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Home My WebLink About0217 HORSESHOE LANE - Health L orseshoe Lane ille P 07 099 No. 4210 1/3 ORA Pendaf lexo 10% aoanne {yiwa2d 217 Ko2,3e,3hoe Lane Cente,zviiie, ftzz. 02632 9-1000 gaiion zee/?�Uc tank. 1-6 'X8' gio ck cezzpoo e No dint zigu.tion &ox. X ..9: e � 1,� tl 2 0ATE .71/27103---- PROPERTY AD DRE SS: 217_ No/z,3ezhoe Lane 17azz_----- . --026.12----------------- On the above date, I inspected the septic system ,a1 the above address. Tnis system consists of the loll,owing: 7. 7- 1000 gaieon 3ept.ic .tank. $�.ECE..�NE® ?. No Diz.t2.igu.t.ion &oX. 3. -6 'X8' l39ock ce�s�/zoog. Baseo on my inspection, I certify the following condlllons: JAN 0 6 2004 4. 7h.iz i,3 a �i.t ee rive ze/a.t i.c zyz.tem: (78 Code) TOWN OFBARNSTABLE 5. The 6e/2t jc �3y stem .ins in /22ogerz woak.ing o2dea HEALTH DEPT. at .the /22ezent time. 6. Oaz.te wate2 .i.6 48" Fe eow the ive zt /2.i/2e o� .the ee.6zpooi, SIGNATUR Fame J P . Macomber Jr �orripany : �4 �Qh per_ MdS4mt2�� d_ Son, Inc . C.O� MAP - ----- - ------ PARCEL 0 q9 C use c4LU-,_ °1a - _2Z.632-0066 LOT a^one : 508 . 775_ ) ) )8 _ __ __ ThIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRA NTY Ktly JOSEPH P. MACOMBER- & SON, INC. Tanks-Cesspools•Leachllelds Pumped & Installed Town Sewer Connections P 0 Box 66 Cenlerville, MA 02632,0066 775-3338 775-6412 1. S Ix COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION A �t TITLE 5 OFFICIAL INSPECTION FORM—NOT;FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 217 Ko/tzezhoe Lane en e2v.t TITE, 17 azz. Owner's Name:%hy7 iz ,4y:ewa2rL Owner's Address: 11121103 Date of Inspection: Same Name of Inspector: (please print) jo z e gh %. Na c o m gee aiz. Company Name:7. 2, Nacom9e2 9 Son Inc. Mailing Address: R a 66 Cen e2vi e, Na,37. 02632 Telephone Number: 5 0 8-7 7 5-3 3 3 8 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 too-Section.15:340 of Title 5(310 CMR%15.00). The system: �✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails nre• Date• Inspectors Signat ]� The system inspector shal ubmit 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. 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 Page 2 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:27 7 Ko2,3e shoe .Lane Cen.te2v.i.Q.2e; l'la��. Owner: Ph j.g q��wa2cL Date of Inspection: _1 1/2 1/p 3 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A S stem Passes I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.363 or in 3.10 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: - 7he he t.ic t Z em iz in R!co/2e2 woak ing oadea sty fho nnv sonf rime. B. System Conditionally Passes: 4)V) 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. /,00 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. ND explain: ,/ F_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: 2 rage.) or 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ` CERTIFICATION(continued) Property Address:21 7 Kozze.6hoe Lane Cen e2v.c e, a� Owner: Ph y to i.b y wag Date of lospection: 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. I, 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: X-L� Cesspool or privy is within 50 feet of a surface water DLO 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: &eb The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or rributary to a surface water supply. Al 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 0 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM::INSPECTION FORM r' PART A CERTIFICATION(continued)' Property Address: 217 /lo2zezhoe Lane en te2v1 e, a. -6. Owner: %hy. iiz AyZwazd .Date of Inspection: 11121103 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 SASor cesspool ischarge.or ponding.of effluent to the surface ofthe 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 W squid depth ineesspool is less than 6"below invert or available:volume is less than'h.day flow !s Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number times pumped 0 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 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 i 00.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:anslysis, 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.] . '> (Yes/No)The system fails.I have determined that one or moreof 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 10j000 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 e system is within 206 feet of a tributary.to a surface drinking water supply ea IWPA or a mapped _ the system is located to a nitrogen sensitive area(interim Wellhead ProtectionArea ) pp Zone II of a public water supply well a 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. 4 Page 5 of 1 I OFFICIAL INSPECTION FORM-NOT FORYOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE RISPOSALISYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 217 K o 2,3 e,6 h o v L n n o C ert i-A R 2)J P P D, Q A A Owner:%huLei 3 .Date of Inspection: 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 :�4Were any of the system components pumped out in the previous two weeks? �as 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 Z_ Were all system components,excluding the SAS, located on site? f� 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 deternr'rned based on: Yes no — ZExisting 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(3)(b)] 5 Page 6 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C At SYSTEM INFORMATION Property Address:217 Hoazezhoe Lune en eav-e e, a�s�. Owoer:%fty.e-e.Lb ,4y.ete�¢2C� - Date of-Inspection: 11/21/03 FLOW CONDITIONS ,... RESIDENTLIL Number of bedrooms(design): J Number of bedrooms(actual): DESIGN now based on 310 CMR 15.203 (for example, 110 gpd x N of bedrooms): 2&le Numbcr of current residents: _ Does residence have a garbage p-%__nder(yes or no):. Is laundry on a separate sewage system�,ye�a or no):7V jl(yes separate inspectlon required) m Laundry system inspected (yes or no): L Seasonal use: (yes or no): / 2001=18 D00 a e eons=49, 3Z %[� Water meter readings, i(available (last 2 years usage(gpd)). 9 Sump PAP(Yes or no): _ , yai_Ronz=60. 28 CjlD Last datc.of occupancy; 7W COMM ERCLAUINDUSTRIAL Type of esublishment: �1 Design flow(based on 310 C?*t 15.203); X I- Buis of design now(seaulpersons/sgft,ete.): Grease alp present (yes or no): 4.l Industrial waste holding unk present (yes or no): 24 Non•sanit.ary waste discharged to the Title S system(yes or no):.en ) Water meter readings, i(available; Last date o(occupaney/use: IE OTHER(describe): GENERAL INFORMATION Pumping Records Souicc of information: ItZIVIR 40, 1fI?X Q,? Was system pumped as pan of the inspection(yes or no): If yes, Yolumc pumped: gallons • How was quantity pumped determined? Reason (or pumping: TYPE OF SYSTEM Septic wtY, er-t er , soil absorption system kb�Lnglc cesspool Overflow cesspool t nvy hared system (yes or no)(if yes, attach pr.evlous inspection records, if any) abInnovativc/Ahem&(ive technology, Atuch a copy of the current operation and maintenance contract (to be obtained from system owner) o�Tight tank .41 Atucb a copy of the DEP approval Other(describe): Appr xtmatc ate of all c ponents, date Unstalled (if known)and source of information; .. �� IAV Were sewage odors detected when arriving at the site (yes or no):/j 6 Page 7 or I I OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DI$POSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Addros: 217 llorzze shoe Lane O:wvvr ?h1,4Rk1;A yP�tccrzd Date or lns:pection: 17727103 BUILDINC SEWER(I:ocate on site plan) i/ 4" orzanyeferzy. /z.ipe & �E.ii-i—i.nys Depth below grade:� ��/ .th2ough out .the. zy,3.tem. Materials o.r con struction: east iron 0$40 PVC"Daher(explaEn) Distance from private water supply well or suction line: i Comments(on condition of1'9ints, ventfrtg,evidence of lcaksge;cte.): jo.int,6 aaReaa, .t.iaht. No evidence. o4. .eeakape. The 6y-6.tem .iz vented thrzou h the rzoo e vend.6. SEPTIC TANK: /ems Ay �(locate on site plan) � grade: below D�p th � JJ Material orconstruction: oncre.tc i�—nct�al rtbe.rglass�olycthylene. id oth *explain) e It tanit is metal list age: is age egnrumcd by a Ccklficaic orC-7pliancc(yes or no),.gk(attach a copy or certificate) .• ,, „ � � '� pimens1ons: Sludp depth. Distance from top oorsludgc to bonom oroutici tee or baffler Scum thickncssa , , Distance from top of scum to top or outlet tee or bafflc:��"v Distance from bottom of scum to bottorn of outlet tee or baffle: H.ow.weFe dimensions determined; 1 , 4 o�. Comments.(on pumping recommendations, inlet and outlet tee orba fle condition, structural integrity, liquid levels as rclated.to outlet invert, evi:dcnce of.leakage,etc.): y. Pum the ze .t.ia .tank evert 2--3 earzs, Inee.t & ou.t eet .inverzL3 Z,he .tari `.1 i auc u/za -•,srou'a and 6how.3 no evidence o� eeakaye�Liqu.id eeve� a.t the ou.t.�e.t•- .invea. .ii . CREASE TRAA�Glocate on site plank '� rr, ,,' -r• , Depth below grads:I—f-0 Material of conswction:/ concret mctaLj�,fib erglass,), polyethytcn*6Pother (explairt): Dimensions; &4 Scum thickness: Distance Hotta top of scum to top of outlet(cc yr baffle ?' d—)A Distance from.bottom or scum to bottom of outlet tee or baffle: Date or last plumping:, d2d J Commcnu(on pumping recomntcndations,:Inlet and outlet tee or baffle condition, strucwtl Integrity, liquid levels as related to outlet invert, evidence or leakage,etc): 42ease .trza/? .is noi- /2rze,erzt. , 7 Page 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFICE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 217 Horz,3e,3hoe Lane ,3. Owner: ,7aortne Auewaltd Date of Inspection: L I/7 1/0 3 TIGHT or HOLDING TAN)V2 - (tank must be pumped at time of inspe'ction)(locate on site plan) Depth below.grade: tm Material of construction: concrete metal fiberglass�olyethylene,c>iQ other(explain): Dimensions: Capacity: gallons Design Flow:, AZIA gallons/day Alarm present(yes or no): Alarm level:_A,)A Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): 7.ighf nn hn.Pr/ina fnnk.a nno nnf nnoAoni r DISTRIBUTION BOx&).4e,(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: yQ _ 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.): Diztaigution &ox i,6 not R/zezent. PUMP CHAMBE114 (locate on site plan) Pumps in working order(yes or no):�1 Alarms in working order(yes or no): - Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): P.um.p chamPe2 .is no.t 2�.sont 8 Page 9 of I I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Add ress:21 7 H0'Z'3 _,ihop f.nne C-enIeau, 00a /Yin s6 owner:Phu e-e-iz A(d-ewalzd Date of inspection: 9 9/2 9 /Q 3 — SOIL ABSORPTION SYSTEM (SAS): w®(locate on site plan,excavation not required) 1-6 'X8' Ceo ck ce s,3/zoo-e If SAS not located explain why: Lo ea.t ecl • See 2a GP 10 Type leaching pits, number: 0 lo leaching chambers, number: leaching galleries, number: leaching trenches,number, length: leaching fields, number, dimensions: 26 _ overflow cesspool, number: L— �—ti innovative/altemative system Type/name of technology:z0-/PP' Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): Loa No .3.i yn�3 oLP hydILaa e ie )ea.i.eaae o2 123n azng, 3 oz b ate d2y, Vegetation .ib no zma e. CESSPOOL (cesspool must be pumped as part of inspect ion)(I.ocate on site plan) Number and configuration: / Depth—top of liquid to inlet invert: Depth of solids layer: / � r Depth of scum laver: f Dimensions of cesspool: Materials of constructionMEAc5i. Indication of groundwater inflow(yes or no): ti2� Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Same in iPo)a PRIVY A.,(locate on site plan) Materials of construction: Dimensions: dl�—q Depth of solids: I Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 2.i)U 1A nnf PlzeAcnl, 9 Page 10 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 217 f1o2.6e,3hoe Lane en e2vi e, Ala,3,3. Owner: P hyiiiz Ayiwalzd Dtrte of Inspection: 11121103 SKETCH OF SEWAGE.bISPOSAL 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. 2s/1/d 7 0#.5 <D' S Y 0 '1 / Pr i `6 10 Page I I of I I OFFICLkL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued). Property Address: aoanne. ,4y ewa zd 217 Hnn. oA no famine Owoer:Cen.te�tv.i.e.ee, (3as�. Date of lospectioo: 11121103 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30 feet Please indicate (check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record - If checked, date of design plan reviewed: N,4 _YLSUbserved site (abutting property/observation hole within ISO feet of SAS) No Checked with local Board of Health-explain: N,4 _��Checkcd with local excavators, install r . (a c doc'n Cation) �SAccessed USGS database-explain: h 12• / own. ailnbta�ee. ma. uz. You must describe how you established the high ground water elevation: JZzed: Gah2p1'U R 1I22ea Nndai 12116194 kzouad wa.te2 e.eeva;Lionz a&ove zea .eeve.e. U,3ed: IZS(f'S-0O. ,cnn,)nfinn woPP r/nfri 71-1no 1992 Uzed: gu o0„f n 92 nnni? P.Pn#v #2 ,4rfnua.e gaound wa;tea e.eevice.t.ionz L,caching Pit ,eet 1q �b Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment I.$ ft per Frimpter Method Therefore, the vertical. separation distance between the bosom Of the leaching pit and the adjusted groundwater table is ' feet. 11 • ,' SO I. rr .�_rr-+r+r.-n•.+•nmrs-�r•:i*r.rrr.:•rm*ers•r:.rr-r-i rtrn•a:*�.rrs1 .. .rrt-m^rtr^r-..-., _... 11'OHN OF Barnstable BOARD OF HEALTH SWISURFACF SENAOF D19POSAL SYSTEM IN311FCTION FORM - PART D .- CERTIFICATION •^-•-ri.r.-m•rt.rrir+rt•.r.rTrT-rrir-•.�.-•imrs:r'rrormTcxrc m^m+nz-•w•tcrt mnn•rmr-nrstv+Trnrrrr.•.-r.rrr- r•�. .-. � -TYPE OR PRINT CIXARLY- PROPERTY I NSPEC7'ED STREET ADDRESS 217 Hoe.6ezhoe Lane Cen.te2viiez, Mazz. 0263 ASSESSORS MAP , BLOCK AND PARCEL # A',�r�9! OWNER' s NAME Doane Ryfwaad PART D - CERTIFICATION r NAME OF INSPECTOR Joseph P. Macomber Jr . COMPANY NAME Joseph P. Macomber &'"ton Inc COMPANY ADDRESS Box 66 Centerville Mass 02:632 Street Town or City Stit• t I P COMPANY TELEPHONE ( 508 ) 775-3338 FAX ( 508 ) 790-1.578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage dispos.a7 system nt this address and that the information reported is true., accurate , and omplete as of the time of - inspection- The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Ch/e�one ; • GZ � System PASSED The inspection which I have conducted has not found any information which indicates that th.e system fails to adequately protect public health or Lhe environment as defined in 310 CMR 16 - 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form , System FAILED* ` The inspection which I have co 'acted has found that the system fails to protect the *public health and the environment in accordance with Title 5 , 3.10 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection: form , Inspector Signaturemate COPY of thistt cification must be provided to the "OWNER , the BUYER U.nb here applicable ) and the DOARD OF ,{EAL'I'1( * If the inspection FAILED , th'e owner or " perator shall upgrado * the ayatem within one year of the date of the inspection , unless allowed or required , otherwise as provided in 3.10 CMR 15 , 305 , partd . doc