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0056 WILD GOOSE WAY - Health
56 WILD GOOSE WAY; " Centerville A;= 167 —052 . S M EA DI No.2-1=M UPC 12M .msmL=m • we.In UM CERTIFICATE OF ANALYSIS Page: 1 of 1 Barnstable County Health Laboratory (M-MA009) Kilo `'ss�cFI�c'S" Report Prepared For: Report.Dated: 10/07/2015 Joseph Garodnick Joseph Garodnick Order No.: G1590521 56 Wild Goose Way Centerville, MA 02632 Laboratory ID#: 1590521-01 Description: Water-Drinking Water Sample#: Sample Location: 56 Wild Goose Way, Centerville Collected: 09/27/2015 Collected by: customer Received: 09/28/2015 Test Parameters ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Lead 0.056 mg/L 0.0010 0.015 EPA 200.8 LAP 10/01/2015 Routine ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 LAP 09/29/2015 Copper 0.60 mg/L 0.10 1.3 SM 3111B LAP 09/30/2015 Iron 3.7 mg/L 0.10 0.3 SM 3111B LAP 09/30/2015 pH 7.1 PH AT 25C NA 6.5-8.5 SM 4500-H-13 DCB 09/28/2015 Sodium 9.2 mg/L 2.5 20 SM 3111E LAP 09/30/2015 Total Coliform Absent P/A 0 0 SM 9223 RG 09/28/2015 Conductance 130 umohs/cm 2.0 EPA 120.1 DCB 09/29/2015 Lead level is above the maximum contaminant level, and its retesting is recommended. The water may present aesthetic problems(taste, odor, staining)due to Iron. Attached please find the laboratory certified parameter list. Approved By: (Lab Manager) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 �e�vr1- Gt-�G��P� :$ aFT� rV CERTIFICATE OF ANALYSIS Page: 1 of 1 Barnstable County Health Laboratory (M-MA009) `'sr^cHUS' Report Prepared For: Report Dated: 11/3/2015 Joseph Garodnick Joseph Garodnick Order No.: G1590885 56 Wild Goose Way , Centerville, MA 02632 �-h Laboratory ID#: 1590885-01, Description: Water- Drinking Water Sample#: Sample Location: 56 Wild Goose Way Centerville, MA, Collected: 1 glp/2015 Collected by: Received: 10/26/2015 Test Parameters ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Lead 0.0066 mg/L 0.001 0.015 EPA 200.8 LAP 10/29/2015 Attached please find the laboratory certified parameter list. Approved By: 5 (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 K16 () L! 06195- p , V iLLA I- l� CE tv �� IHS7A LLEP'S MANE & ADDRESS t U I L D E R OR OWNER 00 DATE PERMIT ISSUED - 3 DATE COMPLIANCE ISSUED 57.. �� �t3� oT, No.__.1:..._....±Z/� `2 g Fizz THE COMMONWEALTH OF MASSACHUSETTS Off( BOARD OF HEALTH -_--_-------OF.... `�1�-1414�.��.� � � 261C� rj�r ApplirFation for R-opos al Works Tonstrnrtiun "immix Application is hereby made for a Permit to Construct (k ) or Repair ( ) an Individual Sewage Disposal System at: .......... ....�l�c--�-14.1... -- ........... Location-Address o Lot N ......................................... % os�.�_ � •�sG �yL,9�-,�e l..Q. S'�r�t A � -. _.. . e�cQ. %G,QviLce__. ............... ... jo Owner Add ess a '•r� �= l'! ........................................... G'�3?.��P.__, f� i�'S:A/dl-4 Installer Address UType of Building Size Lot___�o_Z�_ � ._Sq. feet ,., Dwelling—No. of Bedrooms_________________J.....................Expansion Attic 00 Garbage Grinder Other—Type T e of Building No. of ersons____________________________ Showers �W YP g --------•---•--------------- P ( ) — Cafeteria ( ) dOther fixtures -----------------•----••-•-•---•--•--•-••--•--•-•-••----•-••••••-----------•-•-•-••---------•------------•-----•----•--....-••--•• W Design Flow.......J 5.............................gallons per person per day. Total daily flow.......It(a........................gallons. WSeptic Tank—Liquid*capacity_.!6W_gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ ............_......_ Width..................._ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No. -- ___.. Diameter.._.._,L.'...... Depth below inlet____________________ Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1.... Z._._minutes per inch Depth of Test Pit____________________ Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ..................-•-...................... _.. 0 Description of Soil.---3 ' _ o `'`� " 2'� Z . �►-�csad.a.kc1�Z. c.� • --•-•--•--...--•••-•••--------••---•-•-•-••-•----•----••-••---------••---- W VNature of Repairs or Alterations—Answer when applicable______________________________________________________________________________________________ ..-• -------•--•----•••-••••----••--••---------•--------•--•---•----•----•--•-•--•----------------•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions f iITIE 5 of the State,,Sanitary Code—The undersigned further agrees not to place the system in opeWnun ij to of Compliance has been issue y board f health. ned------•_..... -- ---•----•------•-----•-••� atApped BY ---- - _------• �/ Application Disapproved for the following reasons:_---------•---••------------•-••---•-------------------•--------------------------------••••---•-•--••..._-•---- -•--•------------------------ -----------•-----------------•--•------------•-•----------.. r Date Permit No-------g5-` 3aL.......................-- issued.......... - ---- •- -g-y-................. Date r, • `iA t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Dispoottl Works Tonstrn.rtion Permit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: .. ..'��....S.Q.! -....1- ,1�.�...1.` Od _.1�. �'�`'`� .PU/L,C Location- dress ......................................... ...1 4 ?>C.u/sue S'G°U,>j)e.F °8 OCpf. eeAj 7G.�2v/tce -•-•••............. •--••-•--......_.................___...._...... ....-----•-•----......_........_....... . ................................................./J Owner s ^ �..+ t)ddjess t�/9�t'tiS/!�✓��•'4 Installer Address / •.»! Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-----------------J......................Expansion Attici 0 Garbage Grinder `4 Other—T e of Buildin a yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otthfixtures d --------------------------------------------------------------------------------------•••••...--- 17 6-------------------------------------- W Design Flow.... .....................................S gallons per person per day. Total daily flow-,..........................................gallons. WSeptic Tank—Liquid capacity_-.-.._._...gallons Length................ Width................ Diameter...---....--.... Depth................ x Disposal Trench—No..................... Width___r•------.-..-.-- Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..�"......-N------- Diameter... Z--........ Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box (V Dosing tank ( ) '-' Percolation Test Results Performed by..................................................... �. -•--•---------------- Date........................................ ' Test Pit No. L.—J?'......minutes per inch Depth of Test Pit............::...... Depth to ground water......................... IT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.---................ O r c us,©�c. , '. : 12. Nth `�A.; Description of Soil ? -- --• - - VNature of Repairs or Alterations—Answer when applicable............................................................................................... ...----••-------------------------------------------------•------------------------------------_...------•---------•---••--•----•--------•--------•---•---•-----•-•-------•----------•-.....__.....•--- Agreement: The unde signed agrees to install-the aforedescribed Individual Sewage Disposal System in accordance with the provision fof T TLC 5 of the_State Sanitary,.;Code— The undersigned further agrees.,not to place the system in operation u oil ca pliance ha's been,issu y board f h'ealth. fined ' t P�'a~" c.'......----•-. . V - / wApplication Approved BY....................................... ...................................................... " '. � � ' Date Application Disapproved for the following reasons_______________________ --------------------------------------------•--------...-----••..... ..............•------------------•-------...-----------------------------.....--------.......--••-------•-----•------------------••---••----------••-----•-------------------•---•-•---•--•------•..._.. Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.......... .......................................................................... Trrtif irtttp of Tompliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (,X) or Repaired ( ) by------------------ f?! . :.... l �:.. -------•----•-----•------.-•-- �,,,, taller ... � j....---•------- �. .-- _ :9 at /�` ./.._.._l�r� �`� -- . � '".-�4 ......- ................. has been installed in accordance with the provisions of TIT F �of TU State Sanitary Code as described in the 2.( 4 application for Disposal Works Construction Permit No............................ ....... dated-...._..: �r ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE COA4STRURAS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-•---.... �....'.. .._- ........ Inspector_.. ... ........... - ...... r' THE COMMONWEALTH OF MASS USETTS f� BOARD OR HEAL H ............................................OF................................................................................ No.............. FEE.... "_" ..ca.. Disposal Workii Tonstriirtion "permit Permissionis hereby granted.......1- % r -.............................................................................'..................................... to Construct ( ) or�Repair (" ) an Individual Sewage Disposal Sy t at No... 1- �` s � cam"" _-.�/ i P:.x .-----------•---------- Street 1 as shown on t• ion r Disposal Works Construcfipet#t *0.7" --------------•-•• t Board of Health DATE................................................................................ pp FORM ..1255 A. M. SULKIN, INC., BOSTON W 1 t14 6-/S-r2r3"A Zot2i.W D -DISPOSAL P17 U 79 1 noo SAL. �4Too 11 15(t>6'W LL. AY2 = 2.2.Cv 'SF C IT U' AAA4; 'Z'Z69 )z 2-5 s(,5 6 PD / TR vM&A Af2(3A .~ 1, 13 �H of n�rss9 PETER Tn���t, ��� Ala �-� ep. SULLIVAN > �t�of+uass � � L IDA 1 L:y Fcow" dei 5 G lP D, a � RICHARD ��, , No.29733A. BAXTIER f W2C,OL,'ST-l.oW PATe l"10 2 OYL A Ma 4048SS v o I 24(m h A�pF�Fc,sTeP`v\��``Q 0 FSS/ON (QlJT-Au. a JAAtl�ayy to 1' of-- (anlx3 :r 48 --. 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