste Oil Kerosene Jet Fuel Other: Estimated Valume of Materials: Cuble Yards Tons: Other: Contaminant Source(check one/specify): Transportation Accident ® Underground storage Tank 0 other: Response Action Associated with Bill of Lading(check one): ® Immediate Response Action Release Abatement Measure Utility-Related Abatement.Measure limited Removal Action Comprehensive Response Actlon ❑ other Remediation Waste Charoterization Support Documentation attached: Site History Information ® Sampling and Analytical Methods and Procedures W Laboratory Data ® Field Soreening Data If supporting documentation Is not appended,provide an attaohment stating the data and in connection with what ,. document such Information was previously submitted to DER G. LICENSED SITE PROFESSIONAL(LSP)OPINION: ' Name of Organization: RENNETT O%FIT r v rNr_ LSP Name* nsvid I Rennetl' Title:. 2ireehor ofEnviranmg is SP'LdQass Telephone: _1QR-R96.66_1Q Ext.: 102 I attest under the pains and penalties of etu that I have personalty examined and am.familiar with this submittal,including any and all documents P P P ry accompanying this submittal. In my professional opinion and judgment based upon application of ' (i)the standard of Dare in 309 CMR 4,02(1), (ii)the applicable provisions of30B CMR 4.02(2)and(3),and (ii)the provisions of 309 OMR 4.03(5), ' to the best of my knowledge,information and belief,the assessment actions undertaken to characterize the Remediatlon Waste which is(are)the subject of this submittal for acceptance at the facility identined in this submittal comply with the applicable provisions of 310 CMR 40.0000,and such facility Is permitted to accept edietion Waste having the ehameteristics described in this submittal. I am aware that s' nsnies may result,Including,but not limited to,posslb fln and i nment,if I submit fnformatton which I know to be false,inaccurate late. OA'V1D seal: C. LSP Signature: t' BENNETT m r_ No,4303-*4 Date: ,9� `r F� /STE License Number: 4101 S/rE pt - DEC. 2.2003 1:38PM BENNETT & OREILLY INu.d4r r.d Massachusetts Department of Environmental Protection BWSC-01 ZA Bureau of Waste Site Cleanup Rel Trackin u ber ' BILL OF LADING (pursuant to 310 cMR 40.0030) a 18130 H. CERTIFICATION OF PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS BILL OF LADING. I certify under penalties of law that I have personally examined and am famillarwM the information contained in this submittal,including any and all documents aocompanying this certification,and that,based on my Inquiry of those indNiduals Immediately responsible for obtaining the information,the material information contained herein is,to the best of my knowledge and belief,true,accurate and complete. I am aware that there are significant ' penalties,includi , ut not limited to,pos '41e fines and imprisonment,for willfully submitting false,inaccurate/-r ncomplet information. Signature: Date; � ' Name of Person(print): tcnniq C - i 1 1 1 Massachusetts Department of Environmental Protection BWSC-012B Bureau of Waste Site Cleanup ' BILL OF LADING (pursuant to 310 CMR 40.0030) Release Tracking Number D E P SUMMARY SHEET OF 4❑ - 18130 ' I. LOAD INFORMATION: naA�olsp entativ : Signatur of R iving cifftyrTemporary Storage Representative: Load 1: Date of Shipment: © � � "" P Time of Shipment: �'O �0 j i Date of Receipt: Time of Receipt: VAM F „MPM /� r ❑Truck/Tractor Registration: Trailer Registration(if any): i 14- 0� PM 1 7� /� 6 17 f 7 i Load Size(cu.yds ons. Load 2: Sign ure o ranspo er Repre nta' i Signat of ivin acility/Temporary Storage Representative: Date of Shipment:P Tim f Shipment: i Time of Receipt: Date of Receipt: �AM ❑ PM AM ❑ PM Truck/Tractor Registration: Trailer Registration(if any): i L/ 7 �� 6?,77 i Load Size(cu.yds./tons): /DC Load 3: Signature of Transporter Representative: Signature of Receiving Facility/Temporary Storage Representative: i i Date of Shipment: Time of Shipment: i ❑ Date of Receipt: ❑ AM PM i Time of Receipt: ' i ❑ AM ❑ PM i Truck/Tractor Registration: Trailer Registration(if any): Load Size(cu.yds./tons): Load 4: Signature of Transporter Representative: i i Signature of Receiving Facility/Temporary Storage Representative: i Date of Shipment: Time of Shipment: � Date of Receipt: Time of Receipt: ❑ AM ❑ PM i ❑ AM ❑ PM Truck/Tractor Registration: Trailer Registration(if any): i I Load Size(cu.yds./tons): Load 5: Signature of Transporter Representative: i Signature of Receiving Facility/Temporary Storage Representative: Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: ❑ AM ❑ PM ❑ AM ❑ PM Truck/Tractor Registration: Trailer Registration(if any): i i Load Size(cu.yds./tons): Load 6: Signature of Transporter Representative: i Signature of Receiving Facility/Temporary Storage Representative: i Date of Shipment: Time of Shipment: Date of Receipt: Time of Receipt: ❑ AM ❑ PM i ❑ AM ❑ PM i Truck/Tractor Registration: Trailer Registration(if any): i Load Size(cu.yds.Rons): i J. LOG SHEET VOLUME INFORMATION: Total Volume Recorded This Page(cu.yds.Aons) Total Carried Forward(cu.yds./tons): Total Carried Forward and This Page(cu.yds./tons): ' Massachusetts.Department of Environmental Protection BWSC-012B Bureau of Waste Site Cleanup ' BILL OF LADING (pursuant to 310 CMR 40.0030) Release Tracking Number SUMMARY SHEET OF 4❑ -1 18130 ' I. LOAD INFORMATION: Signpture of Transporter Representative: i Signature of ece' ' g Faci' empo ry Storage Representative: Load 1: , �� Date of Shipment: Time of Shipment: I O Date of R' ipt: Time of Recei J �] AM � PM I �� AM � PM Truckrrractor Registration: Trailer Registration(if any): / " I Load Size(cu.yds./tons): 77 Load 2: Signature of Transporter Representative: I Signature of Receiving Facility/Temporary Storage Representative: I I Date of Shipment: Time of Shipment: I Time of Receipt: Date of Receipt: AM PM i AM PM I Truck/Tractor Registration: Trailer Registration(if any): I Load Size(cu.yds.Aons): Load 3: Signature of Transporter Representative: I Signature of Receiving Facilityrremporary Storage Representative: I Date of Shipment: Time of Shipment: I Date of Receipt: AM PM I Time of Receipt: O.AM PM Truck/Tractor Registration: Trailer Registration(if any): I I Load Size(cu.yds.Aons): M Load 4' Signature of Transporter Representative: I Signature of Receiving Facility/Temporary Storage Representative: I ' Date of Shipment: Time of Shipment: I Date of Receipt: Time of Receipt: AM ❑ PM AM PM TruckrTractor Registration: Trailer Registration(if any): I 1 I Load Size(cu.yds.Aons): Load 5: Signature of Transporter Representative: , Signature of Receiving Facility/Temporary Storage Representative: I I Date of Shipment: Time of Shipment: I Date of Receipt: Time of Receipt: AM PM i AM PM Truckrfractor Registration: Trailer Registration(if any): , I Load Size(cu.yds.Aons): I Load 6: Signature of Transporter Representative: I Signature of Receiving Facility/Temporary Storage Representative: I Date of Shipment: Time of Shipment: I Date of Receipt: Time of Receipt: AM PM , AM PM Truck/Tractor Registration: Trailer Registration(if any): I I Load Size(cu.ydsAons): I J. LOG SHEET VOLUME INFORMATION: Total Volume Recorded This Page(cu.yds.Aons) ' Total Carried Forward(cu.yds.Aons): Total Carried Forward and This Page(cu.yds./tons): 1 ' Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup BILL OF LADING(pursuant to 310 CMR 40.0030) Release Tracking Number SUMMARY SHEET OF ' K. SUMMARY OF SHIPMENTS: Daily Volume Shipped Date of Shipment: Date of Receipt: Number of Loads Shipped: (cu.y d s ons): 1 1 1 1 Summary Sheet Total Shipped: 7 Bill of Lading Total Shipped (only if different): ' Revised 1013/94 Page 1 of 2 ' Massachusetts Department of Environmental Protection BWSC-012C Bureau of Waste Site Cleanup �. BILL OF LADING(pursuant to 310 CMR 40.0030 Release Tracking Number SUMMARY SHEET R - F[�13 U ONLY COMPLETE ONE COPY OF THIS PAGE AND ATTACH TO THE FINAL COPY OF THE SUMMARY SHEET. L. ACKNOWLEDGMENT OF RECEIPT OF REMEDIATION WASTE AT RECEIVING FACILITY OR TEMPORARY STORAGE: Receiving Facility/Temporary Storage Representative(print): William R. Reinhardt Title: Manager Signature: Date: �j�� y1��1.�.��vLl. �c.L^k-� ) M. ACKNOWLEDGMENT OF SHIPMENT AND RECEIPT OF REMEDI ON WASTE BY PERSON CONDUCTING RESPONSE ACTION ASSOCIATED WITH THIS BIL OF LADING: ' I certify under penalties of law that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this certification,and that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in herein is,to the best of my knowledge and belief,true,accurate and complete, I am aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false,inaccurate,or incomplete information. Signature: Date: Name of Person(print): i, i Revised 10/3/94 Page 2 of 2 1 1 1 1 APPENDIX D i 1 1 1 i 1 1 t 1 1 1 1 1 LS RECT DEC 3 �oo GROUNDWATER Groundwater Analytical, Inc. P.O.Box 1200 ANALYTICAL Buz Main.Street Buzzards Bay, MA 02532�. i Telephone(508)759-4441 November 24, 2003 FAX(508)759-4475 www.groundwateranalytical.com Mr. David Bennett I Bennett & O'Reilly, Inc. P.O. Box 1667 Brewster, MA 02631 LABORATORY REPORT ■ Project: Hawthorn Terrace Condo Assoc./BO03-3909 Lab I D: 67139 Received: 11-19-03 Dear Dave: Enclosed are the analytical results for the above referenced project. The project was processed for Rush 3 Business Day turnaround. This letter authorizes the release of the analytical results, and should be considered a part of this report. This report contains a sample receipt report detailing the samples received, a project narrative indicating project changes and non-conformances, a quality control report, and a statement of our state certifications. The analytical results contained in this report meet all applicable NELAC standards, except as may be specifically noted, or described in the project narrative. This report may only be used or reproduced in its entirety. attest under the pains and penalties of perjury that, based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report.is, to the best of my knowledge and belief, accurate and complete. Should you have any questions concerning this report, please do not hesitate to contact me. Sincerely, Eric H.J nsen Operati ns Mana er EHJ/srn Enclosures 1 GROUNDWATER ANALYTICAL Sample Receipt Report Project. Hawthorn Terrace Condo Assoc./BO03-3909 Delivery: GWA Courier Temperature: 6'.0 Client: Bennett&O'Reilly, Inc. Airbill: n/a Chain of Custody: Present Lab ID. 67139 Lab Receipt 11-19 03 Custody Seal(s) n/a Cab ID �^x F�e1d ID;s & ri Matnx Sampled _ Metho� otes �67139-2 Stockpile Soil 1111 7/03 1 5:30 TPH by GC ASTM D3328-00 Mod ' Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336966 250 mL Glass Greenwood BX9569 None n/a n/a n/a I 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 r GROUNDWATER ANALYTICAL ASTU.METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GURD . 1 Lab ID: 67139-02 Hydrocarbons Laboratory 3.0 r ' 2.0 r 1.5 � r - 1.0 � r 0.5 1 0.0 0 b 10 15 20 25 30 35 -� Retention Time (Minutes) 1 1 1 r r GROUNDWATER ANALYTICAL ASTM Method D3328-00(Modified) Hydrocarbon Fingerprint by GGFID Field ID: Stockpile Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67139-02 QC Batch ID: HF-1929-M Sampled: 11-17-03 15:30 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 16 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-24-03 13:29 Dilution Factor. 5 Analyst: WN %Solids: 95 w,. This sample has GC/FID characteristics that are similar to: 1. Fuel Oil No.2/Diesel Fuel. 2. Based on the distribution of the isoprenoid hydrocarbons to the n-C alkanes, the Fuel Oil appears to be mildly weathered. . n �:- _Ana�yte ,_.,. G.,a0(1G, dtl0lt i.._..' .Note$ _ 1JnEt5` :Iep£or�ngLiimt`"�"` Total Petroleum Hydrocarbons 6,500 mg/Kg 290 QCrro ateComound� bS tked lNeasl�red Reoue, '"�'0 �; intts ortho-Terphenyl 2.6 d d 60-140 Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. I Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. d Surrogate recovery not measurable due to required sample dilution. 1 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL Project Narrative Project: Hawthorn Terrace Condo Assoc./BO03-3909 Lab ID: 67139 Client: Bennett&O'Reilly, Inc. Received: 11-19-03 16:40 t =''�rfiYs.' � 5^ Documentation"and Client Commumcat�on � '.'s7�. 5.+'w ""' s.3.. .:W'.'_' , ,zF w x}n' atw .�^r:a�`,.,r.� ' The following documentation discrepancies,and client changes or amendments were noted for this project: 1 : No documentation discrepancies,changes,or amendments were noted. ��, �,�� ,��`� �.B<Method Modrfications Non Conformances and Observations; �� The sample(s) in this project were analyzed by the references analytical method(s),and no method modifications, '. non-conformances or analytical issues were noted,except as indicated below: 1 . ASTM Method D3328-00(Modified): Sample 67139-02. Surrogate recovery was not measurable due to required sample dilution. r ' Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 228 Main Street,P.O.Box 1200 GROUNDWATER ®i! Of V/`9 Buzzards Bay,MA 9-444 CHAIN-OF-CUSTODY RECORD ANALYTICAL Telephone(508)canal 41•FAX(508)759-4475 AND WORK ORDER N www.groundwateranalytical.com 1q 0 077617 Project Name: Firm: iliril �l4 rrJio �e `ery-'4-- • �p�yy7 �f �r TURNAROUND ANALYSIS REQUEST /Issue 'A ®,` ��' J-i-1L• 0Z STANDARD(10 Business Days) Its allies Semlvolatlies WHO /PCBs Metals PelmleumH Erooarhon Haz. Project Number: Address: H Extractable V.I. Ext TP General Chemistry Other Z PRIORITY(5 Business Days) vnUP Waste '. .,RU ,SNP &K 16i (Rush g requires Rush Authorization Number) F a g d , s Sampler Name: City/State'/Zip: ° ° ° ° H 3 0 o e z ❑Please Email to: - M Please FAX to:.SQL cis Eti c°"� 3 ° _ K Project Manager: H B o I g Telephone: BILLING "' ° - o - E y 0 1 0 0 _ 9 �± 0 0 0 ❑ a _ E 1� 0 Purchase Order No.: o A m m ❑ Third Party Billing: INSTRUCTIONS:Use separate line for each container(except replicates). o 9 ° o❑ GWAQuote: a d n 0 5 x Sampling Matrix Type Container(s) Preservation Filterer o 0 0 0 0 0 0 0 0 0 2 0 5 a o o 0 r e ° tt ., — e n = A .g o a ❑ a o IDENTIFISAMPLE „Fs, w — B A d — LABORATORY W a o n m g ❑ CATION 3 3 N < - - — NUMBER E e a s 3 o a $ ° 0 IY) $_ e a $ d .o ❑ ❑ ° d o (Lab Use On E ,"S, r n .F< Z c �, a ❑ m Om c o c 9 Q = a Q c a c a 6 v A s 0❑ o❑0 00 a o 0 0 0 0❑❑ 0 0 0 o a £ a s .4 z x a U ,C�N.t9} i ;:rat i .,✓;'se h f "'✓ N v.'I; s .r� M ylA `'-x;•t-aei at 7* y f .:e .n.,.ax�:s.- z _,,. ,_f,�w:;t; �,,.`k s ad x ! .#� tl e=! ^, w i Ei �. .rY,�.>:.z r =' x. :c•�f.=. .,n.,.«,. a n gz r:.,:,.p.; .. r 'y 5 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a ❑ ❑ Elmst '`a�x`�"M d"r� r r '.�:�`�1 € ;a.- 7*o- 111511 "~x ✓, :SA x V t -��,:, Fi iF�i. n. tiffs. �. , J u u A +aik ,' i J - T I _.x r : r*� m::y^ °r%.�_f fir,��v..�L "��v�SNr s�. T� 1 Vy' ��'' �''- �^a h x p�,rrl. srt� a �-�r"3� '�'f s�`i'�y r}'E�`��7 y x 777 7 . :x: nr R .,,;,h. } M i I H.n,,;ik`- s � 9 t nd. &.:,-'�1;uve' h n r4ty k.San s�Gt'c: �;lCe, 5ryka-'h vl,r,1:�:te'ir.., a . i i Y Ir ::: ,n ✓ _ F'.'3x d- Rt5F1 - d A r,`N't`Y..�R "F,;i,..N ., ..�:;..,.....v,w,4#,�, ', 1 r .x 5, ?{n I ��,.�.,i k„:s✓ o- a✓m�:.'i r�u<,r.RCr ,v+,:�^."x°' °n3` r.''ml,'Y w.,. ;*� r Sth'r?:' ;r1(s r .7nr ''tl #1 qS (Ip a F aj'�'�i`L' pad t' -:vcm �„n,a..T7`,a✓- .ir 7rn..4sia `.reru F'"r s 4?0q i'sn:»��u�i;.,I.x_ f .o-i -F xr - r } rc�R : `' °+ `` stc ;3'w f n.. z,1 r ,an A:.,` : om t_ s.3 had * ... ,e .ds.� ., i --+r#•r �.-= F_« `1°-;g• .:.e: l s r i�'?l�, ��:•r:'I!�r... - aai:,.Tw .�'za:;#laanY,s ,�,n.:,.a'rai#�� e,..�:� i;"�!/:��' �r �� ` , s`,ig.`•{tg�k"3,h,f.��i�� +';..�;�a�;��1�.�,,�'Y,�q�'r,.,�,;t i r'w, t ,w t REMARKS/SPECIAL INSTRUCTIONS DATA QUALITY OBJECTIVES CHAIN-OF-CUSTODY RECORD P'"= ?''a pt:a1,','. rry Regulatory Program Project Specific;OC NOTE:All samples submitted subject to Standard Terms and Conditions on reverse hereof. MA DEP MCP Data En�ltancement Affirmation State Standard Deliverables Many regulatory programs and EPA methods require project zzg�� 9 P 1 Date Time Received by: Receipt Temperature:p 5YES ONO MCP Data Certification is required. specific Spikes, Project specific QC includes Sample ora orytes,9 ❑CT fi34MCPGW-1/S-1 ❑PWS Form Matrix Spikes,and/or Matrix Spike Duplicates.Laborato QC Is n re toe�trieer�cee tiff C DYES❑NO MCP minimum Field QC requirements ❑ME ❑MCP GW-2/S-1 O not project specific unless prearranged:Project specific QC /hf��I'll,Jr0 IJ�Q z-e°c Reammanded have been'met for this project. samples are charged on a per sampletasis.Each MS,MSD Relinqui of t Date .Time Recei ed Container Count: P I WMA p NY STARS ❑ and Sample Duplicate requires an additional sample aliquot. y py (Metals,bematrixchromiumand cyanide analyses ��/�0 ]yod IJ) //� _ 'Y, 5 require one matrix spike perlosamples) ❑NH ❑Drinking Water "//pV/Y(n// 'f79,/!i OYES O;NO MCP Drinking Water samples required. ❑NY ❑Wastewater Project Specific OC Required Selection of QC,Sample Relinq Ishe D to Time R c Ned by Lab ry: Shipping/Airbill (Require collection of contingent duplicate samples. ❑RI ❑Waste Disposal ❑Sample Duplicate O Please use sample: k J/� Number: Trip blanks are also required,if VOA samples collected l Qf ( 'Q ❑VT ❑Dredge Material ❑Matrix Spike - Signature: -'e�e�a w'`..rz F's:^ p❑— ❑ ❑Matrix Spike Duplicate Method ri fiSKipmAnt:[9 GWA Courier O Express Mall❑Feder ross Custody Seal 0 UPS 0 Hand 0 Number: GROUNDWATER ANALYTICAL Quality Assurance/Quality Control 1 e a u w r Q 1 Groundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the guidance provided by Interim Guidelines and ' Specifications for Preparing Quality Assurance Project Plans, US EPA QAMS-005/80 (1980), and Test Methods for Evaluating Solid Waste, US EPA, SW-846, Update III (1996). Quality Control protocols include written Standard Operating Procedures (SOPs) developed for each analytical method. SOPS are derived from US EPA methodologies and other established references. Standards are prepared from commercially obtained reference materials of certified purity, and documented for traceability. Quality Assessment protocols for most organic analyses include a minimum of one laboratory control sample, one method blank, one matrix spike sample, and one sample duplicate for each sample preparation batch. All samples, standards, blanks, laboratory control samples, matrix spikes and sample duplicates are spiked with internal standards and surrogate compounds. All instrument sequences begin with an initial calibration verification standard and a blank; and excepting GC/MS sequences, all sequences close with a continuing calibration standard. GUMS systems are tuned to appropriate ion abundance criteria daily, or for each 12 ' hour operating period, whichever is more frequent. Quality Assessment protocols for most inorganic analyses include a minimum of one laboratory control sample, one method blank, one matrix spike sample, and one sample duplicate for each sample preparation batch. Standard curves are derived from one reagent blank and four concentration levels. Curve validity is . verified by standard recoveries within plus or minus ten percent of the curve. .�trs�>vrii�;�.,��tA;��°�a�,.��'�'a-,L .n.,Fm:., .°,�,., :,'�'_v.Y.�.�. ..'� «<_'��.�...�...w%,'�,&Ave,:r� x �.,.b:, xr. �`�"Fsa. .�;,� ,v�.•a.�.*.,: ,`�.�.�?.., .a�:. .. .,.�' Batches are used as the basic unit for Quality Assessment. A Batch is defined as twenty or fewer samples of the same matrix which are prepared together for the same analysis, using the same lots of reagents and the same techniques or manipulations, all within the same continuum of time, up to but not exceeding 24 hours. Laboratory Control Samples are used to assess the accuracy of the analytical method. A Laboratory Control Sample consists of reagent water..or sodium sulfate spiked with a group of target analytes representative of the method analytes.: Accuracy_is defined as the degree of agreement of the measured value with the true or expected value.. Perent Recoveries for the Laboratory Control Samples are calculated to assess accuracy. Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliquot of sodium sulfate. Method Blanks are taken through all the appropriate steps of an analytical method. Sample data reported is not corrected for blank contamination. . Surrogate Compounds are used to assess the effectiveness of an analytical method in dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to the target analytes of interest in chemical behavior, but which are not normally found in environmental samples. Percent Recoveries are calculated for each Surrogate Compound: ' Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 . GROUNDWATER ANALYTICAL Quality Control Report Laboratory Control Sample Category: ASTM D3328-00 Mod Hydrocarbon Fingerprint Instrument ID: GC-4 HP-5890 QC Batch ID: HF-1929-M Extracted: 11-20-03 18:00 Matrix: Soil Analyzed: 11-21-03 15:49 Units: mg/Kg Analyst: WN Fuel Oil No.2 130 120 92 % 60 140 I�QCSur'rogate Compound Spiked Measured �Recbyeryx:- QC Lrmits e„ , ortho-Terphenyl 2.7 2.7 100 % 60-140% 1 Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02,American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. ' Sample extraction performed by microwave accelerated solvent technique. Report Notations: All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. 1 1 1 ' Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL Quality Control Report Method Blank Category: ASTM D3328-00 mod Hydrocarbon Fingerprint Instrument ID: GC-4 HP-5890 QC Batch ID: HF-1929-M. Extracted: 11-20-03 18:00 Matrix: Soil Analyzed: 11-21-03 15:07 Analyst: WN 'K.4 H"NR � -'i Total Petroleum Hydrocarbons BRL mg/Kg 30 MG gpl. 1 6M ortho-Terphenyl 2.7 2.3- 85 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 ! 1 GROUNDWATER ANALYTICAL Certifications and Approvals Groundwater Analytical maintains environmental laboratory certification in a variety of states. Copies of our current certificates may be obtained from our website: ' http://www.groundwateranalytical.com/qualifications.htm r r x wm a.r "" , ��s'kw 'atk'�d`.x' �` - r" ' � CONNIECTICUT Department of HealthrServicesl P j � k r H U586 � K �`§t sr ,YD" ",..w.. ;F✓_s- b"dx7 2 'u•. „""i:C Categories: Potable Water,Wastewater,Solid Waste and Soil http://www.dp h.state.ct.us/B RS/Envi ron mental_Lab/OutStatelabli st.htm r -,4,�F10RIDA Department of H alth,Bureau Categories:SDWA,CWA, RCRA/CERCLA ' http://www.floridadep.org/labs/qa/dohforms.htm Categories: Drinking Water and Wastewater http://www.state.me.us/dhs/eng/water/Compliance.htm MA SACHU�SETTDepartmentof�Env�ronrnenta Protect�o"nt°M MA=1a3 � �� ' Categories: Potable Water and Non-Potable Water http:l/www.state.ma.us/dep/bspt/wes/fiIes/Certlabs.pdf NEW HAMPSH{RE, Department of EnvronmentaE Serv�ces�, 2$027U3 � ,�. �, www . Categories: Drinking Water and Wastewater ' http://www.des.state.nh.us/asp/NHELAP/labsview.asp Categories: Potable Water, Non-Potable Water and Solid Waste http://www.wadsworth.org/labcert/elap/comm.html ��` s a �, ,r.-. '"`�• �'�� A Z�a�h�a a 7�S� �"F"�.c "��°a:."' '" '�,*e �`" ;1�, y�„k�;� a ? �': Y z V. PENNSYLVAN%IA Department of Environments!P°rotection �68665 � � �, r 1 Environmental Laboratory Registration(Non-drinking water and Non-wastewater) http://www.dep.state.pa.us/Labs/R6gisiered/ Ij RHODE ISLAND,-Department of Health; �.w(+ �`r_ Categories:Surface Water,Air,Wastewater, Potable Water,Sewage http://www.healthri.org/labs/labsCT—MA.htm U-S De artment of A r�culture ,Sort Pei r 4 aX p ,g _��_ ._.., .' ft t rmit� S 53921 . r ✓a,, .. ..,2G.. ,' Foreign soil import permit VERMONT, Department of Environmental Conservation,Water Supply D ong-~ ; ' Category: Drinking Water http://www.vermontdrinkingwater.org/wsops/labtable.PDF Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 ' Groundwater Analytical,Inc. GROUNDWATER P.O.Box 1200 ANALYTICAL Buz Main Street ' Buzzards Bay,MA 02532 Telephone(508)759-4441 November 26, 2003 FAX(508)759-4475 www.groundwateranalytical.com Mr. David Bennett Bennett & O'Reilly, Inc. P.O. Box 1667 Brewster, MA 02631 LABORATORY REPORT Project: Hawthorn Terrace Condo Assoc./BO03-3909 Lab I D: 67156 Received: 11-19-03 ' Dear Dave: Enclosed are the analytical results for the above referenced project. The project was processed for ' Priority turnaround. This letter authorizes the release of the analytical results, and should be considered a part of this ' report. This report contains a sample receipt report detailing the samples received, a project narrative indicating project changes and non-contormances, a quality control report, and a statement of our state certitications. The analytical results contained in this report meet all applicable NELAC standards, except as may be specifically noted, or described in the project narrative. This report may only be used or reproduced in its entirety. I attest under the pains and penalties of perjury that,.based upon my inquiry of those individuals, immediately responsible for obtaining the intormation, the material contained in this report is, to the best of my knowledge and beliet, accurate and complete. Should you have any questions concerning this report, please do not hesitate to contact me. Jensen ' ' EH)/kal Enclosures r 1 GROUNDWATER ' ANALYTICAL Sample Receipt Report ' Project: Hawthorn Terrace Condo Assoc./BO03-3909 Delivery: GWA Courier Temperature: 6'C 1 �' p Client: Bennett&O'Reilly, Inc. Airbill: n/a _ Chain of Custody; Present La�tD 67756 Lab Receipt 11 19 03 CustodySeal(s? n/a ------ 41 Lab ID Field ID � 3 .`""Matrix SampledMethod f �� m ""k� Notes 67156-1 SW-Sx3:0-4 Soil 11/19/03 9:45 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336959 250 mL Glass Greenwood I BX9569 None n/a n/a n/a �L�ab�IDs1s �ieid lD v: � j° MatnN Sample{ Method �v �" 9tlotesr � k .,:zr��,,:awt�,-m" av;sv 67156-2 SW-N 4-10' Soil 11/19/03 9:45 MA DEP EPH with PAHs Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336954 250 mL Glass Greenwood BX9569 None n/a n/a n/a Lab�� eIdID� *<,,« F � Matrixt b Samettodx µ m '. .Notes` � a 67156-3 SW-S: 4-10' Soil 11/19/03 10:20 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336953 210 mL Glass Greenwood BX9569 None n/a n/a n/a �r�labl�D jp�y �F�etdlD�� rx�� x „�Matr�x �z Sampled'��`�Metlod � � m_"1/1. s FEW 67156-4 SW-E: 4-10' Soil 19/03 10:25 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336958 250 mL Glass I Greenwood BX9569 None n/a n/a n/a �LabID� FeeldtD.. �Matnx �>Sampled - Method �t r � `• ,.�, t< � Notes�� „� �� _"_,�,;� 67156-5 SW-W: 4-10' Soil 11/19/03 10:30 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336955 250 mL Glass Greenwood BX9569 None n/a n/a n/a Lab tD Field IDS :' Matrix 4 "Sampled ' M hodk '3_ € Notes ' 67156-6 SW-N:m1e0-13' Soil 11/19/03 11:00 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336956 250 mL Glass Greenwood BX9569 None n/a n/a n/a Feeld lD x Matrix rSampled Method"" "_; Notes ° I 67156 7 SW S: 10-13' Soil 11/19/03 11:05 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336949 250 mL Glass Greenwood BX9569 None n/a n/a n/a 1Field ID a* Matrix Sampled Method t r sw I,M, Notes� � r ..,',t �. ,. PiM 67156-8 SW-Er�10-13' Soil 11/19/03 1.1:10 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC lot Prep Ship C336950 250 mt Glass Greenwood BX9569 None n/a n/a n/a a r g uCab ID .� Fee1d ID ," ` �. Matrix+, Sampled '"'Method"` .ca, - 8 �t� 67156-9 SW-W: 10-13' Soil 11/19/03 11:15 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336951 250 mL Glass Greenwood BX9569 None n/a n/a n/a % LaID Field'ID` '� �Matriz Sam led Method � � ifV�otes� �a..,,... ;�.� ; ew .« 67156-10 BOH @ 13' Soil 11/19/03 11:20 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336952 250 mL Glass . Greenwood BX9569 None n/a n/a n/a II Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL Sample Receipt Report (Continued) Project: Hawthorn Terrace Condo Assoc./BO03-3909 Delivery: GWA Courier Temperature: 6'C Client: Bennett&O'Reilly, Inc. Airbill: n/a Chain of Custody: Present Lab ID 67156 Lab Receipt 11-19 03 Custody Seal(s) n/a Lab IDt Field ID *'? a Matnx . Sampled_ Method 3Y t � y Notes y � F� 67156-11 SW:Nx2 04' Soil 11/17/03 15:05 TPH by GC ASTM D3328-00 Mod ' Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C307028 40 mL VOA Vial n/a n/a None n/a I LabIDF�eld_IDs � (1latnxxSaht pled Met od . 5 .v . 67156-12 SW:Ex2 04' Soil 11/17/03 15:10 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C336972 250 mL Glass Greenwood BX9569 None n/a n/a n/a eLab lD .?F�e1d tDt .LL.r'..,t� Matnx� Sampled 67156-13 SW:Wx2 0-4' Soil 11/17/03 15:15 TPH by GC ASTM D3328-00 Mod Con ID Container Vendor QC Lot Presery QC Lot Prep Ship 007029 40 mL VOA Vial n/a n/a None n/a n/a n/a a v r ='Lab ID r. F�eId YD -,`r Matnx" *Sampled Method µ .��w Notes 67156-14 SW-N: 4-10' Soil 11/17/03 10:15 MA DEP VPH with Targets Con ID Container Vendor QC Lot Presery QcLot Prep Ship ' C333156 60 mL Glass Industrial BX8483 Methanol R-3705P 1 07-29-03 1 08-12-03 i 1 1 Groundwater.Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ' ANALYTICAL Data Certification Project: Hawthorn Terrace Condo Assoc./BO03-3909 Lab ID: 67156 Client: Bennett&O'Reilly,Inc. Received: 11-19-03 16:40 i "31 ..,*�✓_.. �_K � ;` �r_a..a y, r:rr.'3'x,<M.._._ .�e..,.�.w. ^ fAnaltMfh � My.3 �tt ACffEPCrtp myid Project Location: n/a MA DEP RTN: n/a This Form provides certifications for the following data set: ' MA DEP VPH: 67156-14 MA DEP EPH: 67156-02 Sample Matrices: Groundwater ( ) Soil/Sediment (X) Drinking Water ( ) Other ( ) 8260B ( ) 8151A ( ) 8330 ( ) 601013 ( ) 7470A/1A ( ) Methods Used 8270C ( ) 8081A ( ) VPH (X) 6020 ( ) 9012A2 ( ) As spe m MA DEP 8082 ( ) 8021 B ( ) EPH (X) 7000 S3 ( ) Other ( ) C"o P afied end um;ofMAnal al i LdstsRelease Tra in Number(RTM if-known lvtethotls #"�s ` 2 SSW-846 Method 9072A(Equivalen to-9014}of MA DEP Physwlogically AvaQ le Cyafii ftPA en ual me 7 Method s"� ' (chuck aU thatapply) 3 3 S 4 SW 846Methodsw7000 5eslist individthod and aoalyte An affirmative response to questions A, B,C and D is required for"Presumptive Certainty"status. A. Were all samples received by the laboratory in a condition consistent with that described on the Chain-of-Custody documentation for the data set? Yes B. Were all QA/QC procedures required for the specified analytical method(s) included in this report followed, including the requirement to note and ' discuss in a narrative QC data that did not meet appropriate performance standards or guidelines? Yes ' C. Does the analytical data included in this report meet all the requirements for"Presumptive Certainty,"as described in Section 2.0 of the MA DEP document CAM VII A,Quality Assurance and Quality Control Guidelines for the Acquisition and Reporting of Analytical Data? Yes D. VPH and EPH methods only: Was the VPH or EPH method run without significant modifications,as specified in Section 11.3? Yes A response to questions E and F below is required for"Presumptive Certainty"status. E. Were all QC performance standards and recommendations for the specified methods achieved? Yes F. Were results for all analyte-list compounds/elements for the specified method(s)reported? Yes All No answers are addressed in the attached Project Narrative. I,the undersigned,attest under.the pains and penalties of perjury that,based upon my personal inquiry of those responsible for obtain* the information,the material contained in this analytical report is,to the best of my n wledge and belief,accurate and complete. Signature: Position: Operations Manager Printed Name: Eric H.J risen Date: 11-26-03 Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532 i GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID '. Field ID: SW-Sx3:0-4 Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass Client: Bennett&O'Reilly,Inc. Preservation: Cool ' Laboratory ID: 67156-01 QC Batch ID: HF-1929-M Sampled: 11-19-03 09:45 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g ' Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 21:03 Dilution Factor: 1 Analyst: WN %Solids: 94 ' AT '�13110'116 ... .. uahtatrve Identification No petroleum product was identified for this sample. Total Petroleum Hydrocarbons BRL mg/Kg 62 ortho-Terphenyl 2.8 2.2 81 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. ' Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID ' Lab ID: 67156-01 Hydrocarbons Laboratory 0.35 ' 0.30 ' 0.25 ' 0.20 0.15 0.10 ' 0.05 ' 0.00 0 5 10 15 20 25 30 35 Retention Time (Minutes) GROUNDWATER ANALYTICAL Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GUID ' Field ID: SW-N 4-10' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-02 QC Batch ID: EP-1774-M Sampled: 11-19-03 09:45 Instrument ID: GC-9 Agilent 6890 ' Received: 11-19-03 16:40 Sample Weight: 16 g Extracted: 11-20-03 16:00 Final Volume: 1 mL Analyzed(AL): 11-23-03 16:27 %Solids: 94 Analyzed(AR): 11-23-03 17:12 Aliphatic Dilution Factor: 1 ' Analyst AG Aromatic Dilution Factor 1 r �¢' ra EP1H Ranges Wf `". �� '��':-""�_ `',.� s �''° Concentratron r %F '✓'t(otes�: tUmtsReporungtimt' n-C9 to n-C18 Aliphatic Hydrocarbons t BRL �mg/Kg 31 n-Cl9 to n-C36 Aliphatic Hydrocarbons t BRL mg/Kg 31 n-CI1 to n-C22 Aromatic Hydrocarbons t° BRL mg/Kg 31 Unadjusted n-CI1 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg 31 91-20-3 Naphthalene BRL mg/Kg 0.51 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.51 85-01-8 Phenanthrene BRL mg/Kg 0.51 83-32-9 Acenaphthene BRL mg/Kg 0.51 208-96-8 Acenaphthylene BRL mg/Kg 0.51 86-73-7 Fluorene BRL mg/Kg 0.51 120-12-7 Anthracene BRL mg/Kg 0.51 206-44-0 Fluoranthene BRL mg/Kg 0.51 129-00-0 Pyrene BRL mg/Kg 0.51 56-55-3 Benzo[a]anthracene BRL mg/Kg 0.51 ' 218-01-9 Chrysene BRL mg/Kg 0.51 205-99-2 Benzo[b]fluoranthene BRL mg/Kg 0.51 207-08-9 Benzo[k]fluoranthene BRL mg/Kg 0.51 50-32-8 Benzo[a]pyrene BRL mg/Kg 0.51 193-39-5 Indeno[1,2,3-c,d]pyrene BRL mg/Kg 0.51 ' 53-70-3 Dibenzo[a,h]anthracene BRL mg/Kg 0.51 191-24-2 Benzo[g,h,i]perylene BRL mg/Kg 0.51 QC%Surrogate`Compouncl �'�?;, ,� 'Sptk_ed Measured- ,,„. Recovery „ � �� QC�,-Ltm�ts� ry��s,„ Fractionation: 2-Fluorobiphenyl 2.7 2.4 87 % 40-140% 2-Bromonaphthalene 2.7 1.5 54 % 40-140% Extraction: Chloro-octadecane 2.7 2.5 93 % 40-140%. ortho-Terphenyl 2.7 2.7 99 % 40-140. ° r ,- , r t/ C l.el'sft#,tCdfq'n a, 14Fd..+:,'.k, bV '1Y 0 S. . �L .M."h!,4 .:'{L,y 1.'a+z�- ..>`.�-i. ,.�._ v.e. �._. ._ i .,z�n1311.:. 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all perforrnance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.1.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(1998). Sample extraction performed by microwave accelerated solvent extraction technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. �l t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID Field ID: SW-S: 4-10' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass ' Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-03 QC Batch ID: HF-1929-M Sampled: 11-19-03 10:20 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 16 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 21:48 Dilution Factor: 1 Analyst: WN %Solids: 96 W� No petroleum 34, goal illenfirficalon p product was identified for this sample. Total Petroleum Hydrocarbons BRL mg/Kg 60 QC';Surrogate Compoundr" ` t r Splked ,?Measured, Recovery 4 ' a QC Limtts' x� �, v ' ortho-Terphenyl 2.7 2.2 84 % „v Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 ' GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID Lab ID: 67156-03 Hydrocarbons Laboratory 0.35 0.30 0.25 020 ' 0.15 0.10 0.05 0.00 0. 5 10 15 20 25 30 35 Retention Time (Minutes) 1 GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID Field ID: SW-E: 4-10' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./6003-3909 Container: 250 mL Glass ' Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-04 QC Batch ID: HF-1929-M Sampled: 11-19-03 10:25 Instrument ID: GC4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g ' Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 22:33 Dilution Factor: 1 Analyst: WN %Solids: 97 :+ a, ' .racs�az� M ' t . �- aZ'+' ,.x�.r .#*� ...4' g"�.. ?ka:i,`r a't �;z:• �.r,.«� r,,asQualttaflve.l(tlrflcaflon�' A..� ., �. �„vim,, R No petroleum product was identified for this sample. �" s ..r b cM41 sr-' '.2 5e ..wu- And�yte ,cE4 C011CelttldtlOtl g #x _NOtCS Uftt1S x jRepoAmgL�m�t Total.Petroleum Hydrocarbons BRL mg/Kg 61 ?acY ^, ^tt 5 s' era & �'ti" QC Surrogate Compqund sg Splked Measured Recover. 5 CLimlts ortho-Terphenyl 2.7 2.3 83 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 1 GROUNDWATER ' ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID Lab ID: 67156-04 Hydrocarbons Laboratory 1 0.35 ' 0.30 0.25 0.20 0.15 0.10 0.05 0.00 0 5 10 15 20 25 30 35 Retention Time (Minutes) 1 _ _ GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID Field ID: SW-W: 4-10' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./B003-3909 Container: 250 mL Glass Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-05 QC Batch ID: HF-1929-M Sampled: 11-19-03 10:30 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 15:07 Dilution Factor: 1 Analyst: WN %Solids: 96 .. "",QuahtatlV"„e"IdentlflCdtlOtt ,'ar 'wn £a23 -r; .z..._... �M-s. *� ...:_. wd-�-z��"., .... . No petroleum product was identified for this sample. yt x� , k,-r^€-° e ;§ t,� a`tCOnCe trdt1011p '` NOteS s w UR17•S � ReportmgL�mf`"'r'. l Total Petroleum Hydrocarbons BRL mg/Kg 61 QC Surrogate�Compound '. j„Sptked Measured Q, ,_a Recovery ".. s. QCLmlts :t ortho-Terphenyl _. 2.7 1 2.2 1 81 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 1 I ' Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified)' Hydrocarbon Fingerprinting by GC/FID 1 Lab ID: 67156-05 Hydrocarbons Laboratory 0.35 0.30 0.25 0.20 0.15 0.10 0.05 0.00 0 10 20_ 30 40 50 60 70 Retention Time (Minutes) I t - GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID Field ID: SW-N: 10-13' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250rnL Glass Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-06 QC Batch ID: HF-1929-M Sampled: 11-19-03 11:00 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 15:49 Dilution Factor: 1 Analyst: WN %Solids: 97 : "I"�.�'�;. No petroleum product was identified for this sample. A alyte �t 7 .. �Cb c nfration Note R. s 4 �l�ntsRportmg um�t _r . Total Petroleum Hydrocarbons BRL mg/Kg 61 i QCSurrogate Compound Sprked Measured j `Recovery ) y QC Ltmits ortho-Terphenyl 2.7 1.8 68 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the I basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 1 I 1 - - Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 1 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID Lab ID: 67156-06 Hydrocarbons Laboratory 0.35 0.30 0.25 I 0.20 0.15 0.10 0.05 0.00 0 10 20 30 40 50 60 70 ' Retention Time (Minutes) 1 1 t GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) �. Hydrocarbon Fingerprint by GC/FID Field ID: SW-S: 10-13' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass ' Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-07 QC Batch ID: HF-1929-M Sampled: 11-19-03 11:05 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 16:34 Dilution Factor: 1 Analyst: WN %Solids: 97 � No petroleum product was identified for this sample. Cimit' ` Total Petroleum Hydrocarbons BRL mg/Kg 60 Q { . a CsSurrogateCom ound Sprkeds)INeasurec! � � Recovery � _ QCtmtt5' >...�,� ..._, k. KP �_ ��.�... .�_ �.. .__ W�E ,m .� _._� ortho-Terphenyl 2.7 2.2 85 % 60-1, Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the ' basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 1 - 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 i GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) 1 Hydrocarbon Fingerprinting by GC/FID Lab ID: 67156-07 Hydrocarbons Laboratory 1 0.35 0.30 0.25 1 0.20 0.15 0.10 0.05 1 0.00 0 10 20 30 40 50 60 70 Retention Time (Minutes) 1 GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon. Fingerprint by GC/FID ' Field ID: SW-E: 10-13' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-08 QC Batch ID: HF-1929-M Sampled: 11-19-03 11:10 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 17:19 Dilution Factor: 1 Analyst: WN %Solids: 94 No petroleum product was identified for this sample. Total Petroleum Hydrocarbons BRL mg/Kg 62 QrC-Surrogate Compound� k �. �, Spiked 'Measured �- � ,Recovery �� `��_�"_�QC Limtts��` :'r,�a" ortho-Terphenyl 2.8 1 2.3 84 % � � 6)-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the ' basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. I Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GG/FID Lab ID: 67156-08 Hydrocarbons Laboratory 0.35 0.30 0.25 ' 0.20 0.15 ' 0.10 0.05 0.00 0 10 .20 30 40 50 60 70 Retention Time (Minutes) GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID Field ID: SW-W: 10-13' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass Client: Bennett&O'Reilly,Inc. Preservation: Cool ' Laboratory ID: 67156-09 QC Batch ID: HF-1929-M Sampled: 11-19-03 11:15 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 18:03 Dilution Factor: 1 Analyst: WN %Solids: 97 < uahtatiue�i'denldicatton .,9a...,= No petroleum product was identified for this sample. Ng VA alte ,', " ? " ` " Concentration � Ngtes � UnItSRep rtmg.Lim�t Total Petroleum Hydrocarbons BRL mg/Kg 61 QC Surrogate Cornpound < Spiked Measured ,- Recovery ) Q mtts_---- ortho-Terphenyl 1 2.7 2.3 85 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution: 1 ' Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) ' Hydrocarbon Fingerprinting by GC/FID i Lab ID: 67156-09 Hydrocarbons Laboratory 0.35 0.30 ' 0.25 0.20 0.15 ' 0.10 0.05 1 0 00 0 10 20 30 40 b0 60 70 ' - Retention Time (Minutes) GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FI D ' Field ID: BOH a 13' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass ' Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-10 QC Batch ID: HF-1929-M Sampled: 11-19-03 11:20 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 16 g 1 Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 18:48 Dilution Factor: 1 Analyst WN %Solids 97 Qualitative 1'lenYtficatron �w � u o _ .. No petroleum product was identified for this sample.. `A �e UlittS`Yr-"ZReporfmgLimit �'" Total Petroleum Hydrocarbons BRL mg/Kg 60 �CSu rr o afe'Com o nd" t e, S tked rl4leaured� � Recovery F `QC LlmttsPs ortho-Terphenyl 2.6 2.2 85 % 60-140% I Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the ' basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. i 1 1 1 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID ' Lab ID: 67156-10 Hydrocarbons Laboratory 0.35 0.30 0.25 ' 0.20 ' 0.15 0.10 0.05 0.00 0 10 20 30 40 50 60. 70 ' Retention Time (Minutes) GROUNDWATER ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GUID Field ID: SW:Nx2 0-4' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 40 mL VOA Vial Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-11 QC Batch ID: HF 1929 M Sampled: 11-17-03 15:05 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 20:18 Dilution Factor: 1 Analyst: WN %Solids: 94 ., ,z y Q,uahtatweldentrftcatton ,: •`",r °'mot:.. _ �' No petroleum product was identified for this sample. y "`:t x COnCentr .. .' r5`UnitS,. µReporting Limit Total Petroleum Hydrocarbons BRL mg/Kg 62 dte cOrt1 OURd ',� � :s f S iked �1 VI Cd '�* w'�AeRoCOVeh'y""� '+aR,31 ' ".'r arx"QC'�_ .IrI11tS + '"ar.,i.rs ortho-Terphenyl 2.8 �2.3 83 % 60-140 Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID Lab ID: 67156-11 Hydrocarbons Laboratory 0.35 0.30' 0.25 0.20 - 0.15 Ii 0.10 0.05 0.00 0 . 10 20 30 40 50 60 70 Retention Time (Minutes) GROUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID Field ID: SW:Ex2 0-4' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 250 mL Glass I Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-12 QC Batch ID: HF-1929-M Sampled: 11-17-03 15:10 Instrument ID: GC4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 16 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 21:03 Dilution Factor: 1 Analyst: WN %Solids: 96 5 t � � � �� uahtatrve�ldentrficatton� .� � � ,� No petroleum product was identified for this sample. ';� Concentration � „� . Notes � *� Urtlts iR�eportmg�L�mdvr��"- Total Petroleum Hydrocarbons BRL mg/Kg 60 ortho-Terphenyl 2.7 2.2 80 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000)., Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 1. GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID 1 Lab ID: 67156-12 Hydrocarbons Laboratory 0.30 0.25 0.20 _ 0.15 I 0.10 �f 0.05 0.00 .0 10 20 30 40 50 60 70 1 Retention Time (Minutes) GRDUNDWATER ANALYTICAL ASTM Method D3328-00 (Modified) Hydrocarbon Fingerprint by GC/FID Field ID: SW:Wx2 0-4' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 40 mL VOA Vial Client: Bennett&O'Reilly,Inc. Preservation: Cool Laboratory ID: 67156-13 QC Batch ID: HF-1929-M Sampled: 11-17-03 15:15 Instrument ID: GC-4 HP-5890 Received: 11-19-03 16:40 Sample Weight: 15 g Extracted: 11-20-03 18:00 Final Volume: 1 mL Analyzed: 11-21-03 21:48 Dilution Factor: 1 Analyst: WN %Solids: 96 �__--'-- No petroleum product was identified for this sample. •� a A a �, r<e�^- haw a#�a - a one a e i q iv rrr x Analyte V11 A gyp' * Concentration rµ NOteS, ��IIi S. . Reporting t�mi 5 Total Petroleum Hydrocarbons BRL mg/Kg 62 QCSurrogate Compound , $piked Measured ec' Rovery ortho-Terphenyl 2.7 _ 2.4 88 % 60-140 Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL ASTM METHOD D3328-00 (Modified) rHydrocarbon Fingerprinting by GC/FID Lab ID: 67156-13 Hydrocarbons Laboratory 0.35 0.30 0.25 i 0.20 0.15 0.10 0.05 i °-00 50 60 70 0 10 20 30 40 1 Retention Time (Minutes) ANALYTICALRTER Massachusetts DEP VPH Method Volatile Petroleum Hydrocarbons by GC/PID/FID Field ID: SW-N-. 4-10' Matrix: Soil Project: Hawthorn Terrace Condo Assoc./BO03-3909 Container: 60 mL Glass Client: Bennett&O'Reilly,Inc. Preservation: Methanol/Cool Laboratory ID: 67156-14 QC Batch ID: VG10-1993-E Sampled: 11-17-03 10:15 Instrument ID: GC-10 HP 6890 Received: 11-19-03 16:40 Sample Weight: 40 g Analyzed: 11-25-03 14:38 Final Volume: 26 mL Analyst: PO %Solids: 94 Dilution Factor: 1 T!7 �[liCentrdib[li.. n-05 to n-C8 Ali hatic Hydrocarbons t0 BRL mg/Kg 1.0 n-C9 to n-C12 Aliphatic H drocarbons t® BRL mg/Kg 1.0 n-C9 to n-CI0 Aromatic Hydrocarbons' BRL mg/Kg 1.0 Unadjusted n C5 to n-C8 Aliphatic Hydrocarbons' BRL mg/Kg 1.0 Unadjusted n-C9 to n-C12 Aliphatic Hydrocarbons t BRL mg/Kg 1.0 a eke r1m lamp �CASNutnbe,�¢ '�Analyte�, �� „, :? y� ��Con+�entratton �: ,Notes , 1634-04-4 Methyl tert-butyl Ether° BRL mg/Kg 0.10 71-43-2 Benzene° BRL mg/Kg 0.10 108-88-3 Toluene a BRL mg/Kg 0.10 100-41-4 Ethylbenzene x BRL mg/Kg 0.10 108-38-3 and 106-42-3 meta-Xylene and para-Xylene$ BRL mg/Kg 0.10 95-47-6 ortho- X lene$ BRL mg/Kg 0.10 91-20-3 Naphthalene BRL mg/Kg 0.50 QvrrogatC ompound S,tk Measu et9 Re pve G Lrmt . __.�_ ,P.�u ...... .... era` .: �� . 2,5-Dibromotoluene(PID) 3.4 3.3 97 % 70-130 2,5 Dibromotoluene(FID) 3.4 3.6 105 /° 70 13o% procedures q Y 1. Were all A/ C required b the method followed? Yes Q Q 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.2.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. 1 Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(1998). Results are reported on a dry weight basis. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be -reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-05 to n-C8 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations. ® n-C9 to n-C12 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations and the concentration for the n-C9 to n-C70 Aromatic Hydrocarbons range. tt Analyte elutes in the n-05 to n-C8 Aliphatic Hydrocarbons range. # Analyte elutes in the n-C9 to n-C12 Aliphatic Hydrocarbons range. 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL Project Narrative Project. Hawthorn Terrace Condo Assoc./B003-3909 Lab ID: 67156 Client: Bennett&O'Reilly, Inc. Received: 11-19-03 16:40 - ` z' '4��.-">`� fi � '�,*, ��"' '/. �Documentafion and Client Cornmurncation� = 4•{* . 0-5x„va,xr.*.?�ta;�"aY.P-o...,n..,. The following documentation discrepancies,and client changes or amendments were noted for this project: 1 . Project 67156 was changed from Standard(10 business day)to Priority(5 business day)turnaround. The project was given a due date of 11-26-03,per Scott Kraihanzel, 11-19-03. 1x S ' *'SWA, z<j � yyB Methotl Motlifications, Non Con#ormancesandi Observations ; �y� � �x The sample(s) in this project were analyzed by the references analytical method(s),and no method modifications, non-conformances or analytical issues were noted,except as indicated below: 1 . No method modifications, non-conformances or analytical issues were noted. I j 1 1 Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532 O ® z Main Street,P.O.Box 1200 6�®�®A/YATER Buzzards Bay,MA 02532 CHAIN-OF-CUSTODY RECORD - ANALYTICAL Telephone(508)759-4441-FAX(508)759-4475 AND WORK ORDER 1�1° 077616 www.groundwateranaly6cal.com Project Name: Firm: s.2d�rre�- y'„-- �9 q� TURNAROUND ANALYSIS REQUEST cs"�' A,ca,. n ,0 OrReeRZTry,- STANDARD(10 Business Days) Valatiles SemNolaliles ExtractahB�Vo. Metals Petroleum Ext.TPHHyd rosarean Haz.VaI.TPH Waste General Chemistry Other Project Number: Address: ❑ PRIORITY(5 Business Days) n �'¢ ,¢ !gad ❑ RUSH(RAN- 1 x I d g t4-Y p - c^+ 164 t:, ,sy'S ;. (Rush requires Rush Authorization Number) 0 ❑ ❑ ❑ y 3 ❑ ❑_ z Sampler Name: City/State/Zip: ❑Please Email to: Please FAX to: ate. �q Lr�1 a r o o o ; Project Manager: Telephone: BILLING r ° 0 9 e o ❑ Purchase Order No.: �B.( 3` 90g ❑ o o a o 0 o m o a s x N ❑ Third Party Billing: _ is s a o 9 80 o INSTRUCTIONS:Use separate line for each container(except replicates). p GWAQuote: — m z m m a 9 a g z o e D Sampling Matrix Type Contafner(s) Preservation Fiitere o 0 0 0 0 0 0 o a o a o o o ° a e ❑ SAMPLE — n — LABORATORY a d a m a ,r u IDENTIFICATION 3 3 — — �„ s — E " o �` a" — _ _ _ NUMBER ��" E = n `' 9 ? �� 3 ° o _ 2 O O O mE mE E E s i —ztiE a m m mm m m — ❑—a" N m 00 0 ❑ m❑ o 000a u 1 -& c ( I ❑ ❑ Q ❑ .m❑aae -191 ❑o ❑_=oO m❑ ❑`Ee o❑a ❑❑ m❑y° o= 0 w (Lab Use Only) ❑ ❑ — E _ sC �-'�' ro w'.p.r,3a u�. a� �3''Z L r. � 3'y .iC. ,.,t;.:,.R1rP 4.. h -6 7I6: #•;� a s. �.�..°a .. t t 57~. .., p. -:-5 ��r ,, � �tL,'s'" ,,� v a�.:.3�.��"�-: .a f ;mot ::. .. .. .... .. _x.... .,. �A.. N.. .. f § �L 9 f;a,:.w. LY. .r..1 . : r .:'.:. 1 XX. .C:-,rQ s- _:.. i ',i ,.,. a.f"✓,^ ,g, .„n r lS r:,; s, -°:;_ .. . , - .-...... )s,. ., i2 ,<3.. f i.1...1�'.�. �i >..p_. C. .;t ✓' :.r f.. .i .h..�.. :,c f1 K \ ,-".4 .') Y 1 ,i..:.,� M .Y.�i:, i ;Y,s S r.ar+.'isa,�, ,.,:._Aa,.� n, .vE#a � 4,t r. ;vxiC� ' 4 Se._ "�� f g r s �' a I+ r 1 - y ,. a. _ ��,. _ c.1:,ut., Q z'. r _a,.' >.ik •r5 ,+,n :<iE, o,f.t — .,-t t`�: r ,W4 s u its. t i, �`.. ,�, .�.. kj.- s rkt,aa�;s'ra.�.t `dsCC.a�e .. �. .`..,. .-... ii, _ E,. '.' .;.i x� 2 t 4., ��xn:*.�si w •I { S 4 MARKS/SPECIAL INSTRUCTIONS DATA QUALITY OBJECTIVES CHAIN-OF-CUSTODY cn 6 RECORD Regulatory Program Project Specific QC NOTE:All samples submitted subject to Standard Terms and Conditions on reverse hereof. MA DEP MCP Data Enhancement Affirmation State Standard Deliverables Many regulatory programs and EPA methods require project Relinquished by Sampler: Date Time Received by: Receipt Temperature: ited ®YES ONO MCP Data Certification is required, specific QC.Project specific QC includes Sample Duplicates, l C q ❑CT R MCP GW-1/S-1 ❑PWS Form Matrix Spikes,and/or Matrix Spike Duplicates.Laboratory OC is � s 'E1"69D, // ❑me Oc.m. d.cl not roe p prearranged. I P � "�� z-s•c Recammentletl DYES ONO MCP minimum Field QC requirements ❑ME ❑MCP GW-2/S-1 ❑ project ct specific unless rearran ed.Project specific QC have been met for this project. samples are charged on a per sample basis.Each MS,MSD Relinquished by: Date Time Received by:(� Container Count: P I y y MA ❑NY STARS ❑ and Sample Duplicate requires an additional sample aliquot. / !Metals,hexavalent chromium and[snide analyses require one matrix spike per20samples) ❑NH ❑Drinking Water OYES ONO MCP Drinking Water samples required. D NY ❑Wastewater Project Specific OC Required Selection of OC Sample Relinquished by: Date , Time R 'ved by Labo for: Shipping/Airbill !Require col/action of contingent duplicate samples. ❑RI ❑Waste Disposal Number: blansre.,so'equtr'd,iVOAsamples collected P ❑Sample Duplicate ❑Please use sample: y p 1�� ,,,,. ❑VT ❑Dredge Material ❑Matrix Spike Signature:-- -!A.4- `' Method of Shlp ❑GWA Courier❑Express Mail❑Fede E rasa Custody Seal ❑— ❑ ❑Matrix Spike Duplicate' 0 UPS 0 Hand 0 Number: ®,q �a 228 Main Street,P.O.Box 1200 SROtl��i� ®® R Buzzards Bay,MA 02532 CHAIN-OF-CUSTODY RECORD ANA LYTIC L Telephone.gro nd5wateranalytcal.com FAX(508)759-4475 AND WORK ORDER N? 077617 Project Name: Firm: ��yy [[pp TURNAROUND ANALYSIS REQUEST e� �fr' G. ZIC, 94 STANDARD(10 Business Days) Volallles Sem4'Plet Metals PebolaumH dmcarbon Hat• Ext.T H Vol.PH Waste General Chemistry Other Project Number: Address: .O PRIORITY(5 Business Days)/`�/� pr��,,�� ® RUSH(RAN- 29L� E , 1',O.(3016 !��7 (Rush requires Rush Athorizetian Number) ❑ ❑ .2i ❑.❑. E Sampler Name: City/State/Zip: ❑Please Email to: o s M Please FAX to:5-0c- aw F4d&, a o 'fn8 "30r\ rb 9 mod.&.1s sk.t°" All 1 6 a o _ - Project Manager: Telephone: BILLING O h n > n 9 <r;„,,;.Aea�: •c�' 7' a] Purchase Order No.:8003`31�"`� ❑ Third Party Billing: INSTRUCTIONS:Use separate line for each container(except replicates). ❑ GWA Quote: o _ a a a a a o c m a Sampling Matrix T e Containers a m m $ m m $ - a o o ❑ ° a - a o Yp ( ) Preservation Ritere a o ❑ o ❑ o ❑ o ❑d n ❑ a s s SAMPLE. w W - _ _ LABORATORY _W m 0 a a s a m ° = o ° m IDENTIFICATION 3 - - e 0 5 _ _ NUMBER E i3 = m ? 8 ° m '� m a c o w 5 5 S s 5 y - m (Lab Use Only) - e o d _ y - o o 0 0 ' _ O 1- 3 h o 1 0 4n z E E .� `? m .S E E E — ,Y. v w m iw o§'m `'�' o o =.' 'o ¢ a n '.". r'F' o ` S c c m A o E w 0 o z o 41=5' 0.1k1p o z ¢ ¢ c� o o m — .- �. ❑ 9 c� e n o m m o m va ry m w i s Z E to [a m�ry m U _ ._ a m m m m m m m m r- - F � _ o o a. S o— o cs n 1 ❑ ❑ ❑o❑❑ ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a ❑ ❑ ❑ o p �,..�.1r.> n..F .;> 8. r: a�.,:•t�- fit.N'^x '�,°1 ° t t` a I ?;•;: b� a `a - � t ..._.r.. ,...SE1. �:�. .:,,.,. ,., r: ,— - t r E.. . 2 .v..: M.... a: 3:. L r .. .,. ,sR .. .M.., :.. .,.., �, I s,a r...��•:~a;' r .t e.... li ^� ,, h �,, at •.,.t r wKT sa;l An a :, t" ";' v:: i F ,', -.:a f I s t t v.... m.�..+,._ 4 �. A .. 6 ` �.. Mpsi� "1t s...m.,y k .. ;' y:_ k .. q a 'ti }i a",:': l ..� ;r n�w�g a. _:�, � ,sH�- �A .,,u�,.r., ``�-- >F.,�.�`" t A rs;'R r< YP yx, wi.. x 'n.'"... sf a. ^a^ c -5 :v r!. �......4 ,.nr,t -ax +rt 1 •'u ;G,_. � .t �• � `f, yi a. ,� t 4 T- 7 _s St $ a77 5 ,'i" r ax a I `tits ;l _- 'v f i + xu °i rn .:.-.ram �._� _ a �.-:•.. REMARKS/SPECIAL INSTRUCTIONS ( "` r DATA QUALITY OBJECTIVES CHAIN-OF-CUSTODY RECORD S' •",-P, x�.•A'^�� tYus��¢R cb Regulatory Program Project Specific OC NOTE:All samples submitted subject to Standard Terms and Conditions on reverse hereof. MA DEPMCP Data Enhancement Affirmation State Standard Deliverables Many regulatory programs and EPA methods require project Relinquish by S pl r: Date specific QC.Project specific QC Includes Sample Duplicates, / r Time Received by: Receipt Temperature:,IBYES ONO MCP Data Certification is required. ❑CT OMCP GW-1/S-1 ❑PWS Form Matrix Spikes,and/or Matrix Spike Duplicates.LaboratoryOC is / %° f��- (� OYES ONO MCP minimum Field QC requirements ❑ME ❑MCP GW-2/S-1 ❑ not project specific unless prearranged.Project specific C /9-/d o �t t 30 ��fs e'•4 Ecp. WIce Recommended 6 have been met for this project. samples are charged on a per sample basis.Each MS,MSD Relinquished y: Date Time Received Container Count: P and I C3YMA ❑NY STARS ❑ and Sample Duplicate requires an additional sample aliquot. l p Abby require he ma/ex spike per 20 samples) analyses - °' )f�! 0 )1od require onematrixspikeper 20 samples) ❑NH ❑Drinking Water / NY �✓� OYES ONO MCP Drinking Water samples required. ❑NY ❑Wastewater Project Specific OC Required Selection of OC Sample Relinq ishe � D to Time R c ived by lab ry: Shipping/Airbill fftequire collection of contingent duplicate samples. ❑RI ❑Waste Disposal I I Number: Trip blanks are also required,if VOA samples collected O Sample Duplicate O Please use sample: .�.� /�r/ _ �, .,. ❑VT ❑Dredge Material Method of ipmenc EI GWA Courier❑Express Mail❑Fede�l-E ress � Custody Seal- Signature: .f:.^ ❑Matrix Spike ❑— ❑ ❑Matrix Spike Duplicate ❑UPS 0 Hand❑ Number: 1 GROUNDWATER ANALYTICAL Quality Assurance/Quality Control '�-�� .± .fie d a. �a�ri �w.� �.u•� �, 4�x ,�K.�,, ¢. '3�v� .�r,3�:: x � 9�� 7 "� �PYO ranl�YerYIfW� �m ,tie I ' Groundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the guidance provided by Interim Guidelines and ' Specifications for Preparing Quality Assurance Project Plans, US EPA QAMS-005/80 (1980), and Test Methods for Evaluating Solid Waste, US EPA, SW-846, Update ►II (1996). Quality Control protocols include written Standard Operating Procedures (SOPS) developed for each 1 analytical method. SOPS are derived from US EPA methodologies and other established references. Standards are prepared from commercially obtained reference materials of certified purity, and documented for traceability. Quality Assessment protocols for most organic analyses include a minimum of one laboratory control sample, one method blank, one matrix spike sample, and one sample duplicate for each sample preparation batch. All samples, standards, blanks, laboratory control samples, matrix spikes and sample duplicates are spiked with internal standards and surrogate compounds. All instrument sequences begin with an initial calibration verification standard and a blank; and excepting GUMS sequences, all sequences close with a continuing calibration standard. GUMS systems are tuned to appropriate ion abundance criteria daily, or for each 12. hour operating period,whichever is more frequent. Quality Assessment protocols for most inorganic analyses include a minimum of one laboratory control: sample, one method blank, one matrix spike sample, and one sample duplicate for each sample preparation batch. Standard curves are derived from one reagent blank and four concentration levels. Curve validity is verified by standard recoveries within plus or minus ten percent of the curve. 1 Batches are used as the basic unit for Quality Assessment. A Batch is defined as twenty or fewer samples of the same matrix which are prepared together for the same analysis, using the same lots of reagents and the same techniques or manipulations, all within the same continuum of time, up to but not exceeding 24 hours. Laboratory Control Samples are used to assess the accuracy of the analytical method. ,A Laboratory Control Sample consists of reagent water or sodium sulfate spiked with,a group of target analytes representative of the method analytes: Accuracy is defined as the degree of agreement of the measured value with the true or . expected value. Perent Recoveries for the Laboratory Control Samples are calculated to assess accuracy. Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliquot of sodium sulfate. Method Blanks are taken through all the appropriate steps of an analytical method. Sample data reported is not corrected for blank contamination. Surrogate Compounds are used to assess the effectiveness of an analytical method in dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to the target analytes of interest in chemical behavior, but which are not normally found in environmental samples. Percent Recoveries are calculated for each Surrogate Compound. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 i GROUNDWATER ANALYTICAL Quality Control Report 1 Laboratory Control Sample Category: ASTM D3328-00 Mod Hydrocarbon Fingerprint Instrument ID: GC-4 HP-5890 QC Batch ID: HF-1929-M Extracted: 11-20-03 18:00 1 Matrix: Soil Analyzed: 11-21-03 15:49 Units: mg/Kg Analyst: WN Fuel Oil No.2 130 1 120 92 %k 60 140% QC Surrogat Compound t ... `, _'. r <z.. Spted�,_ Measured R_e_cover C Ltm .� ortho-Terphenyl 2.7 2.7 100 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Report Notations: All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. 1 ( Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 -GROUNDWATER ANALYTICAL Quality Control Report Method Blank 1 Category: ASTM D3328-00 Mod Hydrocarbon Fingerprint Instrument ID: GC-4 HP-5890 QC Batch ID: HF-1929-M Extracted: 11-20-03 18:00 Matrix: Soil Analyzed: 11-21-03 15:07 Analyst: WN 40Concentration Total Petroleum Hydrocarbons BRL mg/Kg 60 ortho-Terphenyl 2.7 1 2.3 85 % 160-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 1 1 1 1 - 1 1 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL Quality Control Report Laboratory Control Sample Category: MA DEP EPH Method Instrument ID: GC-9 Agilent 6890 QC Batch ID: EP-1774-M Extracted: 11-20-03 16:00 Matrix: Soil Analyzed(AL): 11-21-03 16:16 Units: mg/Kg Analyzed(AR): 11-21-03 17:00 Analyst: AG r �CAS Ntirnlien, ° .�� Aialytet ��`' � �-�,� 4��,Sptked „��Measured ' R overy�., e� QCL mitsM�° 111-84-2 n-Nonane(C9) 3.3 2.0 60 % 40-140 629-59-4 n-Tetradecane(C14) 3.3 2.4 73 % 40-140% 629-92-5 n-Nonadecane(C19) 3.3 2.9 86 % 40-140% ' 112-95-8 n-Eicosane(C20) 3.3 3.0 91 % 40-140% 630-02-4 n-Octacosane(C28) 3.3 3.0 91 % 40-140% 91-20-3 Naphthalene 3.3 2.3 68 % 40-140% 83-32-9 Acenaphthene 3.3 2.7 82 % 40-140% 120-12-7 Anthracene 3.3 3.4 102 % 40-140% 129-00-0 Pyrene .3.3 3.4 102 % 40-140% 218-01-9 Chrysene 3.3 3.8 115 % 40-140% QC`Surrogate Cornpounil 4 + _ ,, .� x P c, x QC L�mttS •; � � S eked ,.Measured R_egove Fractionation: 2-Fluorobiphenyl 2.7 2.4 91 % 40-140% 2-Bromonaphthalene 2.7 2.3 88 % 40-140% Extraction: Chloro-octadecane 2.7 2.6 97 % 40-140 ortho-Terphenyl 2.7 2.6 98 % 40-140% Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(1998). Sample extraction performed by microwave accelerated solvent extraction technique. Report Notations: All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. 1 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL Quality Control Report Method Blank Category: MA DER EPH Instrument ID: GC-9 Agilent 6890 QC Batch ID: EP-1774-M Extracted: 11-20-03 16:00 ' Matrix: Soil Analyzed(AL): 11-21-03 14:51 Analyzed(AR): 11-21-03 15:32 Analyst: AG n-C9 to n-C18 Aliphatic Hydrocarbons t BRL mg/Kg 30 n-C19 to n-C36 Aliphatic Hydrocarbons t BRL mg/Kg 30 n-C11 to n-C22 Aromatic Hydrocarbons to BRL mg/Kg 30 ' Unadjusted n C11 ton C22 Aromatic Hydrocarbons t BRL mg/Kg 30 GAS Number Analyte x Ts s tConceptratioo z Notes Units Repomrg��mt 91-20-3 Naphthalene BRL mg/Kg 0.50 91-57-6 2-Methylnaphthalene BRL mg/Kg. 0.50 85-01-8 Phenanthrene BRL mg/Kg 0.50 83-32-9 Acenaphthene BRL mg/Kg 0.50 208-96-8 Acenaphthylene BRL mg/Kg 0.50 86-73-7 Fluorene BRL mg/Kg 0.50 ' 120-12-7 Anthracene BRL mg/Kg 0.50 206-44-0 Fluoranthene BRL mg/Kg 0.50 129-00-0 Pyrene BRL mg/Kg 0.50 56-55-3 Benzo[a]anthracene BRL mg/Kg 0.50 218-01-9 Chrysene BRL mg/Kg 0.50 205-99-2 Benzo[b]fluoranthene BRL mg/Kg 0.50 207-08-9 Benzo[k]fluoranthene BRL mg/Kg 0.50 50-32-8 Benzo[a]pyrene BRL mg/Kg 0.50 193-39-5 Indeno[1,2,3-c,d]pyrene BRL mg/Kg 0.50 53-70-3 Dibenzo[a,h]anthracene BRL mg/Kg 0.50 ' 1 91 24-2 Benzo[g h i]perylene BRL mg/Kg 0.50 QC SurrogaYeCompoundr S rked�,Measured��aRecovery t: E z SQLimtts q r Fractionation: 2-Fluorobiphenyl 2.7 2.4 89 % 40-140%... 2-Bromonaphthalene 2.7 2.4 88 % 40-140% Extraction: Chloro-octadecane 2.7 2.5 95 % 40-140% ortho-Terphenyl 2.7 2.7 100 % 40-140% Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(1998). ' Sample extraction performed by microwave accelerated solvent extraction technique. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. iGroundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER r ANALYTICAL Quality Control Report 1 Laboratory Control Sample Category: MA DEP VPH Instrument ID: GC-10 HP 6890 QC Batch ID: VG10-1993-E Analyzed: 11-25-03 12:04 Matrix: Soil Analyst: PO Units: mg/Kg S3g.°°^ „tCAS Nurriber Apatype <3 ._., Sptked r„ Measured Recovery .. QC l ttnjts 1634-04-4 Methyl tert-butyl Ether 2.5 2.5 99 % 70-130% 71-43-2 Benzene 2.5 2.6 104 % 70-130% 108-88-3 Toluene 2.5 2.7 107 % 70-130% 100-41-4 Ethylbenzene 2.5 2.5 100 % 70-130% I 108-38-3 and 106-42-3 meta-Xylene and para-Xylene 5.0 5.5 109 % 70-130% 9547-6 ortho- Xylene 2.5 2.7 107 % 70-130% 91-20-3 1 Naphthalene 2.5 2.0 78 % 70-130% QC Surrogate Compound x.,r _ >,r Sptked Measuredfi RecoveryQCLtmits x 2,5-Dibromotoluene(PID) 7.5 6.0 81 % 70-130% 2,5-Dibromotoluene(FID) 7.5 6.0 81 % 70-130% ' Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(1998). Report Notations: All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER r ANALYTICAL Quality Control Report Method Blank Category: MA DEP VPH Instrument ID: GC-10 HP 6890 QC Batch ID: VG10-1993-E Analyzed: 11-25-03 13:08 Matrix Soil Analyst PO tVPHRariges � � ' aConce trn anon NofesU`n1ts p° !ngLmi n-05 to n-C8 Aliphatic Hydrocarbons t0 BRL mg/Kg 1.0 n-C9 to n-Cl2 Aliphatic Hydrocarbons to BRL mg/Kg 1.0 ' n-C9 to n-C10 Aromatic Hydrocarbons t BRL mg/Kg 1.0 Unadiusted n-05 to n-C8 Aliphatic Hydrocarbons t BRL mg/Kg 1.0 Unadjusted n-C9 to n-Cl2 Aliphatic Hydrocarbons t BRL mg/Kg 1.0 1634-04 4 ber Methy I tert butyl Et � � Concentrator n '�, , Notes ' r� Units her° BRL mg/Kg � 0.10 71-43-2 Benzene° BRL mg/Kg 0.10 1 108-88-3 Toluene° BRL mg/Kg 0.10 100-414 Ethylbenzene: BRL mg/Kg 0.10 108-38-3 and 106-42-3 meta-Xylene and para-X lene# BRL mg/Kg 0.10 95-47-6 ortho- X lene BRL mg/Kg 0.10 ' 9120-3 Naphthalene BRL mg/Kg 010 �Q,GSurrogafesCompound �3 .�� 4-1��`�,°, Sptked� Measured � �Recouery�� •�� _ _ ;QC^��Limtts `}z � i 2,5-Dibromotoluene(PID) 4.9 4.5 92 % 70-130% ' 2,5-Dibromotoluene(FID) 4.9 4.8 98 % 70-130% Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(1998). Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-05 to n-C8 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations. 11 n-C9 to n-C12 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations and ' the concentration for the n-C9 to n-C10 Aromatic Hydrocarbons range. 1x Analyte elutes in the n-05 to n-C8 Aliphatic Hydrocarbons range. # Analyte elutes in the n-C9 to n-Cl2 Aliphatic Hydrocarbons range. 1 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 GROUNDWATER ANALYTICAL Certifications and Approvals ' Groundwater Analytical maintains environmental laboratory certification in a variety of states. Y rY h' Copies of our current certificates may be obtained from our website: ' http://www.groundwateranalytical.com/qualifications.htm CONNEGxTICUT;'Departinerit of Health Ser'uices, PH 0586-� � � ��- �� ,i :'• Categories: Potable Water,Wastewater,Solid Waste and Soil - http://www.dph.state.ct.us/BRS/Environmental Lab/OutStateLabList.htm y FLORIDA,;Department of�Health, Bureau of Laboratories, E8764'3 �, � "� �s `��^�� f' � �� Categories:SDWA,CWA, RCRA/CERCLA http://www.floridadep.org/labs/qa/dohforms.htm p �;M�INE,De ar�tment'of7Human Services�MA�a103 '`� �^ �'` e m Categories: Drinking Water and Wastewater http://www.state.me.us/dhs/eng/water/Compliance.htm MASSACHUSETrTS, Department of Enronmenfal Protection, M M103 .. x�t.� Categories: Potable Water and Non-Potable Water http://www.state.ma.us/dep/bspt/wes/fi Ies/certl abs.pdf �N�E�f�iPSH�RE,�'Departmentof Envrr�mentalSer�uc s, .202�703` � � �, � "�` ,a� .,..�.. �.' a� ..,4• ,,,'n _fit a ..,,..n.d ,.:�.. ,? ='.i ,:... a°'^ �xatz:�.xm�k^Yk.. �2 :v,. 3e:� `a�'�-ss�+�"a ��Sx;,°�,. :"w•..+.3.?.., ,.s::�: .,n�. 3 Categories: Drinking Water and Wastewater ' http://www.des.state.nh.us/asp/NHELAP/labsview.asp Categories: Potable Water, Non-Potable Water and Solid Waste http://www.wadsworth.oroabcertlelap/comm.html ��:PEf�iNSYL�ANIA Department of'En�vironmental P�„rotectionr 8�665�„� �� 1��`"�" ` � Environmental Laboratory Registration(Non-drinking water and Non-wastewater) http://www.dep.state;pa.us/Labs/Registered/` NF RHODE ISLANp,.Department of Health; 54� x r `" .. *w <"{" ,�.,>., '.: ,..�.n � r.«Y�° r" �.,., '.," ,. _'"�-�,,.e.:P,',u"s`".^ 's- ,xx� 1' Categories:Surface Water,Air,Wastewater, Potable Water,Sewage http://www.healthri.org/labs/labsCT-MA.htm U S Department of AgriculturiSoil� erm�t,Ra�S539,2�1�,,� �� s� �� ; � � , z Foreign soil import permit � 3es�-i�#�' .dl"a" vERMONTi�DepaI rnent of Environmental Conservation,Water Supply Dwision � ` t � ; - -r e `�As.= ...2 ' Category: Drinking Water http://www.vermontdrinkingwater.org/wsops/labtable.PDF Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532 1 1 1 1 1 1 APPENDIX E 1 1 1 1 1 1 1 1 1 1 1 1 1 B'E.NN.E T 'T AT REILLY, Inc. ngineering, Environmental & Surveying Services 1573 Main Street ' Sanitary 21E/Site Remediation Property Line PO Box 1667 Site Development Hydrogeologic Survey Subdivision Brewster,MA 02631 Waste Water Treatment Water Quality Monitoring Land Court 508-896-6630 Water Supply Licensed Site Professional Trial Court Witness 508-896-4687 Fax QUALITY ASSURANCE & QUALITY CONTROL PROGRAM Quality Assurance& Quality--Control Program For Soil and Groundwater Sampling INTRODUCTI.ON The Quality Assurance & Quality Control (QA/QC) Program outlines the purpose, policies, organization and operations to support sampling work conducted by BENNETT&O'REILLY,INC.. The procedures.-and protocal represented herein are consistent with the MA DEP "Standard References for Monitor Wells [WSC-310-91J, and the recommendations of a MA certified laboratory. Implementation of this program will help to ensure the validity of data used to provide professional engineering and environmental opinions to clients. The following definitions are used in the QA/QC Program: ' Quality Assurance refers to the concepts used in defining s P g a system em for verifying and maintaining a desired level of quality in a product or process. ' Quality Control is a specific,step-by-step description of how the Quality Assurance Program will be carried out. This QA/QC Program guides field sampling activities. Project specific QA/QC Programs are adopted when warranted. Modifications to the-QA/QC Program may made only after specific - approval by the QA/QC Officer(Project Manager). i i i 1 1 ' The specific objectives of the QA/QC Program are to: 1. specify the level of quality of each field procedure used in collecting samples; 2. identify deficiencies in field procedures which might affect the quality of data; and P g q �' , 1 3. require sufficient documentation to verify the credibility of the sampling methods employed. PROGRAM ORGANIZATION AND RESPONSIBILITY 1 The Project Manager of BENNETT & O'REILLY, INC., is responsible for the quality of work -produced. The Project Manger directs the QA/Q.0 Program to document the control of field efforts and resulting data. 1 In this capacity,the Project Manager is expected to do the following: 1. prepare detailed QC Plans; 1 2. obtain analytical and sampling procedures reference materials; 1 3. ensure that all field test and measurement equipment is maintained and calibrated properly; 1 4. monitor..quality assurance activities to ensure conformance with authorized q tY policies, procedures, and sound practices,and recommend improvements as necessary, ' 5. ensure that all field sampling is conducted in accordance with guidelines p g gu d nes contained herein, 6. oversee-all-field sampling efforts to detect conditions which might directly or indirectly jeopardize the utility_ of resulting analytical data, such as improper ' calibration of equipment or cross-contamination through improper storage of samples; ! 7. ensure that sample handling procedures are adequate for the sample types received; ! 8. inspect the quality of purchased sampling materials. 2 1 ! ' SAMPLE MANAGEMENT, COLLECTION,AND PREPARATION Introduction Sample management and stringent documentation are essential for successful quality assurance. The ' procedures in this section are designed to ensure collection of samples which truly represent the matrix being sampled by eliminating trace levels of contaminants from external sources. Sample Management The management of samples,up_to the point of delivery to the laboratory for analysis is under-the ' supervision of the Project Manager,who shall ensure that samples are collected,labeled,preserved, stored, and transported according to the prescribed methods. If significant deviations from the sampling protocol occur,resulting in a suspected compromise of the sample integrity, all samples ' collected during the sampling effort prior to correction of the procedure will be discarded and fresh samples collected. ' Sample Collection ' Groundwater Monitoring wells will be sampled in accordance with the following sampling procedures: 1. Identify the well and record the well number on the groundwater sampling record an an Monitoring Well Sampling Log(attached). ' 2. Open the well cap and measure total organic volatile (TOV) concentrations at the wellhead with the use of a portable photoionization detector. Record levels'detected. 3. Measure groundwater level to the nearest 0.01 foot from the top of the well casing using a water level indicator. Record water level on a Monitoring Well Sampling Log(attached). Water level indicators will be decontaminated between wells. 4. The volume of standing water in the well casing will-be calculated and recorded on the Monitoring,Well Sampling Log. At least three-well volumes will be purged �i either by pump or disposable bailer. Newly installed monitoring wells will be developed by purging at least ten volumes. Purging of wells will be complete when ' either dissolved oxygen, pH, conductivity or temperature has stabilized relative to previous sampling rounds. Once the purging is complete,wells will be screened for each of the above parameters and recorded on the Sampling Log . 5. Samples will be collected using either a disposable bailers or pump. Samples will be transferred into appropriately sterilized/preserved containers, taking care to minimize agitation of the sample [Refer to attached "Recommended Sample Containers..."Groundwater Analytical]. 3 6. Sample containers will be properly labeled with tags provided by the laboratory. Samples will be logged in on a chain-of-custody form. ' 7. Samples taken for precipitate metal analysis will be acidified to a pH of less than 2.0 in the field. -When samplin water for volatile compounds, care must be exercised to rev g p prevent loss of compound through evaporation, and to control susceptibility to outside contamination. ' Precautionary measures include: ' -- -- l. avoiding engine exhaust,gasoline containers,degreasing solvents;solvent-laden rags- - and non-compatible decontamination agents; 2. sampling bottles will only be opened at the time of sampling and quickly closed after ' collecting the sample,preventing aeration of the sample with the atmosphere or any other gas; 3. slowly filling bottles to capacity with sample and securing cap without entrainingair bubbles; 4. invertingthe bottle while tapping lightly to check for air pp g g y bubbles; ' 5. adding additional sample to eliminate air bubbles if present,repeating steps 3 and 4; 6. placing samples on ice (approximately VQ immediately after collection in a dark, ' dry location; 7. segregating samples with a secondary barrier such as zip-lock bags, etc.; and ' 8. analyzing y g sample as soon as possible wrtlun the specific holding tunes after collection. Pump tubing will be decontaminated as follows: l. Pump non-phosphate detergent solution through system for two minutes. 2. Pump clean hot tap water through system for two minutes or until clear, whichever is longer. ' 3. Pump analyte-free water through system for two minutes. 4. Seal tubing ends; wrap and label with date of cleaning. 4 1 I Soils When collecting and screening soil samples,the procedures to be used are: 1. Prior to sampling surficial locations,surface vegetation,rocks,leaves,and debris will be cleared from the sample point to allow collection of a clean soil sample. If surficial soil samples are to be collected,a hand trowel or shovel and spatula will be used. The sampling equipment will be decontaminated as outlined below. 2. Boring samples will be collected via drilling rig-operated split spoon procedures. Soil samples collected from excavations or test pits will be collected directly with an auger.(if necessary)-from-grade-to-approximately-four--feet below grade.- Samples- collected at deeper depths will be obtained directly from the bucket of the backhoe. A stainless steel spatula will be used to remove soil from the backhoe bucket for placement in the appropriate sample containers. 3. Soil samples.collected for TOV screening will be placed in glass soil jars with aluminum foil placed under the screw cap. Samples will be allowed to warin to ambient temperature before screening or will be screened in a heated vehicle after warming. The jar will be shaken for fifteen seconds prior to warming and after warming to ensure proper headspace development. Total organic vapors will be measured via a portable photoionization detector (PID) and their concentration recorded either on a Geological Borehole Log or field log. ' 4. Soil samples will be stored and shipped in appropriate ro riate sealed containers. ' 5. Sample containers will be marked to indicate sampling date, time, location, and depth. Samples will be logged in on chain-of-custody forms(copy attached). 6. The stratigraphy of each soil boring and test pit excavation,and the construction of each monitoring well will be recorded by the on-site geologist on the appropriate Geologic Borehole Log or test pit field log(copies attached). When sampling soils for volatile compounds, care must be exercised to prevent loss of compound iand to control susceptibility to outside contamination. Precautionary measures include: . 1. avoiding engine exhaust,gasoline containers,degreasing solvents,solvent-laden rags. and non-compatible decontamination agents; 2. opening sampling bottles only at the time of sampling and quickly closing after ' collecting the sample; 3. placing samples on ice(approximately 4°Q immediately after collection in a dark, dry location; 5 l 4. segregating samples with a secondary barrier such as zip-lock bags,etc.; and 5. analyzing sample as soon as possible within the specific holding times after collection. Soil sampling equipment (shovel, auger, etc.) will be decontaminated between each sampling location with a potable water rinse, alconox soap wash, and a final potable water,rinse. Drilling and excavating apparatus (augers, rods, casing, core barrels, backhoe bucket, and other equipment coming in contact with the borehole or excavation)will be decontaminated between each boring and excavation via steam cleaning. If necessary;an alconox soap-wash-followed by a steam- cleaning will be included. 1 Sample Preservation To prevent or retard the degradation/modification of chemicals in samples during transit and storage, the samples will be refrigerated at or below 4° C in appropriately preserved containers. Samples will be delivered to the laboratory by courier or by overnight delivery service. DATA MANAGEMENT Logging of Samples The accountability of a-sample samplebe ins when the is taken from its natural environment. g Sample handling (chain-of-custody) records must be completed at the time of sampling. The following chain-of-custody procedure must be implemented by the Field Team Leader to assure sample integrity. 1. The samples are under custody of the Field Team Leader if a.they are in his (or her)possession; b. they are in view after being in possession: c. they are locked up or sealed securely to prevent tampering; or, d. they are in a designated secure area. 2. The"original"of the sample handling form must accompany the samples at all times ' after collection. A copy of the sample handling form is kept by the Field Team Leader. 3. When samples are transferred in possession, the individuals relinquishing and receiving will sign, date, and note the time on the form. 6 1 1 The Sampling Handling Record will contain information to distinguish each sample from any other sample. This information will include: 1. the project for which sampling is being conducted; 2. the matrix beingsamples air, oundwater, soil P ( � � , etc.); 3. the sampling date and time; -- -- - -----4------field-sample identification-number and-chain-ofi-custudy-identifrcation-number, ---- 5. the number and type of containers and the type'of preservative used(if any); and, 6. signature of the person performing the sampling. Each sample will be assigned a unique identification number,which will be marked on the sample container. The sample handling record will be forwarded to the laboratory with the samples. As a precaution against this record being lost or altered,the sampling personnel'will retain a copy of the ' sampling handling record documenting all information up until the first change of sample custody. This record will be filed by the Project Manager. 1 Sample Identification Numbers Reporting of date to the data management system will require the assignment of a unique ' identification number to each sample collected(including quality control samples).'A record will be maintained by the Project Manager to associate the field sample with the various identification numbers used to analyze the field sample. Specific sample identification procedures are developed tfor each field sampling effort by the Project Manager. 7 t t FORM SAMPLES BENNETT & O'REILLY, Inc. MONITOR WELL SAMPLING LOG 1573 Main Street,P.O. Box 1667 Engineering and Environmental Services Brewster,MA 02631 (508)896-6630 FAX(508)896-4687 CLIENT DATE(S) TIME: TIDE: LOCATION JOB NUMBER. SAMPLER MEASURING POINT GROUND SURFACE OR T.O.C: T.O.C. Elev.of Total Standing Water Depth to Static Volume HNU Dissolved Well . reference Depth 'Water Table Conductivity Water Volume Purged PI-101 pH Oxygen Temperature Comments: Number point of Well (feet) Height Elevation (gallons) (gallons) (pp-) (F) (feet) (feet) �(feet) (feet) (mg/L) NOTES: 1 BENNETT & O'REILLY Inc. 1573 Main Street,P.O.Box 1667 Brewster,MA 02631 Engineering and Environmental Services (508) 896-6630 MONITOR WELL SAMPLING LOG _CLIENT DATES) LOCATION JOB# MEASURING POINT SAMPLER GROUNDSURFACE OR T.O.C. Well Elev. of Total Depth to Standing Water Static Volume. HNU Comments Number.• reference Depth of,- .,Watec. Water: Table.. Volume Purged PI-10.1 point Well: (Feet) Height Elevation (gallons)::; (gallons),.- (ppm) (feet) (feet) (feet) (feet) 1 NOTES: - ' BENNETT � O'REILI,Y Inc. 1573 Main Street,P.O. Box 1667 Brewster, MA 02631. Engineering and Environmental Services (508) 896-6630 1 MONITOR WELL SAMPLING LOG ' RESPIRATION ANALYSIS CLIENT DATE(S) LOCATION JOB# SAMPLER Well Total Approx. Standin.- Length of HNU Methane Oxygen Carbon Comments: Number Depth of Depth to Water r screen PI-101 (%CH,) (%0" Dioxide Well Water Height above (ppm) (%CO, ' (feet) (feet) (feet) SWL f NOTES: 1 BEr1MTT & O'REILLY, Inc. Sheet of 1573 Main Street 508-896-6630 ' PO Box 1667 508-896-4687 Fax Brewster,MA 02631 Job Number: Date: Time: Test Hole Number: Job Name: Witness: . Casing I. D.: Ground Elevation: Reference Elevation-(TOG): FallingHead-E] Rising Head 0 - - ' Aquifer Saturation Thickness (If Confined): Depth of Boring(A): Well Screen Length(L): Length of Test Section(L): ' Depth.of Groundwater.Table(H). Depth of Top of Test Section.(B): Type,of Material in.Test:Zone:. ' Notes: 2r TIME ELAPSED WATER ACTIVE (sec.) TIME(sec.) h/Ho DEPTH(x) HEAD(h) B w STATIC A —I 2R 1-- h=H-X(falling head) or h=X-H(rising head) Ho=H-Xo (falling head) or Ho=Xo-H(rising head) Xo=X at t 0 A,B,H&L are defined above. Job Nam : Job Num er Date: Location: Weather: Witness: Start Dater Pump & low Rate Location: TOC: Location: TOC: Location: TOC: NOTES: Time Time 1 Depth to Water Static Water Lv. Draw Down Depth to Water Static Water Lv. Draw Down Depth to Water Static Water Lv. Draw Down pH/Concl./Temp. (sec). 0 1 2 3 - - 4 •5 6 7 8 9 15 .30 (sec.) 45 (min) _ 1 2 3 4 5 _ 6 . 7 - 8 9 _ 10 20 30 40 50 60 70 _ 80 90 100 190 280 370 4.60 550 640 730 820 910 000 — i 1 BENNETT & O'REILLY, Inc. Sheet of 1573 Main Street 508-896-6630 ' PO Box 1667 508-896-4687 Fax Brewster,MA 02631 Sieve Analysis Data and Computation :Sheet Job Number: Date: Job Name: Sample Number: Sample Collected By: Sample Tested By: Notes SIEVE WEIGHT PERCENT CUMULATIVE PROJECT OPENING SIEVE RETAINED RETAINED PERCENT MANUAL. ' MILLI- MESH IN GRAMS (Cumulative) FINER SPECIFICATION METERS (Cumulative) i 1 - 1 PASSED MESH SIEVE TOTAL Sample Weight Wet: Sample Weight Dry: ' Percent Moisture: Sample Weight Passed Through Sieves: BENNETT & O'"ILLY, Inc. Sheet of 1573 Main Street 508-896-6630 PO Box 1667 508-896-4687 Fax Brewster,MA 02631 Job Number: Date: Job Name: SAND GRAVEL SILT SAND Test Hole Number: Witness: Drilling Contractor: PEAT CLAY Sampling Method: GEOLOGIC BOREHOLE.LOG Type oof o /o Blows per Well Lithology/Sediment ithology ..Depth of Depth Specification:&Remarks, Description Sample 6"Drive Recovery . PID Response (ppm) S .. 10 15 20 .25 SWL: 30 35 40 45 50 r - BENNETT & 01REILLY9 Inc. REPORT NUMBER: 1573 Main Street 508-896-6630 PO Box 1667 508-896-4687 Fax Brewster,MA 02631 INSPECTORS DAILY RECORD OF WORK PROGRESS, . Job Number: . Date: Job Name: Feature: Contractor: Type of Work: _... Weather Conditions: Temperature: Contractor's Work Force(Indicate classification,including Subcontractor personnel) Equipmentin.-use,.or:idled,(identify.which) Materials or equipment delivered,quantity onpay items placed ' Non-conforming materials or work,field problems,inspections of previously reported deficiencies Summary of construction activities 228 Main Street,P.O.Box 1200 GROUNDWATER Buzzards Bay,MA 02532 CHAIN-OF-CUSTODY RECORD ANALYTICAL Telephone(508)759-4441 AND WORK ORDER o FAX(508)7594475 N_ 049825 Project Name: Firm: TURNAROUND ANALYSIS REQUEST .Volatllea Semlvetztlla� PesWarb C1 Metala- PatraWai eroorooe aa:. General Chemletry Glher ❑ STANDARD(10 Business Days) nract b e o n vat. waste Project Number: Address: ❑ PRIORITY(5 Business Days) E ❑ RUSH(RAN ) a o � a (Rush requires Rush Authorization Number) „_k o ❑ ; Sampler Name: City/State/Zip: Please FAX ❑ YES ❑ NO h FAX Number. a a Protect Manager: Telephone: BILLING s a Purchase Order No.: GWA Reference No.: th INSTRUCTIONS:Use separate line for each container(except replicates). e m I a a I .o o .gd o 0 a n Sampling Matrix e g 9. e $ a _ S a e Typ Contalner s ❑ ❑ ❑ o 01010 lo o € (.) Preservation Flilered ❑ ❑ ❑ o R o _ _ ❑ - SAMPLE - �' 3 iA1j'J: . "J_ o e g N o o e p LABORATORY5 ' ° ❑ ❑ IDENTIFICATION t= a s ,� e $ NUMBER e s o 0 3 ° ❑ > 5 (� 5 m5 (Lab Use Only) ;: s gig 2 ' 0 ° _ € ❑ ❑ ❑ ❑IT FF ❑ ❑ ❑ ❑ ❑ ❑ o o a a ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ o ❑ ❑ ❑ ❑ ❑ ❑ o ❑ . ------------------ i --------------- T-H-14-EEEF . ------------ T ' 111- 1. I I-IT I I 1 1: 1 ITF REMARKS I SPECIAL INSTRUCTIONS DATA QUALITY OBJECTIVES _ CHAIN-OF-CUSTODY RECORD Regulatory Program Protect Specific QC❑Safe Drinking Water Act NOTE:All samples submitted subject to Standard Terms and Conditions on reverse hereof.❑MA Many regulatory programs and EPA methods require project Re[in quisliell by Sampler: Date Time Received by:..DEP Form specific QC.Project specific QC Includes Sample Duplicates, ;},; Receipt Temperature: ❑NPDES/Clean Water Act Matrix Spikes,and/or Matrix Spike Duplicates.Laboratory QC Is Specify State: not project specific unless prearranged,Project specific QC ❑RCRA/Haz.Waste Char. samples are charged on a per sample basis:For water samples, Relinquished by: Date Time Received by: Shipping/Airbill ❑MA MCP(310 CMR 40) each MS,MSD and Sample Duplicate requires an additional Number: Reportable Concentrations sample aliquot. ❑.RCGW-1 Cl RCS-1 Project Specific OC Required Selection of CC Semple Relinquished by: Date Time. Received by Laboratory: Custody Se ❑RQGW'•2❑RCS-2 aU❑Sample Duplicate ❑Selected by laboratory - Cooler Serial ❑MA Dredge Disposal ❑Matrix Spike Number: P ❑Please use sample: ❑NH❑RI 0 CT❑ME ❑Mehix s Ika Du ncate Method of Shipment ❑GWA Courier❑Express Mail❑Federal Express Specily'i Category: P P 0 UPS 0 Hand❑ �ivYr�or�c$t.�o�rOx�s lives . A CERT:JVD_NNA 063 449 RYZ 130 SANDIfta MA 02563 50,6( 6460) 1-�$ 339-6460 LAB USE ONLY: FAX(50$)$M-6446 WATER ANALYSIS REQUISITION: DATE: DATE RECEIVED: SAMPLE NO.: TIME: NO. COPIES: NEXT DAY SERVICE BY 5:00 PM ( $20 00 Surcharge ) PICK UP: MAIL: NAME: WATER LOCATION: PHONE: FAX: ' MAILING ADDRESS: SAMPLED BY: PAYMENTIAMT. RECEIVED: WELL SPECS.: BILL TOIAMT.: - — Lab use only ANALYSIS REQUESTED: WATER SAMPLE TYPE: FHA-HUDNA HETEROTROPHIC PLATE COUNT COPPER NEW WELL COLIFORM BACTERIA LEAD EXISTING WELL pH ARSENIC TOWN WATER CONDUCTANCE SILICA _ IRRIGATION NITRATE-N ZINC FILTER/CONDITIONER NITRITE-N TDS MISCELLANEOUS SODIUM TANNINS NEW MAIN IRON SULFIDE TITLE 5 MANGANESE SILVER POOL SPA CHLORINE POTASSIUM RCRA 8 CALCIUM IOC's COLIFORM BACTERIA MAGNESIUM SEC. CONT. PSEUDOMONAS HARDNESS FLUORIDE HETEROTROPHIC PLATE COUNT ALKALINITY OTHER ANALYSIS REQUESTED: SULFATE FECAL COLI FORM CHLORIDE METHOD: DEP SAMPLES COLOR VOLATILE ORGANICS PWS#: TURBIDITY METHOD: . SAMPLE SITE: FREE CO2 METALS Cie. Sink) AMMONIA-N METHOD: SAMPLE LOCATION: ODOR (ie. Kitchen/Well) INSTRUCTIONS: BACTERIA-Obtain sterile sample bottle. Remove strainer/aerator from faucet. Turn on cold water. Allow it to run (5) five minutes. Fill container. Do not touch the inside of the bottle or the cap with anything. POTABLE WATER SAMPLE-Follow instructions for bacteria. Sample size approximately 500 mis. LEAD-Cali lab for instructions. VOLATILE ORGANICS/METALS- Call lab for instructions. i CHAIN OF CUSTODY FORM ENVIROTECH LABS, INC. .. Client: 449 Route 130 Address: Proj. No. Project Name: Sandwich, MA.02563 (508)888-6460/ 1-'800-339-6460 Sampler: FAX (508)888-6446 Phone#: Signature: Fax#: Field No. Date Time Comp Grab pStation Location Container Pres, sample type. Analysis Requested Relinquished: DatelTime Received: Reliquished: Date/Time Received: Relinquished: Date/Time Received: Relinquished: IDat errim Received: 1 1 1 ' TECHNICAL REFERENCE • , . , ! IT, • i i • • • Volatile Organic Analyses Minimum Recommended Required Holding Category Methods Qty.� C6ntainer(s)2 Preservation TimeB Aqueous Samples Volatile Organics- 601/8010 40 mL 3 Vi.x 40 mL Glass Cool to 4°C3 14 Days 602/6020 als w/teflon HCl to pH<24 624/8260" septum caps12 Remove Chlorine' 56 .2 524.2' Acrolein and Acrylonitrile 603/8030 40 mL 3 x 40 mL Glass Cool to 4°C3 14 Days Vials w/teflon Check pH;Adjust 4-5' septum caps12 Remove Chlorine? Solid Samples Volatile Organics 8010/8020 log 1 x 125 mL Glass Cool to 4°C3 14 Days ' - 8260 Vial w/teflon septum cap12 OR 2 x 40 mL Glass ' Vials w/tefign septum caps 12.13 Acrolein and Acrylonitrile 8030 log 1 x 125 mL Glass Cool to 4°C3 14 Days Vial Wieflon septum cap12 OR 2 x 40 mL Glass -- Vials w/teflon septum caps 12.13 Semivolatile Or anie Analyses g Minimum Recommended Required Holding Category Methods Qty.' Container(s)? Preservation Times Aqueous Samples Semivolatile Organics 625/8270 1 L 2 x 1 L Amber Cool to 4°C3 7 Day69 Glass Bottle Remove Chlorine' W%teflon liner" Semivolatile Organics 8270 2 L 3 x.1 L Amber Cool to 4°C3 7 Days9 (Low-level,bothAcid Modred Glass Bottle Remove Chlorine' and Base/Neutral fractions) w%teflon liner" Semivolatile Organics 8270 1 L 2 z 1 L Amber Cool to 4°C3 7 Days9 (Low-level,only one fraction Modified Glass Bottle Remove Chlorine' Acid or Base/Neutral) l w/teflon liner" Semivolatile.Organics 525.2 1 L 2 x 1 L Amber Cool to 4°C3_ 7 Days- (Drinking Water) Glass Bottle HCl to pH<24 w/teflon liner" Add Sodium Sulfite24 2,3,7,B-TCDD(Dioxin) 1613 1 L 2 x 1 L Amber Cool to.4°C3 7 Days9 (Drinking Water) Glass Bottle w/teflon liners' Polynuclear 610/a100 1 L 2 x1 L Amber Cool to 4°C3 7 Days9 Aromatic- 8270 Glass Bottle Remove Chlorine' Hydrocarbons w/teflon liner17 Solid Samples Semivolatile 8270 30 g Glass Jar Cool to 4°C3 14 Days" Organics w/teflon liner17 Polynuclear 8100 30 g Glass Jar Cool to 4°C3 14 Days10 Aromatic 8270 w/teflon liner" Hydrocarbons GRDUNDWATER ANALYTICAL 27 -ATIAILINF.M.N.511MI HIM Pesticide and Herbicide Analyses Minimum Recommended Required Holding Category Methods Qty., Container(s)2 Preservation Time8 Aqueous Samples Carbaate Pesticides 531.1 60mL 2 x 125 Glass Bottle Cool to 4°C3 m 28 Days (Drinking Water) w/teflon liner" Add Sodium Thiosulfate26 Adjust pH to 3 with Monochloroacetic Acid Buffer Organochlorine 608/8080 1 L 2 x 1 LAmber Cool to 4°C3 7 Days-' Pesticides&PCBs Glass Bottle Check pH;Adjust 5-96 1 w/teflon liner" Remove Chlorine' Organochlorine Pesticides 508 1 L 2 x 1 LAmber Cool to 41C3 7 Days21 &PCBs Glass Bottle Add Sodium Thiosulfate2s (Drinking Water) w/teflon liner" Polychlorinated Biphenyls 508A 1 L 2 91 LAmber Cool to 4°C3 14 Days 22 by Perchlorination Glass Bottle (Drinking Water) w/teflon liner" Organohalide Pesticides 505 40 mL 3 x 40 mL Glass Vials Cool to 4°C3 7 Days20 ' &PCBs w/teflon septa caps" Add Sodium Thiosulfate26 (Drinking Water) Organophosphorus 614/8140 1 L 2 x 1 LAmber Cool to 4°C3 7 Days9 Pesticides Glass Bottle Check pH;Adjust 6-86 w/teflon liner" Remove Chlorine? Chlorinated 615/8150 1 L 2 x 1 LAmber Cool to 41U 7 Days' Herbicides Glass Bottle Remove Chlorine' w/teflon liner" Chlorinated Herbicides 515.1 1 L 2 x 1 L Amber Cool to 4°C3 14 Days 23 (Drinking Water) Glass Bottle Add Sodium w/teflon liner" Thiosulfate26 Glyphosate 547 40 mL 2 x 40 mL Glass Cool to 41C3 14 Days ' (Drinking Water) Val w/teflon liner Add Sodium Thiosulfate26 Endothall 548.1 100 mL 2 x 125 mL Glass Cool to 4°C3 7 Days 21 (Drinking Water) Bottle w/teflon liner" HCl to pH<24 Add Sodium Thiosulfate26 Diquat and Paraquat 549.1 250 mL 1 x 1 LAmber Cool to 4°C3 7 Days27 (Drinking Water) Glass Bottle H2SO4 to pH<24 w/teflon liner" Add Sodium Thiosulfate26 I EDB and DBCP 504.1 40 mL 3 x 40 mL Glass Cool to 40C3 14 Days (Drinking Water) Vials w/teflon Add Sodium Thiosulfate26 septa caps 12.17 EDB and DBCP Boll 40 mL 3 x 40 mL Glass Cool to 4°C3 14 Days Vials w/teflon HCI to pH<24 septa caps 12,11 Remove Chforine7 Solid Samples Organochlorine 8080 30 g Glass-Jar Cool to 4°C3 14 Days10 Pesticides&PCBs w/teflon liner17 Organophosphorus 8140 30 g Glass Jar Cool to 4°C3 14 Days10 Pesticides w/teflon liner17 Herbicides 8150 30 g Glass Jar Cool to 4°C3 14 Days10 w/teflon liner17 EDB and DBCP 8260 10 g 1 x 125 mL Glass Cool to 41C3 14 Days Vial w/teflon septa cap 12.17 ' OR 2 x 40 ml.Glass Vials w/teflon septa caps 12.13,17 2a- I 1 1 llore] Hydrocarbon Analyses Minimum Recommended Required Holding Cagegory Methods Qty.' Container(s)z Preservation Time° Aqueous Samples Hydrocarbon D3328-78 1 L 2 x 1 LAmber Cool to 41C3 7 Days' Fingerprint Glass Bottle 17 H2SO4 to pH<2 (GC/FID) w/teflon liner Total Petroleum 418.1 1 L 2 x 1 LAmber Cool to 4°C3 28 Days Hydrocarbons Glass Bottle HISO4 to pH<2 (TPH-IR) w/teflon liner Oil and Grease 413.1 1 L 2 x 1 LAmber Cool to 4°C3 28 Days 413.2 Glass Bottle H2SO4 to pH<2 w/teflon liner Gasoline Range 8015/API 40 mL 3 x 4o mL Glass Cool to 4°C3 14 Days Organics Vials w/teflon HCI to pH<24 I . ..... .septa-caps12 Diesel Rang a 8100/API i L 2 x 1 L Amber Cool to 4°C3 7 Days9 Organics Glass Bottle H2SO4 to pH<2 w/teflon liner" MA DEP Volatile 8015/MA DEP 40ml- 3 x 40 mL Glass Cool to 4°C3 14 Days Petroleum Hydro- Vials w/teflon HCI or H2SO4to pH<24 12 carbons(VPH) septa caps MA DEP Extractable 8100/MA DEP 2 L 3 x 1 L Amber Cool to 4°C3 14 Days Petroleum Hydrocarbons(EPH) 8270 Mod Glass Bottle H2SOQ or HCI to pH<24 with low-level PAHs GC/MS-SIM w/teflon liner" Solid Samples Hydrocarbon D3328-78 30 g Glass Jar Cool to 4°C3 14 Days10 Fingerprint Modified w/teflon liner" (GC/FID) Total Petroleum 418.1 30 g Glass Jar Cool to 4°C3 14 Days10 Hydrocarbons Modified w/teflon liner (TPH-1R) Oil and Grease 413.1 30 g Glass Jar Cool to 4°C3 14 Days10 413.2 w/teflon liner Modified Gasoline Range 8015/API log 1 x 125 mL Glass Cool to 4°C3 14 Days Organics Vial w/teflon septa cap 12 Diesel Range 8100/API 30 g Glass Jar Cool to 4°C3 14 Days10 Organics w/teflon liner" MA DEP Volatile Petroleum 8015/MA DEP 50g 1 x 125 mL Glass w/50ml- Cool to 4°C3 14 Days Hydrocarbons (VPH) Methanol and Glass Jar without Methanol. MA DEP Extractable 8100/MA DEP 30g Glass Jar Cool to 4°C3 14 Days. Petroleum.Hydrocarbons(EPH) WIteflon liner" Metals Analyses Minimum .Recommended Required Holding Category, Methods Qty.' Container(s)2 Preservation Time8 Aqueous Samples Total Metals 200s 100 mL Plastic Bottle HNO3 to pH.<2 180 Days (except Mercury) 6010 Cool to 4°C3 700.0s Dissolved Metals 200s 100 mL Plastic Bottle Filter First" 180 Days (except Mercury) 6610 HNO3 to pH<2 7000s Cool to 4°C3 Total Mercury 245.1 100 mL Plastic Bottle Cool tofo 4 C3<2 28 Days •. 74,70 1 GRDUNDWATER ANALYTICAL .29 �Wfl 0 k filTi I. • Metals Analyses Minimum Recommended Required Holding Category Methods Qty., Container(S)2 Preservation Time" Dissolved Mercury 245.1 100 mL Plastic Bottle Filter First" 28 Days 7470 HNO,to pH<2 Cool to 4°C3 SDWA Lead and 200.9 1 L 1 x 1 L Plastic Cool to 4°C3 180 Days . Copper Rule 200.7 Bottle Chromium, 218.1-5 200 mL Plastic Bottle Cool to 4°C3 24 Hours Hexavalent Solid Samples Total Metals 6010 2 g Glass Jar Cool to 4°C3 180 Days (except Mercury) 7000s w/teflon liner Total Mercury 245.5 0.6 g Glass Jar Cool to 4°C3 28 Days 7471 w/teflon liner Hazardous Waste Characterization Analyses Minimum Recommended Required Holding Category Methods Qty.1 Container(s)2 Preservation Time Solid Samples" TCLP Volatile 1311 150 g 2 x 125 mL Glass Cool to 4°C3 14 Days' 9 Organics 8260 Vial w/teflon septum cap 2 TCLP Metals, 1311 300 g Glass Jar Cool to 4°C3 28 Days19 Semivolatiles, 6010 w/teflon liner 14 Days19 Pesticides and 7000s Herbicides 8080 8150 8270 Ignitability 1010 100g .Plastic or Glass Cool to 4°C3 None Modified Jar Corrosivity 9045 20 g Plastic or Glass Jar Cool to 4°C3 None Reactivity SW-846 20 g Plastic or Glas Jar'" Cool to 4°C3 None Paint Filter 9095 io0 g Plastic or Glass Jar None None Conventional Physical Properties Analyses Minimum Recommended Required Holding Category Methods Qty.1 Container(s)2 Preservation Time Aqueous Samples Color 110.1-3 50 mL Plastic or Glass Bottle Cool to 4°C3 48 Hours Conductance 120.1 100 mL Plastic or Glass Bottle Cool to 4°C3 28 Days Hardness 130.1-2 100 mL Plastic or Glass Bottle Adjust pH<215 180 Days Cool to 4°C3 Odor 140.1 200 mL Glass Bottle Only Cool to 4°C3 24 Hours pH 150.1 25 mL Plastic or Glass Bottle None Analyze. immediately Solids,Total 160.1 100 mL Plastic or Glass Bottle Cool to 4°C3 7 Days Dissolved(TDS) Solids,Total 160.2 100 mL Plastic br Glass Bottle Cool to 40C3 7 Days Suspended(TSS) Solids,Total(l S) 160.3 100 mL Plastic or Glass Bottle Cool to 41C3 7 Days Plastic or Glass Bottle Cool to 4°C3 7 Days Solids,Total 160.4 100 mL Volatile(TVS) Solids,Settleable 160.5 1 L Plastic or Glass Bottle Cool to 4°C3 48 Hours (SS) Turbidity 180.1 100 mL Plastic or Glass Bottle Cool to 4°C3 48 Hours 30 Conventional Inorganic Analyses - Minimum Recommended Required Holding Category Methods Qty.' Container(s)2 Preservation Time Aqueous Samples Acidity 305.1 100 mL Plastic or Glass Bottle Cool to 4°C3 14 Days Alkalinity 310.1-2 100 mL Plastic or Glass Bottle Cool to 4°C3 14 Days Bromide 320.1 160 mL Plastic or Glass Bottle None 28 Days ' Chloride 325.1-3 50 mL -- Plastic or Glass Bottle None 28 Days Chlorine, 330.1-5 200 mL Plastic or Glass Bottle None Analyze Total Residual Immediately Cyanides 335.1-3 500 mL Plastic or Glass Bottle Remove Sulfide14 14 Days NaOH to pH>12 Cool to 4°C3 Fluoride 340.1-3 300 mL Plastic Bottle Only None 28 Days Iodide 345.1 100 mL Plastic or Glass Bottle Cool to 40C3 24 Hours Nitrogen,Ammonia 350.1-3 400 mL Plastic or Glass Bottle H2SO4 to pH<2 28 Days Cool to 40C3 Nitrogen, 351.1-4 500 mL Plastic or Glass Bottle H2SO4 to pH<2 28 Days '. Total Kjeldahl Cool to 4°C3 Nitrogen, 353.1-3 100 mL Plastic or Glass Bottle H2SO4 to pH<2 28 Days Nitrate plus,Nitrite Cool to 4°C3 Nitrogen,_ 353.2-3 100 mL Plastic or Glass Bottle Cool to 40C3 48 Hours Nitrate(Wastewater) Nitrogen,Nitrate 353.2-3 100 mL Plastic or Glass Bottle Cool to 4°C3 28 Days (Chlorinated Drinking Water) - Nitrogen,Nitrate 353.2-3 100 mL Plastic or Glass Bottle Cool to 40C3 14 Days (Non-Chlorinated Drinking Water) H,SO,to pH<24 Nitrogen, 353.2-3 50 mL Plastic or Glass Bottle Cool to 4°C3 48 Hours Nitrite Minimum Recommended Required Holding Category Methods Qty.1 Container(sy Preservation Time Aqueous Samples Orthophosphate 365.1-3 50 mL Glass Bottle Only Filter(0.45 µm) 48 Hours ' Cool to 4°C3 Oxygen,Dissolved 360.1 300 mL Glass Bottle Only None Analyze Immediately Phosphorous,Total 365.1-4 50.mL Glass Bottle Only H2SO4 to pH<2 28 Days Cool to 41C3 Silica 370.1 50 mL Plastic Bottle Only Cool to 41C3 28 Days Sulfate 375.1-4 50 mL - Plastic or Glass Bottle Cool to 40C3 28 Days Sulfide 376.1-2 500 mL Plastic or Glass Bottle NaOH to pH>9 7 Days 2 mL Zinc Acetate Cool to 46C3 Sulfite 377.1 50 mL Plastic or Glass Bottle None Analyze Immediately Conventional Organic Analyses Minimum Recommended Required Holding Category Methods Qty.' Container(s)2 Preservation Time' Aqueous Samples Biochemical 405.1 1 L Plastic or Glass Bottle Cool to 4°C3 48 Hours Oxygen Demand (5 Day BOD) Chemical 410.1-4 50 mL Plastic or Glass Bottle HZ 4 SO to pH<2 28 Days Oxygen Demand Cool to 4°C3 - (COD) GROUNDWATER ANALYTICAL 31 1 Lei • PIN k1l 1 1 Conventional Organic Analyses Minimum Recommended Required Holding Category Methods Qty.' Container(s)' Preservation Time' Aqueous Samples Organic Carbon, 415.1 25 mL Plastic or Glass Bottle H2SO4 to I<2 28 Days Total(TOC) Cool-to 4°C' Phenolics 420.1-3 500 mL Glass Bottle Only H2SO4 to pH<2 28 Days ' Cool to 4°C' Surfactants 425.1 250 mL Plastic or Glass Bottle Cool to 4°C' 48 Hours (MBAS) Microbiological Analyses Minimum Recommended Required Holding Category Methods Qty' Container(s)' Preservation Time, Aqueous Samples Coliform, Various 100 mL Sterilized Bottle Cool to 4°C' 6 Hours Total(Wastewater) Remove Chlorine' Coliform, Various 100 mL Sterilized Bottle Cool to 4°C' 6 Hours Fecal (Wastewater) Remove Chlorine' Coliform, Various 100 mL Sterilized Bottle Cool to 4°C' 30 Hours Total(Drinking Water) Remove Chlorine Coliform, Various 100 mL Sterilized Bottle Cool to 40C' 30 Hours Fecal(Drinking Water) Remove Chlorine E.Coll Various 100 mL Sterilized Bottle Cool to 4°C' 30 Hours (Drinking Water) Remove Chlorine' Radiological Analyses 1 Minimum Recommended Required Holding Category Methods Qty.' _ Container(s)' Preservation _ Time Gross Alpha and Beta 900.0 1 L Plastic or Glass Bottle HCl or HNO to pH<2 180 Days Radium-226 903.1 1 L Plastic or Glass Bottle HCI or HNO to pH<2 180 Days Radium-228 904.0 1 L Plastic or Glass Bottle HCI or HNO to pH<2 180 Days Strontium-90 905.0 1 L Plastic or Glass Bottle HCI or HNO to pH<2 180 pays Tritium 906.0 1 L Glass-Bottle None 180 Days 1 1 32 I'll 4 1 • SAMPLING NOTES 1, The minimum quantity specified is the minimum amount of sample material the vial.The cap should then be gently placed on the vial,taking care not to necessary to perform the analysis.This quantity allows for no margin of disturb the crown of liquid,and firmly rotated tight.The vial should then be error. examined to verify the absence of all air bubbles. For some analyses,Groundwater Analytical recommends specific types and Solid samples for Volatile Organic Analyses(VOA)must also be collected numbers of containers(e.g.,an Aqueous Volatile Organic sample requires 3 with a minimum of headspace or air pockets.Sample vials should be packed x 40 mL Glass Vials w/teflon septum caps).In such cases,the recommended fully and tightly sealed.Vial threads should be wiped clean prior to capping ' container(s)allow for an adequate margin of error. for best seal.When packing vials,however,avoid excessive manipulation of the sample material which may result in a loss of volatile organics.A wide Forother analyses,Groundwater Analytical only recommends a general type mouth 125 mL Glass Vial w/teflon septum cap is the preferred sample con- of container(e.g.,a Solid Semivolatile Organic sample requires a Glass Jar tainer. ' wReflon liner).In such cases,it is strongly recommended that twice the mini- mum quantity of sample material be collected in the recommended type of 13. Solid samples for Volatile Organic Analyses may be collected in 40 mL Glass container. Vials that have been acidified with Sodium Bisulfate(NaHSO4),Hydrochloric Acid(HCI)or Sulfuric Acid(HZSO4).The presence of acid in the containerwill For solid samples, in addition to the minimum quantities required for indi- have no detrimental effect on the sample. vidual analyses, each sample also requires 20 g of sample material for a ' percent solids(or percent moisture)determination.Example:,A soil sample 14. Maximum holding time is 24 hours when Sulfide is present.Samples may be collected forTPH-IR(30 g),8 RCRA Metals(2.6 g)and PCBs(30 g)requires tested with lead acetate paper before the pH adjustment in order to deter- a minimum of 62.6 g of material for the desired analyses,and 20 g of material mine if Sulfide is present If Sulfide is present,it can be removed by the addi- for percent solids(or percent moisture),for a total required minimum of 82.6 tion of Cadmium Nitrate powder until a negative spot test is obtained.The g of material.It is then recommended that this minimum by doubled,and at sample is then filtered,and NaOH is added to adjust the pH>12. 1 least 165.2 g of sample material be collected in a Glass Jar w%teflon liner. 15. Adjust to pH<2 with Nitric Acid(HNO,)or Sulfuric Acid(HZSO,).Acidification For solid samples,all minimum quantities are calculated net of all foreign retards biological action,reduces absorption effects and prevents the forma-- objects,such as sticks,leaves and rocks. tion of precipitates and/or complexes. 2. Only sample containers pre-cleaned according to US EPA protocols are rec- 16. Samples should be collected with a minimum of aeration.The sample bottle ommended.Appropriate pre cleaned and pre preserved containers are avail should be filled completely,excluding all headspace,and capped. able from Groundwater Analytical.Pre-cleaned sample containers should not be prerinsed with sample prior to sample collection.Prerinsing may cause 17. Extractable organic samples are susceptible to Phthalate ester contamina- elevated results. tion.Phthalate ester contamination is generally caused by sample contact with a plastic material,particularly flexible plastics.Use care to avoid sample 3. Samples should be immediately cooled,stored and shipped refrigerated.4°C contact with any plastic,other than Teflon. (34°F)is the recommended temperature.Refrigeration retards biological deg- radation,reduces the volatility of compounds,retards the hydrolysis of non- 18. Specified quantities of sample material are for only single phase solid samples aqueous compounds, reduces absorption effects and prevents continuing (i.e.no free liquids).Liquid phase or multiple phase samples regufre different chemical reactions. quantities of sample material.Contact laboratory for advice prior to collecting liquid phase or multiple phase samples forTCLP analyses. '. 4. Adjust to pH<2 with Hydrochloric Acid(HCI).Acidification retards biological action,reduces absorption effects and prevents the formation of precipitates 19. Samples forTCLP Volatile Organics analysis must be leached within 14 days and/or complexes.Sulfuric Acid(Hz SO4)or Sodium Bisulfate(NaHSO`)may of collection.The leachate must then be analyzed within 14 days of leaching. be substituted for HCI in EPA Methods 8010,8011,8020 and 8260. 1 Samples forTCLP Metals analysis must be leached within 28 days of collec- 5. Adjust to a pH range of 4.0 to 5.0 with Hydrochloric Acid(HCI),Sulfuric Acid tion,if Mercury is being analyzed.The leachate must then be analyzed within (HZSO4)or Sodium Hydroxide(NaOH). 28 days of leaching.If Mercury is not being analyzed,then samples forTCLP Metals must be leached within 180 days of collection,and the feachate ana- 6. If sample will not be received by laboratory within 24 hours of collection,then lyzed within 180 days of leaching, adjust to specified pH range with Sulfuric Acid(HZSO4)or Sodium Hydroxide ' (NaOH).The pH adjustment may be omitted if it is performed upon receipt at Samples for TCLP Semivolatile Organics,TCLP Pesticides,and TCLP Her- the laboratory within 24 hours,and may be omitted if the sample is extracted bicides analyses must be leached within 14 days of collection.The leachate within 48 hours of collection. must then be extracted within 7 days of leaching.The extract must then be analyzed within 40 days of extraction. 7. If free chlorine fs present in the sample,then Sodium Thfosulfate(Na2S O) should be added.Free chlorine can react with organic compounds to 6m 20. Samples must be analyzed within 7 days of collection.However,if Heptachlor chlorination by-products. Free chlorine is likely to be found in chlorinated is not being determined,sample holding time to analysis may be extended to municipal drinking waters and treated wastewaters.Sodium Thfosulfate,a 14 days. reducing agent,is added to remove the free chlorine.For most levels of free chlorine,add 4 drops of 10%Sodium Thfosulfate to samples in 40 mL vials, 21. Samples must-be extracted within 7 days of collection.Extracts must then be 1 and add 5 mL of 10%Sodfum.Thfosulfate to samples in 1 L Bottles. _ analyzed with 14 days of extraction. B. The rested Holding Time is the maximum of time a sample may be held be- 22. Samples must be extracted within 14 days of collection.Extracts must then tween collection and'initiation of analysis or extraction. be analyzed with 30 days of extraction. 9. Samples must be extracted within 7 days of collection.Extracts must then be 23. Samples must be extracted within 14 days of collection.Extracts must then analyzed within 40 days of extraction.' be analyzed with 28 days of extraction. 10. Samples must be extracted within 14 days of collection.Extracts must then 24. Add 40-50 mg of Sodium Sulfite to each liter of sample to reduce free chlo- be analyzed within 40 days of extraction. rine that may be present Free chlorine can react with organic compounds to form chlorination by-products.Free chlorine is likely to be found in"chlori- 11. Samples for dissolved metals must be filtered prior to preservation with Nitric nated municipal drinking waters and treated wastewaters.Alternatively,use Acid(HNO).Filtration must be done with a 0.45 micron membrane filter. 40-50 mg of Sodium Arsenite.Do not use Sodium Thfosulfate,as it may pro- Feld filtration and preservation is preferred. duce a residue of elemental sulfur which may interfere with the determinatibn However,if field filtration is not possible,samples should be cooled to 4°C of some analytes. and shipped to the laboratory for filtration and preservation.Filtration must be 25: Samples must be extracted within 7 days of collection.Extracts must then be done as soon as practical after collection.Groundwater Analytical recom- analyzed with 30 days of extraction. mends that filtration be done within 24 hours of collection.If samples are not going to be field filtered,do not preserve samples with Nitric Acid(HNO). 26. Add Sodium Thiosulfate to reduce free chlorine that may be present.Free chlorine can react with organic compounds to form chlorination.by-products. 12. Aqueous samples forVolatile Organic Analyses(VOA)must be collected with- 'Free chlorine is likely to be found in chlorinated municipal drinking waters. ' out any headspace or air bubbles.Volatile organics dissolved in watertend to Use approximately 80•mg of Sodium Thiosulfate per liter of sample. volatilize readily and will fill any air bubble available in the vial.Particularly with low level samples,this results ina loss of material upon opening the vial. 27. Samples must be extracted within 7 days of collection.Extracts must then be VOA vials must be filled.slowly until the liquid forms a meniscus on the rim of analyzed with 21 days of extraction. GROUNDWATER ANALYTICA"L 33" ' COMMONWEALTH OF MASS ACHUSETTS DEPARTMENT OF ENVIRONMENTAL. PROTECTION STANDARD REFERENCES FOR MONITORING WELLS SECTION 1.2 TABLE OF!,.CONTENT,S 1 ' section 1.2 Page i January 1991 SECTION 1.2 TABLE OF CONTENTS ' 1.0 introduction 1.1 Foreword 1.2 Table of Contents 1.3 Definitions 2.O First Steps 2.1 Reconnaissance Surveys 2.2 Work and Cost Plans (Reserved) 2.3 Health and safety Plans 3.0 Subsurface Investigations 3.1 Exploratory Test Pits 3.2 Drilling Techniques ' 3.3 Borings in Contaminated Areas 3.4 In-situ Sampling of soil 3.5 Soil Classification 3.6 In-situ sampling of Rock 3.7 Rock Classification 3.8 Laboratory Tests for soil 3.9 Plugging Boreholes ' 4.0. Piezometers, observation wells and Monitoring Wells 4.1 Monitoring Well Network Design 4.2 selection of Well Construction Materials 4.3 well Installation Procedures 4.4 As-built Notes and Records 4.5 Well Development 4.6 . Decommissioning of Monitoring Wells 5.0 Interpretation of Ground Water and Aquifer Characteristics 5.1 Water Level Measurements ' 5.2 In-Situ Hydraulic Conductivity Tests 5.3 Pumping Tests 5.4 Packer Tests 5.5 Surveying and Datum Planes 6.0 sampling of Monitoring wells 6.1 , Quality Assurance/Quality Control 6.2 sampling Techniques 6.3 Sample Handling 6.4 Chain of Custody ' 6.5 Decontamination of Sampling Equipment i t - ' Section 1.2 Page ii January 1991 Section 1.2 Table of Contents (continued) 7.0 Computer Models (Reserved) 8.0 Geophysical Techniques (Reserved) I A # 1 •p � �1 ark q,' '�* pdrl �.1 'o 'xt Y ,{i•' = �+�.ti '. 1, �.4"t � ' �� Y• �, .f J t a r ,A14 M �! ..� s';'f ' oo �:d` `? "�' �'�`^ 't�- ,.''' �•rs ��e �.t y\ t' M^y 1"""/t��v-�s r yT, ?' �%, a a}�t\ d�T,.;I{ r+ l �i, •y } 'gc "S .e \ '�t { , `'4 y x f yxr`� x� tz r ;tx ,!ice£&.rs� �y� i{�.r +r.t' � l�`' �.s'• .: •. �fc,'�r. =a` � � ,�, 's�..'' _ � ��:� , `;�;�l f:x'I r t ,ras F a7 .yC ,�+`�ir p} Yy�y«. 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DATE: S 01.2- Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION Property Address: , 72, C ra,9 i, e- eAn,.A r d ,�nit•'t Assessor's Map and Parcel Number: a G 2— 07 3 Size of Lot: l• S 3 /tc/� S Wetlands Within 300 Ft. Yes Business Name: 91,40rne_ T rro,ce. No Subdivision Name: APPLICANT'S NAME: PPnn-S Phone 7rl U— y/U 9 S� Did the gweer of the property authoriz you to represent him or her? Yes No �ro�ert owh.erl w:II � Prese�,� PROPEiTY OWNER'S NAME CONTACT PERSON Name: - 7e_rlwe Name: Address: _ 97-Z Address: 2 '7.2 Phone: 7 gO'G/10 9 Phone: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) Gin ow &A be SG[ ' i .n WeiA lac u e ho NATURE OF WORK: House Addition ❑❑❑❑❑❑ House Renovation ❑ Repair of Failed Septic System i` Che ist(to be completed by office staff-person receiving variance request application) Four(4)copies of the completed vaiance request form Four(4)copies of engineered plan submitted.(eg.septic system plans) ®n'd _ eI e v�Qro'�Mff) Four.(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals (same owner/leasee only],outside dining variance renewals(same owner/leasee only],and variances to repair failed sewage disposal systems (only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. Q:\HEALTH\WPFILES\VARIREQ.DOC COMMONWEALTH OF MASSACHUSETTS = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SV'yy %Ca 350 MAIN STREET WEST YARMOUTH,MA 508-775-2800 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP 267 PAR 073 , Property Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner's Name: HAWTHORNE TERRACE CONDOMINIUMS Owner's Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Date of Inspection SEPTEMBER 18,2002 Name of Inspector: (please print) JAMES D.SEARS Company Name: A&B Canco Mailing Address: 350 Main Street West Yannouth,MA 02673 Telephone Number: 508-775-2800 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 the inspection. The inspection was P P P Performed based on my training and experience in the proper func tion and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: r-.2, The system inspector shal submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent tot he buyer,if applicable,and the approving authority. Notes and Comments THIS IS A SHARED SYSTEM-UNITS 6-10 AND 16-20 ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: N/A 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined" please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): Broken pipe(s)are replaced Obstruction is removed Distribution box is leveled or replaced ND explain: The system required pumping more than 4 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 ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 C. Further Evaluation is Required by the Board of Health: N/A Conditions exist which require further evaluation by the Board of Health in order to detennine if the system is failing to protect public health,safety,or 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 public health safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or 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,safety and 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 SAS and the SAS is within a Zone 1 of public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to detennine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 D. System Failure Criteria applicable to all systems: N/A You must indicate"yes"or"no"to each of the following for all inspections: Yes No X Backup of sewage into facility or system component due to 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 leaching is less than 6"below invert or available volume is less than %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 X Any portion of the SAS,cesspool or privy is below high ground water elevation N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone 1 of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A 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. (This system passes if the well water analysis performed at a DEP certified laboratory,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 or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. 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) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking 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. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system is failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Form 6/15/2000 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 Check if the following have been done. You must indicate"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 Were any of the system components pumped out in the previous two weeks? X Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X Was the facility or dwelling inspected for signs of sewage back up? X Was the site inspected for signs of break out? X Were all system components,excluding the SAS,located on site? W X Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the Condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum X Was the facility owner(and occupants if different from owner)provided with information on the Proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yes No X Existing information. For example,a plan at the Board of Health. X Determined in the field(if any of the failure criteria related to Part C is at issue approximation of Distance is unacceptable)[310 CMR 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 FLOW CONDITIONS RESIDENTIAL—CONDOMINIUMS(10 UNITS,2 PER UNIT) Number of Bedrooms(design): 20 Number of bedrooms(actual): 20 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms: 2200 Number of current residents: N/A Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): YES Seasonal use(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): RECORD ON FILE AT BARNSTABLE WATER COMPANY Sump pump(yes or no) NO Last date of occupancy: PRESENT COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CM 15.203): Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of infonmation: ANNUALLY Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy X Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be Obtained from system owner) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: UNKNOWN,NEW LEACHING 1997 PERMIT#97-259 Were sewage odors detected when arriving at the site(yes or no): NO J Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 BUILDING SEWER(locate on site plan): X Depth below grade: 12" Materials of construction: X Cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): X (2 TANKS) Depth below grade: Material of construction: X Concrete metal fiberglass polyethylene other(explain) s If tank is metal list age: Is age contnned by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: TWO 2,000 GALLON PRE CAST Sludge depth: 2" Distance from top of sludge to the bottom of outlet tee or baffle: 28" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 17" How were dimensions detennined: ASBUILT,TAPE AND PLAN Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): BOTH MAIN TANKS ARE 2,000 GALLON PRE CAST.ALL COVERS ARE 18"STEEL AT GRADE.BOTH TANKS HAVE INLET AND OUTLET TEES IN PLACE.NO SIGN OF OVERLOADING SEEN IN TANKS. GREASE TRAP(located on site plan) N/A Depth below grade: Material of construction: concrete metal fiberglass _ polyethylene other (explain): Dimensions: 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: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 I Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no) Alann level: Alann in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION TWO BOXES if resent must n S BUTION BOX: X ( p s be ope ed)(locate on site plan) Depth of liquid level above outlet invert: 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.,): ONE BOX FROM OLD SYSTEM 16"X16",30"BELOW GRADE WITH 18"STEEL COVER AT GRADE. NEWER BOX IS 4' BELOW GRADE WITH 18"STEEL COVER AT GRADE. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type X leaching pits,number: 3 X leaching chambers,number: 3 leaching galleries,number leaching trenches,number,length leaching fields,number,dimensions: 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.) LEACHING HAS THREE OLD PITS.COVERS BELOW GRADE.PITS HAD FAILED IN PAST.LINES STILL TIED INTO SYSTEM. LEACHING HAS THREE 500 GALLON CHAMBERS INSTALLED IN 1997.4"WATER IN CHAMBERS.NO HIGH STAIN LINE.NO SIGN OF OVERLOADING OR SOLID CARRY OVER.TWO 18" STEEL COVERS AT GRADE. CESSPOOLS: N/A (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 layer: 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.): PRIVY: N/A (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 vegetation,etc.) Title 5 Inspection Form 6/15/2000 9 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: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. ' i I i 3 i I j u i I 1 a c � a b I i 1 0 I I f 1 � I i { 9 i i 's f I CO) i j - 3 I i i I Title 6 Inspection Form 6/15/2000 10 � 5 i t f Page I I of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ,Property Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to groundwater 20+ feet Please indicate(check)all methods used to determine the high ground water elevation: X Obtained from system design plans on record-If checked,date of design plan reviewed: Observation site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: OFF PLAN AND PAST REPORT. Title 5 Inspection Form 6/15/2000 11 ` 1 Town of Barnstable • snxrrsrnstE, "�: A,. Board of Health rED N10� P.O.Box 534,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,RS. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. November 22, 2002 Mr. Dennis Cotto 272 Craigville Beach Road, Apt. 15 Hawthorne Terrace Condominiums Hyannis, MA 02601 RE FAILED SEPFTIC SYSTEM/ DENIAL OF YOUR ..REIfEST TO REPLACE LEACHING PITS WITH NEW LEACHING PITS Dear Mr. Cotto: Your request to replace the "failed" leaching pits with new leaching pits at 272 Craigville Beach Road, is denied. This property is located within a nitrogen sensitive area (groundwater protection district). The State Environmental Code, 310 CMR 15.202 specifically reads as follows: 'A recirculating sand filter or equivalent alternative tech nology'approved by the Department shall be a required designed component of all systems with a design flow of 2,000 gpd or more to be located in Nitrogen Sensitive Areas....' Also 310 CMR 15.254 specifically reads as follows: 'pressure distribution of septic tank/recirculating sand filter effluent to the soil absorption system shall be required for all system designs in excess of 2,000 gpd.' Your proposal to replace the failed system did not include a recirculating sand filter, equavilent alternative technology, nor pressure dosing as required. You are reminded that the failed system must be replaced within two years of the date of the failed inspection report (NOTE: The report is dated September 23, 2002). Therefore, a new replacement system must be installed with pressure dosing and a recirculating sand filter or other DEP approved innovative/alternative nitrogen reduction technology on or before September 23, 2004. PER RDER THE BOARD OF HEALTH 7; ayfiller, M.D. j ChaiBOAOF HEALTH Q:HEALTH WP/Cotto i No.m1:7-R Fee 5� 0VY., ,,/ r THE COMMONWEALTH OF MASSACHl1SETTS Entered in computer: 16PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS y 01ppIication for Migonl *pttem. Com6truction 3dermit Application for a Permit to Construct( )Repair(K X)Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Hawthorne Terrace Condo' s �72. Craigvill Beach Road Assessor's Map/Pazcel 0 West Hyannisport,Mass. Installer's Name,Address,and Tel.No. 5 0 3—7 7 —3 3 3 3 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8 J. P.NTT�.t.,�9c+�ir<�c.:� w"; ;t �: 1 r.cc;_ J.P.Macomber & .Son Inc. 'Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 Type of Building: Dwelling XX No.of Bedrooms Ap Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Ingtallin tee—in tl}e ekttl2tend of the septic tank This for Units 11 -1 5 Raisincr of nne Distri huti tin box mover nutlet end of tank will a1So be broug t to gjeag-setin�'�'sp &e d:a cast iron ring & cover. 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 Certifi- cate of Compliance has been issue y this B d al Signed Date 1 0/1 7/0 Application Approved by 41 Date Application Disapproved for the following reasons 61 77 Permit No. Date Issued — —_ -------s----------------------- -.'~` Fee $5 0. 0 0 v ..� � `e. �,.. vim. f � �` . " y{ � E)C0111111110NWEALTH OF=MAS;.•�ACHU ETTS '' ' Entered.in computer. Ye PU9L,fC HEALTH DIVISION'-TOWN OF BARN ' ABLE'AASSACHUSETTS 1. icatton�for ` fg o�aY p�tem� con traition ertuit Application for a Permit to Construct( �)Repair( X)Upgrade( )Abandon( ). ,�;Cotnplete Sys m. O Individual Components Location Address or Lot No. Owner's Name;Address and 3•el''No. Hawt}�are Terrace C n8o's � - ', Assessor'sMap arcel 038 Craigvill. Beach Road. Q West Hyanni.sport,Mass. Installer's Name,Address,and Tel.No. 5 0 S—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3.3 3$ J.P;RkwMIT&M&& Stan ITr>ra'1C. J.P.Macomber & Son Inc. Box 66 Centerville,Mass.02632 113ox 66 Centerville,Mass.02632 Type of Building: r_ Dwelling XX No.of Bedrooms lP Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of i Re ars or Alterations Answer when applicable)Repairs ( PP ) I pSta;j i'_ztem�' i n t ate^Gi-?rt iV e n r3 of f-hP cpnti r i-ank .Tbic for rjni is 11 1 r, Oai ci ng of -on,- ' Di ci-ri htati nn hox tznel of rank will al cn ha hrotac1hi- to '"ya :1 gateal�asCinsWp &pd:a cast iron ring & cover. 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 Certifi- cate of Compliance has been issue by this B and qf�H al Signed , _ / �. ' ,dY '� Date 1 0/17/0 4. Application Approved by /,1 Date Application Disapproved for the following reasons o ( t / Permit No. Date Issued /X. /I THE COMMONWEALTH OF MASSACHUSETTS p 4 BARNSTABLE, MASSACHUSETTS Certificate of Comphattce 16,(f r, xf THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(d )Repaired(XX)Upgraded( ) Abandoned( )by J.P.Macomber & Son Inc. I ' atHawthorne Terrace Condo"s 272 Craigvi Ile Be ch Roh" constructed in accordance with the provisions of Title 5 and the for DisposalY System Construction Permit No.. dated Installer J.P.Macomber & Scan 1_nc- Designer J. . Macomber & Son xnc.. The issuance of this permit shall not be construed as a guarantee that the system, ill function as designed Date ro J 7, Inspector t V —-----_—--------------------------------- No. Fee$5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS � PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS ligoot &pztem Con!aruction Permit Permission is hereby granted to Construct( )Repair(XX)Upgrade( )Abandon( ) System located at 7-72 C raiavi 11P Reach RoAd WP_t Nvanni _nori- Mac_ Units 11 -15 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the M following local provisions or special conditions.Provided:Construct ust b0/c90Vplbted within three years of the date of thi�rm`. Date: C7 �I - -- Approved by COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION 272 Craigville Beach Rd RECEIVE® ' Hyannis. P r 07 ^� W MAIN STREET &� WESTYARMOUTH,MA OCT 3 2002 508-775-2800 TOWN O OF NSTABLE TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP 267 PAR 073 Property Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner's Name: HAWTHORNE TERRACE CONDOMINIUMS Owner's Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT, MA 02672 Date of Inspection SEPTEM BER 18,2002 Name of Inspector:(please print) JAMES D. SEARS Company Name: A& B Canco Mailing Address: 350 Main Street West Yannouth,MA 02673 Telephone Number: 508-775-2800 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: -,� Date: yn ,Z_ -OA The system inspector shall Zbmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent tot he buyer,if applicable,and the approving authority. Notes and Comments THIS IS A SHARED SYSTEM-UNITS 6-10 AND 16-20 ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X _ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: N/A 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined" please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): Broken pipe(s)are replaced Obstruction is removed Distribution box is leveled or replaced ND explain: The system required pumping more than 4 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 ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 C. Further Evaluation is Required by the Board of Health: N/A Conditions exist which require further evaluation by the Board of Health in order to detenmine if the system is failing to protect public health,safety,or 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 public health safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or 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,safety and 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 SAS and the SAS is within a Zone 1 of public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 3 Page 4 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 D. System Failure Criteria applicable to all systems: N/A You must indicate"yes"or"no"to each of the following for all inspections: Yes No X Backup of sewage into facility or system component due to 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 leaching is less than 6"below invert or available volume is less than'/z 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 X Any portion of the SAS,cesspool or privy is below high ground water elevation N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone 1 of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A 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. (This system passes if the well water analysis performed at a DEP certified laboratory,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 or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this fonn.) NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. 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) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system is failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Form 6/15/2000 4 Page 5 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 Check if the following have been done. You must indicate"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 Were any of the system components pumped out in the previous two weeks? X Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X Was the facility or dwelling inspected for signs of sewage back up? X Was the site inspected for signs of break out? X Were all systern components,excluding the SAS,located on site? X Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the Condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum X Was the facility owner(and occupants if different from owner)provided with information on the Proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yes No X Existing information. For example,a plan at the Board of Health. X Determined in the field(if any of the failure criteria related to Part C is at issue approximation of Distance is unacceptable)[310 CMR 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 FLOW CONDITIONS RESIDENTIAL—CONDOMINIUMS(10 UNITS,2 PER UNIT) Number of Bedrooms(design): 20 Number of bedrooms(actual): 20 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms: 2200 Number of current residents: N/A Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): YES Seasonal use(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): RECORD ON FILE AT BARNSTABLE WATER COMPANY Sump pump(yes or no) NO Last date of occupancy: PRESENT COMMERCIALANDUS TRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: ANNUALLY Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy X Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be Obtained from system owner) Tight tank • Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: UNKNOWN,NEW LEACHING 1997 PERMIT#97-259 Were sewage odors detected when arriving at the site(yes or no): NO Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: 1 AWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 BUILDING SEWER(locate on site plan): X Depth below grade: 12" Materials of construction: X Cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): X (2 TANKS) Depth below grade: Material of construction: X Concrete metal fiberglass polyethylene other(explain) s If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: TWO 2,000 GALLON PRE CAST Sludge depth: 2" Distance from top of sludge to the bottom of outlet tee or baffle: 28" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 17" How were dimensions determined: ASBUILT,TAPE AND PLAN Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): BOTH MAIN TANKS ARE 2,000 GALLON PRE CAST.ALL COVERS ARE 18"STEEL AT GRADE.BOTH TANKS HAVE INLET AND OUTLET TEES IN PLACE.NO SIGN OF OVERLOADING SEEN IN TANKS. GREASE TRAP(located on site plan) N/A Depth below grade: Material of construction: concrete metal fiberglass _ polyethylene other (explain): Dimensions: 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: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no) Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: X TWO BOXES (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.,): ONE BOX FROM OLD SYSTEM 16"X16",30"BELOW GRADE WITH 18"STEEL COVER AT GRADE. NEWER BOX IS 4' BELOW GRADE WITH 18"STEEL COVER AT GRADE. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type X leaching pits,number: 3 X leaching chambers,number: 3 leaching galleries,number leaching trenches,number,length leaching fields,number,dimensions: 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.) LEACHING HAS THREE OLD PITS.COVERS BELOW GRADE.PITS HAD FAILED IN PAST.LINES STILL TIED INTO SYSTEM. LEACHING HAS THREE 500 GALLON CHAMBERS INSTALLED IN 1997.4"WATER IN CHAMBERS.NO HIGH STAIN LINE.NO SIGN OF OVERLOADING OR SOLID CARRY OVER.TWO 18" STEEL COVERS AT GRADE. CESSPOOLS: N/A (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 layer: Dimensions of cesspool: ti 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.): PRIVY: N/A (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 vegetation,etc.) Title 5 Inspection Fonn 6/15/2000 9 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: 272 CRAIGVILLE BEACH ROAD W. HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: SEPTEMBER 18,2002 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I it j 3 I � 1 � � i � • a C C G 6 CK i � I i i I ' ! c O i i I � E i i 0 j � f s � I Title 5 Inspection Form 6/15/2000 10 i i � L Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 1 Property Address: 272 CRAIGVILLE BEACH ROAD W.HYANNISPORT,MA 02672 Owner: HAWTHORNE TERRACE CONDOMINIUMS Date of Inspection: _SEPTEMBER 18,2002 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to groundwater 20+ feet Please indicate(check)all methods used to determine the high ground water elevation: X Obtained from system design plans on record-If checked,date of design plan reviewed: Observation site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: OFF PLAN AND PAST REPORT. Title 5 Inspection Form 6/15/2000 11 I Health Complaints 24-Sep-02 Time: 1:00:00 PM Date: 9/16/02 Complaint Number: 3724 Referred To: DAVID STANTON Taken By: DAVID STANTON Complaint Type: TITLE V SEWAGE Article X Detail: Business Name: Hawthorne Terrace Condo's •Number: 272 Street: craigville beach rd Village: HYANNIS Assessors Map Parcel: 267 073 Complaint Description: There are several problems with the most recent inspection that occurred at these Condos. He is in the process of inspecting the systems, of which one is in failure, and the • other is passing. A lot of things don't match up with the previous inspection by John Graci, conducted in 2000. The diagram on the inspection just says covers to grade, but that is only for a very few. The inspection said there were only two leach pits on the southern system, and yet he has located 5. It makes no mention of the other units across the way, that are also tied into the same system as units 11- 15. Actions Taken/Results: DS MEET WITH JIM SEARS FROM AB CANCO ON 09/16/2002. DS BROUGHT SEPTIC PERMITS FOR THE PROPERTY FROM 1978, 1996 AND 1997. THE NORTHERN SYSTEM WAS PASSED BY AB CANCO. I CHECKED TWO OF THE THREE 500-GALLON CHAMBERS INSTALLED IN 1997 BY BRYAN AYOTTE. THE TWO-500 GALLON CHAMBERS I CHECKED HAD 1 'y0 T - Health Complaints 24-Sep-02 RISERS. THEY ONLY CONTAINED A VERY SHALLOW AMOUNT(3"-4") OF WASTE WATER, AND APPEARED TO BE FUNCTIONING FINE. THE SOUTHERN SYSTEM IS WHERE THERE WERE SOME PROBLEMS. THE 2000-GALLON SEPTIC TANK ON THE WESTERN SIDE OF THE SYSTEM DID NOT HAVE A TEE. IT WAS BUILT WITH A PRECAST CONCRETE TEE, THAT HAD EITHER DETORIORATED OR BROKEN OFF. THE DISTRIBUTION BOX WAS FULL OF SOLIDS. THE DISTRIBUTION BOX WAS STARTING TO DETERIORATE, AS SOME OF THE CONCRETE WAS FLAKING OFF. THERE WERE FIVE OUTLET LINES COMING OUT OF THE DISTRIBUTION BOX. THE THREE OTHER LEACH PITS, LOCATED BY JIM WERE EXPOSED. THEY WERE IN FAILURE (LESS THAN 6"TO THE INLET), WITH THE EXCEPTION OF ONE OF THEM, THAT WAS MORE THAN TWO THIRDS FULL, AND VERY CLOSE TO FAILURE. I FIND IT HARD TO BELIEVE THAT THE DISTRIBUTION BOX WAS INSPECTED IN 2000, BECAUSE I HAVE NEVER SEEN A DISTRIBUTION BOX HAVE FIVE OUTLETS LEADING TO JUST TWO LEACH PITS. ALSO NOTED ON THE INSPECTION WAS THAT THERE WERE ONLY TWO 1000-GALLON LEACH PITS, WHEN IN ACTUALLITY THERE WERE FIVE (3 INSTALLED IN 1978 PER AVAILABLE TOWN RECORDS, AND 2 INSTALLED IN 1996 BY MACOMBER, ALSO AVAILABE TOWN RECORDS) THE 2000 GALLON SEPTIC TANK THAT WAS LISTED ON THE REPORT STATED IT WAS STRUCTURALLY SOUND, WAS THE PRECAST CONCRETE TEE ALSO STRUCTURALLY SOUND AS WELL? WAS THE OTHER 2000-GALLON SEPTIC TANK LOCATED THAT WAS A PART OF THIS SYSTEM? IT MADE NO MENTION OF WHICH 2O00-GALLON SEPTIC TANK WAS INSPECTED, WAS IT THE WESTERN OR THE EASTERN TANK? BOTH TANKS UTILIZE THE SAME LEACHING SYSTEM; 2 1 Health Complaints 24-Sep-02 THEREFORE THEY BOTH SHOULD HAVE BEEN INSPECTED. THE"DIAGRAM"ON THE INSPECTION REPORT SIMPLY STATED "COVERS TO GRADE" THERE WERE NO MEASURMENTS GIVEN, THE OTHER THREE LEACHPITS DID NOT HAVE COVERS TO GRADE, THE DISTRIBUTION BOX DID NOT HAVE A COVER TO GRADE! ALL OF THE CURRENT SEPTIC SYSTEM COMPONENTS HAVE PLANS, PERMITS, AND AS BUILT CARDS AT THE HEALTH DEPARTMENT. THE SOUTHERN SYSTEM IS IN FAILURE. Investigation Date: 9/16/02 Investigation Time: 2:45:00 PM 3 Health Complaints 24-Sep-02 Time: 1:00:00 PM Date: 9/16/02 Complaint Number: 3724 Referred To: DAVID STANTON Taken By: DAVID STANTON Complaint Type: TITLE V SEWAGE Article X Detail: Business Name: Hawthorne Terrace Condo's Number: 272 Street: craigville beach rd Village: HYANNIS Assessors Map Parcel: 267 073 Complaint Description: There are several problems with the most recent inspection that occurred at these Condos. He is in the process of inspecting the systems, of which one is in failure, and the other is passing. A lot of things don't match up with the previous inspection by John Graci, conducted in 2000. The diagram on the inspection just says covers to grade, but that is only for a very few. The inspection said there were only two leach pits on the southern system, and yet he has located 5. It makes no mention of the other units across the way, that are also tied into the same system as units 11- 15. Actions Taken/Results: DS MEET WITH JIM SEARS FROM AB CANCO ON 09/16/2002. DS BROUGHT SEPTIC PERMITS FOR THE PROPERTY FROM 1978, 1996 AND 1997. THE NORTHERN SYSTEM WAS PASSED BY AB CANCO. I CHECKED TWO OF THE THREE 500-GALLON CHAMBERS INSTALLED IN 1997 BY BRYAN AYOTTE. THE TWO-500 GALLON CHAMBERS I CHECKED HAD 1 Health Complaints 24-Sep-02 RISERS. THEY ONLY CONTAINED A VERY SHALLOW AMOUNT(3"-4") OF WASTE WATER, AND APPEARED TO BE FUNCTIONING FINE. THE SOUTHERN SYSTEM IS WHERE THERE WERE SOME PROBLEMS. THE 2000-GALLON SEPTIC TANK ON THE WESTERN SIDE OF THE SYSTEM DID NOT HAVE A TEE. IT WAS BUILT WITH A PRECAST CONCRETE TEE, THAT HAD EITHER DETORIORATED OR BROKEN OFF. THE DISTRIBUTION BOX WAS FULL OF SOLIDS. THE DISTRIBUTION BOX WAS STARTING TO DETERIORATE, AS SOME OF THE CONCRETE WAS FLAKING OFF. THERE WERE FIVE OUTLET LINES COMING OUT OF THE DISTRIBUTION BOX. THE THREE OTHER LEACH PITS, LOCATED BY JIM WERE EXPOSED. THEY WERE IN FAILURE (LESS THAN 6"TO THE INLET), WITH THE EXCEPTION OF ONE OF THEM, THAT WAS MORE THAN TWO THIRDS FULL, AND VERY CLOSE TO FAILURE. I FIND IT HARD TO BELIEVE THAT THE DISTRIBUTION BOX WAS INSPECTED IN 2000, BECAUSE I HAVE NEVER SEEN A DISTRIBUTION BOX HAVE FIVE OUTLETS LEADING TO JUST TWO LEACH PITS. ALSO NOTED ON THE INSPECTION WAS THAT THERE WERE ONLY TWO 1000-GALLON LEACH PITS, WHEN IN ACTUALLITY THERE WERE FIVE (3 INSTALLED IN 1978 PER AVAILABLE TOWN RECORDS, AND 2 INSTALLED IN 1996 BY MACOMBER, ALSO AVAILABE TOWN RECORDS) THE 2000 GALLON SEPTIC TANK THAT WAS LISTED ON THE REPORT STATED IT WAS STRUCTURALLY SOUND, WAS THE PRECAST CONCRETE TEE ALSO STRUCTURALLY SOUND AS WELL? WAS THE OTHER 2000-GALLON SEPTIC TANK LOCATED THAT WAS A PART OF THIS SYSTEM? IT MADE NO MENTION OF WHICH 2O00-GALLON SEPTIC TANK WAS INSPECTED, WAS IT THE WESTERN OR THE EASTERN TANK? BOTH TANKS UTILIZE THE SAME LEACHING SYSTEM; 2 Health Complaints 24-Sep-02 THEREFORE THEY BOTH SHOULD HAVE BEEN INSPECTED. THE"DIAGRAM" ON THE INSPECTION REPORT SIMPLY STATED "COVERS TO GRADE" THERE WERE NO MEASURMENTS GIVEN. THE OTHER THREE LEACHPITS DID NOT HAVE COVERS TO GRADE, THE DISTRIBUTION BOX DID NOT HAVE A COVER TO GRADE! ALL OF THE CURRENT SEPTIC SYSTEM COMPONENTS HAVE PLANS, PERMITS, AND AS BUILT CARDS AT THE HEALTH DEPARTMENT. THE SOUTHERN SYSTEM IS IN FAILURE. Investigation Date: 9/16/02 Investigation Time: 2:45:00 PM I 3 i ;q REcE'�ED IUr)V 0 4 2000 7,0 EALTH D S7. ate COMMONWEALTH OF MASACHUtSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONEYINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION a��-off Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Address of Owner: BOX 488 W.HYANNISPORT MA.02672 Date of Inspection: 10/24/00 11 3• Name of Inspector: JOHN GRACI I am a DEP approved system inspector pursuant to Section15.340 of Title 5(310 CMR 15.000) t Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT q 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 _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date:10/25/00 The System Inspector shall submit ,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 ,)) . 'The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.M, inspection does not imply an warrant or guarantee of the longevity of the septic stem and an of its corn onent's useful life." P PY Y Y 9 9 Y P Y Y P r� THE SYSTEM PASSES TITLE V INPECTI,ON.RECOMMEND PUMPING THE EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. ;7 �-b revised 9/2/98 Paoe 1 of 11 `i t el SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: X 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. 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 o 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. n/a 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. nla Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)o 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 nta 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 ,F, o h ri V. . rdtt >tl; revised 9/2/98 Paae 2 of 11 ��a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 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)TFIAT THE SYSTEM I! 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 n/a (approximation not valid). 3) OTHER n/a ,t i revised 9/2/98 Paoe 3 of 11 il. • 1. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 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 compounds,ammonia nitrogen and nitrate nitrogen. 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 9/2/98 Paoe 4 of 11 I ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner: HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 ;i* . Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No lr. 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. 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. Ifs\ 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`ori: 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. f k riGi 65 it revised 9/2198 Paae 5 of 11 I ii SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom Number of bedrooms(design): 10 Number of bedrooms(actual): 10 Total DESIGN flow: 1100 gpd Number of current residents:10 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no);�NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): n/a gpd Sump Pump(yes or no): NO Last date of occupancy: n/a COMM R IA /IND (STRIA Type of establishment: n/a Design flow: n/a gpd(Based on 15.203) Basis of design flow:n/a d Grease trap present:(yes or no): NO Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: n/a Last date of occupancy:n/a OTHER: (Describe) n/a GENERAL INFORMATION a PUMPING RECORDS and source of information: SYSTEM WAS PUMPED ON OC.12TH BY CANCO System pumped as part of inspection:(yes or no):NO If yes,volume pumped nla gallons Reason for pumping:nla }; TYPE OF SYSTEM X Septic 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:n/a r vt, APPROXIMATE AGE of all components,date installed(if known)and source of information: 1987 Sewage odors detected when arriving at the site:(yes or no): NO revised 9/2/98 Paoe 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 BUILDING SEWER:X (Locate on site plan) Depth below grade: 12" Material of construction: _ cast iron X 40 Pvc _ other(explain) Distance from private water supply well or suction line: n/a Diameter: n/a Comments: (condition of joints,venting,evidence of leakage,etc.) TOWN WATER SEPTIC TANK: X (locate on site plan) Depth below grade: 6" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: n/a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 2000G L 12'H 6'6"W 6'6"" Sludge depth: 0" Distance from top of sludge to bottom of outlet tee or baffle: 34" Scum thickness: 0" 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: n/a 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.) THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE GREASE TRAP: _ (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other Explain: n/a Dimensions:n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a 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.) n/a K, ;I revised 9/2/98 Paae 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-16 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other Explain: n/a Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm present: NO Alarm level:N/A Alarm in working order: NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n/a DISTRIBUTION BOX:X (locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. PUMP CHAMBER: _ (locate on site plan) Pumps in working order:(Yes or No): NO Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n/a revised 9/2/98 Pape 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 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: n/a Type: leaching pits,number:(2) 1000 GAL 6'X 6' leaching chambers,number: (0)n/a leaching galleries,number: (n/a)n/a leaching trenches,number,length: (n/a)n/a leaching fields,number,dimensions: (n/a)n/a overflow cesspool,number: (n/a)n/a Alternative system: n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PITS APPEARS TO BE FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE.THE PITS WERE EMPTY AT THE TIME OF THE INSPECTION. CESSPOOLS: _ (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer. n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a revised 9/2/98 Paoe 9 of 11 o SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH RD WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 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) revised 9/2/98 Paoe 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 272 CRAIGVILLE BEACH RD UNITS 11-15 WEST HYANNISPORT, MA 02672 Name of Owner HAWTHORNE TERRACE CONDOMINIUMS C/O JOHN BORINI Date of Inspection: 10/24/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a; USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate Deep_ SITE EXAM _ Slope _ Surface water _ Check Cellar _ Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions k _ Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET revised 9/2/98 Paoe 11 of 11 C0IA111O KWE ALTH OF MASSACHU SETTS _ EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS == DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE 'WINTER STREET, BOSTON b29 0210E (617) 292-5500 TRUDY CORE Secretary ARGEO PAUL CELLUCCI DAVID B STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 292 Craigville Beach Rd.. Name of owner Gary Levine H annisport , MA Address ofOwner:Ll9 "itnw Cnnrord., MA 01742 Date of Inspection: /� Name of Inspector:(Please Print) C.,j.?oD I am a DEPpr veo system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company_Name: a. S .v T C a Mailing Address: 1 - r� ' Telephone Number: ,46 g'- '717 y 17 1) Z 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: _ Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Z10, IL v Date: 6 The System Inspector shall submit 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 ` •ti system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS � 9 REM EO + to J U N 1 8 1999 a TOWN OF OMNSTA9LE S HEALTH DEPT. revised 9/2/98 Pagel of11 • ►OW Primed on Recycled Paper I. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM �. PART A r CERTIFICATION (continued) "rop"Address: �92 Craigville Beach Rd.. ,. Hyannisport , MA Jwner: Gary Levine Date of Inspection:.P_ y C / INSPECTION SUMMARY: Check C, or D: A. SYSyTEM PASSES: kk 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: 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 y s, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not. 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. 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 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 N � < e, revised 9/2/98 ' Page 2ofII F ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Prop"A ess:292 Craigville Beach Rd.. , .Hyannisport, MA Owner: Gary Levine Date of Inspection: S—.7-L^9 5 C. FU THER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: onditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the blic health, safety and the environment. 1) S STEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS OT 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) S TEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS F NCTIONING 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 (approximation not valid). 3) 0 HER revised 9/2/98 Page 3of11 L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ; PART A CERTIFICATION Icontirwed) Property Address: 292 Craigville Beach Rd.. , Hyannisport , MA owner: Gary Levine Date of Inspection: S`;- D. SYSTEM FAILS: You must'ndicate either "Yes" or "No to each of the following: I ave determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this d ermination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility-or system component due to an overloaded or-clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. 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 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(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 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 compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE S STEM FAILS: You must indic to either "Yes" or "No" to each of the following: The f lowing criteria apply to large systems in addition to the criteria above: The sy tern 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 nd safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply Lpantment e system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA) or a mapped Zone II of a public ater supply well) The owner oor of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM " PART B CHECKLIST Property Address: 292 Craigville Beach Rd.. , Hyannisport, MA Owner: Gary Levine Date of Inspection: -e-q Check if the following have been done: You must indicate either "Yes" or"No as to each of the following: Yes/ No Pumping information was provided by the owner, occupant, or Board of Health. 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.. _ As built plans have been obtained and examined. Note if they are not available with NIA: _ The facility or dwelling was inspected for signs of sewage back-up. .jel _ The system does not receive non-sanitary or industrial waste flow. 1/ The site was inspected for signs of breakout. All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles ,q 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 B.O.H. y .. — K Determined in the field (if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) r .;` A. ,.. 115.302(3)(b)) _ The facility owner(and occupants,if different from owner) were provided with information on the proper maintenanco-of SubSurface Disposal Systems. revised 9/2/98 Page 5of11 ' t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM `- PART C SYSTEM INFORMATION IropertyAddress: 292 Craigville Beach Rd.. , Hyannisport , MA Owner: Gary Levine , Date of Inspection: 0j, FLOW CONDITIONS RESIDENTIAL: Design flow: 4j,S�b g.p.d./bedroom. Number of bedrooms (design): ,3 Number of bedrooms(actual):, Total DESIGN flow ors 0 Number of current residents: Garbage grinder(yes or no):2—cD' Laundry(separate system) (yes or no)k If yes, separate.inspection required. Laundry system inspected (yes or no) Seasonal use(yes or no): t/A Water meter readings, if a ailable (last two year's usage(gpd): 1 998 • 25, 000 gal. Sump Pump(yes or no):_,44,_4 1997 26, 000 gal. Last date of occupancy: COMMERCIAL/INDUSTRIAL: Type o establishment: Design ow: qpd ( Based on 15.2031 Basis of design flow Grease ap present: (yes or no)_ Industri I Waste Holding Tank present: (yes or no)_ Non-sa itary waste discharged to the Title 5 system: (yes or no)_ Water eter readings, if available: Last to of occupancy: OTH R:(Describe) Last a of occupancy: GENERAL INFORMATION . PUMPING RECORDS,and source of information: System p! 'umped as part of inspection: (yes or no) If yes, volume pumped: / 6-0 gallons Reason for pumping: ✓d a4 TYPE SYSTEM Septic 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 CEP Approval Other APPROXIMATE AGE of all components, date installed Af known)and source of information: Sewage odors detected when arriving at the site: (yes or no)A O x*izp�r .ti revised 9/2/96 Page 6of11 4k SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C • SYSTEM INFORMATION(continued) 'rop"Address: 292 Craigville Beach Rd.. , Hyannisport, MA Owner: Gary Levine Date of Inspection: 8L DING SEWER: ILo to on site plan) Dept below grade:_ Mate 'al of construction:_cast iron_40 PVC_other(explain) Dista ce from private water supply well or suction line Diam er Com ents: (condition of joints, venting, evidence of leakage,-etc.) Jkf SEPTIC TANK:_ (locate on site plan) ri Depth below grader Material of construction: t concrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age_ Is.age confirmed by Certificate of Compliance_(Yes/No) Dimensions: 4K `'k G f Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outletJ teepr baffler How dimensions were determined: �p a M ;omments: (recommendation for pumping, condition of inlet a d outlet tees or baffles, depth of liquid lev jjD relation to outlet invert, tructural integrity, evid nce of lea ag ) L GCl �"0 - .9 dtA—K /n �r ,�d o a GR SE TRAP: (locat on site plan) Depth elow grade:_ Materia of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dimens' ns: Scum t ickness: Distan from top of scum to top of outlet tee or baffle: Distan a from bottom of scum to bottom of outlet tee or baffle: Date last pumping: Corn ants: (re mmendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, ev ence of leakage, etc.) revised 9/2/96,,.... Page 7of11 �.4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'roperty Address: 292 Craigville Beach "d..-, Hyan-nisport ; MA Owner: Gary Levine Date of Inspection:s e.4— $ T OR HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection) Iloc to on site plan) Dept below grade:_ Mater 1 of construction:_concrete metal_Fiberglass_Polyethylene_other(explain) Dimen ions: Capaci y: gallons Desig flow: gallons/day Alarm resent Alar level: Alarm in working order: Yes_ No_ Date f previous pumping:. Co ants: (c dition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:V (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) - dy'!� 12 t/ PUM CHAMBER:_ (locat on site plan) Pump in working order: (Yes or No) Alarm in working order(Yes or No) Com nts: (note ondition of pump chamber, condition of pumps and appurtenances, etc.) revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ° PART C SYSTEM INFORMATION(continued) lropertyAdclmss:292 Craigville Beach Rd.. , Hyannisport , MA Owner: Gary Levine Date of Inspection: S—,;L L"Cr' `J SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible; excavation not required, location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number:_ leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note conditigLLof soil, signs of hydraula.failure, level of ponding, damp soilj condition of vegetation, etc.) �- R 'e—A 5 CESSPOOLS:_ (locate on site plan) Number and configuration: L� Depth-top of liquid to inlet invert: Depth of solids layer: )epth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Co ments: (not condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRI _ (loc to on site plan) M erials of construction: Dimensions: D pth of solids: C mments: ( to condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) revised 9/2/98 Page 9ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) -ropertyAddress: 292 Craigville Beach Rd.. , Hyannisport , MA Jwner Gary Levine- Date of Inspection: —,2 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) I I �AG _ { I revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ropertyAddress: 292 Craigville Beach Rd.. , Hyannisport , MA Owrw. Gar Levine Date of Inspection: Y A e s g 17 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Ad Estimated Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record / I/ 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 est''a✓✓blished the High Groundwater Elevation. (Must be completed) revised 9/2/98 Page 11of11 i_n_� Ar No. 7/0Fee $50V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[pprication for &gozal *pgtem Construction Verna Application for a Permit to Construct( )Repair t )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 292 Craigville Beach Rd.. , . r' ; Gary Levine Assessor'sMap/Parcel W. Hyannisport , MA 14.9 Stowe Rd. ,Concord, ILIA Installer's Name,Address,and Tel.No. Designer's ame,A dress and Tel. o. Wm. E . Robinson Septic Service P 0 Box 1089, Centerville , MA Type of Buildmg: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Sand Nature of Repairs or Alterations(Answer when applicable) New Title-5 septic inc . Tank, n—hnx and 2 1 as nh chambers. 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 Certifi- cate of Compliance has been issued by thi BopA of Health .✓ Signed Date 1 Application Approved by Date Application Disapproved for the following reasons L(/;/ Permit No. Date Issued ( Fee $50\ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS < Rpiricatiou for Mi5pozar 6petem Colt.5truction Permit Application for Aermit to Construct( )Repair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Addres§or Lqt No. Owner's Name,Address and Tel.No. 292 Craigville Beach Rd. , , Gary Levine Assessor'sMap/Parcel W. Hyannisport, MA 149 Stowe Rd. ,Concord, MA Installer's Name,Address,and Tel.No. Designer's Name,A dress and Tel.No. Wm. E. Robinson Septic Service P 0 Box 1089, Centerville, MA lypeof Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) ,Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow galfbns per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Sand Nature of Repairs or Alterations(Answer when applicable) New Title-5 septic inc . Tank, D—box and 2 leach chambers Date last inspected: — l .- 7 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 Certifi- cate of Compliance has-been issued by this Boa3d of Health ✓ f Signed ► Date 3" 07 Application Approved by ! Date Application Disapproved for the following reasons el �. Permit No.- "" la Date Issued + ——————— ——————————————————— —————---- THE COMMONWEALTH OF MASSACHUSETTS Levine BARNSTABLE, MASSACHUSETTS (Certificate of (tompriance THIS IS TO CERTIFY, that the On-site Sewage Des osal S stgm Constructed( )Repaired (X )Upgraded( ) Abandoned( )by Wm. E. Robinson O e pt 1 S elv is e at 292 Craigyille Beachd.. Hyannis_ ort a n constructed in.�ccori nce with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Wm E . Robinson S r. Designer , The issuance of this permit shall of c Jtrued as a guarantee that the s to will function //XdesigtirA (� /0 c Date a Inspector - -f ------- -1 7 d ,✓ ! i No. Fee THE COMMONWEALTH.OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po!6al *pgtem Cow6truction Permit Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( ) System located at 292 Craigville Beach Rd. , W. Hyannisport, MA and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special-conditions. Provided: Constructio ust be o eted within three years of the date'of th's e t. /Vv ,,II - Date: � Approved by i!� 4;"14 / � , NOTICE: This Form Is To Be Used For The Repair Of Failed Septic Systems Only. - o� CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I,_ William E. Robinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated s,- 13— q / concerning the property located at 292 Craigville Beach Rd., W, Hyannisport, MA meets all of the following criteria: * There are no wetlands within 100 feet of the proposed leaching facility. * There are no private wells within 150 feet of the proposed septic system. * There-is no-increase in flow and/or change in use proposed. * There are no variances requested or needed. * If the proposed leaching facility will be located with 250 feet of`any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Evaluation(according to Health Division well map) ,5 SIGNED: �j ► ,�„ DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). Al p � • o f u �r ! a 1 1 V -- -------- �\ TOWN OF BARNSTABLE r � LOCATION 49a CdtAln ui 1&, *mk Q SEWAGE # 17 r-C) VILLAGE `i e lt/r is %� ASSESSOR'S MAP do LOT INSTALLER'S NAME&PHONE NO. [�l/x1 E ' fit G 7-7 5- 9 7 7/. SEPTIC TANK CAPACITY 156(n LEACHING FACILITY: (type) t' -q Li I S ,(size) aY-- 10 f ZS NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: f r-m- COMPLIANCE DATE: 2 J 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 .)Sno� �o l� �- � 44 0t ' e BORTOLOTTI CONSTRUCTION, INC. 765 WAKEBY ROAD,MARSTONS MILLS,MA 02648 Z t 508-771-9399 508428-8926 FAX: 508428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 7 ' Date of Inspection:1111,;W 0 I pecto 's Name: _ Owner's Name and Address: CERTIFICATION STAT .M .NTs I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true, accurate and complete as of(lie time of inspection. The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposals Wins. The System: t/ Passes Conditionally Pas Needs Further uatio Local Aproving Authority Fails Inspector's Signature: J Date:' The System Inspec or shall submit a copy of this inspection report to the Approving authority within thir- ty(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 lie 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 STIMMARY• A)SYS M PASSES: I have not found any information which indicates that the systetn violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair, passes inspection. i Indicate yes,nor,or not determined(Y,N,OR ND). Describe basis of determination in all instances. If "Pot determined",explain why not. The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing sep- tic tank is replaced with a conforming septic tank as approved by The Board of Health. Sewage backkup or breakout or high static water,level observed in the distribution box is due too 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): - 1 - , A� r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A V CERTIFICATION (continued) Broken pipe(s)replaced Obstruction is removed Distribution Box 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 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 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 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 FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:` The system has a septic tank and 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 with 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 the facility and the presence of ammonia nitrogen and nitrate nitrogen is'equal to or less than 5 ppm. D)SYSTEM FAILS: 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. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clog- ged-SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day now. Required pumping more than 4 times in the last'year NOT due to clogged or obstructed pipe(s). Number of times pumped -2- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 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 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 compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 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 surface drinking water supply The system is within 200 Feet of a tributary to a surface drinking water supply The system is located in a.nitrogen sensitive area Interim Wellhead Protection Area (IWPA)or a mapped Zone 11 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 further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B y , CIIECKLIST X r Check if the following have been done: dumping information was requested of the owner,occupant,and Board of Health. ✓None of the system components have been pumped for atleast 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. As-built plans have been obtained and examined. Note if they are not available with N/A. 7"The facility or dwelling was inspected for signs of sewage back-up.. _4z The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. ✓All system components,excluding the Soil Absorption System,have✓:T been located on site. he septic tank manholes.were uncovered,opened,and the interior of the septic tank was in- spected for condition of baffles or tees,material of construction,dimensions,depth of liquid, ,A16pth of sludge,depth of scum. ✓The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. -3- u 'SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) //The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .. . . SYSTEM INFORMATION �7"FLOW CONDITIONS RFSMIFNTI Design Flaw: Ins Number of Bedrooms:_ Number of Current Residents: Garbage Grinder: ,012n Laundry Connected To System: Seasonal Use:�d Water Meter Readings,if 'lable: Last Date of Occupancy: COMMFRCLAIJiNDUSTRIAL:/00 " Type of Establishment: s . , e ,.. Design Flow;_ gallons/day 'Grease Trap Present:'(yes or no) Industrial,Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings,If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENE INFORMATION PUMPING RECORDS and of information QCt✓ _ System Pumped as part of inspection:_ If yes,volume pumped: k7d, gallons Reason for pumping: M F SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection-records, if any) Other(explain): PROXMUTE AGE of all components,date installed(if known)and source of information; Sewage odors defikted when arriving at the site:,c; } -4- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: v `� Depth below grad Material of Construction: concrete metal FRP_Other (explain) Dimisions: Sludge Depth: Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: ". Distance from bottom of scum to bottom of outlet tee or baffle: A011 If_-. 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.)Vz;Q 2 o?6W ��hJ J?w' ang. GREASE TRAP: Depth Below Grade: Material of Construction: concrete metal_FRP_Other (explain) Dimensions: Scum Thickness: ."... Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth.of liquid rt level in relation to outlet invert,.strirctural integrity,evidence of leakage, etc.) TIGHT OR HOLDING TANK: Depth Below Grade: Material of Construction:_concrete_metal_FPP_Otluer(explain) Dimensions: Capacity: gallons Design Flows gallons/day Alarm Level: z Comments: (condition of inlet-tee,coiudlion of alarm and float switches.etc s)14 '<•.° ., .,t.Y .• DISTRIBUTION BOX: Depth of liquid level above outlet invert: r. lel Comments.: (note if lfvel and distribution is eq al eviden a of solids carryover,evidence of lea4ge into or out of box,etc.) �. .QJ�% Gc sY Q �lDz,�o o D /27 G qa IF PUMP CHAMBER: Pump ii in working order: Comments: (note condition of purnp chamber,condition of pumps and appurtenances, etc.) • 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SOIL ABSORPTION SYSTEM(SAS): ke (Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type ^ Leaching pits,number: of Leaching chambers, number: Leaching galleries,number: Leaching trenches, number,length: Leaching fields,number,dimensions: Overflow cesspool,number: Commen : (note condition of soil,signs of hydr ulic fail a level of nding,condition vegetation etc.) - AG y * / 6cle L / 'a ) �i CESSPOOLS:_/_A) , Number and configuration: Depth-lop of liquid to inlet invert: 'f Depth of solids layer: Depth of scum layer: Dimensions of Cesspool• Materials of construction: Indication of groundwater: Inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soitk,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) PRIVY: w Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) -6 SUBSURFACE SEWAGE DISPOSAL SYS'1'EM`INSPECTION*FORM PART C SYSTEM INFORMATION(continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks: Locate all wells witWn 100 Feet. C 1 �31 /2-0 DEPTH TO GROUNDWATER: Depth to groundwater: & Feet of Determinatio or A proximation: S , -7 TOWN OF BARNSSTABLE LOCATION a(7aZ ��V/(�. -A0, SEWAGE # VILLAGE��Q��`L�� Q ASSESSOR'S MAP &LOT ` INSTALLER'S NAME&PHONE NO. A �/_,l7 SEPTIC TANK CAPACITY QQ� LEACHING FACILITY: (type, �t 6"� e) 3 NO.OF BEDROOMS__ BtJ LDER OR OWNER PERMU DATE:�,"L?~Q� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 rs �_a \ . �� . = f . . %� \. , \. , � . . � � ' � \° �� - � / . � � � / �_ \ \ � � :� • � �' � . !� { . m / . ± ƒ :. �• �\ \\ , \� . < + \� . <�\ . \�\< .A\\ Ala-,l E No. •� ^ �J�% '' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Migpozaf *p5tem Construction i3ermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or L_ of No� T�� Owner's Name,Address and Tel.No. rG, w 11G,e ,1^ r f ('/ � /� Assessor's ap/Parcel J / C�s Installer's Name,Address,and Tel.No. p"ftor% Designer's Name,Address and Tel.No. Qo?Z66)W C!/2./✓O 6iv&s G l 5 Type of Building: Dwelling No.of Bedrooms 2-e�) Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) G GO YK 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 Envir nmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue this d of ealth. _ Signed Date v "27-q Application Approved by Date V Application Disapproved for the following reasons Permit No. — ?-/--9 Date Issued - ———————————————-----------------------,�►: --- '-Fee --. No. - :: THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes { ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for Migpogal *pgtea-Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No.0 Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. QPINI*07T-6 Designer's Name,Address and Tel.No: 0207/�EE °GiR. P1,0A5r&,5M c/5 Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) t Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. ., Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 52�0 6W AI f.0 ZK11K alnbll - f 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 ofWthn Envir nmental Code and not to-place the system in operation untila`Certifi- cate of Compliancehas been issue this of ealth. _ Signed Date °'_7 7 / Application Approved by t Date 2 7 5 ,Application Disapproved for the following reasons ,z_ Permit No. E7 7_ 9 Date Issued f. —————————————————————————-- THE COMMONWEALTH OF MASSACHUSETTS :> BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed N-- )RepairedX Upgraded( ) Abandoned( )by at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Z,. dated Installer Designer The issuance of this 3STirnyhall not,b cg strued as a guarantee that the system will funeti n as designed. Date e / Inspector ——--`•��'j ----------------------- '=` -- —————— c G — No. / 7 .2 Fee �Q THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Digpogal *pgtem ngtrurtton Permit Permission is hereby yranted to Construct((� )Repair( Upgrade( )Abandon( ) System located at��Wv��r and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Con tructi n must be completed within three years of the date,o2V� Date: ? ( f Approved by y NOTICE:This Form is to be used for the Repair of Failed Septic Systems Only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL,- WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS).` .` . . 1, �RIR�_/9 (T�, hereby certify that the application for disposal;works construction permit signed by me dated —q concerning g the, property located at 27.2 C;RAICW6&�' meetsidl of the following criteria: 1 r • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED DATE: LICENSED SEPTIC SYSTE INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. pQax TOWN OF BAR�NSSTABLE LOCATION �? r � �V� �-- SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PH NO. K CAPACITY SEPTIC TAN ,� � LEACHING FACULITY: (type l''.� _ E `� � ��"e) 3 NO:'OF BEDROOMS BUILDER OR OWNER P) ItMTTDATE —COMPLIANCE DATE: Sepaiation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge:of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by ti- 1 � Q i f' Fee $40-00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Migozal *potem Construction Permit Application is hereby made for a Permit to Construct( )or Repair(g)o an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 272 Craigville Beach Road Hawthorne Terrace Condo Wes ' I taller's a ddre s,and T 1 0. 7 Desi ner's Name,Address and Tel.No. �`ox �'�" Lien. ervil eS asS75829i obert P.Bunikis .P.Macomber Jr. Type of Building: Dwelling No.of Bedrooms ?0 Garbage Grinder(NO) Other Type of Building C on d o to t No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 2200 gallons per day. Calculated daily flow 2 03E 11 n gallons. Plan Date Number of sheets Revision Date Title ' Description of Soil Medium sand to fine sated Nature of Repairs or Alterations(Answer when applicable) Adding a d d s t; o n a l J/-. -leaching pits to existing sYstems _ IF_2000 gallon + nzs 2 4 boxes and 6 leach 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 Certifi- cate of Compliance has been issued by w *Mth-i o of ealth. Signed Date 5/10/9 6 Application Approved by Application Disapproved for the following reasons Permit No.� ^ ✓Cf 7 Date Issued r.+� .-• v. ti_,,,.,:w .., T"r .ai.m p. ., r G~ d ' 3 .,., f qe-l*+y ate.:/ No. a { _ � � w Fee $40.00 ' _. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Ytcation for Mizpozaf �&p5tem Conaruction 3permit, F Application+is hereby made for a Permit to Construct( )or Repair(X)o an On-site Sewage Disposal System at: I Location Addressor Lot No. 5' Owner's Name,Address and Tel.No. 272 Craieville' Beach Road Hawthorne Terrace Condo • West H .annis o t _ I taller's a ddre s,and T 1 5 $r 'r 5 $ Designer's Name,Address and Tel.No. foxi " L'enervilleas�s . �2 obert P.Bunikis J.P.Macomber Jr. t Type of Building: Dwelling No. of Bedrooms 20 Garbage Grinder(NO) Other Type of Building (,on ri n I g No.of Persons Showers( ) Cafeteria( ) Other Fixtures J, P `l Design Flow 2200 gallons per day. Calculated daily flow 2OxI I c) gallons. Plan Date Number of sheets Revision Date Title F Description of Soil Medium sand to fame sabd Nature of Repairs or Alterations(Answer when applicable) Adding n(I rl i t i o n 1 g LoP=Qhlng plts to exis� ti�Ig SYStamg /, ?n00 gallon tanks d bo xes and leatpizs 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 Certifi- cate of Compliance'has been issue by this o of Health. Signed Date 5/10/96 Application Approved by ' Application Disapproved for the following reasons E) ., Permit No. Y �Ar 7 Date Issued THE,COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS J Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced KX)on by J.P.Macomber Jr. for Hn_jrtb_0T-j3n Tor-p-ga Ag-Apia-ti-o,n as 272 Crai Ville Beach W _Mg qhas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. .1 dated ^' Use of this system is conditioned on compliance with the provisions set forth ber6w: No. �`" � Fee$40.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,. MASSACHUSETTS 1i6pogal *pgtem Construction permit Permission is hereby granted to j,p,Ian a r,mw bg-" I". to construct( )repair(XX)an On-site Sewage System located at 72O-ra=gville Beaeh I-R ua West Hyann spor ,Mass and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must a completed within two years of the date below. Date: r �� Approved ley - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) • ICI I, Joseph P. Macombgrjjz.hereby certify that the application for disposal works construction permit signed by me dated 5/1 Q/46 , concerning the property located at 272 0 -a;sTiiis Beagh Re&d meets all of the West Hyannisport,Mass . following criteria: • There are no wetlands within 300 feet of the proposed septic system 4 • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change.in use proposed • There are no variances requested or needed. SIGNED ' - DATE: 5/10/96 LIC D SEPTIC SYSTEM INSTALLER IN THE TO`VN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. t SEWAGE PERMIT° :-NO• ° YI t,L.AG E rt; :N<S;TA LLER'S NAME i ADDRESS f '•'� �BPS ��Gd�1�✓�I' ... -- ::L D E R OR OWNER i 'WAJ.-:E PERMIT I S S ED `�_ ��• 79---' _ D#.;fi:'E COMPLIANCE ISSUED 7 - z,37 -7C .. • qr6, 5 /,1. • c P � r� f(v J _ die ' r ep s 9 9 t i ac 41 Y y •'gym' ''Y • tlt t • �tA Y- • f , L �K ffi No. 6' (J Fee $40.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS ZIppricatiou for Ziooml *pgtent Cottgtruction permit Application is hereby made for a Permit to Construct( )or Repair(g)o an On-site Sewage Disposal System at: Location Address or Lot No. V ` f—S �'`lS Owner's Name,Address and Tel.No. 272 Craigville each Road Hawthorne Terrace Condo west I taller'sAiune Addres,and Tgl 5n$_ rf 5 8 Designer's Name,Address and Tel.No. fox ott7� lliien ervil�e Peas �2 Robert P.Bunikis .P.Macomber Jr. Type of Building: Dwelling No.of Bedrooms 2 0 Garbage Grinder(NO) Other Type of Building rondo t s No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 2200 gallons per day. Calculated daily flow 2Ox1 1 n gallons. Plan Date Number of sheets Revision Date Title Description of Soil Medium sand to fi ne aa)`ld Nature of Repairs or Alterations(Answer when applicable) Adding addition leaehing pits pits. 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 Certifi- cate of Compliance has been issued by this o of ealth. Signed Date 5/10/96 Application Approved by Application Disapproved for the following reasons Permit No. /00 7 Date Issued 1 .� v ---------------_ --------- ------ TH"bMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE; MASSACHUSETTS ertif icate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced g$)on by J.P.Macomber Jr. for HAWthorne Terrace ARAGGlatien as 272 Cra3 vil ® Beach Road, WASt Hymnni as been constructed in accordanc with the provisions of Title 5 and the for Disposal System Construction Permit No. ® dated ° Use of this system is conditioned on compliance with the provisions set forth b ow: " w r No. 0 Fee' / 0.00 THE COMMONWEALTH-OF MASSACHUSETTS, PUBLIC HEALTH DIVISION- BARNSTABLE, MASSACHUSETTS ,MigPoOaf bpgtem QCongtruction Permit Permission is hereby granted to T, .Ms a aliba Jr to construct( )repair(X)j an On-site Sewage System located at T Grralgyt i ie Beaeh Rea West Hyannisnort,Masra_ and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions: ' All construction must a completed within two years of the date below. Date: Approved A TOWN OF B A 'RNS.`^ ABLE 9 LOCATION %y'�7`jt��J/� �r > s SEWAGE # �'"' /if7 VILLAGE ASSESAR'S MAP &LOT INSTALLER'S WAb PHON+E�NO. or OW A-4 SEPTIC TANK CAPACTTY WQ 4VU LEACHING FACILrTY: (type) i ?iJ— (size) 100C) NO.OFBEDROOMS ;Ft s--• G �Lry U�,�fs lI-/S /'S. BLM-DER OR OWNER PERMITDATE: �'� l � COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Ground*ater Table and 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 00 ® �y s a P 015 493 608, Receipt for Certified Mail No Insurance Coverage Provided Do not use for International Mail _ (See Reverse) Sent Street d No. P.O.,St and ZIP Code Poste e Certified Fee /O Special Delivery Fee Restricted Delivery Fee Return Receipt Showing pt to Whom&Date Delivered m Return Receipt Shpwing,to Whom, c Date,and Address d TOTAL P stage/ , C &Fees ! T^ p� 0 Postm M E t U. V STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, ' CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES Isss front). 1 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). rr 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of,the article date,detach and retain the receipt,and mail the article. I 3.-1'f au�w nt a return receipt,write the certified mail number and your name and address on a c return-receipt card°Forin 3811,and attach'it to the front of the article by means of the gummed ends'd space.permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT C i1,,REQUESTED adjacent to the number. C If you n delivery restricted tg the addressee,'or to an authorized agent of the addressee, M wa endorse"RESTRICTED DELIVERY on the front of the article. E Z — _ 0 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If u return receipt is requested,check the applicable blocks in item 1 of Form 3811. N a 6. Save this receipt and present it if you make inquiry. 102595.93-Z-0478 °7 SENDER: 9 I also wish to receive the y Complete items 1 and/or 2 for additional services. 4) • Complete items 3,and 4a&b. following services (for an extra 4> • Print your name and address on the reverse of this form so that we can v 4) return this card to you. fee): d • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address y does not permit. � r L Write"Return Receipt Requested"on the mailpiece below the article number. _a «, 2. ❑ Restricted Delivery • The Return Receipt will show to whom the article was delivered and the date .y c delivered. Consult postmaster for fee. 3. Article Addressed to: 4a. Article Number ! ` CL 4b. Service Type EElRegistered ❑ Insured �� I- -V Certified �� ❑ COD W p Express I'} ❑ Return Receipt for pj Merchandise 7. Date of D 1 erx a / c�S 0 5. Signature (Addres 8. Addressee's Address(Only if requested Y and fee is paid) to ul `+ 1X. 6 ignature (Agent) r 7 0 PS Form 3811, December 1991 *U.S.GPO:1993-352-714 DOMESTIC RETURN RECEIPT r UNITED STATES POSTAL SERVICE �c��E R, _I C pm .r Official Business to SEP °j '� _ PENALTY FOR_P�IY,ATE-^� USE TO AVOID PAYMENT. �I OF POSTAGE,$300 I I I Print your name, address and ZIP Code here I Health Oepartmot Town of Bam*ble -- P0.Box534 . t ti.�'x l f�` F° .rr r F > a + :`� 5 pU.J �'' y i w '��,, •.?,':' �{ •"i }}r°.f ,x4 .4 w ii r .it ��_ l,M.,` F'i. i . ,„l. TOWN OF BARNSTABLE BAR-W 428 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager �'j -� 4 OO&ZAWC Address of Offender MV/MB Reg.# j Village/State/Zip &hrA.A Q/ -2 if Business Name u am on �� 19 Business Address Signature of Enforcing Officer', Village/State/Zip 4 Location of Offense aZ y'a C.�� ✓/ � t Enforcing Dept/Division Offense "Ulslrek► / Facts � cJ Le--. T (14 Y �l (fir -krA)�) i�mtr -kO02 "S® -o art pry This will `serve only as a warning. At this time no legal action has been taken. It is the goal of ' Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary. compliance. Subsequent violations will result in appropriate legal action by the Town. { TOWN OF BARNSTABLE BAR-W 426 Ordinance or Regulation ` • WARNING NOTICE Name of Offender/Manager ( i '#?i _i' f} �, .4_Jj h,,P Address of Offender MV/MB Reg.# Village/State/Zip Business Name 0 am/ �, one 19��` J Business Address ;� f�,,,-�+.�; AA Signature of Enforcing Officer'' Village/State/Zip f � !� l zCcyo Location of Offense I axe �% �� !��f ��;t r; Pt- Enforcing Dept/Division Offense 0 jt v Facts �..eu ► �' �", r t i .i , �' PCV This will "serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary . compliance. Subsequent violations will result in appropriate legal action by the Town. No.......... ..........I................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............OF......./ ....... //C ....................................................................... Appliratiatt for Dioposal Works Tonstrurtion Famit Application is her e a Perrilit to Construct Repair an Individual Sewage Disposal System at: AIT ww I WL- ................................... ...... ------- C. cation-Address-y—. or Lot Na 1 ..... .......; ... .. .. . .......... .... .. ... . OwnerI ddress .......... I ......... ...... .................... .............................................................. In alley Address Type of Bu' ding ......... U Size Lot.._ P----- Sq. feet Dwelling No. of Bedrooms.__.... V4_2t_& 04.f!::j�.Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other fixtures .......................................... ---------------- ..............................*----------------------- ....................... Design Flow.......................//j��..........gallons per person per day. Total daily flow................C-AY el-V_;e/ Ions.dl .........�=................gal 0 t Septic Tank—Liquid'capaci y?-..-.'".gallons Length.....4.... Width..C.�........ Diameter---------------- Depth...Y..'.��_. Disposal Trench—N9,;.................... Width.._.........._...... Total Length.............._.. Total leaching area.........._...__ Sq-. f t. ........6........ ... -------- Total leaching area_.�Y, Seepage Pit No Diameter... ......... Depth below inlet......2F.' .......;�..sq. ft. Other Distribution Dosing ta? Percolation Test Results Performed by........ . .......................................I................... Date. T.................................. Test Pit No. per inch Depth of,.Test Pit......;�!�!......... Depth to ground water.._.................._.. Test Pit No. 2 ...minutes per inch Depth of Teit, Pit.......... ..... Depth to ground water......................._ ......................................................... ....................7'r----------------------------...................................... 0 Description of Soil-aa: ---... ..................... ................. ........ ..................... ................................................. ........................................................ ....... ................................... ------------ -------------------------------------------- ------------- ------ ......... ------- ------------------------- ------ W----q4r��n ---------- U �s r te o Answ 'whejapp%ble. .... . ................................................................................... ..................................i...... --ent The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 5 of the State Sanitary Code—The undersigned further agrees not to place the system in the,provisions of TI,�,,.4,, operation until aCertificate of Compliance has been issued by the board of health. 'Sig d ..................... ----------------------------- D to . .. ...... ... .. Application Approved By... ........................................ Date Application Disapproved for the followingreasons:.�............................................................................... ............................... ................................................................................................................................................ ........................... Date PermitNo......................................................... Issued. ....... ....................................... Date THt'COMMONWEALTH OF:MASSACHUSETTS BOARD OF HEALTH JP........................OF......... a- 441t. ?.a.- . . . ................... THr �COTIFY, That e Individualconstructed or Repaired Sal!System by.!t... ... ............... ...................................... Jn�iallen. A a A....... ��Ww----,pity -jet installed iof 'bed has been'L n acco,V-Ja with the provisions of T State Sanitary Code as desc e in the ap or Construction Permit,N ,p lc�ation-for-'DisposalXV ks 01 ...... dated` THE . . ........................... E ISSUANPE OF THIS CERTIFICATE,, NOT SE" NS SL TRUED AS A GUARANTEE THAT THE 1,YSTEM WILL FU.rT!PW $ATISFAMAY. DATE. �:V i"'. e. . ........................ ............................ .Inspector ............................. ....................................... THE COMMONWEALTH OF,MA SSACHYSETTS BOARD OF HEALT �� - 7.......OF . ...... law, No._...:_..... QQ FAEI.Z�................ :7 Permission is hereby grante-- d 7., . .......................................... to • r epair Co r Indi al POS sterR) at .... ........ ......... S� - ` treet' as shown'o of Bui ding not n Indij a, . ........ n the application for Disposal Works Constru bk,,064. it 0 ...7.,N. Dated..�_J Y� ........... l:W70 .............. 'B�!rd Of DATE ... ........ :.--- - ......... .... FLeal ; FORM 1255 HOBBS & W INC, PUBLISHERS ,.1, r r 1. ,��'s- �tk.. {'_`''' ,Z,,o .`r'-^''',fir 3 ,f a: g �y,s 13' , -`_:r F� F K ;4 r F.w } .t. g-c.t` ,th ' R .,�,�-�1_�ID*,.,,�I..I,I--I.,...7...."-r--."--,�, -IS ��A , a: i1.1`- .. Q� yf� r r l d? S V' `...'G/J/:-� ^. 'a t t!i 11 7 r • L .S- a p 4 yA �1 �- _ '.a y '"' h "S tkx - t t4 Y" s p k H _ t '.d 4 vt1: .I-,.I-,-_I,I.,1;"'",.,,,�-,-I.,�..,";,��i:�w-1---...-�,,—2�I.:�4.,-_:.�.--.I1,,..4,,-�rI..1�--�,-.�---1�'I r�.,-k-'�I,.�,,-t�-,.,-,�-�7,.,.-1-�"--..:-. P f 7 4�-^'h ,F p 'a tt€ s X •.;„ , ` _wpm..=, ��',�3�'� S .t 4 r _ k }" a '9u ^;r '+^4 c "^ '4 Fky.4 '�'s't` w.�' 1 , �,- S is '" ;..>w1 T ' R y -' 'as } { v c r r 3 .."Ld' o-' r a c> "r r - > lx 'Pv > 1 7 F d. sT ,; } �' i' , a 4 8 a i ��: jq/r�yy{y��, mow. ,, . , f A`'4 1. .2 CC - :3 t 4;JP i t < 's . S t 9( !6. 9 Y 7 P -' 5 5 Y -^ J f 3 x �(` '/ j ^a Rwo y Y d- { 1 r'.- ! rl ._ .�aS 1 M - { i az 4, t y� - T �-� ''}M' f . . :. iris. ,!( q,,,e. �;. +r l y3 + 'N ,R -,{Jl .s ,S M ''may, _ r 3 y 4 -- t - 2 f S S a.. - ._ its ` ,�, y{ ' Pr=a t 3 F y h,A g-" J. n f ,. �`7.. i `-,—; .Y-..,f ,Et r 'Ts "�' '.� ". � #T , g.4 s 3 J?+v ' .,. iG ; fi`ry J .x, kX e,i, tk �' * '"' . "sr y, �.• �`vi saw tfJn �K' r _4 .J.a #.a ,i�" ..rx.� sy re• r,:. ,'^.:.,<� .,.r6rq ..,` - .- c+'�',,. ,tE='; 0..�"� .59�a. ":. -°,"..+, A� i� 'x",,,,; -hx 'n, Ld +6j' , +4 .:. .�'k #. 7fc y --! �.d�'S'a4�, "P`'a.,§ T5� ''f�.' 'r, i�'r'•c-• y -;, �T -' `"' M•$,"� ` 7 -�I-.-1I�,'.f-,*I---7,-I I`��-* r- ft`"'- z f r l % 4 t t k a's.s`...ram �.r.�,�, I. +.1` i �. '$i * •3 � .rid '1 b 's +�a 't j. i' { 4 F . * - R g{.,-, r ,Y kt 4 3r: mar —, �-I-I , a ,.°� k - - : " r �.n -a;e.. }y ` x rty. r 4 L QI ' 1ykt r G r,R ,*�y.. s .+' �i ? .+`� .' '" a �.:;�' E„- fit- r t 5i' C -"k , :- i ' Rz tt: i ,� y '` ��r A .. f f 4 �' �'- 9.. .( .y7 "`� T ,tee '. '' { 4 '�.�. Y z'-,n ,,e,t d y ,ry,rye�'� ,.yam 4^ - yy #.' s -f4 - ate.°3 s n-a <. �,,,"t d L , tt } e { ..i { y ' M Y T c, t„ ,c , j __ v) No.� ..l.:V .vr..... THE COMMONWEALTH OF MASSACHUSETTS r BOAR® OF HEALTH - ,/�- lJ.0 `!n.............OF...... �' .�! •`S•✓`........,6�C •....................... AplifirFa#ion for Disposal Works Tonstrnr#inn rrnti# Application is here V e for as Permit to Construct (P-j"or Repair ( ) an Individual Sewage Disposal System at: 0 tilt oww S WL- Location-Address 49 or Lot Ngm y r S ................. - .M...._................._....... .. Owner ddress W 4r In alley Address U TYPe of Bui ding fBs r°E��<�f c+ �� - / / Size Lot_____._...A________________Sq. feet Dwelling—No. of Bedrooms............ '.Expansion Attic ( ) 'Garbage Grinder ( ) ( ) —a Other—Type of Building ............................ No. of persons...__..__._______.__.__.____ Showers Cafeteria ( ) 44 Other fixtures -----------------•-----------------•---•--------------.-•-•-•--•--•• •---....••••••---•--............----•---------------•----......._.......... d Design Flow.......................1— --. ---_gallons per person per day. Total daily flow............._......��. ........gallons. W ! I ry )/ f4 Septic Tank—Liquid capacityZ".!.gallons Length....!A ... Width.C..'r Diameter---------------- Depth.......�. Disposal Trench—No. .................... Width.................... Total Length.........._......... Total leaching area....................sq. ft. Seepage Pit No _____---. Diameter.__..tA.._...... Depth below inlet......s�_._...._._ Total leaching area.[S"i_ .....sq. ft. z Other Distribution box O� Dosing tank aPercolation Test Results Performed by......... .:....� 4it. .�.t _#.. ._ ._._...._..._._._ Date._?'"`.. �_.�g_.7.1r� Test Pit No. 14.4.!4 minutes per inch Depth of,,,Test Pit -- ..._ Depth to ground water________________________ ri Test Pit No. 2 J.Ae2...minutes per inch Depth of Test Pit.................... Depth to ground water........................ fYi ............................................................... __ . __ Description of Soil c -V 1 ,vi� w ................................................. S - -- -- ......... Q-• ---•-------------------------------- W y� - --------•---------------------------•-••--- ::-.- --- --------------------------------------------------------------------------------------------•------•-------.--- ---------:------ v - when appli ble ' r >rs ,or�Arlteratioi}s—Answer ,cow 44 ent: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT;1 .. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. r Sig d. ...... ` D � Date ------ Application Approved BY 1 �.. ...• .�` �'`�— 7 ..-----•---•----••- -••--•............. t' Application Disapproved for the following reasons:................................................I............... ............•................................... la 5, ed- 7_a,r- 7� Date n Permit No................•........................................ Issu - ----• ....••••---•--..._•..........----------. Date � f 0 �07� . d No..----... -.... F:Es............................. T�THE'COMMONWEALTH,OF MASSACHUSETTS I r BOARD OF HEALTH �� .... .!'j OF..... ........y,....r. 4.,�...................................................... .....------............►. ...................... Aplifirtt#ion for Diipnia ;forks Tonstratr#inn Vamit Application is hereby made for a Permit to Construct r Repair ( ) an Individual= Sewage-Disposal System at N t i/t d c� G� pis. i o> dl, i•C.s ,� . .......--• .......,f ........................ ---.... ----- ---.........- ..... +�+ -7-ftcation-AddressV,- / or Lot N ,l,.-! _ .. �R. ...--•--•..... '�iG---- ........_. ..... ._-_.. rY .............. ...._. .. _- --..... .. ._. ... .._. Owner 0 Address ......... ......`.. JL?r .................................... :...... .................•...... .._ ---..... .................... / In t Her # Address ,r+ T e of Bu .r , / fi �. . YP g - .� �E I f OVWr% ' /%1 Size Lot---- ----=- ---------Sq. feet Dwelling—,TT . of Bedrooms__.._ 4*AP tD"t /r"4t#jNtK.Expansion Attic ( ) Garbage Grinder ( ) IN Other—Type of. Building ..........._r_..._.,._...... No. of persons............................Showers ( ) — Cafeteria ( ) �``_. Other fixtures . Design Flow......................jr ®,,..gallons per person per lay TotaICd�il �flow ...._____.__.___ gallons.H "$ W, t � d Septic Tank—Liquid capacity ...........gallons Length_____1�" Width__._.`' .... Diameter_______________ Depth_ W . Disposal Trench—: Width.... t .... Total Length . •.... Total leaching area..... sq. ft. Seepage Pit No-------e ----- Depth `" .. ..__._...... TotdHeaching area_ ......._...sq. -- Diameter............... De th below inlet_.___. ft. Z' Other Distribution box ( Dosing tap:k Percolation Test Re ults Performed by......... ............ M. __ �_. Date.. ............t t - � Test•=Pit No. �.�+ _._minutes per inch . Depth of Test Pit !iA' �__._. Depth to ground water........._.......... _____ (z, Test Pit No. 24.2/40----minutes per inch:,. Depth of Test Pit.... ...... Depth to ground water_'-_>-.•............... .: r+ �t -•-••-•---••-•- O Description of Soil !' h 1 - --~ -------------- , t %, <. +J UW •-•--•-•---•=----------------............................. ---•-••--••-------......... Nature of Repairs or Alterations_Answer=when applicable________ __ ___ '_...__:_.._._:......................... 1• kgreement 'The undersigned agrees to install the aforedescribe.d Individual Sewage Disposal System in"accordance with the provisions of iITIE 5 of.the State Sanitary Code—The undersigned further agrees not to place the system in " operation until a_Certifica.te of_Compliance has been issued by the board of health. 41 S_ i 'ed /."r'.'/., G�✓"l''�......._,•.-••--•--•----••---•---•-•-----•••--•-•-••......-• ................................D to A Plication Approved BY-• ................• ........................................F Date Application Disapproved for.the following reasons: :---•----••-•----•-------•--•------•--------------------------------•---------•......••.....--•_--••- ..-•---•------•----------•-•-•-•-•---------------------------------•------•------------------•----......--•-••-•--••--••-•--•----•--------------••-••-•-•--•---••------•--•........:...-•-••------------ Date PermitNo......................................................... Issued ................................. Date Y THE COMMONWEALTH OF t.MASSACHUSETTS . BOARD OF HEALTH ... ...................OF..... ..y5r+.�''�1! L��d✓ �.a........................... (9rdifiqt#r -at, Tautpliatta TH S IS TQ. C51kTIFY, That e Individual 1w9ge` sal'System constructed (�� ) or Repaired ( ) by �..�. -•---•--•..... -••-------------••-•......._.._...._ Installer at ..... .... 1kk1_ 3�v t ,,Has been installed in accordance with the provisions of T 5 of The State Sanitary Code as desc abed in the rziF i fix G�/ F ham{ = _ application.for DisposaI orks Construction Permit No.-- d___. !�" :: dated` . ^/' .........� _____________________ r ijdL .- THIE ISSUANCE OF ,THIS CERTIFICATE,SHALL NOT'BE 4` N,STRUED AS A GUARANTEE THAT THE SYSTEM WILL FU9INCTION' SATISFACTORY. . 4 DATE.... .... ...........•......... .-••---•---------------•----•••--•-- Inspector 5 THE COMMONWEALTH OF MASSACHUSETTS ''`4 /. BOARD OF HEALTH , 7 �...� h No......................... FEE ..................... s anstrm ' U. err Dispo Work Permission is hereby granted':-- -•- 0 ............................. to Cons rut (y�-) or Repair_( ) n Indio al Se age°epos stem at No l ` Lt��1" c1. __�.. ` :...._[c€� i - at "f ......................... .. ' v y Street //•. ...; as shown on the application for Disposal Works Construction.. mit o____________________ Dated..`.J.n :?A:.L_........ �. , '• M BBBo.a,.rd of xe alt DATE_ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS . w.+ THE `COMMONWEALTH OP•'MASSACHUSETTS BOARD OF HEALTH " .....7-0 ... ...........OF.. +rr! k`?✓ °.. TO C TIFY, That e Indivi ual wage sal System constructed (°'�'r) or Repaired ( . ) Installer r , mr• ,stalled in accodan with the provisions of T '� fho State $a.mtary Code as desc bed in the :'Lion for-`Disposal� Vorlfs Construction Permit No.__ f_ f ,, «7 4,� s :,.-- dated. .� /4�- ' T IE ISSUANCE'OF .THIS CERTIFICATE :SHALL' Fd®T''iE d;N ,�`RIDE® AS A CUARAWYEE THAT THE STE�OI 19ilILL FUNCTION' SATISFACTOIa1, --- ......................... Inspector ---- ---- " THE: COMMONWEAL-TH OF.•,MA9SACH,USETTS. - " BQAR:D OF HEALT +� _ No. .. ; 19 ..... -...OF ,t , `�' ' ..." . ..• � . rt err Permission is.hereby granted."!.>_ to''Con rut or a air :. --- -•-•-••- �7 )-. p ( kj)/ap.l ndiv' al �'� Po yst - - _ <. street . l as shown.".'on the application for Disposal V�Torks Construcin m>t o._ Datec�_:`.rri' �! �• '" , . / DAT r ----- Ir'._._., H oafd'of $east ,FORM 12Ru. HOBBS & WARREN, INC..-PUBLISHERS. a r 0 GENERAL NOTES ` 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION 582'56'1i;,--_ - METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE 529 10 ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. ( THIS PLAN MUST BE 2.CB/FNDND- ` �� KENNEp - of HEALTH AND O PROVED BY THE BOARD THE ES GN NGNEER. (40,W11 Y C//?C 3. 4- SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL MAP 267 / PUBLIC)LF $M1? J6:: BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. -r = • }PARCEL 186 4. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS _/ ,. �\ \ - l:y `- f S7?5 ' / 4 4 +• �• *> �" '( THAN'ELEVATION=29.13'FORADISTANCE OF IS'AROUND THE PERIMETER GUARINO �"-' / - ?0?E G • �,•j _ T.Q• OF THE SAS.UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST /y T�-50• \ 'LQ; ;5�i, FIVE FEET FROM SAS.AND THE TOP OF THE LINER IS NOT LESS THAN THE / // �\ su•- • ¢V`OS '�� ry, + BREAKOUT ELEVATION. 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 1.46'z EX.INf.30.16'= (X�•X_(1/ `. \\ \ CB/FND. t '$[,:-' •-� - 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO 1 7'l x v BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR m /4 \' � .,�v\ , i '�• ` 4 ^ D INSPECTION.SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING \ X ` I APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. --`�r(X��''{r� -x_ MAP 267 r � - 8. ELEVATIONS BASED ON N.G.V.D.DATUM OF 30.00'MSL OBTAINED FROM PARCEL 179 - - ' .r �'-. CATCH BASIN RIM AS SHOWN ON PLAN. DAWSON l� - ~j 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING CHAMBERS TO BE �f /� �'• '' •q .� THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE PUMPED AND FILLED LY17H ( r. v tl. �`(�, ',Q AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES.REPORTANY CLEAN SAND(TYP,) 1 EXISTING ' 9 r v- °� • DISCREPANCIES TO THE DESIGN ENGINEER ONDOMINIUM a c PROPOSED SEWER MANHOLE d -0 r� - 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE COMPLE{ E 8'INV.OUT=29.SP J- :., • Y ' • STRUCTURES SHALL BE MADE WATERTIGHT. FIELD VERIFY ANY AREA=271943 SO PI- ^ ` r , 66, 1� - 8 ) 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ELECTRICAL FLAG / SLEEVE SEWER PIPE AT p •I ��: 4 ZONING REGULATIONS. OWNER/APPLICANTISTO OBTAIN SUCH WATER MAIN CROSSING 1 37, ROAD / DETERMINATION FROM APPROPRIATE AUTHORITY. a 10-EITHER SIDE(TYP-) a �:8 n•1r �B it r Y 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS PROPOSED 4'SCH.T40�PVC ( 7 •Ay\fj. LOCATED UNDER PAVEMENT,DRIVES OR TRAVELED WAYS IN WHICH CASE SLOPE AT I%MIN.\•••-j r „• EX.INV=3020'(«F) - •� �' •• .1 4{ :Q {{ o THEY SHALL WITHSTAND H-20 LOADING. p • ( 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT,DUST AND 6`uy8 11•w ! 4 U N!� .�- FINES. �. 'Q '] ;: •'I7 14. WHERE REQUIRED,CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND EXISTING SEPTIC TANKS TO BE 9 T' o - UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF PUMPED AND FILLED WITH O O f •O ~' /I) Q•t Q ) ' '�• ,v+-� J 5• LEACHING FACILITY.REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN CLEAN SAND AND BOTTOM TO I Q'Q Q Q e } COARSE SAND FREE FROM CLAY,FINES OR OTHER UNSUITABLE MATERIAL IN BE PUNCTURED ITYP.) f - A�� _t !)g.oQ 9 �)I - ~p 91, ACCORDANCE WITH 310 CMR 15255(3). 1 PROPOSED B•SDR 35 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN EX.INN=30.00' PIPE SLOPE AT-75% �• 1 4tl. . _ (/ TT4�N' SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK 1 Ft 7" 'lt 1`�', .T� • L'S v 16: PROPOSED PROJECT IS LOCATED WITHIN: PROPOSED 9.000 }T• ,t _ {^/ ASSESSORS MAP 267 PARCEL 73(A-T) w O (o GALLON SEPTIC TANK 1 zj•.';. �\\ u I V 77. OWNER OFRECO RD: HAWTHORNE TERRACE CONDOMINIUMS EJ05TING LEACHING FRS TO 6E PUMPED AND FILLED WITH ' -� O ' / „} q ,-. 3 () _ _ - T `'' ADDRESS: 272 CRAIGVILLE BEACH ROAD CLEAN SAND(TYP.) MAP 267 4 HYANNIS,MA 02607 MAP 267 +n PARCEL 001 18. FEMA FLOOD ZONE C PARCEL184 f I HUGHES LOCUS PLAN 19.- AS SHOWN ON COMMUNITY PANEL# 2500050008D PLAN REFERENCE: KARPOVSKY ! ' _ ] / 1.PLAN ENTITLED'HAWTHORNE TERRACE SITE PLAN,WEST SCALE:1'=1000' HYANNISPORT,BARNSTABLE,MASS,FOR JAMES J.TAYLOR-.DATED PROPOSED AIR SUPPLY ' O PROPOSED 6000 GALLON SEPTEMBER 1978,SCALED AT 20 FEET TO AN INCH.BOOK 327 PAGE 77. VENT TO RUN UP SIDE OF SEPTIC TANK WITH 2.PLAN ENTITLED'HAWTHORNE TERRACE SHOWING SANITARY/SEWER BUILDING TO TOP OF ROOF MICROFAST INSERT CONNECTIONS AS BUILT',DATED OCTOBER 18.1978,SCALED AT 20 FEET TO W AN INCH. 70'DIA. - 4D L / 20, ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. VENTING PIPE 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE.THIS PLAN IS TO BE USED S I 0.3' ONLY FOR SEPTIC SYSTEM UPGRADE.JC ENGINEERING WILL NOT ASSUME ANY 3"DIA MIN- Z v /'�- •+ 1 / DESIGN DATA. LIABILITY FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. BLOWER PIPING 21'T B/FND. a (OP 3 LP i7? (HC 2) DIST-) NUMBER OF BEDROOMS(ASSESSORS)40 > NUMBER OF BEDROOMS(DESIGN) 40 PROPOSED BLOWER LP 0 . LP PC 4 2'' (PC 5) '` PROPOSED 6.500 GALLON ON CEMENT PAD TO ' 3i_ PUMP CHAMBER DESIGN FLOW 110 GAUDAY/BEDROOM TEST PIT DATA TEST PIT DATA LEGEND BE ENCLOSED FOR TOTAL DESIGN FLOW 4400 GAUDAY , ~19'3 = 8800 GALIDAY --50-- EXISTING CONTOUR NOISE PROOFING X � � DESIGN FLOW X 200% _ -31-, I 30.0' USE PROPOSED 9,000&6,000 GALLON TANKS 50 PROPOSED SPOT GRADES X X I // MAP 267 'r'', ''I +' EXISTING MAN HOLE FOR 'I Z PROPOSED CONTOUR y I�/ PARCEL73 SPRINKLER SYSTEM �i AREA=1.5+/-ACRES � ' 1 INSPECTOR: Samuel White INSPECTOR: Samuel While �_ A EXISTING ELECTRICAL UTILITIES INSTALL 2-100'x 30'LEACHING FIELDS SOIL EVALUATOR Samuel PhllosJensen SOIL EVALUATOR:Samuel Phllm Jensen 10.0' SIDEWALL CAPACITY B.M.Catch Basin � LEACHING-BATCH I�, 3 {. � DATE: Apnl 04,2003 DATE Apd104,2003 -CAS EXISTING GAS LINE Rim Elev.=30.00' BASINS fTYP- 1 ' NO SIDEWALL AREA CREDIT TEST PIT# 1 TEST PIT#: 2 v EXISTING WATER LINE MSL BOTTOM CAPACITY ' �30-�7[/'�-�{-yg,,- PROPOSED(2)30'x 100' -(LENGTH x WIDTH)x(.74 GAUSO.FT.)= GAL/DAY ELEV TOP= 3z" ELEV TOP= 31.82' 19 TEST PIT LOCATION _ PAVED � _ LEACHING FIELDS PARKING t 372 'I (2)(100.0'x 30.01 x(.74 GAUSO.FT.)= 44,440.0 GAL/DAY ELEVWATER= >126•B.G.S. ELEV WATER= 1':�; 10001 PROPOSED 9,000 GALLON SEPTIC TANK AREA PERC RATE <2 MIN/IN PERC RATE MIN/IN DOSING&STORAGE REQUIREMENTS F. PRO POSED 1,000 GALLON SEPTIC TANK DESIGN FLOW: 4,400 GPD DEPTH OF PERC 1.= -56' DEPTH OF PERC= O W/MICROFAST UNIT DOSING REQUIRED: 4 CYCLES/DAY TEXTURAL CLASS: 1 TEXTURAL CLASS: 1 ( O O O PROPOSED 6,500 GALLON PUMP CHAMBER I) 1� 4.400 GPD/4=1,100.0 GAUCYCLE MAP 267 DISTANCE REQUIRED BETWEEN PUMP 4'SOLID SCHEDULE 40 PVC PIPE _ PARCEL 72 ON AND PUMP OFF FLOATS: 1 2-SOLID SCHEDULE 40 PVC PIPE �_ .' 1100 GAUCYCLE- 723 GAUFT=1.52 FT/CYCLE MOCHEN/ ------ 2'PERFORATED SCHEDULE 40 PVC PIPE MAP 267 �o (USE V-8"TO PROVIDE FOR BACK FLOW) 1 8"SDR 35 PIPE ', PARCEL 85 I _ 39.8- 31.8�. .�' 0 SSTORAGE REQUIRED ABOVE WORKING LEVEL'4.400 GAL. 32 HEVWOOD I n - m TORAGE PROVIDED ABOVE WORKING LEVEL'4.579 GAL. .04' 0 31.82' 96.87' ACTUAL ELEVATION"AS-BUILT" Sandy Loam Sandy Loam TOTALS: A 5 110 0 YR 3//vel A 10 YR 3/2 TOTAL LEACHING AREA 61000 SOS - 12^ 31.04' 12' 30.82' -30 Loamy Sand Sandy and Loam TOTAL LEACHING CAPACITY 4,440 10 YR 516 B 10 YR 4/6 I \ _ 100.0' 1 PROPOSED 4'WYE TO GAL.DAV B 5_10%Gravel REV. DATE BY APP'D. DESCRIPTION '3 RESERVED FOR eOMD OF He-USE DISTRIBUTE FLOW EQUALLY . 34• 29.21' 39' 2&5T "AS-BUILT"SEPTIC SYSTEM 36 _ M-C Sand M-C Sand PREPARED FOR:HAWTHORNETERRACECONDOMINIUMS �-L �.- -� Pem 2.SY 614 2.SY 6/4 1 GAS LINES TO BE FIELD 10-20%Gravel 10-20%Gravel \ ,5 . ( VERIFIED AND RELOCATED 56' - ..� AS NECESSARY C C LOCATED AT 272 CRAIGVILLE BEACH ROAD NOTE: HYANNIS,MA 02601 \ 18.1' 1.CONTRACTOR TO VERIFY ALL DESCRIPTION HC 1 HC 2 HC 3 \ \ �3y UTILITIES BEFORE SEPTIC COVER IN(1) 69.S 27,1' -___ \ \ CONSTRUCTION BEGINS No Groundwa 21.54 ter Terminated due W SCALE: 1 INCH=20 FT. DATE:JANUARY 13,2004 -_ \ 2 POSSIBLE FILL LINE AT Sr ON Observed 80 gas gne o 1a 20 4? eo IC COVER OUT EASTERN SIDE OF TP i.VERIFY SEPT (2) 58.T 37.8' ---- 126' ' ' 25.16' CRAIGVILLE B SIDEWALK AT TIME OF INSTALL AND REMOVE () PREPARED BY: EACH ROAD ALIC DIST.) AS NECESSARY(SEENOTEI4) OBSERVATION 3 49.6' 60.5' TI 1 JC ENGINEERING,INC. _ AS-BUILT (40•WIDTH-p(IBUC - - 3,PROPERTY LOCATED IN A PUMP COVER(4) ____ 26.6' 29.9- DEPARTMENTOFENVIROIdMEN7TAL 2854 CRANBERRY HIGHWAY PROTECTION APPROVEDZONE2 pUMPCOVER(5) -- - 25.3' 15.3' - PLAN EAST WAREHAM,MA 02538 508.273.0377 SITE PLAN D. BY s Z Deskne4a, .46y.JLC OB No.3]1 SCALE:1'=20' - SHEET 1 - x y i ALTERNATE TOP SLAB. REINFORCED TO MEET I H-20 LOADING 20'MIN.ACCESS COVER(TYPICAL FOR 3) ADJUST TO REQUIRED PROVIDE LEBARON LK-100 MANHOLE COVERS ACCESS TO INSPECT _ INSTALL 1/4'MESH GRADE W/MIN.2 OR TO FNISH GRADE FOR ALL COMPONENTS PUMP OUTS MU6T 10 VENTING PIPE (SCREEN(SEE -BLOWER WITH HOOD INSTALL 1-1/4'PVC TO BUILDING.JOINTS TO BE MADE MAX 4 BRICK COURSES BE PROVIDED(6'MIN. \NOTE 8) (BY BIO-MICROBICS) PROVIDE LEBARON LK-100 FINISH GRADE OVER TANKS EL: V✓ATERTIGHT.WIRE PUMP AND FLOATS TO DUPLEX'PAC-2' HOISTING CABLE 7 x 19 j OR EQUIVALENT DIA)(SEE NOTE 1Z) 24"DIA SEE NOTE 1 MANHOLE COVERS TO 31.75' LEVEL CONTROLLER W/SUBMERSIBLE PRESSURE BELL. STAINLESS STEEL 1/8" DIMENSION WITH OBSERVATION FINISH GRADE FOR ALL SET FRAME W FULL BED OF MORTAR REINFORCED PORT COMPONENTS NEMA 4 JUNCTION BOX CORROSION RESISTANT 8 DIA/1,760 LB.STRENGTH MANHOLE FRAME 8 4SE 31.21'-32.46' LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 4'BALL VALVE w/UNIONS CONCRETE COLLARS. FINISH GRADE OVER TANKS EL= 1'DIA DROP FRONT m J - ''-- - 3-DIA CONNECTORS SUPPORTED BY 1-1/4'PVC CONDUIT, SCH.40 PVC TYPE MH.STEPSBITUMASTIC COATING FOR 2'-0'*/- = BRACIN (7,6cm)MIN ELECTRICAL JOINTS TO BE MADE WATERTIGHT SANITARY MANHOLE TOP OF TANK CONDUIT O SEE BLOWER (T PRECAST REINFORCED FLUSH WITH DRAWING RUBE pIPING(SE BLOWER (2)BARNES 4SE-L PUMP 275 GPM @ 25'TDH 230 V SINGLE CONCRETE M.H.CONE BOTTOM OF HSF 4.SX GASKET CONTROL PHASE 4.5 HP,6.5'IMP.DIA MODELp 4SE4524L �z SECTION 4'-0'DIAMETER CONCRETE LID SYSTEM)SEE ro WITHIN t-1/2' NOTE 3. �- MIN.0.121N.STEEL PROPOSED 4'SCH.40 TO 4-SCH_40 TO UPER VERTICAL FOOT, 'rc S"SDR 35 PROPOSED TREATMENT 4'NIANIFOLD :a 3" m MANIFOLD woPLACED ACCORDING savE 1sx 3. 2'DROP MIN. 8'SDR 35 ZONE m TO AASHTO 3'OROP MAX. 9' aro PROPOSED 'SCH.40 TEE L-6900' �< 8"SDR35 T w/CLEAN-OUT DESIGNATION M199 to ' -sLoaE I CAP _ _ vr=3 a 0's _ eNAA oNi "'DIAMETER HEIGHT OF RISER 2$.9$ T 8'-4" INV.OUT=3r 2$3�75t--� m L-4g° 78'0' 6" 1'CLEAR "CLEAR SECTIONS VARY / ( ,� I LIQUID 'L8 65' L�s+•�� 2$•62� uaM N FROM 1'T04' 2L9'65 2$'9�' LEVEL NFLUENi 2$,14' ' OUTSIDE OF (28'81') WASTE FA-MICROBIC)) ( 2822' iEao oNnnao6 ( I N 6, ( FROM BID-MICROBIC)) PUMP 27.17 c . 5-MINPIPE 2" (27.25') m CLEARANCE SETTLING z E LEG EXTENSION INLET TEE- ZONE4'SCH.40 PVC DISCHARGE PIPE 6'CRUSHED STONE p2t9 GALLON SEE SEE SEE NOTES 6 8 7 w TWO(2)-114'WEEP HOLE IN DISCHARGE PIPE ROVIDE"V' NOTE 5 NOTE 4 4"BALL CHECK VALVE SCH.40 PVC 100 8'BASE PRECASTOPENINGS - OVER MECHANICALLY MIN.LIQUID 6'CRUSHED STONE COMPACTED BASE CAPACITY _ OVER MECHANICALLY o P.S.I.FLOWMATIC OR EQUAL RUBBER BOOT AND CEMENT CONCRETE (15971L)SEE _ COMPACTED BASESTEEL BAND CLAMPCLASSA' LENGTH 1T-0' WIDTH 10'-0- DEPTH 10'-6 NOTE10 LENGTH 1T-0- WIDTH 10'-0' DEPTH T-0 LENGTH 17'-0" WIDTH 7-a DEPTH 11SANITARY PIPE CONi'SING LENGTH 17'-0' WIDTH 7'-0" DEPTH 11'-2' PIPE OPENINGS TO BE9 000 GALLON SEPTIC TANK(LOW PROFILE) 6 000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) 6,500 GALLON PUMP CHAMBER PRECAST IN RISERSE 143 BAR AROUND OPENINGS FOR PIPES 6,500 GALLON PUMP CHAMBER 18-DIAMETER AND OVER,1-COVER PROPOSED 9,000 GALLON SEPTIC TANK NOT TO SCALE NOTE ALL TANKS SHALL BE CAPABLE OF PRECAST CONCRETE PROPOSED 6,000 GALLON SEPTIC TANK& WITHSTANDING AASHTO H-20 LOADING TANKS BE PROPOSED 6,500 GALLON PUMP CHAMBER SHALL DIMENSIONS ARE TAKEN F STABLE *TANK SHALL BE MANHOLE(H20) PRECAST O.INC. INC SPECIFICATIONS MACME AND WATE PRO FEDERTIGHT NOT TO SCALE NOT TO SCALE _ _r o LIFTING HOLE 3"AIR LINE PIPING(TO 3/4"TO 1-1/Y DOUBLE WASHED STONE TO CROWN OF PIPE 114'PERFORATION TO BE PLACED BLOWER W/HOOD(BY 3"PIPE CA IN THE END CAP HORIZONTALLY BIO-MICROBICS) (SEE NOTE 5) BLOWER BY BIO-MICROBICS) 2.OF 1/8'TO 1/2"DOUBLE WASHED STONE NEAR THE CROWN OF THE PIPE AT 6'MIN DIA PUMP O OUT PORT(SEE THE END OF EACH LATERAL. NOTE 4) n FINISH GRADE OVER LEACHING FIELD= 30.2�1.8' e SLOPE @ 2%MIN.OVER SYSTEM 24"DIA S� ( " A� A INFLUENT WASTE 'S y 18" TOP OF SAS.=28_83 FROM SETTLING TANK jj MANHOLE/OBSERVATION o o 3'DIA4-WAYTEC PORT E Iy �_ - 1} CONTINUOUS PITCH BACK T8'DIA 70 PUMP CHAMBER 6^OBSERVATION mCONCRETE BASEPORT(OPTIONAL) FAST 4"SCH.40 FORCE MAIN 2"SOLID PVCI�I 7 IF10'OIAVENTINGPIPETREATED 2"PERFORATED LATERPAL - BOTTOM OF TRENCH TO BE LEVEL EL.= 28,O' 24,219 GALLON LEVEL INV.ELEV.=2$.50 MIN.LIQUID 7• (2$.$"� 12'I(.- S MIN. ELECTRICAL CONDUIT EFFLUENT 45'ELBOW (28.3') '0 BLOWER CONTROL CAPACITY 4 X 2 TEE 3'MIN.AIR PIPING SYSTEM) (21293L) (TYP) O Q al 4'M/WIFOLD S=0.5% TREATMENT FAST MODULE BY 6^DIA IN BACK TO FORCE MAIN GROUND WATER ELEV=<21.54' ZONE FASTBIO-MICROBIC 3'PIPECAP 6" _ PUMP FIELD PROFILE BLOWER HOUOT TO SCALE QSIING DIMENSIONS T TO SCALE OUT PORT 12' 7TiS(795.6tt.3cm) 79Y.5"(200.731.3cm) (SEE CONCRETE THRUST FINISH GRADE OVER LEACHING FIELD= 30.2-31.8' 17 NOTE 4) 114'PERFORATION A BLOCK 156' AT 7 O'CLOCK(TYF. r SLOPE @ 2%MIN.OVER SYSTEM 396-) tU tt.75 ( 5' (TYPJ / TOP OF SA.S.= 26.83' T LENGTH 17'-0" WIDTH 10'-0" DEPTH T-9" EL=27.75' _ (29.5)� 2"PVC 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) _ K„mo N > 2'OF1 e'T012' -PERFORATED PIP I NOT TO SCALE Z n z DOUBLE WASHED J-❑m"d "'O STONE 1.ALL APPURTENANCES TO FAST(EG.SEPTIC TANK PUMP OUTS,ETC.)MUST CONFORM TO ALL COUNTY,STATE,PROVINCE,AND LOCAL CODES. O ro +e oEEarH 2-FOUR-WAY 3'DIA.PVC TEE IS PROVIDED BY THE FACTORY AS WELL AS 3'PVC PIPE EXTENDING HORIZONTALLY FROM THE TEE IN BOTH DIRECTIONS AND -EL=27.60 CAPPED OFF OUTSIDE OF THE MODULE LINER.THE AIRLINE MUST COME IN FROM THE TOP AND ATTACH TO THE PVC TEE. 3/4"TO 1-1/2"DOUBLE 2"LATERAL(tvPJ WASHED STONE TO 6' 6' N - 56.5' 3.PRIMARY AND SECONDARY TANKS MAYBE ONE DUAL COMPARTMENT TANK WITH A BAFFLE.NOTE:MINIMUM COMPARTMENT DIMENSIONS REMAIN THE 100.0 TO CROWN OF PIPE 3' 3' 3°, 5'MI". SAME. BLOWER HOUSING BASE 1I4'PERFORATION AT A n a < 4.FAST TANK MUST RAVE MINIMUM OF ONE ACCESS PORT FOR PUMP OUT,MORE THAN ONE IS RECOMMENDED. 5 O'CLOCK(TYP.) GROUNDWATER ELEV. 21.54'm a - DIMENSIONS(SECTION A-A) VIEW FIELD END VIEW A-A 5.FOUR HOLES FOR LIFTING THE FAST LINER ARE SUPPLIED.CONTRACTOR-SUPPLIED PLAN V UPPLIEDSPRERDER BARS ARE TO BE USED IN LIFTING THE UNIT.PLACE � NOT TO SCALE SPREADER BARS BETWEEN LIFTING HOLES. NOT TO SCALE NOT TO SCALE 1 BLOWER MUST BE WITHIN 100 FEET(30.5M)OF FAST UNIT WITH LESS THAN 4 ELBOWS. ANCHOR BOLTS SEE OTT LEG ORIGINAL FOR DISTANCES GREATER THAN 100 FEET-CONSULT FACTORY.BLOWER BASE MUST ORIGINAL EXTENSION FOOT ACCESS TO INSPECT INSTALL 7/4'MESH BE ABOVE NORMAL FLOOD LEVEL NOTE 2 FOOT 70 ORIGINAL SCHEDULE 1.SECURE ORIGINAL T X 7"FOOT TO LEG PUMP OUTS MUST 10'DIA VENTING PIPE SCREEN(SEE 2. 810-MICROSICS REQUIRES THAT PIPING FROM BLOWER TO TANK BE GALVANIZED OR FOOT.SEE 40 PVC PIPE EXTENSION BY PLACING TWO SCREWS IN NOTE 8) BLOWER WITH HOOD NOTE 1. BE PROVIDED(6'MIN. CPVC.PIPING INSIDE TANK TO FAST AIRLIFT MUST BE CPVC OR NONCORROSIVE EACH SIDE OF THE LEG EXTENSION.EIGHT DIA.)(SEE NOTE 12) 24^DIA (BY BID-MICROBICS) OBSERVATION SEE NOTE 1 MATERIAL DO NOT RUN GALVANIZED PIPE LENGTH IPITO TREATMENT TANK SEE CUT SECTION SCREWS PER FOOT ARE INCLUDED AND 3. BLOWER CONTROL SYSTEM BY BIO-MICROBICS,INC. NOTE 4. --1I��IT�-SEE NOTE 3. SHOULD BE USED ON EACH LEG PORT 8' 3.875' EXTENSIONS. - 4. EACH ORIGINAL FEET ARE ON THE BASE OF THE FAST TREATMENT MODULE. n TYP EACH LEG EXTENSION IS TO BE ATTACHED TO THEIR CORRESPONDING 3' IA - FOOT WITH THE PROVIDED HARDWARE.SEE LEG EXTENSION DRAWING. ANCHOR MODIFIED LEG 2.O ANCHOR ALL LEG EXTENSIONS TO BASE " BRACING (7,6cm)MIN TOP OF TANK SEE BLOWER ELECTRICAL CONDUIT 5- ANCHOR ALL LEG EXTENSIONS TO THE BASE OF THE TANK EXCEPT THE CENTER LEG PLAN VIEW OF THE TANK EXCEPT THE CENTER LEG BOLTS EXTENSION WITH 4' FLUSH WITH (TO BLOWER EXTENSION.PLACE BOLTS AT OPPOSITE CORNERS OF THE FOOT EXTENSION BASE.IF EXTENSION.PLACE BOLTS AT OPPOSITE REV. DATE BY APP'D. DESCRIPTION PVC PI BOTTOM OF DRAWING RUBS PIPING(SE CONTROL SYSTEM) ELONGATING THE LEG EXTENSIONS PAST 23'(58.4cm)IN HEIGHT,THE CENTER LEG PROVIDED 12' NOTE 2. CUT SECTION SEEPE CORNERS OF THE LEG EXTENSION BASE.IF "AS-BUILT"SEPTIC SYSTEM HSF 4.5 X GASKET SEE NOTE 3. EXTENSION MUST ALSO BE BOLTED DOWN.ANCHOR BOLTS ARE NOT PROVIDED. LEG EXTENSION ELONGATING THE LEG EXTENSIONS PAST CONCRETE LID23-IN WITHIN 1-1/2' 6. T.8-)LE ELONGATE THE EN FOOT INTO TTHEPRORAE P 12-IECES.NEXT, CUT A4*,CUTTHE3.PIPE T' LEG EXTENSION (HSF 4.5X) MUST HEIGHT,BOLTED DO LEG EXTENSION PREPARED FOR: ' TREATMENT (9.Bcm)LEGEXTENSIONINTO TWO SEPARATEPIECES.NEXT,CUTA4'SCH 40 PVC PIPETO SEE NOTES. MUST ALSO BE BOLTED DOWN.ANCHOR HAWTHORNE TERRACE CONDOMINIUMS ZONE THE DESIRED LENGTH AND SLIP THE PIPE OVER THE TOP CUT SECTION AND THE BOTTOM BOLTS ARE NOT PROVIDED. CUT SECTION OF THE LEG EXTENSION.ATTACH PIPE WITH STAINLESS STEEL SCREWS. NONCORROSIVE 024' FAST AIR LIFT 024' EQUAL ELONGATION MUST BE DONE ON EACH LEG WHEN THE PROVIDED tY IS FOUND CLAMP EVERY 2 FT (030.Scm) (030.Scm) 3.TO ELONGATE FOOT PAST THE LOCATED AT INSUFFICIENT. GASKET NON-CORROSIVE GASKET PROVIDED 12",CUT THE 3.9"DIA..LEG 7. IF LEGS ARE EXTENDED PAST48',USEOFSCH800RSTRONGERPIPEISRECOMMENDED. EXTENSION IN THE CENTER INTO TWO 272 CRAIGVILLE BEACH ROAD E 8. RUN VENT 10'DIA TO DESIRED LOCATION AND COVER WITH 1/4"MESH SCREEN.VENT CLAMP EVERY 2 FT SEPARATE PIECES.THEN CUTA SCH 40 HYANN IS,MA 02601 INFLUENT RISER PVC PIPE TO THE DESIRED LENGTH AND t WASTE 8'DIA(10.2an) MUST NOT CAUSE EXCESSIVE BACK PRESSURE. 3'AIR RISER 3"AIR SLIP THE PIPE OVER THE TOP AND BOTTOM FROM AST INSERT(BY FAST TREATED S. PLEASE SEE DRAWING HSF 4.5 X SUPPLY SUPPLY SETTLING N BID-MICR EFFLUENT 10. COPYRIGHT(C)2001,BID-MICROBICS,INC. CUT SECTIONS OF THE LEG EXTENSIONS. SCALE: N.T.S. DATE:JANUARY 13,2004 LINE LINE I ZONE z 11. SETTLING TANKS EQUALING 12 XTO 1 X DAILY FLOW MUST BE USED PRIOR TO FAST. NONCORROSIVE 4.ATTACH PIPES WITH STAINLESS STEEL LEG EXTENSION 12. FAST TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT,MORE GASKET GASKET PREPARED BY: SEE g SE SEE NOTES 687 CLAMP EVERY FT SCREWS.IF LEGS ARE EXTENDED PAST 4219 GALLON NOTE5 �+"� NOTE4 THAN ONE IS REQUIRED. / NON-CORROSIVE FAST USE OF SCH 80 PIPE IS RECOMMENDED. it 1 JC ENGINEERING,INC. MIN.LIQUID 13. FAST COVERS OVER THE AIRLIFT AND ONE PUMPOUT MUST BE TO GRADE AND FAST AIR LIFT! CLAMP EVERY FT. AIRLIFT AS-BUILT 2854 CRANBERRY HIGHWAY CAPACITY SEALED WITH GASKETS.COVER OVER PUMP CHAMBER MUST BE TO GRADE 5.THE AIR SUPPLY INTO THE FAST UNIT C5971LJ 14. 10"VENT AND AIR SUPPLY PIPES MUST BEPRCHEDTOWAROSTHE TANK FOR DRAINAGE. AIR.SUPPLY OPTIONSBEENOTES MUST BE SECURED SO AS TO PREVENT EASTWAREHAM,MA02538' SEE NOTE10 15. FIRST SIT OF AIR SUPPLY PIPE TO BE GALVANIZED. DAMAGE FROM PIPE VIBRATION. PLAN 508.273.0377 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) 16. UNIT TO BE FIRMLY SECURED TO THE TANK TO PREVENT MOVEMENT IN ANYDIRECTIOPL MICROFAST 4.5 X DETAILS Drexn By.SJZ Designed By.JLC Checked BY JLC' JOB No.3T1 �'° N07 TO SCALE 17. VENT LOCATION AND:HEIGHT ARE CRITICAL NOT TO SCALE I sHEET2 ' GENERAL NOTES 1, UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION _ - METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE 5.28 10 \ - - ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. CB/FND. B/FND- _ - 2. ANY CHANGES TO THIS PLAN MUST RE APPROVED BY THE BOARD (gO.WY OF HEALTH AND THE DESIGN ENGINEER. - TD RCL - 3. 4-SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL MAP 267 / (+( E PUBLIC) \ BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. PARCEL 186 / / ` ��. �i w "j¢� �B k 4: TO PREVENT BREAKOUT,THE PROPOSED FINISH.GRADE SHALL NOT BE LESS GUARINO =°' / \l 7Z°SZaz• j -p !� .y ^�'j:+ - THAN'ELEVATION=29AT FOR A DISTANCE OF I5'.AROUND THE PERIMETER OF THE SAS.UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF THE LINER IS NOT LESS THAN THE �/ \\ �. \ i •7.- �" �5•`.® �' lc� BREAKOUT ELEVATION. ''A "'"' T S. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. m / N89'30'50'E ' - y'�.:y ��` • 4 '-J ..1 6 THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. EX.INV.30.18's y ,gam \ 1.46' Z X-'- b/ Y \ i,1-•' t y Ti 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO m ^\X�y \ CB/FND. / ••� -� - D Y" BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR \ ��-•-X \ i 7„ - INSPECTION.SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING m \ -X+-X-X MAP 267 APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. "`_�X^--X��v N PARCEL 179 ••1 .y 8. ELEVATIONS BASED ON N.G.V.D.DATUM OF 30.00'MSL OBTAINED FROM 1 \ /`77 ✓y •t CATCH BASIN RIM AS SHOWN ON PLAN. EXISTING CHAMBERS TO BE \ - f a DAWSON- _ .t .:s'F'. . t • x 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION B « i THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE PUMPED AND FILLED WITH EXISTING ^ _ eL n,: '�•�•� ,-•S ,f AT 1-886-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES.REPORT ANY CLEAN SAND(TYPJ CON ' I y • DISCREPANCIES TO THE DESIGN ENGINEER. DOMINIU a PROPOSED SEWER MANHOLE 1 -�vd r /f ••t COMP M ` J �+ . • �T 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE FIELD VERIFY ANY - - AREA LEX �I I 8"�OUf=� �T ;aJyyl` ti, STRUCTURES SHALL BE MADE WATERTIGHT. ELECTRICAL FLAG '� -27,194 t Sq,F7. �p A • +'• ^. •,( �• 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR _II SLEEVE MAIN R PIPE ATOSSING F •+!" i '`• L, 8 ^ 1 WATER MAW CROSSING 1,•.. • " x^'W •�•• •• 4•.�l ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH .,F •i• k, �` 37• RO -� "� DETERMINATION FROM APPROPRIATE AUTHORITY. cT>'n 10 EITHER SIDE(TYP-) y` 8 a p 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS PROPOSED 4-SCH.40 PVC - - - SLOPEATI%M1N._(TYP.) 11�� t.+•r •� o ��B y LOCATED UNDER PAVEMENT,DRIVES OR TRAVELED WAYS IN WHICH CASE �._7{{ j EX.INV:3020'(N-) o � THEY SHALL WITHSTAND H-20 LOADING _kM t y 'p• je ( Q 0' ,.•^ 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT,DUST AND ail Y • -,0 P Ua c - • FINES.. EXISTING SEPTIC TANKS TO BE > - U y��`.:' - 14. WHERE REQUIRED,CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND PUMPED AND FILLED WITH .. O O - I) II: -.0 1 j.:,'A - UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF CLEAN SANOAND BOTTOM TO I • Ri` '� •- .+u- - LEACHING FACILITY.REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN BE PUNCTURED(TYP.) �' ��B,�,a 4 +�� _~" _ COARSE SAND FREE FROM CLAY,FINES OR OTHER UNSUITABLE MATERIAL IN > 10.0. PROPOSED W SDR 35 Q up : �pb. 2� O { ACCORDANCE WITH 310 CMR 15255(3). EX.INV=30.00' ' PIPE SLOPE AT.75%I g •� �G _ S _ 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN'•e fi �•- '' 1( �� ' r�'� SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK p : '"< < �t•• 16. PROPOSED PROJECT IS LOCATED WITHIN: - > PROPOSED 9.000 GALLON SEPTIC TANK ASSESSORS MAP 267 PARCEL 73(A-T) > - - EMS FING LEACHING PITS ro 6E I O / -I o - w T" xy ( L• O "r 17. OWNER OF RECORD' HAWTHORNE TERRACE CONDOMINIUMS PUMPED AND FILLED WITH O O I J *t ,/ ,1,T. 3ys+ a '�-"- , - ADDRESS: 272 CRAIGVILLE BEACH ROAD CLEAN SAND(TYP.) - - MAP 267 ' I m MAP 267 HYANNIs,MA 02601 PARCEL 007 18. FENA FLOOD ZONE C PARCEL 184 - - ':' -HUGHES LOCUS PLAN AS SHOWN ON COMMUNITY PANEL# 2500050008D 19. PLAN - KARPOVSKY - - - REFERENCE: - 'y - •=1000' HYANN 1 1.PLAN ENTITLED"HAWTHORNE TERRACE SITE PLAN,WEST PROPOSED AIR SUPPLY i O C) PROPOSED 6000 GALLON SCALE:1ISPORT,BARNSTABLE,MASS,FOR JAMES J.TAYLOR'.DATED VENT TO RUN UP SIDE OF SEPTIC TANK WrrH - SEPTEMBER.t978,SCALED AT 20 FEET TO AN INCH.BOOK 327 PAGE 77. - BUILDING TO TOP OF ROOF > > 2.PLAN ENTITLED"HAWTHORNE TERRACE SHOWING SANITARY/SEWER' MICROFAST INSERT CONNECTIONS AS BUILT',DATED OCTOBER 18,1978,SCALED AT 20 FEET TO W - - ANINCH. VENTING - \ y VENTINTIN G PIPE _ LP I _ _ - _ _ 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 10.3•> - - - 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE.THIS PLAN IS TO BE USED .3•DIA.MIN. ", _ / - •: __ O a5 I J 1 ONLY FOR SEPTIC SYSTEM UPGRADE.JC ENGINEERING WILL NOT ASSUME ANY BLOWER PIPING J� - /` B/FND. DESIGN DATA _ ; LIABILITY FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. 3 \ (0p 3) LP ,]2, „C 2) v DIST.) - NUMBER OF BEDROOMS(ASSESSORS) 40 - PROPOSED BLOWER " LP O LP Pr.q om' (PC 5) ^ PROPOSED 6,500 GALLON NUMBER OF BEDROOMS(DESIGN) CU - - PUMP CHAMBER DESIGN FLOW „D GAUDAY/BEDRQDM ON CEMENT PAD TO TEST PIT DATA TEST PIT DATA LEGEND 3 r- BE ENCLOSED FOR ' - TOTAL DESIGN FLOW 4400 GAUDAY - - -NOISE PROOFING X I 793 - -50-- EXISTING CONTOUR DESIGN FLOW X 200%-= 8800 GAUDAY 30.0' USE PROPOSED 9,000 8 6,000 GALLON TANKS - T F50-1 PROPOSED SPOT GRADES X I MAP 267 d.'j : r- �-,�, EXISTING MAN HOLE FOR _ - PARCEL 73 SPRINKLER SYSTEM PROPOSED CONTOUR 7777� AREA=1.5+/-ACRES ' INSPECTOR Samuel White - INSPECTOR: Samuel Whita -Fj7iC EXISTING ELECTRICAL UTILITIES I _ m.0' INSTALL 2 100 x 30'LEACHING FIELDS SOIL EVALUATOR:Samuel PNms Jensen. SOIL EVALUATOR.Samuel Philos Jensen - - SIDEWALL CAPACITY n104,2003 A GAS EXISTING GAS LINE - - - - - DATE: M DATE: Pril 04,2003 B.M.Catch Basin LEACHING CATCH ] NO SIDEWALL AREA CREDIT TAKEN Rim Elev.=30.00' BASINS TTYP.) _ I� �::�1 TEST PIT A. 1 TEST PIT#: 2 -V EXISTING WATER LINE MSL 1 � BOTTOM CAPACITY PROPOSED(2)3Q x 100' ELEV TOP= 32.04' ELEV TOP= 31.82' PAVED -: •..I f (LENGTH x WIDTH)x(.74 GAUSO.FT.)= GAUDAY TEST PIT LOCATION ®� LEACHING FIELDS (2)(100.0'x 30.0')x(.74 GAUSO.FTJ= 4�440.0 GAL/DAY ELEV WATER= >126'B.G.S. ELEV WATER= PARKING .. 37.2' : - O O O PROPOSED 9,000 GALLON SEPTIC TANK AREA •4• PERC RATE= <2 MIN/IN PERC RATE= MINflN O DOSING&STORAGE REQUIREMENTS PROPOSED 1,111 GALLON SEPTIC TANK I ` DESIGN FLOW: 4,400 GPD DEPTH OF PERC= 38•-56' DEPTH OF PERC= W/MICROFAST UNIT I -� •'_-.f:'-' I DOSING REQUIRED: 4 CYCLES/DAY TEXTURAL CLASS: 1 TEXTURAL CLASS: 1 I O O PROPOSED 6,500 GALLON PUMP CHAMBER 11h 4.400 GPD/4=1,100.0 GAUCYCLE / _ � ' •F�`'' I MAP 267 DISTANCE REQUIRED BETWEEN PUMP 4"SOLID SCHEDULE 40 PVC PIPE .I I•-_' - ON AND PUMP OFF FLOATS: MTp PARCEL 72 -----_ 2"SOLID SCHEDULE 40 PVC PIPE MOCHEN 1100 GAUCYCLE- 723 GAUFf=1.52 FT/CYCLE MAP 267 yo + 2"PERFORATED SCHEDULE 40 PVC PIPE PARCEL 85 ' - I - t2 r-, (USE t'-8-TO PROVIDE FOR BACK FLOW) _ 39.8' STORAGE REQUIRED ABOVE WORKING LEVEL:4,400 GAL B'SDR 35 PIPE HEYWOOD STORAGE PROVIDED AB OR LEVEL'4,579 GAL.ABOVE WORKING -- ACTUAL ELEVATION"AS-BUIL 0 32.04' 0 31.62' (96.8T) T" sandy Loam Sandy Loam TOTALS: A Sl• I.- 7� 10 YR 312 A 10 31, ' m 5-10/ YR 3/2 Gravel TOTAL LEACHING AREA 6,000 SQ.FT. 12". 31.04'. -12' ` 30.62' Loa y Sand Sandy Loam 100.0' 'PROPOSE04"WYETO - TOTAL LEACHING CAPACITY B 5/6aI B 10 YR 4/6 REV DATE - DESCRIPTION - APP'D. '��•,�+ - - DISTRIBUTE FLOW Y - - RESERVED FOR 90 0OF HE-H USE \ EQUALLY 34" of c 29.21' 39 28.5r "AS-BUILT"SEPTIC SYSTEM 4.440 GAL/DAY 5-1 BY -•�9 7 �„ r° GAS L1NE5 TO BE FIELD - Pem 25Y 6T4 2 SY 6/4d PREPARED FOR: r' "' -'- 1 ASNECESSARY�� 56° ' 1020%Gravel 0.20%Gavel HAWTHORNE TERRACE CONDOMINIUMS .L�.: - I-. C C LOCATED AT I T 272 CRAIGVILLE BEACH ROAD 16 _ ~ m 18.1' 1!OCONTRACTOR TO VERIFY ALL DESCRIPTION MCI HC 2 HC 3 - HYANNIS,MA 02601 \ �•t \ 4 �3i� x _ UTILITIES BEFORE ' \ SEPTIC COVER IN(1) 69.5' 27.1' \ CONSTRUCTION BEGINS "" = DATE:JANUARY 13 2004 2.POSSIBLE FILL LINE AT-SM ON No Groundwater 7erminated due to SCALE: 1 INCH 20 FT. _ So 78�/ EASTERN SIDE OF TP t.VERIFY SEPTIC COVER OUT(2) 58.3' 37.8' --•- 126 Observed 21.54' 80" gas line 25.t6' 0 10 20 ^o CRAIGVILLEB - SIDEWALK DIST.) AT TIME OF INSTALL AND REMOVE OBSERVATION COVER(3) 49,6- 60.5' ---- II n. �I PREPARED BY: EACH ROAD -_ AS NECESSARY(SEE NOTE 141 _ /`1 _R 3.PROPERTY LOCATED IN A- - PUMP COVER(4) --__ 26.6'- 29.9' - "AS-BUILT" JC ENGINEERING,INC. . PUBLIC .. ._ ... .. _ (40'WIDTH- ) DEPARTMENT OF ENVIRONMENTAL - - PROTECTION APPROVED ZONE 2 PUMPCOVER(S) -_ 25.3' 15.3' PLAN 2654 CRANBERRY HIGHWAY - PLAN EAST WAREHAM,MA 02538 SITE PLAN 508.273.0377 OuBY.WZ O.z91•d y.JLC OH IdBy.AC JOB No.371: SCALE:1"=20' - sHEETt s 1 � ALTERNATE TOP SLAB. - REINFORCED 70 MEET 1 H-20 LOADING 20'MIN.ACCESS COVER(TYPICAL FOR 3) ADJUST TO REQUIRED PROVIDE LEBARON LK-100 MANHOLE COVERS ACCESS TO INSPECT INSTALL 1/4'MESH i GRADE W/MIN.20R TO F. GRADE FOR ALL COMPONENTS ) PUMP OUTS MUST 10'VENTING PIPE SCREEN(SEE - MAX.4 BRICK COURSES BLOWER WITH HOOD INSTALL 1-1/4'PVC TO BUILDING.JOINTS TO BE MADE OR EQUIVALENT BE PROVIDED(6"MIN. NOTES) (BY BID-MICROBICS) PROVIDE LEBARON LKAOO FINISH.GRADE OVER TANKS EL, WATERTIGHT.WIRE PUMP AND FLOATS TO DUPLEX*PAC-2" - DIMENSION WITH DIA)(SEE NOTE 12) 24'DIA SEE NOTE 1 MANHOLE COVERS TO 31.75' LEVEL CONTROLLER W/SUBMERSIBLE PRESSURE BELL. HOISTING CABLE 7 z 19 SET FRAME IN FULL BED OF MORTAR REINFORCED OBSERVATION FINISH GRADE FOR ALL STAINLESS STEEL 118' MANHOLE FRAME&COVER 1 CONCRETE COLLARS. .. FINISH GRADE OVER TANKS EL 31.21'-32.46' PORT - COMPONENTS - NEMA 4 JUNCTION BOX CORROSION RESISTANT 8 DIA/1,760 LB.STRENGTH .. 1'DIA:DROP FRONT / _ _ - - -„ _ :- _ ,.�. •-_ .- LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 4'BALL VALVE w/UNIONS TYPE M.H.STEPS BITUMASTIC COATING FOR 2'-0"+/_ 3"'IA CONNECTORS SUPPORTED BY 1-1/4"PVC CONDUIT, SCH.40 PVC fV' yBFtACIN 7.6cm MIN ELECTRICAL JOINTS TO BE MADE WATERTIGHT SANITARY MANHOLE ( ) - TOP OF TANK SEE -BLOWER CONDUIT(TO - PRECAST REINFORCED FLUSH WITH DRAWING RUBS PIPING(SE BLOWER (2)BARNES 4SE-L PUMP 275 GPM @ 25'TDH 230 V SINGLE -U - CONCRETE M.H.CONE BOTTOM OF GASKET CONTROL PHASE 4.5 HP,6.5-IMP.DIA.MODEL#4SE4524L HSF 4.5 X SECTION CONCRETE LID SYSTEM)SEE 2'-0'+A - 4'-0^DIAMETER 4'SCH.40 TO Z� MIN.0.121N.STEEL 'zOtF PROPOSED I WITHIN I-1/2' .NOTE 3. 4'SCH.40 TO Uy PER VERTICAL FOOT, 8'SDR 35F PROPOSED I. 3' I MANIFOLD TREATMENT 4'MANIFOLD '1-II� wo PLACED ACCORDING 2'DROP MIN. 8"SDR 35 ZONE E m o� TO DESIGNATION SLOPE .s% 3' 3'DROP MAX. 9^i 1 PROPOSED w/CLEAN-OUT "SCH.40 TEE DESIGNATION M799 L=69.00' 1cvEu1 Tsy _ I 8"SDR 35 yV _T 4'-0"DIAMETER HEIGHT OF RISER �28.98'� T 8'd' INV.OUT= E L=490' - m I 3T m-3 0' rZa.37' -sEoaE >s%mn IFnO ONMO ON�� CAP 1"CLEAR -2'CLEAR SECTIONS VARY - /29.65, Za.90' 1 LIQUID- 28.65' - 1Z�29 a Za.6Z' zuBM N �118.0' - 6• - P FROM 1'T04' LEVEL NFLUEM }' c C OUTSIDE OF 1� ( 28.&1 �I„ FAST INSERT BY (28.14') �� WASTE ( LEAD ON-ON 1. 27.22' 5'MIN PIPE+2" _ FROM BIO-MICROBICS) 28.22' - i 6' CLEARANCE - 27.25 -PUMP (27.17') m - 4 SETTLING LEG EXTENSION INLET TEE 4'SCH.40 PVC DISCHARGE PIPE ROVIDE"V' 6"CRUSHEDSTONE tMN OVER MECHANICALLY 4I..GALLON SEE NOTES 6 878'BASEPRECAST - OTE 4 - m - - TWO(2)-1/4'WEEP HOLE IN DISCHARGE PIPE OPENINGS MIN.LIQUID 4 RUBBER BOOT AND STAINLESS COMPACTED BASE CAPACITY -- -- -- - 6'CRUSHED STONE _ '- 4"BALL CHECK VALVE SCH.40 PVC\lOo CEMENT CONCRETE .. .OVER MECHANICALLY - - P.S.I.FLOWMATIC OR EQUAL STEEL BAND CLAMP FOR CLASS*A" - (15971 L.)SEE -COMPACTED BASE SANITARY PIPE CONNECTION LENGTH 1T-0" WIDTH 10'-0' DEPTH 10'-6' NOTE10 LENGTH if WIDTH WIDTH 10'0' DEPTH 7'-9" . LENGTH 17'-0" WIDTH 7'-0" DEPTH 11'-2" i'STONE BEDDING 9,000 GALLON SEPTIC TANK(LOW PROFILE) 6,000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) 6,500 GALLON PUMP CHAMBER LENGTH 17-0" WIDTH T-04 DEPTH 11'-2" PIPE OPENINGS TO BE - - PRECAST IN RISER SECTION 143 BAR AROUND OPENINGS FOR PIPES IB'DIAMETER AND OVER,I-COVER - PROPOSED 9,000 GALLON SEPTIC TANK 6,500 GALLON PUMP CHAMBER PROPOSED 6,000 GALLON SEPTIC TANK& NOTE:ALL TANKS SHALL BE CAPABLE OF NOT TO SCALE PRECAST CONCRETE WITHSTANDING AASHTO H-20 LOADING TANKS PROPOSED 6,500 GALLON PUMP CHAMBER SHALL BE INSTALLED ON A LEVEL STABLE MANHOLE(HZO) - BASE.DIMENSIONS ARE TAKEN FROM ACME *TANK SHALL BE WATERTIGHT NOT TO SCALE NOT TO SCALE- - - PRECAST CO.,INC.SPECIFICATIONS - - - AND WATERPROOFED T�U v LIFTING HOLE R n 3•AIR LINE PIPING(TO 3/4'TO 1-112"DOUBLE WASHED STONE TO CROWN OF PIPE 1/4'PERFORATION TO BE PLACED BLOWER W/HOOD(BY SEE NOTE 5 3"PIPE CA -611 BLOWER BY BID-MICROBICS 6'MIN DIA PUMP IS ) ) 2'OF 1/8"TO 1/2'DOUBLE WASHED STONE IN THE END CAP HORIZONTALLY BIPMICROBICS) OUT PORT(SEE O NEAR THE CROWN OF THE PIPE AT NOTE 4) - E FINISH GRADE OVER LEACHING FIELD= 3U.2'-31.8' THE END OF EACH LATERAL. - 4" SLOPE @ 2%MIN.OVER SYSTEM INFLUENT WASTE 24"DIA - -- (29.13') - FROM SETTLING TANK - MANHOLE/OBSERVATION 18' A q 3"DIA 4-WAY T PORT .TOP OF S.A.S.=28.83' o I` CONTINUOUS PITCH BACK J_ 6.OBSERVATION 8'DIA i TO UMP CHAMBER PORT(OPTIONAL) - FAST m 4"SCH.40 FORCE MAIN - - _CONCRETE BASE< �2'SOLID PVC 2"PERFORATED LATERAL SET II-IjFmI�- 4.279GALLON 10"DIA VENTING PIPE TREATED +i BOTTOM OF TRENCH TO BE LEVEL EL.= 28.0' - MIN.LIQUID - - EFFLUENT '^.'� LEVEL INV.ELEV._28,50' (Z8.3�) - - 7" - 45"ELBOW - - - ELECTRICAL CONDUIT CAPACITY - (TYP) - �_ - 4 X 2 TEE (28.8') 12"' 5'MIN. (TO BLOWER CONTROL (21293L.) � -- `- �� 4"MANIFOLD 5=0.5% - - 3•MIN.AIR PIPING SYSTEM) O O BACK TO FORCE MAIN GROUND WATER ELEV.<21.54' TREATMENT FASTMODULEBY ,PIPE CAP. - 6. s•Ow.MIN - FIELD PROFILE - BLOWER HOUSING DIMENSIONS. ZONE BID-MIQROBICS _ n :PUMP OUT NOT TO SCALE - NOT TO SCALE PORT 77--S'(195.621.3cm) 79`2.5'(200.731.3cm) (SEE - -CONCRETE THRUST .. NOTE 4).. :, 1/4'PERFORATION A - FINISH GRADE OVER LEACHING FIELD= 30.2-31.8' 17' 12' AT7O'CLOCK(rvPJ 10 :BLOCK SLOPE,@ GRADE OVER SYSTEM _ - 5' (TMP•) _ TOP OF S.A 8- 28.83' LENGTH 17-0" WIDTH 10'-0• DEPTH T-9' EL-27.75 (29.13'� 2'PVC Tp 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) mrmo-ma PERFORATED PIPE I D AtD-1oOz 2"OFLE TOHE 1. NOT TO SCALE - DOUBLE WASHED ' 1.ALL APPURTENANCES TO FAST(EG.SEPTIC TANK,PUMP OUTS,ETC.)MUST CONFORM TO ALL COUNTY,STATE,PROVINCE,AND LOCAL CODES. m p m O STONE - - - O 6"EOECTNE 2.FOUR-WAY 3"DIA.PVC TEE IS PROVIDED BY THE FACTORY AS WELL AS 3"PVC PIPE EMENDING HORIZONTALLY FROM THE TEE IN BOTH DIRECTIONS AND - I EPTM M CAPPED OFF OUTSIDE OF THE MODULE LINER.THE AIRLINE MUST COME IN FROM THE TOP AND ATTACH TO THE PVC TEE. DEL=27.60 z .. 3/4".TO 1-1/2"DOUBLE .. 1 2'LATERAL(fYP.) > WASHED STONE TO 6' 6' 56.5" 3.PRIMARY AND SECONDARY TANKS MAYBE ONE DUAL COMPARTMENT TANK WITH A BAFFLE.NOTE:MINIMUM COMPARTMENT DIMENSIONS REMAIN THE 100.0' O CROWN OF PIPE 3' 3' SAME. - - .. 114'PERFORATION AT' A D n - 30 5'MIN. - N - 5O'CLOCK(fVP.> - m BLOWER HOUSING BASE 4.FAST TANK MUST FIAVEA MINIMUM OF ONE ACCESS PORT FOR PUMP OUT,MORE THAN ONE IS RECOMMENDED. D GROUND WATER ELEV?<21.54' DIMENSIONS(SECTION A-A) 5.FOUR HOLES FOR LIFTING THE FAST LINER ARE SUPPLIED.CONTRACTOR-SUPPLIED SPREADER BARS ARE TO BE USED IN LIFTING THE UNIT.PLACE PLAN VIEW p FIELD END VIEW A-A SPREADER BARS BETWEEN LIFTING HOLES. - - - NOT TO SCALE NOT TO SCALE - NOT TO SCALE ANCHOR - ... - 1- BLOWER MUST BE WITHIN 100 FEET(30.SM)OF FAST UNIT WITH LESS THAN 4 ELBOWS. BOLTS SEE BOLT LEG ORIGINAL - - ACCESS TO INSPECT - INSTALL 1!4'MESH FOR DISTANCES GREATER THAN 100 FEET-CONSULT FACTORY.BLOWER BASE MUST NOTE Z ORIGINAL EXTENSION FOOT 10'DIA VENTING PIPE BE ABOVE NORMAL FLOOD LEVEL. FOOT TO ORIGINAL PUMP OUTS MUST SCREEN(SEE - SCHEDULE i.SECURE ORIGINAL T X 7'FOOT TO LEG BE PROVIDED(6'MIN. ARUBB 8) BLOWER WITH HOOD 2- 810-MICROBICS REQUIRES THAT PIPING FROM BLOWER TO TANK BE GALVANIZED OR FOOT.SEE PVC PIPE EXTENSION BY PLACING TWO SCREWS IN DIA.)(SEE NOTE 12) 24'DIA (BY BID-MICROBICS) CPVC.PIPING INSIDE TANK TO FAST AIRLIFT MUST BE CPVC OR NON-CORROSIVE NOTE 1: EACH SIDE OF THE LEG EXTENSION.EIGHT OBSERVATION SEE NOTE 1 - MATERIAL DO NOT RUN GALVANIZED PIPE LENGTH INTO TREATMENT TANK i SEE CUT SECTION SCREWS PER FOOT ARE INCLUDED AND PORT - 3. BLOWER CONTROL SYSTEM BY BIO-MICROBICS,INC. NOTE 4. /- SHOULD BE USED ON EACH LEG - 4. (1 1)ORIGINAL FEET ARE ON THE BASE OF THE FAST TREATMENT MODULE. 8' 3.875" SEE NOTE 3.' _-'- - _ EACH LEG EXTENSION IS TO BE ATTACHED TO THEIR CORRESPONDING - ti 7YPDTIEXTENSIONS. BRACING FOOT WITH THE PROVIDED HARDWARE.SEE LEG EXTENSION DRAWING. 2.ANCHOR ALL LEG EXTENSIONS TO BASE TOP OF TANK (7.6cm)MIN ELECTRICAL CONDUIT 5. ANCHOR ALL LEG EXTENSIONS TO THE BASE OF THE TANK EXCEPT THE CENTER LEG PLAN VIEW ANCHOR MODIFIED LEGOF THE TANK EXCEPT THE CENTER LEGFLUSH WITH SEEBLOWER BOLTS EXTENSION WITH 4'(TO BLOWEREXTENSION.PLACE BOLTS AT OPPOSITE CORNERS OF THE FOOT EXTENSION BASE.IF EXTENSION.PLACE BOLTS AT OPPOSITE REV. DATE BY APP'D. DESCRIPTION DRAWINGPIPING(SE SEE PVC PIPEBOTTOM OF HSF 4.5 X CONTROL SYSTEM) ELONGATING THE LEG EXTENSIONS PAST 23-(58.4cm)IN HEIGHT,THE CENTER LEG PROVIDED 12" NOTE 2. CUT SECTION - CORNERS OF THE LEG EXTENSION BASE.IF CONCRETE LID SEE NOTE 3. EXTENSION MUST ALSO BE BOLTED DOWN.ANCHOR BOLTS ARE NOT PROVIDED. LEG EXTENSION ELONGATING THE LEG EXTENSIONS PAST "AS-BUILT"SEPTIC SYSTEM TREATMENT WITHIN 1-1/2" 6. TO ELONGATE THE FOOT PAST THE PROVIDED 12'(30.5cm)EXTENSION,CUT THE 3.9'DIA. LEG EXTENSION (HSF 4.5X) 23'IN HEIGHT,THE CENTER LEG EXTENSION PREPARED FOR: ZONE - (9-8cm)LEG EXTENSION INTO TWO SEPARATE PIECES.NEXT,CUT A 4-SCH 40 PVC PIPE TO SEE'NOTE 3. MUST ALSO BE BOLTED DOWN.ANCHOR THE DESIRED LENGTH AND SLIP THE PIPE OVER THE TOP CUT SECTION AND THE BOTTOM BOLTS ARE NOT PROVIDED. HAWTHORNE TERRACE CONDOMINIUMS CUT SECTION OF THE LEG EXTENSION.ATTACH PIPE WITH STAINLESS STEEL SCREWS. NON-CORROSIVE 024' FAST AIR LIFT 024' EQUAL ELONGATION MUST BE DONE ON EACH LEG WHEN THE PROVIDED iT IS FOUND CLAMP EVERY 2 FT (030.Scm) (030.5cm) 3.TO ELONGATE FOOT PAST THE - LOCATED AT - / INSUFFICIENT. - PROVIDED 12',CUT THE 3.9"DIA.LEG L/ 7. IF LEGS ARE EMENDED PAST 48",USE OF SCH 80 OR STRONGER PIPE IS RECOMMENDED. GASKET NON-CORROSIVE GASKET EXTENSION IN THE CENTER INTO TWO 272 CRAIGVILLE BEACH ROAD CLAMP EVERY 2 FT INFLUENT u 8. RUN VENT CA 10"DIA.TO DESIRED LOCATION AND COVER WITH 1/4•MESH SCREEN.VENT - SEPARATE PIECES.THEN CUT A SCH 40 HYANNIS,MA 02601 RISER PVC PIPE TO THE DESIRED LENGTH AND _ 8'DIA.(10 2cm) MUST NOT CAUSE EXCESSIVE BACK PRESSURE. 3'AIR RISER 3•AIR SLIP THE PIPE OVER THE TOP AND BOTTOM WASTE `FAST INSERT(BY 9. PLEASE SEE DRAWING HSF 4.5 X. SUPPLY SUPPLY CUT SECTIONS OF THE LEG EXTENSIONS. SCALE: N.T.S. DATE:JANUARY 13,2004 FROM `r FAST TREATED SETTLING 6 BID-MICROBICS) EFFLUENT J0. COPYRIGHT(C)2001.BIO-MICROBICS,INC. ZONE Z 11, SETTLING TANKS EQUALING 1/2 X TO 1 X DAILY FLOW MUST BE USED PRIOR TO FAST. LINE- LINE LEG EXTENSION NONCORROSIVE GASKET GASKET 4.ATTACH PIPES WITH STAINLESS STEEL PREPARED BY: SEE m SE 12.. FAST TANK MUST HAVE AMINIMUM OF ONE ACCESS PORT FOR PUMP OUT.MORE SEE NOTES 6 8 7 .CLAMP EVERY 2 FT SCREWS.IF LEGS ARE EMENDED PAST 48'. 4219 GALLON NOTES NO7E4 THAN ONE IS REQUIRED. NON-CORROSIVE FAST USE OF SCH 80 PIPE IS RECOMMENDED. 11 1 JC ENGINEERING,INC. MIN.LIQUID 13.. FAST COVERS OVER THE AIRLIFT AND ONE PUMPOUT MUST BE TO GRADE AND - FASTAIR LIFT CLAMP.EVERY 2 FT... AIRLIFT AS-BUILT CAPACITY - SEALED WITH GASKETS.COVER OVER PUMRCHAMBER MUST BE TO GRADE. S. Z$54'CRANBERRY HIGHWAY (15971L.) - : 14. 10"VENT AND AIR SUPPLY PIPES MUST BE PITCHED TOWARDS THE TANK FOR DRAINAGE M THE AIR SUPPLY INTO THE FAST UNIT, AIR SUPPLY OPTIONS SEE NOTES MUSTBE SECURED SOAS70PREVENT EAST WAREHAM,MA02538 SEE NOTE 10 -- - -15. FIRST OF AIR SUPPLY PIPE TO BE GALVANIZED_ 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) " DAM AGE FROM PIPE VIBRATION. PLAN soa.z73.o3n. NOT TO SCALE- "Is. UNIT TO BE FIRMLY SECURED TO THE TANK TO PREVENT MOVEMENT IN ANY DIRECTION. MICROFAST64.5 V,DETAILS. . 17. VENT LOCATION AND HEIGHT ARE CRITICAL 'F J/� /'1 G7 Draws By SJZ oe:1g 113r.JLC Cl-.l lg JLC JOB Na 311 NOT TO SCALE. - SNE. ( 1 GENERALNOTES u ' 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION S82°56' METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. S 28 10 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD CB/FND.Z'B/FND- �� KFI1//�/ OF HEALTH AND THE DESIGN ENGINEER. / FDY 3. 4°SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL MAP 267 r \ \ (40 W/OTH.UBR�CE \ �p�. `8 BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. PARCEL 18fi / �� 4. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS GUARINO jS'/ ,./ \� S7Z.5Z,0�e \ _ k / gip• / �er� © x• r Q~ OF THE SASELEV.UNLESS A 40 TION= MIL GEOMEMBRANE A DISTANCE OF I5'AROUND THE LI ER IIS PLACE AT PERIMETER �- ./3> 168,SO• \ 3 ,= _ •''"' �' } S'i BREAKO TFE ELEVATION. THE TOP OF THE LINER IS NOT LESS THAN THE / �\ - �"" �>fp0. • *�^ .vi 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL N89°3058'E O - - (p�. 'y O 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO 1.46 m EX.1NV.-30.10= X� / •-5/ \� \ C13/FND. ~ U ~-fie BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR Z X-- \X X- _ O _ • • rf .O •„ INSPECTION.SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING m ` - APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. �_ �•-X - I •• 9 a,• 8. ELEVATIONS BASED ON N.G.V.D.DATUM OF 30.00'MSL OBTAINED FROM MAP 267 1 r� + ` `� X CATCH BASIN RIM AS SHOWN ON PLAN. ` x- x 'Y X-X 3 PARCEL 179 7 f }• 9 CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION f DAWSON **• •:f ? EXISTING CHMAEERS TO BE - � •� 11 h =)• _ tl THROUGH DIG-SAFE AND LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE PUMPED AND FILLED WITHEXISTING .� " e1 0 'x•~_Ij. �. .4 ATCREPDIG-SAFEANDANY OTHER APPLICABLE AGENCIES.REPORT ANY CLEAN SAND(7YP.) CONDpryplAgU a '; PROPOSED SEWER MANHOLE �� ` • DISCREPANCIES TO THE DESIGN ENGINEER. EXISTIN f., •• 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE COMPLEX M STRUCTURES SHALL BE MADE WATERTIGHT. FIELD VERIFY ANY AREA=Z7 19q yy,,..J[ ,• •{ 3' Y it. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ELECTRICAL FLAG -/ *SQ.FT, Sq. _ I SLEEVE SEWER PIPE AT +�'. . • i �". �:• L, •'g ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH WATER INUN CROSSINGl 7 " DETERMINATION FROM APPROPRIATE AUTHORITY. W EITHER SIDE OSS11 f �� 8 P"" h�7 ROAD , 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS JJJ • Jp LOCATED UNDER PAVEMENT,DRIVES OR TRAVELED WAYS IN WHICH CASE PROPOSED 4'SCH.40 PVC )) f - •• 1I.• y{ •;•yo r - I THEY SHALL WITHSTAND H-20 LOADING. SLOPE AT I%MOY(Typ.) 1 r Ex.INV.30,2Cf(*7-) ^l •'° i't .'•1 12,,:, J�yjyD',_y P 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT,DUST AND 1 +Us--�(/'Sn� o- 18 !Q Q p•' ! n ••'1�' - FINES. V y Q Q 1, EXISTING SEPTIC TANKS TO BE `� tl _ 74. WHERE REQUIRED,CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND PUMPED AND FILLED KS O !8 Q II o'7 8 )f " - UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF ' O + R OTHER UNSUITABLE MATERIAL IN CLEAN SAND AND BOTTOM TO ... 4!U+Q Q �, - S •. ,r -.� _-^ LEACHING FACILITY.REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN WITH BE PUNCTURED ITYP.) ' . CONTRACCOACTOR ANCE SHALL NOTIFY ESIGN NG PROPOSED 8'SDR 35 1 1{I. ( ,` 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN EX.INV.=30.00' f0.0' PIPE SLOPE AT.75% ` C/T I ` • - a` ?. _ SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. ( ', T. ' _ 16. PROPOSED PROJECT IS LOCATED WITHIN: PROPOSED 9,006 i {1J� _ � � )• ASSESSORS MAP 267 PARCEL 73 A-T 1 " / GALLONSEPTICTANK '�'1 � -� tl '.`0 _ R 17. OWNER OF RECORD: HAWTHORNE TERRACE CONDOMINIUMS ADDR S• - EXIS nNG LEACHING PITS CO BE / O 0 I ° PUMPED AND FILLED WITH \ ES.' � . '.. ,4�.-•z+ 1 ,,.gym .z. 272 CRAIGVILLE BEACH ROAD W HYANNIS,MA 02601 CLEAN SAND(TYP.) I MAP 267 18. FEMA FLOOD ZONE C - MAP 267 PARCEL O01 AS SHOWN ON COMMUNITY PANEL# 250005 0008 D �.m� HUGHES - - LOCUS PLAN 19. PLAN REFERENCE: PARCEL IB4 1,PLAN ENTITLED"HAWTHORNE TERRACE SITE PLAN,WEST KARPOVSKY SCALE:! - 1'=1000' HYANNISPORT,BARNSTABLE,MASS,FOR JAMES J.TAYLOR",DATED- / 'm O PROPOSED OW GALLON PLAN EMBER 197$SCALED AT 20 FEET TO AN INCH.BOOK 327 PAGE 77. PROPOSED AIR SUPPLY O 2.PLAN ENTITLED°HAWTHORNE TERRACE SHOWING SANITARY/SEWER VENT TO RUN UP SIDE OF SEPTIC TAM(WITH CONNECTIONS AS BUILT",DATED OCTOBER 18,1978,SCALED AT 20 FEET 70 BUILDING TO TOP OF ROOF - ? MICROFAST INSERT AN INCH. W 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 10"DIA m LP ' - - 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE.THIS PLAN IS TO BE USED VENTING PIPE ONLY FOR SEPTIC SYSTEM UPGRADE.JC ENGINEERING WILL NOT ASSUME ANY S 10.3' I LIABILITY FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. 3"DULMIN. / //? a ! DESIGN DATA BLOWER PIPING 21.7- B/FND. i .. (OP 3) LP J3 DIST.) NUMBER OF BEDROOMS(ASSESSORS) 40 >; NUMBER OF BEDROOMS(DESIGN) 40 Lp d• y PROPOSED 6,5W GALLON _ TEST PIT DATA PROPOSED BLOWER • LP 3 PC om" (PC S) X PUMP CHAMBER DESIGN FLOW 110 GnuoaY/BEDRooM TEST PIT DATA LEGEND ON CEMENT PAD TO ' _ - - - TOTAL DESIGN FLOW 4400 GAUDAY - NO BE LOSER FOR X _ _ 19.3' DESIGN FLOW X 200%-= 8800 GAUDAY - - -50-- EXISTING CONTOUR 30.0' USE PROPOSED 9,000&6,000 GALLON TANKS 50 PROPOSED SPOT GRADES MAP 267 ��. -I'. �'; EXISTING MAN HOLE FOR _ _ _ 50 PROPOSED CONTOUR - PARCEL 73 SPRINKLER SYSTEM Samuel White - •r _Ify'' I INSPECTOR: Samuel White INSPECTOR: -E/T7C EXISTING ELECTRICAL UTILITIES AREA=I.SH•ACRES J. INSTALL2-100'x30'LEACHINGFIELDS f 10.0' SOIL EVALUATOR:Samuel Philos Jensen _ SOIL EVALUATOR Samuel Phdos Jensen ' '.•' SIDEWALL CAPACITY April 04,2003 DATE: April 04 2003 r -GAS EXISTING GAS LINE DATE: LEACHING CATCH - 'I.T J '-ti NO SIDEWALL,UREA CREDIT TAKEN TEST PIT M 1 TEST PIT#: 2 _ - -v - EXISTING WATER LINE B.M.Catch Basin BASINS TG CA BOTTOM.CAPACITY - Rim El.,=30.00' Al.(FpT _ =qp- /:�Q - �3 04 PROPOSED(2)3V x Iw - (LENGTH x WIDTH)x(.74 GAUSQ.FT)= GAUDAY ELEV TOP= 32.04' ELEV TOP= 31.82' TEST PIT LOCATION 1:f PAVED i[fi4: - LEACHINGFIELDS (2)(100.0'x30.O')x(.74GAUSO.FTJ- 4,440.0 GAUDAY ELEV WATER= >126"B.G.S, ELEV WATER= OOO PROPOSED 9,000 GALLON SEPTIC TANK PARKING ?!" 37.2' .� _ AREA - ' PERC RATE_ <2 MIN/IN PERC RATE= MIN/IN PROPOSED 6,000 GALLON SEPTIC TANK 1 f r i f DOSING&STORAGE REQUIREMENTS Wl MICROFAST UNIT - ' - - DESIGN FLOW: 4,400 GPD - DEPTH OF PERC= 38'-56' DEPTH OF PERC= r DOSING REQUIRED: 4 CYCLES!DAY TEXTURAL CLASS: 1 TEXTURAL CLASS: 7 O O O -PROPOSED 6,500 GALLON PUMP CHAMBER / '' � 4,400 GPD/4=1.100.0 GAUCYCLE - 4'SOLID SCHEDULE 40 PVC PIPE MAP 267 DISTANCE REQUIRED BETWEEN PUMP 2"SOLID SCHEDULE 40 PVC PIPE _% _ PARCEL 72 ON AND PUMP OFF FLOATS: MAP 267 ' � ' MRCEL 7 1100 GAUCYCLE_ 723 GAUFT=1.52 FT/CYCLE ___--- 2"PERFORATED SCHEDULE 40 PVC PIPE ,c �I-'. (USE 1'-8'TO PROVIDE FOR BACK FLOW) 8^SDR 35 PIPE PARCEL85 - I _ 39.8' �3t8¢ .�. m STORAGE REQUIRED ABOVE WORKING LEVEL:4,400 GAL. 9687') ACTUAL ELEVATION"AS-BUILT' HEYWOOD I J\ ' q ( m STORAGE PROVIDED ABOVE WORKING LEVEL•4,579 GAL ' 11' -e _ 0 32.04' 0 31.82' ,� .I Sandy Loam Sandy Loam 1 }t TOTALS: A 10 YR 3/2 A 10 YR 312 L. .'' S10%Gravel TOTAL LEACHING AREA 6,000 SQ.FT. 12" 31.04' 12" 30.82' Loamy Sand Sandy Loam TOTAL LEACHING CAPACITY 4,440 GAL/DAY B 10 YR 5/6 B 10 YR 4/6 REV. I DATE BY APP'D. DESCRIPTION 1000' �3y PROPOSED4'WYETO. 5-10%Grave1' FESERVEa FOBO "AS-BUILT" DC SYSTEM285 DISTRIBUTE FLOW EQUALLY 2921 39° PREPARED 38" M-CSand M-C Sand Pam z. zsys/4SY HAWTHORNE TERRACE CONDOMINIUMS GAS UNESTO BE FIELD 56° Gm el 10-20%Gravel - ? _ y VERIFIED AND RELOCATED LOCATED AT •'� ' C - 1 AS NECESSARY C r 272 CRAIGVILLE BEACH ROAD HYANNI A 02601 1.00ONTRACTOR TO VERIFY ALL DESCRIPTION HC 1 HC 2 HC 3 - \ - �37� \x UTILITIES BEFORE .- - - + ,4 - SEPTIC COVER IN(1) 69.5' 27.1' _ Terminated due to SCALE: 1 INCH=20 FT. g DATE:JANUARY 13,2004 CONSTRUCTION BEGINS - No Groundwater 0 10 go eo - 2.POSSIBLE FILL LINE AT SO*ON ____ Observed gas Line 25.16' EASTERN SIDE OF TIP 1,VERIFY SEPTIC COVER OUT(2) 58.3' 37.8' 126° 21 54' 80" PREPARED BY: B/FND. AT TIME OFINSTALLANDREMOVE OBSERVATION 49.6' 60.5' ---- .. 11AS-BUILT' JGENGINEERING,INC. CRAIGVILLE BEgCH ROAD SIDEWALK Dlsr.) " AS NECESSARY(SEE NOTE 14) PUBLIC) 3.PROPERTYLOCATEDINA PUMP COVER 2s.s' - zs.s' .. _ I 2854 CRANBERRY HIGHWAY (40'WIDTH- - - _ - - - .1 DEPARTMENT OF ENVIRONMENTAL , PROTECTION APPROVEAZONE2 PUMPCOVEF.(5) 25.3' 15.3' _ ;. PLAN EAST WAREHAM,MA 02538 ' ' 508.273.0377 Day.SJZ OeslgnetlB,.ILC jChttke4By JLC JOB 71 SITE PLAN SHEETI SCALE:1'=20' 1 �+ ALTERNATE TOP SLAB.. - REINFORCED TO MEET - - - - + I-E20 LOADING ADJUST TO REQUIRED 20'MIN.ACCESS COVER(TYPICAL FOR 3) PROVIDE LEBARON MANHOLE COVERS ACCESS TO INSPECT INSTALL 1/4'MESH GRADEMIN-2 OR TO FINISH GRADE FOROR ALL COMPONENTS PUMP OUTS MUST 10•VENTING PIPE SCREEN(SEE MAX.4 BRICK COURSES - BE PROVIDED 6 < BLOWER WITH HOOD INSTALL 1-1/4'PVC TO BUILDING.JOINTS TO BE MADE OR EQUIVALENT - (°MIN. NOTE 8) gy g10-MICROBICSI. ' PROVIDE LEBARON LK-100 FINISH GRADE OVER TANKS EL, WATERTIGHT.WIRE PUMP AND FLOATS TO DUPLEX"PAC-2" DIMENSION WITH DIAJ(SEE NOTE 12) OB24' IA SEE NOTE 1 MANHOLE COVERS TO 31.75' - LEVEL CONTROLLER W/SUBMERSIBLE PRESSURE BELL. HOISTING CABLE 7 x 19 SET FRAME IN FULL BED OF MORTAR REINFORCED OBSERVATION FINISH GRADE FOR ALL STAINLESS STEEL 1/8' MANHOLE FRAME&COVER 7 CONCRETE COLLARS. FINISH GRADE OVER TANKS EL.=31:21'-32.46' PORT COMPONENTS � NEMA4 JUNCTION BOX CORROSION RESISTANT 8 DIA/1,760 LB.STRENGTH 1°DIA DROP FRONT / Nam' - __ '• - _ •-�7 •�': -ins-- UOUID-TIGHT CABLE CONNECTORS SUPPORTED 4"BALL VALVE w/UNIONS TYPE M.H.STEPS BITUMASTIC COATING FOR 2'-0•+/- - ^- 3 DIA = _ CONNECTORS SUPPORTED BY 1-1/4'PVC CONDUIT, SCH-40 PVC T BRACIN ELECTRICAL SANITARY MANHOLE TOP OF TANK SEE .- BLOWER IN CONDUIT(TO JOINTS TO BE MADE WATERTIGHT PRECAST REINFORCED g FLUSH WITH DRAWING RUBS PIPING(SE BLOWER (2)BARNES4SE-L PUMP 275 GPM @ 25'TDH 230 V SINGLE O CONCRETE M.H-CONE , BOTTOM OF HSF 4.SX GASKET CONTROL PHASE 4.5 HP,6.5-IMP.DIA.MODEL#4SE4524L ¢z SECTION - n : CONCRETE LID SYSTEM)SEE 4'-0-DIAMETER w MIN.0.121N-STEEL PROPOSED WITHIN I-1/2" NOTE 3, 'z-cLEA" 8"SDR 35 - 4"SCH.40TO MANIFOLDTO Ww PER VERTICAL FOOT, ' LPROPOSED s,oa q' TREATMENT 4"MANIFOLD - i" 3' m PLACED ACCORDING. 2"DROP MIN. 8"SDR 35 ZONE E o$ TO AASHTO sior= sx 3 3"DROP MAX- 9•f 1 PROPOSED o i xy ox DESIGNATION M799 L=69.00' e.. _ _ I �e 8"SDR 35 /CLEA0TEE T - I 37. 3200'ys Ito a T. I w/CLEAN-OUT - I 4'-0•DIAMETER 28.37J Irpo ax/uc oxJ_ cAP 'HEIGHTOF RISER (2$.9$') 8'-4" INV.OUT E L=490'�5 -{- 18.0 1'CLEAR -2"CLEAR SECTIONS VARY - I LIQUID 28.655' Z$. - - 28.62 uaaM ox I• �p 29.65' 28.90' INFLUENT _ 2$.14 FROM 1'T04' LEVEL / - - -OUTSIDE OF ( (2$.81') WASTE ;,, FAST INSERT \ ,�- 2$.2Z' LEAD OwwG ON to 27.22' - PIPE+2" FROM BID-MICROBICS) 27 17 5"MIN - SETTLING v (27.25�) CLEARANCE Eui'a (27.1 0 _ . 6'CRUSHEDSTONE - ZONE E SEESEE/ LEG EXTENSION INLET TEE 0 4'SCH.40 PVC DISCHARGE PIPE 8"BABE PRECAST ROVIDE•V" - -- OVER MECHANICALLY - 4219 GALLON ( NOTES V NOTE 4 SEE NOTES 6&7 - OPENINGS - - COMPACTED BASE MIN.LIQUID 6"CRUSHED STONE } () RUBBER BOOT AND STAINLESS CEMENT CONCRETE CAPACITY _ _ OVER MECHANICALLY .. - TWO 2-7/4'WEEP HOLE IN DISCHARGE PIPE m - �� 4"BALL CHECK VALVE SCH:40 PVC-100 ItiffiM STEEL BAND CLAMP FOR CLASS"A" (15971L.j SEE , P.S.I.FLOWMATIC OR EQUAL LENGTH 1T-0" WIDTH. 10'-0" .DEPTH 10'-6" - COMPACTED BASE NOTE t0 - LENGTH 17'-0' WIDTH 10'-0' .DEPTH T-9' WIDTH SANITARY PIPE CONNECTION - -- LENGTH 17'-0" - 7'-0" DEPTH 11'-2" - 1'STONE BEDDING -• - - - - LENGTH 17'-0" WIDTH :T-0" DEPTH 11'-2" PIPE OPENINGS TO BE 9,000 GALLON.SEPTIC TANK(LOW PROFILE) 6,000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) 6,500 GALLON PUMP CHAMBER PRECAST IN RISER SECTION - - - - - 14i3 BAR AROUND OPENINGS FOR PIPES - ITDIAMETER AND.OVER,1"COVER _ PROPOSED 9,000 GALLON SEPTIC TANK - - 6,500 GALLON PUMP CHAMBER NOT TO SCALE - - - - - PRECAST CONCRETE PROPOSED 6,000 GALLON SEPTIC TANK& WIDTs ANONGKAASHTOH2CAPABLE GTANKS �1 PROPOSED 6,500 GALLON PUMP CHAMBER - - SHALL BE INSTALLED ON A LEVEL STABLE _ .. . MANHOLE(HZO) : -- - BASE.DIMENSIONS ARE TAKEN FROM ACME - - ( - PRECAST CO.,INC.SPECIFICATIONS - - 'TANK SHALL BE WATERTIGHT NOT TO SCALE : NOT TO SCALE - - - AND WATERPROOFED f-N 'LIFTING HOLE 3•AIRLINE PIPING(TO 3/4"TO 1-112•DOUBLE WASHED STONE TO CROWN OFPIPE 114"PERFORATION TO BE PLACED BLOWER W/HOOD(BYSEE NOTE 5 3"PIPE CAP BLOWER BY BIO-MICROBICSO MIN DIA Pj ) 2"OF 1/8"-TO 1/2"DOUBLE WASHED STONE - IN THE END CAP HORIZONTALLY - BI0.1v11CROBICS)UUT PORT( O - � NEAR THE CROWN OFTHE PIPE ATNOTE4) _ E - FINISH GRADE OVERLEACHING FIELD= 30.2'-31.8' ;THE END OF EACH LATERAL.4" SLOPE @ 2%MIN.OVER SYSTEMza^olA (29.INFLUENT WASTE ; y MANHOLE/OBSERVATIOCTOP OF S.A,S._28_83'- i_FROM SETTLING TQC�' A A" IA 4-WAY TE PORT o - -CONTINUOUS PITCJ TO PUMP CHAMBER OBSERVATION :` 8"DIAPORT(OPTIONAL) \/ FAST 4"SCH.40 FORCE MAIN _LCONCRETE BASE.�Z'SOLIDPVC 2".PERFORATED LATERAL SET (: �II � I -I �I_IJ II- .4,219 10"DIA VENTING PIPE TREATED BOTTOM OF TRENCH TO BE LEVEL EL.= 2$,Q' z T'EFFLUENT 'R - - LEVELINV.ELEV:='1$,rjQ' (28.3�)MIN.L - 7'. - 45'ELBOW -- ELECTRICAL CONDUITCA29 (TYP) 171 c 4 X 2 TEE - (Z8.$') 12"I- 5'MIN. � (TO BLOWER CONTROL(2129O O 4"MANIFOLDS=0.5% - - - 3'MIN.AIR PIPING SYSTEM)EBACK TO FORCE MAIN GROUND WATER ELEVT. SIO-FAS MROBICSODULE Y 3PIPE CAP 6' s"DIAMw FIELD PROFILEBLOWER HOUSING DIMENSIONS BID-MICROBICS..- - ' NOT TO SCALEPUMP �OUT _ P .. - - PORT - - ( .NOT TO SCALE 77"i5'(195-631.3cm) _ 79't.5"(200.731.3cm) - (SEE - .. - - ., NOTE 4) 1/4"PERFORATION A BLOCK CONCRETE THRUSTFINISH GRADE OVER LEACHING FIELD= 30.2'-31.8' -..� 17"--- - - 12" . i5fi" (3156" "' AT 7 O'CLOCK(TYP.) 10, r - SLOPE @ 2%MIN.OVER SYSTEM LENGTH '17'-0" WIDTH 10'-0" DEPTH 7'-9". .-.-. TOP OF BA.S. 28.83' EL 27 7J- (29.13') 2"PVC 6000 GALLON SEPTIC TANK WITH FAST INSERT(LOW PROFILE) DQD p>; PERPDRATEDPIPE NOT TO SCALE - Z.l1 0 O 2",OF 1/8°TO 1!2' - { P" .. ..� .DOUBLE WASHED � m 1.ALL APPURTENANCES TO FAST(EG.SEPTIC TANK,PUMP OUTS,ETC.)MUST CONFORM TO ALL COUNTY,STATE,PROVINCE,AND LOCAL CODES. m p "1 STONE - - .. is O 6 FFE-E .. 2.FOUR-WAY 3'DIA.PVC TEE IS PROVIDED BY THE FACTORY AS WELL AS 3'PVC PIPE EXTENDING HORIZONTALLY FROM THE TEE IN BOTH DIRECTIONS AN O - ( DEPTH DEL=27.60 CAPPED OFF OUTSIDE OF THE MODULE LINER.THE AIRLINE MUST COME IN FROM THE TOP AND ATTACH TO THE PVC TEE. z - - - - 3/4"TO 1-1/2"DOUBLE - 2'LATERAL(v '_ WASHED STONE TO 3.PRIMARY AND SECONDARY TANKS MAY BE ONE DUAL COMPARTMENT TANK WITH A BAFFLE.NOTE:MINIMUM COMPARTMENT DIMENSIONS REMAIN THE 100.0' 6' -6' ' _ 56.5" SAME :. O CROWN OF PIPE 3' 3' i - . : 5/O'CLOCK(TY ON AT O m - 30' 5'MIN. 1 BLOWER HOUSING BASE 4.FAST TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT,MORE THAN ONE IS RECOMMENDED. - n y GROUND WATER ELEV=<21.54' S.FOUR HOLES FOR LIFTING THE FAST LINER ARE SUPPLIED.CONTRACTORSUPPLIED SPREADER BARS ARE TO BE USED IN LIFTING THE UNIT-PLACE - �^ FIELD.END VIEW A-A - DIMENSIONS (SECTION A-A), - - - SPREADERBARSBETWEENLIFTINGHOLES- - - PLAN VIEW - p - - NOT TO SCALE - NOT TO SCALE NOT TO SCALE - � _ - :. - T ANCHOR. 1. BLOWER MUST BE WITHIN 1 H FEET FEET)OF FAST UNIT WITH LESS THAN 4 ELBOWS. BOLTS SEE BOLT LEG ORIGINAL -FOR DISTANCES GREATER THAN 100 FEET-CONSULT FACTORY.BLOWER BASE MUST ORIGINAL EXTENSION FOOT , - ACCESS TO�NSPECT INSTALL 1/4'MESH NOTE 2 /r - - PUMP OUTS MUST 10"DIA VENTING PIPE SCREEN(SEE 9E ABOVE NORMAL FLOOD LEVEL FOOT / TO ORIGINAL 4' --BE PROVIDED(6'MIN. NOTE 8) BLOWER WITH HOOD 2. BIO-MICROBICS REQUIRES THAT PIPING FROM BLOWER TO TANK BE GALVANIZED OR FOOT.SEE SCHEDULE 1.SECURE ORIGINAL 7"X 7"FOOT TO LEG 24-01A - (BY BIO-MICROBICS) CPVC.PIPING INSIDE TANK TO FAST AIRLIFT MUST BE CPVC OR NON-CORROSIVE NOTE 1. 40 PVC PIPE EXTENSION BY PLACING TWO SCREWS IN DIA-)(SEE NOTE 12) 7 a EACH SIDE OF THE LEG EXTENSION.EIGHT - OBSERVATION SEE NOTE 1 MATERIAL DO NOT RUN GALVANIZED PIPE LENGTH INTO TREATMENT TANK SEE PORT BLOWER CONTROL SYSTEM BY BIO-MICROBICS,INC. -- .NOTE 4. O D O H AND 'H `_CUT SECTION SCREWS PER FOOT ARE INCLUDED _ - 4. (11)ORIGINAL FEET ARE ON THE BASE OF THE FAST TREATMENT MODULE. &,-I 8 �� 3.875"- SEEN NOTE 3 SHOULD BE USE N EACH LEG ,3 I T EACH LEG EXTENSION IS TO BE ATTACHED TO THEIR CORRESPONDING I TYP _ _ _, EXTENSIONS. 3 DIA FOOT WITH THE PROVIDED.HARDWARE.SEE LEG EXTENSION DRAWING. �IIIQI�I� BRACING. (-Cm)MIN n PLAN VIEW L ANCHOR �-MODIFIED LEG - 2.ANCHOR ALL LEG EXTENSIONS TO BASS TOP OF TANK SEE ELECTRICAL CONDUIT S. ANCHOR ALL LEG EXTENSIONS TO THE BASE OF THE TANK EXCEPT THE CENTER LEG OF THE TANK EXCEPT THE CENTER LEG ' FLUSH WITH BLOWER (TO BLOWER - EXTENSION.PLACE BOLTS AT OPPOSITE CORNERS OF THE FOOT EXTENSION BASE.IF BOLTS EXTENSION WITH 4' 1 DRAWING RUBE PIPING(SE - SEE PVC PIPE EXTENSION.PLACE BOLTS AT OPPOSITE REV. DATE BY APP-D. DESCRIPTION BOTTOM OF HSF 4.5 X GASKET CONTROL SYSTEM). 'ELONGATING THE LEG EXTENSIONS PAST 23"(58.4cm)IN HEIGHT,THE CENTER LEG PROVIDED12" NOTE 2. - CUT SECTION CORNERS OF THE LEG EXTENSION BASE.IF CONCRETE LID SEE NOTE 3. EXTENSION MUST ALSO BE BOLTED DOWN.ANCHOR BOLTS ARE NOT PROVIDED. LEG EXTENSION ELONGATING THE LEG EXTENSIONS PAST "AS-BUILT"SEPTIC-SYSTEM WITHIN 1-1/2- 6. TO ELONGATE THE FOOT PAST THE PROVIDED tY(30.5cm)EXTENSION,CUT THE 3.9'DIA. _ 23"AN.HEIGHT,THE CENTER LEG EXTENSION PREPARED FOR: TREATMENT LEG EXTENSION (HSF 4.5X) ZONE (9.ecm)LEG EXTENSION INTO TWO SEPARATE PIECES.NEXT.CUTA 4'SCH 40 PVC PIPE TO - SEE NOTE 3. MUST ALSO BE BOLTED DOWN.ANCHOR THE DESIRED LENGTH AND SLIP THE PIPE OVER THE TOP CUT SECTION AND THE BOTTOM HAWTHORNE TERRACE CONDOMINIUMS E - - 024' 024" BOLTS ARE NOT PROVIDED. - - CUT SECTION OF THE LEG EXTENSION.ATTACH PIPE WITH STAINLESS STEEL SCREWS. NON-CORROSIVE � FAST AIR LIFT 7-M7EQUAL ELONGATION MUST BE DONE ON EACH LEG WHEN THE PROVIDED 12"IS FOUND CLAMP EVERY 2 FT (030.5cm) - (030.5cm) INSUFFICIENT 3.TO ELONGATE FOOT PAST THE LOCATED AT _ 7. IF LEGS ARE EXTENDED PAST 48',USE OF SCH 80 OR STRONGER PIPE IS RECOMMENDED. GASKET NON-CORROSIVE GASKET'' PROVIDED 12".CUT THE 3.9"DIA.LEG INFLUENT y ` 8... RUN VENT 10 DIA r0 DESIRED LOCATION AND COVER WffH 1/4'MESH SCREEN.VENT CLAMP EVERY 2 FT EXTENSION IN THE CENTER INTO TWO 272 CRAIGVILLE BEACH ROAD _ RISER _ SEPARATE PIECES.THEN CUT A SCH 40 HYANNIS,MA 02601 WASTE \ MUST NOT CAUSE EXCESSIVE BACK PRESSURE. - .PVC PIPE TO THE DESIRED LENGTH AND `FAST INSERT BY 8'DIA(102cm).. 3'AIR FROM ( 9. PLEASE SEE DRAWING HSF 4.5 X- - - 3'AIR RISER :SLIP THE PIPE OVER THE TOP AND BOTTOM - - SETTLING - "7.6 v- BIQ-MICROBICS) FAST TREATED. 10. COPYRIGHT(C)2001,BIO-MICROBICS,INC.- - SUPPLY - SUPPLY SCALE: N.T.S. -DATE:JANUARY 13,2004 EFFLUENT -� LINE - LINE •CUT SECTIONS OF THE LEG EXTENSIONS ZONE ti. SETTLING TANKS EQUALING 112 X TO 1 X DAILY FLOW MUST BE USED PRIOR TO FAST. EXTENSION NON-CORROSIVE 4 4,ATTACH PIPES WITH STAINLESS STEEL2tj��YLE. SEE NOTES 6&7 12. -FAST TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT-MORE CLAMP EVERY 2 FT GASKET - -GASKET PREPARED BY: SCREWS.IF LEGS ARE EXTENDED PAST 4F'. 4219 GALLON THAN ONE IS REQUIRED- - / NON-CORROSIVE FAST.-' USE OF SCH 80 PIPE IS RECOMMENDED. ' "AS-BUILT" 1 1 JC ENGINEERING,INC. MIN.LIQUID - 13.+;FAST COVERS OVER THE AIRLIFT AND ONE PUMPOUT MUST BE TO GRADE AND FAST AIR LIFT) CLAMP EVERY 2 FT AIR LIFT - - AS-B U I LT CAPACITY SEALED WITH GASKETS-COVEROVERPUMP'CHAMBERMVST.BETOGRADE. - - -- - .''.' - 2854CRANBERRYHIGHWAY - (15971LJ _ _ 14. 10"VENT AND AIR SUPPLY PIPER MUST BE'.PITCHED TOWARDS THE TANK FORIDRAINAGE- '1-' S.THE AIR SUPPLY INTO THE FAST UNIT AIR SUPPLY OPTIONS'SEE NOTE5 MUST.BESECUREDSOASTOPREVENT PLAN EAST WAREHAM,MAOZS3$ SEE NOTE10 6000 GALLON SEPTIC.TANK WITH.FAST INSERT(LOW PROFILE) .15- FIRs7so•oFAiasuPPLYPIPEroBEGALvnmzEo;.,.. _ - ,1 _ 16. UNIT TO BE FIRMLY SECURED TOTHETANKTOPREVENTMOVEMENTINANYDIRECTION. - MICROFAST,�4,5XIDETAILS DAMAGE FROM PIPE VIBRATION: _ 508273.0377 NOT TO SCALE - - 17- VENT LOCATION AND HEIGHT ARE.CRITICAL ' NOT.TO SCALE * JZ JLC / ! .: i Ornwn By.S peslgned By. CM1eGed","J c J B,Na.371 ' }. � I - SHEET2 - ' ALTERNATE TOP SLAB. REINFORCED TO MEET H-20 LOADING 20" MIN. ACCESS COVER (TYPICAL FOR 3) ADJUST TO REQUIRED PROVIDE LEBARON LK-100 MANHOLE COVERS GRADE W/MIN. 2 OR ACCESS TO INSPECT INSTALL 1/4' MESH TO FINISH GRADE FOR ALL COMPONENTS PUMP OUTS MUST 10"VENTING PIPE SCREEN (SEE MAX. 4 BRICK COURSES BLOWER WITH HOOD INSTALL 1-1/4" PVC TO BUILDING. JOINTS TO BE MADE BE PROVIDED (6"MIN. NOTE 8) PROVIDE LEBARON LK-100 FINISH GRADE OVER TANKS EL.= WATERTIGHT. WIRE PUMP AND FLOATS TO DUPLEX"PAC-2" OR EQUIVALENT 24" DIA _ (BY BIO-MICROBICS) , HOISTING CABLE 7 x 19 DIMENSION WITH DIA.)(SEE NOTE 12) OBSERVATION i�V SEE NOTE 1 MANHOLE COVERS TO 31 .75 LEVEL CONTROLLER W/SUBMERSIBLE PRESSURE BELL. SET FRAME IN FULL BED OF MORTAR REINFORCED FINISH GRADE FOR ALL STAINLESS STEEL 1/8" MANHOLE FRAME & COVER CONCRETE COLLARS. FINISH GRADE OVER TANKS EL.- 31 .21'-32.46' PORT COMPONENTS NEMA 4 JUNCTION BOX CORROSION RESISTANT& DIA./ 1,760 LB. STRENGTH 1" DIA. DROP FRONT - _ - LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 4" BALL STEPS BITUMASTIC COATING FOR 2'-0"+/- - 3" DIA - CONNECTORS SUPPORTED BY 1-1/4" PVC CONDUIT, SCH.40 PVC VALVE w/UNIONS TYPE M.H. S S i 1 BRACING ELECTRICAL JOINTS TO BE MADE WATERTIGHT SANITARY MANHOLE TOP OF TANK BLOW)MIN SEE - -- BLOWER CONDUIT(TO PRECAST REINFORCED FLUSH WITH DRAWING RUBB PIPING (SE BLOWER X (2)BARNES 4SE-L PUMP 275 GPM @ 25'TDH 230 V SINGLE CONCRETE M.H. CONE o BOTTOM OF NOTE 2 CONTROL Q PHASE 4.5 HP, 6.5" IMP. DIA. MODEL#4SE4524L U - HSF 4.5 X GASKET � �z 2'_0"+/_ SECTION 4'-0" DIAMETER M -------- - SYSTEM)SEE M CONCRETE LID zp: MIN. 0.12 IN. STEEL PROPOSED WITHIN 1-1/2" NOTE 3. U W PER VERTICAL FOOT, 2"CLEAR 8"SDR 35 i r 40 To '� Uw PROPOSED 35D TREATMENT T -i 4" MAN FOLD - H.40 TO 3" MANIFOLD wZ _ PLACED ACCORDING _ 2 DROP MIN. " ZONE °OTO AASHTO SLOPE 75%mi . t0 3� 3" DROP MAX. 9" q77 ( PROPOSEDo� � 8"SDR 35 iv � ALARM ON DESIGNATION M199 L=69.00 MIN.SLOPE @ 75� _ w/CLEAN OUT O I �� =3 .00' - _ Q _-'SLOPE @.75%min. � rn __ _ ___ - _ CAP 37 28.37' L =49.0' LEAD ON/LAG ON ro 4'-0" DIAMETER HEIGHT OF RISER (28.98') T 8'-4" INV. OUT= in ' ALARM ON L. = 118.0' g�� c-`°,) ill CLEAR SECTIONS VARY I LIQUID 28.29 ) _ 28.62 ; PUMP _00 2 CLEAR 29.65 28.90 28.65 FROM V TO 4' LEVEL INFLUENT `� `� N OUTSIDE OF 28.81' - (28.14 ) 27.22' ( ) WASTE �.,� N FAST INSERT(BY � � LEAD ON/LAG ON<fl FROM BIO-MICROBICS)77, 28.22 M 27.17' " PIPE +2" PUMP ( ) _ o 5"MIN SETTLING ( ,) - 6 CLEARANCE 27.25 ZONE ZrE LEG EXTENSION INLET TEE FF C° 4"SCH.40 PVC DISCHARGE PI6"CRUSHED STONE SEE SEESEE NOTES 6&78" BASE PRECAST ROVIDE "V" OVER MECHANICALLY 4219 GALLON NOTE 5 in NOTE 4 9M - °D " OPENINGS COMPACTED BASE MIN. LIQUID __ ! b _ o TWO(2)- 1/4 WEEP HOLE IN DISCHARGE PIPE CAPACITY 6" CRUSHED STONE N 4"BALL CHECK VALVE SCH.40 PVC 100 RUBBER BOOT AND STAINLESS CEMENT CONCRETE OVER MECHANICALLY (15971L.) X&AAV COMPACTED BASE P.S.I. FLOWMATIC OR EQUAL STEEL BAND CLAMP FOR CLASS "A" LENGTH 17'-0" WIDTH 10'-0" DEPTH 10'-6" NOTE 10 SEE LENGTH 17'-0" WIDTH 10'-0" DEPTH 7'-9" LENGTH 17'-0" WIDTH 7'-0" DEPTH 11'-2" SANITARY PIPE CONNECTION 1'STONE BEDDING LENGTH 17'-0" WIDTH 7'-0" DEPTH 11'-2" PIPE OPENINGS TO BE 9,000 GALLON SEPTIC TANK (LOW PROFILE) 6,000 GALLON SEPTIC TANK WITH FAST INSERT (LOW PROFILE) 6,500 GALLON PUMP CHAMBER _ PRECAST IN RISER SECTION 143 BAR AROUND OPENINGS FOR PIPES 6 500 GALLON PUMP CHAMBER 18" DIAMETER AND OVER, 1"covER PROPOSED 9,000 GALLON SEPTIC TANK , GALLON�V _ PROPOSED 6 000 GALLON SEPTIC TANK & NOTE: ALL TANKS SHALL BE CAPABLE OF NOT TO SCALE PRECAST CONCRETE WITHSTANDING AASHTO H-20 LOADING TANKS MANHOLE (H20} PROPOSED 6,500 GALLON PUMP CHAMBER SHALL BE INSTALLED ONALEVEL STABLE BASE. DIMENSIONS ARE TAKEN FROM ACME "TANK SHALL BE WATERTIGHT NOT TO SCALE PRECAST CO., INC. SPECIFICATIONS AND WATERPROOFED NOT TO SCALE +7� - s._. _... ":=+-.-�Rom'•-.._- .. t- _ ._�. --�.Yr',:��.:y.,r.�3:-�.;'�.;;. -'-s:'�''' ._elf ..,` =t ..- .., j Y~ LIFTING HOLE 3"AIR LINE PIPING TO 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE 3" PIPE CAP ( 1/4" PERFORATION TO BE PLACED BLOWER W/HOOD(BY 6" MIN DIA PUMP (SEE NOTE 5) BLOWER BY BIO-MICROBICS) + 2"OF 1/8"TO 1/2" DOUBLE WASHED STONE IN THE END CAP HORIZONTALLY BIO-MICROBICS) _01NEAR THE CROWN OF THE PIPE AT O OUT PORT(SEE p � ;; FINISH GRADE OVER LEACHING FIELD= 30.2'-31.8' THE END OF EACH LATERAL. 4" '< NOTE 4) ul EM SLOPE @ 2% MIN. OVER SYSTEM INFLUENT WASTE 24"DIA ``' `y - ? (29.13') CO MANHOLE/OBSERVATION 18" TOP OF S.A.S. - 28.83 _ FROM SETTLING TANK �A q 3 DIA 4-WAY TE PORT =- C:) M ce) • CONTINUOUS PITCH BACK _ °O N -- TO PUMP CHAMBER = 6"OBSERVATION 8"DIA FAST E 4" SCH.40 FORCE MAIN _ CONCRETE BASE _ PORT(OPTIONAL) T ,n v r0 I�P&I I I I�M 2 SOLID PVC2 PERFORATED LATERAL SET J I I� I m I H I-I I I� �- 4,219 GALLON r V10" DIA VENTING PIPE TREATED +i _ BOTTOM OF TRENCH TO BE LEVEL EL. = 28•0 MIN. LIQUID EFFLUENT �? *� __ - LEVEL INV. ELEV. = 28•�jQ' � z �-'I I-" T�' 1I- 7" 45' ELBOW (L8.3 ) El ECTR4,'_Pt_(;ONDUt% 5'MIN. CAPACITY (TYP) I` 0 4 X 2 TEE (28'8 ) 12" TO BLOWER CONTROL (21293L.) 4" MANIFOLD S=0.5% 7MIN.AIR PIPING SYSTEM) O O n `�' BACK TO FORCE MAIN GROUND WATER ELEV.= < 21.54' -' TREATMENT FAST MODULE BY 6" DIA MIN FIELD PROFILE. ZONE 3 PIPE CAP 5" BIO-MICROBICS NOT TO SCALE - BLOWER H .t��. Ana« _:�x. - _rt�-.=��r,T�.�= �-��t- PUMP USING DIMENSIONS - r� - - -z--• ;, . _.._'�= _.e _�s ��_.- ----- �_;��.� OUT NOT TO SCALE PORT 77"±.5"(195.6±1.3cm) 79"±.5"(200.7±1.3cm) (SEE CONCRETE THRUST NOTE 4) 1/4" PERFORATION A FINISH GRADE OVER LEACHING FIELD= 30.2'-31.8' 17" 12" BLOCK 156' M AT 7 O'CLOCK(TYP.) 10, F17 5. SLOPE @ 2% MIN. OVER SYSTEM LENGTH 1T-0" WIDTH 10'-0" DEPTH 7'-9" 5' (TYP.) TOP OF S.A.S. = 28.83' "v �'`d EL.=27.75' (29.13') 2"PVC 6000 GALLON SEPTIC TANK WITH FAST INSERT (LOW PROFILE) _ - _ - -- ` � m o0 o co K � PERFORATED PIPE --- _ o D O D o r- D 2"OF 1/8"TO 1/2" _ - NOT TO SCALE M z n A Cam'-' -n DOUBLE WASHED 1. ALL APPURTENANCES TO FAST(EG. SEPTIC TANK, PUMP OUTS, ETC.)MUST CONFORM TO ALL COUNTY, STATE, PROVINCE,AND LOCAL CODES. iL m p m 00 STONE zo t EFFECTIVE 2. FOUR-WAY 3" DIA. PVC TEE IS PROVIDED BY THE FACTORY AS WELL AS 3" PVC PIPE EXTENDING HORIZONTALLY FROM THE TEE IN BOTH DIRECTIONS AND DEPTH M CAPPED OFF OUTSIDE OF THE MODULE LINER. THE AIRLINE MUST COME IN FROM THE TOP AND ATTACH TO THE PVC TEE. R EL.=27.60 I _ ' �_� i O 3/4"TO 1-1/2" DOUBLE Z 2" LATERAL(TYP.) v WASHED STONE TO 2 3. PRIMARY AND SECONDARY TANKS MAYBE ONE DUAL COMPARTMENT TANK WITH A BAFFLE. NOTE: MINIMUM COMPARTMENT DIMENSIONS REMAIN THE 100.0' C CROWN OF PIPE 3' 6' 6' 3, N 56.5" SAME. 1/4" PERFORATION AT A n n 5'MIN. 4. FAST TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT, MORE THAN ONE IS RECOMMENDED. 5 O'CLOCK(TYP.) D 30 - BLOWER HOUSING BASE D GROUND WATER ELEV. < 21.54 5. FOUR HOLES FOR LIFTING THE FAST LINER ARE SUPPLIED. CONTRACTOR-SUPPLIED SPREADER BARS ARE TO BE USED IN LIFTING THE UNIT. PLACE PLAN VIEW M z FIELD_END_ VIEW A-A DIMENSIONS (SECTION A-A) SPREADER BARS BETWEEN LIFTING HOLES. - NOT TO SCALE NOT TO SCALE NOT TO SCALE 1 BLOWER MUST BE WITHIN 100 FEET(30.5M)OF FAST UNIT WITH LESS THAN 4 ELBOWS. ANCHORBOLTS SEE BOLT LEG ORIGINAL FOR DISTANCES GREATER THAN 100 FEET--CONSULT FACTORY. BLOWER BASE MUST NOTE 2. ORIGINAL EXTENSION FOOT ACCESS TO INSPECT INSTALL 1/4" MESH BE ABOVE NORMAL FLOOD LEVEL. FOOT TO ORIGINAL 4" PUMP OUTS MUST 10"DIA.VENTING PIPE SCREEN (SEE 2 FOOT. SEE SCHEDULE 1. SECURE ORIGINAL 7"X 7" FOOT TO LEG BE PROVIDED 6"MIN. NOTE 8) BLOWER WITH HOOD BIO-MICROBICS REQUIRES THAT PIPING FROM BLOWER TO TANK BE GALVANIZED OR 40 PVC PIPE EXTENSION BY PLACING TWO SCREWS IN ( 24"DIA (BY BIO-MICROBICS) CPVC. PIPING INSIDE TANK TO FAST AIRLIFT MUST BE CPVC OR NON-CORROSIVE NOTE 1. NOTE 4. DIA.)(SEE NOTE 12) OBSERVATION SEE NOTE 1 MATERIAL. DO NOT RUN GALVANIZED PIPE LENGTH INTO TREATMENT TANK. SEE 4. EACH SIDE OF THE LEG EXTENSION- EIGHT 3. BLOWER CONTROL SYSTEM BY BIO-MICROBICS, INC. f-CUT SECTION SCREWS PER FOOT ARE INCLUDED AND PORT Z�I SEE NOTE 3. SHOULD BE USED ON EACH LEG 4. (11 ORIGINAL FEET ARE ON THE BASE OF THE FAST TREATMENT MODULE. = 8 3.875" EXTENSIONS. --- 3° IA - EACH LEG EXTENSION IS TO BE ATTACHED TO THEIR CORRESPONDING N TYP FOOT WITH THE PROVIDED HARDWARE. SEE LEG EXTENSION DRAWING. BRACING (7.6cm)MIN 5. ANCHOR ALL LEG EXTENSIONS TO THE BASE OF THE TANK EXCEPT THE CENTER LEG PLAN VIEW ANCHOR MODIFIED LEG 2. ANCHOR ALL LEG EXTENSIONS TO BASE TOP OF TANK SEE - BLOWER ELECTRICAL CONDUIT BOLTS EXTENSION WITH 4" OF THE TANK EXCEPT THE CENTER LEG FLUSH WITH DRAWING RUBB PIPING SE (TO BLOWER EXTENSION. PLACE BOLTS AT OPPOSITE CORNERS OF THE FOOT EXTENSION BASE. IF SEE PVC PIPE EXTENSION. PLACE BOLTS AT OPPOSITE REV. DATE BY APP'D. DESCRIPTION BOTTOM OF ( CONTROL SYSTEM) ELONGATING THE LEG EXTENSIONS PAST 23"(58.4cm) IN HEIGHT, THE CENTER LEG PROVIDED 12" NOTE 2. CUT SECTION CORNERS OF THE LEG EXTENSION BASE. IF n �r CONCRETE LID HSF 4.5 X GASKET NOTE:? SEE NOTE 3. EXTENSION MUST ALSO BE BOLTED DOWN. ANCHOR BOLTS ARE NOT PROVIDED. LEG EXTENSION ELONGATING THE LEG EXTENSIONS PAST AS-BUILT SEPTIC SYSTEM OAAA WITHIN 1-1/2" 6. TO ELONGATE THE FOOT PAST THE PROVIDED 12"(30.5cm) EXTENSION, CUT THE 3.9 DIA. �/ 23" IN HEIGHT, THE CENTER LEG EXTENSION ---- - TREATMENT -- -- (9.8cm)LEG EXTENSION INTO TWO SEPARATE PIECES. NEXT, CUT A 4"SCH 40 PVC PIPE TO LEG EXTENSION HSF 4.5X�SEE NOTE 3. MUST ALSO BE BOLTED DOWN. ANCHOR ems, PREPARED FOR: .,�, y. HAWTHORNE TERRACE CONDOMINIUMS ZONE THE DESIRED LENGTH AND SLIP THE PIPE OVER THE TOP CUT SECTION AND THE BOTTOM BOLTS ARE NOT PROVIDED.E 024" 024" � ioHN L Wm, CUT SECTION OF THE LEG EXTENSION. ATTACH PIPE WITH STAINLESS STEEL SCREWS. NON-CORROSIVE FAST AIR LIFT / CHURCHiLL slit r` M (030.5cm) (030.5cm) ( EQUAL ELONGATION MUST BE DONE ON EACH LEG WHEN THE PROVIDED 12" IS FOUND CLAMP EVERY 2 FT 3. TO ELONGATE FOOT PAST THE � CIVIL 7 LOCATED AT -- ---- INSUFFICIENT. PROVIDED 12", CUT THE 3.9"DIA. LEG 418 GASKET NON-CORROSIVE GASKET ' 7. IF LEGS ARE EXTENDED PAST 48", USE OF SCH 80 OR STRONGER PIPE IS RECOMMENDED. EXTENSION IN THE CENTER INTO TWO 272 CRAIGVILLE BEACH ROAD CLAMP EVERY 2 FT E - � 8. RUN VENT 10"DIA. TO DESIRED LOCATION AND COVER WITH 1/4" MESH SCREEN.VENT RISER SEPARATE PIECES. THEN CUT A SCH 40 HYANN IS, MA 02601 INFLUENT - C9 u MUST NOT CAUSE EXCESSIVE BACK PRESSURE. PVC PIPE TO THE DESIRED LENGTH AND WASTE r? 8"DIA ) . (10.2cm 3"AIR RISER 3"AIR FAST INSERT(BY 9. PLEASE SEE DRAWING HSF 4.5 X. SLIP THE PIPE OVER THE TOP AND BOTTOM _ i 13/ FROM 7 FAST TREATED SUPPLY SUPPLY CUT SECTIONS OF THE LEG EXTENSIONS. SETTLING 3" 7.6cm ! BIO-MICROBICS) EFFLUENT 10. COPYRIGHT(C)2001, BIO-MICROBICS, INC. LINE LINE SCALE: N.T.S. DATE: JANUARY 13, 2004 11. SETTLING TANKS EQUALING 1/2 X TO 1 X DAILY FLOW MUST BE USED PRIOR TO FAST. ZONE _Z LEG EXTENSION NON-CORROSIVE GASKET GASKET 4. ATTACH PIPES WITH STAINLESS STEEL SEE 2 0 SEE SEE NOTES 6&7 12. FAST TANK MUST HAVE A MINIMUM OF ONE ACCESS PORT FOR PUMP OUT. MORE CLAMP EVERY 2 FT SCREWS. IF LEGS ARE EXTENDED PAST 48", PREPARED BY: THAN ONE IS REQUIRED. NON-CORROSIVE FAST �� JC ENGINEERING INC. 4219 GALLON NOTE 5 M NOTE 4 CLAMP EVERY 2 FT AIR LIFT USE OF SCH 80 PIPE IS RECOMMENDED. AS BUILT - --- - - -- - - 13. FAST COVERS OVER THE AIRLIFT AND ONE PUMPOUT MUST BE TO GRADE AND FAST AIR LIFT MIN. LIQUID - _- -- SEALED WITH GASKETS. COVER OVER PUMP CHAMBER MUST BE TO GRADE. 2854 CRANBERRY HIGHWAY - - _ 5. THE AIR SUPPLY INTO THE FAST UNIT CAPACITY 14. 10"VENT AND AIR SUPPLY PIPES MUST BE PITCHED TOWARDS THE TANK FOR DRAINAGE. AIR SUPPLY OPTIONS SEE NOTE 5 MUST BE SECURED SO AS TO PREVENT EAST WAREHAM, MA 02538 (15971L.)SEE NOTE10 6000 GALLON SEPTIC TANK WITH FAST INSERT (LOW PROFILE) 15. FIRST 50'OF AIR SUPPLY PIPE TO BE GALVANIZED. DAMAGE FROM PIPE VIBRATION. PLAN 508.273.0377 16. UNIT TO BE FIRMLY SECURED TO THE TANK TO PREVENT MOVEMENT IN ANY DIRECTION. M I C RO FAST® 4.5 X D ETAI LS NOT TO SCALE 17. VENT LOCATION AND HEIGHT ARE CRITICAL. I Drawn By: SJZ T Designed By. JLC T Checked By:JLC JOB No.371 NOT TO SCALE SHEET 2 GENERAL NOTES S82056'15:V 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE 5.28'1 ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. CB/FND /FND. - kE/VjvEO 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE MAP 267 \ (40,wl°THy P Rc�E 3• 44"SCHEDULE 40 PVC PIPEGN ENGINEER. WITH WATER TIGHT JOINTS SHALL / UBCIC) �' a • i • • s r ' f 8 BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. PARCEL 186 / / `� \ I « r *" « • 4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS GUARINO /32 \, S�2°S202• • Y Q ' " `«i *+• Wt THAN ELEVATION = 29.13' FOR A DISTANCE OF 15'AROUND THE PERIM ETER • « • • •• .SCI1 T OF THE SAS. UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST / SOS • " FIVE FEET FROM S.A.S. AND THE TOP OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. • • w "� • 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. m � _ � N89°30'58"E C, cs � Z EX. iNV.=30.16'± -----� \ \ \ ' 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. _ y�/ 1.46' ! -•'' • • � � 7. LOCAL BOARD OF HEALTH AND r -\--\�v \ \ CB/FND. • k !/ •+•. " • DESIGN ENGINEER TO BE NOTIFIED PRIOR TO \ /� --\-__�(_ \ +� '�"`: D . BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR m \ /\\ \C--\ \ • r s r • i♦ r • i INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING x--X--\___\ \ N MAP 267 , •• �' • /�+ + •r •• • r APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. �\� `'' • ' i ! • + r 8. ELEVATIONS BASED ON N.G.V.D. DATUM OF 30.00'MSL OBTAINED FROM \ \- PARCEL 179� • '' ` • ' �/ CATCH BASIN RIM AS SHOWN ON PLAN. \ +'� N DAWSON r " ; M ;r s * 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING CHAMBERS TO BE - \ • • THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE PUMPED AND FILLED WITH k1'' N r tt s1f i •' • ' w • • 11 I � " " "• • r• AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. EXISTIN " co . •114 Et s ,_I�• •r CLEAN SAND (TYP.) G ,� ' o • . • ♦ • ". • is C ES. REPORT ANY CONDOMINIUM � -�, � PROPOSED SEWER MANHOLE i � + _ t • « � DISCREPANCIES TO THE DESIGN ENGINEER. COMPLEX I 8" INV. OUT= 29.50' + r 2 « • ♦ sr r 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE FIELD VERIFY ANY �• AREA =27 m " .. s i• • r • STRUCTURES,194± I - o i w • SHALL BE MADE WATERTIGHT. ELECTRICAL FLAG SQ•FT SLEEVE SEWER PIPE AT • • • • • # " • � s• . � � 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR WATER MAIN CROSSING d • i ! i• • w • •• 0 0 • ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH 10' EITHER SIDE (TYP.) • •+ , .ih s r " , • ROA " DETERMINATION FROM APPROPRIATE AUTHORITY. PROPOSED 4" SCH. 40 PVC •w s o ■ 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS SLOPE AT 1% MIN. (TYP.) A •♦ •• • s w r •• s • II LOCATED UNDER PAVEMENT DRIVES OR TRAVELED WAYS IN WHICH CASE S I EX. INV.=30.20' (+/-) s . kiAS ' •"R' O _ THEY SHALL WITHSTAND H-20 LOADING. W ► '� Qt r•.• r • •" 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND EXISTING SEPTIC TANKS TO BE----- 3 • •�O r r • `� � �11 FINES. � 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND PUMPED AND FILLED WITH % • rA l� ��" (lr � r u- • o (I • - UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF CLEAN SAND AND BOTTOM TO !� ` oil; * o " LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN BE PUNCTURED (TYP.) � � � If It � i � " _ a V all � • -- • COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN 3 �\ 10 0, PROPOSED 8"SDR 35 �� a �I If / • c� • ACCORDANCE WITH 310 CMR 15.255(3). EX. INV.=30.00'± ---------- PIPE SLOPE AT .75% °1� { • \ - '- 2h f, ` - • = r 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN • • - A SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. 16 ------_-_-_----_---_---=:-:: -=------------- PROPOSED 9,000 . �, 3 ----- ---------------- PRO LOCATED WI 3 L, ASSESSORS MAP PARCEL - _ � - • . • POSED PROJECT IS CATED THIN- EXISTING LEACHING PITS TO BE - O ,! GALLON SEPTIC TANK o "` '' « • 267 73 A T O `� 1 • 17. OWNER OF RECORD: HAWTHORNE TERRACE CONDOMINIUMS PUMPED AND FILLED WITH I = CLEAN SAND (TYP.) ------ -:-- ADDRESS p / - : 272 CRAIGVILLE BEACH ROAD MAP 267 6 MAP 267 \ 3 I HYANNIS, MA 02601 PARCEL 001 18. FEMA FLOOD ZONE C PARCEL 184 co HUGHES LOCUS PLAN AS SHOWN ON COMMUNITY PANEL# 250005 0008 D KARPOVSKY I '� - 3 f ro 19. PLAN REFERENCE: \ i 1. PLAN ENTITLED" HAWTHORNE TERRACE SITE PLAN, WEST PROPOSED AIR SUPPLY 0 :j SCALE: 1" = 1000' HYANNISPORT, BARNSTABLE, MASS, FOR JAMES J. TAYLOR", DATED VENT TO RUN UP SIDE OF � PROPOSED 6000 GALLON 3 SEPTIC TANK WITH SEPTEMBER 1978, SCALED AT 20 FEET TO AN INCH. BOOK 327 PAGE 77. BUILDING TO TOP OF ROOF 3 MICROFAST INSERT 2. PLAN ENTITLED" HAWTHORNE TERRACE SHOWING SANITARY/SEWER w I / CONNECTIONS AS BUILT", DATED OCTOBER 18, 1978, SCALED AT 20 FEET TO 10"DIA. - i AN INCH. VENTING PIPE 0 °' 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. o� 3 o "`'' SC 2) 10.3' f 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED 3"DIA. MIN. Z \ , / 3`L p p 1 - - - - -- - ONLY FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY BLOWER PIPING �(. 21.T DESIGN DATA LIABILITY FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. B/FND. (OP 3) a - �DIST.) LP "'r; (HC 2) NUMBER OF BEDROOMS(ASSESSORS) 40 NUMBER OF BEDROOMS (DESIGN) 40 a. - PROPOSED 6,500 GALLON PROPOSED BLOWER LP (PC 4) 6 (PC 5) PUMP CHAMBER ON CEMENT PAD TO /- 31- � r- DESIGN FLOW 110 GAUDAY/BEDROOM TEST PIT DATA TEST PIT DATA LEGEND BE ENCLOSED FOR I TOTAL DESIGN FLOW 4400 GAUDAY NOISE PROOFING 19.3'` 8800" DESIGN FLOW X 200 % = GAL/DAY - 50 - - EXISTING CONTOUR 30.0' USE PROPOSED 9,000&6,000 GALLON TANKS 50 PROPOSED SPOT GRADES I / MAP 267 I . ' - EXISTING MAN HOLE FOR X x ( / PARCEL 73 SPRINKLER SYSTEMS PROPOSED CONTOUR AREA= 1.5+/-ACRES � �- INSPECTOR: Samuel White INSPECTOR: Samuel White INSTALL 2-100' x 30' LEACHING FIELDS EXISTING ELECTRICAL UTILITIES �.- 10.0' SOIL EVALUATOR:Samuel Philos Jensen SOIL EVALUATOR:Samuel Philos Jensen _ - - SIDEWALL CAPACITY J I DATE: April 04, 2003 April 04, 2003 GAS EXISTING GAS LINE B.M. Catch Basin LEACHING CATCH 'l T_ 1 I--_ NO SIDEWALL AREA CREDIT TAKEN DATE: P Rim Elev. =30.00' :--. BASINS TYP. t ® _ __ _ _ � BOTTOM CAPACITY TEST PIT#: 1 TEST PIT#: 2 W - ---- EXISTING WATER LINE MSL I�30_ PROPOSED (2)30'x 100' LENGTH x WIDTH x .74 GAUSQ.FT. - GAL/DAY ELEV TOP= 32.04' ELEV TOP= 31.82' PAVED LEACHING FIELDS ( ) ( ) TEST PIT LOCATION .- ®-r (2)(100.0'x 30.0')x�.74 GAUSQ.FT.)= 4,440.0 GAUDAY ELEV WATER= >126"B.G.S. ELEV WATER=_ PARKING 37.2' _ _ AREA O 0 O PERC RATE _ <2 MIN/IN PERC RATE __ MIN/IN PROPOSED 9,000 GALLON SEPTIC TANK r DOSING & STORAGE REQUIREMENTS PROPOSED 6,000 GALLON SEPTIC TANK / 1 = DEPTH OF PERC = o Q o 0 _ - DESIGN FLOW: 4,400 GPD DEPTH OF PERC 38"-56" � WN MICROFAST UNIT I I DOSING REQUIRED: 4 CYCLES /DAY TEXTURAL CLASS: 1 TEXTURAL CLASS: 1 ' 4,400 GPD/4= 1,100.0 GAUCYCLE Q Q Q PROPOSED 6,500 GALLON PUMP CHAMBER I/ MAP 267 DISTANCE REQUIRED BETWEEN PUMP 4" SOLID SCHEDULE 40 PVC PIPE 1 PARCEL 72 ON AND PUMP OFF FLOATS: I a P MAP 267 I �o - �� ^ MOCHEN 1100 GAUCYCLE - 723 GAUFT = 1.52 FT/CYCLE 2" SOLID SCHEDULE 40 PVC PIPE (USE V-8"TO PROVIDE FOR BACK FLOW) - - - - - - 2" PERFORATED SCHEDULE 40 PVC PIPE PARCEL 85 39.8' 3 -1.82 J HEYWOOD I ��, = y� STORAGE REQUIRED ABOVE WORKING LEVEL:4,400 GAL. --- 8"SDR 35 PIPE 0) STORAGE PROVIDED ABOVE WORKING LEVEL: 4,579 GAL. 96_87' ACTUAL ELEVATION "AS-BUILT" M 0 32.04' 0 31.82' <'6 0 o TOTALS: A Sandy10 YR 3/2 A Sandy Loam 10 YR 3/2 "' -_ - � 6,000 5-10% Gravel -30 TOTAL LEACHING AREA SQ.FT. 12" 31.04' 12" 30.82' Loamy Sand Sandy Loam 100.0' 1 PROPOSED 4"WYE TO TOTAL LEACHING CAPACITY 4,440 GAL./DAY g 10 YR5/6 g 10 YR 4/6 5-10/o Gravel REV. DATE BY APP,D. DESCRIPTION - - DISTRIBUTE FLOW EQUALLY -- -- I 34" 2g 21' 39" 2$57, RESERVED FOR BOARD OF HEALTH USE �� 11 - - .-- 38" # 11 4 AS-BUILT SEPTIC SYSTEM - - M-C Sand w o '�'� - Perc M C Sand PREPARED FOR: M -_._. -- - /. = GAS LINES TO BE FIELD - - 2.5Y6/4 2.5Y6/4 °r ^cyG HAWTHORNE TERRACE CONDOMINIUMS VERIFIED AND RELOCATED 10-20%Gravel o a JOHN i_ 10-20/o Gravel CHURCH�LL AS NECESSARY C .E.. 56" o J C No 418:,7 LOCATED AT \ 272 CRAIGVILLE BEACH ROAD\ - NOTE: 1. CONTRACTOR TO VERIFY ALL DESCRIPTION HC 1 HC 2 HC 3 HYANNIS, MA 02601 N85°25'46 VV 3�\ UTILITIES BEFORE 3 v \ " \ CONSTRUCTION BEGINS SEPTIC COVER IN (1) 69.5' 27.1' -___ �- - No Groundwater 2. POSSIBLE FILL LINE AT 50"ON Terminated due to SCALE: 1 INCH = 20 FT. DATE: JANUARY 13, 2004 180.00' SEPTIC COVER OUT 2 58.3' 37.8' ---- Observed gas line EASTERN SIDE OF TP 1, VERIFY ( ) 126" 21.54' g0" 25.16' 0 10 20 ao so B/FND. _ SIDEWALK AT TIME OF INSTALL AND REMOVE CRAIGVILLE BEACH - _ (°IST.) AS NECESSARY(SEE NOTE 14) OBSERVATION COVER(3) 49.6' 60.5' ---- � "AS-BUILT ofPREPARED BY: ROAD - 3. PROPERTY LOCATED IN A(40'WIDTH- PUBLIC) �- - - DEPARTMENT OF ENVIRONMENTALPUMP COVER(4) ---- 26.6 29.9JC ENGINEERING, INC. PROTECTION APPROVED ZONE 2 PUMP COVER(5) ---- 25.3' 15.3' 2854 CRANBERRY HIGHWAY PLAN EAST WAREHAM, MA 02538 SITE PLAN- 508.273.0377 SCALE: 1" =20' Drawn By: SJZ Designed By: JLC Checked By:JLC JOB No.371 - _._ SHEET 1 Barnstable kL A \ OWNERS OF RECORD Hawthorne Terrace Condominium Association 5.28' 10.83' Master Deed Book2808 Page 341 CB/FND. CB/FND. � KFNPlan Book 327 Page 77 CraigvilleMAP 267 r \ (40'WIDHPCIRCLEUBLIC) PARCEL 186 ��-` GUARINO �-' '63 S0. KEY MAP N89030'58'E ` Ex. INV.=30.16' X---,.. t��' ` � �` 1.46' LEGEND Y-X V CB/FND. - - CB/FND.El Concrete Bound, Found /\ J( /� - E<T/C - Existing Electrical Utilities �( w Existing Water Line -._X ` ► MAP 267 GAs Existing Gas Line `rn - PARCEL 179 ' ` `"X M TP } Test Hole Location DAWSON �""'�-�� Existing Hedge Row EXISTING CHAMBERS TO BE \ �"� Existing Tree PUMPED AND FILLED WITH CLEAN SAND (TYP.) CONDOMINIUM S "' ' MINIUM r. n ,�'` �'� PROPOSED SEWER MANHOLE COMPLEX j . ,''p ' 8„ INV. OUT=29.50' FIELD VERIFY ANY AREA I ELECTRICAL FLAG _27'194 t SQ•FT. ��' ` SLEEVE SEWER PIPE AT WATER MAIN CROSSING 10 EITHER SIDE(TYP.) PROPOSED 4"SCH.40 PVCrq SLOPE AT 1% MIN. (IYP.) ' f j EX. INV.=30.20'(+/-) W S EXISTING SEPTIC TANKS TO BE PUMPED AND FILLED WITH I O I �, CLEAN SAND AND BOTTOM TO f BE PUNCTURED(TYP.) j � � t � PROPOSED 8"SDR 35 ' EX. INV.=30.00' PIPE SLOPE AT .75% 3 _ .. PROPOSED 9,000 I v ' GALLON SEPTIC TANK EXISTING LEACHING PITS TO BE O i PUMPED AND FILLED WITH O j CLEAN SAND TYP. ,, c 3 N MAP 267 MAP 267 EE PARCEL 001 ' I I J TO PARCEL 184 ' HUGHES I I KARPOVSKY ' X PROPOSED AIR SUPPLY + O 1 O PROPOSED 6000 GALLON VENT TO RUN UP SIDE OF I ' SEPTIC TANK WITH I BUILDING TO TOP OF ,: `� MICROFAST INSERT MAP 267 I ROOF j k 10 DIA. _..._.._ F PARCEL 73 VENTING PIPE M LP I. ' I j I I AREA = 1 .5 +/- ACRES x 3 DIA. MIN. BLOWER PIPING X fi � �' �` . W' .� p,,. � x - ' - 1.0'- -� I� B/FND. -- - - -`_ r LP DIST.) I I x LP _ PROPOSED 6,500 PROPOSED BLOWER , LP "' GALLON PUMP CHAMBER ON CEMENT PAD TO " BE ENCLOSED FOR I . ' _ - 18.3 sW-N k NOISE PROOFING . --� r O O X I -- - MAP 267 ... .�:. : { EXISTING MAN HOLE FOR Sw-W / r 5W-E i PARCEL 73 . I I '' SPRINKLER SYSTEM x AREA= 1.5+/-ACRES .I — ': : — 10.0' B.M. Catch Basin LEACHING Rim Elev. =30.001CATCH BASINS 1 I - >I I MSL (TYP.) �w. R .. 3 0 I :' 1 PROPOSED (2)30'x 100' - - PAVED - .. . �. - 3 j I I I LEACHING FIELDS - PARKING >c AREA - I 1 .I MAP 267 PARCEL 72 X MAP 267 TO I ... I f MOCHEN PARCEL 85 I - ` -39.8'- 131:82 I I ► -- .---.� , �c ! .. .L I �. HEYWOOD ,'m .�,. j I ao �'\. ..�-,'\ - NOTE �. � I j I I � CB/FND. THE 51TE INF©RMATION SHOWN ON THIS PLAN :�.. I (DIST.) WAS TRANSFERRED FROM DIGITAL DATA SUPPLIED BY JC ENGINEERING, INC., EAST WAREHAM, MA \ SIDEWALK ----- ` - - 100.0'- - - - PROPOSED 4"WYE TO - - - DISTRIBUTE FLOW EQUALLY �- --_ RTN #4-1 S 103 AREA OF CLASS A-! �'n - -- -- ' _ V ILLS �A _ HAWTHORNE TERRACE c .T .� '--_-.. .: .: �� _ � : � .� -- rf - RESPONSE ACTION OUTCOME CH ROAD — — — 40� CONDOMINIUM ASSOCIATION � WIDTH - PUBLIC) c%Dennis Cotto,President,272 Craigville Beach Road,Apt.5,Hyannis,MA 02601 -77 Title: IMMMEDIATE RESPONSE ACTION y , K HAWTHORNE TERRACE CONDOMINIUM PLAN�- 17.4' 272 CRAIGVII LE BEACH ROAD,HYAI�INIS,MA Scale 1"=10' 1_ BENNETT & O REILLY, INC. - _ ENGINEERING,ENVIRONMENTAL,&SURVEYING SERVICES _ B/FND. 1573 MAIN STREET,P.O.BOX 1667 PLAN CRAIGVIL (DIST.) BREWSTER,MA 02361 E BEACH — — — --- _ -----� ROAD — — _ PHONE:(508)896-6630 FAX:(508)896-4687 Scale 1"-2O' (40'WIDTH-PUBLIC) - _—` ---- — ----- DATE SCALE BY CHECK JOB NUMBER 12/29/03 1" =20' SEK/e DCB B003-3909 1 _. ..,�.........o..-_......�..r+r..,+:,..n wa..w+..,.�.a erlti.N...na.,ww,w••...mot_..,......,...�. .4..........•. i S p C _ D 1 ) gD EF( F M' � S'� cam•-..,, `.. 1 � e t � l D l ✓� 2 00C t yr'N I + 1 IN, r....✓k i --•-.-.1 �_ �"'---�._, Try�!� � � 1` � 1 �i f I L.F.�4 C tir•. A/T r �N �'� Ul A:_-ram v �►-� (,� i ! \3 t�—r LiG�/ T . t7 e .8 i (� . p _ l F�- ---� , f� i Mt>►'�':.",/CA 5ti rr'Jf.�7/ Y `: > ` �tar,//`� Cirf�.it'/.S 5 &UIZ - ' F'D R PR-A o N fYY q tFY EZ4:>RE � EG C /Y!` £N�lN�:�/2S e!� SU�'YE%'•��/�t�'� :'�t14g1,F�ti,. 7/e /`'L'4!A, •Sf 33 a7A cf-d Uri -- +N n t 5 (e 1`lam- uli& COMO � T 1 I I r TOWN OF BARNSTABLE �� LOCATION SEW.kGE # ` ILLAGE 1 S D ASSESSOR'S AP&LOT INSTALLER'S NAME&PHONE NO. s SEPTIC TANK CAPACITY � LEACHING FACILITY: (type) ` ` � (size) NO.OF BEDROOMS BUILDER OR OWNER , 'e/ PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 lead g •acili Feet Furnished b �. 4 daw7-h6V�A,-P. ? e'rr2gce Coed l` TOWN OF BARNSTABLF LOCATION 7oZ ') 2r SEWAGE# VILLAGEDQ' - J2OQCY ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) OF BEDROOMS OWNER O PERMIT DATE: COMPLIANCE DATE: 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 TOWN OF BARNSTABLE .31V ITS t—� LOC.AIION SEWAGE # VILLAGE N S NAME&PHONE NO. SEPTIC TANK CAPACITY F R7//� f�5P 1'C /a.v LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER i PERMITDATE: COMPLIANCE DATE: 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 s 4' � (9, o �° �� o , � o � �� o O a e n � O � �' - � TOWN OF BARNSTABLE �G�J O�f� G G LOCATION SEWAGE *. VILLAGE ASSESSOR'S MAP &LOT�� INSTALLER'S NAME&PH N SEPTIC TANK CAPACITY iZZC II' LEACHING-FACMITY: (type ! '' t j e) 31� NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE:` -`7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 r � " ' V =1 , TOWN OF IB.AM-' S7AE LE r LOCATION '"'/`1 //�J/r ��j'•�+ � SEWAGE # VILLAGE ASSESSOR'S MAP& LOT INSTALLER'S NAM) &PHONE NO. . e 0-W SEPTIC TANK CAPACITY LEACHING FACII =: (type) f i �-" 1(size) 1000 NO.OF BEDROOMS WC$ o"'—' � un kS 11-11 $ 1-5 UMJ;�ER OR OWNER !!�ZA PERMITDATE: '� ' COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 j'I a I � i9 ref ll�X SN LOCATION ,� SEWAGE PEIMIT NO. VILLAGE INSTA LLER'S NAFAE i ADDRESS r / BUILD//ER OR OWNER .�yf �ofr DATE PERIMIT I S S 0 ED _ /�.. DATE COMPLIANCE ISSUED .21 —? '' i - r �� t l� � �t � � G P � � 4'RY x�� r x � � �o � - - --- 1 i P •�s- �. TOWN OF BARNSTABLE �. IvCKA IGN 0� 9;2 6A051I6 1-dt f drW"11 ""'SEWAGE # VILLAGE Ilu" "� ��r ASSESSOR'S MAP & LOT;Z ]3�'S NAME&PHONE NO. SEPTIC TANK CAPACITY S S` z Ceti LEACHING FACILITY: (type) (size) NO. OF,BEDROOMS BUILDER OR OWNER n/� ��7 ��''�£ '1't' P/pC£ Cs0• OS PERMItDATE: COMPLIANCE DATE: 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 h I o �� b � II ,� a a �, O d O a O �