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Home My WebLink About0161 HARBOR HILLS ROAD - Health 161 HARBOR HILLS RD., CENTERVH,LE e A= UPC 12534 No.2-153LOR HASTINGS,MN commonwealth of Mos=husetts John Grad Executtve Office of Ermronmentoi Affairs -D.E.P. Title V Septic Inspector De�art�nent of - _ - P.O. Box 2119 - Teaticket;MA 02536 . Environmental Protection - (508) 564-68-13 _ Ac- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION F ~� Cf� PART A t AUc /1/RT� - CERTIFICATION �,; Property-Address: 161 Harbor Hufs Rd W.HyannlsPort Address of Owner: 19,96 Date of Inspection:=195 (If different) $ - Leonard DILorenzo:42 Laurel Rldge Rd.N.Kln'* Name of Inspector JohhGracl Company Name,Address and Telephone Number: 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: X Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: 819196 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. .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. INSPECTION SUMMARY: Check A, B.C, or D: A] SYSTEM PASSES: x I have not found any information.which indicates that the system violates any of the failure criteria defined as 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 completion of the replacement or repair, passes inspection. Indicate yes, no,or not determined(Y, N, or ND). Describe basi of determination in all instances. If "not determined", explain why not.) _ The septic tank is metal, cracked,structurally u sound,shows substantial infiltration or exfikration,or tank failure is. imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 11115195) One Winter Street • Boston,Massachusetts 021;08 • FAX(617)556-1049 • Telephone(617)292.5500 1 .......... - - w SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART A- _ - CERTIFICATION (continued) Property Address: 161 Harbor Hills Rd.W.HyannlsPort - Owner: Leonard DlLorenzo:42 Laurel Ridge Rd.N.Kinston R.I. Date of Inspection:V9196 - _ Sewage-backup or breakout or high static water level observed in the distribution box is 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 leveled 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 FUNCTIONING 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 of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 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 volatile organic compounds indicates that the well is free from pollution for that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 m. g q PP 3) OTHER 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 in 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 cesspool. SAS is in hydraulic failure. evised 11115195) 2 SUBSURFACE_SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART A CERTIFICATION (continued) Property Address: 161 Harbor HUis Rd.W.HyannlsPort - - Owner: Leonard OlLorenzo:42 Laurel Ridge Rd N.Kinston R.I. Date of Inspection:819196 D] SYSTEM FAILS(continued) _ 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 112 day flow. _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers 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 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. 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. EJ LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria: The.system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: _ the system is within 400 feet of a surface drinking water supply _ 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) 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. (revised 11115195) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM -PART B - CHECLIST sPort Property Address: 161 Harbor Leonard DlLolrenzo:2 Laurl elR dge Rd.N.Kinston R.I. _Owner: Date of inspection:819196 Check if the following have been.done: _ X Pumping information_was.requested of-the owner,occupant,and Board of Health. -. heand the m has X None of the syst eceiving em components have been pumped for at least two we oduced into the systemtre b ecentlyor aseen rparl of this s flow rates during that period. Large vofumes of water have not been In r inspection. - X As built plans have been obtained and.examined. Note if they are not available with NIA. 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. tic tank was X The septic tank manholes were uncovered,of construction,dimensions depth ond the inter.ior of the f liquid, depth inspected sludge, depth of scum. for condition of baffles or tees,material X 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. x The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11115196) 4 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION _ Property Address: 161 Harbor Hills Rd.w.HyannlsPort Owner: Leonard DlLorenzo:42 Laurel Ridge Rd.N.Kinston R.I. Date_ of Inspection:8J8188 _ FLOW CONDITIONS - RESIDENTIAL: Design flow: 330 gallons Number of bedrooms: 3 - Number of current residents: 1 Garbage grinder(yes or no): Na - - Laundry connected to system(yes or n.o): Yes - Seasonal use(yes or no): Yes Water meter readings,if available: nla Last date of occupancy::summer use COMMERCIAL/INDUSTRIAL: Type of establishment: nla Design flow:0 • gallons/day 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: nla Last date of occupancy: rda OTHER: (Describe) n/a Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: . System has not been pumped In the last two years System pumped as part of inspection: (yes or no)No If yes,volume pumped: 0 gallons Reason for pumping: n1a TYPE OF SYSTEM X Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records,if any) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source information: 1073 Sewage odors detected when arriving at the site: (yes or no) No (revised 11115105) 5 - a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION_ FORM PART C SYSTEM INFORMATION(continued) —Property Address: 161 Harbor Hills Rd.W.HyannisPort Owner: Leonard DlLorenzo:42 Laurel Ridge Rd.N.Kinston R.I. Date of Inspection:818196 -- - SEPTIC TANK_: x _ (locate on site plan) Depth below grade:4'. Material of construction:x concreate_metal FRP_other(explaih) _ Dimensions: L 8'6'H 5'7"W 4'10' - - Sludge depth:3' = Distance from top.of sludge to bottom of outlet tee or baffle: 24' Scum thickness:6" Distance from top of scum to-top.of outlet tee or baffle:6' Distance form bottom of scum to bottom of outlet tee or baffle: 12' 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.) Septic system is,structurally sound.Recommend pumping system every two years for maintenance. GREASE TRAP: (locate on site plan) Depth below grade: n1a Material of construction: _concrete_metal_FRP_other(explain) Dimensions: n1a Scum thickness:n1a Distance from top of scum to top of outlet tee or baffle:Na Distance from bottom of scum to bottom of outlet tee or baffle: n1a 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.) n1a µ (revised 11115195) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 151 Harbor Hills Rd.W.HyannlsPort _ Owner: Leonard.DlLorenzo:42 Laurel Ridge Rd.N.Kinston R 1. Date of inspection:8I9198 _ TIGHT OR HOLDING TANK: (locate dri site plan) ' Depth below grade: rda Material of con struction:_concrete metal_FRP_other(explain) — Dimensions: nla Capacity: n1a gallons Design flow: n1a gallons/day Alarm level: n1a Comments: (condition of inlet-tee, condition of alarm and float switches, etc.) Na . DISTRIBUTION BOX: x (locate on site plan) Depth of liquid level above outlet invert: Uquld 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.) D-box is structurally sound. PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)_ Comments: (note condition of pump chamber,condition of pumps and appurtenances, etc.) nla (revised 11115195) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART C SYSTEM INFORMATION(continued) - Property Address: 151 Harbor Hills Rd.W.HyannisPort Owner: Leonard DILorenzo:42 Laurel Ridge Rd.N.Kinston R.I. _ Date of Inspection:819196 SOIL ABSORPTION SYSTEM (SAS):x - (locate on site plan,if possible; excavation not required, but may be approximated by non-intrusive methods) If not-determined to.be present;explain: rda - Type. _ - leaching pits, number: n1a leaching chambers,number:n/a - leaching galleries, number: n/a. leaching trenches,number, length: rda leaching fields, number, dimensions:n1a .overflow cesspool, number:6x8 block Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) The overflow cesspool and 2'of water in it at the time of the inspection.it is structurally sound and functioning properly. CESSPOOLS:_ (locate on site plan) Number and configuration: Na Depth-top of liquid to inlet invert: n/a Depth of solids layer: n1a Depth of scum layer: n/a Dimensions of cesspool: n1a Materials of construction: n/a Indication of groundwater: n1a inflow(cesspool must be pumped as part of inspection) nla Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Na PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: nia Depth of solids: rda Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) PrivyComments (revised 11115l95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - SYSTEM INFORMATION(continued) Property Address:,:mmarbor.Hills Rd.W.HyannisPort- Owner: Leonard OlLorenzo:42-Laurel Ridge.Rd.N.Kinston R.I. Date of Inspection:11191913. SKETCH OF SEWAGE DISPOSAL SYSTEM: -- include ties to at least two permanent references landmarks or benchmarks - locate all wells within 100' AA 31 3� DEPTH TO GROUNDWATER Depth to groundwater:12 feet method of determination or approximation: IISGS Maps and Charts (revised 11115/95) 9 I. 1 r , vkooe- �o �r tit. , e s TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY. (type) (size) NO.OF BEDROOMS .OWNER 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 a No.. . ---' Fzc� ...................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF H ALTH f'fq✓Ll�. .............O F.. .................................. Apptiration for Dispasa1 Marko (flanstrnr#iun rumit Application is hereby made for a Permit to Construct (61—or Repair ( ) an Individual Sewage Disposal System a Lo�L�ion.- .Ale&------- A'dd s Q Bey or �y� r/ — Owner � Address a .................... � '2./ lam• Installer Address Type of Building Size Lot/Z6 .'5 _____Sq. feet Dwelling—No. of Bedrooms_____________ ____________________________Expansion ttic ( ) Garbage Grinder ( ) p, Other—Type of Building _P No. of persons_______________________ Showers ( ) — Cafeteria ( ) P4 Other fixt es ------------------------------ - W Design Flow_________________ __0___.___________...gallons per person per day. -Total daily flow___.______ {%-&._-___._._.........gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter---------------- Depth.......... x Disposal Trench—No.____________________ Width-------------------- Total Length................... Total leaching area....................sq. ft. Seepage Pit No..... _ _ Diameter____________________ Depth below inlet........ ------- Total leaching area----- _sq. ft. Z Other Distribution box . Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------------------------------------•--•-- Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water-_.-_--_-__-_______-.--- tz., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ P4 ........ O Description of Soil................... W ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be ssued by the board healtt w Date Application Approved By•"/"1_ �iL.L<-- • •••-'•--•••-•••----•-•- �- �.� at Application Disapproved for the following reasons:---------•--------------------------------•------••------•-------------•--------•------------------------------- -----------------------•--- ----------------------------------------------------------------------- -------------------------------------------------------------------------•---------------- Date Permit No......................................................... Issued.__-� - ...... ____ ---'-- -- - -- - -- --------- -- - - -- — - - --- - - - - --- ---- ------Date-- - - ----- -- - ------- ------ Fps;............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH fr f4��' A :.. ............OF... �� '%' furl tom _• �.. Appliratiun for Bhipvii tl Workii Tonfitrnrtinn Pumit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ..- :� . . � ........... ! -- , ...-C_: ° Lo N"p.. .... '� -------------•_.:: i :r�. Location-Address r .........�- — v...... � £ .............................p i ' •: ---------------------------------------- -owner Address r ....................... �___.}- ... �. _a,.-",.✓-'..�........................ .._....-----------'--......_.........................................._......_...............---- r Installer Address Q Type of Building Size Lot.?., ° .fe .Sq. feet V 3 Dwelling—No. of Bedrooms________________ ..........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building 1:2__,:_ ,f ,h 4{No. of -sons --- Showers ( ) — Cafeteria ( ) Otherfixt res ............................... - ----------------•-------------•--•--••-•-------------------------------------------------------------- W Design Flow__________________y__tt_ _.._....__....__..gallons per person per day. Total daily flow____.__._.. _________----.-._.-gallons. WSeptic Tank—Liquid capacity-_----_---__gallons Length................ Width_.._-----..----. Diameter_--.-..------__ Depth---.-----_----- x Disposal Trench—No--------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..._ _. ._ Diameter.................... Depth below inlet....... Total leaching area....�'-r_',_ __sq. ft. ,. Z Other Distribution box O Dosing tank � Percolation Test Results Performed by.......................................................................... Date---------------------------------------- Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.-.-_----------__-_-.--. ;14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------_-_--------_------ ') O Description of Soil------------------ t ' = FiUi ...........................................'.---................. .. W UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ ----------------------------------------------------------- ----------------------------------------------------------------------------------------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI 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. f { r Date----------------- Application Approved By.-°°`�, a "----------------------- » . t�� -- � Application Disapproved for the following reasons:......................... ------------------ Date PermitNo....................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... .............OF... / ............................ �tler�tf ir��r of �nnt�li�nre T S I TO CURTIFY, That the Individual Sewage Disposal System constructed (�, r Repaired ( ) by L i"'ram "= g -- -- �•- --Installerr at._4 g7_2�----------—,) has been installed in accordance with t e provisions of Article XI of The tate `amtary Code as described in the application for Disposal Works Construction Permit No................... dated.._' _____..�. - - . ----------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU RANTt`�E THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................---•-------------................. Inspector.................................................. '-------......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH ..... No...... -•--- --...... FEE- ................. il��tl > rk Tm $rnrinn >Drn�i Permission is-hereby granted-..~_-- � f `=---•-'----�� hart ••-"--•-•..............•------------------- . ------------------•--- to. Constr ct ( or Repair ) arylndivldual Ste Dispo al ystem at No.- ....... '•-• ...... - ---- �.> y •------ f J as shown on the application for Disposal Works Construction Ps it No p Dated } f, '7_ ............11 . --'Boa o ie' X --- ------ ---------- 4d �i� DATE ---- ------ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS