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Home My WebLink About0069 RIVERVIEW LANE - Health 69 RIVERVIEW LANE,.CENTERVILLE { A' 228.175 s NCP2�i53LOeF{ `�qm� � HASTINGS.MN TOWN OF BARNSTABLE -�� c✓` �� LOCATION G;q � 'U 1�•9�1°. SEWAGE# VILLAGE �aJ/ GY .d,. 1�1'Il��ii ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1041W— LEACHING FACILITY: (type) ,��r �ad.r5 (size) �� NO.OF BEDROOMS BUILDER OR OWNER A?hWY' PERMTTDATE: � COMPLIANCE DATE: Separation Distance Between the: r Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet�ea hi a ility) Feet Furnished by y 47 le 421 DATE: -4/22/96 PROPERTY ADDRESS: 69 glverv; ew Lan'(-. R ECEIVED Centerville ,Mass . 5 1996 02632 HEALTH DEPT. TOWN OF EARNSTAGLE On the above date, I Inspected the septic system at the above Address. This system consists of the following: 1 . 2-6lx8l , concrete block cesspools . Based bn my Ins.n ction, I certify the following conditions: 1 . This is not a title five septic system. 2. This is sewage eytem that is about 26-30 years old. 3 . House -seasonally for 13 . years and Year round for only the past year. 4. The sewage ,sytem is in proper working order at the present time.Overflow should be lowered. Water is over invert pipe ;then some water passes to the verfl w. SIGNATURE: , •G '( Name _J P Macomber Jr,,__�____ i Company: J• P_Macon)ber, & Son-,Inc.,; Address:__.66-------I------ Centcrvill,e .Mass__0.2632 Phone:---50.8.-Z7..5-3338------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY LJOSE . MACOMBER & SON, INC.nksMC pools-LeachfleldsPumped & Installedown Sewer Connectlons6' Centerville, MA 02632-0066 775-3338 775-6412 commonweonh of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection WUllam F.Weld STrudy Cox? �cr.�+ry aOVOMW David B.Struhs Arpeo Paul Celluocl Convnbaforwr LL Governor � e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A - CERTIFICATION Property Address: 69 Riverview Lane Centerville MA Address of owner 48 Shubael Gorham Road Date of Inepect!on: 4/19/96 (If different) Centerville ,Mass . 02632 Name of lnspector. Joseph P.Ma cNOmb Jr. Company Na.ue,Address and Telephone um r. J.P.Macomber & Son Inc Box. 66 Centervifle ,Mass . 02632 CERTIFICATION STATEMENT 508-775-3338 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 _lZConditionally Passes _ Needs Further Evaluation By the Local Approving Authority — Fails Date: Inspoctor's Signal The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system i4 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 oMce of the Department of Environmental Protection. The original should be sent to the system owner rind copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D: A) SYSTEM PASSES: 1�6 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. BJ 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",explain why not) ,{Jae, The septic tank is metal, cracked,structurally unsound, shows substantial infiltration or exilltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/95) I One Winter Street a Boston, Massachusetts 02108 a FAX(617) 556-1049 a Telephone (617)292.5-900 r SUBSURFACE SEWAO);DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) PropervAddr"a 69 Riverview Lane Centerville ,Mass . 02632 Owner. Melissa Rapo Date of Lapeotionr 4 9/9 6 Bl SYSTEM CONDITIONALLY PASSES (continued) .L Sawage backup or breakout or hi static water Ievel observed in the distribution bout L due to brokea or obstructed pipes) or due to a broken,sattlad or uneven distribution box. The system will pass inspection if(with approval of the Board of Health)s broken pipes)are replaced obstruction is removed distribution box is levelled or replaced 1. The system required pumping more than four times a yeas'due to broken or obstructed pipa(s). The system will pass inspection if(with approval of the Board of Health): broken pipes)are replaced obstruction is removed Cl FURTHER EVALUATION Is REQUIRED BY THE BOARD OF HEALTIIs 410 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: li'1 Cesspool or privy is within 50 feet of a surface water AW Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. Z) 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 ENVIRONMENTt •� The system has a septic tank and roll absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soli absorption system and is within 60 feet of a private water supply wall. The system has a septic tank and soli absorption system and is less than 100 foot but 50 feet or more from a private water supply well,unless a well water annlyais 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 b ppm. 8) OTHER WA r ��o n9 T 45 r�w2� 1$ S�r9 ►.v�r�� mar ��w�fe �1•�r r�•,� . (revised 11/03/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (Continued) ProPe Y rt Addr"& 69 Riverview Lane Centerville ,Mass . 02632 Owner. Melissa Rapo Date of Inspootfow 4/19/96 DJ SYSTEM FAILS: • ' • Q I have dst•rniinad that the system violates one or more of the following failure criteria as defined in 310 CMR 16.303. The basis for this daterminatlon is identified below. The Board of Health should be contacted to datermlas what will be aecessary to Correct the a Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. V Discharge or ponding of effluent to the surface of the tround or surface waters due to an overloaded or clogged SAS or cesspool. No bA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. a& Liquid depth in cesspool h leas than 6"below invert or available volume is leas than UZ day flow. Requirod pumping more tluan 4 times is the last year NOT due to clogged or obstructed pipe(+). Number of times pumped d(Q Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. d0 Any portion of a cosspool or privy is within 100 foot of a surface water supply or tributary to a surface water supply. aJZQ 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 60 feet of a private water supply well. Any portion of a cesspool or privy is law than 100 feet but greater than 60 foot 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 ultrogen and nitrate nitrogen. EJ LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system servo a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system Is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim WellhoAd Protection Aron(IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system sha.l bring the system and facility into f1:11 Compliance with the psoundwater treatment progm= requirements of 314 CMR 6.00 and 6:00. Ploat a Consult the local regional office of the Department for A:rther information.. (revised 11/03/95) 3 ti SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST • m PropeAyAddreac 69 Riverview Lane Centerville,Mass . 02632 Owner. Melissa Rapo ' Date of Inipootion: 4/19/9 6 Check if the following have been done: ,Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has boon 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. 6AAs built plans have been obtzined and examined. Note if they are not available with N/A , The facility or dwelling was inspected for signs of sewage back-up. , The system does not receive non-sanitary or industrial waste flow ,/The sits was inspected for signs of breakout. ZAII system components,bifcluding the Soil Absorption System, have been located on the site. AI .The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of bafIIos or tees, material of construction, dimensions, depth of liquid,depth of sludge, depth of scum. —Ir-4hr size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. 2The facility owner(and occupants, if different from owner) were provided with information on the proper maintenance of Sub. .Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PropertyAddreaw 69 Riverview Lane Centerville ,Mass . 02632 Owner: Melissa Rapo Date of Inspection: 4/19/96 FLOW CONDITIONS RESIDENTIAL Deeiga llow:��jh ga�lona�GrGL��Y e Number of bedrooms.•. Number of current residents: i Garbage grinder(yes or no):_LQ Laundry connected to system(yes or no).) b Seasonal use(yes or no).A"n Water meter readings,if available• /�`/ C1 Last date of occupancy: " ""J x COMMERCL&LJINDUSTRIAL: Type of establishment: Design flow:_Aja_gallona/day Grease trap pre" t: (yes or no) } Industrial Waste Holding Tank present: (yes or no)V ' Non-sanitary waste discharged to the Title 5 system: (yes or no)-&�I* Water meter readings, if available: r Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and so o information: I l System pumped as part of inspection: (yes or no) If yes,volume pumped: XOMOIR Reason for pumpiag: t V' G/�i?X_LI / ��1�yc'_Y; TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool 4fPrlvy Shared system(yes or no) (if yes, attach previous inspection records, if any) Other(eir 4"L._ APPROXIMATE AGE of all components, date installed(if known) and source of information: Sewage odors detected when arriving at the site: (yea or no) (revised 11/03/95) 5 b . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (oontinued) Property Address: 69 Riverview Lane Centerville,Mass . 02632. Owner. Melissa Rapo Date of Inspection:4/19/9 6 s sFznr,TVM-A�W E1 s (locate on site plan) Depth below grade:, Material of construction Conemte_metal_FRP_other(ezplain) AIR Dimensions: Sludge dept}.: IVA Distance from top of sludge to bottom of outlet tee or baffle: yfi- Scum thiclmess: A2A _ Distance from top of scum to top of outlet tee or baffle:A! 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:/�y r� (locate on site plan) Depth below grade:-zV,4 Material of construction:�concrete_metal_FRP_other(ezplain) Dimensions: A`h- Scum th9clmess; n"Pr 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, evid-ega of,;Pakage,etc.) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) property Address; 69 Riverview Lane Centerville,Mass . 02632 Owner. Melissa Rapo Date of Inspection:4/19/9 6 s . TIGHT OR HOLDING TAM-A/9A YZ' (locate on site place) s Depth below grader ncseta_metal_FRP_other(explain) Material of construction:/6oAft R Dimensions:, " Capacity: _A)4 gallons Design flow: gallons/day Alarm level: Comments: (conditio of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: ( ]e v e distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) d tips-�wr 5 . PUMP CHAMBER (locate on site plan) pumps in working order:(yes or no)—/-7-Ld- Comments: (note condition of pum chamber condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 69 Riverview Lane Centerville,Mass . 02632 Owner. Melissa Rapo Date of Inspection: 4/1 9/9 6 SOIL ABSORPTION SYSTEM (SAS). (locate on she plan,if possible:excavation not required,but may be approximated by non-intrusive methods) • If not determined to be present,explain: Type: pits,number. leathI4 chambers,number. 1wbinj 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.) A led higher than the incoming line to the main cesspool. CESSPOOLS: (locate on site plan) Number aad configuration: /10 Depth-top of liquid to inlet invert: Depth of solids layer. I/ Depth of scum layer. Dimea:icas of cesspool: Materials of construction: G el Indication of groundwater �ntl, iailow(cesspool must be pumped as part of inspection) Comments:(note Condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) gamy sand to sand & gravel!No signs of hydraulic failure•No signs of _ p nnriingAll vPOPt.at.inn i a normal -Main c .sspgol was pumped as par of .the inspection. PRIVY: �� (locate on site plan) Materials of oo s• on: /Il/� Dimension Depth of solids:ML Common (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) (revised 11/03/.95)• 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddresw 69 Riverview Lane Centerville ,Mass. 02632 Owner. Melissa Rapo Date of Inspection:4/19/9 6 e SKETCH OF SEWAGE DISPOSAL SYSTEM: • include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' Centerville Osterville Xarstons Mills Water Company 428-6691 j Ct' AT of r L 0 R y q DEPTH TO GROUNDWX Ex r , C' c(i % /f C ,. 7— Depth to Vvundwater. +f«t ------ mothW of tion or approximation: Transit• Bottom of Herro Run to the bottom of Qeqqj:)Qn1 Herron riin is on 1 onl .Pumped main cesspool as req' F9 rnn water encountered at bo tom of cesspool. (revised 11/03/95) 9 r W Ln THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. June 8, 1995 Acting Director of the ion of Water Pollution Control y:>•r..�nr rn:•r-r.�a:�r: •r. r-•rn rr..r,::•s-�rrr:.r..- rr�s•a:r--rcr..rr.__ . .. .._ ._._. .. - .-t:r<s-:rr=•ram•—r-r-r...... c-..Y I1 TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D '- CERTIFICATION �� .... T.••::a-r.::.:^.r.-trrn•r.:r.:.:.r.•.-irk—rr-.•.•:-:.---.--Tz-�-.�rsr rr.-^rs:zrrss r=rrs�-• massn rrnrrrs-:rrrrrrr.•..:rrr•r.•-:•-. -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS _69 Riverview Lane Centerville ,Mass . 02632 ASSESSORS MAP, BLOCK ANQ PARCEL # OWNER' s NAME Melissa Ra�po PART D - CERTIFICATION T NAME OF INSPECTOR Joseph P. Macomber Jr.. COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State LIP COMPANY TELEPHONE ( 5Qa ) 725 - 3338 FAX ( 508m) 790 - 1 578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposaj system at this address and that the information reported is true , accurate , and complete as of the time of :inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one: XxXX_X System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conducted has found that the system fails to protect the public liealth and the environment in accordance with Title 5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . r , Inspector Signatur/,a Date 4123/96 One copy of this ert.ification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALZ'ii. * It the inspection FAILED, the owner or"'.operator shall u pgrade ' the syatem within one year of the date of the, inspection , unless allowed or required otherwise as provided in 310 CFIR 15 . 305 ,