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Home My WebLink About0056 LONG BEACH ROAD - Health 56 LONG BEACH RD. CENTERVILLE ai I rrrmeauQ °�' UPC 12534 No. 2_ 1_ 53LOR '4nr HASTINGS,MN e p� a N.� �� ^`/f.� //fit�O � . �1� ��J'W �� \�� a0& r�( Commonwealth of Massachusetts Title 5 Official Inspection For -TI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r'I 56 Long Beach RoadI Property Address Dennis Farrington -' Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 page. Citylrown 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 forms A. General Information �� a 0 09 on the computer, use only the tab 1. Inspector: key to move your cursor-do not Kevin Usilton use the return Name of Inspector key. Wastewater Treatment Services r� Company Name 44 Commercial Street Company Address Raynham Ma 02767 City/Town State Zip Code 508-880-0233 S113528 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 Furt a"r"r Eva uation;by /eLocal Approving Authority 1/30/18 Inspector's Signa re Date 17 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 off 117e Y V 4 S Commonwealth of Massachusetts w Title 5 Official -Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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: ® 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: The system is operating as designed and under the daily design flow of 220 pd. B) System Conditionally Passes: El 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 Alj Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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. I 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 Fora Subsurface Sewage Disposal System Form Not for Voluntary Assessments 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 page. Citylrown 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 Lt5m. 3113 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 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ElRequired pumping more than 4 times in the last year IVOT 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 w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220gpd Lt5m.•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 ;M s 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 page. City/Town State Zip Code Date of Inspection D. System Information Description: The system is designed for a 2 bedroom home @220gpd. The system includes a 1500 gallon 2 compartment septic tank with a I/A(FAST) technology system in the 2nd compartment for treatment. The treated effluent flows by gravity to a 1,000 gallon pump chamber that feeds a Soils absorbtion system. Number of current residents: 1 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 116gpd 9 ( Y 9 (gp ))� , Detail: The system is under the daily design flow of 220gpd m Sump pump? ❑ Yes ® No Last date of occupancy: currentDate 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 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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: 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ° 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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: 10 years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3+,feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): All piping looks to be in good condition with no signs of leakage. All ventinglooks normal pp 9 9 9 Septic Tank(locate on site plan): Depth below grade: 2+1 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) The septic tank has access covers to grade over the inlet tee and baffle wall for inspections plus pump outs. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallon Sludge depth: 2"-2" 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 'GSM 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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 0" 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 How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No pump out recommended due to low levels of sludge on either side of the baffle wall also no scum layer present in the 1st compartment. The inlet tee and outlet tee's are in good condition with the outlet tee built into the FAST unit. The liquid level is at operating level. The structural integrity of the baffle wall and septic tank are in good condition with no signs of leakage or infiltration. 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 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name . information is required for every Centerville Ma 02632 1/30/18 page. CitylTown 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 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.): 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.): The pump chamber has access cover to grade over the inlet and pumps and floats. The pump and floats are operating as intended with a tank alarm located in the house. * 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: 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 Form -Not for Voluntary Assessments 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: (3) Cultec units ❑ 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.): No signs of hydraulic failure in the observation port, no signs of ponding or damp soils. The vegetation is normal. 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 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments ,M 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts N Title 5 Official Inspection form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Long Beach Road Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 page. Citylrown 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: 3 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: 10/17/2007 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 high ground water from the design plan on record. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 56 Long Beach Road M Property Address Dennis Farrington Owner Owner's Name information is required for every Centerville Ma 02632 1/30/18 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 'ar :.I�, ,�'��SV�;�'� �Wmt� rn mlem m�ne..a.,m,ee.N vwn,�r��A,.�•n w= >w.v ,- I _ L1yT.F�Imwnumr °,.maw....r w..e•mwnu vma ., n „ t . �""��, � ,* �OT.•1`R VON 9AV11 LY1Yt1SAt T1 110J'L f.i_ - - . y. y GENERAL NOTES: I me ? { SOIL TEST PIT DATA =Amafl.all= { f l IrrwrF ec,.mlaE m �� CENTERVILL'E'-RIVER AIL '� ow. ~7. ..,•.�.M� dL .3.8 off' ... - �L. /•• ,- °.r...... w. � £+ AL r t �•N twF i^r ;u DESIGN CRITERIA: „ 6 s I< A L / N 4 µ .S^LT w I aL-, ].e 1 BEDROOMS ATDQG.P.B./D,LC.P.D. UNI1e8 eNezn� _ _ �, REQUIRED SEPTIC TAW: o�Av.11sra s�mummee,inf_en S. .l..t++`4 ..�'R aGo •'2o0R -p:'� _GAL �• .I f Jlt LOT 2O6 SEPTIC TANK PROVIDED: - •i I"`. SIZE OF.LEACHING:FACILITY REQUIREDi 'o^ t, AREA 20 000 S:tF "� '4 z NOTF, TES RI InRo RAIi .TNEEMIRE`SRE.UFS WIENIN�ME. t_ 2 moew :I r' -220 oA tm-ctVQ 'w.ir LFAOIMo'ARG ew.i ascP -- I 20D'.RIVER FRONT CORRIDOR.•--- _ mmooYm uc m cm® SIZE OF LFAd4i;6 FAC6iY PROVIDED:. _ )..L SALT T!1'•-'..�f o•FA uARS '..»�,.'m°w.�orro esNa° s..'e_:W--._�. �_: �i cei} "t, S,,''1'``j c��-Y'`.,*.L 7Y�jI w'.fll.l'`m�*:, ..ny. - I- - _ T LN�e+,4v (-y .,x♦x..e ff♦]x..a T 'IL e.ea2).H.>:•a]1>2eS]•-51,9o.KF. 69 SF_.. `. • {. wr.. _, ,, z',,,.,.� y� i 4..,r. ,. . .:/t� .,;. .\r -...xµ m a';DATUAA` ""f", �tr '�, y ..- _ r �;+✓.. .'°xaeJ ,w , ...,... e r../,'~ 4 .x.5".`» v�y '., ',tC'yµ 'YC,' (}.: ter...,,.,. -..:I,i' .,,'f ::". ,...• ., ; Ir^'. .,JL_, :7+ �.,... "fvERncAi.oATvu NG:V:D :- _, n w -*w. jl.,, ,.. r'' '..r,F,_4a:.r;s:..._.. .t• a ,.1 LocAR wM EPAVEME7IT.LONG. n .:ry s .v. ,'.�# ✓.tl,�.r, tthr _., , "%1. .. .. ,� „"!'k...b5w3R' ..d' ,� ,iBENL17•MARI('..USED;PK,OAv ,(t V'� M_ d+ ,• ., / EAST:,DS°o0.yq 1I+1 , . ;, # �soa OF.,SEWAGE/y :.. .. ,• \,, x.1, a ,eEACH ROAD:':EIEV rDESfG'N .-.,-.'..�,..., R. - ' \: .: ...,, P•... ~.-•. :X.:. ,+ „'.'�- ,,,.,..:y bao ea�w'.. ... __-..I _., t,?...:,yI 4Y ...', ..'sE'"7,, mr.s+G. ,/, :,. st.,..,.;�.�rcr`- ,. I.,1'• . E,OS4.,RQs'D` VV - _ aI '1 .. .� ,.i// ..-, -s <.VARIANl:ES1,REQL'JESTED _ ::_ a .w.d':N Ot� .p:,� v, ."'... .• , .,...:- i y �1AeLArmtec::: u1..:: sll� r S _ z`� ....wv,,;,u.>rxww REPAIR.� .„ .DT1EwNG.. :.ltfattD:lEDpAS; ,„ +-•.. , .• ,°ta•' �''f`LOCAL'BOARD OF.?HEALTH REGULATIONS e'»' .,:cJ!, •'y.FF-s:Ds'� -, ,. :r .y-'n - a r:: L No stnne:TANK:ole.+m�oSAL'snTEM SNAu BFAGH ROAD 'q '� aloaf P ..SALT] / - I MMw.1oD FT.6.ANY.:.nA1FRCWRSE d1.,wEIUND I ^.,»".s. _. _ -• �'X, •:•'1� p .tiNARSN, ,"d uNLES$.oMERNRE SPEQFIFD BY;ME BOARD OF NFJiIM', I, f_- M. r _. f^ r / � TANK IS 47 TROY r - (170 ro+Diw1 saL s vR k i ABsoRBnoN'smcv Is so mL ur'uARSH Uae CEfN(ERVIliCE.MA.. k wA1X w T; rnau rNw.):`" AS9FS50RS�AAAP 206: ;. � � 310 CIAR:;A5 000 TFIE.rS_TATE ENNRONMENT'AL� .r.,a, m _ BEACH CLUB'. tPARGEL I l n� oFuE'z coDE.nTLEI s k - t -.E11f�NE N-,HcOVADE'et of _ FF .,� ', I - - I-,.. r.v 1 r, 1 , e.,, .� -r- .rcL.^,,{� ti :.%"' +'$, t:tttou> ETION ta:2Sa(2'pG BREAK''=EAROlER:17 2p07'. _..a..-,4. ,.... \Y... AI;:,.PEOUF5IEDRMAn.AN:1111'EDGE OF - .V ^ .(fT �[,ws,:re 'h '.-t',:tr .I�,•L�ro BE»ar;EEr.ro.,ME,,EDc�oF.Tn4E sort•-Aesoaena+: ,y„u " ' ^;a'.... y;"„- r .�. :.? I ,,1 a -.- y ,'• JI R 4 r,I,G µ.-. Du ,. ""/ 'I Iz� g11gCRtM 76.155;=57FROH!�RROPERTI•lA7E'TO -- „• uKD:1aEx�Rw .. - ,,�.. ,:.� }p, ..,J .. i♦Rf)V,sEcnON Is.s1n'.-DFID RLS110C114N FOR Trio n.. ' i, :IAtIpA'AgtIP \ TEEE,11O1:'wrolE ,.:',.,-. M �a•,.,. ' ,taco:;QAILdN EII+,,i ; .. RLG1eED- ,Y ;• ". I ,A All, THE�EHI�RE+.,SRE 15 LOCATID�M p ' �• p N. ., - -.,•.,. ,,i" "i,-�,_ I >_../ � , t ,:�0��I �7 Il -e�fEMA ZENE AI3.ELEVATIONY°t� �-"I • I _ ^ly ._f1°4�o �I colniWMln�,NEL:NUNBE!i,.2a00t,,AiOeIL�D ., PIe71V5® h. ',.- - c : '• I �'°7#:\ FEV,ISW.7-2_91.dr'...: ,": A`'r(�FK"`^y+"^Y•w+lw^ e:n.x--.,- -�1 ..ATi_c�n e 'Li. t:173/06`>`. ..ETOStac'rTREEs r•' . \ SILT FDICE - _ t t" '' to �^r4 4. '— T , g .�-1. I 110 GPD%A6 AfltES 239 CPD/AC,+ - rt p \� F, t c4t0 ru7Ac�.p.fL • . � I � �� - MS.GEDR6V1 C{AFmOif t • M. L A , RE1101F _.> 631OCEAN ME* EAST,TRH TD�'PROlE1l'r6D' r% , aw.eRa I iRaPosm X s // vM TNZE.1ATGe(i 7RtRK d r'` �' P3ww.reo�•�y + .\_ ,EXISDND _ um IN"Y FXW RIPBT11017ar, "T" Y-.-•. uaT Oi saL SLT FEMiE: CEDAR SEES_ eeroept) s� - .Rnmra fseE r � VRiif V i ..a.-.,.. � �� ..TL..,�.a ,•- .M, t : \ lh:..'° +tw-41" 4 t'1 Y y�A�.�.•.T�.:Y"wM1aM�T4i.., , �:: 'OIFi11f-OtIT r-'. r 1 , r2 t 1 {y'Lr ,:.i.�5�.?b ,it �i'`5,r,.' .,'` ,e'T%�' k' ..,, R' :t.'3 b`;'` �`I t• ^ L.hz 4.., i. _ _LONG ,BEACH ism:+'' = _.- max u , pp 'ROA #e • r"'''- `._..>; ,' ,_. ,. .' �, �`"�a ��tb '�I'�z w I� ,,�_ h,. ter �y .Lr ,��,p�.tr" per:sEgwgt--�oatA'w- -' 1 ' k � I 44 Commercial Street Please complete all items marked* Raynham, MA. including three signatures. Mail 02767 signed original contract to: Wastewater Treatment Services,Inc. 44 Commercial Street Tel: (508).080-0233 Ravnham,MA 02767 Fax: (503)330-7232 INSPECTION AND EFFLUENT TESTING AGREEMENT Agreement entered into by and between Wastewater Treatment-Services,Inc. (herein called WTS)andAhe 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 redder the following services only: Equipment wiii be iiispec�d at least 2 times per year that this Agreement remains in effect,with the first inspections beginning L/ . These inspections will include: 1) Testing of the sludge depth in the septic tank. 2) Inspection,power testing and clean/replace intake filter of the air blower. 3) Inspection of the alarm system. 4) Inspect overall condition of FAST® System. 5) Notification to OWNER of any pro.blerns encountered. ' 6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parts. WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 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 current labor rates of$78.00 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 resider 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;includingbut not limited to 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. Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS must receive the payment before expiration of the current contract year to assure continuous contract coverage. Failure to return payment may result in suspension of service,cancellation of the contract and/or nullification of warranties, at the election of WTS. OWNER may not assign this contract without the prior written consent of WTS. It will remain in force until a party cancels by written notice to the other at the address given herein. MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE Bio-Microbics MicroFAS 200665 Centerville,MA $240.00 EQUIPMENT OW ER . Wastewater Treatment Services,Inc. *Signed by OWNER: =��1 Dennis Farrington Signed: *Address: 56 Long Beach Ro d 44 Commercial Street Raynham,MA 02767 Tele: (508) 880-0233 *City: State: Zip: Fax: (508) 880-7232 Centerville MA 02632 �/ l Telephone 617-529-5836 Effective Date of Agreement E-Mail address:r dennis.farrington@yahoo.com OWNER understands that(1)ANNUAL RATE payment is for one year only commencing on the effective date set forth above and is non-refundable;and(2)Current DEP Regulations require OWNER to maintain a service agreement for the life of the FAST®S stem. I HAVE READ AND UNDERSTAND THE FOREGOING. *Signed by OWNER: � Effluent Testing Effluent sample taken 2 tim 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 (X )REMEDIAL ( )PROVISIONAL *SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y)or(N) if YES,please attach copy of permit (X)pH,BOD5,TSS,Nitrate,nitrite,TKN,Ammonia ( )Other: *Cost for testing: $290.00/Visit Operator assigned: Michael Moreau Telephone: 508 989-2744 *Approval for Effluent Testing wnLls ignat �`c' i 7 } 1 44 Commercial Street Raynham,MA 02767 Tel: (508)880-0233 Fax: (508)880-7232 August 11, 2017 Mr. Dennis Farrington P.O. Box 279 Barnstable, MA 02630 Reference: Onsite Wastewater Treatment System- Serial Number: 200665 Dear Mr. Farrington: Attached please find the Field Inspection& Service Report and Test Results (as required) for services performed on 7/6/17 at your property located at 56 Long Beach Road, Centerville, MA. Please review the Service Report and Test Results and be sure to refer to the effluent limits set for your property by the Massachusetts Department of Environmental Protection and your Local Approving Authority. Should you have questions on the requirements for your property, please contact our office for further information. Sincerely, cZ Wastewater Treatment Services, Inc. Service Department Enclosures 1 '• I 1 � C O N P a K a l E 0 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsite biomicrobics.com,www.biomicrobics.com, 800-753-FAST(3278) MASSACHUSET'T'S FIELD INSPECTION & SERVICE REPORT For Bio-Microbics FAST°Systems 24522 INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: 56 Long Beach Road Name: Wastewater Treatment Services,Inc. Centerville,MA 02632 Owner Name: Dennis Farrington Mail Address: P.O.Box 279 . Mail Address: 44 Commercial Street Barnstable,MA 02630 Raynham,MA 02767 Phone: 617-529-5836 Fax: e-mail: Phone: (508)880-0233 Fax: (508)880-7232 e-mail: INSTALLATION INFORMATION Model No. Serial No. Startup Date Date of last pump out MicroFAST.5 200665 4/25/2008 10/2013 Approval Type () General () Provisional () Piloting (x)Remedial () General Denite Seasonal Residence ()Yes (x) No EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS. Electrical Panel(s) Visual Alarm Operating N/A Audio Alarm Operating (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Settleable Solids Test Performed x Pump out Required x Primary Settling Zone Sludge Depth 6" Aerobic Treatment Zone Sludge Depth 6" Thickness of Scum Layer 01' Sludge Level Distance to Outlet 11 i Depth of Ponding Within SAS Visual Observation Comments: firm Measurement Comments: EFFLUENT LIMIT RESULT Estimated Daily Flow 220 gpd pH(Standard Units) 6 to 9 Turbidity <40 NTU Dissolved Oxygen >2 Mg/L Color Clear Clear Temperature Odor Not Septic Earthy Effluent Solids (x)None ()Some Effluent Samples Taken: Influent: ()pH ()BOD ()CBOD ()TSS ()TKN ()Nitrate ()Nitrite ()Total Nitrogen()Phosphorus()Spec.Cond. ()Ammonia ()Alkalinity ()Oil/Grease ()VOC ()Fecal Coliform Effluent: (x)pH (x)BOD ()CBOD (x)TSS (x)TKN (x)Nitrate (x)Nitrite ()Total Nitrogen()Phosphorus()Spec.Cond. ()Ammonia () Alkalinity ()Oil/Grease OVOC ()Fecal Coliform Description of any maintenance performed since previous inspection&during this inspection: Cleaned Filter,Checked Splash Recycle Notes and Comments: Please be advised that the alarm associated with this system is not operational.Please call our office at your convenience to discuss repair. CERTIFIED OPERATOR NAME CERTIFICATION NUMBER SERVICE DATE Philip Dwyer 16029 7/6/17 OPERATOR SIGNATURE' Environmental Chemistry Environmental Services Site Assessment An Site Sampling Quality Assurance Services $ C� . IData Auditing C O R P 0 R A `C I O N Mike Moreau CERTIFICATE OF ANALYSIS Wastewater Treatment Services,Inc. REPORTED: 07/26/2017 44 Commercial Street Raynham, MA 02767 ORDER#: G 1715071 COLLECTED BY: P.Dwyer SAMPLE DATE: 7/6/2017 TIME: 10:30 DATE RECEIVED: 7/7/2017 LOCATION: 56 Long Beach Centerville MA SAMPLE ID: Farrington Effluent(S/N 200665) DESCRIPTION: WATER RESULTS OF ANALYSIS I i I - E zs'§ y t 2" .t :._5# '"' s, tA• t Analyttcal Test Parameters LAB-ID#: 1715071-01 Ammonia,Nitrogen 350.1 EPA 350.1 07/13/2017 mg/L 0.10 0.38 BOD , SM 5210B 07/07/2017 mg/L 4.0 <4.0 Kjeldahl,Nitrogen EPA 351.2 07/24/2017 mg/L 0.50 1.95 Nitrate,Nitrogen 4110B SM 4110 B 07/07/2017 mg/L 0.5 40.6 Nitrite,Nitrogen 4110B SM 4110 B 07/07/2017 mg/L 0.25 ND pH SM 4500 H+B 07/07/2017 S.U. 0-14 6.6 Solids,Suspended ISM 2540 D 07/11/2017 mg/L 4 8.0 Robert E. Ij 11 signed by RobeN E. NA=Not Applicable ,9-Roba°E9enuey �,elyyntl I°alanaa a� i. oab®h2o,e:,.net ND=Not Detected Bentley 2'5b"_ Approved By: :.-oala:Z°,.°,.°zo:o:3 <' = Less Than Lab Director / Date *' = Detection Limit Page 1 of 1 Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph:508-946-2225 V✓ �OfSHE Toys Barnstable oT Town of Barnstable AHmeficaCfty BAnNs-r SBLE, ' Board of Health ,ml 9� �679.AIfD MAt a' 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi June 30,2015 Mr. Dennis Farrington Box 279 Barnstable, MA 02630 RE: Sampling of Wastewater Effluent from your Innovative/Alternative (MicroFAST) System at 56 Long Beach Road, Centerville Dear Mr. Farrington, You are granted permission to reduce the frequency of sampling and monitoring of the wastewater effluent from your onsite sewage disposal system consisting of innovative/alternative technology (MicroFAST system/remedial approval) at�46 Long Beach Road, Centerville. A public hearing was held before the Board of Health on June 9, 2015. The Board has received the report of eleven test results with a median Total Nitrogen level of 19.44 mg/liter and a median TKN level of 1.05 mg/liter. This permission is granted with the following conditions: ❖. The wastewater effluent shall continue to be tested once per year. ❖ Operation and Maintenance Inspections shall be conducted on a regular basis in accordance with MA DEP Regulations. S4ARD Wr, hairmanBHEALTH Cc: Barnstable County Health Department Q:\WPFILES\IA Monitoring Adj Farrington LongBeachRd Jun2015.doc zon- /� - XI , ell z � , i�_��_ I .iM 1 ! ii�iiiC�iiiiiii�iiiii s�niiiCi�iiii■�i�i�� ON amon .. ..... ........ommommmmmmmmmmmmmosmmmommmom .. ON MMMmMMmMMmMMMM ON MEMMEMEMMMEMEMMME ON MlMMMMMMMMMMMmMM ME NNE ME ommommmosomms 0 ME 0 Ill OMMOMMEN ME MMMMMMMMMM ME mom ME mommmmosoms MMMMMMMMMmMMMMmMMmMMM moommoom III moommosomm ME Mill mom ME 0 momom 0 MEMSEEMME SO No MMMmMMMMmmMMMMMMMMlm ON MMMMMMMMmMMMMMM MEMO m Ill NNE 0 ME MmMM 0 mr 111 IN ME C ME NNE�■��iiommmmiom ME Min��C 0 NON Ca Mill i ENO nowSNOMEN Ill ME ME ON MOM!Emomomm ME mommoom ME MOMMEMEMEN ON BOH 6/9/15 Dennis Farrington 56 Long Beach Road, Centerville MA 206-011 Town Permit# 2008-131 Remedial- w/nitrogen limits N<19 mg/L per.BOH 2 bedroom, Lot size 20,675 sq ft 2008 Microfast .5 Zoning- CBDCV Per BOH 12/19/07 Quarterly O+M with effluent testing for pH, BOD5, TSS, TN , TKN,Nitrate, and Ammonia Note: Testing has been only done yearly since 2010, but there are 11 tests total (see attached summary) Property was a seasonal rental Recommendation: Effluent testing — once a year during summer season I/A System Sample Report History or Bps 56 Long Beach Road, Barnstable ° , Barnstable County Department of Health and Environment P.O. Box 427, Barnstable, MA 02630 CH Effluent Sample Results Date TN Nitrate Nitrite TKN Ammonia BOD5 TSS pH 07/17/2008 209 17.81.85 1.29 = 8.8 .y 5 7 10/31/2008 13.7 12.8 0.15 0.75 2 2 7.2 R //3_0/20/Y0 0409 21:35 19 7 0.125 1.52 2 10/13/2009 15.4 14.1 0.25 1.05 0.05 2 2 7.6 09/20/2010 19:44 ° 2.15 4.69. 12.6 12.2; 6.1 5 �.. 7.7 ._ 08/09/2011 13.37 11.5 1.87 11.1 14.5 7.3 _ . .a . .. . ._ 08.,/06/2, 012` 14.57 . 13.6 K 0.97 �°r 0.14 2 '2 .7.4 08/05/2013 21.31 20.6 0.71 14 2 2 6.8 . . - - - � �. �08/22/2013 21.31 -, 20.6 0.71 0.14 2 ` 6.8 11/25/2013 28.3 28.3 R 2 2 7.5 210/14/2014 16; 16. 0.159 6.7 Median 19.44 16 0.25 1.05 2 2 7.2 .,89 Influent Sample-Results No Influent Sample Results 06/032015 03:11 pm Page 1 of 1 v LXJY P °FI' T°wti Town of Barnstable Barnstable • 1ARNSTABLE, �Board of Health " "�`ac� � 9 MASS. bMA�a 200 Main Street, Hyannis MA 02601 2007 OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Dennis G. Farrington, PO Box 279, Barnstable,MA 02630 ACKNOWLEDGEMENT: May 1, 2015 Re: 56 Long Beach Woad, Centerville We received your request to review the above mentioned property for reduction of monitoring of your I/A septic system. ",You must supply copies of 8 consecutive monitoring test results prior to May 26, 2015 to us. Vpon doing that, you will be on the agenda for our Board of Yfealth meeting on,dune 9, 2015. Thankyou. Your item will be on Board of Health Meeting on the: Date of: Tuesday, June 9, 2015 You, or a representative for you, is expected to be present to answer questions the Board may have. Meeting Location: Town Hall, 367 Main St, Hyannis Hearing Room, Second Floor Time: 3:00—6:00 P.M. Approximately three days prior to meeting, an agenda will be sent but to you— once it is available. It will also be available on line at the town website: www.town.barnstable.ma.us Go to ..."Boards & Committees > Board of Health - or- Go to Official Agendas Any questions, please call Sharon Crocker a�508-862-4739. Thank you. QAAGENDAS BOHUet Receipt of BOH Submission 56 Long Beach Rd Cent May 12 2015.doc i i -- - --- - - - - -- 00 _ i _-- Commonwealth of Massachusetts 3 Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 56 Long.Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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 A. General Information filling out forms U on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return key. Name of Inspector S.M.Jones Title V.Septic Inspection Company Name 74 Beldan Ln. Centerville Ma 02632 Cityrrown State Zip Code 774-248-4850 smjonestitle5@gmail.com SI4522 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 Evaluation by the Local Approving Authority 7/29/2014 Inspector'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. d q { - 3 � t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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: The dwelling located at 56 Long Beach Rd Centerville is served by a Title V septic system consisting of a 1500 gallon FAST tank, 1500 gallon pump chamber and 3 Cultecs in a 11'x23'xl'trench. The system was found to be in proper working condition 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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 ❑ ® 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-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 M 56 Long Beach Road _ Property Address Georgia Giardini Owner Owner's Name information is Centerville Ma 02632 7/29/2014 required for 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.] ❑ ® 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 CM 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 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 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 M 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 page. Cityrrown 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): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 239 gpd provided 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 M 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 page. Cityfrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 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 Seasonaluse? ® Yes ❑ No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date 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 . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments GSM ,•'' 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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: 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed 4/2008 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): ' Depth below grade: 1 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: 2feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallons Sludge depth: 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 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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 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 How were dimensions determined? measurements were not taken Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was structurally sound, inlet and outlet tees were intact. Blower system was functioning at time of inspection. Covers are to grade. 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 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 page. CityrFown 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 N/A 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.): 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.): Floats were not manually triggered. * 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: t5ins-3113 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 M 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 page. City(rown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number, ® leaching chambers number: 3 Cultecs ❑ 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.): s.a.s. was inspected through the observation port and was found to be dry with no signs of past hydraulic overloading. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 page. Citylrown 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.): s t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 — - I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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 � g •Z � A-i 3-7 r_ A,Z Z7 fb , fj-Z 35 � A3 y 1 3 O �grly� o65E� ►3-3 Yy.c J`. ��r`-� is LP-40s 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 ° M 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 page. Citylrown 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: 3 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 ❑ 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: 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Long Beach Road Property Address Georgia Giardini Owner Owner's Name information is required for every Centerville Ma 02632 7/29/2014 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•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 44 Street i Commercial Pleasd complete all items marked• 'Raynham;"MA including three signatures. Mail signed original contract to: 02767 Wastewatet Treatment Services.Inc. as Commercial street Tel:(508)880.0233 La7mham.M .02767 Fax:(508)880-7232 p 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. i Upon acceptance of this agreement at WTS's office,WTS will render the following services only: i Equipment will be inspected at least 2 times per year that this Agreement remains in effect,with the first inspections beginning These inspections will include: ; 1 1) Testing of the sludge depth in the septic tank. 2) Inspection,power testing and cleanlreplace intake filter of the air blower. 3) Inspection of the alarm system. 4) Inspect overall condition of FAST®System. 5) Notification to OWNER of any problems encountered. 6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parts. WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 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 current labor rates of$78.00 per hour. Emergency serviee 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 I 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, t 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. F t i OWNER understands and agrees that WTS is not responsible for special,incidental or consequential damages,including but not limited to 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. i t Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS must receive the payment before expiration of the current contract year to assure.continuous contract coverage. Failure to return payment may result in suspension of service,,cancellation of the contract and/or nullification of warranties,at the election of WTS. OWNER may not assign this contract without the prior written consent of WTS. It will remain in force until a party cancels by written notice to the other at the address given herein. MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE Bio-Microbics MicroFAST 200665 Centerville,MA $�30.00 EQUIPMENT OWNER Wastewater Treatment Services Inc. *Signed by OWNER: f Georgia Giardini Signed: *Address: ? ? 56 Long Beach Road 44 Commercial Street 1 Raynham,MA 02767 Tele:(508)880-0233 *City: State: Zip: Fax: (508)880-7232 Centerville MA 02632 i Telephone 508-775-0301 Effective Date of Agreement E-Mail address: OWNER understands that(1)ANNUAL RATE_ payment is for one year only commencing on the effective date set forth above and is non-refundable•and 2 Current DfiP Re lati ns re( ) o require OWNER to maintain a � 9 4 service agreement for the life of the FAST®System. I HAVE READ AND UNDERSTAND THE FOREGOING. *Signed by OWNERA- -4- 'v- Effluent Testing Effluent sample taken 2 times per year and delivered to a qualified testing lab for evaluation. Results sent to j State and local Agencies as well as the OWNER. OWNER is responsible for providing acceptable access to 1 effluent to enable a grab sample to be taken for laboratory testing performed. PERMILY *(PLEASE CHECK ONE) { )GENERAL (X)REMEDIAL ( )PROVISIONAL *SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y)or(N)if YES,please attach copy of permit (X)pH,BOD5,TSS,Nitrate,Nitrite,TKN,Ammonia ( )Other: *Cost for testing: $280.00/Visit Operator assigned: ]Michael Moreau Telephone: (508)989-2744 *Approval for Effluent Testing 'U dv�nerl Signature • E. 44 Commercial Street Raynham,MA 02767 Tel: (508)880-0233 Fax: (508)880-7232 January 7, 2014 4 I I p Ms. Georgia Giardini 4702 West Oak Court Palm Beach Gardens,FL 33410-1264 Reference: FAST®Wastewater Treatment System- Serial Number: 200665 Dear Ms. Giardini: Attached please find the Field Inspection& Service Report and test results(as required) for services performed on 11/25/13 at your property located at 56 Long Beach Road, Centerville,MA. Please call if you have any questions or require additional information. , Sincerely, Wastewater Treatment Services, Inc. { Service Department i s Enclosures 1 is R Ir- 1 f , I r 2 !NEA C eA Pa a A TQa a 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707,Fax 913-422-0808 e-mail:�nsiteCa�biomicrobics com,www.biomicrobics.com,800-753-FAST(3278) r FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAS7'System INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: 56 Long Beach Road Name:Wastewater Treatment Services,Inc. Centerville,MA02632 Owner Name:Georgia Giardini j Mail Address: 4702 West Oak Court Mail Address: 44 Commercial Street Palm Beach Gardens,FL 33410-1264 Raynham,MA 02767 i s Phone:56I-627-2285 Fax: e-mail: Phone:(508)880-0233 Fax:(508)880-7232 e-mail: I i INSTALLATION INFORMATION ; Model No. Serial No. Date of Installation Date of Iastpump out i MicroFAST.5 200665 4/25/2008 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating x AudioAiarm Operating x (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pum pout Required x i Primary Settling Zone 12" i Aerobic Treatment Zone 12" EFFLUENT(optional] LIMIT - 'RESULT Estimated Daily Flow 220 gpd pH(Standard Units) i Color Clear 4 Temperature { Odor Eby i Comments: t TECHNICIAN SERVICE DATE f1 Michael Oliveira 1125/t3 { + i 1 Environmental Chemistry Environmental Services * Site Assessment Site Sampling Quality Assurance Services AMIU,cal a2dmce pata Auditing G 0 R P O R A T 1 0 N Mike Moreau CERTIFICATE OF ANALYSIS Wastewater Treatment Services,Inc. 44 Commercial Street REPORTED: 12/04/2013 Raynham, MA 02767 ORDER#: G1363198 COLLECTED BY: M.Oliveria SAMPLE DATE: 11/25/2013 TIME: 9:30 DATE RECEIVED: 11/25/2013 r LOCATION: 56 Long Beach Rd.Centerville,MA SAMPLE ID: Georgia Giardini Grab DESCRIPTION: WATER I RESULTS OF LYSIS f i Test Parameters LAB-W#: 1363199- 1 Ammonia,Nitrogen 350.1 EPA 350.1 12/03/2013 mg/L 0.10 ND i BOD SM 5210B 11/27/2013 mg/L 4.0 <4.0 Kjeldahl,Nitrogen EPA 351.2 11/27/2013 mg/L 0.50 ND Nitrate,Nitrogen 4110B SM 4110 B 11/25/2013 mg/L 0.50 28.3 Nitrite,Nitrogen 411013 SM 4110 B 11/25/2013 ing/L 0.25 ND pH SM 4500 H+B 11/25/2013 S.U. 0-14 7.5 Solids,Suspended SM 2540 D 11/27/2013 mg/L 4 <4.0 NA=Not Applicable ND=Not Detected Approved By: Less Than Detection Limit La anager / Date '*' = RECEIVED t{ e REC.EI ED ULL D 7 i a 1 4: 3 4 t i i � I Analytical Balance Corp., 422 West Grove Street, Middleboro, MA 02346 Ph:508-946-2225 page 1 of 1 THE COMMONWEALT F ASACHUSETS No. 31 ee Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for �Di Poo' bpttem Cor��tr CtiOit Permit � Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No.I-& °may Owner's Name,Address,and Tel.No. e"o>�/fir �l L.., /�a /Z3 Assessor's Map/Parcel Jdco / // D7-17r ajo Ole Installer's Name,Address,and Tel.No. ar4iTk 4.pwl/ Designer's Name,Address and Tel.No. isc Type of Building: Dwelling No.of Bedrooms p Lot Size �Q eao sq. ft. Garbage Grinder (60 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)_ gpd Design flow provided --2,3� gpd T Plan Date OC 7,?� Number of sheets . Revision Date ;2'g`0 t Title �0 1 i T,,0g' Sr L S , 1,, — fC Ze"0 / �c b t� Size of Septic Tank+ KrO4 c /-J,9O A.cJ-,1_Type of S.A.S.ZeNy, j T J-y Description of Soil J Ila Nature of Repairs or Alterations(Answer when applicable) f"),ci- Sy S�`±n A,)I Date last inspected: Agreement: The undersigned agrees to ensure the constr ion and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of t ironmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar alth. Sign Date a7` —® Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Date Issued .t�*.;�1: 'tirr-.,,a., .; ij .. ••"� a^ ,..,,,.,, -..�.�-.F _ +..r .- ..:.--o..•._,., ,.r...r_.. , ,.Y-a;,.v w.,Nr. I Ic A9W44,Ai �9�o Fee /v V � THE COMMONWEALT OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 1 = � ~ " 2pplication f r i o acr ip tent Con!6tr c iota Permit , Application for a Permit to Construct O Repair Zpgrade O Abandon O © Complete System ❑Individual Components..: Location Address or Lot No.T6 `GsJ f �� 5 Owner's Name,Address,and Tel.No. Cam,,fit" 5-1 c, /_4 /73 Assessor'sMap/Parcel Q�, / S3>Y-77t--a7y "a Installer's Name,Address,and Tel.No.�C/?�kyT�`¢ �'✓ Designer's Name,Address and Tel.No. 3 old ` Type of Building: Dwelling No.of Bedrooms � Lot Size sq. ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) + Other Fixtures r� Design Flow(min.required) gpd" Design flow provided d �i , .3S gpd Plan Date OC T /�/o?�f'/ �Number of sheets Revision Date `T-o Title _(1�ti5V r /- �• cts /�is.aaseL �ti°i�`��, ✓�r'�s� }G Lest / cS !1� Size of Septic Tank ISvpGil 11 JU ✓/,i/ �v 4j). Type of S.A.S.r41A'1 1) /v 4 013'.1�,1 Description of Soil ,-� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: f Agreement: d 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 Pe2"thi,. ronmental Code and not to place the system in operation until a Certificate of b4 " pliance has been issued by this Board"of- µ Sign �„ - Date Application Approved by la- % -� Date ,f _ V .. Application Disapproved by: , , Date; f for the following reasons Permit No. Date Issued ————————————-- ——————�— ———— ————THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CE-RRTIFY,,that the On-site Sewage Disposal System Constructed ( ) Repaired (1,/) Upgraded ( ) Abandoned( //)by at �`p Gp- �� y �i!� -� �,. Ile has�een co(%st`ructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Q �' dated Installer ;7 .Yv/a,"/ y S�ir-ls`i�-� Designer #bedroomsa91 " ./�. r� ��,r/�pG� Approved design flow .VV2 • J r gpd The issuance of this,permit shall not be construed as a guarantee that the system/will'fun•tion as des'Qned. ' Date L/� �_ 1 t�U�( Inspector\ / ,{,t.,_ --- ---�j---I— - ----------------------------- Lf i �ti� Fee /C ——— No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH•DIVISION BARNSTABLE, MASSACHUSETTS lwigool �&pgtem C,o 5truction Permit Permission is hereby granted to Construct ( ) Repair ( !/) Upgrade ( ) Abandon ( ) System located at �� y✓ /��G L7 - 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: Constr16ction us completed within three years of the date oYf this p j. f Date �� Approved b � �J pp JUL-01-2008 TUE 01 :33 PM BSC GROUP NORWELL FAX NO. 6173458027 P. 011 Town of Barnstable Regulatory Services Thomas F.Geiler,Director i ; Public Health Division Thomas McKean,Airector 200 Main street, Ryanuis,MA 02601 Fax: 508-790-63()4 Office: 508-862-4644 I)ftte• 980- Sewage Permiit q23 '1 1 Assessor's MaplParcel Installer&Designer-Certification Form CS rt o�/° Installer: Designer: �5C �11 w �CJn s� pry 70 S% Address: Address: �� {� j a�ewb�� A,' e 2-o c-r /1 d� On !�-3-a � l<JvJr��• ts issued a permit to install a (date) (installers) septic system at � Z R�f g&*.,*' based on a design drawn by (address) Rsef e-;�Cj'1,ea dated I� rT a /� de {designer) �I certify that the septic system.referenced above was installed substantially according to V V lateral relocation, of the the design, which may include minor approved changes such as distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.a. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if regWred) was inspected and the soils were found satisfactory. Cri4F�ga .. v . .y t 4 DMAD J. `fa CRISPIN a (I ; er.' Si lure) {; CML No.32112 �i ti.•.tr, \� esigner's Signature) (Affix De-sr3 p Here) P ASE RETURN TQ BARNSTABLE PYTBUIC IEALTIEI AIVISI.ON. CERTIFICATE OF COMPLIANCE 'WILT. NOT IS ISSi7ED UNT1L BOTH Yt THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BANSTABLE PUBLIC 1�ALTH DIVISION. THANK YOU. q:loffice form osigneteertifiastion form.doc SC GRO-OP 4V . March.14, 2008 384 Washington St. Norwell, MA 02o6i Town of Barnstable Board of Health Tel: 781-659`7981 _ Fax: 617-345-8027, 200 Main Street Hyannis, Massachusetts 02601 Attention: Wayne Miller, M.D. Chairman- SUBJECT: Proposed Sewage Disposal SystemA , 56 Long Beach Road Barnstable, Massachusetts Assessors Map 206, Parcel 11 (0'.5 Acres), Dear.Members of the Board of Health: In response to your letter dated December 19, 2008, BSC offers the following: _• Buoyancy calculations have been provided-in Attachment 1. These buoyancy calculations indicate the tanks will not float even if totally submerged and empty. • The groundwater levels were observed at elevation 1.0 during the`.soil evaluation completed for this design. Based on several,other septic designs completed by BSC along Long Beach Road' and for the .1997. approved plan for this site,, elevation 1.9'was the accepted seasonal high water level..-The plans have been edited to-correct.-the scriveners,error of "elevation 1.4" for the seasonal high Y groundwater, elevation to the accepted elevation 1.9 level. This did not substantively change the plans.. " The-septic tank calculation has been revised at,200/o of the daily flow. This did not"effect.the,design.. • The tanks,are proposed to be water-tight by use of bolt-on covers. �. The finished grade has been edited to-lower the grade over the septic tank to correspond to that required to.cover the soil adsorption system. e A two (2)-bedroom Title V deed.restriction was recorded-for the subject property on March 6, 2008,at the Barnstable County Registry of Deeds Book 22730, Page_ . 179. A copy of the recorded deed restri'mon,is provided'as Attachment 2. Engineers •: WPA-Form-5-.Order of.Conditions DEP File•Number SE'3-469'5 issued:by the Environmental ,. f+ Town of Barnstable Conservation Commission was recorded. at the Barnstable Scientists x County Registry of Deeds at'Book 22730, Page 181. Attachment 3 ,provides a copy of.the recorded order of conditions.' _ GIS Consultants t. Landscape .Architects Planners Surveyors Proposed Sewage Disposal System 56 Long Beach Road hBarnstable, MA, March 14, 2008, Page 2 Please call me-at 617-896-4451 if you have any questions or ,require additional - information. Sincerely; B C Group, Inc: . hidJ. Cri pis , PLS Senior Associate cc: Ms.Georgia Giardini,4702 Water Oak Court, Palm Beach Gardens,-FL 33410 • Mr. Rob Gatewood, Conservation Administrator, 200 Main Street, Hyannis, MA 02601 P:\PRJ\4555900\BOH variance\2008-03-14 LET Board of Health Response.doc 3/14200812:40 PM -- c ATTACHMENT 1 ��%i!C I ^'�'�� invert 2.75 liquid level in tank 0 elev bottom tank -1.75 water level 4.5 side end walls depth of submergance 6.25 roof floor walls length 11 33 width 6 33 hieght 7 66 floor thick 0.5 30 roof thick 0.5 wall thich 0.5 weight conc 157 tank weight 25434 soil over tank 2.5 weight soil 85 14025 Total weight 39459 buoynant force 25740 boyant force 13719 negative number means it floats concrete on top thickness 0 feet 0 cf 8832.384 0 pounds boyant force 13719 negative number means it floats invert 2.6 liquid level in tank 0 elev bottom tank -1.9 water level 4.5 side end walls depth of submergance 6.4 - roof floor walls length 8.75 39.375 width 9 39.375 hieght 6 43.75 floor thick 0.5 40 roof thick 0.5 wall thich 0.5 weight conc 157 tank weight 25512.5 soil over tank 2.5 weight soil 85 16734.38 Total weight 42246.88 buoynant force 31449.6 boyant force 10797.28 negative number means it floats concrete on top thickness 0 feet 0 cf 8832.384 0 pounds boyant force 10797.28 negative number means it floats ATTACHMENT 2 Bk 22730 Po 179 � 11826 0 3-06-2 08 a 12 = 13P DEED RESTRICTION WHEREAS, Georgia Giardini of 4702 Water Oak Court. Palm Beach Gardens, Florida, 33410 is the owner of 56 Lone Beach Road located in Barnstable (Centerville),Massachusetts hereinafter referred to as the locus property and being shown on Town of Barnstable Assessors Map 206 as parcel 011, more particularly described in Barnstable County Registry of Deeds Book 11059 page 158. WHEREAS, Georgia Giardini as the owner of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any existing home or newly built home, until such time as public sewer becomes available and is connected to, or until an alternative system can be approved, on said lot as a pre-condition to obtaining a disposal works construction permit in compliance 310 CMR 15.00 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS,the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V., Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, is requiring that the agreement for the restriction on the number of bedrooms in any house on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, NOW, THEREFORE, Georgia Giardini does hereby place the following restriction on her above-referenced land in accordance with this agreement with the Town of Barnstable Board of Health, which restriction shall run with the land until such time as public sewer becomes available and connected to, or until an alternative system can be approved on said lot and shall be binding upon all successors in title: 1. Georgia Giardini agrees that any house located on the locus property shall contain no more than two (2)bedrooms. Georgia Giardini agrees that this shall be a deed restriction, until public sewer is connected to, or until an alternative system can be approved affecting 56 Long Beach Road located in Barnstable (Centerville), MA, and being shown on the Town of Barnstable Assessors Map 206 as parcel 011,more particularly described in Exhibit"A" at Barnstable County Registry of Deeds Book 11059 page 158. For title of the locus property see the following deed: Book 11059, Page 155 Executed as a sealed Instrument P day of /I W f4 acy_'�Q -�7 ` Grt Owner's sima e Owner's signature Owner's signature STATE OF FLORIDA &a cj- C ss 96,1 JQ f'-y Oa 20pL?- Then personally appeared the above-named eO✓�t G,arj��+i known to me to be the person's who executed the foregoing instrument and acknowledged the same to be their free act and deed, before me; STEPHANIE TRETINA Comm#DD0703777 _,titer Notary Public Mores&912011 nsome Fbrin....da Notary Assn.,Inc My c ssion expires: n....... .....e.. ..r.....n nn.. ..e l � (date) P:\PRJ\4555900\BOH vanance\2008-01-15 ao BOH Title 5 Deed Restriction.doc 1/15/2008 4:17 PM REC7EIPT Printed:03-06-2008 @ 12:18:11 BARNSTABLE COUNTY REGISTRY OF DEEDS JOHN F. MEADE, REGISTER Trans#: 53430 Oper:CYNTHB Book: 22730 Page 179 Inst#: 11826 Ctl#: 826 Rec:3-06-2008 @ 12:13:56p BARN 56 LONG BEACH RD DOC DESCRIPTION TRANS AMT 1 GIARDINI, GEORGIA L RESTRICTION County Fee $ 10.00 10.00 Surcharge CPA $20.00 20.00 State Fee $40.00 40.00 Surcharge Tech $5.00 5.00 Total fees: 75.00 Book: 22730 Page: 181 Inst#: 11827 Ctl#: 827 Rec:3-06-2008 @ 12:13:56p BARN 56 LONG BEACH RD DOC DESCRIPTION TRANS AMT 1 GIARDINI, GEORGIA L ORDER County Fee $ 10.00 16.00 Surcharge CPA $20.00 20.00 State Fee $40.00 40.00 Surcharge Tech $5.00 5,00 State/County pg 'adj 6.00- Total fees: 75.00 Ctl#: 828 Rec:3-06-2008 @ 12:13:56p DOC DESCRIPTION TRANS AMT --- ----------- --------- POSTAGE FEE County Postage Fee 2.00 Ctl#: 829 Rec:3-06-2008 @ 12:13:56p DOC DESCRIPTION TRANS AMT -IMPRINT COPY County Imprint Fee 1.00 ***Total charges: 153.00 CHECK PM 1520 153.00 y ATTACHMENT 3 �r Massachusetts Department of Environmental Protection L71� Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code A. General Information Important: Barnstable When filling From: 1.Conservation Commission out forms on the computer, 2. This issuance is for(check one): a. ® Order of Conditions b. ❑ Amended Order of Conditions use only the tab key to 3. To: Applicant: move your cursor-do not Georgia' Giardini use the return a. First Name b.Last Name c.Company key. 56 Long Beach Road d.Mailing Address rah Centerville MA 02362 e.City/Town f.State g.Zip Code 4. Property Owner(if different from applicant): a. First Name b.Last Name c.Company d. Mailing Address T"¢r<y B e.City/Town f.State g.Zip Code - a�+s<,u3�,t 9FD ``m$ Project Location: 56 Long Beach Road Centerville a.Street Address b.Village 206 011 c.Assessors Map Number d.Parcel Number Latitude and Longitude, if known (note: electronic filers will click for GIS locator): e.Latitude f. Longitude 6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Barnstable a.County b.Certificate(if registered land) 11059 155 c.Book d. Page 7. Dates: October 26, 2007 December 18, 2007 DEC 3 12007 a.Date Notice of Intent Filed b.Date Public Hearing Closed c. Date of Issuance B. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Site Plan a.Plan Title BSC Group, Inc. David A. Crispin, P.E. b. Prepared By c.Signed and Stamped by September 1, 2007 1" = 10' d.Final.Rpision Date e.Scale f.Additional Plan or Document Title g.Date wpaform5.doc- rev.3/1/05 Bamstable revised 7/5/2007 Page 1 of 9 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. ❑ Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution d. ❑ Private Water Supply e. ❑ Fisheries f. ® Protection of Wildlife Habitat g. ❑ Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control 2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: a. ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued.A description of the performance standards which the proposed work cannot meet is attached to this Order. c. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified.in the Wetlands Protection Act. Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) 3. ❑ Buffer Zone Impacts: Shortest distance between limit of project disturbance and wetland boundary (if available) a.linear feet Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. ❑ Bank a.linear feet b.linear feet c.linear feet d.linear feet 5. ❑ Bordering Vegetated Wetland a.square feet b.square feet c.square feet d.square feet 6. ❑ Land Under Waterbodies a.square feet b.square feet c.square feet d.square feet and Waterways e.cu.yd dredged f.cu.yd dredged wpaforrn5.doc- rev.3/1/05 Barnstable revised 7/5/2007 Page 2 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code B. Findings (cont.) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 7. ❑ Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feet Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet 8. ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet 9. ® Riverfront area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d.square feet e.square feet f.square feet Sq ft between 100-200 ft 1800 g.square feet h.square feet i.square feet j.square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) 10. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below 11. ❑ Land Under the Ocean a.square feet b.square feet c.cu.yd dredged d.cu.yd dredged 12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13. ❑ Coastal Beaches a.square feet b.square feet c.c/y nourishmt. d.c/y nourishmt. 14. ❑ Coastal Dunes a.square feet b.square feet c.c/y nourishmt. d.c/y nourishmt 15. ❑ Coastal Banks a.linear feet b.linear feet 16. ❑ Rocky Intertidal Shores a.square feet b.square feet 17. ❑ Salt Marshes a.square feet b.square feet c.square feet d.square feet 18. ❑ Land Under Salt Ponds a.square feet b.square feet c.cu.yd dredged d.cu.yd dredged 19. ❑ Land Containing Shellfish a.square feet b.square feet c.square feet d.square feet 20. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a.cu.yd dredged b.cu.yd dredged 21. ® Land Subject to Coastal 1800 Storm Flowage a.square feet b.square feet wpaform5.doc- rev.3/1105 Barnstable revised 7/5/2007 Page 3 of 9 I Massachusetts Department of Environmental Protection ��-- Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster,wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all. administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection"[or, "MA DE P"] "File Number SE3-4695 wpaform5.doc• rev.311/05 Barnstable revised 7/5/2007 Page 4 of 9 J Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of'Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A)to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17.. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission,which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. 18. All work associated with this Order is required to comply with the Massachusetts Stormwater Policy Standards. Special Conditions: If you need more space for additional conditions, select box to attach a text document ❑ wpaform5.doc• rev.3/1/05 Barnstable revised 7/5/2007 Page 5 of 9 Massachusetts Department of Environmental Protection L7 Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No 2. The Barnstable hereby finds (check one that applies): Conservation Commission 3. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: § 237-1 to § 237-14 Town of Barnstable Code a. Municipal Ordinance or Bylaw b.Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. 4. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: § 237-1 to § 237-14 Town of Barnstable Code a. Municipal Ordinance or Bylaw b.Citation The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. If you need more c. The special conditions relating to municipal ordinance or law are as follows: space for P 9 P Y additional See pp. 6.1 and 6.2 conditions, select box to attach a text document wpaforrn5.doc• rev.3/7/05 Barnstable revised 7/5/2007 Page 6 of 9 SE3-4695 Name: Georgia Giardini Approved Plan = September 1, 2007 Site Plan (2 sheets) by David A. Crispin, P.E. Special Conditions of Approval I. Preface Caution: Failure to comply with all Conditions of this Order of Conditions can have serious consequences. The consequence may include issuance of a stop work order,fines, requirement to remove unpermitted structures, requirement to re-landscape to original condition,inability to obtain a certificate of compliance, and more. The General Conditions of this Order begin on page 2 and continue on pages 3 and 4. The Special Conditions are contained on pages 4.1,4.2 and 4.3 if necessary. All conditions require your compliance. II. Prior to the start of work, the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein, General Condition number 8 (recording requirement) on page 3 shall be complied with. 2. It is the responsibility of the applicant, ant the owner and/or successor(s)an d the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work. 3. General Condition 9 on page 3 (sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice one(1)week in advance of the start of work. 5. The work limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer. 6. Staked strawbales backed by trenched-in siltation fencing shall be set along the approved work limit line. Effective sediment controls shall remain until the site is stabilized with vegetation. 7. A sequence of color photographs showing the undisturbed buffer zone shall be submitted to the Conservation Commission. Note:the strawbales and siltation fence must show in the foreground (or bottom of)the photographs. p.6.1 III. The following additional conditions shall govern the project once work begins: 8. A landscaping concept for the septic"mound"shall be developed in consultation with the Conservation Agent. 9. General conditions No. 12 and No. 13 (changes in plan)on page 3 shall be complied with. 10. General condition No. 17(maintaining sediment controls)on page 4 shall be complied with. 11. There shall be no construction disturbance of the site beyond the work limit. 12. The Conservation Commission, its employees, and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 13. This permit is valid for three(3)years from the date of issuance, unless extended by the Commission at the request of the applicant.Caution: a future Amended Order does not change the expiration date. 14. This approval is contingent upon the approval of the Board of Health for the subsurface sewage disposal system. 15. Any fill used for this project shall be clean fill. Fill shall contain no trash,refuse,rubbish, or debris. 16. During construction,no area shall be left unmulched or unvegetated for more than 30 days. All areas disturbed during construction shall be revegetated immediately following completion of work at the site. Mulching shall not serve as a substitute for the requirement to revegetate disturbed areas at the conclusion of work. 17. The landscaping concept, once approved by the Conservation Agent, shall be imp lemented. IV. After all work is completed,the following condition shall be promptly met: 18. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance. Where a project has been completed in accordance with plans stamped by a registered professional engineer, architect,landscape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance.At the time of the request for a Certificate of Compliance,an updated sequence of color photographs of the undisturbed buffer zone shall be also submitted. p.6.2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code E. Issuance This Order is valid for three years, unless otherwise specified as a special DEC 3 1 2007 condition pursuant to General Conditions#4, from the date of issuance. 1.Date of Issuance Please indicate the number of members who will sign this form: This Order must be signed by a majority of the Conservation Commission. 2.Number ol Signers The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office, if not filing electronically, and the property owner, if different from applicant. ---� Signatures:,,--- ._ Notary cknowledgement Commonwealth of Massachusetts County of On this Day of Month Year Before me, the undersigned Notary Public, &AN personally appeared Name of Document Signer proved to me through satisfactory evidence of identification, which was/were Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of Barnstable Conservation Commission City/Town Signature of Notary Public CLAUDETTE BOOKBINDER Printed Name of Nota lic; NOTARY PUBLIC Place notary seal and/or any stamp above I ; :: 'i:0[t�MONN�EAITN OF hAASSACN'JSETTS My Commission Exp e w6) MY COMMISSION EXPIRES 11/21/08. This Order is issued to the applicant as follows: ❑ by hand delivery on by certified mail, return receipt requested, on OEC 3 1 2007 Date Name Signature Date wpafonn5.doc- rev.3/1105 Barnstable revised 7/5/2007 Page 7 of 9 Massachusetts Department of Environmental Protection �•— Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - .Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code F. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office b issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project. Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order or Determination, or providing written information to the Department prior to issuance of a Superseding Order or Determination. The request shall state clearly and.concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, §40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. Section G, Recording Information is available on the following page. wpaform5.doc• rev.3/1/05 Barnstable revised 7/5/2007 Page 8 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: ` WPA Form 5 - Order of Conditions SE3- 4695 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of this form shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------------------------------- To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 56 Long Beach Road, Centerville, MA 02632 SE3-4695 Project Location DEP File Number BARNSTABLE REGISTRY OF DEEDS Has been recorded at the Registry of Deeds of: Barnstable 2 k 22.73 0 F":9 I County Book Page for: 03-06-2 I0 8 12 a 13P3. Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant wpaform5.doc• rev.311/05 Barnstable revised 7/5/2007 Page 9 of 9 �oFt► roh� Town of Barnstable y�P Conservation Commission saxxsTAs , = 200 Main Street Hyannis Massachusetts 02601 fD MA'1 Office: 508-862-4093 FAX: 508-778-2412 Enelosures to be returned to the Conservation Commission 200 Main Street Hyannis,MA 02061 Dear Applicant: Please find attached Forms A,B and C referenced in the Special Conditions Section of your enclosed Order of Conditions. ® Forms A and B must be fully executed and returned to the Conservation Commission prior to the start of work. ® Form C must be executed by your agent at the time a Certificate of Compliance is requested,once work is complete. Thank you,for your attention to this detail, and for your anticipated compliance with your Order of Conditions. Please call us with any questions. Sincerely, A�.--�---,�-----a Rob Gatewood Conservation Administrator q:forms:formret i . oFIKE T� Town of Barnstable Conservation Commission - ►BrE: 200 Main Street MA88 g Hyannis Massachusetts 02601 Office: 508-862-4093 FAX: 508-778-2412 Form A For SE3- ALL PARTIES INVOLVED WITH THIS PROJECT MUST SIGN THIS STATEMENT The undersigned confirm that they have read and understand the Notice of Intent, Order of Conditions, and approved plans for the project. The undersigned also understand that subsequent plan revisions shall require advance approval by the Conservation Commission. Please sib name on this line. Pleaseprint name on this line. Property Owner Date Return this form to: Barnstable Conservation Commission 200 Main Street Hyannis,MA 02601 Fax: 508-778-2412 rev3/12/02 Town of Barnstable Conservation Commission "LE: 200 Main Street °4>,,. b9 ,.•� Hyannis Massachusetts 02601 Office: 508-862-4093 FAX: 508-778-2412 Form B For SE3- Below please find the names, addresses, and business telephone numbers of the project supervisor and alternate project supervisor who are responsible for ensuring on-site compliance with the Order of Conditions. Project Supervisor Alternate Project Supervisor Name Name Address Address Business Telephone# Business Telephone# Property Owner's Signature Date Print Name Applicant's Signature (if different) Date Print Name Return this form to: Barnstable Conservation Commission 200 Main Street, Hyannis, MA 02601 rev.3/14/02 °f� Towti Town of Barnstable Conservation Commission Form C BARNSTABLE, 9 MASS. 1679. M A 200 Main Street Hyannis Massachusetts 02601 Office: 508-862-4093 E-mail: conservation@town.barnstable.ma.us FAX: 508-778-2412 Certificate of Compliance Request Applicant Name: Please check the appropriate box. Enter n/a if not applicable. Compliant Non- Compliant File No. SE3- Work limit line was not exceeded by any alteration or cutting. A certified foundation plan was submitted to the Conservation Division. Before and after photographs of the undisturbed buffer were submitted to the Conservation Division. No plan deviations within the 50' setback from resource area. No plan deviations between 50' and 100' of the resource area. ❑ F-i Areas disturbed during construction have been revegetated. Mulching is not a substitute for vegetation. Drywells or gravel trenches were installed. ❑ Landscaping or vista pruning was done in consultation with Conservation staff Work limit markers (wood stakes) remain in place. Pool disinfection is by ozone injection ❑ Post-dredge bathymetric survey was submitted Piers, ramps, floats and outhaul pilings are the permitted size, shape and configuration EI Piers, ramps and floats in storage are the permitted size, shape and configuration This checklist does not relieve applicants and their representatives from compliance with other general and special conditions of the Order of Conditions. Please describe all deviations in your request letter. Please submit this completed checklist along with your written request for a Certificate of Compliance and your check for$50 made payable to the Town of Barnstable. Representative's Signature Date Q:\Conservt\DEPFORMS\Form C.doc rev:06 JAN 2005 I Michael J. Corwin Melanie S. Kim 828 Hammond Street Chestnut Hill, MA 02467 January 28, 2008 RE: Registering Order of Conditions for 48 Fells Pond Rd. The BSC Group, Inc. 349 Route 28 West Yarmouth, MA 02673 Dear Julie, Please find enclosed my check#3575 for $76.50, to the Barnstable County Registry of Deeds for fees related to registration of the order of conditions for 48 Fells Pond Rd. Thank you very much for your help. Sincerely, Michael Corwin i RECEIPT Printed:03-06-2008 ® 12:18:11 BARNSTABLE COUNTY REGISTRY OF DEEDS JOHN F. MEADE, REGISTER Trans#: 53430 Oper:CYNTHB J. Book: 22730 Page: 179 Inst#: 11826 Ctl#: 826 Rec:3-06-2008 ® 12:13:56p BARN 56 LONG BEACH RD DOC DESCRIPTION TRANS AMT --- ----------- --------- 1 GIARDINI, GEORGIA L RESTRICTION County Fee $ 10.00 10.00 Surcharge CPA $20.00 20.00 State Fee $40.00 40.00 Surcharge Tech $5.00 5.00 Total fees: 75.00 ------------------------------------- Book: 22730 Page: 181 Inst#: 11827 Ctl#: 827 Rec:3-06-2008 1-f 12:13:56p BARN 56 LONG BEACH RD DOC DESCRIPTION TRANS AMT 1 GIARDINI, GEORGIA L ORDER County Fee $ 10.00 16.00 Surcharge CPA $20.00 20.00 State Fee $40.00 40.00 Surcharge Tech $5,00 5.00 State/County pg adj 6.00- Total fees: 75.00 Ctl#: 828 Rec:3-06-2008 0 12:13:56p DOC DESCRIPTION TRANS AMT --- ----------- --------- POSTAGE FEE County Postage Fee 2.00 Ctl#: 829 Rec:3-06-2008 ® 12:13:56p DOC DESCRIPTION TRANS AMT IMPRINT COPY County Imprint Fee 1.00 *** Total charges: 153.00 CHECK PM 1520 153.00 44 Commercial Street Raynham, MA 02767 Tel: (508)-880-0233 Fax: (508) 880-7232 April 30, 2008 Barnstable Board of Health 200 Main Street 3 Hyannis, MA 02601 n Attention: Board of Health Agent 2:_f Reference: Home FAST Treatment Serial Number: 200665 C- r".*, Fri Attached please find a copy of the Product Registration Report for the FAST Treatment System for the startup performed on 04/25/2008 at the home of Georgia Giardini located at 56.Long Beach Road, Centerville, MA. Also, attached is a copy of the fully executed Inspection&Testing Agreement. If you have any questions or require additional information please do not hesitate to call. Sincerely, Donna L. Callahan Enclosures r � r Mt=1 8450 Cole Parkway w Shawnee, KS 66227 w Phone 913-422-0707 w Fax: 912-422-0808 e-mail: onsiteCa)biomicrobics.com m www.biomicrobics.com M 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 d Date Ship ed to End User 4/17/08 Serial # 200665 OWNER NAME Georgia Giardini ADDRESS 56 Long Beach Road CITY/STATE/ZIP Centerville,MA 02632 PHONE/FAX B10-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 NAME Bortolotti Construction ADDRESS 45 Industry Road CITY/STATE/ZIP Marston Mills,MA 02648 PHONE/FAX 508-771-9399 . . . CONSULTING ENGINEER if a licable NAME BSC Group ADDRESS 384 Washin ton Street CITY/STATE/ZIP Norwell,MA 02061 PHONE/FAX 781-659-7981 Good Bad NA Good Bad NA ELECTRICAL PANEL(S) TREATMENT UNIT(S) Visual Alarm Operating Air vent clear31- Audio Alarm Operating Septic tank level U' BLOWER(S) Septic tank meets min. size Di Wired for correct voltage 13 Septic tank filled to operating level Inlet/outlet piped correctly Air Lift Operation Filter element installed 0 Recirculation tube in place Blower hood secure Li Fasteners tight Blower works correctly a Lj WATER-TIGHT JOINTS Blower located within 100' of LY ❑ Lj Treatment unit to septic tank 0/ Lj treatment unit Air line clear 01/ L3 Entrance tube to insert cover Air inlet screen clear a/ Lj Insert to insert cover Blower hood vents clear ❑ Discharge line connection ®/ Factory Authorized Personnel: Title: Firm: Wastewater Treatment Services Inc. Date: WMA!w t"ue ua:cr r_rcuM-JMtnurKUU +15088BO723Z T-98T F.OZ/05 F-067 44 Commercial Street Please cotnpiete all items marked• Raynham, lA including three signatures. Mail 02767 sinned original contact to: WP.qtCWffU.T3AYnMLscrvicL 4JM C^44 CpfnMMill Qtryet Tel: el: (508)880-=3 Ravnh,lm.MA 07767 Fax: (508)880.7232 INSPECTION AND EFFLUENT TESTING AGREEMENT Agreement entered into by and between Wastewater Treatutent 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 inspzc ed at least 2 times per year that this Agreement remains in effect,with the first inspections beginning These inspections will )nclude: 1) Testing of the sludge depth in the septic tank. 2) Inspection,power testing and clean/replace intake filter of the air blower. 3) Inspection of the alarm system. 4) Inspect overall condition of FAST"System, 5) Notification to OWNER of any problems encountered. 6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parrs. WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 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 current Iabor rates of$78.00 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 Sarizdays;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 but not lirnited to 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. IV-MAK-ud ua:Zd FROhJRMPROD +1508880T232 T-98T P.03/06 F-06�-- a Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current contract(1) either a new contract or an offer to extend the current contract's term, and (2)an invoice for one year of service. It is OWNER's responsibility to timely return the payment and either the new contract or the accepted extension,completed and signed. WTS must receive the payment and document before expiration of the then current contract year to assure continuous contract coverage. Failure to return such documents on time or to otherwise comply with this contract, may result in suspension of service, cancellation of the contract and/or nullification of warranties, at the election of WTS. OWNER may not assign this contract without the prior written consent of WTS. It will remain in force until a party cancels by written notice to the other at the address given herein,or until the contract term expires,whichever is sooner. MANUFACTURER MODEL NO. SERTAT.NO. LOCATION ANNUAL RATE Bio-Microbies Micro];AST Centerville, MA $220.00 EQUIPMENT OWNER Waswwater Treatment Services,Inc. *Signed b OWNER: � ��/001 r� � y r/L Georgia Giardini Signed: *Address: 56 Long Beach Road 44 Commercial Street Raynlam, MA 02767 Telc: (508) 880-0233 *City: State: "Lip: Fax: (508) 880-7232 Centerville MA 02632 Telephone 508-775-0301 Effective Date of Agreement Daytime Telephone: OWNER understands that(1)ANNUAL RATE payment is for one:year only commencing on the effective date set forth above and is non-refundable; and(2) Current DEP Regulations require OWNER to maintain a service agreement for the life of the I:AST'0'System. I HAVE READ AND UNDERSTAND THE FOREGOING. *Signed by OWNER.: �La Effluent Testing Effluent sample taken 4 times per year for 2 years 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. PERAM. *(PLEASE CHECK ONE) ( )GENERAL (X)REMEDIAL ( )PROVISIONAL *SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y)or(N)if YES,please attach copy of permit (X)pH,BOD5i TSS,Nitrate,Nitrite,TKN, Ammonia ( )Other: *Cost for testing: $280.00/Visit Operator assigned: William Everett Telephone: (508)400-3868 *Engineer: BSC Group *Approval for Effluent Testing ouG Q tai� Homeowner's gignature BSC GROUP 384 Washington St. Norwell, MA-0266i. May,20, 2008 < . Tel:781,654-7981 ' Fax.b�7=i45-8o27.. Town"of Barnstable r Board of Health 200 Main Street Hyannis,NIA 0260.1 RE: As Built Pla-n 56 Long'Beach Road Members of the Board: = On.behalf'of our client Georgia Giardini, 56 Long Beach Road, Barnstable,' Massachusetts; the BSC Group offers the attached as built plan of the recently ' constructed septic system repair. ~ The work included the installation of a"replacement septic system.with associated soil. absorption system, FAST system;pump chamber landscaping and the fillingl of a failed, cesspool. To the best of my professional knowledge,belief and understanding, the ° project was completed insubstantial compliance with the plan'of record. If you have any questions or need additional information, please-feel free`to._contact me ` t At (781) 659-7981: Sincerely, BSC GROUP David J. rispin,P:E., P.L.S ; Senio Associate ,= a t" Enclosures (as built plan),, •. 1 _ _ gineeps. �viror enial �entist�s GIS Consultants Landscape r : Architects Planners P;\PRJ\4555900\Environmental\GiardiniCOC-ss-2008-5`8.doc`_ Surveyors Barnstable �P ti Town of Barnstable f i A"medcacity }" M MAS BCE' " Board of Health �y rnss. �a apA x63g. ��+ A� 200 Main Street, Hyannis MA 02601 2007 Office: 508-8624644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi December 19, 204 David Crispin, P.E. 384 Washington St. Norwell, MA RE: 56rLong Beach Road; Centerville/.I/A System A=206-11 Dear Mr. Crispin, You are granted variances, on behalf of your client, Georgia Giardini, to construct an innovative/alternative sewage disposal system at 56 Long Beach Road, Centerville. The variances-granted areas follows: Section 360-1, Town of Barnstable Code:To construct a leaching facility 50 feet away from the wetland in lieu of the required 100 feet separation distance required. 310 CMR 15.255: To construct a soil absorption system five (5) feet away from the property line, in lieu of the minimum ten (10) feet separation distance required. 310 CMR 15.255 (2) (G): To construct an impervious barrier five (5) feet away from the soil absorption system to prevent break- out. The variances are granted with the following conditions: (1) The designing engineer shall submit revised plans showing buoyancy calculations, method for determining the adjusted high groundwater elevation at this site, redesign of the septic tank (using the updated Title 5 calculations), showing the water-proof method of the septic tank within a flood zone, and a reduction of four feet mound over the septic tank. (2) The new innovative/alternative sewage disposal system shall be installed within one year, before December 18, 2008. Q:\WPFILES\CrispinGiardini2007.doc (3) No more than two (2) bedrooms are authorized at this property. (4) The applicant shall record a properly worded deed restriction, signed by the property owner, at the Registry of Deeds restricting the number of bedrooms at this property to two, before the applicant obtains a disposal works construction permit. (5) The system shall be installed in strict accordance with the DEP design standards (approval letter) for the Smith and Loveless Modular FAST and in strict accordance with the revised plans. (6) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised plans. (7) The wastewater effluent shall be tested quarterly for the first two years of operation. The effluent shall be monitored for the following parameters: pH, Ammonia, TSS, BOD, Total Nitrogen (TN), Nitrate, and TKN. The TN shall not exceed 19 mg/liter. (8) After two years of satisfactory operation of the innovative/alternative system, the applicant may request a reduction in monitoring frequency, I writing to the Board of Health. (9) The applicant shall submit a copy of the signed two-year Operation and Maintenance Agreement (O&M) between the contractor and the homeowner to the Board of Health. The engineer or O& M contractor shall conduct inspections to the I/A system a minimum of twice yearly. These variances are granted because physical constraints at the site severely restrict the location of a soil absorption system due to the wetlands located on the parcel. The proposed septic system is designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. The existing cesspool is in all probability, sitting in the groundwater table. This proposed replacement system which consists of alternative technology might alleviate a source of pollution to the groundwater in the area. Si4 erely y,.- u`Is a 1 e Miller, M.D. Chairman Board of Health Q:\WPFILES\CrispinGiardini2008:doc f QFTME Tp� DATE: -��o• FEE - BAItMSTABLB. y MASS. 039. `0� REC. BY Town of Barnstable n SCHED. DATE: �� V 64 Board of Health 200 Main Street, Hyannis MA 02601, Office: 508-862-4644 Wayne A.Miller,1M.D. FAY: 508-790-6304 Paul J.Canniff,D.'LD. VARIANCE REQUEST FORUM LOCATION A Property Address: 56 Long Beach Road Assessor's Map and Parcel Number: 206.11 Size of Lot: 20,000t sf Wetlands Within 300 Ft. Yes R Business Name: No Subdivision Name: cv APPLICANT'S':VAME: Georgia Giardini Phone 508-775-0191 Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: Georgia Giardini Name: David Crispin, PE — BSC Group Address: 83 Ocean View, New Haven CT 06512 Address: 384 Washington Street, Norwell, MA Phone: 508-775-0381 Phone: 617-896-4451 7 %X� O WY VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE('lay attach ifmore space needed) 100' to Wetlands — Local 50t to Glatlands 110 ('.MR-1 5-255 — 5' to property Line Grading Near Property Line— '11 n C.MR 15* 416 — ZBr +prinnm Restriction No Expansion Reem 310 CMR 1 5 225 (24 — 11sa e€ Breakout Barrier NATURE OF WORK: House Addition ® 11000; House Renovation 13 Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in d separate completed sets. Four(4)copies of the completed variance request form r� Four(4)copies of engineered plan submitted(e.g.septic system plans) ! �a Four 4 copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) __ — O P� P _ P P ) Signed letter stating that the property owner authorized you to represent him/her for this request ti Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (foe-Title V and/or local sewage regulation variances only) to 0 1 Full menu submitted(for grease trap variance requests only) pt Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewalsf[same own erlleasee-_. only], w outside dining variance renewals[same onertleasee only],and variances to repair failed sewage disposal systems[only if no expansion to chi.building proposed]) T•: Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne'tiller,Cl airman NOT APPROVED Paul J.Canniff,D.'LD. ` REASON FOR DISAPPROVAL u `� T�1!'Ie 5 Caic� C:\Dccumen7s and Secrings\decollik\Loca1 Ser_�ings\Temporary =._ernes 000? —d -� No e ►C�e-,d- �\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 MITT ROMNEY ' ELLEN ROY HERZFELDER Governor / Secretary KERRY HEALEY ROBERT W.GOLLEDGE,Jr. Lieutenant Governor Commissioner APPROVAL FOR REMEDIAL USE j Pursuant to Title 5, 310 CMR 15.00 Name and Address of Applicant: Smith &Loveless Inc. 14040 Santa Fe Trail Drive Lenexa, KS 66215 Trade name of technology and model: Modular FAST (hereinafter called the "System"). A schematic drawing of a typical unit and a Technology checklist are attached and are a part of this Approval. Transmittal Number: W 042189 Date of Issuance: June 4, 2004 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental, Protection hereby issues this Approval for Remedial Use to: Smith & Loveless, Inc., 14040 Santa Fe Trail Drive, Lenexa, Kansas (hereinafter "the Company"), approving the System described herein for Remedial Use in the Commonwealth of Massachusetts. Sale and use of the System are conditioned on compliance by the Company and the System owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Approval constitutes a violation of 310 CMR 15.000. Glenn Haas, Director Date Division of Watershed Management Department of Environmental Protection This information is available in alternate format.Call Donald M.Gomes,ADA Coordinator at 617-556-1057.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep ��a Printed on Recycled Paper Ren w'a`lo f Remedial Use Approval Modular FAST Page 2 of 9 I. Purpose 1. The purpose of this approval is to allow use of the System in Massachusetts, on a Remedial Use basis. 2. With the necessary permits and approvals required by 310 CMR 15.000, this Approval for Remedial Use authorizes the use and installation of the System in Massachusetts. 3. The System may only be installed on facilities that meet the criteria of 310 CMR 15.284(2). 4. This Approval for Remedial Use authorizes the use of the System where the local approving authority finds that the System is for upgrade of a failed, failing or nonconforming system and the design flow for the facility is less than 10,000 gallons per day(GPD). H. Design Standards 1. The System, a fixed film aeration treatment process, is an aerobic process in which the media is 100-percent submerged. In the submerged application, the aeration and mixing are provided by an airlift mechanism. A draft tube, in the center of the System, extends through the media. Air is pumped into the draft tube by a compressor; wastewater is pumped from below the media to the top of the submerged media. The pumped liquid impacts the splash plate, which directs the wastewater across the top of the submerged media. The splash plate also creates a break-up of the wastewater into droplets to increase the surface area of the liquid to enhance the aeration of the wastewater. The oxygenated wastewater then passes down, through the media, where the bacterial activity takes place. The System uses both fixed film and suspended bacteria in the degradation of the organic material. 2 . The System is designed to allow the plastic or epoxy-coated steel modular inserts, the treatment unit with the media, to be installed in an appropriately sized precast or cast-in- place concrete tank. The inserts are constructed of PVC or high-density polyethylene plastic in modular units with the number of units and the tank size governed by the wastewater design flow and characteristics. 3. The System is designed with storage volume beneath the media to provide sludge storage of excess solids, which slough off the media. The sludge storage zone must be periodically pumped, based on sludge accumulation. Prior to or at the time the excess sludge is being removed, the air scour system should be activated to loosen and remove solids attached to the media. The removed solids will settle to the bottom of the tank and be removed with the sludge. I 1 , I&ne"l—lof Remedial Use Approval ' Modular FAST Page 3 of 9 4. The System shall be installed between the septic tank and the distribution system of a standard Title 5 system constructed in accordance with 310 CMR 15.100 - 15.279, subject to the provisions of this Approval. 5. The System may be used in soils with a percolation rate of up to 90 minutes per inch (MPI). For soils with a percolation rate of 60 to 90 MPI, the effluent loading rate shall be 0.15 gpd/sq. ft. III. Allowable Soil Absorption System Design 1 . Reduction of the Required Soil Absorption System Size - An applicant is eligible for up to a 50 percent reduction in the area of the soil absorption system required by 310 CMR 15.242, where all of the following conditions are met. Accordingly, in approving design and installation of the System by a particular Applicant, the local approving authority may allow up to a 50 percent reduction in the area of the soil absorption system required by 319 CMR 15.242, provided that all of the following conditions are met: A. No reduction in the required separation (four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone underlying the SAS and the high groundwater elevation is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. B. No reduction in the required four feet of naturally occurring pervious material is allowed unless the Applicant has demonstrated that the four foot requirement cannot be met anywhere on the site. Any such reduction must first be approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. C. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, the local approving authority may allow a reduction under a local upgrade approval in accordance with 310 CMR 15.405 (1) (a), (b), (f), (g), and (h). D. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, even taking into account provisions for local upgrade approval as described above, then pursuant to 310 CMR 15.410, the applicant first must obtain variance(s) from the local approving authority and then approval of the Department. 2 . Reduction of the Required Separation Distance to High Groundwater Elevation - An Applicant is eligible for a reduction in separation (four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone ltC riewa of Remedial Use Approval Modular FAST Page 4 of 9 underlying the SAS and the high groundwater elevation, where all of the following conditions are met. Accordingly, in approving design and installation of the System by a particular Applicant, the local approving authority may allow a reduction in the required separation (four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch) between the bottom of the stone underlying the SAS and the high groundwater elevation, provided that all of the following conditions are met: A. A minimum two foot separation (in soils with a recorded percolation rate of more than two minutes per inch) or a minimum ++„oo f^n+ w ara ion (in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone underlying the SAS and the high groundwater elevation is maintained. B. No reduction in the required SAS size is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. C. No reduction in the required four feet of naturally occurring pervious material is allowed unless the Applicant has demonstrated that the four foot requirement cannot be met anywhere on the site. Any such reduction must first be approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. D. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, the local approving authority may allow a reduction under a local upgrade approval in accordance with 310 CMR 15.405 (1) (a), (b), (f), (g), and (h). E. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, even taking into account provisions for local upgrade approval as described above, then pursuant to 310 CMR 15.410, the applicant first must obtain variance(s)from the local approving authority and then approval of the Department. 3 . Reduction of the Requirement for Four Feet of Naturally Occurring Pervious Material—An Applicant is eligible for a reduction in the required four feet of naturally occurring pervious material in an area of no less than two feet of naturally occurring pervious material, where all of the following conditions are met. Accordingly, in approving design and installation of the System by a particular Applicant, the local approving authority may allow a reduction in the required four feet of naturally occurring pervious material in an area with no less than two feet of naturally occurring pervious material,provided that all of the following conditions are met: A. The Applicant has demonstrated that the four foot requirement cannot be met anywhere on the site. r Ttene"I-bf Remedial Use Approval Modular FAST ` Page 5 of 9 B. No reduction in the required SAS size is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. C. No reduction in the required separation (four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone underlying the SAS and the high groundwater elevation is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. D. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, the local approving authority may allow a reduction under a local upgrade approval in accordance with 310 CMR 15.405 (1) (a), (b), (f), (g), and (h). E. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, even taking into account provisions for local upgrade approval as described above, then pursuant to 310 CMR 15.410, the applicant first must obtain variance(s) from the local approving authority and then approval of the Department. IV. General Conditions 1. All provisions of 310 CMR 15.000 are applicable to the use of this System, the System owner and the Company, except those that specifically have been varied by the terms of this Approval. 2. Any required operation and maintenance, monitoring and testing shall be performed in accordance with a Department approved plan. Any required sample analysis shall be conducted by an independent U.S. EPA or DEP approved testing laboratory, or a DEP approved independent university laboratory. It shall be a violation of this Approval to falsify any data collected pursuant to an approved testing plan, to omit any required data or to fail to submit any report required by such plan. 3. The facility served by the System and the System itself shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. 4. In accordance with applicable law, the Department and the local approving authority may require the owner of the System to cease operation of the system and/or to take any other action as it deems necessary to protect public health, safety, welfare and the environment. 5. The Department has not determined that the performance of the System will provide a level of protection to public health and safety and the environment that is at least Renewal of Remedial Use Approval Modular FAST Page 6 of 9 equivalent to that of a sewer system. No System shall be installed, upgraded or expanded, if it is feasible to connect the facility to a sanitary sewer, unless as allowed by 310 CMR 15.004. When a sanitary sewer connection becomes feasible, the facility served by the System shall be connected to the sewer, within 60 days of such feasibility, and the System shall be abandoned in compliance with 310 CMR 15.354, unless a later time is allowed, in writing, by the approving authority. 6. Design, installation and operation shall be in strict conformance with the Company's DEP approved plans and specifications, 310 CMR 15.000 and this Approval. 7. Pressure distribution designed in accordance with Department guidance is required for all installations of the System. V. Conditions Applicable to the System Owner 1. The System is approved for the treatment and disposal of sanitary sewage only. Any wastes that are non-sanitary sewage generated or used at the facility served by the System shall not be introduced into the System and shall be lawfully disposed. 2 . Effluent discharge concentrations shall meet or exceed secondary treatment standards of 30 mg/L biochemical oxygen demand (BOD5) and 30 mg/L total suspended solids (TSS). The effluent pH shall not be less than 6.0 or more than 9.0. 3. All samples shall be taken at a flowing discharge point, i.e. distribution box, pipe entering a pump chamber or other Department approved location from the treatment unit. Any required influent sample shall be taken at a point that will provide a representative sample of the influent. Influent sampling locations shall be determined by the system designer, subject to written approval by the Department. 4. Operation and Maintenance Agreement: A. Throughout its life, the owner shall operate and maintain the System in accordance with the Company and designer's operation and maintenance requirements and this Approval. To ensure proper operation and maintenance (O&M), the owner shall enter into an O&M agreement. No O&M agreement shall be for less than one year. B. No System shall be used until an O&M agreement is submitted to the approving authority which: a. Provides for the contracting of a person or firm trained by the Company as provided in Section VI(6) and competent in providing services consistent with the System's specifications, with the operation and maintenance requirements specified by the Company and the designer, and with any specified by the Department; r Tcenedval of Remedial Use Approval Modular FAST Page 7 of 9 b. Contains procedures for notification to the Department and the local board of health within five days of a System failure or alarm event and for corrective measures to be taken immediately; C. Provides the name of an operator, which must be a Massachusetts certified operator if one is required by 257 CMR 2.00, that will operate and monitor the System. The operator must operate and visit the System, for the first year, at least every three months. 5 . The System owner shall at all times have the System properly operated and maintained in accordance with this Approval, the designer's operation and maintenance requirements and the Company's approved procedures and sampling protocols. The System owner shall notify the Department and the local approving authority in writing within seven days of any cancellation, expiration or other change in the terms and/or conditions of their O&M agreement. 6 . Prior to transferring any or all interest in the property served by the System, or any portion of the property, including any possessory interest, the owner of the System shall provide written notice of all conditions contained in this Approval to the transferee(s). Any and all instruments of transfer and any leases or rental agreements shall include as an exhibit attached thereto and made a part thereof a copy of this Approval for the System. The System owner shall send a copy of such written notification(s)to the Department and local approving authority within 10 days of such notice being given. 7 . Effluent from the System serving a facility shall be monitored quarterly. At a minimum, the following parameters shall be monitored: pH, BOD5, and TSS. After one year of monitoring and reporting and at the written request of the owner, the Department may reduce the monitoring and reporting requirements. 8 . By January 3 V of each year for the previous year, the System owner shall submit to the approving authority all data collected in accordance with item 7, above, and an O&M checklist and a technology checklist, completed by the System operator for each inspection performed during the previous calendar year. Copies of the checklists are attached to this approval. 9. Prior to the issuance of a Certificate of Compliance for the System, the System owner shall record and/or register in the appropriate Registry of Deeds and/or Land Registration Office, a Notice disclosing both the existence of the alternative septic system subject to this Approval on the property and the Department's approval of the System. If the property subject to the Notice is unregistered land, the Notice shall be marginally referenced on the owner's deed to the property. Within 30 days of recording and/or registering the Notice, the System owner shall submit the following to the Department and the local approving authority: (i) a certified Registry copy of the Notice bearing the book and page/instrument r itu e raitof Remedial Use Approval Modular FAST ' Page 8 of 9 number and/or document number; and(ii) if the property is unregistered land, a Registry copy of the owner's deed to the property, bearing the marginal reference. 10. Within fourteen days of the local approving authority's issuance of the Certificate of Compliance for the System, the owner shall submit a copy of the Certificate of Compliance to the Department. vi . Conditions Applicable to the Company 1 . By January 3151 of each year, the Company shall submit a report to the Department, signed by a corporate officer, general partner or Company owner that contains information on the System, for the previous calendar year. The report shall state: the number of units of the System sold for use in Massachusetts including the installation date and date of start-up during the previous year; the address of each installed System, the owner's name and address, the type of use (e.g. residential, commercial, school, institutional) and the design flow; and for all Systems installed since the date of issuance of this Approval, all known failures, malfunctions, and corrective actions taken and the address of each such event. 2. The Company shall notify the Director of the Watershed Permitting Program at least 30 days in advance of the proposed transfer of ownership of the technology for which this Approval issued. Said notification shall include the name and address of the proposed new owner and a written agreement between the existing and proposed new owner containing a specific date for transfer of ownership, responsibility, coverage and liability between them. All provisions of this Approval applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. 3 . The Company shall develop and update the following: minimum installation requirements; an operating manual, including information on substances that should not be discharged to the System; a maintenance checklist; and a recommended schedule for maintenance of the System essential to consistent successful performance of the installed Systems. 4 . The Company shall develop and update as required a standard protocol essential for consistent and accurate measurement of performance of installed Systems, including procedures for sample collection and analysis of the System. The protocol shall be in accordance with the latest edition of Standard Methods for the Examination of Water and Wastewater. 5 . The Company shall make available, in print and electronic format, the referenced procedures and protocol in paragraphs 3 and 4 directly above to owners, operators, designers and installers of the System. 6 . The Company shall institute and maintain a program of operator training and continuing education, as approved by the Department. The Company shall update the list of qualified operators and make the list known to users of the technology. Renewailf Remedial Use Approval Modular FAST Page 9 of 9 7 . The Company or its designee shall conduct an intended use review of the System prior to the sale of any nonresidential unit to ensure that the proposed use of the System is consistent with the unit's capabilities. 8 . The Company shall furnish the Department any information that the Department requests regarding the System within 21 days of the receipt of that request. 9 . The Company shall include copies of this Approval and the procedures and protocol described in Section VI(3) and(4) with each System that is sold. In any contract executed by the Company for distribution or re-sale of the System, the Company shall require the i d stributor or re-seller to provide each purchaser of the System with copies of this Approval and the procedures and protocol described in Section VI (3) and (4). VII . Reporting 1. All notices and documents required to be submitted to the Department by this Approval shall be submitted to: Director Watershed Permitting Program Department of Environmental Protection One Winter Street - 6th floor Boston, Massachusetts 02108 VIII. Rights of the Department 1. The Department may suspend, modify or revoke this Approval for cause, including, but not limited to, non-compliance with the terms of this Approval, non-payment of the annual compliance assurance fee, for obtaining the Approval by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Approval, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to this Approval and/or the System against the owner, or operator of the System and/or the Company. w042189%5B 1%5D.doc 1 293 Washington Street Norwell MA 02061 December 29, 1997 f . Barnstable Board of Health Barnstable Town Offices O PO Box 534 Hyannis, MA 02601 A/{/ RE: 56 Long Beach Roadpppe�� 1998 Giardini-Applicant Ho�igg� 4k 781 659 7981 FAX 781 Members of the Board: 9 As a supplement to our letter and plans earlier submitted, BSC is resubmitting an updated septic System Inspection Report for the Board's use in their approval of a temporary tight tank for the above referenced site. This report documents the cesspool is within the groundwater and therefore constitutes a failed system. As we discussed at the Board's meeting on December 3, 1997, our request is made only to meet the requirements of the bank, (for mortgage purposes), and the tight tank is not envisioned to be constructed or utilized due to the pending site re-development which includes a full Title 5 system. Unfortunately, it is not possible to design, permit and construct a new Title 5 system within the time line required by the bank's mortgage conditions on the property. Therefore, we request the Board's approval of a tight tank allowing Ms. Giardini to move forward with her site upgrade permitting. As security, in the event that the site cannot be permitted with a full new Title 5 system, an escrow account exists for the installation of the tight tank. Regarding DEP approval, because the tight tank is not intended to be constructed(and there is no demand by the bank that the system be constructed unless all other permitting fails), DEP approval is not necessary at this time. 'If of course it becomes necessary to install the tight tank then the escrow account would be used. Should for some reason the construction be required and the escrow account be used, that process would of course continue. Specifically, we request the Board approve the request for: Engineers A temporary tight tank and to stipulate that the construction shall occur within one year as per Environmental 310 CMR 15.305 unless during this time frame the site can be designed, permitted and Scientists constructed with a new Title 5 septic system,thus saving the expense of actual construction of the tight tank. GIS Consultants Landscape I look forward to seeing you on January 6, 1998 to receive your approval for this project. Architects Sincerely, Planners The BSC Group-No ell, Inc. Surveyors avid J Crispin, P , PL Associate CC: Georgia Giardini G:corres\5559.wpd 12746 Wilderness Drive Palm Beach Gardens,FLA 33418 FOP�F'THE?-0 TOWN OF BARNSTABLE 0 OFFICE OF ? BAB.a9TAIM BOARD OF HEALTH NM& v° 1639.0 MA 367 MAIN STREET £ Y k' HYANNIS, MASS.02601 January 21, 1998 David Crispin BSC Companies, Inc. 293 Washington Street Norwell, MA 02601 RE: 56 Long Beach Road, Centerville Dear Mr. Crispin: You are granted permission, on behalf of your client, Georgia Giardini, to construct a temporary holding tank at 56 Long Beach Road, Centerville, Massachusettes with the following conditions: (1) The construction shall occur with one year unless an alternative-type septic system can be designed, permitted, and constructed within this time frame. (2) The holding tank shall be utilized for a period not to exceed twelve months. (3) The tank shall be tested for water-tightness and shall be certified in writing by the designing engineer that it was tested and found to be water-tight. This permission is granted because the existing cesspool failed a recent inspection due to the fact that it is sitting in the groundwater table. The use of a tight tank would alleviate a source of pollution to the river. Sincerely yours, Susan G. Rask, .S. Chairman Board of Health Town of Barnstable SGR/bcs crisping 293 Washington Street Norwell MA 02061 December 295 1997 i Barnstable Board of Health Barnstable Town Offices — PO Box 534 Hyannis,MA 02601 -- 781 659 7" RE: 56 Long Beach Road FAX 781 345 ac Giardini-Applicant Members of the Board: of a temporary tight tank for the above referenced As a supplement to our letter and plans earlier submits d'BSC is resubmitting an updated septic System P Inspection Report for the Board's use in their thin t site. This report documents the cesspool is within the groundwater and therefore constitutes a failed system. 1997 our request is made only to meet the As we discussed at the Board's meeting on December and the tight tank is not envisioned to be constructed requirements of the bank,(for mortgage purposes), g due to the pending site re-development which includssa witlTntthe time line required by the or utilizedermit and construct a new Title 5 system is not possible to design, p Therefore,we request the Board's approval of a tight tank bank's mortgage conditions on the property. upgrade permitting. allowing Ms. Giardini to move forward with her site p As security, in the event that the site cannot be permitted with a full new Title 5 system, an escrow account exists for the installation of the tight permitting fails),DEP approval is not Regarding DEP approval,because the tight tank is not intended beconstructed(and there is no demand Reg g to install the tight tank then the escrow account by the bank that the system be constructed unless al of p necessary at this time. If of course it becomes necessary would be used. Should for some reason the construction be required and the escrow account be used, that process would of course continue. Specifically,we request the Board approve the request for: in one year tem orary tight tank and to stipulate that the construction be des gned,pccur ermitted, and as per Engineers A p 310 CMR 15.305 unless during This time frame the site Environmental constructed with a new Title 5 sep`c system,thus saving the expense of actual construction of Scientists the tight tank. GIS Consultants 6, 1998 to receive your approval for this project. I look forward to seeing you on January Landscape Architects Sincerely, Planners The BSC Group-No ell,Inc. Surveyors avid J Crispin,P ,PL Associate CC: Georgia Giardini 12746 Wilderness Drive Palm Beach Gardens, FLA 33418 I _ � �t 293 Washington Street Norwell MA 02061 October 17, 1997 781 659 7981 Barnstable Board of Health FAX 781 345 8027 Barnstable Town Offices P O Box 534 Hyannis MA 0 ATT: Thomas McKean- Board of Health Agent Re: 56 Long Beach Road- Centerville, MA Georgia Giardini: Applicant. Members of the Board: This letter is submitted to request approval for the installation of a temporary 2,000 gallon holding tank at the above referenced site to hold domestic sewage. This submittal is not for the approval of the new septic system and elevating of the building as shown in progress on the attached plans. This special request is made for the following reasons: 1) In order to allow Mrs.Giardini to satisfy the bank's the mortgage policy, a passing "septic system"be in place by January 30 1994 ') It is extremely unlikely that the septic system and site improvements can be designed, Engineers permitted by all approving authorities, bid, financed and constructed by January 30th Environmental 1998 in time to secure Mrs. Giardini's Mortgage. Scientists Gts Consultants) Installation of a temporary holding tank would allow time for completion of the septic design and would allow for the environmental permitting process and would allow the Landscape use of the roe next spring/summer b the Applicant. Construction then could occur Architects property rtyY Planners in the fall without impacting the long term design/ improvements to the site and the adjacent environment. Surveyors 4) Title 5 (section 15.305) allows one year to repair a septic system after failing an inspection, (which has not occurred yet), or allows the Board the authority to establish some other(longer) schedule. Under this regulation we ask the Board approve the holding tank and waive its construction until the more extensive repair is made, (as I shown in progress on the plan), or one year whichever is a shorter time frame. Using this approach, the bank would require an escrow account for the holding tank to ensure construction would occur if the more significant improvement did not occur. We look forward to working with the Board to develop a construction and permitting alternative that will satisfy the language of the Board of Health requirements while also providing improved protection to the Centerville River Ecosystem. Please call if you have any questions. Si erely, /.. The BSC Group -Norwell Inc. David J Crispin PE' Associate encl: Plan CC: Rob Gatewood, Conservation Administrator Georgia Giardini 293 Washington Street Norwell MA 02061 { July 29, 1998 .. -' 'BSC.Companies, In Barnstable Board of Health 357 Main Street Barnstable Town Hall 781 659 796 Barnstable , MA 02501 FAX 781 345 80' Re: Proposed Septic System Repair 56 Long Beach Road, Craigville Members of the Board, This letter is to request variances required from Title 5 and from the Barnstable supplemental Regulations for the repair of the septic system at above references site. The proposed septic system has been designed to replace the cesspool (and temporary holding tank approved in January 1998) and conforms to the regulations excepting the following regulations: 1) Supplementary regulation 1.13 : The septic tank is 40 feet from a coastal wetland and the soil adsorption system is 50 feet from coastal wetlands. This requires variance from the supplementary regulations which require that the system be located 100 feet from coastal wetlands. The proposed design strives to meet the minimum Title 5 standards but does not meet the supplementary requirements due to extensive wetlands on site. It is noted that the system is at a minimum 130 feet from the mean high water mark. To achieve maximum degree of environmental protection the system includes the use of an innovative FAST system. Engineers 2) Title 5 section 15.255 : Breakout control is proposed to be by use of an impervious barrier. sheet piling which can be installed b use The barrier is to consist of high density polyethylenep g ( y Environmental Scientists of a backhoe) coupled with silicone sealed joints. The face of the wall will be covered with stones to resemble a dry stone wall such that the piling will not be visible. The design and the GIS Consultant!heed for the variance, is controlled by the need to stay 50 feet from wetlands and by a"street Landscape building line"taking which prohibits objects over 2 '/2 feet high within 10 feet of the street right Architects of way line. By providing the impervious barrier and due to the highly permeable sands on site, Planners the design provides equal level of environmental protection as would compliance with this regulation. Surveyors 3) Title 5 section 15.12.8.No reserve area is shown on the plans.This is due to the lack of land on the site conforming with the setback to wetlands or other setbacks. Whereas this lot is. severely restricted by wetlands it is unlikely that the number of bedrooms would ever be expanded and it is considered that any repair of the leaching area would consist of the removal of the failed system and placement of a similar system in the same location as that proposed. For this reason there is no reserve area shown and the design provides equal level of environmental protection as would compliance with this regulation. ` It is noted that this design offers improved environmental compliance and that it complies with Local supplementary regulation 1.14 for sizing and separation from the high water table. Please call if you should have any questions. Sincerely, The BSC Group Inc. David J. Crispin PE PLS Associate ✓ encl: Plans, variance reque Forms, Disposal Works Construction application J:\SEPTIC\45559GEO\giardi.wpd GroupThe BSC 14 I4U. TOWN OF BARNSTABLE DATEINC "-' 9 OFFICE OF FEE /® t� �• BOARD. OF HEALTH RECEIVED BY _ L 7ASITTllt - + 367 MAIN STREET c1At�• HYANNIS,MASS-02601 VARIANCE REQUEST FORH EN ,��IS� DAY TO ALL VARIANCES MUST BE SUBMITTED FIFTE S P_ TiI . SCIIEDULED 130ARD OF IIEALTIT MEETING. 6 NAME OF APPLICANT 6eorctia G ar .; ADDRESS OF APPLICANT 83 .Ocean Ave. New: Haven CT. 06512 NAME OF OWNER OF PROPERTY Same SUBDIVISION NAME NSA DATE APPROVED ASSESSORS MAP AND PARCEL NUMBER 206- 11 LOCATION OF REQUEST 56 Lon Beach Road SIZE OF LOT 20• Leo SQ.FT WETLANDS WITHIN 200 FT'YNO X VARIANCE FROM REGULATION(List Regulation) Local Regulation 1 .13: Leachin facilit L 100 ' from Water Course. REASON FOR VARIANCE(May attach if more space is needed)_ See Letter dated See Plan dated July 28 , 1.998 PI,11N - FOUR COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPPROVAL BRIAN R. GRADY, R.S. , CHAIRMAN SUSAN G. RASK, R.S. JOSEPH C. SNOW, H.D. BOARD 0 . HEALTH TOWN OF BARNSTABLE 1 .-.. ...__��.��..... � .ice � • Ilu. TOWN OF BARNSTABLE DATE J o CFFlCE CF FEE BOARD OF HEALTH RECEIVED By _ 367 MAIN STREET IIYANNIS,MASS.02601 VARIANCE REQUEST FORM ALL VARIANCES MUST BE SUBMITTED FIFTEEN 15 DAYS PRIOR TO Tllr, SCREDULED BOARD OF REALT)t MEETING. NAME OF APPLICANT - feorcria Ciard; n - = TEL. No._77S'034 ADDRESS OF APPLICANT -83 Ocean Ave. New: Haven CT. 06512 NAME OF OWNER OF PROPERTY Same SUBDIVISION NAME N/A DATE APPROVED ASSESSORS MAP AND PARCEL NUMBER 206- 11 LOCATION OF REQUEST 56 Long Beach Road SIZE OF LOT 2 d. gaa SQ.FT WETLANDS WITHIN 200 FT-YES X NO VARIANCE FROM REGULATION(List Regulation)__ Title 5: 15 .12 .1L. "A" Breakout Wall REASON FOR VARIANCE(May attach if more space is needed) See Letter dated i gap See Plan dated July 28 , 1998 PLAN - FOUR COPIES OF PLAN MUST BE . SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPPROVAL BRIAN R. GRADY, R.S. , CHAIRMAN SUSAN G. RASK, R.S. JOSEPH C. SNOW, H.D. BOARD OF HEALTH TOHN OF BARNSTABLE t+u. TOWN OF BARNSTABLE DATE 0 4' OFFICE OF FEE RECEIVED BY i„airnn B OARD OF HEALTH _ •""• 367 MAIN STREET r�Y�• HYANNIS.MASS.02601 _ VARIANCE REOUTEST FORM AT,T, VARIANCP.S MUST BE SUBMITTED FIFTEEN 15 DAYS PRIOR TO 'I't1T: SCIIEDULED 130ARD OF IIEALTIT MEETING. NAME OF APPLICANT - 9erdr l a Giardi ni TEL. o ADDIftESS OF APPLICANT -83 _-Ocean Ave. New: Haven CT. 06512 NAME OF OWNER OF PROPERTY Same ' N/A DATE APPROVED SUBDIVISION NAME ASSESSORS MAP AND PARCEL NUMBER 206- 11 LOCATION OF REQUEST 56 Lon Beach Road SIZE OF LOT 210. 900SQ.FT WETLANDS WITHIN 200 FT•YNSO X VARIANCE FROM REGULATION(List Regulation) Title 5: .15..12 .8 - No Reserve Area Provided. REASON FOR VARIANCE(May attach if more space is needed) See Letter dated may I q. 1 Q See Plan dated July 28 , 1998 PLAN - FOUR COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPPROVAL BRIAN R. GRADY, R.S. , CHAIRMAN SUSAN G. RASK, R.S. JOSEPH C. SNOW, M.D. BOARD OF HEALTH TO" of BARNSTABLE i I 293 Washington Street Norwell MA 02061 ' September 3, 1998 BSC7 Companies, Inc. Town of Barnstable Board of Health 367 Main St. Hyannis,MA 0 2-4 01 781 659 7981 REF: Georgia Giardini—56 Long Beach Rd.-Board of Health Hearing—September 8`h FAX 781 345 8027 BSC JOB#45559.00 DEP File#SE3-3369 Dear Members of the Board: Jerry Dunning suggested that I write to the board with a historic overview of the project to date. On December 3, 1997 The BSC Group met with you to discuss the feasibility of permitting a tight tank at locus in accordance with 310 CMR 15.305. (See letter attached). The meeting was continued until January 6 when the Board granted approval of the tight tank provided it be installed in one year. The project is being reviewed by the Conservation Commission at a continued hearing on November 17`h. The Client's goal is to rebuild and expand the existing structure complete with a FAST system to replace failed cesspools. Again,this was all reviewed at our.January 6`h hearing with the objective of coming back to obtain an additional approval for a new FAST system. As always please contact me with your questions. I look forward to seeing you September 81h. Sincerely, The BSC Group,Inc. Orman W. Hayes Engineers Sr.Managing Scientist, Associate Environmental Scientists GIS Consultants Cc: Georgia Giardini 56 Long Beach Road Landscape Centerville,MA 02362 Architects E Planners ncl (3) Surveyors P:\PRJ\45559\DOC\45559.00.doc TOWN OF BARNSTABLE ?�'�f;i N E T��♦ , OFFICE OF = ;=13T"L i BOARD OF HEALTH rued °ems i63X `em 367 MAIN STREET HYANNIS, MASS. 02601 October 22, 1998 a Georgia Giardini 83 Ocean Avenue New Haven, CT 06512 RE: 56 Long Beach Road, Centerville A=206-11 Fast System Dear Ms. Giardini: You are granted variances to construct a replacement onsite sewage disposal system at 56 Long Beach Road, Centerville. The variances granted are as follows: B.O.H. Part VIII, Section 10.00: To construct a leaching facility 50 feet away from the wetland in lieu of the required 100 feet separation distance required. 310 CMR 15.255 (21 (61: To construct an impervious barrier three feet away from the soil absorption system to prevent break-out. 310 CMR 15.248: To construct an onsite sewage disposal system without providing any space for a reserve area. The variances are granted with the following conditions: (1) The designing engineer shall supervise the construction of the onsite sewage disposal system and certify in writing to the Board of Health that the system was installed in strict accordance with the submitted plans dated May 19, 1998, revised on October 1, 1998. (2) The wastewater effluent shall be monitored quarterly for two years for the following parameters: TNK,Nitrate, Ammonia, BOD, and TSS. I i The variances were granted because the existing cesspool is in all probability, sitting in the groundwater table. This proposed replacement system which consists of alternative technology, would alleviate a source of pollution to the groundwater in the area. Sincerely yours, usan G. Ram;R.S. Chairperson Board of Health Town of Barnstable SGR/bcs 293 Washington Street Norwell MA 02061 October 17, 1997 781 659 7981 Barnstable Board of Health FAX 781 345 8027 Barnstable Town Offices P O Box 534 Hyannis MA 0 ATT: Thomas McKean- Board of Health Agent Re: 56 Long Beach Road- Centerville, MA Georgia Giardini: Applicant. Members of the Board: This letter is submitted to request approval for the installation of a temporary 2,000 gallon holding tank at the above referenced site to hold domestic sewage. This submittal is not for the approval of the new septic system and elevating of the building as shown in progress on the attached plans. This special request is made for the following reasons: 1) In order to allow Mrs.Giardini to satisfy the bank's the mortgage policy, a passing "septic system"be in place by January 30 1997. ) It is extremely unlikely that the septic system and site improvements can be designed, Engineers permitted by all approving authorities, bid, financed and constructed by January 30th Environmental 1998 in time to secure Mrs. Giardini's Mortgage. Scientists GIS Consultan0) Installation of a temporary holding tank would allow time for completion of the septic design and would allow for the environmental permitting process and would allow the Landscape use of the property next spring/summer b the Applicant. Construction then could occur Architects p p YY in the fall without impacting the long term design/improvements to the site and the Planners adjacent environment. Surveyors 4) Title 5 (section 15.305) allows one year to repair a septic system after failing an inspection, (which has not occurred yet), or allows the Board the authority to establish some other(longer) schedule. Under this regulation we ask the Board approve the holding tank and waive its construction until the more extensive repair is made, (as shown in progress on the plan), or one year whichever is a shorter time frame. Using this approach,the bank would require an escrow account for the holding tank to ensure construction would occur if the more significant improvement did not occur. We look forward to working with the Board to develop a construction and permitting alternative that will satisfy the language of the Board of Health requirements while also providing improved protection to the Centerville River Ecosystem. Please call if you have any questions. Si7BSC w Throup -Nor 1 Inc. Dspin P Assocae encl: Plan CC: Rob Gatewood, Conservation Administrator Georgia Giardini Nov I Z2 77 00 : :Jf' [3^F-,PJGTAOLC I ICALTI 1 OCf T O 007GOG004 / � 1, DATE C5' NOV 2 5 1997 FEIr $65 . 00 Town of Barnstable REC. BY s B rd of Health 367'IvI n Street, Ilyannis MA 02601 L)Mcc, 509-790.6265 Susan G.Rask,R.S. FAX, 50$475-3344 Ralph A.Murphy,M.D. VARIANCE h��1>�S'F FDA AU vaYi2ncc revue is must he submitted 8t least P�{een(151 tSa�s priix lii the.scheduled Ruard of lieakth mceiin�. C/o David Crispin NAMF OF APPI,ICAN'I' Georgia Giardini TFL. N0.781-659-7981 ADDRESS OF APPLICANT 12746 Wilderness Drive Palm Beach Gardens, FLA 33418 NAME OF OWNER OF PROPERTY Estate of Chester Bearse SUBL)IVISION NAME N/A _ DATE APPROVED N/A ASSESSOR'S MAP AND PARCEI,NUMBER 206-11 I,0C'.ATION OF REQUEST 56 Long Beach Road SILL, OF I,O'I`_ 20 ,900 SQ.FT WETLANDS WITIIIN 200 FT.YES X NO VARIANCE FROM REGULATION (List Regililation) Temporary Holding Tank per 310 QMR 15 : 260 REASON FOR VARIANCE (May attach if more space is needed) To allow time to design permanent Title 5 -system and me t requirements of bank mortgage. (See attached letter) PLAN - F()IJR CUPfI=.S OF PLAN MUST Lif? Si1BMI'I"t Fr) CLEARL7' OUTLINING VARIANCL REQU1~S'r. VARIANCT? APPROVED _ Susan G. Rusk, R.S., Chairman NOT APPROVED Brian R. Grady, R.S. REASON FOR DISAPPROVAL Ralph A. Murphy, M.D. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: ell.A.cf,4 I Owner. �'� Date of Inspection: B] SYSTEM CONDITIONALKYFA SES (continued) 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). Describe observations: 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 r obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: A//1` 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 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 to 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) OTHER (revised 04/25/97) Page 2 of 10 r � CO` IMONWEALTH OF NLASSACHUSETTS (7' EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS I DEPARTMENT OF ENVIRONMEtiTAL PROTECTIO\ �? ONE WINTER STREET. BOSTON. NIA 02108 617-292-4; 00 WILLIAN F.WELD TRUDY CO: Governc: Secret_ ARGEO PAUL CELLUCCI DAVID B.STRU: Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissic PART A 1I CERTIFICATION Property Address: a ^ 7,!� G�j Address of Owner: Date of Inspection: 1 2� (If different) Name of Inspector: �� t ��I3 '� I am a DEP approved system ins ector pursuant to Section 1".340 of Title 5 (310 CMR 15.000) Company Name: � 05 C ✓�, v/a -" 14e ,-iw��/�v41f Mailing Address: ?_ 9 Telephone Number: 7,l - f `2 0) 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: Date: The Svstem Inspector shall s mit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submii the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system own- and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, Or D: A] SYSTEM PASSES: .-N4 I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.30' 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, up - completion of 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. 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; the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tar, 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 04/25/97) Page 1 of 10 DEP on the World Wide Web http:/twww.magnet.state.ma.us/det) Printed on Recycied Paper r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: j � ��A✓��✓� '`'/ /`1!/ Owner: Cj ,/r-;k A,' / Date of Inspection: ,e r, D] SYSTEM FAILS: You m dicate either "Yes" or "No" as to each of the following: I shave 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 correc 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. Am, 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: /V You must indicate either "Yes" or "No" as 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 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 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 4� C��/� a-9 Owner: Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No p� 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 N/A. The facility or dwelling was inspected for signs of sewage back-up. �C The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. r _ 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 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: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)J (revised 04/25/97) Page 4 of 10 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Z, Date of Inspection: 'Z�� l/ FLOW CONDITIONS RESIDENTIAL: Design flow: /140 g.p.d./bedroom for S.A.S. Number of bedrooms: Number of current residents: Z Garbage gnr.der (yes or no):_&O Laundry connected to system (yes or no): Seasonal use tees or no): 12 Water meter readings, if available (last two (2) year usage (gpd): Sump Pump (yes or no): 1,k�o Last date of occupancy: COMMERCI.AUINDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: Ives or no)_ Non-sanitary waste discharged to the Title S system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)_ If yes, volume pumped: gallons 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C // SYSTE!M�INFORMATION (continued) Property Address: / Owner: Date of Inspection: BUILDING SEWER: / (Locate on site plan) e-r r Depth below grade:—/—Z Material of construction: 0(cast iron _40 PVC _other (explain) Distance from private water supply well or suction hr- ; /V n Diameter le Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ efe �s�✓o�,L (locate on site plan) Depth below grade: Material of construction: _,concrete _metal _Fiberglass _Polyethylene —other(explain) :> if tank is metal,.,`list age _ is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: 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 outlet tee or baffie: How dimensions were determined: 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.) GREASE TRAP: A (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: (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.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: s G " i��l�JC'-a C'1 AW Owner: Gi 9�co/N/ Date of Inspection: /011177 TIGHT OR HOLDING TANK: t7ank must be pumped prior to, or 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/da\ Alarm level: Alarm in working order_ Yes; _ No Date of previous pumping: Comments: (condition 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.) PUMP CHAMBER:_ Al/9 (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.) (revised 04/25/97) Page 7 of 10 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / SYSTEM INFORMATION (continued) Property Address: [._6 s✓r ly-,"4 e-Z A Owner: �? Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):_ /� ��G 4. (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:_ leaching chambers, number:__ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) CESSPOOLS: _ (locate on site plan) Number and configuration: 2) Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: A Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of poncjing, condition of vegetation,/etc.) f Ej�+v✓..rJ !.i�J 7�1 y,,��S Gr J'i%f' ( v 7— 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.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of Inspection: Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) u e ///� ,�Z��-r r �7 (revised 04/25/97) Page 10 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) / Property Address: S L.aA ��'�? -v( A%1 Owner: /j Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) / , 7 y (revised 04/25/97) Page 9 of 10 Town of Barnstable P# D Department of Health,Safety,and Environmental Services Public Health Division Date NoyEI�IBFTZ q, 1�9� 367 Main Street,Hyannis MA 02601 3 wtNsreerE, Mess. ` Date Scheduled Nov. q.IO)fl Time 10*00 Fee Pd. 01cm Soil Suitability Assessment for Sewage Disposal Performed By: Dot-10VA13, 5CO6— Witnessed By: J Cie_c( W V 001►44 LOCATION & GENERAL INFORMATION ;; Location Address Owner's Name My G EOIZ it A d-I A IZp 01 �, PTEAGN �UAO Address -5 fj 41 E_ Assessor's Map/Parcel: M A P 2 /PA RL-r--L Il Engineer's Name Tk4- 55& 14YOV19 NEW CONSTRUCTION REPAIR _� Telephone# bl " (-VD °� Land Use Slopes(%) 6 -27-d Surface Stones Q�0 0605Ee-V1r11D Distances from: Open Water Body ft Possible Wet Area ti 75 ft Drinking Water Well — ft Drainage Way ft Property Line V ZO ft Other "' ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) _o 5' m TP I y 8'EAGH IZ0A p Parent material(geologic) UA-t;ML OULIE Depth to Bedrock 7 ID Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater . "DETERMYNATTOhi FO ......... SEASONAL.HIGH.W ER TABLE Method Used: Depth Observed standing in obs.hole: 3(o in. Depth to soil mottles: in. Depth to weceping t:em side of obs.1:ze:e: — in. Groundwater A i siment ft. index Well# _._ Reading Date:—. lnd:.-x Well level.-.---- Adj.factor Adj.Groundwatcr Level PERCOLA TI MUST-* vAte 9 '7Ime %4%ZT Observation I Hole# 2� Time at 9" 'i 2 S �Att_o N 5 t.►.I Depth of Perc Time at 6" S M 11J v'TE S Start Pre-soak Time @ 40 25 Time(9"-6") End Pre-soak 10 ' 30 Rate Min./inch J L Z Site Suitability Assessment: Site Passed�C __ Site Failed: Additional Testing Needed(YM) Original: Public Health Division Observation Hole Data To Be Completed on Back-� Copy: Applicant T DEEP OBSERVATION HOLE LOG Hole# I . Dcpth from Soil I lorizon Soil"fcxture Soil Color • Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. 0 Q SL WM 9 1) 15AW2 2,5 oGE s��Dt� 4►'AI D �oaSE i SIPYt.£LaPAt1JQ (oC�—md' '/_3 2'1� 7�L M-c sa►.�D DEEP OBSERVATION HOLE LOG Hole# Dcpth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % DEEP OBSERVATIOK ItOL.E L:OG Hole# Depth from Soil Ilorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stoones,Boulderes. DEEP OBSERVATION HOLE LOG :: ` Hole# Depth from Soil Ilorizon Soil'texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Slnicture,Stones,Boulderes. 0 u Flood Insurance Rate Map COW1Mv Ntfi� �4►J�1— 25()Oo 1 000e P �EVISED Jul 2� 199 z Above 500 year i,00d boundary No X Yet. Within 500 year boundary No_ Yes X Within 100 year flood boundary No Yes Dep(h of Naturals Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ___� If not,what is the depth of naturally occurring pervious material? Certification v I certify that on S e)Q 197 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,experti aril experience described in 310 CMR 15.017. 07 Signature L%� � _ _ Date i Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection William F.Weld Governor Trudy Coxe Secretary,EOEA David B. Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: :1 �G %0eA � Address of Owner:Date of Inspection: iZ_l7—j 7 (If different) / Name of Inspector: DA,i#to C At Sip/^� Company Name, Address and Telephone Number: —TRE CSC_ C, vt'avrO— CERTIFICATION STATEMENT ?c't— E — 7;P 49/ 1 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 SF F.Jy'2 k _ Needs Further Evaluation By the Local Approving Authority ,.' De Fails 6e..SSP�aL lil/ . ec/„ y o 41( PIN Inspectarfs—Signat re: Date: No.32112 A The System In ector s al mit a copy of this inspection report to the A J4 p Approving Authority within thtrt%t 3`0)taays of completing this nsnecti0n. If the systen- s a shared system or has a design flow of 10,00.0 gpd or greater, the inspector and the system owner shall submit the repo-, to the appr riatp regional office of the Department of Environmental Protection. The original shoui be sem tc ;ne ;\stern owner ano copies sen; to the buyer, ii appilcabie any Li INSPECTION SUMMARY.- Check A, B. C. or D A] SYSTEM PASSES: I have not found any information which indicates that the system 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 completion.of the replacement or.repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances.. If"not determined", explaim.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 septic tank is replaced with a conforming septic tank as approved by the. Board of Health. `revised 8/15/95) 1 One Winter Street a Boston, Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500 A 40 Printed on Recyded Paper t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A �CERTIFICATION (continued) Property Address: r Owner: e Date of Inspection: —`r 7 B] SYSTEM CONDITIONALLY PASSES (continued) 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 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 FNVIRON-NjF,T _ din;..2 �. ;.inn ! "� ;,. ��. �,,.1-, �.,;,.o. n.,l. ..•t„.«... .. �_ , .., a.. .. ,...�__ -"rr ... ... .. surface water supply. _ The s ste , has a septic tank and sail absorption system and is within a Zone I of a public water supply well. _ The sy sten-, ha, a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The s)�tEfi' hay a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private v.,ater 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• 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 effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. (revised 6/15/55) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 2(o ��`` �t Owner: 67 14. di w Date of Inspection: /-2 /10" 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 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 SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of 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 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 (W�IPA) 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 8/15/95) 3 r , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: d�pvt im r f Date of Inspection: �z/7/_r7 Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. "yeC/� �jNdsv� 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. K,4—As built plans have been obtained and examined. Note if they are not available with N/A. Yj�The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow The site was inspected for signs of breakout. m components, excluding the Soil Absorption System, have been located on the site. All system co p g p , A)U_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. / T b_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. /vo TF, •--. .•., """e r OdPr1 with information on the proper maintenance of Sub- _ Surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: S.2� � "f �✓f� Owner: <t'f*-,jV/ ./i Date of Inspection: I,Z `i 7 1�-;7 / l FLOW CONDITIONS RESIDENTIAL: Design flow: 7-'20 gallons Number of bedrooms: Z- Number of current residents:—Z Garbage grinder (yes or no):_ O Laundry connected to system ( es or no): /v U Seasonal use (yes or no): rZ4-/ Water meter readings; if available: Al Last date of occupancy: COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gallons/day 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: OTHER: (Describe? Last date of occupancy. GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as pan of inspection: (yes or no'_ If yes, volume mimped eallon 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) Other (explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: _ o r /"1/v rstr/o✓ Sewage odors detected when arriving at the site: (yes or no) � (revised 8/15/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: �� Z"- �''�� Owner: Date of inspection: t O �� SEPTIC TANK:_ (locate on site plan) G� Depth below grade: Material of construction: _concrete _metal _FRP —other(explain) Dimensions: 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 outlet tee or baffle: 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.) GREASE TRAP:_ (locate on site plan; Depth below, grade: Material of construction: _concrete _metal _FRP _other(explain) Dimensions: Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumper pp condition of.inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakagr eic.! irev:_ed 8/'-S 95i 6 3 , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: -SC ZOAA0�`¢ Owner: Date of Inspection: 7 f7 TIGHT OR HOLDING TANK:_ / (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP —Other(explain) Dimensions: Capacity: gallons Design floe+,: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_ (locate on site plan; Depth of liquid level above outlet invert: Comments: tnole if levei and UlsttiUu'oui. .. 04Ll.:, Cuc.ilc u: PUMP CHAMBER:_ X14 (locate on site plan) Pumps in working order.(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Awl Owner: Date of Inspection: SOIL ABSORPTION SYSTEM (SAS)):_ (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:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) CESSPOOLS: _ �✓� (locate on site plan) 1 Number and configuration: Depth-top of liquid to inlet invert: h Depth of solids laver: hE h Depth of scum laver: R h Dimensions of cesspool: Ua/ 9'-6A/'-j Materials of construction: �JS � InUiCaiiUii G4 i: aic:. N — A.6" w inflow (cesspool must e pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) NCC .4tj00-7- y1 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.) (revised 8/15/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' DEPTH TO GROUNDWATER Depth to groundwater: feet method of determination or approximation: (revised 6/15/95) 9 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 02 293 Wasningion 5ireet Norwell MA 02061 December 29, 1997 Barnstable Board of Health Barnstable Town Offices PO Box 534 Hyannis,MA 02601 RE: 56 Long Beach Road Giardini -Applicant FAX 781 345 8027 Members of the Board: As a supplement to our letter and plans earlier submitted,BSC is resubmitting an updated septic System Inspection Report for the Board's use in their approval of a temporary tight tank for the above referenced site. This report documents the cesspool is within the groundwater and therefore constitutes a failed system. As we discussed at the Board's meeting on December 3, 1997,our request is made only to meet the requirements of the bank,(for mortgage purposes),and the tight tank is not envisioned to be constructed or utilized due to the pending site re-development which includes a full Title 5 system. Unfortunately,it is not possible to design, permit and construct a new Title 5 system within the time line required by the bank's mortgage conditions on the property. Therefore,we request the Board's approval of a tight tank allowing Ms. Giardini to move forward with her site upgrade permitting. As security. in the event that the site cannot be permitted with a full new Title 5 system,an escrow account exists for the installation of the tight tank. Regarding DEP approval, because the tight tank is not intended to be constructed(and there is no demand by the bank that the system be constructed unless all other permitting fails),DEP approval is not necessary at this time. If of course it becomes necessary to install the tight tank then the escrow account would be used. Should for some reason the construction be required and the escrow account be used, that process would of course continue_ Specifically, we request the Board approve the request for: Engineers A temporary tight tank and to stipulate that the construction shall occur within one year as per Environmental 310 CMR 15.305 unless during*his time frame the site can be designed,permitted,and Scientists constructed with a new Title 5 sepsc system,thus saving the expense of actual construction of the tight tank. GIS Consultants t.andse" I look forward to seeing you on January 6, 1998 to receive your approval for this project. Architects Sincerely, Planners The BSC Group-No ell,Inc. Sunreyo►s avid J Crispin. P . PL Associate CC: Georgia Giardini G:wrres15559.wpd 12746 Wilderness Drive Palm Beach Gardens, FLA 33418 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 03 ..\ COMMONWEALTH OF KkSSACHL•SETTS Ha r; EXECUTIVE. OFFICE OF ENV1RONINIE\TAL AFFAIRS r DEPARTMENT OF EtiAIRONMENTAL PROTECTION' �N ' ONE WINTER STREET. BOSTON. %IA 0-2106 e;'-:9:-;;vG . WILLIAV F WELD TRL'DSI CC, Govemc: DAViD ARGEO PAUL CELLUCCI STR.: Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commiss�: PART A CERTIFICATION Property Address: S .-, Address of Owner: Date of Inspection: IZ /Y7� (If different) Name of Inspector. Ct�r S /... I am a DEP approved system ins tor pursuant to Section 1-340 9LTitle 3 (310 CMR 15.000) Company Name: Z` �5 C �R.:'i,.e ' Ik(c.l[.--;/ice+[ Mailing Address: 00V1trh,,•e rr v Telephone Number: 7.9 f - C s`1 ' `7 �' f CERTIFICATION STATEMENT i cerui�y that I have personadv inspected the sewaee disposal system at this address and that the information reported be+ow is true. accu rat and complete as of the t-rne of mspec;ion. The inspection was performed based on my training and experience in the proper funetron anc maintenance of on-siie seKage disposal systems. The system; _ ?asses Condit-onall. Passes ,e-ds Further Evaivatio By the Local Approving Authority Fa��s Inspectors Signature: Date: 12 23-7 3 7 The System Inspector sF.all s mit a copy of this inspection report to the Aporoving Authority within thirty(301 days of completing this inspection. if the sysiern 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 aoDrooriate regional office of the Department of Environmental Protection. The original should be sent to the system owr and copies sent to(he buye% if applicable, and the approving authorm, INSPECTION SUMMARY: Check A, B, C, Or D: A} SYSTEM PASSES: -N.4 I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.3c: Any failure criteria not evaluated are indicated below. COMMENTS: 81 SYSTEM CONDITIONALLY PASSES: N h One or more system components as described in the'Conditional Pass' section need to be replaced or repaired. The system, uc completion of the replacement or repair, as approved by the Board of Health, will pass. indicate ves, no. or not determined (Y, N. or ND1. Describe basis of determination in$11 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 Corrokance (attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection: the septic tank,whether or not metal, is cracked. structurally unsound, shows substantial infiltration or exfiltratton, or le failure :s imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tangy as approved by the Board of Health. (rq••:vod 04/21/91) pa" l of to DEP on Ine Wono Wioe Web- nttD'rrwww rnagnet.tilate mavvaec Pnnlea on ReWiveo Paw 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 04 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A / CERTIFICATION (continued) Property Address: �� LG i ell Owner: Date of Inspection: �z ' ' ' BJ SYSTEM CONDITIONAL Y PA SE' cconunued! / _ c water level observed in the distributiop box is due to broken or obstructed of Sewage backup or breakout or high stdU the pipets) or due to a oroken. settled or uneven distribution box. The system will ass inspection if{with approval Board of Health, Describe observations: broken pipets)are replaced obstruction is removed distribution box is levelled or replaced _ The system reavired pumping more than four times a year due to broken or obstructed pipe(s). The system will pass Inspection if!with a3proval of the Board of Health): oroken pipets) are replaceC oDstrvct+on i5 removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which eauire further evaluation by the Board of Health in order to determine if the system is failing to protect the public health. 5afety and ,ne environment. 1) SYSTEM WILL PA$5 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 pnvv is within 50 ieet of a surface water Cesspool or pn: is within SO feet of a bordering vegetated wetland or a salt mash. 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 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 to a Surface water supply or tributan, to a surface water supply. _ The system has a septic tank and soil absorption system and the SAS is within a Zone t of a public water supo'Y well. The syste-- hay a wont tank and soil absorption system and the SAS is within 50 feet of a private water supply well. Theti n system and the SAS is less than 100 feet but 50 feet or more from a v m h as a septic tank and SCiI absor p a s,ste private water suoD�% well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that is equal to or the weli is free irom pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen less than 5 pom. .method used to determine distance .(Approximation not valid). 3) OTHER (r�vi��d 01/25/971 D�g� 2 of 10 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 05 SUBSURFACE SEWAGE DISPOSAL S)STE.tit INSPECTION FORM PART A CERTIFICATION (continued) Propertv Address: S G/ /� Owner: G.ir�r/o//_.v / Date of Inspection: D) SYSTEM FAILS: / You m dicate eqt e- "yes"or-No- as to each or the following: have oeier—i�nec that the system violates one or more of the following failure criteria as defined in 310 CAR 15.303. The oasis for this oeterminat,on is identified below. The Board of Health should be contacted to determine what will be necessary to cone' the ia(lure. Yes No Backuo of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. O.scnaree or ponding of effluent:to the surface of the ground or surface waters due to an overloaded or clogged SAS or cess000l ;a;c :(quid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Lictu•d depth in cesspool is less than 6" below invert or available volume is less than 1/2 day now, Recurred pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numoe, of times pumped An% oomon of the Soil Absorption System. cesspooi or privy is below the high groundwater elevation, am oomon of a cesspool or privy is within too feet of a surface water suppiv or tributary to a surface water supply. a.n•; portion of a cesspool or prnj• is within a Zone I of a public well. A,!%-. pomon of a cesspool or privy is within So feet of a private water supply well. Ai: portion of a cesspool or privy,s less than 100 feet but greater than 50 feet from a private water suppiv well with r acceptable water quality analysis. If the well has been analyzed to be acceptable, attach coov Of well water analysis fo cohiorm bacteria. volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: �v You must indicate ertl-,e• "Yes" or"No"as to each of the following: 'he =o;o, rF criteria appiv to large systems in addition to the criteria above: The svverr se-ves a faciiir�- with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public heaitn and 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 _ (he 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 orograr requirements of 3's :-N4R 5.00 and 6.00. Please Consult the local regional office of the Department for further iniormation. troviaed 04/2507' Page 3 of 10 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 06 y SL:SSUPFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM g CHECKLIST Property Address: S G C` '"f �-,r' Owner: Dale of Inspection: Check if the following have been done: You must indicate either"Yes-or-No"as to each of the following: Yes rvo was provided by the owner, occupant, or Board of Nealt . Pumping iniormation has been ceivin norma None of the sys:em components have been pumped for at least two weeks and been the system introdu t therSystemgrecentll recently of flow rates during that period. Large volumes of water have not bee as part of this jnsoect,on. _ As built plans kake peen obtained and examined, Note if they are not available with N/A. The facilfi a-swell rig Was inspeGted is signs of sewage back-up. �G. fhe sgstem cops not reserve non-sanitary or industrial waste flow. The site %,w rspected for signs of breakout. All sv!te'r =..00--ents. excluding the Soil Absorption SYstertL have been located on the site. v� The septic tank mar,noles were uncovered. opened. and the interior of the septic tank was inspected for condition of baffles or teei. -naterlal o:construction. dimensions, depth of liquid, depth of sludge,depth of scum. The size and local on of the Soil Absorption System on the site has been determined based on The faciirn• Qwne, land occupants, if difierent from owner) were provided with information on the proper maintenance of Sub-5uriace Disposal System, Existing iniormauon. Ex. Plan at B.O.H. Determined n the field iif any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable ['5,302t3i(b)) page 4 at 10 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 07 SLASURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO` FOR-%t PART C SYSTEM INFORMATION a,.Property Address: Owner: 4--l-,:ir.1 pwti i Date of Inspection; /�� (/ Flow CONDITIONS RESIDENTIAL: Design flow: I!G o.d•,bedroorrm for S.A.S. Number of bedrooms-1— Number of current residents: 2 Carbage g-,,-der tyes or no:_'&L' Laundry cor-eaed to 5v5tem Ives or no):Nv Seasonal use ryes or no! i s �� Water meter readings. t�avadable ilasr two (21 year usage (gpd): Sump Pump lees or not /o Last date of occuoanC: COMMERC14LrINDUSTRIAL: 11PA Tvoe of establishment Oesign flow eai:onsroav Grease trap present. ivies or no:._ Inoustrial Waste Holding Tanis oresent: ;ves or no!! Non•sanrtary waste d•scnareed to the Title S system: tyes or not_ Water meter readings !f ava,labie last date oT o cupanc. OTHER; .Describe — Last date of occuoanc% GENERAL INFORMATION PUMPING RECORDS a^d source of rniormairon• /(/ /f Svstem pumpeo as pan of inspection: ryes or no;_ If yes, volume pumped: gallons Reason fo- oumorng TYPE OF SYSTEM Septic tank/d,stributron box/sod absorption system C� Single cesspool Ove'tlow cess000l Pnw Shared system Ives or not lif yes, attach previous inspection records, if any) I/A Technologv ecc. Copy of up to date contract? Other APPROXIMATE ACE o:all components, date installed (if known) and source of information: a/N�NGw/�i Sewage odors detected when arriving at the site: (yes or not crwized 04/25/97) Pbg* 5 of 10 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 08 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / SYSIE"A INNFRMATION (continued) Property Address: W (L4�— Owner zO"^' Date of inspection: Y/f7 BUILDING SEWER: (Locate on site plan) Depth below grader Material of construction: _7( cast iron ,aQ PVC other texplaini OIstance from private water supply well or suction Diameter /1 Comments: (condition of joints. venting, evidence of leakage. etc.) SEPTIC TANK:, (locate on site plant c� Depth below grade:` .Material of construction: _concrete _metal ,Fiberglass _Polyethylen@ _otheriexplaml if Lank is metal, list age — Is aae con:,rmed by Centi,caie of Compliance �(Yes/Not Dimensions: Sludge deoth:�_ D,sfance irom top of sludge to boron 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 boron of outlet tee or baffle: How dimensions were determined. 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. e,.c. GREASE TRAP: /4 ilocate on site plant Depth below grade:! .Material of construction; `concrete _metal_Fiberglass _Polyethvfene _otheriexpiain) Dimensions: Scum thickness, Distance from top of scum to too of outlet tee or baffle: Distance from bottom of Scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, cond-on of inlet and outlet tees or battles. depth of liquid level 1n relation to outlet invert. struaura integrity, evidence of leakage. etc., (rovispC page 6 of 10 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 09 SL,.BSU-RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR-" PART C SYSTEM INFORMATION (continued) Property Address: Owner: G'j �f.co/•. Date of Inspection; TIGHT OR HOLDING TANK:_ 'Tank must be pumped prior to,or at time. of inspection) (locate on site plan: Depth below grade material or construction concrete ,metal _Fiberglass—Polyethylene other(explainl Dimensions: Capaciry gallons Design flow: gallonsida. Alarm level: Alarm in working order Yes;_ No Date of previous pump,ng Comments. (condition of inlet :ee. condition of alarm and float switches. etc.) DISTRIBUTION BOX:_ / V (locate on site pian Depth of liquid level aoove ouoer invert! Comments: (note if level and disinbc--on is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.),_ PUMP CHAMBER:— (locate on site plan! Pumps in working order: (Yes or Noi Alarms in working order(Yes or No, Comments: (note condition of pump chamber. condition of pumps and appurtenances. etc.) (rooiead 04/25/97) Vega 7 of 10 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 10 z �J w SUBSURFACE SEWAGE DISPOSAL sYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) 4 Property Address: 57(v Owner: e4 Date of Inspection! SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possrbie. exca%avon not required. but may be approximated by non-intrusive methods; If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number:__ leaching trenches, number,length: leaching fields, number, d,mensiens: overflow cesspool, number:— Ahe►natrve system: Name of Technology: Comments: (note condition of Soil. signs of hvdrauk failure, level of ponding, condition of vegetation, etc.) CESSPOOLS:_ (locate on site plaro Number and configuration: Depth-top of liquid to inlet invert Depth of solids layer: Depth of scum layer: Dimensions of cesspoo;: Materials of construction: Indication of groundwater: inflow (cesspoo mv.t be ourriDed as part of inspection! Comments: (note condition of soil. signs of hydraulic failure, level of pon ing, condition of vegetation.etc.) / PRIVY: (locate on site pldll Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs o hydraulic failure, level of ponding, condition of vegetation, etc.( (revised 04/25/07) page 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PrOOerty Address: Owner: Date of Inspection: Depth to Groundwater Feet Please indicate all the methods used to determine high Croundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) --re-s Determine it from local conditions Check with local Board of healti^ Check FE!KA t+saos Check pumping records Check local excavators. installers Use USCS Data Describe in your own words ho%% 4ou established the High Groundwater Elevation. (Must be completed) Ai LO e /0// /*7 (savir.d 04/25/971 Pay 10 of 10 01/06/1998 09:59 6173458027 THE BSC GROUP INC PAGE 12 • U SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / SYSTEM INFORMATION (continued) Propert Address: Owner: Date or inspection: G! �'� /Z17 i 7 SKETCH OF SEWAGE DISPOSAL. SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all webs within 100' (Locate where public water supply comes into house) 74 el /�/f/ ,q 7 p� 9 o! 10 <reraaed Oa!]Si9 1 9 TOWN)OF BARNSTABLE LOCATION S( &wo 13�4 o`b SEWAGE# VILLAGE �nTrw� JY ASSESSOR'S MAP&PARCEL 206 INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY/S?,! LEACHING FACILITY:(type) 4�'�1/,, Am,; ( � (size) // �j«7,s-. )E_/1 NO.OF BEDROOMS v� OWNER PERMIT DATE: V—3—6�T COMPLIANCE DATE: Separation Distance Between the: a 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 yi' y9 //a�G�C /FoG GsC y o�0 %nsG��ia' 10 TOWN OF BARNSTABLE LQCATION 1 (� LOn S t4�S � SEWAGE#c)aOl'J,7/ VILLAGE ASSESSOR'S MAP&PARCEL ;PQlr1// INSTALLERS NAME&PHONE NO. / �/�,6� J�.rro�� ?B- 79:.2K ISEPTIC TANK CAPACITY 1540 671,t,4.7o /fz:) Cot _ LEACHING FACILITY:(type) « /or i �3� (size) // X.;2 Tf NO.OF BEDROOMS `OWNER ;t 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 SC GW, I W 39 Jaw D O par f�RPri76dQ L f�0� � NOTES: 1. SEPTIC TANK SHALL BE STEEL 4. INLET AND OUTLET TEES TO BE SC•IED. 40 PVC GENERAL NOTES: REINFORCED CONCRETE TEES TO BE UNDER MANHOLE COVER. i 2. SEPTIC TANK TO WITHSTAND H-20 LOADING 5. RECOMMENDED MANUFACTURER-ROTONDO OR 1. THIS PLAN IS FOR DESIGN AND CONSTRUCTION OF THE SEWAGE APPROVED EQUAL 3. ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL BE WATERTIGHT. NOTES: DISPOSAL FACILITY ONLY. 2. ALL CONSTRUCTION METHODS AND 1. 1,000 GALLON PUMP CHAMBER TO MATERIALS SHALL CONFORM TO MASS. WITHSTAND H-20 LOADING D.EP TITLE 5 AND LOCAL BOARD 24"0 CAST IRON CAST VENT 2. ALL PIPE CONNECTIONS AND OF HEALTH REGULATIONS. IRON MANHOLE COVERS AIR CONCRETE CONSTRUCTION SHALL BE 3. ALL PIPES SHALL BE SCHEDULE 40 TO WATERTIGHT. TBROUGHT TO FINISH BLOWS 3. RAISE MANHOLE TO FINISH GRADE OR EQUAL GRADE, 80 MIN. PUMP POWER WITH SEWER BRICK AND MORTAR. 4. THERE ARE NO KNOWN PRIVATE WELLS do FLOAT 0 FULL OUTER MORTAR PARGE TO LOCATED WITHIN 150 FT. OF THE HOLDING TANK PRECAST CONCRETE / CONTROL I PROVIDE WATER TIGHT SEAL PROPOSED LEACHING FACILITY NOR ANY KNOWN WELLS PROPOSED WITHIN SEE NOTE 3. SEPTIC TANK 30" MIN. 6" , CABLES O t 0 4. POWER CABLES TO BE PLACED IN 150' OF ANY KNOWN LEACHING FACILITY. COVER 6 I CONDUIT IN ACCORDANCE WITH LOCAL NOTES 11'-0" `e.�:. •e PUMP TO BE in BUILDING AND WIRE CODES. 5. WITHIN LIMIT OF EXCAVATION REMOVE 10'-0" FAST NI ' :e INLET UNDER MANHOLE 5. ALARM TO BE ON SEPARATE CIRCUIT ALL TOPSOIL. SUBSOIL AND OTHER REcra.E r.n+e TEE FROM PUMP MOTORS. IMPERVIOUS MATERIAL rr 1. BLOWER MUST BE WITHIN 100 FEET OF 18• a ; s 6. REPLACE WITH CLEAN WASHED SAND SEE NOTE 7 60 .I FAST UNIT WITH LESS THAN 4 ELBOWS IN -3 '� 3• = OR OTHER CLEAN GRANULAR SOILS THE PIPING SYSTEMO2100 FT.). FOR • DISTANCES GREATER THAN 100 WIDE 4 5'_1» PLAN CONFORMING TO THE FOLLOWING FEET--CONSULT FACTORY. BLOWER MUST BE •I� BA 0 4. 6.-1. SIEVE ANALYSIS.- LOCATED ABOVE NORMAL FLOOD LEVELS. 5'_00 4'-5" 6 DIA. 10X (MAX) BY WT. SHALL • 24' DIA MIN. C.I. BOLT-ON 3 MERCURY FLOATPASS No.O 30rr 25rr _ 6-0 :: ORIFICE 4'-0"MIN. ouTLET e- MANHOLE COVER BROUGHT 40 X OF No. 4 SIEVE SHALL 2. RUN VENT TO DESIRED LOCATION 24 MIN.:_ LIQUID TEE TO FINISH GRADE LEVELS PASS No. 100 CAP OBSERVATION/VENT PIPE WITH 6' M ;� DEPTH �. _ � /' �C <5 X (I- No. 4 SIEVE SHALL VENT GRATE SEE ADDITIONAL VIEWS 74 PASS No. 200 • DRAWING AND SEE TABLE FOR SIZING. BOTTOM ON LEVEL STABLE.BASE &I g• 3 �� UNIFORMITY COEFFICIENT O No. 4 SETTLING ZONE TREATMENT ZONE � G,�rr I PLAN VIEW • ��, TO SEPTIC 1-1/2' PVC DISCHARGE PIPE SIEVE </=6.0 J••F 6 MIN. 3/4 TO 670 GALLON TANK SECURE CHAIN 3' DIA. (MINIMUM) 3. ALL APPURTENANCES TO THE FAST (e.g. 1 1/2' STONE CROSS-SECTION VIEW EMERGENCY 0 WALL , 1-1/2- UNION 7. EXISTING UTILITIES WHERE SHOWN VENT PIPE OPTION SEPTIC TANK, PUMPOUTS, ETC.) MUST STORAGE IN THE DRAWINGS ARE APPROXIMATE. SEE NOTE 2. CONFORM TO MASSACHUSETTS STATE CODES. qLq ELEV. /4'0 HOLE TO DRAIN THE CONTRACTOR SHALL BE RESPON- iq = w O FORCE MAIN SIBLE FOR PROPERLY LOCATING AND I 6 m COORDINATING THE PROPOSED CON- PUMP (I`l SL. o CHECK VALVE 4. BLOWER CONTROL SYSTEM BY + _ o w STRUCTION ACTIVITY WITH DIG-SAFE BIG-MICROBICS, INC. » ~D 0 2" SCH 80 AND THE APPLICABLE UTILITY BLOWER WITH HOOD 6 w o m ACCESS MANHOLE 6' OBSERVATION/VENT (BY BIO-MICROBICS> pUMp OFF a w PVC THREADED COMPANY AND MAINTAINING THE TO, GRADE. PORT SEE NOTE 2. SEE NOTE 1-+- - IO a co 41 PIPE EXISTING UTILITY SY5T1]�A IN SERVICE. 5. COPYRIGHT CC) 2001, DID-MICROBICS, DIG-SAFE SHALL BE NOTIFIED PER INC. \\\ - - MYERS SRM 4-1/4 HP. THE STATE OF MASSACHUSEITS . 35 GPM O 14' TDH. STATUTE (�IAPTER 82, SECTION 409 6' MIN. 3/4' TO 1 1/2' STONE (LOCATE UNDER MANHOLE) 6. MUST INCREASE TANK SIZE BY 20Y. IF AT TEL 1-800-322-4844. THE MINIMUM OF 10 INCHES IS USED BETWEEN ENGINEER DOES NOT GUARANTEE THE UNIT AND THE BASE OF THE TANK. THEIR ACCURACY OR THAT ALL 2' DIA. PVC AIR LINE CONSULT FACTORY FOR APPROVAL. SECTION UTILITIES AND SUBSURFACE STRUCTURES ARE SHOWN. LOCATIONS AND ZELECTRICAL CONDUIT 7, THE PRIMARY COMPARTMENT .MAY BE A 1500 GALLON SEPTIC TANK w/MICRO FAST 0.5 DETAIL ELEVATIONS OF UNDERGROUND UTILITIES (TO BLOWER --. .._.._._._ -------___..._._-----_---____..._-_..._._... _._____...-_- T___.---_-_-- CONTRACTOR SHALL VERIFY SIZE. CONTROL SYSTEM) SEPARATE TANK. NOT TO SCALE ____.__.._. ..___..-._._. -. TAKEN FROM RECORD PLANS. THE SEE NOTE 4. LOCATION AND INVERTS OF UTILITIES S. FOUR LEG EXTENSIONS MAY BE USED TO TDH VS. Q i AND STRUCTURES AS REQUIRED PRIOR � STAND UNIT IN TANK ELIMINATING THE NEED _ TO THE START OF CONSTRUCTION. FOR THE LID. REFER TO INSTALLATION i MANUAL FOR MORE INFORMATION. RECYCLE LINE 2rj 8. THIS SYSTEM IS NOT DESIGNED F(X2 THE USE OF A GARBAGE GRINDER. A GARBAGE GRINDER IS NOT 1Y MIN. COVER FINISHED GRADE I RECOMMENDED DUE TO RECOGNIZED H 4' DIA. NOTE 20 ADVERSE IMPACTS lIJ THE LEACHING FAST TREATED SEE TABLE ON PAGE: _ EFFLUENT 0.5, 0.75, 0.9, a 8 °fib •°'f�„ °C :' °b' qf,tea; � i_ FACILITY. INFLUENT 1.0 8� 1.5 FAST 1-1/2' PVC 777`0i;;� $ 15 WASTE SEE NOTE 7 UNITS DIM CHART ��' a-�, 12' EFFECTIVE ! _ (CUT VIEW) MA �°• . F a � DEPTH _ -+-TDH cT ■ �- 21.5 12 1- 10 SRM4 12" PROFILE 3 CONTACTOR UNITS - SETTLING ZONE TREATMENT ZONE PER ROW. 10' MIN. 3 CJLTEC CONTACTOR 100 END TO_END __. _ SEE NOTE 6 5 BREAK-OUT BARRIER i.. • LOAM do SEED 2X MIN. FINISH GRADE 0 SUSPENDED ' --�- 1 5 20 25 30 35 40 45 50 55 60 PVC (PERT) N / - Im _! DESIGN O F S E WAG E FULL LENGTH. L2' N . OF 1 8 TO Q 1/2' WASHED STONE l9P i SAND FILL 3/4' TO 1-1/2" DOUBLE DISPOSAL SYSTEM 48 WASHED STONE (NO FINES) -_ '_------„' --1 REPAIR CROSS-SECTION 56 LONG BEACH ROAD r• IN iN THE INTEREST OF TECHNOLOGICAL PROGRESS, ALL PRODUCTS ARE 'SUBJECT TO DESIGN AND/OR MATERIAL CHANGE WITHOUT NOTICE. CULTEC CONTACTOR 100 CEIVTEp V 1LLE, MA Date 6-22-04 0.5,0.75, 0.9, 1.0 & [� B10- 1.5 FAST®Units ASSESSORS MAP 206 MICRO. FAST 0.5 SYSTEM nn1CROB1 NOT TO SCALE D RATED for and ch sew SOIL ABSORPTION SYSTEM DETAIL PUMP CHAMBER DFTAI L PARCEL 11 - NOT TO SCALE �^ by BMI NOT TO SCALE A OC.TOBER 17, 2007 REVISIONS: NO. DATE DESC. ~ MANHOLE COVERS AS REQUIRED INSPECTION FRAME NEENAH THREADED CAP (BRING TO FINISH GRADE) MAGNETIC MARKING R-1978 OR APPROVED EQUAL \� FINISH GRADE FFE=6.09 TAPE (TYP.) FINISH GRADE � (REFER TO NOTES) :, SLOPE PROVIDE ADDITIONAL O ;,� �`" - - - - -� - PREPARED FOR: PEASTONE AS REQUIRED ORIFICE SHIELD TO BE SNAPPED SECURELY = 2X MIN. 4' PVC 4' PVC SCH 40. INv=c MS. GEORGIA GIARDINI INTO PLACE AROUND ALL PERFORATIONS SCH 40 1/4'/l�T MIN INS 0 ON EACH LATERAL SLOTS ON ORIFICE SL(I'E 1-1/2"� P� FQ�y=F BOT=H 83 OCEAN VIEW f- MI SIFTED TO BE LOCATED DIRECTLY OVER 40 L PVC BREAKOUT I NE W HAVE N, CT 06512 EACH PERFORATION. - LEACHING GALLEY BARRIER, ' I BREAKOUT ELEV.-5.6. 0 p 1-)r LATERAL W/10 - 11fe• BOTTOM ELEV.-4.0 (MAX.) I= I= 3' MINIMUM W/REMEDAIL ZABEL ORIFICE SHIELD PERMIT FOR FAST (XtIFlCES O 2' ON CENTER % O c=i Z ESTIMATED SEASONAL � �` o 0 0 0 0 o GROUNDWATER=H � �� `" BSC CHAMBER . c� 3/16" PERFORATIONS TO BE DRILLED AT 5 O'CLOCK AND 7 1.500 GALLON INVERT ELEVATIONS• 384 Washington Street O'CLOCK. ALTERNATE PERFORATIONS BETWEEN BOTH SIDES OF 1' GALLON PRECAST CONCRETE • 4' PERT. PIPE. SEE PLAN FOR NUMBER OF PERFORATIONS. 1 DRAIN ` • .- �?1C TANK CONCRETEPUMP CHAMBER A. 4" INVERT AT BUILDING - Norwell, Massachusetts SCHD. 80 PVC � � OaPREVENT4CLOGGING.ERFORATIONS TO BE DRILLED SMOOTH ; FAST 0.5 a. STONE BASE PER B. 4 INVERT AT SEPTIC TANK (IN) 3.00 NOTE: 1. REFER TO 'SOIL ABSORPTION (SMITH AND LOVELESS nr,!* H o -r C. 4' INVERT AT SEPTIC TANK (OUT) 275_ 02061 ALL PIPING TO BE SOLVENT WELDED SCHEDULE 40 PVC MODULAR FAST �,,,4�`� jss,, -� D. 4-,INVERT AT PUMP CHAMBER (IN) � 78l 659 7981 SYSTEM' DETAIL REGARDING SYSTEM tNt l!' csiis� E. 2" INVERT AT PUMP CHAMBER (OUT) ...2 60 MATERIAL AND DEPTH OF 0 APPROVED EQUAL) �f z DAVID J. MATERIAL FOR THE SOIL t? -''� ABSORPTION SYSTEM. CRI:.�IN �„ © 2007 BSC Group, Inc. CML °�� INVERTS AT LEACHING FACILITY- No. 32112 ^cr rt`0 F. 2 INVERT AT BEGINNING O rSCALE: VARIES OF LEACHING SYSTEM 5.40 �!v` G. 2" INVERT AT END SUBGRADE Of LEACHING SYSTEM &40 PRESSURE SHIELD DETAIL P I . Q� H. ELEVATION AT BOTTOM FILE: 5559sep1-2007.dwg OBSERVATION PORT DETAIL RESSU EPROFILE OF LEACHING SYSTEM �- DWG. N0: 4043-11 SHEET 2 OF NOT TO SCALE NOT TO SCALE NOT TO SCALE I. SEASONAL GROUNDWATER 2 ELEVATION 1.4 JOB. N0: 4-5559.00 SEPTIC TANK DETAIL: 1 , 500 GALLON DISTRIBUTION BOX DETAIL: NOT TO SCALE SOIL ABSORBTION SYSTEM: CULTEC CONTACTOR 100 REVISIONS SPECIFICATIONS FOR THE SMITH & LOVELESS "FAST" TREATMENT SYSTEM NOT TO SCALE 18" DIA 60 MIN. CAST IRON N0. DATE DESCRIPTION RAISE M.H w/ � NOT TO SCALE MANHOLE OVER BROUGHT NOTES: 1. SEPTIC TANK SHALL BE STEEL 4. INLET AND OUTLET TEES TO BE SCHED. 40 PVC SEWER BRICK TO FINISH GRADE NO. OF OUTLETS 12" MIN. COVER FINISHED GRADE & MORTAR GENERAL: The Contractor shall furnish and install one (1) single home "FAST" REINFORCED CONCRETE. TEES TO BE UNDER MANHOLE COVER. REMOVABLE 2" WALLS treatment system complete with polyethylene enclosure, PVC filter media, blower 2. SEPTIC TANK TO WITHSTAND H-20 LOADING 5. RECOMMENDED MANUFACTURER-ROTONDO OR COVER �� assembly, draft tube assembly, sidestream attachment for recycle, discharge line 3. ALL PIPE CONNECTIONS AND CONCRETE APPROVED EQUAL r " i,a"8°rPc4f4Pagt�a �,Pa4f°tPa„ 9,�aq �Pawgfigs°aofi�Pao° Via ` alarms ventilation system, and all other appurtenances required for CONSTRUCTION SHALL BE WATERTIGHT. VENT �.v:v• ::v.:' 2 NOTES: ^� assembly, controls, yS PP TO AIR BLOWER T 4" PVC iii S kni M �4 , proper installation and operation. 24 CAST IRON THRU ROOF acg k 1 15 DEPTH " 1. DIST. BOX TO WITHSTAND H-10 LOADING. Ili MANHOLE COVERS / a" a"°i BROUGHT TO FINISH � 15 2. PROVIDE INLET TEE OR BAFFLE WHERE ///�`a °ef a o a o a�f, o o aka c� 6• TREATMENT SYSTEM: The system shall be a single home "FAST" treatment system GRADE, 80# IN. 6" 5 5" OUTLETS 8" SLOPE OF PIPE EXCEEDS 0.08 FT./FT OR with a rated hydraulic capacity of up to 1350 GPD as manufactured by Scienco/Fast .of PRECAST CONCRETE d�X. 12"MIN. COVER SEPTIC TANK 30" MIN. 6" ' , • IN PUMPED SYSTEM. 21.5 6" St. Louis, MO, equipped with waste recycle back to the settling zone of the septic tnnk " COVER 6 �av° ° °oQ lea GENERAL NOTES: rr " v•. .v 4 6" PROFILE 3 CONTACTOR UNITS for DENITRIFICATION. 11 -0 : r. '��' 4°� �� a° 2• 3. FIRST TWO FEET OF PIPE OUT OF DIST. PER ROW. 1. THIS PLAN IS FOR DESIGN AND �r-_ •• 3 ROWS - 3 CULTEC CONTACTOR 100 END TO END W/8" STONE AT BOTH ENDS CONSTRUCTION OF THE SEWAGE 10'-0" FAST UNI -� BOTTOM ON LEVEL �/� BOX TO BE LAID LEVEL. CONTROLS: Controls for the system shall be mounted in a NEMA 1 enclosure located - 11 STABLE BASE 6" MIN. CEMENT DISPOSAL FACILITY ONLY. CROSS-SECTION CONCRETE BASE BREAK-OUT BARRIER 2. ALL CONSTRUCTION METHODS AND ` 4. RECOMMENDED MANUFACTURER-ROTONDO LOAM & SEED MATERIALS SHALL CONFORM TO MASS. Within the basement of the residential dwelling, as noted On the plans, and shall be as T 3 3" TO 6 INCHES OR APPROVED EQUAL. 2" 2% MIN. FINISH GRADE D.E.P TITLE 5 AND LOCAL BOARD detailed on the plans. t 6" WIDE BEYOND D-BOX 18 " DIA M.H. CAST OF HEALTH REGULATIONS. BAFFLE : 5'-1" ALL AROUND INLET Q �- INTO COVER 5. ALL PIPE CONNECTIONS AND CONCRETE 3. ALL PIPES SHALL BE SCHEDULE 40 TEE . " 6'-1" h .•..;.:.:.:..•. i The alarm system shall consist of visual and audible alarms t0 indicate failure of the 5-0 4•_5» << 6" DIA. 4-0 MIN. CONSTRUCTION SHALL BE WATERTIGHT. SUSPENDED OR EQUAL. • " LIQUID �: 30 1/2" ( ) ��_ '3 t ¢�''� T2" MIN. OF 1/8" TO 4. THERE ARE NO KNOWN PRIVATE WELLS blower assembly. The visual system consisting of both visual and audibly alarms shall - - 6-0 :: ORIFICE DEPTH r- 4 PVC PERF v L " be wired Into the system control. The location Of these alarms Shall be approved by the OUTLET 6. RAISE MANHOLES TO FINISH GRADE WITH FULL LENGTH. �;= �,� 1 2 WASHED STONE LOCATED WITHIN 150 FT. OF THE -r 24" MIN. TEE SEWER BRICK AND MORTAR. FULL OUTER �/ ° W ° / 12, == \ MORTAR PARGE TO PROVIDE WATER TIGHT SAND FILL %�%/� " " PROPOSED LEACHING FACILITY NOR Owner and the Engineer. Each audible alarm shall be equipped with a silence switch for �� " " \3/4 TO 1-1/2 DOUBLE ANY KNOWN WELLS PROPOSED WITHIN manual silencing of the alarm horn. M'"' `'r`�::::;_ -`:�i.::::r �_'."�:`_:_ �_�_ r SEAL. g» 3�6 6" I` WASHED STONE (NO FINES) 150' OF ANY KNOWN LEACHING FACILITY. o a o l Tr'1 I� 5. WITHIN LIMIT OF EXCAVATION REMOVE "FASTTM" CHAMBER: The "FAST" system shall be situated in the septic tank of the PLAN VIEW o8 BOTTOM ON LEVEL STABLE BASE PRECAST DIST. BOX 11 � ALL TOPSOIL, SUBSOIL AND OTHER " 6" MIN. 3/4" TO //�// /�l' //� J � system, as shown on the drawings and specified herein. The FAST system and CROSS-SECTION VIEW IMPERVIOUS MATERIAL septic tank shall be delivered to the site as one unit. The Contractor shall provide 1 1/2" STONE PLAN VIEW CROSS-SECTION coordination between the "FASTTM" system and septic tank suppliers with regards to ° 6. REPLACE WITH CLEAN WASHED SOILS OR OTHER CLEAN GRANULAR SOILS fabrication of the septic tank, installation of the "FASTTM" system, and delivery to the PROFILE: NOT TO SCALE. INVERT ELEVATIONS. CONFORMING TO THE FOLLOWING Site. VARIANCES REQUESTED Sl10 (MAX) BY WT. SHALL A. 4" INVERT AT BUILDING 8•31 PASS No. . SIEVE FIRST PIPE LENGTH <10 � OF No. 4 SIEVE SHALL LOCAL BOARD OF HEALTH REGULATIONS: B. 4 INVENT AT SEPTIC TANK (IN) 8.11 PASS No. 100 PROPOSED TO BE SET LEVEL <5 % OF No. 4 SIEVE SHALL EL.= 13.0 FOR MIN. 2' NOTE: ALL 1. NO SEPTIC TANK OR DISPOSAL SYSTEM SHALL BE WITHIN 100 FT. SAND FILL C. 4" INVERT AT SEPTIC TANK (OUT) 7.86 PASS No. 200 FINISHED FLOOR MANHOLE COVER AS REQUIRED 4",PVC PIPE » UNIFORMITY COEFFICIENT ® No. 4 OF ANY WATERCOURSE OR WETLAND UNLESS OTHERWISE SPECIFIED ON SITE D. 4 INVERT AT DIST. BOX (IN) 7.76 (BRING TO FINISH GRADE) " (See constr. SIEVE </=6.0 BY THE BOARD OF HEALTH - TANK IS 40 FROM MARSH (130 TO MHW) EL= 11.0 2 -1/8 -3/8 DOUBLE WASHED STONE notes 6 & 7.) 7.60 SOIL ABSORBTION SYSTEM IS 50' FROM SALT MARSH. (135' FROM MHW.) E. 4" INVERT AT DIST. BOX (OUT) 7. EXISTING UTILITIES WHERE SHOWN CRAWL 2" MIN. BUILDING IN THE DRAWINGS ARE APPROXIMATE. SPACE SETBACK THE CONTRACTOR SHALL BE RESPON- 310 CMR 15.000 THE STATE ENVIRONMENTAL CODE, TITLE 5: �'�� 4 LOAM AND SEED I LINE . ►- �`�'%�` INVERTS AT LEACHING FACILITY: SIBLE FOR PROPERLY LOCATING AND 4" PV 4 PVC SCH 40 3 4'" TO 1-1 2" DOUBLE WASHED STONE 11NG ..._ " I COORDINATING THE PROPOSED CON- 1. FROM SECTION 15.255: BREAK-OUT - IT IS REQUESTED THAT AN IMPERVIOUS SCH 40 % N E"Is STRUCTION ACTIVITY WITH DIG-SAFE INFILTRATOR SYSTEM `GRADE F. 4" INVERT AT BEGINNING AND THE APPLICABLE UTILITY DATUM : BARRIER BE ALLOWED TO MEET THE 4 FOOT SEPARATION BETWEEN THE I= A \I=c , , COMPANY AND MAINTAINING THE AND LEACHING SYSTEM AS SHOWN IN THE PLAN. 6" .,.Z 1= G OF LEACHING SYSTEM 7.50 EXISTING UTILITY SYSTEM IN SERVICE. 1= 1=D . • 1=E BOTTOM EL= H G. 4" INVERT AT END DIG-SAFE SHALL BE NOTIFIED PER VERTICAL DATUM: N.G.V.D. 2. NO RESERVE AREA IS AVAILABLE, SECTION 15.12.8 _ 9 OUTLET BREAK-OUT THE STATE OF MASSACHUSETTS 1.500 GALLON I OF LEACHING SYSTEM 7.40 STATUTE CHAPTER 82, SECTION 409 BENCH MARK USED: PK #3 IN PAVEMENT LONG BEACH ROAD DIST. Box to BARRIER ,: PRECAST CONCRETE GROUNDWATER=1.6 AT TEL 1-800-322-4844. THE `�. SEPTIC TANK H. ELEVATION AT BOTTOM ENGINEER DOES NOT GUARANTEE ELEV.=5.04 (FAST SYSTEM) 6 4 THEIR ACCURACY OR THAT ALL OF LEACHING SYSTEM UTILITIES AND SUBSURFACE STRUCTURES LIMIy F 5,.S111- - ARC_. '~ 1 q ELEVATIOSH ARE NS OFOUNDERGROUND UTILITIES I. SEASONAL GROUNDWATER SALT W F. 9 �'e ELEVATION OEM 0 5LO W.F. 20 TAKEN FROM RECORD PLANS. THE • MARSH Bp ROM "" •4 M ` ` W.F. CONTRACTOR SHALL VERIFY SIZE, • 8 PROPOSED HAYBALES +, W.F. 19 LOCATION AND INVERTS OF UTILITIES ANT �, W.F. 7 O P$ W/SILT FENCE - TOP OF SLOPE AND STRUCTURES AS REQUIRED PRIOR - ® TO THE START OF CONSTRUCTION. -- "- ple O 8. THIS SYSTEM IS NOT DESIGNED FOR A ` P ST THE USE OF A GARBAGE GRINDER. I \ IS NOT W.F. 18 RECOMMENDED RDUET 0 RECOGNIZED ADVERSE IMPACTS TO THE LEACHING I) W.F. 4 t ' LOCATION OF DESIGN CRITERIA: FACILITY. WE IN � EXIST. CESSPOOL EXISTING DWELLING SET ON �n EX T. DESIGN FLOW: [9 E� NEW CONC. FOUNDATION I TO BE FILLED FF=6.09Vol 2 BEDROOMS AT 110 G.P.B./D 220 G.P.D. AIR BLOWER ` EAKAWAY i F12 b FRONT- ON I BUILDING PORCH LINE PANELS F.F. ELEVATION = 1s.o REQUIRED SEPTIC TANK. - PROPOSED GRADE W. 6I ti, 220 GAL. x 150% - 330 GAL. } = 1,50o GAL. 100-YR FLOOD ELEVATION = 11.0 PROPOSED BARRIER ' '� � W.F. x3 5x3 > W F 17 SEPTIC TANK PROVIDED: The BSC Group BREAK-OUFOUNDATION WALLS W/ ' 2 BEDROOM G.= N '�' '•• -•' - '�'-' _' ' - - SIZE OF LEACHING FACILITY REQUIRED: BREAKAWAY PANELS ` DWELLING G 3.0NEW \ '\ DWELL X_.'. ,�,FENCE ' ` % \ aHAY/sILT � � �`` � =13.00'- •WIDE � `.. DESIGN PERC. RATE: 2 MIN./ INCH v=i CARPORT PROP. ,� PROP. FF CLAM ,SHELL• • . W.F. 16 220 GAL/0.74 GAL/SF = 298 S.F. LEACHING AREA SEPTIC VENT THRU 293 WASHINGTON STREET EXISTING TANK f ' ' r x5 ROOF 5x5 ©RIVE '.' '.` NORWELL MA 02061 GRADE �` jmw� ``�, SIZE OF LEACHING FACILITY PROVIDED: ' PROPOSEn HAYBALES �f cS, x6 5x6 �','.'.'. .'.','. .'. .','.' F. 13 "' ALL FILL n MEET W/SILT F,'ENCE O �� N F - - (781) 659-7981 SPECIFICA10N IN � � 5x10 / BOTTOM AREA - 23.5 x 12 - 282 S.F. TIDAL MHW=1.9 CONCRETE FOOTING 5• GENERAL K)TE B. 6, ti y W.F. 1 4 F I '� BEACH CLUB SIDE AREA = ((23.5x2)+(12x2))x 1.15 = 81.65 S.F. ELEV=o - N/ R- OF CRAIGVILLE 282 + 81.65 = 363 S.F. EUGEN M. McQUAD et ux l . `` PROJECT TITLE: TIDAL MLw--1.9 � :: ... .`� I REMOTE •._.'.".".'.'.'. SALT 363 > 298 5 g BLOWER 5x9 5x10 I MARSH W.F. 15 SYSTEM COMPLIES WITH SECTION 1.14 SEWAGE DISPOSAL POR H s p'.I'. I OF LOCAL REGULATIONS: 0.75 GAL/SF CIO ,•,. ^ 1 DUNE APPLICATION AREA (AA) REQUIREMENTS= SYSTEM DESIGN SECTION A-A / REUSE EXISTING r r <.>= ., ., = S.F. (23.5+1) x (11+1)=294 S.F.. �- STONES ALONG ••. :: - o' BLOWER � �,.. o SCALE: HORIZ. 1 = 10 FRONT OF SITS uNr: THE ENTIRE SITE IS LOCATED IN 293 S.F. O.K. REPAIR `' VERT. 1" = 5' IF PERMISSIONS .• 4" PVC :. ._.;.:.; ` ` FEMA ZONE A13, ELEVATION 11 ' m IS OBTAINED ° 20 - w,= I oaCOMMUNITY PANEL NUMBER 25001 008 D PROVIDE 3 ROWS 3' WIDE 56 LONG BEACH RD, .w- - VJ. �.', l CULTEC CONTACTOR 100 SOIL TEST PIT DATA a {•�: �•• TO BE � � � � ? Q,. IU'y REVISED 7-2-92 1.5 : 1 EMBANKM NT VEGETATED RE VED a CENTERVILLE, MA TEST PIT �' 1 W/SEASIDE JUNIPER - JUNISPERUS 1500 GAL U . . . CD * SEPTIC TANK GIRD. EL. 4•o INDICATES INDICATES SEASONAL HORIZONTALIS, 0� SHOREGUARD RET. 1.o PERC. �- OBSERVED -L HIGH WALL. (ELIMINAT IF PERMISSION :;_ GW. EL. TEST GROUND WATER - GROUND WATER I .6• �� ASSESSORS MAP 206 o p SANDY LOAM TO FILL IS OBTAINED FROM McQUA T•p• 1 y d � : °' PROVID Nw -80UI:•DERS LOCUS PLAN: PARCEL 11 1 _Cl MEDIUM TO /` ".! SOIL ABSOR011 TO MSC EXISTING 0 2 COARSE f I LL_ SAND SYSTEM D Box •"'SEX I STI N G EXIST G : � I I CEDAR TREES 3' _ TRESTOBE " " ' - - : 0 4' RE OVED 3' ' 0.....-.. ..�.. 9x0 W.G a Ln 5' *DESIGN G.W.=EL. 1.4 PER OBSERVATIONS ON `" :::::�.::. �� ...:::::.: :: CLAY ..�::• ..... NEARBY PROPERTIES ALTE NATE STO L I " BUILDING SETBACK LINE m 6' 3 PERMISSION I INED. d 6 a POST & RAIL FENC NEW , PREPARED FOR: T COARSE _ 5 "~� W.G 0 10 C , SAND 8 ,�` U. POLE ` \SIGN 0 MAIL Ms. GEORGIA GIARDINI s' BOX �-- 83 OCEAN VIEW 10' " - GAS RELOCATED EDGE OF BIT. CONC. PAVEMENT - NEW HAVEN, CT 06512 B.T.P. 010 TOP F PROPOSED SHOREGUARD WATER SERVICE Q 11' � STO ES=8.5' MIN. SHEETPILE 7 PROPOSED PINUS THUNDERGII DATE: MAY 19, 1998 12' PKN BENCHMARK: LONG � BARRIER UT JUNISPERUS VIRGINIANA PLAN VIEW COMP./DESIGN: D. J. CRISPIN BEACH PUBLIC - 2 W DATE: ELEV.=5.04 ( 0 WIDE) n. NOVEMBER 7, 1997 C t ROAD SCALE: 1" = 10' CHECK: N.H. CCD" TEST BY: SOIL EVALUATOR IMINATE SECTION OF rn J. DONOVAN SHOREGUARD RETAINING THE BSC GROUP, INC. K.H. / D.L. Ln SOIL CLASS `W L IF PERMISSION IS A o 5 10 20 FIELD: R.J./J.D./N.H. ') WITNESSED BY: I OBT INED FROM McQUADE J. DUNNING I . 5559SEP1.DWG LO PERC. RATE: L.T.A.T. 0.74 U. POLE A µ 2 MIN./INCH G.P.D./SQ.FT. OLE DWG N0. 4043-13 SHEET a JOB NO. 4-5559.00 1 OF 2 BUILDING SETBACK LINE PRESSURE TREATED 200 CAP BOARD EL=9.0 FIN. GRADE BOULDER EL.=9.2 BROWN PVC SHOREGUARD SHEET PILING LONG BEACH ROAD 250 SERIES (OR EQUIV.) 1/2" x 16" THROUGH BOLT (1-800-256-8857) : Jm r SAND FILL A EXPOSED SIDE rin EL=6.0' l :. :.'. : 2" x 6" WALE GRADE I SOIL ABSORBTION SYSTEM EXIST. BIT. CONC. EL=5.0'f �. .' 2"x 6" WALE PRESSURE TREATED 6' LENGTH SHOREGUARD SHEET . • 2" x 6" WALE PILING (OR EQUIV.) r� EL.=2.0'f A SOIL FILL SIDE SILICONE SEALED JOINT FULL LENGTH, BOTH SIDES SECTION A-A PLAN VIEW SHOREGUARD-SHEET PILE `; BREAK- OUT BARRIER DETAIL "°� ` 9�F'�'C�3Tl�tQ trt� fSSipNAI NOT TO SCALE r F� PROFESSIONAL ENGINEER DATE SITE PLAN 56 LONG BEACH ROAD IN POLE CENTERVI LLE HAYBALE SUPPORT NET FILTER FABRIC POLES MASSAC H U S ETTS (BARNSTABLE COUNTY) BACKFILL SECTION B cVo — Q SECTION A D ETAI LS c ° TOP VIEW UNDISTURBED Sol MAY 199 1998 0 Q. B A COUPLER REVISIONS: POLE NO. DATE DESC. SUPPORT NET HAYBALE FILTER FABRIC 1 10-1-98 EDITS BACKFILL STAKE — � I - --� SECTION A SECTION B FLOW SILT FENCE — a o ° : HAYBALE UNDISTURBED SOIL ° PREPARED FOR: TOE—IN METHODS JOINING SECTIONS OF FENCE Ms. GEORGIA GIARDINI 83 OCEAN VIEW SILT FENCE . INSTALLATION W H AYB ALES NEW HAVEN, CT 06512 C) `D N.T.S. U Cn m CD o ® The BSC Group, Inc. CD CID 293 Washington Street CD Norwell, Massachusetts 02061 LO `0 781 659 7981 00 © 1998 The BSC Group, Inc. CU SCALE: AS SHOWN cn METERS Cu o FEET U CD r., PROJ. MGR.: D. J. CRISPIN FIELD: RJ/JD L CALC./DESIGN: D. J. CRISPIN Q, DRAWN: D. LEARNED LO CHECK: D. J. CRISPIN M Ln Ln FILE: 5559SEP1.DWG DWG. NO: 4043-13 Cc SHEET 2 OF 2 JOB. NO: 4-5559.00 a LOCUS PLAN: NO SCALE REVISIONS: s� LOCUS INFORMATION NO. DATE DESC. CURRENT OWNER: GEORGIA GIARDINI OVERLAY DISTRICT: RPOD N TITLE REFERENCE: BOOK 11059, PAGE 155 FEMA FLOOD — ZONE DISTRICT: ZONE A-13 EL.=11 PLAN REFERENCE: L.C. 40113-A PANEL #250001 0008 D — ASSESSORS MAP: 206 MINIMUM LOT SIZE: 87,120 S.F. R� PARCEL: 11 EXISTING LOT SIZE: 20,675f � LOCUS �£qCN RD — ZONING DISTRICT: RD LONG 9 A SETBACKS: FRONT 30' SIDE 15' REAR 15' CENTERIVJLLE HARBOR LOCUS MAP I certify to the best of my best NOT TO SCALE professional knowledge, information and belief that the Septic System » >, As-Built conforms with the plan A S — B U ( L T approved by the Barnstable Board of Health. BLDG TIES DESCRIPTION INVERT A B ELEVATIONS HOFA/gs ` 1. 10 HOUSE 3.53 2. 37.9' 27.1' IN TANK 2.97 CA�DJ' CR 3. 32.1' 30.0' OUT TANK 2.72 CMLML ,, .32112 4. 29.9' 32.3' IN PUMP 2.57 �t �° 5 ' OUT PUMP 5.46rctda� 6. ' BEGIN CHAMBER 5.68 7. 43.9' 38.7' IEND CHAMBER PROFE IONAL ENGINEER DATE BOT OF STONE 5.10 ADJ. G.WATER 1.90 I I, III, �111, ,�►1, - - SEPTIC SALT MARSH . AS - BUILT os W.F. s ,�I ,,� �,moo. #56 , p,RSN PWET��N W.F. 20 W.F. 7 d, ° POST LONG BEACH ROAD — W.F. 1; IN, F. 11 _ CENTERVILLE, MA 41, ASSESSORS MAP — 206 N / BED ROOM LIVING ROOM W.F. 12 �I�, PARCEL 11 1�---' W.F. 6 — SALT MARSH W.F. 5 � XISTING HOUSE KITCHEN ,1 I r, 0 1I1 W O BEDROOM CLO. BATH F. 13 APRIL 28, 2008 O O W. • O CO W.F. 14 I I 1, . W.F. 15 PREPARED FOR: 1500 GALLON SEPTIC TAN MS. GEORGIA GIARDINI w/MICRO Fq.ST 83 OCEAN VIEW 0 PUMP I NEW HAVEN, CT 06512 r CHAMBER I XISTING VENT DRIVE --'—''24.9�— I � I I o I I REMOTE BPTIoN I YSTEM I I I BLOWER ,� 349 Route 28 I OVIEWPORT STONE I I West Yarmouth, Massachusetts 02673 L_ SAND OVERDIG _ ___ __.—. ———� 508 778 8919 o ' I © 2008 The BSC Group, Inc. `�POST & RAIL FENCE IP/CAP NEW FND FNOD� � � ® S89'03'25"W 140.0' SCALE: 1" = 10' \ 0 1.25 2.5 5 MEMO iiia GAS RELOCATED WATER 0 5 10 20 Fir SERVICE PROD. MGR.: CRAIG FIELD FIELD: D. GAZZOLO / N. MERCIER LONG BEACH ROAD CALL./DESIGN: P. HAGIST DRAWN: P. HAGIST CHECK: M. DIBB FILE: 5559SEP-AB.DWG LE DWG. NO: 4043-12 SHEET 1 OF 1 JOB. NO: 4-5559.00 EBB / /.. i � GENERAL NOTES: ,. THIS PLAN IS FOR DESIGN AND SOIL TEST PIT DATA DISPOSAL FACILITY ONLYSEWAGE LANDSCAPE SCHEDULE TP # , 2• ALL CONSTRUCTION METHODS AND TEST PIT GRD. EL 4.0 INDICATES OBSERVINDICATED MATERIALS SHALL CONFORM TO MASS. FLOC 0.55 CODE QUANTITY BOTANICAL NAME/COMMON NAME SIZE O, GW. EL 1.0 PERC. - OBSERVED D. HEALTH REGULATIONS. EW . v W.F. 25 RR 41 �A �gA PpT P SANDY LOAM TEST GROUND WATER OF H TITLE 5 AND LOCAL BOARD `1 I I'1• RUGOSA ROSE 1• '1 3. ALL PIPES SHALL BE SCHEDULE 40 MEDIUM TO OR EQUAL CENTERVILLE RIVER - I' . • AS 2,000 AMMOPHILA SREVILIGULATA/ 6" HIGH CULMS 2' COARSE 4. THERE ARE NO KNOWN PRIVATE WELLS // AMERICAN BEACHGRASS SAND *SEASONAL LOCATED WIIHIN 150 FT. OF THE // • • 3' a HIGH PROPOSED LEACHING FACILITY NOR / IMN � 4, - 15N0'' KNOWNN WELLS PRE CHIN FACILITY. GROUND WRIER 5. WITHIN LUT OF EXCAVA71ON REMOVE // '/•'/ �111. �1 I• � 5 CLAY MATERIAL AND OTHER W.F. 24 g' 3 IMPERVIOUS �0.61 / �,I I, � 6. REPLACE WITH CLEAN WASHED SAND OR OTHER CLEAN GRANULAR SOILS •' 7, C EW CONFORMING TO THE FOLLOWING ^ s SAND E DESIGN G.W.=EL 1.4 PER P\, /�/ ' ,III/ •/ 3. 8 9' OBSERVATIONS ON NEARBY SIEVE107L (MAX) Y WT. SHALL PROPERTIES PASS No. 50 SIEVE 10, <10 X OF No. 4 SIEVE SHALL B.T.P. a 10" PASS No. 100 /�• / 11 <5 X OF No. 4 SIEVE SHALL O / / PASS No. 200 l �j j- �l IP j �1 1, / • _ 12� UNIFORMITY COEFFICIENT O No. 4 QG 4f,0.51 X11 . ' d W.F. 23 DA 1E: SIEVE </-6.0 EW 10 �111, NOVEMBER 7, 1997 7. EXISTING UTILITIES WHERE SHOWN. / \ • TEST BY: SOIL EVALUATOR IN THE DRAWINGS ARE APPROXIMATE. THE BSC GROUP, INC. THE CONTRACTOR SHALL BE RESPON- SIBLE FOR PROPERLY LOCATING AND J WITNESSED BY: SOIL CLASS �I I, L.T.A.T. STRUC71ON CTIVITYNATING THE �WITH DIG SAFE J. DUNNING 0.74 G.P.D. SQ.FT. AND THE APPLICABLE UTILITY \i1i/ W.F. 1 W.F. 2 - - --2-MIN./INCH-PERC. RATE: COMPANY AND MAINTAINING THE • �l 1, '• EXISTING UTILITY SYSTEM IN SERVICE. W.F. 22 DESIGN CRITERIA. DIG-SAFE SHALL NOTIFIED PER • THE STATE OF MASSAaiUSETTS ,111, STATUTE CHAPTER 82, SECTION 409 X AT TEL 1-800-322-48". THE ,111/ 3.8 DESIGN FLOW: ENGINEER DOES NOT GUARANTEE THEIR ACCURACY OR THAT ALL _ SALT MARSH I 2 BEDROOMS AT 110 G.P.B./D 220 G.P.D. UTILITIES AND SUBSURFACE STRUCTURES • ARE SHOWN. LOCATIONS AND REQUIRED SEPTIC TANK: ELEVATIONS OF UNDERGROUND UTILITIES LOT 206- 11 GAL. x 200% = 440 GAL. TAKEN FROM RECORD PLANS. ,HE CONTRACTOR SHALL VERIFY SIZE, AREA=20 , 000 ��II' ��II� SEPTIC TANK PROVIDED: = 1,500 GAL. LOCATION AND INVERTS OF UTILITIES S • F• - AND STRUCTURES AS REQUIRED PRIOR F. 21 SIZE OF LEACHING FACILITY REQUIRED: TO THE START OF CONSTRUCTION. NOTE: DESIGN PERC. RATE: •• �1�1, 2 MIN./ INCH �� I, �� ► THE ENTIRE SITE LIES WITHIN THE S. THIS E OF Is NOT DESIGNED FOR THE USE OF A GARBAGE GRINDER. W.F. 3 200' RIVER FRONT CORRIDOR. 220 GAL/0.74 GAL/SF = 298 S.F. LEACHING AREA A GARBAGE GRINDER IS NOT RECOMMENDED DUE TO RECOGNIZED �1�I/ �'1• , SIZE OF LEACHING FACILITY PROVIDED: ADVERSE IMPACTS TO 11 THE LEACHING - - FACILITY. BOTTOM AREA = 23.5' x 11.0 = 258.5 S.F. • - 1 SIDE AREA ((23.5x2)+(11 x2))x 12"= 69 S.F. SALT / •••.. . F. 1A.\` rt- . • �.� . . �W F 19 _ 258.5 + 69 = 327.5 S.F. .00-11 W.F. 20 MARSH - i W.F. 8 PROPOSED • 327.5 > 298 OK W.F. 7/, SILT FENCE- � _ II , _ W.F. 18 DA � u M 11 VERTICAL DATUM: N.G.V.D. LOCATIO OF •� ��1'I,• r ~ `` EXIST. XSSPOOL BENCH MARK USED: PK #3 IN PAVEMENT LONG un . TO [�p FILLED ` . �1I1' BEACH ROAD ELEV.=5.04 DESIGN OF SEWAGE 1 , Roots LIVING ROOM DECK ' •F. 12 �1 I, �1 1, EXIT TREES TO DISPOSAL SYSTEM N R MAIN AND BE �,II - VARIANCES REQUESTED ,N • ' W.F, 6 EXIST. DWELLING PROTECTED AS - .� --J WF• 5 ECESSARY (TYP.) W.F. 17 LOCAL BOARD OF HEALTH REGULATIONS: REPAIR 2 BEDROOM � �/ .. FF=6.09 1. NO SEPTIC TANK OR DISPOSAL SYSTEM SHALL BE 56 LONG BEACH ROAD 1 KITCHEN ' ' SALT _ � fY , �; I• WITHIN 100 FT. OF. ANY WATERCOURSE OR WETLAND MARSH UNLESS OTHERWISE SPECIFIED BY THE BOARD OF HEALTH IN , � rw.F. 16 - TANK IS 43 FROM MARSH (130 TO MHW) SOIL RELOCATED ; , .�- �1 I, , BEDROOM cl_o. WALK WAY j ABSORBTION SYSTEM IS 50 FROM SALT MARSH. (130 CENTERVILLE, MA BATH r ' FROM MHW.) k .F. 13 N/F ASSESSORS MAP 206 r r = ,7W.F. 14 I, THE STATE ENVIRONMENTAL PARCEL 11 w W - BEACH CLUB CODE TITLE 5. W h ' �* W - � 310 CM rn�7 ,, - 3 � ..._ -� ", OF CRAIGVILLE N/F cr TT 4�r- U.11 ia." w - EUGENE M. McQI,IADE et ux �W'1 1. FROM SECTION 15.255(2)(G): BREAK-OUT - IT IS 0C7OBER 17, 2007 z I , REQUESTED THAT AN IMPERVIOUS BARRIER BE ALLOWED W.F. 15 TO BE 5 FEET TO THE EDGE OF THE SOIL ABSORBTION - M� ,� DUNE SYSTEM. REVISIONS: y I I 2. FROM SECTION 15.255 - 5' FROM PROPERTY LINE TO EXIST TREES TO BE ' • -�' W W y W ��- �'- � � ( - N0. DATE DESC. \ ` TOE OF SLOPE. SAVED WITH NEW ,' f W W W 6 y y i W I m 1 3. FROM SECTION 15.416 DEED RESTRICTION FOR TWO 1. 2 21 07 ADDED LANDSCAPING, R I I REVISED GRADE OVER TREE, WELL WHERE i + W y �' * WI 1500 G/1LLON �o� BEDROOM DESIGN. REQUIRED `;Y 7 I 1500SEP- ALL8 THE ENTIRE SITE IS LOCATED IN TANK, CHANGED TANK W MICRO FAST I FEMA ZONE Al 3, ELEVATION 1 1 ' CALCULATION TO 200% / e� I COMMUNITY PANEL NUMBER 25001 008 D FOR SIZING \ PROPOSED I I CRATE CALCULATION: _r .� W W W I J I REVISED 7-2-92 2. 1/23/08 ADDED EXISTING TREES SILT FENCE :. _ _ , W w I \ • AM W W I _ !y I \ - 3. 2/8/08 BOLT-ON MH COVERS _. _ 110 GPD x 50�6 FAST REDUCTION - W I 'GPD/.46 ACRES - 239 GPD/AC PREPARED FOR. ;� ,�• a <440 GPD AC 0 _. •.•_�, •.. �..., �. - W -' I MS. GEORGIA GIARDINI REMOTE OCEAN VIEW �\ 83 EXIST TREES TO BE PROTECTED W BLOWER I \ `` N HAVEN, 0 512 EXISTING CT WITH TREE WELLS` IF TRUNK IS �.:✓ ;� : :.QlBSEftY�T�4:�4T NEW E ( . - y I PROPOSED . o - LIMIT OF SOIL F MORE THAN 3' FROM IMPERVIOUS� .� ' ' SILT FENCE CEDAR TREES " W.,�. REMOVAL (SEE BARRIER) -7 7x3 / �: BREAK-'6tlL OCU W W .� BARRIER I .�- / �'�� •� �._ Cam,., ,•,• oBSC ,... NEW - nr � POST & RAIL FENCE r -' -- c M o - GII ~' GN` �, f U. POLE . z PROPERTY LINE _ 1 1 ' P R 0 \ �; �, ® IL .v .r w_. / I ��Z� �' _ _ __ a° "� .. . . •e �'•� �. N ells Massachusetts setts 02061 / RELOCATED WATER 8 9 f 3 2 5 E EDGE OF BIT. CONC. PAVEMENT .�-y ' �` 7816597981 BLNCHMARK: ` t4O MIL PVC SERVICE PK. 3 BREAK-OUT - ' - 6r \ - *�so ,i °° ►r ` © 2007 BSC Group, Inc. NGVD 5.04 LONG BEACH PRo�iLE (SEE (PUBLIC - 20' WIDE) ROAD ' ,• SCALE: VARIES ) k ° <`,C !sR ILLS A�! PLAN VIEW _.. .� I SCALE: 1" = 10' FILE: 5559sep1-2007.dwg � - LOCUS PLAN ,�'% DWG. NO: 4043-11 0 Y 10 20 NOT TO SCALE: SHE 1 OF 2 • N JOB. N0: 4-5559.00 U. POLE _. ._ U. . NOTES: 1. SEPTIC TANK SHALL BE STEEL 4. INLET AND OUTLET TEES TO BE SCHED. 40 PVC GENERAL NOTES: REINFORCED CONCRETE. TEES TO BE UNDER MANHOLE COVER. 2. SEPTIC TANK TO WITHSTAND H-20 LOADING 5. RECOMMENDED MANUFACTURER-ROTONDO OR 1. THIS PLAN IS FOR DESIGN AND CONSTRUCTION OF THE SEWAGE APPROVED EQUAL 3. ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL BE WATERTIGHT. NOTES: DISPOSAL FACILITY ONLY. 8'-9" 2. ALL CONSTRUCTION METHODS AND 1. 1,000 GALLON PUMP CHAMBER TO MATERIALS SHALL CONFORM TO MASS. -9 " WITHSTAND H-20 LOADING D.E.P TITLE 5 AND LOCAL BOARD 24"0 CAST IRON CAST VENT C2. ALL PIPE ONCRETE CONS TRUCTION IO NS ND BE OF HEALTH REGULATIONS. IRON MANHOLE COVERS, 3. ALL PIPES SHALL BE SCHEDULE 40 BOLT-ON, BROUGHT TO TO AIR WATERTIGHT. OR EQUAL FINISH GRADE, 80 MIN. 3.BLOWER PUMP POWER WITHAL SEWER BRICK AND MORTARSE MANHOLE TO FINISH . 4. THERE ARE NO KNOWN PRIVATE WELLS HOLDING TANK do FLOAT o FULL OUTER MORTAR PARGE TO LOCATED WITHIN 150 FT. OF THE SEAL PROPOSED LEACHING FACILITY NOR PRECAST CONCRETE CONTROL .Ir PROVIDE POWERWATER CABLES TOTIGHT BE PLACED IN SEE NOTE 3. SE'PT1C TANK 30", IN. 6' CABLES o ANY KNOWN WELLS PROPOSED WITHIN CO 6 O 150' OF ANY KNOWN LEACHING FACILITY. 11'-0' I CONDUIT IN ACCORDANCE WITH LOCAL �IE�. ,� ..; .. PUMP TO BE h BUILDING AND HARE CODES. 5. WITHIN LIMIT OF EXCAVATION REMOVE 10'-0" FAST -� �E T UNDER MANHOLE 5. ALARM To BE ON SEPARATE CIRCUIT ALL TOPSOIL, SUBSOIL AND OTHER Fill FROM PUMP MOTORS. IMPERVIOUS MATERIAL n j 1. BLOWER MUST BE WITHIN 100 FEET OF � 6. REPLACE MATH CLEAN WASHED SAND SEE NOTE 7 (^- 60 FAST UNIT WITH LESS THAN 4 ELBOWS IN r • THE PIPING SYSTEW@100 FT.). FOR =- T g" 3 OR OTHER CLEAN GRANULAR SOILS DISTANCES GREATER THAN 100 INLET WADE i 5•_1r PLAN CONFORMING TO THE FOLLOWING FEET--CONSULT FACTORY. BLOWER MUST BE T BA O at SIEVE ANALYSIS: LOCATED ABOVE NORMAL FLOOD LEVELS. 5-0 �� _ 6,-O" 4-5 !: 60 q / f� 24" DIA MIN. C.I. BOLT-ON 1 SSANo.650 SIEVE SHALL O 30 - 25�� 2. RUN VENT TO DESIRED LOCATION 24" MIN. LIQUID N ��T MANHOLE COVER BROUGHT L MERCURY FLOAT <10 % OF No. 4 SIEVE SHALL OR, tr =i :} DEPTH TEE TO FINISH GRADE LEVEL CONTROLS PASS No. 100 CAP OBSERVATION/VENT PIPE WITH 6' Mrr ,a- r /' <5 X OF No. 4 SIEVE SHALL VENT GRATE. SEE ADDITIONAL VIEWS ==% PASS No. 200 • n. IT. DRAWING AND SEE TABLE FOR SIZING. BOTTOM ON LEVEL. STABLE BASE " g• 3 UNIFORMITY COEFFICIENT O No. 4 PLAN VIEW TO SEPTIC SIEVE </ S.0 SETTLING ZONE TREATMENT ZONE �� I 6" MIN. 3/4" TO '�� 670 GALLON TANK SECURE CHAIN 1-1/2" PVC DISCHARGE PIPE - AI CROSS-SEC11ON VIEW 0 WALL 1-1/2" UNION 7. EXISTING UTILITIES WHERE SHOWN 3' DIA. (MINIMUM) 3. ALL APPURTENANCES TO THE FAST Cog. 1 1/2 STONE EMERGENCY VENT PIPE OPTION SEPTIC TANK, PIMIPOUTS, ETC.) MUST STORAGE < IN THE DRAWINGS ARE APPROXIMATE. SEE NOTE 2. CONFORM TO MASSACHUSETTS STATE CODES. ALARMV, 3Z /4"ti HOLE TO DRAIN THE CONTRACTOR SHALL BE RESPON- 6" o0 FORCE MAIN SOX FOR PROPERLY LOCATING AND COORDINATING THE PROPOSED CON- 4. BLOWER CONTROL SYSTEM BY t PUMP ON o W CHECK VALVE STRUCTION ACTIVITY WITH DIG-SAFE BLOWER WITH HMD BID-MICROBICS, INC. -g" ~ 0 2" SCH 80 AND THE APPLICABLE UTILITY ACCESS MANHOLE 6. OBSERVATION/VENT (BY BID-MICROBICS) PUMP OFF 3Z 10 M PVC PE THREADED ANY AND MAINTAINING THE TO GRADE. PORT SEE NOTE 2, SEE NOTE 1 _ STING UTILITY SYSTEM IN SERVICE. 5. COPYRIGHT (C) 2001, BID-MICROBICS, INC. DIG-SAFE SHALL BE NOTIFIED PER MYERS SRM 4-1/4 HP. THE STATE OF MASSACHUSETTS 35 GPM O 14' TDH. STATUTE CHAPTER 82, SECTION 409 " ". � LOCATE UNDER MANHOLE) AT TEL 1-SOD-322-4844. THE THE UNIT 6. MUST INCREASE TANK SIZE BY 20% IF ENGINEER DOES NOT GUARANTEE ' MINIMUM OF 10 INCHES IS USED BETWEEN 6 HMI. 3/4 TO 1 1/2 STONE ( CONSULT FACTORY FORSEAPPROVAL.OF THE TANK. SECTION THEIR ACCURACY OR THAT ALL 2' DIA. PVC AIR LINE U71UTIES AND SUBSURFACE STRUCTURES 1500 GALLON SEPTIC TANK w/MICRO FAST 0.5 DETAIL ARE SHOWN. F UNDERGROUND OU ELECTRICAL CONDUIT 7, THE PRIMARY COMPARTMENT MAY BE A ELEVATIONS of uNDERGRouNo uTtuTlEs CO BLOWER SEPARATE TANK. (H-20 LOADING1 coNTRAAKEN CTOR SHALL VERIOM RECORD `AFY SZE, CONTROL SYSTEM) NOT TO SCALE _ _ SEE NOTE 4. LOCATION AND INVERTS OF UTILITIES S. FOUR LEG EXTENSIONS MAY BE USED TO AND STRUCTURES AS REQUIRED PRIOR STAND UNIT IN TANK ELIMINATING THE NEED TDH vs. Q FOR THE LID. REFER TO INSTALLATION TO THE START OF CONSTRUCTION. jMANUAL FOR MORE INFORMATION. 8. THIS SYSTEM IS NOT DESIGNED FOR RECYCLE LINE 1_ 25 THE USE OF A GARBAGE GRINDER. 12" MIN. COVER FINISHED GRADE A GARBAGE GRINDER IS NOT NOTE RECOMMENDED DUE TO RECOGNIZED H FAST TREATED SEE TABLE ON PAGE: 20 ADVERSE IMPACTS TO THE LEACHING FACILITY. INFLUENT EFFLUENT 0.5, 0.75, 0.9, ��! WASTE 1.0& 1.5 FASTS 1-1/2" PVC SEE NOTE 7 UNITS DIM CHART �"� 120 DEPTH COVE 15 -TDH (CUT VIEW) MA • "� � SRM4 21.5' 12" F- 10 - 12" PROFILE 3 CONTACTOR UNITS SETTLING ZL7�iE TREATMENT ZONE PER ROW. 10' MIN. 3 CULTEC CONTACTiOR 100 END TO END 5 SEE NOTE 6 - BREAK-OUT BARRIER LOAM d: SEED a 2% MIN. FINISH GRADE 0 SUSPENDED �- 15 20 25 30 35 40 45 50 55 60 FULLS TH. 2H_ 2" �. OFI/a" TO DESIGN OF SEWAGE 1/2" WASHED STONE Q WPM) SAND FILL 3/4" TO 1-1/2- DOUBLE DISPOSAL SYSTEM 48r �.w ,er .. ... WASHED STONE (NO FINES) REPAIR CROSS-SECnON 56 LONG BEACH ROAD IN THE INTEREST OF TECHNOLOGICAL PROGRESS, ALL PRODUCTS ARE IN SUBJECT TO DESIGN AND/OR MATERIAL CHANGE WITHOUT NOTICE. CULTEC CONTACTOR 100 CENTERVILLE, MA Date 6-22-04 0.5,0.75, 0.9, 1.0 & MICRO FAST 0.5 SYSTEM Bio- U 1.5 FASTOUnIts ASSESSORS MAP 206 NOT TO SCALE (Plan and cut Views) PUMP CHAMBER DETAIL CH-20 LOADINGS PARCEL 11 �..,�wo, M for Massachusetts SOIL ABSORP11ON SYSTEM DETAIL ,.irk UL01- by BMI NOT TO SCALE NOT TO SCALE OCTOBER 17, 2007 REVISIONS: NO. DATE DESC. MANHOLE COVERS AS REQUIRED, 1. 12 21 07 ADDED LANDSCAPING, INSPECTION FRAME NEENAH THREADED CAP BOLT-ON (BRING TO FINISH GRADE) MAGNETIC MARKING REVISED GRADE OVER R-1978 OR APPROVED EQUAL �-g'� (ARE�M TO•NOTES) FINISH GRADE TANK, CHANGED TANK -�� FINISH GRADE CALCULATION TO 200y FOR SIZING /7\�_ 3:1 SLOPE 2. 1/23/08 ADDED EXISTING TREES PROVIDE ADDITIONAL p ;� _ _ _ _ � : _ 3. 2/11/OS BOLT-ON MH COVERS PEASTONE AS REQUIRED ��= 2X MIN. 4" PVC 4" PVC SCH 40, _ - PREPARED FOR: ORIFICE SHIELD TO BE SNAPPED SECURELY INV G INTO PLACE AROUND ALL PERFORATIONS ��= SCH 40 1/4"/FT MIN 0 ON EACH LATERAL SLOTS ON ORIFICE SLOPE 1-1/Y• PVC F F - BOT-H MS. GEORGIA I BREWED TO BE LOCATED DIRECTLY OVER -40 MIL PVC BREAKOUT to G ARDINI EACH PERFORATION. 3 O Nc. GALLEY OCEAN VIE W EW r 1- BREAKOUT ELEV.=5.6, NEW HAVEN T \_7Jr LATERAL w/10 1%"0 BOTTOM ELE (MAX.) C 06 512 ZABEt< ORIFICE SHIED �:- 'LP MINIMUM W/REMEDA L ORIFIMS O 2' ON CENTER PERMIT FOR FAST p W - � ESTIMATED SEASONAL CHAMBER p c� 3/16" PERFORATIONS TO BE DRILLED AT 5 O'CLOCK AND 7 GROUNDWATER=H O'CLOCK. ALTERNATE PERFORATIONS BETWEEN BOTH SIDES OF 1,500 GALLON 1.500 GALLON INVERT ELEVATIONS: q_,� BSC � V l ECAST CONCRETE 4" PERF. < PIPE. SEE PLAN FOR NUMBER OF PERFORATIONS. 1 DRAIN ` -`��- PRECAST CONCRETE PUMP CHAMBER A. 4" INVERT AT BUILDING scHo so PVC HOLE PER LATERAL PERFORATIONS TO BE DRILLED SMOOTH SEPTIC TANK W/ r 384 Washington Street O TO PREVENT CLOGGING. FAST 0.5 0' SICK BAN B. 4" INVERT AT SEPTIC TANK (IN) &00 gt NOTE: (SMITH AND LOVELESS C. 4 INVERT AT SEPTIC TANK (OUT) 2-Z,'L Norwell, Massachusetts SYSTEM D. 4 INVERT AT PUMP CHAMBER (IN) �4SL 02061 1. REFER To "SOIL ABSORPTION ALL PIPING TO BE SOLVENT WIELDED SCHEDULE 40 PVC MODULAR FAST " SYSTEM" DETAIL REGARDING APPROVED EQUAL) MATERIAL AND DEPTH OF O E. 2" INVERT AT PUMP CHAMBER (OUT) �.l� MATERIAL FOR THE SOIL �dqs INVERTS AT LEACHING FACILITY- 0 659 7981 ABSORPTION SYSTEM. h1 ,�P�1N of p © 2007 BSC Group, Inc. 11AVID J. �� F. 2" INVERT AT BEGINNING CAI '1N y7� � OF LEACHING SYSTEM 5.1Q. SCALE: VARIES C^'IL SUBGRADE Ma 3?1 G. 2" INVERT AT END OF LEACHING SYSTEM 5.90 OBSERVATION PORT DETAIL PRESSURE SHIELD DETAIL SYSTEM PROFILE ;� H. OF AT SYSTEM 4.9 FILE: 5559sep1-2007.dwg DWG. NO: 4043-11 NOT TO SCALE NOT TO SCALE 1. SEASONAL GROUNDWATER SHEET 2 OF 2 NOT TO SCALE V ELEVATION 1.9 toe. 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