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0072 LOOMIS LANE - Health
%2 Loomis Lane Centerville A_23t.- i10 F Fmr=7A b° No.2-153LOR UPC 12534 smesd.cOm • Made In USA !cy- 14 fYGi�/W 1�'Oi R{W V4r1 YY� ��IF.4�35�4ES61firo�i,$imEglflRfl�'1E�V15 � u�Ti4f Ski FkB�ifVAR'i CERI7FlED SOURCN�G 47ii.1SS�"ai�ti@:AQi'k3 i I J V s� s M Oo TOWN OF BARNSTABLE LOCATION ' SEWAGE# VILLAGE <= ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type)T��'�'' � i/��osize) X ✓��� NO.OF BEDROOMS OWNER �� �i9� ��" �'l®�'�' -��0ZIA- PERMIT DATE: ® �'��'�® COMPLIANCE DATE: Separation Distance Between the: /T/ 4z� .Ati/(��4e �i Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 3 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) l ® Feet FURNISHED BY I� ® O o StoneHill Environmental, Inc. 600 State Street,Suite 2 Portsmouth,NH 03801 tel 603-433-1935 fax 603-433-1942 June 4, 2012 StoneHill Project No. 10037 Thomas Lynch Acting Town Manager- Barnstable 367 Main Street Hyannis, MA 02601 Re: Notice of Immediate Response Action Report and Response Action Outcome Statement Threat of Release 72 Loomis Lane, Centerville, MA MADEP Release Tracking No. 4-22536 Dear Mr. Lynch: In accordance with Massachusetts Contingency Plan requirements (310 CMR 40.1403(3)(f)), this letter is to notify you that an Immediate Response Action(IRA)Completion Report and a Response Action Outcome (RAO) Statement have been submitted to the Massachusetts Department of Environmental Protection (MADEP) for the above referenced site. The response actions implemented included the removal of waste oil stored in numerous five-gallon pails and a 200-gallon waste oil tank located at the Site. In addition, a cess pool located near the stored waste oil was pumped out and filled with gravel. All containers containing oil and solid waste such as used oil filters were removed from the property. Based upon the information presented in the IRA Completion Report, hazards to health, safety, public welfare, and the environment have been eliminated through the completed response actions. As such, a Class A-2 RAO Statement has been submitted to MADEP. Should you require additional information regarding the IRA Completion Report or RAO Statement, copies of the documentation are available for review online at www.mass. og_v/dep or at the following address: MassDEP Southeast Region Main Office 20 Riverside Drive Lakeville, MA 02347 If you have any questions or require additional information, please feel free to contact me or my associate Chad Tomforde at 603-433-1935. Sincerely, StoneHill Environm ntal, Inc. CD Timothy S. Stone, PG, LSP w Principal cc: Thomas Mckean, Director Barnstable-Health-Division A 200 Main Street - ` Hyannis, MA 02601 Hydrogeologists•Soil Scientists•Environmental Specialists ENGINEERING & MANAGEMENT SERVICES, INC. J fX4 , July 25, 2011 0) " GD�rfes �Py, Wells Fargo Bank, N.A. e0 �a /,✓vG,e7jr 4101 Wiseman Boulevard P�3 San Antonio,TX 78251 >^/or C> a Attention: Legal Department ^uY Reference: 72 Loomis Lane, Barnstable,MA 52 CM Dear Wells Fargo Bank: rr— CD I am writing on behalf of my client, Mr. Alan Perrault, the present owner of the above- referenced property. Mr. Perrault purchased the property from you on September 17, 2010 after dealing with a your real estate agents for the property,New England Group Services acting on behalf of James Stratigos,REO Sales Manager of Wachovia Mortgage.This letter is written to inform you about a problem that has been created as a result of your company's failure to comply with Massachusetts Oil and Hazardous Waste regulations and failure to disclose those items of noncompliance to my client prior to his purchase of the property.These issues clearly pre-dated the MIS listing date of May 28, 2010 and should have at the very least been disclosed by the listing agent. The MassDEP issued a Notice of Responsibility (NOR) to you that was dated May 18, 2010. This NOR(see attached) was issued as a result of a MassDEP inspection of the property on the morning of April 6, 2010.At that time they observed " numerous improperly stored 5-gallon pails of waste oil, solvents and an abandoned 200 gallon Aboveground Storage Tank which appeared full of waste oil product': Apparently,yourselves or your local real estate agent had these items removed from the property.While the removal was an appropriate response,your representatives failed to properly notify the MassDEP as required in the NOR.The lack of notification and correspondence with the MassDEP has resulted in the MassDEP issuing the attached Notice of Noncompliance (NON). The NON requires my client to document things which,because they were done prior to his knowledge of the site,he cannot possibly do.As the owner of the property at the time that the actual violations occurred,you were responsible for addressing the issues. Because you and your agents failed to disclose the existence of the situation prior to conveyance of the property to my client, my client is notifying you of your responsibility to rectify the situation. My client was very diligent addressing issues that were disclosed to him by the agent and through the information in the MIS listing. Wetlands that had been illegally filled were remedied,an underground storage tank was removed and a new septic system was installed,all of these as a result of full disclosure to my client. The issues that are the subject of the above NOR were never disclosed and as a result,were not addressed by either you or my client.The situation has now escalated into a condition of non-compliance with regulations and has negatively reflected on the property and potentially my client. PO Box 1362,Murrieta,CA 92594 Phone:(951)677-9031 or(5 )728-7805 ma :bob @ emserwces.us i ENGINEERING& MANAGEMENT SERVICES, INC. In order to resolve the matter, I request that you obtain the information (i.e. receipts and manifests for the disposal of any oil or hazardous materials,etc.) that the MassDEP will deem necessary to consider the matter closed. Further, I request that you contract with a Licensed Site Professional(LSP)to prepare a document suitable for submittal to the MassDEP that appropriately documents whether there was or was not a release of oil or hazardous material that corresponded to the "threat of release" that was observed by the MassDEP. Finally,I request that either a document that retracts the reported threat of release or closing of the matter in the form of a Response Action Outcome (RAO) statement be completed by your LSP and submitted to the MassDEP. I will review all information prepared by you to ensure that it fully protects my client. I am writing to you in lieu of my client's legal counsel with the hopes that a reasonable solution can be achieved without having to undertake legal action. I am sure that a letter from my client's attorney would be considerably more demanding than this letter, so please respond at your earliest convenience. If you have any questions,please contact me at 951 677-9031. Thank you for your assistance with this matter. Very truly yours, Engivaj i g&Management Services, Inc. RieroS. Cummings,P ,ISP(inactive) Principal cc: Alan Perrault James Stratigos,REO Sales Manager,Wachovia Mortgage,Division of Wells Fargo Bank New England Group Services Inc, Erick McKenzie Barnstable Board of Health Barnstable Chief Municipal Officer DEP-SERO,Attn: Mr Gerard Martin DEP-SERO,Deneen Simpson,Regional Enforcement Office Attachments (2) PO x 1362,Murrieta,CA 92564one: 7- or 7 -7 Email:bob@ emservices.us ,per �-\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENERGY & ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE 20 RIVERSIDE DRIVE, LAKEVILLE, MA 02347 508-946-2700 DEVAL L.PATRICK IAN A.BOWLES Governor Secretary TIMOTHY P.MURRAY LAURIE BURT Lieutenant Governor Commissioner May 18,2010 James Stratigos,REO Sales Manager RE: Centerville-BWSC Wachovia Mortgage Release Tracking Number:4-22536 A Division of Wells Fargo Bank,N.A. 72 Loomis Lane 794 Davis Street,2"d Floor NOTICE OF RESPONSIBILITY San Leandro,CA 94577 URGENT LEGAL MATTER: PROMPT ACTION NECESSARY Dear Mr.James Stratigos: On April 6,2010 at 11:30 am,the Department of Environmental Protection("MassDEP")received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property which requires one or more response actions. Upon the request of the Barnstable Health Department, Mass DEP Emergency Response personnel inspected 72 Loomis Lane and observed the presence of numerous improperly stored 5-gallon pails of waste oil, solvents and an abandoned 200-gallon Aboveground Storage Tank which appeared full of waste oil product. These observations indicate that a threat of sudden release exists at the property. The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan(the "MCP"), 310 CMR 40.0000, require the performance of response actions to prevent harm to health, safety, public welfare and the environment which may result from this release and/or threat of release and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities.under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. MassDEP has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. MassDEP also has reason to believe that you(as used in this letter, "you" refers to Wachovia Mortgage)are a Potentially Responsible Party(a"PRP")with liability u nder M.G.L.c.21E §5, for response action costs. This liability is "strict", meaning that it is not based on fault, but solely on your status as owner, operator,generator, transporter, disposer or other person specified in M.G.L. c.21E §5. This liability is also "joint and several", meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. This information is available in alternate format.Call Donald M.Games,ADA Coordinator at 617-556-1057.TDDA 866-539-7622 or 617-574-6868. DEP on the World Wide Web: http:/h~.mass.gov/dep + Printed on Recycled Paper Release Tracking Number 4-22536 Page 2 of 3 MassDEP encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials. By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs inured by MassDEP in taking such actions. You may also avoid the imposition of, the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L.c.21 E is attached to this notice. You should be aware that you may have claims against third parties for damages, including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. MassDEP encourages you to take any action necessary to protect any such claims you may have against third parties. ACTIONS REQUIRED Additional submittals are necessary with regard to this notification including,but not limited to,the filing of a written IRA Plan, IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee of$1,200 be submitted to MassDEP when an RAO statement is filed greater than 120 days from the date of initial notification. Specific approval is required from MassDEP for the implementation of all Immediate Response Actions(IRAs)pursuant to 310 CMR 40.0420. Release Abatement Measures may not be conducted until a RAM Plan is submitted pursuant to 310 CMR 40.0443. Assessment activities, the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement. In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form(BWSC-103,attached)be submitted to MassDEP within sixty(60)calendar days of April 6,2010. You must employ or engage a Licensed Site Professional(LSP)to manage,supervise or actually perform the necessary response actions at this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals by calling(617)556-1091 or visiting hqp://www.state.ma.us/Iso. Unless otherwise provided by MassDEP, potentially responsible parties ("PR-Ps") have one year from the initial date of notification to MassDEP of a release or threat of a release, pursuant to 310 CMR 40.0300, or from the date MassDEP issues a Notice of Responsibility,whichever occurs earlier,to file with MassDEP one of the following submittals: (1) a completed Tier Classification Submittal; (2) an RAO Statement or, if applicable, (3) a Downgradient Property Status. The deadline for either of the first two submittals for this disposal site is April 6, 2011. If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal. This site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c.21 E and the MCP. i Release Tracking Number 4-22536 Page 3 of 3 If you have any questions relative to this Notice,please contact Bob Murphy at the letterhead address or at(508)771-6088. All future communications regarding this release must reference the following Release Tracking Number:4-22536. Sincerely, This final docmvKul M is being provided to you eledrouicallr by the Department of EoviroemmW Protection A 4M top of 1W document is on%at the DEP oflite listed on the ldterhesd. Daniel Crafton,Acting Chief Emergency Response/Release Notification Section Bureau of Waste Site Cleanup C/RCM/lg WA13WSC\Document ArchiveW-0022536.NOR.05-15-2010.doc Enclosures: Release Notification Form;BWSC-103 and Instructions Summary of Liability under M.G.L.c.21 E MassDEP's Guide to Hiring a Licensed Site Professional. ec: Town of Barnstable Selectmen's Office email@jown.barnstable.ma.us Town of Barnstable Board of Health Cynthia.martin@lown.bamstable.ma.us C-O-MM Fire Department fadmin@commfiredistrict.com Commonwealth of Massachusetts ` - Executive Office of Energy &Environmental Affairs :. Department of Environmental Protection _ Southeast Regional Office•20 Riverside Drive, Lakeville MA 02347.508-946-2700 DrVAL ='AT^'ICK RICHARD K SULL.VAN 1A. �Ovwr�Cr 'MOTHY P M;,,-RAV {ENh'ETH L.KIVMELL L a Aerant Sever;for C:3rr,r nit;¢;oner July 15, 2011 Mr.Alan D. Perrault RE: BARNSTABLE 2 Anderson Road Release Tracking Number: 4-22536 Hingham, Massachusetts 02043 72 Loomis Lane NOTICE OF NONCOMPLIANCE NON-SE-11-3T-080 THIS IS AN IMPORTANT NOTICE. FAILURE TO TAKE ADEQUATE ACTION IN RESPONSE TO THIS NOTICE COULD RESULT IN SERIOUS LEGAL CONSEQUENCES. Dear Mr. Perrault: The Massachusetts Department of Environmental Protection, Bureau of Waste Site Cleanup (MassDEP), is tasked with ensuring the permanent cleanup of oil and hazardous material releases pursuant to Massachusetts General Law Chapter 21E -The Massachusetts Oil and Hazardous Material Release Prevention and Response Act (Chapter 21E). The law is implemented through regulations known as the Massachusetts Contingency Plan,310 CMR 40.0000 et seq. (MCP). Through the MCP, MassDEP is currently regulating a release of oil and hazardous materials that has occurred at the property located at 14 Loomis Lane, Barnstable. On April 7, 2010, MassDEP was notified that several drums of oil had been abandoned at the property. The origin of the drums was believed to be a former oil furnace serving business that had formerly operated at the location. At the time of the notification,the house at 14 Loomis Lane had been abandoned. MassDEP records indicate that you are the owner of the property. As the current owner, you are a Potentially Responsible Party(PRP)for this release. This Notice of Noncompliance (NON)is provided to inform you that the Site is not in compliance with the MCP. MassDEP has no record of anyone completing the response actions required by the MCP to address this release. The enclosed NON outlines the provisions of the MCP that have not been complied with. Contained within the Noncompliance Summary are the necessary actions you must complete to return to compliance. Additionally, there is a prescribed deadline for your completion of the action(s). MassDEP may assess a Civil Administrative Penalty in excess of several thousand dollars if you continue to be in noncompliance with the violation(s)cited herein. This information Is available In alternate format.Call Michelle Waters-Ekanem,Dlyarsity Director,at 617.292-5751.Too#1-866-539.7622 or 1.617.574-6868 MassDEP 1Nebsite:www.mass.gov/dep Printed on Recycled Paper Release Tracking Number 4-22536 Page 2 of 2 Notwithstanding this NON, MassDEP reserves the right to exercise the full extent of its legal authority in order to obtain full compliance with all applicable requirements, including, but not limited to, criminal prosecution, civil action including court-imposed civil penalties, or administrative penalties assessed by MassDEP. Attachment 1 of this NON is a Fact Sheet containing supplemental information. If you have any questions regarding this matter,or if you would like to discuss compliance with this Notice, please contact John Handrahan, at the letterhead address or by telephone at (508) 946-2883. All future communications regarding this matter must reference Release Tracking Number 4-22536. Sincere rard M.R.Martin, of Compliance&Enforcement Section Bureau of Waste Site Cleanup M/JTH/Ig Enclosures: Notice of Noncompliance Attachment 2:Supplemental Information Regarding This Notice of Noncompliance CERTIFIED MAIL#7010 0780 0000 6737 5146 RETURN RECIEPT REQUESTED W:\13W5C\Document Arch ive\4-0022536.8amstable.NON.07-15-2011 ec: Barnstable Board of Health Barnstable Chief Municipal Officer DEP-SERO Attn:Deneen Simpson,Regional Enforcement Office Attn: Lara Goodine,BWSC—Data cc: DEP-SERO Attn: Regional Enforcement Office NOTICE OF NONCOMPLIANCE NON-SE-11-3T-080 4-22536 NAME OF ENTITY IN NONCOMPLIANCE: Mr.Alan D. Perrault 2 Anderson Road Hingham, Massachusetts 02043 LOCATION WHERE NONCOMPLIANCE OCCURRED OR WAS OBSERVED: 14 Loomis Lane Barnstable DATE(S)WHEN NONCOMPLIANCE OCCURRED OR WAS OBSERVED: See below. DESCRIPTION OF REQUIREMENT(S)NOT COMPLIED WITH: 1. Violation of 310 CMR 40.0501(3)—Tier Classification and Response Action Deadlines Except where a site has filed a Response Action Outcome (RAO) or a Downgradient Property Status Submittal, all sites for which MassDEP receives notification of a release or threat of release of oil and/or hazardous material pursuant to 310 CMR 40.0300 on or after October 1, 1993, shall be classified as either a Tier I or Tier II disposal site in accordance with 310 CMR 40.0500. A Tier Classification submittal and, if applicable, a Tier I Permit application, shall be submitted to MassDEP within one year of the earliest date computed in accordance with 310 CMR 40.0404(3). To date, MassDEP has not received a Response Action Outcome (RAO)Statement,Tier Classification Submittal or Downgradient Property Status Submittal for this Site. The deadline for submittal of one of the above referenced documents was April 7, 2011, 2. Violation of 310 CMR 40.0333—Notification Requirements and Procedures Persons described in 310 CMR 40.0331(1) shall submit to MassDEP a completed Release Notification Form within the earliest of the following dates: a) within sixty (60) days of your notifying MassDEP of the release condition,or, b)withthin sixty(60)days of your receipt of a Notice of Responsibility(NOR) from MassDEP. To date, MassDEP has not received an RNF for this Site. The deadline for submittal of an RNF was June 7,2010. Release Tracking Number 4-22536 NON-SE-11-3T-080 Page 2 of 2 3. Violation of 310 CMR 40 0420(7)—Immediate Response Actin Plans An Immediate Response Action (IRA) Plan shall be submitted to the MassDEP within sixty (60) days of providing oral notification to the MassDEP of a'2 Hour'or'72 Hour' Release. To date, MassDEP has not received an IRA Plan for this Site. The deadline for submittal of an IRA Plan was June 7, 2010. DESCRIPTION AND DEADLINES OF ACTIONS TO BE TAKEN: 1. Within thirty (30) days of your receipt of this Notice, submit to MassDEP either a Response Action Outcome Statement, Downgradient Property Status Statement, or a Tier Classification with, if necessary,a completed Tier I Initial Permit Application. 2. Within thirty (30) days of your receipt of this Notice, submit to MassDEP a completed Release Notification Form. 3. Withln thirty(30)days of your receipt of this Notice,submit to the MassDEP a completed Immediate Response Action (IRA) Plan. An IRA Plan is not required if the IRA has been completed; in that case, you must submit to the Department an IRA Completion Statement. All items must be prepared in full accordance with the MCP. Notwithstanding this NON, MassDEP reserves the right to exercise the full extent of its legal authority to obtain full compliance with all applicable requirements, including but not limited to, criminal prosecution,civil action including court-imposed civil penalties,and Civil Administrative Penalties issued by MassDEP. By: Gerard M.R.Martin,Chief Compliance&Enforcement Section Bureau of Waste Site Cleanup Date: ATTACHMENT 2: SUPPLEMENTAL INFORMATION REGARDING THIS NOTICE OF NONCOMPLIANCE This attachment further explains why this Notice of Noncompliance(NON) has been issued to you. Why was I issued this NON? MassDEP's records indicate that you have not submitted one or more of the documents listed in the attached NON.. This NON was issued to inform you of this fact and offer you an opportunity to come back into compliance by submitting the missing information to MassDEP by the deadlines specified in the NON. You are listed in MassDEP's records as the person who is responsible for cleaning up the release cited in the attached NON. For example,at the time you or another party notified MassDEP that the release occurred, you either informed MassDEP that you accepted responsibility for the cleanup or you were sent a "Notice of Responsibility" (NOR) by MassDEP informing you that we found you responsible for the release. In either case, MassDEP has reason to believe that you are an owner, operator, generator, transporter, disposer, or person who otherwise caused the release or threat of release of oil and/or hazardous materials cited in the attached NON. This means that,under Section 5 of M.G.L. Chapter 21E, you are a Potentially Responsible Party (PRP) and liable for response action costs associated with the release. As a PRP, you are required to conduct and complete certain response actions outlined in the MCP to clean up the release of oil and/or hazardous materials expeditiously. What happens if l fail to comply with or respond to the NON? You have thirty,(30)days from the date you receive the NON to comply. If you fail to comply,you will be assessed a penalty by MassDEP. Your total penalty exposure can be considerable. For example, penalties can be assessed for each day you remain in noncompliance. Note that MassDEP is allowed by law to back calculate daily penalties to begin on the date you received the NON. You can be penalized thousands of dollars should you fail to comply with or respond to the NON by the 30-day deadline. Please refer to the Civil Administrative Penalty Statute,Chapter 21A,Section 16 and 310 CMR 5.00,the Civil Administrative Penalty Regulations, for complete details on the Administrative Penalty rules. When the cleanup contractor finished the work in the field, I thought my dealings with MassDEP were finished. What more do 1 have to do? This is a common question asked when a NON is received. PRPs often think their dealings with MassDEP are over when, for example, the fieldwork is completed by a cleanup contractor. Examples of this type of fieldwork include cleaning up a spill from a saddle tank leak on a roadway, or removing contaminated soil from a tank grave during a tank replacement or oil-contaminated debris from a storage tank after a fire. The fieldwork may be complete, but you still must submit some paperwork to MassDEP to prove that the cleanup was undertaken in compliance with the MCP. The MCP includes deadlines by which you must complete response actions and submit information about those response actions to MassDEP. We track the progress of cleanups by checking to see if you are sending information about your cleanup progress to MassDEP on time. For example, if we do not r 1 receive a Response Action Outcome Statement(RAO) before the 1-year anniversary date of the release, we must assume that the environmental cleanup has not been completed. For work to continue after the 1-year anniversary date of the release, the MCP.requires that you submit a Tier I or Tier II Classification to MassDEP. If MassDEP does not receive either an RAO or Tier Classification by the 1-year anniversary date, we must assume that you are not implementing any cleanup at all. Without your cooperation in obtaining the cleanup information, MassDEP does not know whether serious environmental problems are being addressed. If work is not being performed, MassDEP must take action to ensure it happens. On the other hand, you may have finished the cleanup but neglected to forward the cleanup documentation required by the MCP. What do I have to do to comply with the NON? First, all response actions not directly managed by MassDEP staff must be overseen and directed by a "Licensed Site Professional" or LSP. LSPs are licensed by the Commonwealth, and their stamp and signature are required (together with yours) on all but one form you must submit to MassDEP. If you don't already have the forms and information required for you to comply with this NON, contact the consultant and/or cleanup contractor who worked on your cleanup: If you have not undertaken any cleanup work, contact an LSP immediately. A list of LSPs may be obtained by calling (617) 556-1091 or viewing the list on the Internet at http://www.state.ma.us/Isp. The documents you must submit to MassDEP require LSP stamp and signature. For example, when a cleanup is completely finished,the MCP requires that you submit a document called a "Response Action Outcome" (RAO) to MassDEP in which you attest that you have completed the cleanup in accordance with the MCP. If you do not submit an RAO to MassDEP,the case remains open in MassDEP's files even if the fieldwork is completely finished. If you received this NON and you think the fieldwork is completely finished, call your cleanup contractor and LSP to find out how to have an RAO prepared and submitted to MassDEP. If more environmental studies or cleanup are needed (for example, following the initial cleanup of a highway spill or soil contamination found during a tank replacement),you must submit forms describing your plans to continue the work in a timely manner. Again, these forms must contain an LSP's stamp and signature,and be co-signed by you. Depending on the circumstances,the possible submittals are an Immediate Response Action (IRA) Plan, IRA Status Report, IRA Completion Statement, and/or a Tier Classification Submittal and Tier I Permit Application. You should also be aware that MassDEP does not become involved in or help mediate billing disputes with insurance companies, cleanup contractors, 'or LSPs. A common response to a NON is that an insurance company is slow on paying cleanup bills or will not cover various cleanup costs. We also hear that cleanup firms and LSPs will not send in RAOs and other forms because their clients have not paid their bills. These matters must be resolved privately by you. You ultimately must comply with the attached NON or be subject to significant penalties from MassDEP. NOV/03/2010/WED 04:07 PM SandwichTownOffices PAX No, l 508 833 0018 P, 001/001 Town of Barnstable' ' Regulatory y Services a " Thomas F.Geiler,Director . Public Health Divigion Thomas McKean,Director - 200 Main Street,1Iyaws,�[,A 02601 Office:,508-862-4644 -FQ-x: 509-790-6304 Installer &Design.er Certification Form Date: dca. 31 ZOt 0 Designer. t 8 Z , 490UI Installer:^lWXOP J Address: . Address: �. was issued a pemit to install a (date) OWS err) t septic system at 6�1 based on a design drawA Icy (address) dated (designer) J-_eergfy that-the septic system referenced above was installed substattticaUy3 aocordi zg'to "`the desxgza, which may include minor apFoved such as latq`ak'ieXocatxon of the �bution box and/or septic tank... Z cerki :that the septic systems:referenced above was inat4i W-',%� '`, Ea ,c gea'(,:e,: greater p Lateral xelocatxbz -of the SAS or-any.vejt-6al M—- L_t' -of aAy compone�fi of the.septi � is end}but in accordance with State&J.6ck,Reg�ai ons. Plan revisipix of certified as�hi t y deog*ta;follow. �,2 �CAVIo. - sts3lear's Signature) .. � :., '`. �• .� , SON ado:1166' `�AIUl1AR1��' er s Signature) (AfEX s Sip Here) PL F n TrJRN TO 1$ . `k�' ,.F LIB CAI�'I`H.bI'�S,SI(D R C TE ��y'�' SUP T :'i 4FORM Q:IiWtNseptioDe,signFceruc iot�Forra '•F :' >< :s3 :ii`. ' 0 (J Fee No. t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 'ppifcatfon for Th5po5al *yotern Congtructfon Vermit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( )3<Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel :I ZT ® //p -;V,- -,pp Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms '3 Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �. 0 gpd Design flow provided p gpd Plan Date P 57- Number of sheets Revision Date Title Size of Septic Tank B'w So c Type of S.A.S. 4,VXT/o-0" Description of Soil c.Pe"� D��it�.rr' / 3`X .2 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this B of Health. Signed Date 9� 30/® Application Approved by Date to —(d Application Disapproved by: Date for the following reasons Permit No. Dzo to — YU 2- Date Issued U No. O I % .Z ` ` S t, Fee OV — r computer:Entered in THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN_OF BARNSTABLE, MASSACHUSETTS Yes - ZppYication forlDtopooar *p.5tem Con0truction Permit Appli,�aton for a Permit to Construct O Repair"(Upgrade O Abandon O Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3 p //p R" T? Installer's Name,Address,and el.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building 4e 41`f No.of Persons Showers( ) Cafeteria( ) Other Fixtures -- Design Flow(min.required) 3p gpd Design flow pro'yided © gpd i Plan Date .9— y ./c'! Number of sheets / Revision Date Title Size of Septic Tank d- .0v/o Type�ofiS.A.S. e4'A0'Ciy /c"o�l�►�t)-/o�' Description of Soil �'�'c� „�tA�-r' .01 A Nature of Repairs or Alterations(Answer when applicable) Date last inspected: s Agreement: a The undersigned agrees to ensure therconstruction and maintenance of the afore described on=site sewage disposal system in accordance with the provisions of Title 5 of theInvironmental Code and not,to place the system in operation until a Certificate of Compliance has been issued by this B of Health. ] Signed Date 9• 3 0/o Application Approved by Date It) / —I d Application Disapproved by: Date for the following reasons Permit No. d I 0 - ,ju Z• Date Issued /u -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance r• THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded Abandoned( )by at /oZ .L O o m/.l' L ie.: C'�w.jE`pjd'/`,L ae' has been constructed in accordance with the provisions of Title 5 and the for.Disposal System Construction Permit No. U 1 a - 7 0) dated /o- /v Installer Vi.-W Designer Lt4o'/4 .ef.ejW>4,R9tis ®2 #bedrooms Approved design flow A �w�+p gpd The issuance of this ermit shall not be construed as a guarantee that the system will fun•tio 1 s des ig ed. �/Date f (} Inspector A5 f No. ) 4 1 D 0;L Fee__ /00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS . .= �-� TNjig;:Poza14p!5tem Construction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( Abandon ( ) System located at 7 G©ez, J' .� -ALO- 44, and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this�p i4. Date /U - l —/U Approved by. (V/ , es ' yJ rv, r' �fr i1`t4M°on S!}S IeSI lne 02U �� �r �, P Town of Barnstable P# 1704, Department of Regulatory Services a►twan►er$ i hum Public Health Division ^� t 200 Main Street,Hyannis MA 02601 Date K J o /O Date Scheduled " Time Fee Pd: Soil Suitability;A `essment f •or Sewager ` . ,.f. asposdl Performed By: 4 - J Witnessed By: LOCATION& GENERAL I 'ORMATION Locatio:STR �Go�/f C� e Owner's Name ` �ufil �G71� Assessor Address arcel: 'I30Engineer's Name ! (JNEW CTION REPAIR' Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area — ft Drinking Water Well -__,ft Drainage Way—ft Property Line —_ft Other � ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands 1n proximit y y to holes) AUG 3 0 REC'D ; ay ao�a �2 Parent material(geologic) D A3 Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Fpce Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing in obs.hole: Depth to weeping from side of obs.hole: In, Depth to sail mgttlas: ln. Index Well# Reading Date: Index Well level in, Groundwater Adjustment fr. . Adi,factor Adj.Groundwater level Observation PERCOLATION TEST bale- Time- Hole# Time at 9" Depth of Perc w Time at 6" Start Pre-soak Time @ � � Time(9"-6") End Pre-soak Rate Min✓Inch . Site Suitability Assessment: Site Passed Site-Failed Additional Testing Needed(YIN) Original:Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be ynducted within 1009,of wetland,you must first notify the Barnstable Conservation bivision at least one(1) week prior to beginning. Q:ISEPTICVERCFORM.DOC , DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. o i ten % ravel .r r fi DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsi to % ravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. g Consistency,%Gravel , DEEP OBSERVATION HOLE LOG H_ole# Depth from Soil Horizon Soil Texture Soil Color. ,"t. Sol); `' Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consi en Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes t Within t00 year flood boundary Noz Yes ' Depth of Naturally Occurring Pervious Material a Does at least four feet of naturally occurring perviQu�'mate ial 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 I certify that on O �I. (date)I have passed the soil evaluator examination approved by the Department of Envirg6menlal Protection and that the above analysis was performed by me consistent with . the required training,exp tis nd xperience described in 310 CMR 15.017. Signa a Date Cy old Q:VSEPTlMERCFORM.DOC Town of Barnstable BarnstableOf THE tQw Regulatory Services Department g y \< BA EtNS'CABLE. 9�A MASS, � Public Health Division 9 Mrs a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 70081830000205009519 6/17/2010 New England Group Massachusetts Corporate Office 4 Cocasset Street Foxboro, MA 02035 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 72 Loomis Lane, Centerville, MA was last inspected on May 18, 2010, by Ronald A. Rice, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines . of 1995 TITLE 5 (310 CMR 15.00) due to the following: • A single cesspool system is an automatic failure in the Town of Barnstable. • Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. • 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 less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. You are ordered to replace the septic system within Sixty (60) days from the date you receive this notification. Failure to replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T E BOARD OF HEALTH Thomas McKean, R.S.; CHO Agent of the Board of Health /Z 4 Commonwealth of Nfassacheasetts 1 Title::-5 O iciai i n action F r a Subsurface Sewage.Disposal System Form-Not for Voluntary.Assessments r` P rty Ad ress fjn -t Owner Ow rs Name information is required for ' (/ .(� z) ,5 is Q every page. City/Town Sta Zip Code Date of I spedlon Inspection results must be submitted on'this fonrn. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important A. General Information When fining out ( / O formsthe compputeto r,use 1. I or only the tab key to move your cursor-do not N. e of I actoruse the return key. C pan Na �J ompany Address �- 7a— C '" _ State Zip Code Telephone Number License Number B. Certification 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 the inspection.The inspection was perforated 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 1 in or's Signature 3�' - +� t``a 4 77 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 how 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. lS� I t5ins 0910 Idle 5 official lns'PaWm Fam:Subsurfaces Sewage Disposal System•Page 1&17 1 Commonwealth of Massachusetts �. Title 5 Official Inspection- Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments /join/5 ;�alLf— ProfflyAdd ss C&td Owner OWes Name information Is46 - ©a 6 S O required for Itat'& every page. lr wn Zip Code Date of I specti n B. Certification (cont.) Inspection Summary:Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes","no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or.tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t-9ns•09M Title 5 Official Inspection Forth:Subsurtace Sewage Disposal System•Page 2 or 17 Commonwealth of Massachusetts Tale 5 official Inspection Form Subsurface Sewage Disposal S tem Form-Not for Voluntary Assessments P Address W (� Owner s Name information is 5 0 (),) 630 p required for O every page. City own State Zip•Code Date of Ins coon B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CHAR 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•og/m Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal S stem Form-Not for Voluntary Assessments "7,;t .L In Pro rty Address C Owner e s Name .information is AtI ��n(� required for IL�LJ_ O `� every page. I own State Zip Code Date of I spe ion 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 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 �Ve Lao c,5 Ly y es 12ort Ott f j,he a 1 vi sree4 ❑ Back p 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 El than depth in cesspool is less than 6"below invert or available volume is.less than Y2 day flow t5ins•09/08 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 P perty Add ree D Owner Tffam- erequired for L +n information is nryl'L Aa ! 30 I r� every page. Cityrrown State Zip Code Date of Ins ection B. Certification (cont.) Yes No ❑ 0111, 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. ❑ •2 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 Il 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•09/08 Title 5 Official Ins pection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal Ssystem Form-Not for Voluntary Assessments Pro rty Address Owner s ame w information Is � �a.,b�>0 "� required for every page. CI own State Zip Code Date of Inspectio C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No ❑ 21 Pumping information was provided by the owner,occupant,or Board of Health ❑ L2 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? ❑ 2--"- 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): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form` Subsurface Sewage Disposal S, stem Form-Not for Voluntary Assessments Pro Address I Je—f A) Flg4//t/tel Owner Owrjojs Name v information is U/� Ir I' `► } D� required for " every page. City own State Zip Code Date of Inspection D. System Information Description: Number of current residents: — Does residence have a garbage grinder? ❑ Yes)(No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes 2 No Laundry system inspected? ❑ Yes No Seasonal use? ❑ Yes WNo Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes,K!k .." No Last date of occupancy: Date Commerciallindustrial 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•09108 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 P Address Owner s Name information is required for - "---��-� _. C7- every page. City own State Zip Code Date of In'specilon D. System Information (cant.) Last date of occupancy/use: ®�d� �'► 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? 4 tY 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/Altemative 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-09/08 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 Pro• Addre&s Owner Mqk4� Name 11 information is required for every page.. C /Town " state Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes f2-"No Building Sewer(locate on site plan): l` Depth below grade: feet/C:;2 Material of construction: i/C �/gam cast iron 40 PVC f1h rA❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting,evidence of leakage,etc.): loll ✓ � -i ` Septic Tank(locate on site plan): Depth below grade: feet 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: Sludge depth: t5ins•09/08 Title 5 Official Ins pection Form:Subsurface Sewage Disposal System•Pepe 9 of 17 i_ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments J4 P rty Addre Owner net information is `® required for �iLJ ltl/3•x3��---- I every page. Citylrown Ste Zip Code Dat4of spedi n D. System Information (cont.) Septic Tank(cunt.) 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? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 i -C\ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Pr rty Add Owner O s me / information is 1„ �/� G1�j_}�� ` ,^ required for ISLE. �► I� I l/ �P v V every page. Cityi I own State Zip Code Date of In pectio 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 t5in 09/08 Tills 5 Official Ins pection Form:Subsurface Sewage Disposal System•Pegs 11 of 17 Commonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Pr Arty Addres Owner O �rrs me 1 information is required for YL^ µ►' r'c�� J /� 1 every page. c'lt—yftdwA Zip Code Date of ffispecrion 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.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located,explain why:. t51ns•09/08 Title 5 Official In spection Forth:Subsurface Sewage Disposal System•Page 12 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Pr rty Address n Owner Nn s Name information is required for k I �_1 ITI every page. City own State Zip Code Date of In echon D. System Information (cont.) , Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Typeiname of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):, W���� e4 Number and configuration � Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer f Dimensions of cesspool Materials of construction Indication of groundwater inflow t5ins-09M Title 5 Official Inspection Forth: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 R Ad Ts Owner rs Name information is required for W'ta . every page. C own Zip Code Date 6f Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): A.,S �t, ! 'L"a 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.): pond e tv e, to t5ins•09M Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Pr ,VrI,Ad ress Owner ner s Name information is required for �� i�' every page. Ciitty/rown (nSta te Zip Code- Date o Inspe ion 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 ad Eh f i� � 4- t5ins•09M8 Title 5 Official Ins pection Form:SubsurfaFe Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Dispos/cwy, l System Form-Not for Voluntary Assessments �< l � nlnls P rty Addre 4A) SIZIJV�a AA f, Owner r s Name 0 �� r information is i required for . - \ A, , L — every page. Ci own MState Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope Surface water /a A-W► n Ale4-- Check cellar hallow wells_ /1 0" ry ZX Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water.elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ 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: L y<1�z- 'yL i W I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 tMicial Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Se age Disposal S stem Form-Not for Voluntary Assessments r< . Pqyrty Add ss �f Owner rs Name 1 information Is I n /� /� required for lll!ll�ti���� 0 [� Q every page. CI /T n St/:)1a Zip Code Date of Inspection E. Report Completeness Checklist Insspe ection Summary:A, B, C, D, or E checked Inction SummaryD(System Failure Criteria Applicable to All Systems)completed Y PP Y ) p Ef"Sy stem Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09= Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 0/WED 11 : 58 C-0—MM FIRE DEPT FAX No, 5087902385 P. 001 � b�a�h.`lutiliY,4 1 v a�r,, a nA jMW I 3 CENTERVILLE—OSTERVILLE-MARSTC)NS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE & EMERGENCY SERVICES 1875 Falmouth Road, Rte. 28 s' Emergency Number: Centerville, MA 02632-3117 9-1-1 Business: (508) 790-2375 John M. Farrington Facsimile: (508)790-2385 Fire Prevention/Administration Chief of Department Facsimile. (508)957-8239 Dispatch Center FAX COMMUNICATION MESSAGE DATE: t ATTI\I: FROM: WE ARE SENDING ( ; ) PAGES, INCLUDING THIS COVER SHEET. PLEASE CALL (508)790-2375 IF YOU DO NOT RECEIVE THE TOTAL NUMBER OF PAGES. CONFIDENTIALITY 140TICE: This is>: transmission may contain confidential iniormation belonging to the sender and such information is legally privileged and is intended only for the use of the individual or entity named above. Any copying. disclosure, distribution or dissemination of this information or the taking of any action based on the contenLs of this communication is: strictly prohibited. li you have received this transmission in error, please notify us immediately by telephone and return the: original transmission to us by mail or delivery ai our address above. We shall cover the cost of return mail. Thane,you! 1WWJ IO/WED 11 : 59 C-0-MM FIRE DEPT FAX No, 5087902385 P, 002 Comm Fire District 1875 Route 28 CENTERVILLE, 1A, 02632 1926 INSPECTION REPORT Tuesday April 13, 2010 HOURIHAN, HAROLD T 72 LOOMIS LN CENTERVILLE, MA 02632 Occupancy ID: HOUR02 Date Completed: 04/09/2010 Inspection Type: INVESTIGATION - Hazardous Materials Received call from real estate agent Susan Cahoon 508-362--1300 on complaint regarding this address. She stated this is a bank owned property and she was showing it to a client of hers, she was concerned about open 5 gallon containers with oil storage, in addition to gasoline and propane storage. Inspecttor Grossman on site initially and found area of complaint in shed sides B/C of property adjacent to wetland/marsh area. Shed conatined 30 + 5 gallon buckets of what appeared to be fuel oil, several of the buckets were open. No excessive quantities of gasoline or propane found during this inspection. will follow-up with BOH on 4/12/10 to arrange joint inspection of property. Property appears vacant no immediate fire or health hazard in my opinion. Additional contact information for property as follows. New England Group Christopher Olsen Foxboro, MA . 774--215-1000 Note: Received call from Chris Olsen 1710hrs this date, responding to my voice mail, left earlier today. He referred me to Kenny Olsen 401-225-3632. Left message for Kenney Olsen 4/9/10 1718hrs. 04/09/2010 17:18: 46 mmacneely 04/13/2010 18:29 oFT ra,, Town of Barnstable Regulatory Services # w + BMWMBLE, 9 MASS. Thomas F. Geiler,Director Fo;p. Conservation Division Robert W. Gatewood,Administrator 200 Main Street, Hyannis, MA 02601 E-mail:conservation@town.barnstable.ma.us Office: 508-862-4093 Fax: 508-778-2412 April 12,2010 New England Group Attention: Erik 4 Cohasset Street Foxboro,MA 02035 Re: 72 Loomis Lane,Centerville,MA—previous owner William Hourihan Outstanding Violation,Task II—Conservation Landscape Design Plan Dear Erik: Per our conversation of April 9`h, the previous owner of the above-cited property failed to comply with important conservation enforcement requirements. Task II of a previously approved restoration plan must be completed,to include the following restorative measures: a) Location of new wetland edge,compatible with Conservation By-Laws; b) Design cross-section of earth removal and planting requirements; c) Plan compatible plantings within buffer zone and newly"reclaimed"wetland area; d) Provide a design for landscape and environmental solutions as a response to wetland needs, e.g.,appropriate planting and conservation measures. Match survey plans to landscape plans to show— • all new landscaped materials and areas; • needed details of site amenities proposed,and • existing and proposed"bordering vegetated wetland"edge,and new plantings list. Please contact me at your earliest possible convenience to discuss these issues. Thank you. Sincerely, Darcy Karle Conservation Agent DK/cb enclosures Lct, �s cam-_ a �t�- Ys L�Ae Weor4+ourt ASSESSORS MAP : PARCEL : TEST HOLE LOGS NOTES: ��•���� � � lC7 Y f FLOOD ZONE: _ U t�TLl�l�� j SOIL EVALUATO;' : y . f WITNESS : 1) The installation shall comply with Title V and Town of Barnstable Board of ` REFERENCE : � �� �r � 1= ZL 8 DATE : � )" l health Regulations. o -- 2) The installer shall verify the location of utilities sew i and j ) y sewer inverts a septic PERCOLAT I N R ATE: Z. I I components prior to installation and setting base elevations. 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first TH- I TH-2 two feet out of the d-box to the leaching shall be level. 4) This plan is not to be utilized for property line determination nor any other �� _( ��1'�' purpose other than the proposed system installation. \: ►tW� (►J ZZ o _13 Feet �� � ���7 � ) Z� �`'`(,' ��C/ " )Z �� -� r'0 ID 2 �� Lo �j b 5) All septic components must meet Title V specifications. `�$�- l � 6) Parking shall not be constructed over H 10 septic components. 15 --- - b �✓� 7) The property is bounded by property corners and property lines. LOCATION MAP �\ �" Ip�,�-I I� �/ �j )0 �-,I� � 8) The property owner shall review design considerations to approve of total �P•\ ly _ ___ `�"���l� �, 1 � design flow and number of bedrooms to be considered for design. Receipt of payment for the plan and installation based on the plan shall be deemed \ l� n � 9 approval of the design flow by the owner. �� ) The existing leaching or cesspools shall be pumped and filled with material ��� i� Il 3 per Title V abandonment procedures. Those within the proposed SAS shall q�1 'J be removed along with contaminated soil and replaced with clean sand per D rJ W Title V specs. - -- -- -- - 10)System components to be 10 feet from water line. Sewer lines crossing the fit�L� I17U 05 water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if SEPTIC SYSTEM DESIGN applicable. The proposed SAS is being installed below the water service line. The line is to be sleeved as aforementioned and maintained in place. 41 �! 11) If a garbage grinder exists it is to be removed and is the responsibility of the o FLOW ESTIMATE owner to ensure such. 12)The installer is to take caution in excavation around the gas line if such m 170 '01j, % 3 EEDROOMS AT GAL/DAY/BEDROOM -� GAL/DAY exists. 6 �o� 13)The installer shall verify the location, quantity and elevation of the sewer SEPTi C TANK lines exiting the dwelling prior to the installation. 330 GAIJDAY x 2 DAYS - gD GAL USE 't-> O GALLON QSEPTIC TANK `� , SOIL I L ABSORPTION f YS EM 0 �LLV � (51 710 N 54°0000" E 1 19.92' / n V' ,_ ' , �, U N�O (�Y{�.�.�lr-I f�b1Mf✓!G' J S SIDE AREA: Z joy -y BOTTOM AREA: X X O i-1'- zJ-D�bb co O�fl c F 0 96 SEPT IC SYSTEM SECT I ON � - - CI, w - 4/�. - - --- o69s cF� 3 oE_ wl � �� - -- -- - � - �Lti `Ivy - O cNo kj 1 F �n I 0 0 7°8 ------ � S lob 00 •, �,�u�`. w N io � tom?' D1 bS�D _ �• F�(D� 9 ID5 (� T o �oF� Jo" �D�1f, K� l �F =BOX-�F° ���C7 GAL Ib Z� jj'�D F,t i ' 401 SEPTIC TANK - - 1D M `1 0" W� l 0 51°1 1 0 Z :� /2✓ _ __-- I r 1 S 54°54'20" W 96.35' 44.00' t I SITE AND SEWAGE PLAN fir + �,f j4, LOCATION : #72 I-! OMIh2/� 4. Fy \Y C pi A �44 ?�ervEa�nirF e P��N OFl!'j PREPARED FOR :li sE_ S DAVID Gj; B. MASON, No.1066 O sir G/STEP SCALEAA 6/ DAV I D B . MASON 2- DATE: DBC ENVIRONMENTAL DESIGNS z � � � a�➢ p�� 3� EAST SANDWICH . MA w DATE HEALTH AGENT ( SOS ) 833- 2 177 W